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A
HOMOEOPATHIC TREATISE
DISEASES  OE  CHILDREN


                 BY
           ALPH.  TESTE,
   DOCTOR IN MEDICINE; MEMBER OF  SEVERAL LEARNED
              SOCIETIES, ETC.
TRANSLATED FROM THE FRENCH
EMMA H . COTE.   . / ^- - ' '
    SECOND  EDITION.

REVISED BY J. H. PULTE, M.D.
   ADTHOR OF " HOJHEOFATHIO DOMESTIC PHYSICIAN,"
      "WOMAN'S MEDICAL GUIDE," ETC.
        CINCINNATI:
MOORE, WILSTACH, KEYS & CO.,
       25 West Fourth Stbbet.
             1857. . 
T343t
  Entered, according to Act of Congress, in the year 1854, by

               EMMA  H. COTE,

In the Clerk's Office of the District Court for the District of Ohio.
      Entered, according to Act of Congress, in the year 1857, by

          MOORE, WILSTACH, KEYS &  CO.,

In the Clerk's OfBce of the District Court of the United States  for the
                  Southern District of Ohio. 
AUTHOR'S  PREFACE.
  In default of any other recommendation, this  little work
will possess that  of being the  only one upon the diseases
of children  which at present exists in Homoeopathy.*
  It has been composed  from  the  voluminous files of
Notes, collected, as well  at  Paris, as  in the provinces, but
more  especially during the  five summers that the author
passed  at Bagnoles  de I'Orne, in the capacity of resident
physician at the baths of that place.  The great number
of absolutely new therapeutic indications which it contains,
are consequently  the fruit of experience.
   The  preliminary  remarks by which  the autnor  has
thought it his duty to  precede  the practical part of his
work, are addressed to serious readers,  who have as yet
no fixed opinion upon the fundamental principles  of Hahne-
mann's doctrine ;—a knowledge of which it is their object
to popularize.
   The Hygiene of Children,  which succeeds this introduc-
tion, is especially designed for the use of mothers.

  * The pamphlet  of Hartlaub  cannot be  considered as a treatise
upon the diseases of children.
                                             (iii) 
IV
Author's Preface
  Finally, the Pathological part, properly so called, which
forms  of  itself  about three quarters of  the  volume,  is
clearly enough exposed (so at least  the author hopes),  to
be  intelligible to  persons  who, without  having  studied
medicine, follow, nevertheless, with  interest, the progress
of Homoeopathy, and  are  accustomed to read occasionally
works which treat of it. 
PREFACE   BY  THE  TRANSLATOR.
  The motives which originally prompted the compo-
sition of the present work, as stated by its Author, are
also those which incited its  translation.  It was then
the only work in Homoeopathy, upon the Diseases of
Children, and it is  now first  rendered  available to a
large portion  of the world, by being presented in the
language of this country.
  The  incentives,  indeed, to  its  translation, had
become even  higher than those which  were, at first,
professionally deemed warrantable for its publication.
Its value had been proved.  It had survived the as-
saults  of  opposition, and become crowned with the
clustering laurels of triumphant merit.   The intrusive
novelty of the greater part of its numerous therapeutic
indications, and  the  unlicensed independence of its
attitude, aroused the usual armed  resistance to  its
admission within the guarded portals of science, not-
withstanding  the many humiliations incurred by pre-
scriptive  orthodoxy,  in the history of  Homoeopathic
discovery.
  The  inveterate  objection  was, that  the  author's
startling innovations  upon established opinions, were
predicated solely upon his individual experience, un-
sanctioned by that of older and higher authorities ; as
if this were not almost necessarily the case with every
original contribution to knowledge;  and  as though 
2          Preface by the Translator.
 such primary precognitions could be determined,  in
 general practice, before they were made known !
   It was in vain that  he had diligently explored the
 voluminous records of juvenile disease, accumulated
 both in the capital and  in  the  provinces of France;
 in vain that he  had pursued his investigations, for a
 period of five years, in a professional position so en-
 viably favorable to multitudinous and reliable results.
 None  of  these  considerations  could be admitted  in
 extenuation of his heretical transgressions.
   But it is one of the highest functions of time  to
 vindicate the patience of truth.  This author is  now
 esteemed by many of the most eminent Homoeopathic
 therapeutists and  practitioners of this continent and
 Europe, as  a  brilliant exemplar of enlightened  and
 untrammeled advancement in their science.
  It was at the urgent solicitation of several of these
 candid and competent physicians, who had fully veri-
 fied many of the author's new remedies, over an ample
 field of observation, that the translator  commenced
 the task she  has here performed.   Such personal
 incitements, however, would scarcely have sufficed to
 induce an undertaking so unusual  and  adventurous,
in one of her unprofessional sex, but for those urgent
 impulses of humanity  toward the  infantine  misery
and  mortality of our race, in which, that  sex may
claim  at  least,  an  equal participation  with  the
other.
  The grand cycle of  alternate production and de-
 struction which perpetually controls  the whole  sphere
of terrestrial being, as the only obvious economy of
nature, seems to  concentrate its intensest action upon
the infancy of the  human family.  And it is among
the loftiest mysteries of Divine government, and more 
           Preface by the Translator.          3

suggestive,  perhaps,  than any other, of some com-
pensatory progress  of mind in a future state, that  so
vast a numerical majority of the  human race should
so continually perish  in the mental and organic im-
maturity of their existence, and in the acutest agonies
of disease.  But it is, apparently, at the same time,
one  of the  most providential mitigations   of that
destiny, that an improved system of medicine has at
length been  discovered, which, to  say the  least, no
longer artificially multiplies the number of these gen-
tle victims, nor aggravates their sufferings.
  It has ever been one of the most flagrant reproaches
of the Allopathic system, that its violent and repulsive
remedies should be so barbarously  inapposite to the
peculiar  sensibilities of childhood.   Drugs, so revolt-
ing in smell, taste, and quantity, and so inevitably
productive of derangement and prostration, in the
strongest constitutions, as to severely test the resolu-
tion   even  of adults, have to be forced,  by  manual
cruelty, upon  the convulsive repugnance of helpless
infants,  with the certainty of introducing new dis-
tresses, purely medicinal.
  It is, therefore, with a maternal  sister's liveliest
sympathies, that this approved Homoeopathic Treatise
on the Acute and Chronic Diseases of Children, is
presented to the anguished mothers  of America and
England.  To those heart-wrung watchers of infant suf-
fering, whose yearning hopes and wailing fears have
hitherto  obtained but slight relief  from medicinal
resources, the  new information furnished  in  this vol-
ume,  may restore many a cherished bud, rescued from
blight and death to expand in  bloom and beauty amid
the sunshine of domestic joy. 
4          Preface by the  Translator.

  To professional and literary readers, this Translation
is submitted with the deference and diffidence becom
ing its feminine source.
  For  the too  obvious literality and versional inele
gance  of  the  more  technical portions, she can only
plead  her  paramount  concern  for perspicuity and
accuracy,  at whatever sacrifice of the graces of style;
and, from  all  readers of critical  discernment,  she
courts  that liberal  consideration  which she  cannot
believe will be  ungenerously withheld. 
CONTENTS.
                                                     PASS
Introduction,..............................................  11
What Homoeopathy is,......................................  11
SlMILIA SlMILIBUS CuRANTUR,................................  15
Dynamisation  of Medicines,.................................28
Of the Nature of Disease,...................................45
                      PART  I.

Hygiene of Children,......................................53
Importance of Education,...................................53
First Care of the New-born,................................. 56
Nurses—their Duties and  Kegimen,......................... 61
Nursing Bottles,............................................ 69
Of the Cries of Children,...................................73
Weaning,................................................... 79
Second Period of Childhood,................................ 85
Onanism,..................................................100
Regimen during Homceopathic Treatment,...................110
                     PART  II.
Diseases of Children.......................................115
Diseases of the Skin,......................................116
Acute Exanthemata,.......................................116
Erythema,..................................................116
                                              (5) 
6                       Contents.
                                                        pass.
Ciacks,....................................................118
Burns,.....................................................118
Frost Bites,................................................120
Stings,....................................................121
Erysipelas,.................................................122
Zona—Shingles,............................................125
Pemphigus,......................................«.........126
Urticaria,  or Nettle-Rash,...................................126
Furuncles, or Boils,........................................126
Measles,...................................................127
Roseola,...................................................134
Scarlatina,.................................................135
Purpura,..................................................143
Miliaria,...................................................144
Sudamina,.................................................145
Variola—Small-Pox,........................................146
Varioloid,.................................................164
Varicella—Chicken-Pox,....................................165
Vaccina and Vaccinella—Cow-Pox, and Spurious Cow-Pox,.....166
Chronic Exanthemata,......................................168
Itch,......................................................171
Eczema—Humid  Tetter,....................................185
Herpes—Tetter,............................................187
Crusta Lactea—Milk Crusts,................................191
Crusta Serpiginosa,........................................194
Impetigo,..................................................195
Impetigo  Rodens,..........................................197
Tinea Favosa—Scald Head,.................................197
Tinea Granulata,...........................................201
Tinea Annularis,...........................................202
Pityriasis,.................................................205
Strophulus,................................................205
Prurigo,...................................................206
Psoriasis,.............................,....................207
Scrofula,...................................................207 
                         Contents.                        7
                                                         PAGE.
Syphilis of the New-Born,.................................221
Diseases op the Digestive Organs,..........................228
Stomatitis—Inflammation  of the Mouth—Muguet,.............229
Aphthae—Thrush,..........................................232
Gangrene of the Mouth,....................................236
Dentition,.................................................240
Gastritis,..................................................243
Enteritis,..................................................249
Gripings in Infants at the Breast,...........................258
Colic,.....................................................259
Constipation,..............................................260
Lientery,..................................................261
Dysentery,.................................................265
Typhoid Fever,............................................268
Icterus—Jaundice,..........................................276
Peritonitis,.................................................277
Intestinal Worms,..........................................278
Ascaris  Lumbricoides,......................................279
Ascaris  Vermicularis,.......................................285
Tabes Mesenterica—Atrophy of Children,....................290
Diseases of the Respiratory Organs,........................295
Coryza,....................................................295
Epistaxis—Bleeding from the Nose,.........................298
Angina,...................................................298
Croup,....................................................301
Asthma of Millar,..........................................312
Bronchitis,.................................................316
Pneumonia,................................................317
Pleurisy,.................„.................................319
Hooping-Cough,............................................320
Phthisis  Pulmonalis—Pulmonary  Consumption,...............324
Diseases of the Circulatory Apparatus,....................326
Diseases of the Cerebro-Spinal Apparatus,..................328
Cerebral Fever,............................................329
Spinal Meningitis,.........................................333 
8                         Contents.
                                                            page.
Myelitis—Inflammation of the Spinal Marrow,...............334
Hydrocephalus, (Chronic)...................................334
Convulsions,...............................................336
Chorea—St. Vitus's  Dance,..................................338
Balbuties—Stammering,.....................................338
Diseases of the Organs of Sense,...........................340
Ophthalmia,...............................................340
Otitis,.....................................................340
Diseases of the Locomotive Apparatus,......................341
Rachitis,...................................................341
                             NOTE.
  As the term ounce and ounces of water has  been used in different formula
in this  book, it may be necessary, for the benefit of persons  unused to  this
mode of measuring fluids, to state that, a fluid ounce is equal, in quantity, to
two tablespoonfuls. 
PREFACE TO THE SECOND EDITION.
  The first appearance of Dr. Teste's work on  the
Diseases of Children, created quite a lively attention
among the practitioners of Homoeopathy.  Many of
his therapeutical propositions were entirely new, and
seemingly  unwarranted by  a close reference to  the
pathogenesis of the  proposed remedies;  the  distrust
and  suspicion, therefore, with which at first the pro-
fession regarded them, were just and excusable.  But
these were soon dispelled  by frequent and successful
trials on the sick, and some of them have proved to
be exceedingly efficacious.
  Though we may not agree with Dr. Teste" in all  his
propositions, as we certainly do not in many of his
pathological views, yet we cheerfully admit that by
his   singular method  in  arriving at therapeutical
conclusions, he  has opened a  new  and easier way of
selecting the proper and specific remedy.   In  the
Pneumonia of children, for instance, which is mostly
complicated with hepatic  congestion, he precedes  the
application oipulsatilla and spongia, which he considers
specific, by that of chelidonium, which  has a specific
relation to hepatic disorders.  This method  seems to
shorten the attack very considerably, as I had frequent
occasion to observe.  The application of chelidonium
would generally be followed by the peculiar greenish
discharges characteristic of liver-affection. 
x          Preface to Second Edition.
  In  croup, on  the  contrary, his ipecac and bryonia ■
is  only efficacious in its catarrhal form, not in the
inflammatory, where I still was obliged to exhibit the
formerly known remedies.  In a like manner does his
ipecac and petroleum relieve only the catarrhal dysen-
tery, not the bilious inflammatory or typhous. In many
other cases he is deficient in pathological distinctions ;
his generalizations are too sweeping, and may induce
the heedless to condemn them on the first unsuccessful
trial.   Yet these faults are outweighed by much that
is  good.
  At this day, I should think, no Homceopathist would
like to dispense with the aid he may derive in his
practice from consulting Dr. Teste's suggestions.
  It is hoped, however, that  the present  work will
receive, as it  certainly deserves, a thorough  revision
and greater completeness, particularly in its pathol-
ogy, which should be accomplished by  the distin-
guished author himself.
  As this is not yet done, the American publisher con-
tented himself to  issue the second edition with such
revisions  and notes by the undersigned, as  slight
alterations of the  plates  would  permit,  without
increasing the cost of the  book.
                             J.  H. Pulte,  M.  D.
  Cincinnati, May, 1857. 
INTRODUCTION.
                  SECTION  I.

           WHAT  HOMCEOPATHT  IS.

  Samuel Hahnemann, to whom we are indebted for
the fundamental laws  of Homoeopathy, is, notwith-
standing the insults,  that  folly and ignorance still
offer to his memoiy,  one  of the finest geniuses  the
world has produced.
  Among all the benefactors of humanity, no one,
perhaps, has a  larger  claim upon its gratitude.  We
may safely predict that his reputation  will increase
with time, and that generations yet unborn will bless
his name.
  Sixty years have passed since Homoeopathy  made
its appearance  in  the world.  In consequence of  the
obstacles which,  in  the  beginning,  it encountered
from the folly of some, and the envy  of others, its
progress was at first slow;  it shared, in this respect,
the fate  of all great discoveries.  At present,  how-
ever, it has ceased to be a novelty;  no medical school
counts more adherents. It is practiced in all civilized
                                       (ii) 
12            What Homoeopathy Is.
  countries; it has its  representatives in  Turkey, in
  India, in the two Americas,  its dispensaries and its
  hospitals in most  of  the capitals  of  Europe.   The
  books which treat of it would  already  fill libraries.
  These works, many of which testify to the great men-
  tal superiority of their authors, possess this remarka-
  ble feature in contrast with the  medical books of the
  Old School, that they are all devoted to the develop-
  ment of the  same principle.  It is  in fact the unity
  and invariability of this  principle which  constitutes
  the strength of Homoeopathy, and which  so  forcibly
  distinguishes  it from those deceptive Utopias which,
  under the usurped  name of medical  science, have
  reigned in the schools from Empedocles to  Broussais;
  that is to say, for more than twenty centuries.
   The history of medicine, during this long period, is
 a compendium of all the dreams,  all the extravagan-
 ces, and all the absurdities which it  is possible for
 the human mind to elaborate, when it strays without
 an axiom in the domains of abstraction.
   To judge it by its history, we must believe that, the
 medical  art, which ceased to be anything when it
 endeavored to become  a  science, claimed always to
'•ally itself to metaphysics.   If by this ambitious  alli-
 ance, it escaped  the  inconvenience  of  remaining
 within reach of the vulgar, it incurred the still greater
 one of losing itself in the clouds.
   This strange substitution of sophistry  for the pure
 and  simple observation of nature, has its root in an 
What Hom(eopathy Is.
13
almost invincible  tendency  of the  human  mind.
" Man," says Broussais, " is tormented by a desire to
know the first cause of what he sees, and  when the
impossibility of discovering it is demonstrated to him
he takes refuge in a supposition."*
  We need not then be  too much astonished if, from
the most remote ages, physicians supposed the first
causes of diseases; and if, this first step made, proceed-
ing from hypothesis to hypothesis, they have supposed
even to the virtues of the remedies they prescribed.
  The exposition  of the  system of Galen, whose
sterile branches reach even to the present generation,
is a summary of all the systems which have succeeded
each other, from the infancy of rationalism down to
the  too  famous so-called Physiological  School.
Abstractions of the closet, chimerical hypothesis, fan-
tastical intervention of three spirits and four humors,
whose harmony produces health, and  disagreement
disease;  mysterious  connection  of  these spirits and
these humors with the four elements of Aristotle; in
short, empiric expedients taken at hazard, to equalize,
correct and purify at need, these imaginary principles:
such was humorism in its cradle, and such the humor-
alism which was the favorite practice of our ancestors,
and of which the grossest errors are perpetuated in the
medical practice of the present day.
  Thank Heaven, Homoeopathy has nothing in com-
* Examen des Doctrines M6dicales, tome 1, page 9. 
14
What Homoeopathy Is.
mon with these fatal extravagances which have  so
long made medicine a subject of laughter to the philo-
sopher and  of deception and dread to mankind  in
general.
  Homoeopathy is not a creation, but a discovery.
  It is not a system, but a method.
  It has no other theory than the  logic of facts ;  no
other principle than a certain law of nature, as evi-
dent as an axiom in geometry—as  certain as gravi-
tation and the rotation of the earth.
  If the honor of being the first to signalize this law,
whose incidental manifestation had struck from  time
to time some of his predecessors,  may be contested
with  Hahnemann, his glory, his great glory consists
in having proved that it was  not an  exceptional phe-
nomenon, as  was believed before him, but a general
and constant physiological fact.
  We shall consecrate the second paragraph of this
introduction  to. the  examination  of this  axiom  of
modern medicine. 
Similia Similibcs Cukantur.         15
                  SECTION  II.

      SIMILIA  SIMILIBUS  CTJRANTUK.

   As we  have before  observed, the system of Galen
served  as a  model to  all  succeeding  writers.  In
studying  them, in fact,  we  may  remark, that the
object aimed at by all of them was to reduce to a cer-
tain number  of entities, or, if you  will, to connect
with a limited number of morbid agents, material or
dynamic,  the diseases, so numerous and so dissimilar,
to which man is exposed; then, to oppose to each of
these entities, or to each of these morbid agents, a
group more or less heterogeneous of therapeutic means.
Thence two orders of artificial, arbitrary, forced, un-
natural classifications: classification of diseases — clas-
sification  of remedies.
   Let us first observe, that between these conventional
diseases and the remedies to be  opposed to them, no
one thought of seeking to establish any relation.  The
idea of specific remedies  was incompatible  with the
spirit of the system; so that no  suggestion of this
idea appears until toward the close of the  middle
ages; that is to say,  until the epoch when empiricism
succeeded  in stifling in its brutal grasp  an  art false
from the  beginning, and which, notwithstanding its
old scientific  pretensions, was still more worthless
      2 
16         SlMILIA SlMILIBUS  CcRANTUR.
and more dangerous than empiricism itself.  But le*
us consider things in their origin.
  The first elements of therapeutics were a deduction
from the precepts of hygiene.  As this considered health
an equilibrium resulting from the reciprocal  neutrali-
zation of certain opposite forces in the economy,  the
first pathologists believed themselves wisely imitating
nature in provoking artificially, against the abnormal
and  excessive  tendency of a function at a certain
time, a tendency equally excessive, of the same func-
tion, in an opposite direction.  Thence, naturally,  the
dogmatic inclination for all the  contrasts,  whether
physiological, or purely physical, which it was possi-
ble to obtain.   The corrective of cold was  heat; of
humidity, dryness; of satiety, abstinence, etc.   More
abstract considerations did not fail to give rise to new
oppositions.   The error of  the hygienic   precepts,
generalized  by the successors  of  Hippocrates, was
especially in assimilating the living economy to inert
matter, and  in eliminating theoretically the power of
reaction against the external world,  which character-
izes animal existence,  and whose  character is such
that  the same  physical causes have almost always
upon  organic  and inorganic being, very dissimilar
results.  But if, as we begin obscurely to foresee, the
harmlessness of these precepts was already very ques-
tionable, conceive what medical practice must become
when, to imaginary morbid  principles, they  ventured
to oppose as contraries remedies absolutely unknown ! 
SlMILIA SiMILIBUS  CtTRANTUR.         17
  However, this fatal doctrine of contraries, invented
by Galen, seduced away even the finest minds, which
then exhausted  themselves in vain endeavors  to en-
lighten the chaos of medical art.
  Points  of departure the  most  opposite  did  not
hinder its advocates  from meeting, almost by fatality,
upon this  field  of fiction, there  to labor in the idle
search of  those  abstractions which,  under different
names, form the basis of the vitalism of Stahl, as well
as of the materialistic  systems of  Brown, of Basori,
and of Broussais.
  The theory of  contraries is then  the common tie of
all  the medical  doctrines anterior to Homoeopathy.
Let the  falseness of this theory be demonstrated and
all  the  systems  of  which it is  the key-stone will
crumble at once.
   This  is what  we shall endeavor to do,  and this
labor of analysis will cost us no great effort.
   To cure a disease  by means capable of producing
in  the patient attacked with it, a pathological condi-
tion contrary to that which it presents: such is the fun-
damental law of the theories of the Galenists, in other
 words, the ideal end  of all the schools of medicine
from Grecian antiquity down to the present day.   But
 the theory of contraries necessarily supposes between
 two things certain relations of form or substance, im-
 plying, so to speak, a sort of negative similitude, with-
 out which, all comparison becoming impossible,  there
 is  nothing for the mind to seize upon.   In metaphy- 
18         SlMILIA SlMILIBUS  CuRANTUR.
sics, for example, affirmation and negation are contrary
things, when relating either to two abstractions of the
same category, or to two perceptions  exercised by the
same sense.
  Thus, to the eyes, light is the contrary of darkness,
as sound, to the ears, is the contrary of silence.   We
understand in the same manner, by analogy, but with-
out prejudging, lest we err with regard to the nature of
the phenomena, that cold  is  the  contrary  of heat;
dryness, the contrary of humidity; hunger, the contrary
of satiety.  In being but purely relative to our senses,
these  dychotomies  are not on that  account  the  less
legitimate, since, after all, the abstractions which they
place in contrast have always for each couple identity
of substance.  But is health then the contrary of dis-
ease ?  No! for if,  in an  abstract and  general sense,
which represents nothing obvious to  the senses, it be
so considered, it is by no means the contrary of any
definable disease.  The contrary of  a disease is another
disease, at the same time analogous and identically
dissimilar to the first.  What a problem, just Heaven!
Who  had ever wittingly the temerity to state it,  and
above all, the pretension to solve it!
  I admit in all strictness and concede, for the moment,
to the system-makers, the truth of their hypothesis; that
bleeding is the contrary of hypersemia; leeching the
contrary of a local  inflammation ; a purgative the con-
trary of the inertia of the intestines;  but the contrary
of variola, of psoriasis, of cancer, of  tubercles, of 
           SlMILIA SlMILIBUS  CuRANTUR.        19
herpes, of syphilis, of hysteria, of chorea, of epilepsy,
etc., etc.  Who has seen it ?   Who knows it?  Who
can conceive it ?  Who has a mind acute, and inven-
tive enough to represent it ?
  The doctrine of contraries is then without founda-
tion.  It is but a monstrous vagary, of which routine
has propagated the dogmas—of which  humanity has
borne the terrible effects—and of which  physicians
themselves have not seldom deplored the  emptiness.
" Medicine does not advance,"  says Yan Helmont, "it
turns upon its axis."  And the celebrated Boerhaave,
still more pointedly asked himself,  in a  moment  of
doubt and discouragement, if  it would not have been
better for humanity if there had never been a physi-
cian in  the world.*
   Nevertheless, empiricism, that is to say, chance, had
from the  most remote antiquity sown the germs of a
doctrine  opposed to that of contraries, which only
waited the appearance of a man of genius to be fecun-
dated.
   It is  twenty-two centuries since Democritus wrote
to Hippocrates: "Hellebore, which  restores reason to
the insane, produces derangement  in  the healthy."
Hippocrates himself had said:  " Vomiting is cured by
vomiting."
   These  two  propositions,  put  forth by the  two
greatest physicians of antiquity, contained the most
* Boerh, Instit. Medic, page 401. 
20         SlMILIA SlMILIBUS  CuRANTOR.
complete contradiction to all received ideas which it
is possible to imagine.
  Later, the popular observation of facts analogous
to the singular curative virtues of hellebore  and of
emetics, propagated  certain practices  of which  the
experience of centuries only confirms the efficacy.
  Everybody knows, for example, that the best means
of alleviating the  pain  caused  by a superficial  burn,
is to hold near the fire  the burned  part;  while this
pain, momentarily suspended  by immersion  in cold
water, is reproduced with increased  intensity as soon
as the immersion  is discontinued.
  Everybody knows also, that frictions with snow are,
so to speak, specific for freezing, in cases  where the
contrary influence of  heat would have no other result
than to produce gangrene.
  But by the side of these  striking  facts, empiricism,
which, without suspecting it, undermines all systems,
hatched other facts still more conclusive.   They saw
purgatives arrest diarrhea, that rationalism, at the end
of its resources, had abandoned.  They saw  opium, on
the contrary, that they  had cried up against diarrhea,
triumph over constipation, which the  use  of purga-
tives  had greatly augmented.
  These apparent singularities were  so often repeated,
that it was at length admitted that the greater part of
purgative substances, at least, contained contradictory
properties, and produced, successively, two  orders of
phenomena; first, the primary effect, augmentation of 
Similia Stmilibus Corantur.         21
the peristaltic action, and of the intestinal secretions ;
the other, secondary  effect, dryness  and inertia of
the intestines ;  so that we need not be surprised to find,
in ancient treatises upon medical substances, the same
substance, rhubarb for example, figuring at the same
time in the class of purgatives and in the class of tonics.
   This succession of contrary effects, generally estab-
lished in  regard to purgatives, is  by no means a mode
of action  peculiar to this species of remedies.   With
closer attention, and above all, with fewer prejudices,
physicians would have had no difficulty in understand-
ing that all medicines, without exception, are subject to
the same law; and this first observation would infalli-
bly have  led them to verify that other  capital point,
that  the  primary  effect  of medicines, upon which
turns  the whole system of therapeutics, hardly ever
constitutes more than a crisis  of short  duration, and
generally insignificant results;  while the  secondary
effect, of  which little notice was  taken,  persists for  a
long time, and in reality represents the virtues and
final action of the remedies.
   Thus it is easy to comprehend, that the generalization
of such observations upon the double action of thera-
peutic agents, would have had the immediate result
of completely overturning the reigning theories.  But
matters were not yet ripe for such a revolution.
   However, this was very nearly accomplished in the
sixteenth century, under  the auspices  of  a wonder-
worker. 
22         Similia  Stmilibus Curantur.
  Paracelsus, a sort of visionary and pseudo-savant—
inventor of the famous doctrine of sympathies, and of
the sympathetic ointment, and especially a great seeker
after the real—Paracelsus discovered, one day, in one
of the  ingredients of  a combination  which, according
to him, ought to  produce  the philosopher's stone, a
marvelous  remedy for one of the  most dreadful dis-
eases known.  The remedy had this peculiarity, that
it cured without provoking  either purgation, sweat,
diuresis, or any other species of trouble, apparent in
the functions of the organism.  This remedy was mer-
cury, and the disease it cured, was syphilis.
   The discovery of this fortunate employment of mer-
cury, the  insensible, silent, and  as it were,  secret
manner, in which this  precious medicine acted; in
short, and above  all, the  speciality of the  cases in
which it proved itself salutary, opened evidently new
views of therapeutics.
   The great problem of specifics, so long laid down
by empiricism, had  finally, for  one disease  at least,
received a solution.  The doctrine  of specifics, in a
word, ceased to  be a dream, to become an unquestion-
able reality.   The whole future of medicine was con-
tained in  this;  but unfortunately  no one thought of
seeking the laws of specifics.  It was still necessary,
as  in the past,  to trust to chance,  and grope along in
the search for specifics ; and, as chance is a bad guide,
a blind, a dumb guide—the more  dumb the more you
interrogate it—it happened that several centuries passed 
             SlMILIA SlMILIBUS CtTRANTUR.           23

before another medicinal substance was  discovered to
take rank by the  side of mercury.
   At  last, however, quinine appeared, to double the
number of specifics.
   It was asserted that quinine * cured intermittent fe-
ver, in the same manner that mercury cured syphilis ;
that is to say, without  causing  any  of  those violent
perturbations that  all other medicines produced,  and
from the nature of which were inferred  the dominant
quality and generic denomination of each.
   Quinine  provoking  neither vomiting,  purgation,
urine, sweat, nor sleep, was not then an emetic, or pur-
gative, a diuretic, sudorific,  or  narcotic ;  for the grand
reason that it was bitter, and under the  not less spe-
cious pretext that it  tanned the gastric fluid, as the bark

  * The Allopathic physicians include iron, also, in the number of
their specifics.  Let it be so—they have then three.  What wealth!
And what a proof of the fecundity of clinical experience I  Three
specifics in two thousand years!  And  yet, it is well to observe
that specificity, in  the absolute sense, as understood by Allopathy, is
really but a gross  and lying fiction.  There really exist specific re-
medies  against such or  such  a group of definite  symptoms, (we
employ no others) ; but from  the moment that these symptoms are
absent,  or no longer exist, the  specificity ceases, and the remedy no
longer cures, although the disease still exists and has not changed
its name.  This is equivalent to saying, that it is almost always ne-
cessary to have recourse  to the  employment, successively, of several
specifics to cure one disease.  This is the reason that  Allopathists,
who for the most part do not suspect these facts, see so often, what
never fails to astonish them, mercury fail in syphilis ; quinine, in
intermittent fever,  and iron, in  chlorosis.
       3 
24         Similia Similibus Curantur.
of the oak did leather, they made it a tonic.   But this
silly denomination, while deceiving practitioners upon
the real effects of quinine, was very far from explain-
ing to them how it cured  fever.  In spite of the per-
sistence and the sophisms of the classifiers, Peruvian
bark remained simply and purely a febrifuge, as mer-
cury was an anti-syphilitic.   That is to say, that they
admitted only as primordial facts,  that quinine  cured
fever, and mercury, syphilis. But why did quinine cure
fever ? why did mercury cure syphilis ?   The science
of the most skillful was silent upon this  point.
  But this terrible why f—a stumbling-block to  the
doctrine of contraries—was destined to become  the
very corner-stone of an opposite  doctrine; that is to
say, the supreme law of true medicine.
  We borrow from the excellent works of M. Auguste
Bapou,  the interesting history of this great discovery:
  " Tired of  the errors  of the practice, the vagueness
and insufficiency  of the  precepts  of the schools, this
celebrated  reformer,  (Hahnemann,) had abandoned
the exercise of the art, in order to  devote himself en-
tirely to the labors of the closet.   One day, occupied
in translating the materia medica of Cullen, at the
chapter on quinine, he was struck  with the numerous
and contradictory therapeutic properties  attributed,
without criticism, to this remedy, and the various hy-
potheses, more or less  singular, to explain its  anti-
febrile action.  Then, in one of those sudden inspira-
tions of which the history of great discoveries offers some 
                SlMILIA SlMILIBUS CuEANTUR.          25
     examples, "Let us cut the knot," he  exclaimed,  "I
     will try quinine upon myself, and observe its effects."
     He took a strong decoction of this bark, and was  at-
     tacked with an intermittent fever, accompanied by its
     premonitory symptoms, and by its three stages of cold,
» \   heat, and sweat.   To argue from cause to effect, of the
 W   febrific  properties of quinine from its anti-febrile fa-
 ro   culty, to generalize this mode of action, and apply it
^J   to all specifics, such were, for so ardent a genius, the
 \   results of this remarkable experiment.   He reflected
 J   upon these facts after the manner of Newton, and the
     conception of the law  of similars was accomplished.
       " The generalization of the facts was, however,  an
     exaggerated application of the analogy.  This law of
     similitude was as yet but a preconceived idea, which
     could have little  other Value than as a possibly true
     hypothesis ; it was now to be proved by showing that it
     is manifested not  only in the effects of  quinine, but
\!j   that  it belongs to the mode of  action of the various
     other medical substances.  The certainty of this could
     only  be established by a long series of experiments.
     Hahnemann devoted himself entirely to this  object.
     Endowed with perfect health, he was willing for several
     years to put himself into  a state of permanent disease.
     He tried, successively, the action of the specifics already
     known, and established for each this remarkable pro-
     perty of producing upon  him a  totality of  symptoms
     analogous to the  groups  of symptoms against which,
     according  to  the  writers,  they showed themselves
 
26         SlMILIA  SlMILIBDS CuRANTUR.
efficacious. In all that had been written upon the action
of simple drugs, and upon the effects of acute  and
chronic poisons, he saw the full confirmation of the re-
sults of his own experiments.  At last, in order to make
the counter-proof of his experiments, he administered
to the sick  substances which had produced upon the
healthy a state similar to that under which they were
suffering.  Clinical success stamped upon this thera-
peutic law a last and irrefragable  sanction." *
  Behold then, at last, Galenism and its works irrevo-
cably judged by the double means  of experience and
experiment, and behold the whole therapeutic arsenal
of the Old School  reduced  to its real value; that is to
say, to nothing.
  No! of the absurd conjectures of ancient medicine,
of  the  false doctrines  of the middle ages, of Bru-
nonianism, of Easorism,  of Broussaisism, there will
remain, hereafter,  but the  sad remembrance of their
extravagances,  and of the  evils they have produced.
The expectant medicine, the negation of all medicine,
had already asserted that the curative force of nature
was the only reason of all the pretended success on
which the active methods vaunted themselves.
  The vast erudition of Hahnemann is, beside, em-
ployed to demonstrate to us that  all the  remarkable
cures reported  in  the books, that nature alone would
not have been able to effect, had always been the for-
  * Aug. Rapou : Histoire de la Doctrine Medicale Homceopathique,
tome 1, page 390. 
           SrMILIA SlMILIBUS  CuRANTUR.         27
tuitous  effect of homceopathic remedies administered
empirically.
  Thus the law of similars, sustained by the history
of innumerable  facts and verified since its discovery
by millions of cases, is definitely substituted, in the
minds of men of good sense and good faith, for the
too famous adage: contraria  contraries curantur.
  The whole code of modern therapeutics is reduced to
this precept: To administer for the cure of the sick,
the medicine  which  produces upon the healthy  a
totality of symptoms  the most similar to the totality
of the symptoms presented by the sick.
  But the practical application of this precept implied
a profound knowledge of all the effects produced in
the healthy by each medicinal substance; and it was
to the gigantic task, a labor most urgently necessary,
of re-constructing  the Materia Medica  upon   an
entirely new basis, that  the immortal Hahnemann,
assisted by his disciples, devoted thirty years of his
life. 
£8         Dynamisation of  Medicines.
                 SECTION  III.

      dynamisation of  medicines.

  That, in which especially consists the immense
superiority of the Homceopathic, over the Old School,
is the advantage which belongs to the former, of pro-
ceeding always from experiment to experience, while
the latter is guided only by experience ;  that fallacious
thing of which Hippocrates speaks, and which he dis-
trusted with so  much reason.
  If we have had the good fortune to make ourselves
understood, in the preceding paragraph, this proposi-
tion hardly requires farther explanation.
  In fact, it is well known  that while the Allopathist
borrows  only  from doubtful tradition  the drugs  so
often whimsical or disgusting, that he administers to
the  patient, we  make use only of simple substances,
whose  properties  have been  discovered,  by  experi-
ments, many times repeated, upon the healthy.  It re-
sults from this, that even in cases where we employ a
medicine for the first time, we know in  advance, with
great certainty, all  the effects we may  expect from it.
  In Allopathy, on the  contrary, unless  we give a
forced and paradoxical extension to this maxim of Iam-
blique:  " Medicine  is the  daughter of  dreams," I 
           Dynamisation of Medicines.         29
maintain  that  it is  impossible  to  explain  otherwise
than by accident or imagination, the introduction into
therapeutics of any new medicine.   But let us suspend
these-critical reflections, which every day's experience
verifies, and which the good sense of the public, it is
to be hoped, will soon render superfluous.
   When Hahnemann  undertook the  heroic part of
trying upon himself the toxical substances, of which
it was so important to him to establish the patho-
genesis, a double consideration induced him, from the
first, to reduce  very  much, in his trials,  the doses in
which these substances were ordinarily administered.
He felt on the one part, in fact, that without this pre-
caution, his health, however good it might be, would
not long resist  these  daily toxications; and on the
other hand, a sort of intuition, the test of genius, told
him that the proper specific action of these remedies,
if such they had, should be  different  from those vio-
lent derangements produced by large doses.
   Observation  demonstrated his foresight.   He was
soon convinced that  not only had physicians been de-
ceived in what, till  then,  they had  considered the
proper action of medicines, but that the organic com-
motions, excited by the enormous doses in which they
had been  prescribed, so modified  the manifestation
of their peculiar action, that it had never been observed.
In the preface  to his  Materia  Medica, Hahnemann
expresses  himself on this  subject  in the following
terms: 
30         Dynamisation of Medicines.
  "As to the duration of action  assigned  to each
medicinal substance — which I have sought to deter-
mine by multiplied experiment—I  ought to  remark,
that it can never take place when the medicine is ad-
ministered in large doses, and in a  case of disease, to
which it is not appropriate.  In either case, the dura-
tion of action is much  abridged, because the  medi-
cine is, to a certain extent, thrown off with the evacua-
tions, which are their result, (bleeding at the nose and
other hemorrhages,  coryza, flow of urine, diarrhea,
vomitings, or sweat,) so that its virtues are promptly
dissipated.  The living body rapidly expels this mat-
ter, as it does the miasm of contagious diseases, when
it weakens, and, in part, expels it by means of vomit-
ing, diarrhea, hemorrhage, coryza, convulsions, sali-
vation, sweat, and other movements and  evacuations.
Thence it  happens that, in ordinary practice, neither
the peculiar symptoms nor the duration of action can
be known of antimony, of jalap, etc., because the ex-
cessive doses, in which only these substances are ad-
ministered, pushes  the  organism  to  disembarrass
itself promptly of  them.   It is only when they  do not
produce this  effect,  that is to say,  when they do not
provoke evacuations, that we may observe their char-
acteristic effects, so often important, and of long du-
ration, but which  are rarely noticed, and still more
rarely  recorded.
  The vomiting produced by  two or three grains of
antimony, or twenty grains of ipecacuanha; the purg- 
           Dynamisation of  Medicines.          31
ing by thirty grains of jalap ;  the sweats provoked by
a handful of elder-blows in  infusion, are less the pro-
per effect of these  substances than an effort of the
organism to extinguish as soon as possible their parti-
cular action.
  "We have here the reason that homceopathic doses
produce  so great an  effect; they are not sufficiently
large to excite the organism to rid itself of them by the,
as it were, revolutionary movements of which we have
just spoken."
  It was, then, in progressively attenuating the doses
of the substances that he tried upon himself, for the
purpose, according  to his views, of rendering the re-
sult of his experiments more  and more perfect, that
Hahnemann was conducted, without perhaps thinking
of it, to discover what he afterward called  the Dy-
namisation of Medicines. As this discovery, the most
extraordinary, if not  the  most important, that he
made, or that was  ever made, is still, at this  day,
erroneously regarded as the  principal fact of homoeop-
athy,—so also, are its wonderful phenomena  continu-
ally made the target for the dull  shafts of the Old
School.   Happily, raillery  and sarcasm are as  pow-
erless  as sophisms, against the immovable  evidence
of fact.  And if,  for a certain time, Hahnemann, like
Galileo, had only to repay him for all his painful labors,
the sad satisfaction  of being alone in the right against
all  the world, the  admiration of numerous  disciples 
32          Dynamisation of Medicines.
was soon to him a presage of the universal assent,
destined him by the judgment of posterity.
  Dynamisation  consists  in a series of operations,
whose double object is to reduce, almost infinitely, the
doses of medicinal substances, and to augment the the-
rapeutic action, inherent in their molecules, in direct
proportion  to the division  of these molecules them-
selves.
  All the world knows the rules for these operations.
The principle is the same for all medicines.
  To extend by means of trituration,  or solution, one
part of a medicinal  substance, into one hundred parts
of sugar of milk,  or of alcohol ;* to incorporate in the
same manner a hundredth part of this first mixture,
into one hundred times its weight of one of the two
inert substances, we have just designated ; to proceed
exactly in the same manner with  a third, a fourth, a
tenth mixture — such is the mechanism of the  start-
lingly decreasing  progression to which the remedies
used  by homoeopathy are  submitted.  Each of the
mixtures prepared according to these rules, has, as
well as the number of its order, the name of dilution.

  * The sugar of milk having absolutely no property, is perfectly
adapted to this use.  It is the same with alcohol, which, in the
very small quantities given, either in solution or in globules, is with-
out appreciable effect.  The  sugar of milk serves for the dynamisa-
tion  of insoluble substances, especially the metals.  After the fourth
dilution, it is in all  cases replaced by alcohol. 
           Dynamisation of Medicines.         33
  The thirtieth  dilution  contains  a decillionth, in
weight, of the substance incorporated in the first.
  But, the most imperceptible atom of which the micro-
scope reveals the existence, the  impalpable, invisible,
and almost imponderable mote which floats in a ray of
the sun, is a world in volume, in comparison with a de*
cillionth  of a grain of any matter whatever.   Yet,
nevertheless, it is such doses of mercury, of lime, of
sulphur,  or of arsenic, that often  suffice to arrest the
progress of a mortal malady, and effect the miracle of
cure, in the most desperate cases.
  Reason, however, even the coolest, in its deductions,
and  the  freest from prejudices, revolts  at first sight
from such an assertion ;  but let  facts appear, and rea-
son bends.   Forced to receive, in spite of itself, the
evidence  of the  senses, it draws upon the storehouse
of memory, and  finishes by recognizing, for the pur-
pose, as  it were, of absolving its  faith, that the uni-
verse abounds in facts analogous to this action, prodi-
gious as it is, of homceopathic doses.
  Analogies, however, must be regarded as exception-
able proof of the reality of phenomena, which, in fact,
need no other proof of their existence, than that they
do exist;  but it serves at least the purpose of remov-
ing prejudice,  and  engaging in practical trial, those
sincere men, who, while  doubting, yet seek to be
enlightened.    Permit us,  then,  to notice a few of
these analogies.
  The deleterious effect of certain odors, whose prin- 
34          Dynamisation of Medicines.
ciple escapes the most delicate tests of chemistry, is a
notorious fact, denied by nobody, and at which no one
is  astonished ;  because its frequency has rendered it
familiar.  Who, nevertheless, will tell us the weight
of the effluvia which exhales  from a few flowers of
heliotrope or from a bouquet of hyacinth %
   Does not the miasm of swamps, that  terrible  and
subtle cause of intermittent fever, so completely es-
cape our senses that no  one would even suspect its
existence without the incontestable proof of its origin,
and of its effects ? *
   Who has seen, who has touched, who  has seized in
its flight, that terrible principle of cholera, brought us
by the winds of the  east, from the shores of the Gan-
ges, its cradle—and of whose  material  reality there
are,  however, so few incredulous ?
   To what homoeopathic fraction shall we compare the
quantity of variolous or pestilential emanations, with
which a letter may be impregnated, and which, never-
theless has more than once sufficed to cany to enormous
distances, the disease of which it contained the germ ?
   Recall the experiments of Spallanzani, and those of
Fontana.  The one  impregnated  animals artificially,
by means  of a few  drops of sperm,  mixed  in great
quantities  of various vehicles; the other caused  the

  * The celebrated Professor Folki, at Rome, has recently proved ? by
experiments, that the atmosphere of the Pontine marshes contains
nothing injurious to the health—nothing that is not found in the at-
mosphere of the most salubrious localities. 
           Dynamisation of  Medicines.         35
instantaneous death of a lamb by inoculating it with
a millionth of a grain of the venom of the viper.
  How many atoms of syphilitic virus does it require
to transmit the syphilis?
  How many of the hydrophobic virus  to  inoculate
with hydrophobia ?  The tooth of the dog, which com-
municates it to man, only reaches the skin after having
passed through several  folds of his clothing;  less
than a millionth part of a  drop of the saliva  of the
animal is  perhaps deposited  in the wound.   Again
we must remember, that far from being the virus itself,
this saliva is only its vehicle, which positively reduces
to a homceopathic  infinitesimal the quantity of infect-
ing liquid actually  absorbed.  Nevertheless,  infection
takes  place; the evil incubates; it silently develops
itself,  the  crisis arrives and death ensues !
   But why dwell longer on  particular instances, which
it would be easy to multiply almost to infinity ?  They
 are all comprised  in a general fact upon which we
 entreat our readers to concentrate their  attention;  a
 fact  of  immense  value in physiology as well as in
 physics, and which may be thus presented :
    The dynamic  properties* inherent in  material
 substances, are in inverse proportion to the cohesion
 of these substances.
    Whence it results:
    1.  That bodies, the  most essentially endowed with
» Gravitation excepted. 
36          Dynamisation  of Medicines.
 the power  of modifying the condition  of animated
 beings,  are  those which have no  cohesion whatever,
 and which constantly tend to evaporation.
   2. That in artificially destroying the cohesion of
 solids, we are almost certain to develop in these, the
 properties that, until then,  remained latent.
  Now, the homceopathic dynamisation is precisely the
 verification  of that  principle, which I present in its
 turn as  appropriately forming  a basis for the rules of
 dynamisation.
   If this last, in fact, only aids the spontaneous rare-
 faction,  or what comes to the same thing, the medici-
 nal power naturally residing in mercury, in antimony,
 in arsenic, in  camphor, in all the aromatic plants, in
 a  word,  in  all volatile substances, it literally creates
 the  medicinal force of gold,  of silver, of platina, of
 silicia, of coral, of lycopodium, etc.,  since  this  modi-
fying  power would  not  exist without it.*   Is it  not
 then rational to conclude, that if dynamisation, simply
useful in certain  substances, (for we admit its utility
in all cases), is absolutely indispensable  in others, it
  * Certain writers, and especially M. Auguste Rapou, have emitted
 an opinion upon the nature of dynamisation, which I, for a  long
time  entertained.  According  to these physicians, the inert matter
mixed with the  medicine or triturated with it, contracts its proper-
ties to such a degree as to become itself medicinal.  In this manner,
they explained the transmission from dilution to dilution, of the pro-
 perties of  the mother substance.  The  hypothesis is without foun-
 dation, and I do not hesitate to pronounce  it false.  The secret of
 dynamisation is exclusively in the division of matter. 
Dynamisation of  Medicines.         37
should generally be carried farther, in case of these
latter, than in the former ? *
  It is to be remarked, that the expansive power na-
tural to certain medicines, and developed in others by
dynamisation, seems to exert itself in the living econ-
omy as well as in all other mediums.   Thence results,
without doubt, the general effect so promptly produced
by  homoeopathic  preparations, in contrast with  the
action, almost always purely local, of allopathic reme-
dies ; thence, beside the appropriateness of the higher
dilutions to the treatment of those affections in which
the constitution is involved, and  in  which nervous
symptoms predominate, while organic alterations seem
rather to call for the  employment  of the lower dilu-
tions.
   This naturally conducts us, if not to draw up abso-
lute precepts, at least to express our personal opinion
relative to homceopathic doses.
   And let us commence by avowing, that on this sub-
 ject, the most complete  anarchy, the most deplorable
 confusion reigns among practitioners.  The choice of
 such or such a dilution ;  of drops,  or of globules ; of
 potions, or of powders, appears to be, with  each, but
 an affair of habit,  contracted without  reason,  and
  * It is to be remarked, that practitioners are rather disposed to
follow an inverse rule, that is to say, they willingly employ high
dilutions of substances, which are naturally energetic, and the low
dilutions of substances naturally inert, which is unreasonable. 
38         Dynamisation of  Medicines.
continued, because commenced.  Some (the majority
of  German  Homoeopathists)  adhere  obstinately  to
mother tinctures, and large doses, under the frivolous
pretext, that dynamisation having  not yet been dis-
covered, it was under the influence of these doses that
the greater part of the  pathogenesis, reported in  the
materia medica pura  was produced.   Others, with
Dr. Gross at their head, pushing to a fanatical length
the ideas of  the master, only employ the extreme dilu-
tions called  Tcorsakovienne, that is to say, the five or
six thousandths !   The  first, in yielding to their allo-
pathic reminiscences, or perhaps, by being influenced
unduly by their deference to the prejudices of the Old
School, voluntarily forego the fruits of a magnificent
discovery ; while the others unnecessarily alarm public
opinion, by the almost fantastic improbability of their
pretensions !*
   It is between  these  two  extremes that I would
endeavor to  establish  what is suggested at  once  by
reason and experience.
   But  let us begin  by declaring that we take, as a
starting point,  this  practical truth, to which, as we
have before  stated,  we give  full adhesion, viz: That
  * If I charge upon  the korsakovienne dilutions, the reproach of
furnishing arms to the adversaries of Homoeopathy, and sharpening
against  it the  shafts of  satire, I refrain, nevertheless, from  pro-
nouncing them absurd. I know too  well, that  the infinitely small,
is like  the infinitely great, inaccessible to  human  understanding,
and that in principle, the six millionth dilution is no more absurd
than the tenth, 
Dynamisation of  Medicines.          39
if dynamisation is not absolutely indispensable to cer-
tain medicines,  it is useful to all, and adds, in  all
cases, to their efficacy.
  We  know in fact, that  certain medicines, given in
certain  diseases,  being dynamized, have  often pro-
duced results demanded of them in vain, before their
dynamisation.  I have myself, seen a few globules of
secale   corn, of  the twelfth  dilution,  arrest almost
instantaneously,  a  passive  hemorrhage  of  several
months' duration, and against which the same medi-
cine had  constantly failed when administered in its
crude state,  in doses of twelve grains.  I have also
seen stannum, prescribed at the  thirtieth dilution,
procure the expulsion of enormous quantities of asca-
rides, in the case of an infant  who  had taken allo-
pathic  vermifuges for three months without  effect.
Such cases  are constantly occurring to homceopathic
practitioners.
  We may remark, beside, that facts contradictory to
those here alleged are yet to be produced; that is to
say, that  never,  in  any known  medicine,  has the
power of large doses come  afterward to invalidate the
superiority of properly chosen dilutions.
  With so much the more difficulty do we comprehend
those who cry up the exclusive use of the  first, since
they thus deprive themselves of therapeutic resources,
which, we  declare  it boldly,  are  so important that
without them, we should experience in our  daily prac-
tice an invincible embarrassment.
        4 
40         Dynamisation  of Medicines.
  With what, indeed, should we replace carbo. vege
tabilis, silicea, lycopodium, etc., etc.,  which have no
medicinal properties without dynamisation 1
  Will  we give, on the other hand, by grains  or by
tens of grains, the pure venom of the rattlesnake and
of the trigonocephalus lachesis %
  The predilection for  massive  doses  certainly arises
from incomplete notions of medicine, or false ideas of
diseases.
  " What would you prescribe," said  an  Allopathist
to me one day,  " to an unfortunate man who had just
swallowed a couple of hundred grains of vitriol ?"
" Three hundred grains of magnesia," replied I, with-
out hesitation.   " Why not some of the decillionths %"
said  my  interrogator,  jeeringly.  " Because,  before
combating the disease, it is necessary to destroy the
cause, when this cause still exists; because, in prescrib-
ing three  hundred grains of magnesia, I do not prac-
tice medicine, but chemistry; because, in such a case,
it is neither to the age,  sex, constitution,  or tempera-
ment, or  even  to the   sufferings of the patient, but
only to  the quantity of poison swallowed  that I pro-
portion  the remedy, or rather the antidote.  In this I
only conform to the old precept,  tolle causam,  etc.;  a
precept  which,  by the way, is only absolutely true for
your  School; for, notwithstanding the  removal of the
cause, the disease will  have its course ; then medicines
will succeed to the use of antidotes, and the infinitesi- 
Dynamisation of  Medicines.         41
mals, worthless  as  they may seem to you, will then
show their power."
  Let our readers judge,  by this example, of the
general value of the objections made to dynamisation
by the partisans of the precepts  and of the doses  of
the Allopathists.  We shall not return to this subject,
and it  only remains to us, at present, to speak of the
choice of dilutions.
  This is a difficult,  arduous, delicate, and  complex
question; it is even impossible to solve it, except with
reference to  other considerations.  It is easy to  com-
prehend, in fact, that its solution must  depend, as we
have already intimated:   1. Upon  the  species of
medicine; 2.  Upon the nature of the disease;  3. Upon
the age and constitution of the patient.
  Hence, there are  three points  to  discuss.  First,
concerning the species of medicine as deciding  the
choice  of the dilution, I have already somewhat fully
explained myself.  Thus, it  is well  understood, that,
as  dynamisation  develops the medicinal  action, we
should prescribe, all  other  things being  equal,  the
dilutions higher in proportion to the natural inertness
of  the substance.
   It may be  objected, that if the  greater division of
matter in the high dilutions of inert substances estab-
 lishes between  these and the lower dilutions of active
 substances,  a  certain  equilibrium  of  power;   this
 equilibrium is  broken  by the  abundance, relatively
 more considerable in the last, of the medicinal matter. 
42         Dynamisation of Medicines.
But, however specious this  objection, it vanishes, or
very nearly so, under the test of experience.   Experi-
ence, in  fact, impartial  and infallible judge, proves
superabundantly that the activity of the homceopathic
dose is proportioned incomparably less to the quantity
of medicinal  matter that it  contains, than to the de-
gree of its division.  Were it otherwise, dynamisation
would be a chimera.
  The little importance that we seem to attach to the
greater or  less quantity of crude matter in our medi-
cines may, I feel, appear strange.   Nevertheless, do
we not know, to call analogies once more to our aid,
that neither the symptoms, nor the intensity of a con-
tagious disease, are proportioned to the abundance  of
the principle  which gave it birth ?  Do we not know
that the pustules of  the vaccine  are developed  so
much the more surely, as the hand of the operator has
been light, and the virus sparingly  applied ?  Of two
unfortunate beings  attacked by  hydrophobia,  who
have each the same anguish, and the same death, one
has hardly felt the  bite which caused the infection,
while the other has been torn by the furious animal
and inundated with his deadly saliva.
  I do not hesitate,  then, to pronounce that, if not
entirely unimportant, it is, at least, of very secondary
importance, how many drops or globules should enter
into a dose. *
  * I prefer potions to the dry preparations.  The diffusion of the
first has always  seemed to me more sure and rapid. 
           Dynamisation  of Medicines.         43
  The globules are very small pills of sugar of milk,
saturated  with the medicinal tincture of the various
dilutions.   A single  drop is  sufficient  to saturate
several hundreds.  The manner of this saturation ap-
pears to me to constitute, in itself, a veritable means of
dynamisation.   Thus, the three  hundred   globules,
which represent, in quantity, but the value of a drop,
contain altogether a medicinal power greatly superior
to that of a drop.
   Hahnemann preferred globules to tinctures and used
them exclusively.  In his horror of large  doses, the
decillionths,  even, in the liquid form, seemed  to  him
enormous  doses!  *   *   *  So true it is that great
men have their little prejudices !
   The principal  advantage  in  the globules is their
portableness.  It is, indeed,  a precious advantage for
the  physician,  and  especially for the country physi-
cian, to be able to have always  about him a complete
 pharmacy.
   The nature of the disease, the age and constitution
 of the patient, as we have said, complete our group of
 reasons for determining the choice of the dilution.
   Although this proposition evidently  implies two
 distinct points, we shall, for  the  sake of abridging
 it, treat  it  without  observing  this  distinction.  It
 may, beside, be summed  up in a single principle, a
 principle  based upon  observation, and of which the
 following is the statement:
   The power  of homceopathic  medicines  is in direct 
Dynamisation  of Medicines.
 proportion to the vital  activity of the subject, while
 the duration of their action is in inverse proportion to
 the same.
   Whence we immediately draw the practical conclu-
 sions :
   The younger and more  vigorous the  patient, the
 more acute, rapid and inflammatory the disease, and
 manifesting itself, as it were, by an  increase  of vital-
 ity,  the more important it is to reduce the doses,
 while, at the same  time, we lessen the  intervals  of
 their repetition.
   For old people, on the  contrary, as  well as for
 emaciated or lymphatic  subjects, of a low and feeble
 vitality,  who are  refractory or almost insensible to
 medicinal  excitation,  the lower dilutions are most
 appropriate.
   In conclusion, to increase to a greater or less extent
 the intervals between  the doses, in  the treatment of
 chronic  diseases,  is  a rigorous deduction from the
 principle we have just announced, and of which some
general notions upon the nature of disease, developed
in the following chapter,  will perhaps better enable us
to understand the bearing. 
Of the Nature of Disease.          45
                    SECTION IY.

             OF THE NATURE OF DISEASE.

   Every disease is a partial or general disorder of the
functions whose ensemble  constitutes life, and whose
regular exercise constitutes health.
   There exist, according to the terms even of this de-
finition, two kinds of diseases : local and general, or,
what comes  to nearly  the  same thing, organic—those
with material lesion of one or more organs—and essen-
tial or diffused diseases.
   Clinical observation proves that the former, of how-
ever little intensity they may be  possessed, tend con-
stantly  to generalize themselves, or, to speak  other-
wise, to derange the vital acts  of the whole  body,
while  the latter almost always  end in  some local
lesion.
   The difference between  the two is not the  less
marked: The former are primarily organic; the lat-
ter primarily essential.
   The one  has its origin in the presence of a  subtle
agent, either acquired or spontaneous, but not cogniza-
ble to the senses; the  other, on the contrary, results
from the mechanical or chemical action of an appreci-
able  agent. 
46          Of the Nature  of Disease.
  A man is attacked with typhus ; he at first suffers
only a vague depression, torpor, or sleeplessness—an
indefinite discomfort, an irregular fever:  the disease
is yet general; but  pains in the bowels soon make
their appearance, with ulceration of the small intes-
tines, and the disease is thus  localized.
  Another man crushes his finger under a stone; he
suffers, at first, only from his finger—the disease is
local;  but we have soon traumatic fever, tetanus,
perhaps death—and the disease is generalized.
  One may  easily conceive how often this  generaliza-
tion of local affections, and this at least apparent local-
ization of essential affections, must have put physicians
upon the wrong scent.   Here, where there were  two
distinct facts, the  spirit of the system only wished to
see one.  For vitalists and humorists, apart from sur-
gical  cases, there  were only  essential  diseases; for
materialists  and  solidists,  there  were  only organic
lesions.  The  first  did  not  sufficiently prove their
hypothesis;  their adversaries  denied the evidence.
  If, in fact, the organs being the agents of our func-
tions, it is impossible that an organic lesion could exist
without bringing on a functional disorder, it is a fact of
daily  experience  that  serious functional disorders do
manifest themselves without apparent organic lesion.
  When, in consequence of a prick in his foot, a man
dies of tetanus,  a post mortem  examination of the body
reveals no other lesion than the prick.  Nevertheless,
tetanus, the  immediate cause of his death,  although it 
Of  the Nature  of Disease.         47
be only a secondary phenomenon, constitutes in itself
a definite affection, and one which is perfectly separa-
ble from its cause.   Tetanus is, then, we will not say
an essential affection, but at least an affection exclu-
sively dynamic.
  Now, let us suppose that this terrible nervous affec-
tion  manifests  itself spontaneously; that is to 6ay,
under the influence of a secret cause—in  other terms,
a cause too subtle to come under the cognizance of the
senses—does not tetanus then offer us a  type of essen-
tial disease ?  Here lies the whole question.
  Let us hasten, moreover, to remark, that the absence
of physical lesions is far from being the pathognomonic
and dominant character of essential diseases.   If, in
their first period,  they  only manifest  themselves by
simple  functional aberrations, frightful ravages in the
different organs of the body, often mark  the passage
of the  greater part of them; as, for example, syphilis,
typhus, etc.
  But, what particularly   distinguishes  this sort of
affections,  is, with the  obscurity of their origin, the
almost invariable regularity of their form.  They each
have their  own course—their constant symptoms—their
crises,  and their duration.   They are  susceptible of
being classed into .genera and species, like animals or
plants.  They  are,  in fact,  veritable  existences;
abstract beings,  if you will,  but  whose germs are
nevertheless  realities.
   This, I am aware,  leads  us  into a sort of medical 
48          Of the Nature of Disease.
ontology, but not absolutely that attacked by the sar-
casms of Broussais.   What to us, beside, is the opin-
ion of this head of a  school ?  If we have been, and
if to a certain  extent we  are still, his admirer, we are
not his disciple.
  All superstitions,  said  D'Alembert, have their
nucleus of truth.  Now,  if medical ontology  may  be
considered a superstiton, it  has, beyond a doubt,  its
true side.
  Assuredly, it is absurd to consider a disease as a
real being, like a parasite implanted in the economy,
to live there its own life at our expense.  But for the
effect, substitute the cause; for the disease, its principle,
and you  will have, in place of a chimerical conception,
an hypothesis,  specious, rational, plausible,  and bear-
ing, even, shall I dare to say it, the  criterion of cer-
tainty.
  Is  it  not  incontestable, in fact, that  each of these
diseases, that we call essential, is  the special result  of
a poisonous principle ?  Grant that this principle is not
a visible  and palpable matter,  observation and experi-
ence do not the less  clearly demonstrate that its exist-
ence is positive.   The virus  of syphilis, of variola,  of
the plague, etc., are all for us simply poisons, having,
like arsenic, corrosive  sublimate, prussic acid, the ven-
om of the viper, or of the rattlesnake, etc., etc., their
respective pathogenesis.  We are then in the right, not
only in  admitting these  viri, but in  classing them
exactly as we do known poisons. 
Of the Nature of Disease.          49
  If we are now asked what advantage can arise from
this  particular manner of regarding disease, nothing
can be more easy than to make it understood.
  It substitutes general views for partial observations,
and thus  conducts the practitioner to the employment
of general means and of dynamic remedies.*
  The number of  essential diseases, or if you will, of
essential principles, whose effects  are determined, is
already considerable.  It is beside very probable, that
we do not know them all, as every day reveals a new
one.   The incomparable  merit  of the  homoeopathic
materia  medica is,  that  it furnishes a priori,  the
means of combating them.  It is  thus, that from the
first appearance of the cholera, the pathogenesis long
since known, of arsenic, of copper, of white hellebore,
of camphor,  and  of charcoal,  represented  for  the
Homoeopathist the specifics corresponding to the differ-
ent forms of this  frightful epidemie, to which Allo-
pathy, groping, opposed but powerless, and very often
contradictory means.
   The deleterious action  of virus, or of the miasms,
(the words, save a light shade, are for us synonymous)
is, bike all the other toxical substances, diffused through-
out the universe, more or less active, and more or less

  * To* treat with local means and as so many distinct affections, the
various symptoms of an essential fever, is as puerile, as absurd as it
would be to combat the dangerous effects of a bite of the viper, by
only closing the wound made by the  teeth of the reptile with adhe-
sive plaster. 
50         Of the Nature of Disease.
formidable.  The first are congenital, or develop them-
selves spontaneously in the economy; the last come
from the surrounding  atmosphere.   There are those
which exhaust themselves in us, and are extinguished
after the  explosion which  gave notice of their pres-
ence.   Others,  on  the contrary, resist  time—may
remain latent for years—and often only manifest them-
selves on  the occasion of  some accidental  affection,
and  transmit themselves  from generation  to gene-
ration. .
  The founder of Homoeopathy occupied himself with
only the last of these, and has only pointed out three;
syphilis, sycosis, and psora.  Psora  was the especial
subject of his researches and  meditations during the
latter half of his life.   He saw in it  the true cause of
all chronic diseases.
  This conception of psora, notwithstanding the error
and confusion probably mixed  up with it, was never-
theless a stroke of genius.  It traced a line of demar-
cation, that  we believe natural, although not  recog-
nizable, between acute arid chronic  diseases.   These
are not  simply, as  was  generally  thought  before
Hahnemann, the prolongation of the first.
  Acute diseases have, for the most part, their dura-
tion fixed  by nature;  and when, notwithstanding, the
removal of the cause which excited them, they pass
the limits of this duration,  and seem  to continue
indefinitely, it may  be safely affirmed, that they have
changed their character,  and have awakened  some 
           Of the Nature  of Disease.          51
morbid principle until then  dormant, and foreign, in
the  beginning,  to  their manifestations.  But is this
morbid principle  always the  same ?   Is it always
psora ?  Nothing proves this;  and it  is  in this, at
least, so we think, that Hahnemann deceived himself.
   There exist, perhaps,  as many primitively chronic
diseases as primitively acute  diseases.   It is, perhaps,
as hazardous to consider psora as the unique cause of
all chronic, non-venereal affections, as it would  be to
attribute the small-pox,  the  measles, scarlatina, mili-
aria, etc., to one and the same  miasm.  We are then
very much  inclined to  believe" that this thousand-
headed monster, named by  Hahnemann,  psora, is
essentially multiple.
   How in fact admit, that  the  gout, aneurism, cancer,
tubercles,  etc., etc., are  only  one disease?   This
appears so much  the less probable, that we never see
these different diatheses transform themselves  from
one  to the other, either during the life of the indi-
viduals who  present  them  or the generations to
which they are transmitted.   The son or the grandson
of a gouty parent, has gout, and not cancer.  The son
or grandson of a cancerous parent, has cancer, and not
gout, etc., etc.
  But if this  remarkable phenomenon  of hereditary
transmission ruins the hypothesis of psora in its unity,
it assuredly confirms the general idea.
  I will say then, in summing up, that with the excep-
tion : 1st, of natural deformities, which  may be reme- 
52         Of the Nature of Disease.
died by mechanical means ; 2d, traumatic or chemical
lesions, which belong to the practice of surgery or chem-
istry ; 3d, and last, simple affections, resulting from the
physical  impression of an irritating  agent upon an
isolated organ, I admit but  essential diseases, which
can only be efficiently combated by specific remedies.
It would remain for me now to speak of the classifica-
tion  of diseases.   But such a classification,  to be
logical, would suppose notions much  more complete
than those we at present possess  upon the analogous
action of the morbid principles.  Perhaps experience
may some day furnish us  their true elements; but
such a systematization, which will be the  triumph of
Homoeopathy, will require still much time. 
PART   I,
HYGIENE  OF  CHILDREN.
                   CHAPTER  I.

       IMPORTANCE  OF  EDUCATION.

  The impressions of childhood  remain during life.
They exist in us without our knowledge.  Our partic-
ular tendencies, our sentiments, our opinions even, on
many subjects, are oftener than we think, their con-
sequences.  We owe to them, without suspecting it,
many of our virtues or of our vices, the greater part
of our prejudices, our health or our diseases.
   It is with men as with vegetables : a cutting, which
planted in good earth and properly cultivated, would
have  become a great tree, luxuriant and productive,
will produce, left  to  itself, or unskillfully managed,
but a stunted plant, without vigor and without fruit.
   It may then be affirmed, that  the  destiny  of men
depends, in a great measure, upon  the  care given to
the first years of their existence.  We know not how
better to express  the importance we attach to edu-
cation.
                                          (53) 
54
Importance of Education.
  This  should commence for us on the day of our
birth, and hardly finish before the epoch of  maturity.
It comprises the direction of the mind, and of the
body: the  mind and the body are so dependent upon
each other, that hygiene  and morals are almost  in-
separable things.
  We shall, nevertheless, separate them in  this little
work, where it is not our intention to encroach upon
the  sphere  of the moralist, but to  occupy  ourselves
solely with the physical care to be given to children.
But let it not be forgotten, that the health of the body
often  makes that of the  mind ; the character of the
individual,  and, if we dare not  add his intellectual
aptitudes, at least the degree of mental  application of
which he is capable, depend, in great part,  upon the
strength of his constitution, and upon the more or less
normal manner in which his organs perform their func-
tions.
  Long protracted disease, generally, finishes by falsi-
fying the  ideas  as well as  the sentiments.  Jean
Jacques Rousseau, undoubtedly,  owed  his  misan-
thropy, and the aberrations of his magnificent intellect,
to the tormenting disease from which he suffered.
  The sum of all hygienic  laws, applicable to chil-
dren, consists in the satisfaction of all their natural
wants, while we avoid the creation of factitious  ones.
  But the practice of this double precept, so simple in
appearance, exacts  on the part of the mother almost
as much sagacity as solicitude.  She must know how 
            Importance of  Education.          55
to divine the cause of all  the  discomforts, of all the
sufferings,  of even all  the  wants  of her children,
which they yet  know how to  express only by  their
cries.  She must,  beside,  be  on her guard,  that in'
endeavoring to  console them by useless or dangerous
diversions, her tenderness  does not  lead  her  beyond
proper bounds.
  Time has fortunately  dissipated  many prejudices
touching the first treatment of children.   Thus, in the
majority of cities, at least,  the use of long clothes and
of cradles has  been abandoned.  Unfortunately, in
place of the  abuses which have ceased,  luxury has
substituted others.  The  worst  of all, is the careless-
ness of mothers  who blindly abandon their  children
to mercenary  care.   There are cases, we are aware,
where the mother  herself  cannot, and ought not, to
nurse.  We are so  far  from  absolutely  proscribing
hired nurses, that we shall soon give them our  espe-
cial attention.  But the intervention of a nurse, what-
ever confidence she may  inspire, should never exclude
the immediate and  continued superintendence of the
mother. 
56        First  Care of  the New-born.
                 CHAPTER II.

      FIRST  CARE  OF THE NEW-BORN.

  When the labor has been long and fatiguing, when,
above all, the umbilical cord is found wound round the
neck, and has  been compressed for some moments be-
tween the head and the walls of the pelvis, the child
always comes  into the world  in a state of asphyxia.
But, although it neither cries nor breathes—although it
makes no movement, and the pulsations of the heart are
imperceptible, the asphyxia is not always complete.  It
is necessary then, after having cut the umbilical cord,
to allow a few drops of blood  to flow before applying
the ligature.   We should then take the child upon the
knees, remove from the mouth, with the finger, the
mucus which  may impede the penetration of the air,
sprinkle  it repeatedly with  cold water, and  rub it
briskly after each sprinkling,  either with the hand or
with warm linen.   Finally, if it does not soon recover,
it should be carried to the air, and  we should  blow
strongly into  its mouth, and  re-commence and con-
tinue the same treatment until it breathes, or until its
death is rendered certain.
  We have  seen  children  remain  in this state for
several minutes, without giving any sign of life, then
begin slowly to recover,  and be quite well two  hours 
First Care of  the New-born.        57
after.  If the accident is not immediately mortal, they
generally recover.
  It is the same with the  paralysis of one-half the
face, from compression of the facial nerve by one of
the branches  of the forceps.  This  paralysis gives to
the infant, when it cries or when it attempts to nurse,
a strange expression, at which the  mother and nurse
are sure  to take alarm.
  A few days, or, at the most, a few weeks, will suf-
fice for its recovery, without the use of any medicine.
It is well, however, in such a case, to administer in
the course  of the day, a few teaspoonfuls of a solu-
tion of one or two globules of arnica, of a medium
dilution, in a tumbler of water; a few small doses of
nux vomica, prepared in the same manner, will infalli-
bly dissipate, the next day, or the day after, any traces
of the accident which may still remain.
   Some  children come into the world with the skin,
particularly  the  scalp, covered with   a  sebaceous
coating,  so viscous  and  tenacious that  water alone
will not  suffice to remove it.  It is very easily got rid
of by smearing it slightly with fresh butter, followed
by a warm ablution.   We prefer this method to the
use of soap and water, which is sometimes irritating,
and of which, beside, the  medicinal action  is incon-
testable.
   It is  hardly necessary to add  that the  ablutions
should be given in a  warm apartment, protected  from
 currents of air, and  quickly enough  to prevent the 
58        First Care of the New-born.
water from  becoming  cold on the body of the child.
A bandage of linen,  three  fingers wide, applied  to
the abdomen, will protect the remaining portion of
the umbilical cord.  The real object of this bandage,
which should not be too tight, is to prevent hernia at
the umbilicus.  It is unnecessary in four or five days
after birth.
  About  this time, the skin of the child commonly
changes color.   From  a  red, purple,  or rosy hue, it
becomes  yellow,  at  the  same  time  the  epidermis
cracks and  scales off.  It is a natural phenomenon
that mothers and  inexperienced  nurses  have  some-
times taken for a disease ; but is nothing with which
it is necessary to meddle.
  The senses  of newly-born infants  are  naturaUy
very delicate.  Care should  be taken to avoid expos-
ing their eyes to  too strong a light, and their ears  to
a too loud noise; at the same time, it is better not to
carry these precautions too far.  It is well, for exam-
ple, that the child should accustom itself—and  it does
it easily—to sleep, in spite of the noise of conversation.
  In  some  places, especially  in  the wine countries,
the matrons make it a duty to administer to the lying-
in woman the rotie au  sucre* and regard  it equally
indispensable that the infant, before  taking anything

  *This is a great cup of sweetened wine, with toasted bread soaked
in it. In the  C6te d'Or, in the Haute Saone, the Jura,  etc., not a
woman is delivered without being comforted with this heroic  cor-
dial. 
          First Care of the  New-born.         59
else,  should swallow a  teaspoonful of pure  wine.
Without considering this practice as very dangerous,
(although it might be so in certain cases) we consider
it, at least, quite useless.
  We proscribe more explicitly the syrups of manna
or of rhubarb, administered previously to all nourish-
ment, with a view of expelling the meconium.
  "The health of man," says Hartlaub, "is in inces-
sant strife with ignorance, and this struggle commences
with the first moments of his life.       *     *
Should not the least reflection suffice to convince us of
the injurious  effects of such  active medicinal sub-
stances  upon a delicate being, whose organs are not
yet accustomed to external influences ? "*
  Although we do not look upon manna and rhubarb
as very active  medicinal  substances, we subscribe to
the opinion of Hartlaub.
   This vulgar custom of purging the new-born, is one
of those old humoral traditions, which resist so much
the more easily the  effects of time, that  they have
their  specious side,  and seem  founded  in something
like reason.
   The milk of a woman who has just been delivered,
differs from the milk of a woman delivered six months
Bince, in this, that it is less rich in cream and caseine.
We may suppose it then, like the pure serum (whey),
endowed with laxative properties.  Now as nature, in
her combinations, always shows herself possessed of
infinite wisdom, and  admirable foresight, is  it not 
60        First  Care of the New-born.
rational to suppose that  the  chemical composition of
the milk of a woman in child-bed, is exactly appropri-
ate to the wants  of the being to which she  has just
given birth ?   Hence, the intention of physicians was
to supply artificially this provision of nature in favor
of the poor children, who, deprived  of the maternal
breast, were  destined  to receive from the first,  the
breast of a woman confined several months before.
  But upon  this point, as  upon others, physicians
deceived themselves.   In fact, the majority of infants
pass  spontaneously  the meconium,  which  at  birth
is contained in the intestines.   Laxatives are then use-
less, and beside, if the milk to be given them is unfor-
tunately too nutritive for their  young stomachs,  we
doubt very much if the syrup of manna and  rhubarb
are the  ingredients  best  adapted to  facilitate  its
digestion. 
Duties and Regimen of Nurses.       61
                  CHAPTER III.

        NURSES—THEIR DUTIES AND  REGIMEN.

  There are circumstances, we have said, under which
mothers should  not nurse their children, and  which
even impose upon them the obligation of abstaining
from it.  Such are abscesses of the breast, cracks in the
nipples, or any  defect in the conformation  of these
organs ; the absence or bad quality of the milk ; an
herpetic or syphilitic  affection ; any nervous disease,
such as hysteria or epilepsy, of which the maternal
milk would  favor the transmission  to the child;  and
lastly, pulmonary phthisis, a feeble constitution, or in-
deed, one of those excessively impressible natures, who
make of everything a subject of irritation or chagrin.
  In these various cases it is better to  resort to artifi-
cial suckling, or to another nurse.
  Artificial  suckling  is troublesome.    It  requires
extreme care, and fatigues the mother almost as much
as natural nursing.  But  it has  the  advantage of
avoiding the interposition of a stranger between the
mother and child.
  We recommend it, in consequence, to those mothers
who, not being obliged to labor for a living, are happily
at liberty to consecrate aU their time to their homes, 
 62      Duties and Regimen of Nurses.
 and whom a bad conformation of the breasts, an acci-
 dental disease of these organs, or the want of milk,
 deprive of the precious privilege of nursing.
   The choice of a nurse, when this becomes indispens-
 able,  is a  delicate  and serious  affair.  I shaU quote
 word  for word the reflections of a Swedish physician,
 Rosen de Rosenstein, upon  this subject, in his  Traite
 des Maladies des infants, one of the best works pro-
 duced by the Old School
   "A nurse," said  Rosen, " should be of a tranquil,
 gentle,  moderate, gay and  virtuous character.  She
 should  be from twenty to thirty years of age,  should
 have  been confined a little  sooner than the mother,
 and be accustomed to handle children.   She  should
be in  perfect health, so that there should be no fear of
 her communicating  disease to her charge.  Especially,
 Bhe should be exempt from the slightest taint of scurvy,
and her gums should be carefully examined,  to be
 assured that they  are sound  and  firm; care also,
should be  taken that  she  is  free from any  hidden
virus,  cutaneous eruption, induration  of  the glands,
 and every  other affection which betrays  a  depraved
state of the fluids."
  To  this we would add, that careful  inquiry  should
be made concerning the family of the nurse, to ascer-
tain if any of its members have suffered from any of
those  terrible hereditary diseases, such as scrofula and
epilepsy, against the infection of which it is impossible
to be  too carefully guarded.  It would not be impossi- 
         Duties  and Regimen of  Nurses.       63
ble, in fact, that the nurse herself should be infected,
although she had never presented the slightest symp-
tom of it, and transmit with her milk the germ to her
nursling.
  Rosen continues: "It is  an advantage that the
nurse be  rather  fat  than lean, and  that her con-
stitution  should resemble  that of  the  mother.  She
should be able to suckle  from both breasts, and the
nipples should  be well proportioned ; they should be
sufficiently irritable to become firm when the end of
the finger is passed over them, otherwise the flow of
the milk would be obstructed.
  " The milk, to be good, should possess the following
qualities:
  " 1st. The color should be of a bluish white; 2d, it
should have no  odor;  3d, its taste should be very
sweet, and not salt  or bitter — nor like that of the
first milk of a mother, when  it begins to change, and
become real milk.   It is  best, when  it has the taste
of ordinary  milk, diluted with  a little water, and
sweetened  with a small quantity of sugar; 4th, the
milk  should have but  little body, and should fall
readily  from the nail upon  which a  drop has been
expressed, if the  nail is ever so little inclined; and, if
the hand is suddenly shaken, there should remain no
whitish  trace  upon the nail; 5th, the milk  should
make no impression on the eye, when a drop is let fall
into it; 6th, if, in allowing it to curdle, it gives much
curd, it is good for nothing;  7th, if, in allowing  it to
      6 
64       Duties and Regimen of Nurses.
stand for several hours, it gives much cream, it is not
a good sign, which is also ascertained by weighing it,
for the lighter it is, the more cream it yields  ; 8th, the
older the milk is, the thicker it  is — and  the more
objectionable.   If, then,  one  has to choose between
two  nurses, one aged  thirty years,  with milk but a
month older than  the  mother's, and the other be but
twenty, with milk six  or seven  months  old, the first,
though  the oldest, should be preferred,  other things
being equal."
  Rosen enlarges afterward upon the regimen proper
for nurses, upon the kind of life  they should lead, and
upon all the precautions they should take with respect
to their nurslings.
  "It is not sufficient," says he,  "to have a nurse who
possesses  the qualities above-mentioned:  the health of
the  child still  demands  that she  should  observe a
proper regjmen.  First, she should, if possible, have a
Bpacious chamber, free from the passage of draughts of
air; she should keep moderately warm and observe great
cleanliness. The nurse ought not to expose herself im-
prudently to the cold, at least, her breasts should always
be well covered.   If they are cold,  she  should warm
them before presenting them to the child; otherwise, it
wiU be likely to get a cough, or a cold in the head.  I
should, however, be very far from advising  a nurse
always  to  remain  in her chamber;  on  the contrary,
she should be at liberty to go as  she pleases  into other
apartments, and  to occupy  herself with  household 
          DUTTES AND REGIMEN OF  NURSES.       65
affairs.   I have  remarked, that from  shutting  up a
good nurse in her chamber, her milk became changed;
but would recover  its good qualities  in a  fortnight
after, if she was allowed to go and come in the house,
and occupy herself with some light labor.
  " She should eat sufficiently, and at regular hours.
Wine, brandy, beer and coffee are not  proper for her.
She may  be allowed, although rarely,  tea with  milk.
It is unnecessary to be equally scrupulous with regard
to the choice of food.   The best kinds are those  to
which she is accustomed, and which are most  agreea-
ble to her.  She should, however, refrain from  acids
and every species of onion.
  " She may be  permitted, from time to time, to par-
take of salt food,* but the child would  soon be tor-
mented with colic if she should eat  peas, turnips, and
cabbage.   *    *
   " A  nurse who  suckles well, is  rarely taken with
her courses, and, if this does happen, she often suffers
pain.  I have often distinctly  observed that infants
who nurse at this time are made sick .by it.   The
safest way is  for the nurse to have her breast drawn
by another woman, and give only to the child, during
this time, clarified whey.       *

  * The nurse by this means is excited to drink, and her milk
becomes in consequence more fluid.  This she should do from time
to time, especially, if the child is observed while sleeping to have a
rattling breathing several times in succession, without having taken
too much milk. 
66       Duties and Regimen of Nurses.
  " Exercise is indispensable for a nurse, as much on
account of her health, as for the  production of good
milk, that  is, milk  not  too thick, and  which does
not sour too easily.   Thus she  should  come and  go,
and  even work sufficiently every day to  cause slight
perspiration.   But she should take this exercise an
hour before eating, and not immediately after.
  "If the  child is  not  quiet  enough to  allow  the
nurse to sleep well, she becomes feverish, and the milk
stops, becomes yellow and  unwholesome,  and  she
should then have an assistant, in order that she may
sleep seven or eight hours a day.
  " A nurse should know how to  control  her temper:
for if the child takes the breast soon after she has had
a fit of anger, it immediately suffers in consequence,
and  has convulsive  movements,  or other dangerous
affections, which may cost it its life.  Albinus relates
the following example:  A woman gave her breast to
her child after a violent fit of anger ; it was immedi-
ately attacked with hemorrhage of the  eyes, ears,
nose, mouth, anus, etc., and died.
  " It is not less injurious to give the child the breast
immediately after  the nurse has had  a fright;  she
should, in such a case, have her breast drawn by another
woman, and take some suitable medicine before again
nursing the child."
  Aconite  is,  in such a case, the medicine to which
she should  have immediate recourse.  Five or six glo-
bules of the twelfth  dilution, are to be  dissolved in a 
Duties and Regimen of Nurses.       67
glass  of water, of which she should take a few tea-
spoonfuls every two hours, or at greater or less inter-
vals, according as she has been more or less  seriously
affected by her fright.   But in all cases, it is import-
ant that the child should not take the breast under
twenty-four hours from the time the nurse took the
last teaspoonful of medicine.
  "If the  nurse," pursues Rosen, " suffers from any
anxiety of mind or grief, the child will not fail to ret-
rogade and lose its health.  The cause of this state of
mind, should be ascertained, and if there is no remedy
for it, the nurse must be changed.
  " If the nurse  gets sick, the child should be taken
away until she has recovered.  During this time, it
should take the  milk of another person, or the food
of which I have before spoken.
  " There is no danger in changing the nurse, for any
of the causes mentioned, if the one taken in her place
has  the requisite qualities, and her milk be  a little
younger than  that of the first, six weeks at the most;
otherwise the child  may easily  have a bad diarrhea.
  " The nurse should  present the breast to the child
whenever it is hungry or thirsty, but not every time it
cries ; otherwise, the stomach of the child will become
surcharged  with aliment  it  cannot  digest,  and the
milk, always tending to its usual alterations, becomes
acid, acrimonious,  and causes  vomiting and  colic.
Mothers and  nurses  regard  these vomitings  as very
advantageous to the child ; without doubt, they are  as 
 68       Duties and Regimen of Nurses.
 useful as  those which happen to  adults, who eat and
 drink  so  often during the day,  that they are some-
 times  forced to vomit:  but a nurse will do well  to
 accustom the child to take  the breast only at regular
 hours, and when it really needs it.  She will know by
 the following signs, if it is in need of it:   1st, if a
 certain time has elapsed since he took it last;  2d,  if
 it fixes its eyes upon the nurse, following her with the
 eyes as she comes and goes; 3d, if joy is expressed  in
 the eyes of the child at sight of the breast; 4th, if  in
 presenting the end of a very clean finger to the mouth,
 it takes hold of it and commences to draw.
   " The nurse ought not to give the breast to the child
 immediately after her meals, otherwise the milk sours
 quickly and causes colic; nor in the  morning  before
 taking something,  because the milk has then necessa-
 rily a little acrimony.
   "To prevent the  child from becoming deformed, he
 should nurse alternately from both breasts, and for the
 same reason, it is improper always to carry the child
 on the same arm.
   " In conclusion, a nurse who is  subject to fall  asleep
 in her  chair, should not be  permitted  to seat herself
 near the fire with the child ; but  too  many accidents
have resulted from  this caus*e."
   These wise counsels, given by Rosen,  are addressed
to mothers as well as to nurses.  We earnestly recom-
mend them to both. 
Duties and Regimen of Nurses.       69
                 CHAPTER  IV.

              NURSING BOTTLES

  These were formerly simple bottles with a neck, to
which the nurses attached a little roU of fine Hnen or a
bit of sponge, and of which they made use 10 feed their
nurslings.  But since artificial suckling, brought into
notice by the hygienists, has become as it were a  cus-
tom, industry has taken  in hand the simple invention
of our mothers ; nursing bottles have become  the ob-
jects of a special branch of commerce, and several per-
sons have attached their names to successive improve-
ments they profess to have made; so that we have now
the bottles of Darbo, Breton, Obin,  Charriere, etc.; all
by the way constructed  upon the same principle, and
which can be embraced  in one common description.
  The primitive  nursing bottle, of which we  have
spoken, notwithstanding the apologists  it still finds,
has a very serious fault:  the vacuum, more or less com-
plete, necessarily produced upon the surface by the
progressive diminution of the liquid, hinders its flow:
suction  then becomes difficult,  and even impossible,
if not interrupted from time to time.   Now, experi-
ence and reason  both demonstrate that there is  no-
thing more prejudicial to the health  of a child, espe-
ciaUy to a feeble one, than repeated ineffectual efforts 
70
Nursing Bottles.
at suction.   For  the  rest, we agree with the  old
ladies, that they were not  expensive, and easily kept
in repair; but these advantages do not, in  our opin-
ion, justify their use.
   Nursing bottles are now made with two  openings,
the one  intended for the  passage of  the liquid,  the
other, for the entrance of the  external air;  so that a
vacuum is no longer possible, and consequently there
is no difficulty in the suction:  and we now rarely see
a  child  become  impatient while drinking, or desist
from his efibrts, to cry.  The various ways of arranging
this  extra opening,  without  causing the  liquid to
escape when the vessel  is filled, constitutes,  in part,
the difference which  distinguishes the bottles of the
different manufacturers.   But  their ingenuity has not
stopped here: for in place of the bit of sponge or linen,
they have  substituted an emery stopper,  perforated
through  its  center, and  covered  with an artificial
nipple;  this is sometimes  but a simple adjustment of
elastic cork, of  caoutchouc  or of flexible  ivory—is
oftener  made of a prepared  cow's  teat, whose flexi-
bility is  preserved by immersion in cold water.  This
last would be undoubtedly the  most suitable,  were it
not for the difficulty of keeping it clean, its liability
 to become obstructed and to  deteriorate; for these
 reasons,  we prefer the flexible ivory nipples of M.
 Charriere, notwithstanding their great fragility, which
 makes them sometimes expensive.   All the efforts of
 these manufacturers, however, have not been  able  to 
Nursing Bottles.
71
remove the prejudices still existing, against the use of
nursing bottles.   These are evidently attributable to
the great care required by artificial suckling,  care
that mercenary nurses too often neglect; and espe-
cially to the general ignorance respecting the compo-
sition of the food, to be given to the nursling.
  What liquid is the best adapted  to replace to the
new-born  child, the mother's milk, of which  he is de-
prived ?   This is the great question, up to the present
time badly understood, badly stated, and consequently
badly settled.
  Chemistry and physiology, both demonstrate: 1st,
that the new-born  child, whose digestive powers are
gradually  developed, needs  from  day to day, an  ali-
ment more and more  substantial; 2d, that with wo-
men in good health, the milk passes through  precisely
the series  of transformations which progressively adapt
it to the increasing demands of the child, from the day
of the labor, up to the period of weaning.
   This granted, it follows that no animal milk, that is
to say, no substance of a fixed  nature, is a suitable
substitute for  the maternal milk.  The efforts of art
should consequently be directed to the  discovery of a
variable formula, by means of which to imitate, in all
its phases, the work of nature.
   We give  here  the recipe which we  have  already
published in  another  work, and  the  excellence of
which, we have tested  in numerous cases.
       7 
72
Nursing Bottles.
  Take of beef and veal, each, three ounces, boil them
six hours in  a quart of water, add a little salt—skim
when cold,—mix this broth with equal parts of cow's
milk and water, and warm it a little for use.*  Suppose
we increase every day the quantity of meat in the broth,
and of broth in the mixture, so that the milk shaU finally
disappear, and I venture to  affirm, that we shall have
solved one of  the most important questions  in  the
hygiene of children.
  Let mothers remember these precepts; let them
have  the courage to  put them in practice, should  cir-
cumstances prevent their following the course of na-
ture, and they will not  be slow to acknowledge, with
us,  that nursing bottles,  in  a majority of cases,  are
preferable,  for  their  children, to the breast of  a
stranger.

             * Viande de bceuf, viande de veau ;
              De chaque, 60 grammes ;
              Un litre d'eau. 
Of  the Cries of Children.         73
                  CHAPTER  V.

            OF THE CRTES OF CHILDREN.

  When a child cries, we may be sure that it expe-
riences some want,  discomfort, or actual pain.  The
first thing to be done then, is to discover the cause of
his  cries.
  This cause, in the child just born, is found in the
impression which the  air, a medium colder than that
to which he is accustomed, suddenly  produces  on his
body, in the introduction of this air into his lungs—
sounds, light, the contact of the hands, of  linen, etc.
He gives evident signs of the excitement these cause
him, by the rapid movement of his limbs,  sometimes
by  sneezing, and always by cries.
  From the tone and  degree of intensity of these last,
we  draw inferences which are  rarely incorrect.   "A
child," says M. Billard, " may be considered vigorous,
and likely to live, if his cry is sustained, sonorous and
easy, such a cry always indicates free and full respira-
tion ; ordinarily, a sign of health and vigor in the newly-
born.  We  are  rarely in  error, in relying on this ob-
servation ; we see children, having a certain degree of
plumpness,  and  robust limbs, hardly able to breathe,
and crying with  great  difficulty, who perish from 
74         Of the Cries  of Children.
asphyxia,  cr apoplexy, while others, more feeble, if we
judge b\ .heir  external appearance, but with a vigor-
ous and free cry, undergo, without danger, the sudden
changes that  the  commencement of extra-uterine life
imposes upon them."
  The cause  of the cries  of children,  after this first
commotion has subsided into a refreshing sleep, is not
always so easy  to indicate.
  "There are children," says M. Billard, "who cry
without its being possible to assign a cause for it; and
whom, notwithstanding their  continual agitation  and
wakefulness,  we do not see pine away.   These chil-
dren are distinguished among  all those brought to the
Foundling Hospital, by the pertinacity of their cries ;
and  the nurses, who dread to take  charge of them,
vulgarly designate them by the  epithet,  well  enough
merited, of enfants mechants.   This continual excita-
tion  proceeds, no  doubt, from  a  greater  sensibility in
them, than in other children."
  Fortunately for the nurses, and especially for moth-
ers, les enfants  mechants are the  exceptions, and nearly
always, with  a  little  care,  they can succeed, except in
cases of real disease, in appeasing the cries  of their
children.
  The want  of nourishment,  the discomfort caused
either by a fold in their linen, or in their bed ; an un-
comfortable position, or one too long maintained; cold;
the  irritation produced by the  presence of urine, or
fecal matter upon the external parts; the want of sleep, 
            Of the Cries of  Children.          75
and lastly, the pain caused by the process of dentition,
and other maladies, are the usual causes of the  cries
of children.
  Whether the cries are  caused by hunger, is easily
determined, by considering the length of time that
has  elapsed, since the child has  taken food.   "We
must not always conclude," says M. Billard, "because
a child is quieted by offering it the breast, that  hun-
ger is the cause, of its cries; for there are children  of
such insatiable voracity, that they never refuse the
breast  when it is offered them."
  It should be observed, that this greediness, far  from
being an advantage to the child, has often no other re-
sult than to fatigue the stomach, and cause sometimes
a disease of this organ.   It is  desirable, then, to ac-
custom the child to take the breast, from the beginning,
only at  regular intervals, taking care  to nurse it fre-
quently, in proportion  as  the child  is young.
  We  should ascertain if the  cries of a child  arise
from some  derangement of its dress,  or bed; we
sometimes,  too,   succeed  in  soothing  them, by
changing its  position, if it  has  lain  long in one
posture.
  Care should be taken to preserve a proper tempera-
ture in the  chamber, and  above all, not to allow it to
remain long wet by urine, or soiled with  excrement.
Neglect of this last precaution is liable to cause cracks
in the groin and breech which are probably very pain-
ful ;  it is customary to  powder  these parts with lyco- 
76          Of the Cries of Children.
podium, but we absolutely protest against this custom,
for  the reason  that lycopodium  possesses medicinal
properties, slightly marked, it is  true, but capable,
nevertheless, of exercising a bad  influence upon the
general  health  of the  child.  If necessary, we may
replace the  lycopodium, by the  use of a powder of
worm-eaten wood, a substance absolutely inert.
  The want of sleep, as we have said, becomes some-
times a cause of these cries.
  When  wakefulness is  not produced by  a  morbid
state, one  succeeds  often in putting them to sleep,
by singing a low  and monotonous air;  this method
is used the world over.
  As to the administration of opiates, as a means of
procuring sleep, and especially the syrup of poppies,
of which such monstrous abuse has been, and is still
made in certain countries, we  cannot denounce  it in
terms too energetic.
  During the first three months, children  that are
properly cared for, cry but little.  But  at  the  fourth
month, the period  at which  dentition generally  com-
mences, it is different;  it is then  only that  other
means may be necessary  to calm them than the breast,
or the nursing bottle.  One may facilitate the coming
of the teeth, by passing the finger frequently over the
gums, and by giving them a piece of dry root of marsh
mallow to bite upon; but if this hastens and facilitates
the  protrusion of  the  teeth, the  pain which  accom-
panies it is not lessened.  There is indeed no  way of 
            Of  the Cries of  Children.         77
avoiding this, and it is best, quietly to let nature take
her own course.
  During the period of dentition, children are relaxed
and their stools become green.   They drool, are rest-
less, and cry constantly.   Their cries have at this time
an acuteness which denotes real pain.  They have some-
times cough, or  slight ophthalmia, and almost always
redness, heat, and a little swelling of the cheeks.  If
they are  constipated, it is well to  give them  a little
whey.   As  to  medicines, properly  speaking, it is
better not to have recourse to them,  except upon the
occurrence of symptoms sufficiently marked to  consti-
tute a real disease, as  for example, violent diarrhea,
tympanitis,   convulsions,  etc. Chamomilla, in these
cases, is the medicine  to which we  should give the
preference.  It may be administered of the twelfth di-
lution, or  of  the twenty-fourth, if there is  a predom-
inance of nervous symptoms.   Two or three teaspoon-
fuls, in the  course of the day,  of a tumbler of water,
in which has been dissolved  one or two globules of
this medicine, will almost always suffice to restore the
normal state.  Aconite  and Belladonna would  only
be  appropriate  in  the  cases, fortunately  rare, where
dentition has  brought on either an  intense fever, or
signs of cerebral consestion, or violent convulsions.*
   Dulcamara administered of a medium dilution, in
  * Belladonna, in this last case, should be administered on the
first appearance of the symptoms. 
78         Of the Cries of Chdldren.
the manner we have just indicated for chamomilla,
appears  to me preferable  to this last, especially in
lymphatic  children, when we  have to  combat  an
ophthalmia occasioned by dentition.
  I never consider  it necessary to give to the nurse
the medicine demanded by the symptoms of the child;
for if she herself has no need of it, it is not unlikely
that she would experience from it, and very uselessly.
some unpleasant consequences.  It is one of the great
advantages of homceopathic medicines that they may
be administered to  even the youngest and most deH-
cate children, without exciting repugnance.
  When  the  cries of a child  are caused by a disease
independent of dentition, it  is for the  physician  to
ascertain its nature and apply the remedy.
  Physicians have sought to deduce from the rhythm,
tone and duration of the cries, the character  of the
disease which excites them.   But with the exception
of the affections of the air passages, croup, for example,
or oedema of the glottis,  which causes a peculiar cry,
it seems  to me  impossible to attach to them a symp-
tomatic signification.
  Excessive crying, independently of the cause which
produces it, has a danger of its own.  We sometimes
see  the efforts which they cause, produce hernia, and
even (much more rarely, it is true) cerebral conges-
tions.  Beside,  as we have said, they express  suffer-
ing which should be avoided by every possible means 
Weaning.
79
                 CHAPTER  VI.

                   weanin g.

  The period of weaning is a difficult one, both for
the child  and the nurse, when one commits the im-
prudence  of  entering upon it at an  improper time,
or without having properly prepared  for the tran-
sition.
  The termination  of the first dentition seems to be
the time assigned by nature for this  change;  but we
are rarely to  be governed exactly by this indication.
It appears to me safer and even more logical to be
guided by the health of the nurse and the constitution
of the child.
  When  the nurse has  but  little milk, or milk  of a
mediocre  quality, it is better to hasten the  time,  in
order that the child may  have nourishment of a more
abundant and  substantial  quality.  In  this  case re-
course should be had to  artificial suckling, according
to the precepts  laid down in the chapter on Nursing-
bottles.  In  this manner we shall be able gradually
to substitute  solid food in place of milk.
  For a weakly and ailing  child, it is more necessary
to retain  the breast of the nurse  to a late period than
for a robust  and healthy one; provided always,  that 
80
Weaning.
its  feeble state  is not  caused by her bad  health  or
defective milk.
  In any case, it is not  when  the child is sick that a
change should be made in its  food, unless the change
is made as a means of cure.
  If, for example, it is foreseen during the first two or
three  months that some unavoidable circumstance
will soon render it necessary  to wean the child, it is
infinitely better  to proceed to it at once, than by post-
poning it a month or two, have it occur at the period,
always more or  less painful, of teething.
  We  have  recently had  occasion  to verify the im-
portance of this  precaution.
  A lady had  nursed her child but two months when
her father was  attacked with a  disease which  was
expected  to be  fatal.   The catastrophe was believed
to be inevitable.  It could not be delayed more than
five or six weeks.   The lady  was devotedly attached
to her father, and could not  reconcile herself to the
idea of his  death.  It  was  to be  feared,  in  conse-
quence, that the sad event that she  dreaded, without
being yet willing to believe, would  produce a violent
perturbation from wdiich  her  child  could not  fail  to
suffer.  Wo advised her  to wean it.  She complied
the more willingly as the child  evidently  began al-
ready  to  suffer from  her  inquietude.   Everything
occurred  as we had  anticipated.   The  father died,
and the  grief of  the daughter was  so violent as  to
produce an illness of several weeks' duration.  But 
                     Weaning.                   81
the  child  experienced  no  inconvenience  from  it,
when it would perhaps  have died  had it continued
to take the breast.
   In  some  countries  mothers  make  it  an  almost
sacred rule to nurse their children nine months.  This
comes, no doubt, from the idea that nature intends that
the child shall receive its mother's milk, for exactly
the same  length of time that it lived in her womb.
It is, however, one of those superstitious  fancies that
are totally without foundation.
   When from the  eighth  to the tenth  month  a child
begins to digest without  difficulty other food than the
milk  of its nurse, it is  well to habituate it  to the
change, and to  give  it  the  breast  less frequently in
proportion  as  it  eats more. '  It should not take the
breast until a certain time after having eaten, other-
wise, it will be likely to suffer from indigestion.  The
nurse should especially  avoid giving  the  breast  if,
after  having eaten, it  appears to be  thirsty; water
slightly sweetened is then the only suitable drink.
   We say slightly sweetened, because  the use  of
sugar is so often abused.  This substance, which, when
used moderately, aids digestion, irritates the stomach,
diminishes the  appetite, and produces  acidity and
Bpoils the teeth when taken in excess.
   In fact, sugar mixed with bread crumbs and placed
in contact with a mucous membrane, the  tongue, for
example, is almost instantaneously transformed into
an acid called by  chemists pectic  acid.   It  follows 
82
Weaning.
then that it is in exciting the  stomach in the manner
of condiments, and especially of acids, that sugar aids
digestion.   But  we can easily imagine the  effects
upon  the economy of this  artificial  stimulus, when
from  being repeated every day, its  use becomes a
habit, and the stomach can no longer do without it.
The digestive power is lost, the breath becomes sour,
and the  teeth, constantly bathed  in  an acidulated
saliva, undergo a slow decomposition, which destroys
the enamel, turns  them  dark, renders them brittle,
aud finaUy produces caries.
  I am aware that individual instances may be cited
of persons who have all  their Hves consumed  large
quantities  of sugar, and  who  have nevertheless  at-
tained to an advanced age with very fine teeth.  But,
these  are constitutions  so privileged and robust in all
respects, as to resist the  most extravagant and disor-
ganizing  regimen.   A  particular idiosyncrasy, or
perhaps a natural predominance of the alkaline prin-
ciple  in the saliva, and the gastric juice, may suffice
to explain these exceptions.
  It  is a matter of common observation, that  the
secretion of milk, like  that of all the  other  glandular
fluids, becomes abundant in  proportion as it  is fre-
quently solicited; the contrary proposition being but a
rigorous corollary from this, it follows that,  in propor-
tion as  the breasts are less frequently drawn, the milk
will diminish, and  thus by lengthening gradually the
intervals  of nursing, the nurse will  avoid both  for 
Weaning.                   83
herself and for the child, many of the inconveniences
of weaning.
  Rosen advises, that when it is finally determined
to withdraw the breast, the nipple should be rubbed
with some bitter substance, like the extract of worm-
wood,  whose  disagreeable  taste  would  not fail  to
deprive the child of aU desire for it.
  Much has been said, and much written upon the
nature of the food which should replace the mother's
milk.  Physicians agree upon  this  point, that the
lightest and  most digestible substances should have
the preference, and by one of those inconsistencies  so
common, they  agree  again  in  prescribing the most
indigestible things in the world, to wit: cow's  milk,
pap and  panada.  Happily, the error they commit,
consists less in prescribing these substances to child-
ren, whose  gastric  activity  readily accommodates
itself to them, than in calling them, as a general rule,
easy  of digestion.   The majority of adult stomachs
find milk  and pap of difficult digestion; children di-
gest them much better, but they, especially at a certain
age, would do quite as well with a diet of meat broth.
A bit of roast beef is the habitual plaything of Eng-
lish children ; they suck it and bite it with  their gums,
and it has thus the double advantage of nourishing
the body, and facilitating  the protrusion of the teeth.
   An excellent food, much preferable  to pap, and
which children may take from the hour of their birth
to that  of their weaning, and  afterward, is a sort  of 
84
Weaning.
broth much used  in Germany, and  in  the  north of
Europe, prepared with milk, warm water and grated
biscuit.   But  the  biscuit of which  we speak, does
not  in  the least resemble the fancy article sold in
France, under  the  same name.   It is a kind of very
light and  firm cake, nearly resembling, with the excep-
tion  of the flavors,  which are left out, what is sold in
Paris, under the name of biscottes.   This biscuit may
be replaced by wheat bread, cut in slices, and dried
in .an oven; the dried bread is then grated and boiling
water poured upon  it, a little sugar is then added, and
lastly,  some milk.  The younger the child the thinner
should be the mixture.
  It would be well to  vary the food of infants, by
alternating this preparation with a porridge made of
semolina,  sago,  etc.; but,  as  a general rule, they
should not be kept  upon  an exclusively milk diet after
their first year, and if there is any predisposition to
scrofula, it may be necessary, at this period, to deprive
them of it entirely.
  Lastly,  there is above  all,  an  essentially restorative
and  tonic  agent, imperatively called for by children
of whatever constitution, to wit: the  open air.   " It
is especially in the earlier years of life," says Jean
Jacques Rousseau,  "that the air acts  upon the consti-
tution  of  children; it penetrates their soft and deli-
cate  skins, by  every pore, affecting powerfully their
growing bodies, and leaving upon them impressions,
which are never effaced." 
Second Period  of Childhood.         85
                  CHAPTER VII.

      SECOND  PERIOD OF  CHILDHOOD.

  The physical and moral   education  of children,
must be regulated, in each case,  by a multitude of
different  circumstances,  such as  constitution,  sex,
climate,  character,  intellectual  aptitudes,  etc.,  etc.
There are, however,  certain hygienic  rules applicable
to all; and a summary exposition  of these  rules will
form the subject of the present chapter.
  Notwithstanding  the sophisms  of Rousseau,  who
professed to commence the reformation of  humanity
by imposing upon  it a sort of Pythagorean  diet,  man
is essentially  omniverous; that is to say, he is in-
tended at once  to eat grains, fruits, roots, herbs and
the flesh of animals.  This is shown by the  confor-
mation of his  dental system and digestive apparatus ;
and we see him in all parts of the universe, instinct-
ively conforming to this natural tendency  of his orga-
nization.
  It is  true,  his  tastes, or rather, his wants, vary  a
little in the different latitudes in  which  he is forced
to live.   Men in cold countries, consume  larger quan-
tities, and live more  especially upon animal  food,  than
the inhabitants of warmer latitudes.  The physiological
reason of this difference is easily  understood, but its 
86         Second  Period of  Childhood.
explanation does not belong to our subject.  The only
point upon which we are called upon to express our-
selves, is this: Is it proper that children should  live
in the same manner as adults ?
  It is understood that we speak here of children of a
certain age, and  not of those  who are  still at  the
breast.  But if, in the opinion of aU  the  world, it
would be absurd to confine the latter to the kind  of
food proper for adults, it would be but little more rea-
sonable to submit them  to  it from the  day that they
are weaned.
  In nature everything operates by gradual transitions.
The teeth of children, have not the  solidity of those
of men; they require, then, food which is easily masti-
cated.  And again,  their stomachs,  accustomed only
to milk and liquids, would not long bear up under  the
necessity of digesting only solid substances and strong
meats.  Thus the instincts of children, lead them to
prefer tender  and juicy  food, cream, blanc-mange—
gelatinous meats have almost always their preference;
and it  is only gradually, that we see them accustom
themselves to  eat like their parents.
  Children digest rapidly ; growth in them  facilitates
assimilation; the least abstinence depresses them, and
if prolonged,  would very  soon be  prejudicial; they
should then  eat often.   But however  frequent their
repasts, it  is important that  they should be taken at
regular hours; otherwise  they wiU  eat the greater
part of the time, without appetite, without need,  and 
           Second Period of Childhood.         87
sometimes, for want of something else to do, or for the
sake of amusement.   Now nothing is more pernicious
to their health, than this bad habit that they contract
so easily, of constantly disturbing, by a useless repast,
the  still unfinished digestion of the last one taken.
  Children who live in this manner, are almost always
pale, delicate, suffering, and without ardor for study,
or even for play.
  A vegetable diet,  and  especially  the habitual use
of pastry and farinaceous food, are thought, like milk,
to favor in children the lymphatic temperament, and
consequently  scrofula.  We believe this opinion well-
founded ; but, I think at the same time, that the per-
manent action of a cold  and humid atmosphere has
far  more to do, than a vicious alimentation, with the
grievous  results  attributed to this cause.   The brisk
air  of mountains, on  the contrary, produces  an op-
posite effect.  Thence comes that softness, flabbiness
and decoloration of  the flesh among the  inhabitants
of  the  gorges   and  low  places, while a  sanguine
temperament, activity, vigor and  courage,  are  in
all  parts of the earth distinguishing traits of moun-
taineers.
  Unfortunately, man has not  the  privilege  of
choosing where he will be born, and rarely the choice
of the country where he will pass his life.
  But if the influence of climate, when it is of an
injurious  nature, is an irremediable evil, it behooves
us, when forced  to struggle against it,  to diminish as
         8 
88        Second Period of Childhood.
far as possible its effects, by means of a tonic alimen
tation.  The English,  in this respect, have perfectly
comprehended  their  situation,  and  reason  among
them has corroborated  instinct.  This  is why they
turn their fields into pastures, and give  their children
more roast-beef than bread.
  A child in  good health should have an appetite.
The absence  of  appetite, among  children, is  then
always an indication either of a disease, more or less
latent, of the la,ck of exercise, or of some vicious habit
which we should endeavor to discover. It would in
any case be  rendering  them no service to oblige them
to eat without  being hungry; for whatever they eat
in this manner, so far  from  being beneficial to them,
would in all probability but augment the disorder of
their health.
  Some children manifest an invincible repugnance
for particular articles of food.   To constrain them in
this  respect, appears to me  unwise.  It is better to
leave the  matter to time; it will change their tastes,
if these  ought  to  be  changed.    But,   we  have
unquestionably  instincts which  indicate  what   is
proper for us,  and  the natural repugnance which we
experience for  certain articles  of food, is  proof  that
these are not  adapted to our  stomachs.   Then, of
what use is  it  to torment children for trifles ?  They
have always enough  of inevitable  trouble, without
our procuring it for them now, under the vain pretext
of sparing it to them in the future. 
          Second Period of Childhood.         89
  Nevertheless,  when  children  manifest  a morbid
appetite  for  acids  and green  fruits, we  may mis-
trust the state of their health; for even although these
substances  should not seem to incommode them, the
very facility with which their stomachs support them,
proves that there is something abnormal in their con-
dition.  We  should not forget, beside, that children
are as fond,  and even more so than  men, of excited
sensation, and that their desires are consequently far
from being always an expression of real wants.
  Independently of a regular and well  chosen diet,
many circumstances are still  necessary to the  health
of children, and to the free development of their phy-
sical powers.  Habits of cleanliness, for  example, are
of rigorous necessity.
  They are  to  be bathed, as we have said,  at the
moment of their birth, and there is no reason why
this bath should not  be daily repeated.  This  is one
of those good habits which, once formed, cost nothing,
and may be continued through  life  to our infinite
advantage.
  Be it weU understood, however, that these ablutions
should always be made  with cold water.
  Cold water is  a tonic which renders the skin firm
and fortifies  it  against  inclemencies  of the weather.
Children should  then be  accustomed to it  from the
first week of  their birth.   In no country, in no season,
can cold baths, or cold ablutions cause danger or any
serious  inconvenience, and  it is  only important  that 
90        Second Period of Childhood.
the baths should be taken quickly, in  proportion as
the temperature  of  the  water is low.  Reduced to
simple and rapid immersions, they can have no other
effect, even in the midst  of winter, than  to excite in
the surface a salutary reaction, provided that the skin
be properly dried, and that the bath be foUowed by a
little exercise.
  After what precedes, it is  useless to add that  we
approve, in summer, of river  and sea  bathing.  The
bath is beside, in this case, an opportunity for taking
exercise.  The  custom  of teaching girls  as well as
boys, to  swim, has  gained ground within a few years
past in our large cities, and it is to be wished that this
custom  might spread rapidly in the  provinces, and
especially in  certain parts of the country, where the
most intolerable  want of cleanliness is still common.
  Children should be combed every day.  This recom-
mendation, which among well-bred people will appear
superfluous, and even puerile, wiU on  the other hand
seem extravagant to more  than one peasant.  We
could  cite many villages of Bretagne  or Franche-
comte, where the children are literally devoured  by
vermin, under the fine pretext that they are a sign
of health.
  It would be difficult to indicate the origin of this
revolting maxim; but, it is  pretty certainly a false
one.
  In fact, the spontaneous production, in the hair of
children, of  these  repulsive  parasites,  is  reaUy a 
           Second Period of Childhood.         91
 symptom of disease,  or at least of a bad  condition of
 the body, which ought to be corrected.
   In  some countries, mercurial  ointment is resorted
 to for the purpose of destroying them.   This, in truth,
 is an  expeditious mode;  but it is not less dangerous
 than  prompt.  Its most common result is to repel
 upon  the organs of the senses, or upon the brain, the
 morbid  action which was existing in the scalp, and
 hence, to  produce deafness, amaurosis,  ophthalmia,
 and often even fatal meningitis.
   The children  among  whom  these  parasites  are
spontaneously engendered, are pale and emaciated, or
bloated.  They are subject to chilliness, on the least
exposure to cold; lymph is  abundant, the blood is
poor and circulates badly.  They have generally blue
eyes,  and  light hair, with an earthy or  diaphanous
skin,  and in  a word, all  the signs of the lymphatic
 temperament.
   These parasites most commonly make their appear-
 ance between the seventh and twelfth years, in those
 who are subject to them at all.
   A species of tinea  capitis, most frequently the tinea
favosa, very often accompanies them, and as a conse-
 quence of this last, engorgements of the  parotid, and
 submaxillary glands, and of the cervical ganglions, are
 not unfrequently superadded.
   Children  in this state, require the immediate care
 of their mothers; a  good regimen is the first condi- 
92        Second Period of Childhood.
tion of a return  to health; that of boarding-schools
is generally fatal to them.
  The  spontaneous generation  of vermin, constitut-
ing, as we have  said, a really morbid state, it is  evi-
dent that combing  frequently, will not alone suffice to
remove them ; but it  is at least  incontestable, that to
neglect it, augments to an almost intolerable degree,
the discomfort they occasion.*
  I shall say but little of the dress  suitable for child-
ren—the subject is worn  out—exhausted ; there  are
nevertheless, abuses which stiU exist.
  All the world  knows, for example, how pernicious
to young girls,  is  the use  of corsets.   If  they are
badly made, they deform the figure; if they are well
made, they exercise upon the lungs and the abdominal
viscera, a  compression fatal to  the development of
these organs.
  I do not hesitate  to pronounce them among the most
frequent causes of phthisis pulmonalis, aneurism, gas-
tralgia and spasms  of  the stomach;  and especiaUy, in
consequence of the obstacle they offer to the circula-
tion,  and  free return of the venous  blood  to the
heart, it appears to me evident, that they have  the
effect of keeping up  a sort  of passive congestion of
  * Sulphur and Dulcamara, which are the specifics for tinea favosa,
are at the same time, those of the verminous diathesis which ac-
companies it. 
           Second Period of Childhood.         93
 the organs  of  the  abdomen,  and thus causing  the
 greater part of the affections of the womb with which
 women are so often affected.
   " The  use of corsets," says Hartlaub, " is very in-
 jurious to young  girls, and ought to be entirely pro-
 hibited, unless indeed, they are made so large as not
 to cause the  slightest pressure.  It is an error to sup-
 pose that  corsets  are necessary to sustain the mam-
 mae, and maintain the upper part of the body in a
 vertical  position.  Instead of this, they actually hin-
 der the breasts from taking  a  regular  conformation,
 and render them  soft and  flabby.  They impede  the
 action of the muscles, especially those  of the back,
 weaken them and render  them incapable of sustaining
 the  body  erect;  from  whence results, as  may be
 remarked in  the majority of women, the impossibility,
 without external support,  of holding the upper part
 of the body  in  a  proper position ; and  to nature  is
 attributed a fault,  produced by the means employed to
 correct her pretended imperfections.  An incontesta-
 ble proof  of  this truth is, that boys, who do not wear
 corsets, generally  stand  and walk with  more grace
 and  firmness  than  girls.  The want of exercise,
 however,  is not without  its influence  in  producing
 that relaxation of the muscles, which causes the bodies
 of many women to yield when their corsets have been
removed.   Finally, the whalebone placed in the back
of the corsets  to  sustain  the  eyelets,  twisting and
bending  little by  little, alternately in different direc- 
 94        Second Period  of Childhood.
 tions, produces an unequal  pressure, which joined to
 other causes, may contribute to produce a more or less
 considerable curvature of the spine."
   It is  beside, easily  understood, that corsets are
 the more injurious to young girls, in proportion as
 they  are delicate and  undeveloped.  We think, de-
 cidedly,  that if they must absolutely wear them, they
 ought  not at least to commence their use before the
 age of twelve or thirteen years.  And then, we has-
 ten to add, they must be worn loose and without a busk.
   In general, all kinds of pressure produced by dress,
 is injurious to the  health of children of either sex.
   It is then essential that  their clothes should  be
 large enough to allow the most entire freedom of move-
 ment.  They should be light without being cold, but it
 is especially important,  that  they  should not  be too
 warm.   To  cover children  unnecessarily,  with  the
 idea of avoiding cold, is just the way  to  provoke the
 evil it is intended to prevent; for they become more
 sensitive to changes  of  the  atmosphere, the less they
 are habituated to bear them,
   Beside, to surround  children  with excessive pre-
 cautions,  evinces  misconception  of their  destiny,
 and a lack  of proper foresight with respect to them.
 "A mother fails in her  mission," says Jean  Jacques
 Rousseau, "when she makes  an idol of her  child,—
 when she nurses his feebleness to prevent him from
feeling it, and, hoping to screen him from the laws of
nature, protects him from all  rude effects  and impres- 
           Second  Period of  Childhood.        95
sions, without thinking how, for the sake  of saving
him a few temporary inconveniences, she accumulates
future evils upon his head, and how barbarous a  pre-
caution it is to prolong the feebleness of the child, to
that period, when he must endure the fatigues of the
man.  Thetis, in order to render her son  invulnera-
ble, plunged him, says the fable, in the  waters of the
Styx.  This  allegory  is  clear  and beautiful.    The
cruel mothers of whom  I speak,  do  otherwise: by
plunging  their children into effeminacy, they prepare
suffering for them, and open the door to evils of every
kind, of which,  afterward, they do  not  fail to become
the prey."
  The author of Emile, one or two pages farther on,
adds:
  "Experience proves, that more of those  children
die, who are delicately reared, than  of  those who are
more exposed, and, provided one does not go beyond
their strength, we risk less  by  accustoming them to
the hardships  they are, in all probability, destined to
support at a later period.  It is well to harden their
bodies to the changes of the  seasons, the climates  and
the elements—to hunger, thirst and fatigue—to  dip
them in the waters of the  Styx.  Before the habits of
the body  are formed,  we can  give those  we  wish,
without danger; but when once fixed, change becomes
perilous."
  We perfectly  agree with  Rousseau in these opin-
ions.
        9 
96        Second Period of Childhood.
   After the quotations  we have made, it is  hardly
necessary for us to say  how  much importance  we
attach to  corporeal exercise, in the education of chil-
dren.  The open air and exercise are almost as indis-
pensable to them as the food they eat.
   Deprived of this double stimulant, all their functions
are deranged—they only half exist.  Their faces  be-
come thin;  they no longer eat, or  have capricious ap-
petites ; their fibers become relaxed, and their muscles
atrophied.  They become irritable, weak and coward-
ly, and the least effort overcomes them.  If,  at  the
same time that they are condemned to this deplorable
inaction, a constant effort is made to excite their young
minds, it may be that, for a time, these wiU gain, at
the expense of their bodies ; but not very long ; these
little prodigies, as they are called, will not live, or if
they live,  they will probably be but men of moderate
abilities.
   The sterile precocity of these unfortunate children,
resembles those insipid fruits, whose maturity is forced
by warming the roots of the tree which bears them.
   Let us remark beside, that the intellectual education
generally given to children, has, independently of  the
radical vice of being premature, the not less injurious
one  of perverting  the judgment, and  spoiling  the
character.   Instead of addressing  the  reason, little
beside  the memory  is cultivated; instead  of being
contented  to inculcate in them a love  of goodness,
for its own  sake, they are only excited by the van- 
          Second Period of Childhood.         97
ity of surpassing children  of their own age.  Hence
that fever of self-love with which we are inoculated in
our cradles, by the vanity of our parents ; a fatal and
tenacious fever, that no remedy can cure, whose par-
oxysms  every day renews, and which constitutes the
misery of mankind.   But this does not belong to our
subject.
  It does not require a great effort of intelligence to
comprehend the happy effects  of gymnastic exercises,
upon  the development of the  human  body.  It is a
truth  of such common observation, and so incontesta-
ble, that it would be  superfluous, to demonstrate it
here.  Those occupations which  exercise a part of the
body only, give to this part, as every one  knows, an
extraordinary  preponderance  of strength.   Every-
body has  remarked,  for  instance, the prominence of
the shoulders of bakers, who exercise daily the deltoid
muscles.  A  muscle of the fore-arm, called the pro-
nator radii teres, acquires almost  always in black-
smiths,  such a volume, that their profession has been
frequently recognized by this  sign alone.   Now what
partial  exercise  can effect for one muscle, general
exercise can do for the whole body.
   Among the ancients, Gymnastics were the founda-
tion of education.   The Spartans attributed  to this
cause, and with reason, their vigor, both of soul and
body.  Perhaps it  would  not be an exaggeration to
say, that it was to this also, that the Greeks owed, for
a long  time,  their independence. 
 98        Second Period  of Childhood.
   The tendency of modern  civilization has been, to
assign to Gymnastics but a secondary place in the
plan of education.
   Formerly,  the physical prevailed over  the  moral
man ; it  is so milch the contrary, in our days, that one
is tempted to believe, from the manner in which many
parents raise their children, that in the human duality
they consider the  body  as  the accessory part.  In
modern times, we  do for our animals, precisely wdiat
the Greeks did for  their children.  The cattle-breeders
of Perche, of Normandy, and of Yorkshire, seem alone
to have  profited  by  the example of the Spartans;
but does it not seem  a strange mockery, in view of
the prodigies effected  by training upon cattle and
horses, that  no  effort  is  yet  made, by  anthropolo-
gists,  in  favor of the physical amelioration of the
human race!
  Nevertheless,  let us be  just.  England has  her
boxers, as the Peloponnesus had its wrestlers.   This
savage passion of the English  for pugilism, has  it not
its good  side, and  may not  the human training, me-
thodically practiced in London, for a detestable pur-
pose, be destined,  in changing its object, to introduce
certain rules  of hygiene into our habits, whose bene-
fits it  will be almost impossible properly to appre-
ciate \
  A professor of  the Faculty  of Medicine of Paris,
M. Hyppolite Royer-Collard,  published a few years
since, a memoir on this subject, full of interest. 
          Second Period of Childhood.         99
  The English boxers, before their appearance in the
ring to  fight, as  formerly the  gladiators  of Rome,
or the beasts of the circus, are subjected for several
months,  to  a regimen  of which the effect is to  re-
move every trace of adipose matter, and replace the
fat witb muscular fiber.   They are, in a word, trained
exactly like race-horses.
  Experience proves, and this is  the important part
of the matter, that this regimen produces no  inconve-
nience, but  triples  the strength, and  consolidates the
health.   Here is then, for the  hygienic physician, a
grave subject  for meditation, and M. Royer-CoUard,
has treated it with  all the gravity it  deserves.
  It is not impossible that, when a few years' experi-
ence shall have extended our notions, yet too vague on
this interesting subject, we may be  tempted  to treat
of it  somewhat more at length than at present. 
100
Onanism.
                 CHAPTER VIII.

                    ONANISM.

  Onanism is the saddest abuse man can make of his
body.   It is,  par excellence,  the shameful vice, the
vice of feeble  souls ; a  sort of negative passion, in
which all other passions are extinguished.  Shame to
the man who abandons  himself to  it!  Woe to the
poor child who is, through neglect, permitted  to con-
tract it!
  " It is toward the twelfth or thirteenth year," says
Hartlaub, " that  the sensual instinct  is awakened."
This assertion would undoubtedly be true, if man was
always  born and developed in the normal conditions
of  his  original nature.   But it rarely so  happens.
Civilization depraves his mind and his senses,  and but
too often gives him an  unfortunate precocity, which
some are foolish  enough to admire, because they see
its  advantages, without discovering its dangers.
   There is a multitude of children, of both sexes, who
are liable to contract this habit at the age of five, four,
or  even three years.
   This incomprehensible and fatal sensuality does not,
assuredly, proceed in children from a depraved moral
state ;  but is the symptom of an unhealthy surexcita- 
Onanism.
101
tion, whose sad effects  often survive their cause, and
seldom fail to become habitual, if not promptly re-
medied .
   Let us observe, nevertheless, that independently of
all accidental or pathological cause, there are children
prematurely impelled to sexual excesses, by a congen-
ital vice in  their nervous system.
   Gall's system, verified  upon  this subject by innu-
merable facts,  may  serve here as  a guide.*  The
children of  whom we speak, have the occiput  promi-
nent, and  the  cerebellum manifests,  by two large
protuberances situated immediately above the nape of
the neck, its relative  preponderance in the encephalic
mass.  It is unnecessary to say that these  chHdren
require a special surveiUance.
   Volumes  have been  published upon  the  physical
and  moral results of  onanism.  The truth is,  that it
alone makes greater ravages in the economy than all
the other  passions together.  It is  the scourge of in-
fancy.   Like the foul worm, which devours and cor-
rupts the  fruit  before  its maturity, it  exhausts the
sources  of life, frustrates  all its manifestations, and
secretly consumes, without giving  them time  to act,
all the springs of the human organism.
   We shall rapidly  indicate the signs of this deplora-
ble monomania ;  after which, we shall point out the
means  of combating it.
  * According to Gall, the cerebellum is the seat of the sensual in-
stincts. 
102
Onanism.
  The first sentiment that this species of sensuality
awakens in children, is a  sort of bashfulness, incom-
patible with  the  innocence natural  to their  age.
Bashfulness, in fact, springs from a more or  less defi-
nite  notion of sexual indulgence.  It is the fig-leaf
with which Eve, after her fall, covered her nakedness.
The  bashfulness of a chUd of ten years is always sus-
picious.
  But this sign alone should not be considered suffi-
cient to  determine the judgment  of the   observer,
unless corroborated by observations of a  different
kind.
  Children who are so unfortunate as to acquire this
habit, carry in their external appearance, as well  as
in their character,  certain characteristic features.
  They are commonly  pale  and thin ; their  drooping
eyes  are surrounded by a bluish  circle; there  is an
uncertainty in their look, which seems to fear the ob-
servation  of those  around them ;  they are feeble,
cacochymic, chilly,  apathetic.   Everything fatigues
them ; or rather, they are  always fatigued.  The least
movement makes  them perspire,  and puts them out
of breath; they dread  play as much as study.
  They,  nevertheless,  eat a great deal; and one is
astonished to see so much nourishment profit them  so
little.  Sometimes, on  the contrary, they lose all ap-
petite, or have only capricious tastes.
  Their character  is unequal, irritable, sullen.   They
are  abstracted, taciturn ; disposed  to weep ;  indiffer- 
Onanism.
103
ent and susceptible.  The necessity of concealing a
vice,  of which  they have the consciousness much
sooner than one would believe, and of which they fear
to be suspected, renders them timid to excess, dissim-
ulating, and false.
  Their intellectual faculties suffer from the debility
of their bodies.   They are abstracted, and incapable
of continued  attention  to  anything whatever.  They
are accused of being indolent, and they are so, in fact;
but their  indolence is  caused by  exhaustion.   The
memory soon  suffers, and to learn anything by heart
is beyond  their  strength.  If an attempt is made to
compel them, their useless efforts only end in complete
discouragement.   If they are punished, they resent it,
and finish  by  hating their masters, their parents, and
all human kind.
  Thus years pass  away, years of misery  and tears,
leaving after  them  but bitter regrets and remorse.
Then comes adolescence ;  the child  becomes  a man.
Reason in him strives to master instinct; but whether
it succeeds or not, it is too late: the evil is done ; a
debilitated  body, blunted  senses,  an uncultivated
mind,  a blighted  soul—such  are  the  fatal conse-
quences of a childhood polluted with onanism.
  The unfortunate children  infected with  this  pest,
seek solitude, particularly  avoiding the society of
children of their own  age, whose presence disturbs,
embarrasses, and humiliates them, if they believe them
pure.   They only approach those in  whom they have 
104                  Onanism.
discovered  the  same shameful  sensuality which de-
vours themselves ;  but to these they readily attach
themselves.   Such is, in fact, the nature of the human
soul, that  it  feels itself incomplete in isolation,  and
even in its turpitude seeks sympathy.
  The choice of  associates for  children, is, then, one
of the principal points to which maternal solicitude
should be  directed. Vice has its affinities and its
masters, and this is one of those which is communi-
cated, and the gangrene with which it inoculates, soon
extends to the heart.
  This vice is  often the unknown cause of a throng
of chronic affections.
  Like all other disturbances of the nervous appara-
tus, it enfeebles the senses, confuses the mental facul-
ties, and even, in some  cases,  produces softening of
the brain.   St. Yitus's dance, epilepsy, idiocy, in-
sanity, and spleen,  are the immediate and much more
frequent effects than is generally believed.
   As for the secondary phenomena to which it  may
give rise, they  comprehend all the diseases commonly
referred, by homceopathic physicians,  exclusively to
psora, of which it  must always be a  powerful auxil-
iary.  For  example, it  undoubtedly  accelerates  the
development of  pulmonary  phthisis,  if it  is  not in
many cases  the first and generating cause of tuber-
cles.
   But if onanism should occupy  an  important place
in  the etiology of morbid  affections, it is not  very 
Onanism.
105
seldom, that it, in its turn, is the result of a pre-exist-
ent disease.   It is, in  fact, well known, that  the
presence of worms in the intestinal tube, and espe-
cially of ascarides  in the rectum, often occasions in
little  girls  a vaginal  discharge,  accompanied by a
slight itching, which may reveal to them the secret of
sensations  that they would  not otherwise have sus-
pected.
   These discharges, which are sometimes produced by
onanism itself, are also often caused by pathological
states very different from the verminous affections.
   We shall necessarily allude again to this subject in
treating, in the second part of this little work, of the
chronic diseases of children, and we  shall then point
out the  cases in which  onanism,  as  a  secondary and
purely  symptomatic  phenomenon, commonly yields
with the disease which caused it, to the  medicines in-
dicated.
   We shall,  then, at present, only occupy ourselves
with  idiopathic onanism, if we  may so  speak, and
with the hygienic  and  moral means to be employed
for its cure.
   There  is no  particular diet for otherwise  healthy
children, addicted  to  this vice.   The regimen which
they  should  follow, is  that which is suitable for aU
children of their age.   But  it is  important that this
 regimen should be rigorously imposed.
   Spices, venison, salted or smoked  meat, all  highly-
 flavored dishes, are especially injurious to them. 
106                  Onanism.
   Pepper is a poison we should be glad to see forever
disappear from our culinary preparations.  It is suffi-
cient to read  the  pathogenesis of pepper to  become
convinced of the dangers to which this condiment ex-
poses one, and of the daily abuse which is made of it.
Children should be completely ignorant of its flavor.
   We  extend the  same proscription to  all  spiritous
drinks, and especially to pure wine, which is sometimes
given to little boys, and  even to Httle girls, under  the
insane pretext of fortifying the stomach.  Pure wine,
like all other alcoholic  drinks, momentarily increases
the action of the vital forces, in  accelerating the cir-
culation;  but this factitious  excitation is  always
ephemeral, and the  depression  which follows suffi-
ciently proves, that what a  superficial  observation
takes for an increase of strength, is really but a use-
less vitiation of the principle of life.
   There  is  another  substance  in  general, almost
universal, use, of which fashion has made an aliment,
in spite of reason, and whose effect is, unhappily,  not
less pernicious to   children  than  that of pepper and
alcohol:  we allude to coffee.
   Hahnemann,  in  1803, published  an interesting
memoir upon the effects  of coffee.  It is, as one may
say, a  formal indictment of  this  pleasant beverage.
But while dissenting from what we consider the exag-
gerations  of  Hahnemann—exaggerations which  he
himself admitted  thirty years later—we venture  to
affirm, upon the testimony of our own experience, that 
Onanism.
107
the daily use of coffee is the cause of a throng of dis-
eases.   Leucorrhoea  in  women ; impotence in men—
that infirmity so frequent and so  premature in  our
day—nine times in ten  has no other cause.
  Coffee is  one of the special excitants of the genital
organs, and the disturbance it  produces is  so  much
the more dangerous, as the imagination partakes of it.
Coffee  is, therefore, a  real  poison for those already
inclined to onanism.
  There are,  nevertheless, many families,  especially
in the provinces, where coffee is habitually given to
children with their breakfast!
  Among the products  of  the soil of which the  artifi-
cial taste of modern society has made  eatables, there
are many substances equally objectionable with  those
we have just proscribed :  such as horse-radish,  black
radish, celery,  garlic, juniper, parsley, water-cresses,
angelica, and, generally, all aromatic plants.
   We  do not pretend  here  to  decide  whether  these
vegetables really are, or are not, alimentary substances
which  an adult may use with impunity ; but what we
do  insist upon  is, that they are positively  unwhole-
Bome for children, and  especially pernicious for those
to whom this chapter more particularly refers.
   " These  children," says Hartlaub,  " should sleep
upon hair mattresses, and not upon feather-beds  ; they
should be lightly covered, and they should not be per-
mitted to eat too late, as digestion, when taking place
during sleep,  exerts an influence  upon  the sexual 
108
Onanism.
organs,  which occasions voluptuous  dreams."  They
should also be ligbtly dressed, and should take enough
exercise during  the  day, to insure them a  tranquil
sleep, undisturbed  by the phantoms of the imagina-
tion.
  Some physicians have promised themselves great
results from mechanical contrivances, for the remedy
of this evil, such  as night-gowns, with long sleeves
tied  over  the hands, and fixed upon  the breast by
means of a handkerchief across the shoulders.   These
coercive expedients inspire  us with but little confi-
dence.  They may, however, be useful  for very young
chHdren, for those  who are so confirmed as to pollute
themselves during sleep,  and,  in  short, for those in
whom this practice has already produced imbeciHty.
  The others have the consciousness, if not of the in-
injury they are doing  themselves, at least of the
reprehensible nature  of the act, since they are ashamed
of it.
  Let parents, then, not hesitate to put an end to the
matter at  once,  by entering openly upon an  expla-
nation with them.  It is, undoubtedly, a delicate sub-
ject,  and  difficult  to treat judiciously; but explana-
tions  are indispensable.
  It is necessary to proceed with tact,  and, above all,
with  calmness.  Threats  and severity would be un-
seasonable ; they would only, in a majority of cases,
alienate confidence forever, and substitute hypocrisy.
Let one be content, then, to represent to the child, in 
Onanism.
109
a forcible manner, but without anger or bitterness, the
real evils sure to result from this  shameful practice,
and to trust to the salutary impression which this can
hardly fail to make upon his mind, if the admonition
is made in a suitable manner,  and  at a proper time.
  It is understood, however, that vigilance should not
stop here, blindly trusting to a promise of future good
conduct, a promise which the strength  of habit may
so soon cause to be forgotten.
  Masters, servants even, if they are worthy and ca-
pable of playing such  a part, should be taken into
confidence.  A complete system of surveillance should
surround the  child, night and day, enveloping him
like a net-work, even in his most secret acts.
  Solitude and idleness being for him beset with dan-
ger, he should never be allowed to be either  alone or
idle ; he should be removed from the influence of bad
example, of bad books, but especially of bad society.
   The best  possible means would be to create an occu-
pation for him which would be sufficiently attractive
to excite  a real passion ; for a new passion is the
surest means of extinguishing an old one.
  To counterbalance one faculty by another—to extin-
guish the bad by calling forth the good—such is the
general plan of all good systems of education. 
110              Regimen  During
                 CHAPTER  IX.

     regimen during homoeopathic treatment.

   Allopathic  physicians, and those who echo their
sentiments, are accustomed to say that Homoeopathy
is but a sort of me'decine expectante; that is to say, a
do-nothing system, and only cures diseases by means
of the regimen imposed.
   This  common-place, which  does  not  deserve  a
serious refutation, proves but one thing;—the absolute
ignorance of those, who repeat it, touching the prin-
ciples of the Hahnemannian doctrine, and the marvel-
ous efficacy of the infinitesimals.
  We  are a little curious to learn, in fact, by what
singular privilege it is, that the diet prescribed by
homoeopathic  physicians,  instead of the 6ame diet
prescribed by their adversaries, should have the incon-
ceivable virtue of curing croup, meningitis, scarlatina,
and many other acute diseases which, under the expe-
ditious lancet of  the physiological school, prove so
frequently, and so promptly fatal.   Are the detractors
of Homoeopathy then sincere, in thus interpreting its
success?   If so, it  must be admitted, that medical
rationalism, is still more absurd in its polemics than
in its theories. 
            Homceopathic Treatment.          Ill
  It is true, (and so far from denying, we proclaim it)
that Homoeopathy has, better  than any other school,
appreciated, and given reasons for the importance of
diet.   She  could  not then,  without inconsistency,
refuse  the aid of  an  auxiliary whose power she so
well understood.
  But nothing could be more unjust, than to attribute
her cures to any regimen whatever.  Patients affected
with chronic diseases, which nature alone never cures,
are seen every day to recover under the influence of
the infinitesimals,  without having confined themselves
at all, to any particular diet.
  I admit, however, that these cases ought to be con-
sidered as  exceptional, and nothing  is more easy to
understand.
   In fact, in order that a remedy should act with cer-
tainty in the  sphere of its specificity, it is clear that
its operation should not  be disturbed by the intercur-
rent action  of other medicinal agents; and this is  so
much  the  more evident, from the fact, that it is not
impossible  that among these, might be found precisely
the antidote to the medicine  administered, and upon
which the  physician  founded his hopes  of success;
 and what can be expected from a medicine constantly
 neutralized?
   But supposing even that this neutralization does not
 take place, is it probable that several medicinal agents
 would act  simultaneously in the economy with  as
 much certainty, as if each one operated alone ?  Un-
         10 
112
Regimen During
doubtedly  not,  and, from  the instant that it was
proved  by observation  and  experiments, that  tea,
coffee, acids, and  dentifrices, such as l'eau-de-Botot,
and in a word, all  odoriferous substances, are medici-
nal, we  are logical in absolutely proscribing them.
  Let us add, nevertheless, that if for a long time the
patient  has  been  habituated,  and  without  sensible
inconvenience, to the use of some one of these sub-
stances, the physician may, in particular cases, be less
rigid.   Hahnemann, for example, wiUingly  tolerated
in his patients  the use of the pipe, and I, for myself,
believe that the use of an infusion of  black tea, when
the patient is accustomed to it, is not  injurious in the
treatment of chronic disease.  But this toleration can
never, in any case, be extended to coffee, perfumes, or
dentifrices.
  The character of the disease, the  temperament of
the patient, and especially the nature of the  medicine
prescribed, should determine the physician with regard
to the severity of  the regimen  to be observed.   An
excess of rigor, when one does not fear  to discourage the
patient, is preferable, in  general, to the opposite course.
  Tranquillity of mind,  is a condition not  less  im-
portant to the normal action of remedies, than  absti
nence from prohibited food.
  It  is  difficult to  realize  how  great  an  influence
mental  emotions  exert upon the course of diseases;
they may derange  the action of the  medicines  com-
pletely. 
            Homoeopathic Treatment.         , 113
  A hundred  times, in experimenting  upon  myself
with substances whose pathogenesis I was studying, I
have  remarked  the entire, instantaneous and  final
disappearance of the most marked symptoms in conse-
quence of some surprise, a disagreeable  accident, or
any lively emotion.
  The ardent and  sensitive minds of children, expose
them still more than  adults to shocks from  sudden
and violent  external impressions, and they should be
as much as possible protected from them, as well as
from aU useless irritation.
  As to the quantity of food that they may be per-
mitted to take  in the course of a disease, we may
easily conceive that it depends entirely upon  circum-
stances.   All that can be  said in this respect is, that
with  the exception  of  cases of very  acute  inflam-
mation, Homoeopathy is opposed to dieting; that is to
say, to that absolute abstinence  which has so  often,
with the aid of venesection, conducted  the victims of
 Broussaisism to the grave.
   A few practical indications concerning the drinks
to be allowed when the patient suffers from thirst, as
is the case in all fevers,  will finish this chapter.
   Everybody has  remarked  that, upon  this  point,
Allopathy is  not  over scrupulous.  Citric and even
Bulphuric lemonades, infusions of linden, chamomile,
wild  poppy, hops, etc., decoctions  of dog-grass, bur-
dock,  and sarsaparilla, solutions of carbonate,  or of
tartrate of soda, etc., etc., are, for the physician of the 
114 Regimen During Homcsopathic Treatment.
Old  School, so many soothing  drinks, that he pre-
scribes at hazard, without expecting from them any
effect, and without attaching the least importance to
whether the patient takes one in preference to another.
  With us Homceopathists, it is different; the greater
part of infusions  and diet-drinks, far from seeming
insignificant, have, in our eyes,  the serious objection
of being  medicines.   They  are consequently indis-
criminately stricken out from our therapeutics.
  The only drinks we tolerate, are those which quench
the thirst, without being displeasing to the taste,
such  as slightly sweetened water, toast water, and a
decoction of dates, of jujube, or  of raisins.
  Everybody  knows   how  to  prepare toast water;
throw a few tumblers of boiling  water upon a slice of
toasted bread, add a little sugar, and cool for use;
such is the recipe for  making it.
  As  for the decoctions of dried- fruits, it is super-
fluous to say how they are prepared.  It  is important
that they be not too strong.   Those of Malaga raisins
generally please children.
  Drinks should be  taken of the temperature of the
apartment, in  chronic  diseases; and tepid, but not
warm, in the majority of acute affections.  It is desir-
able that they should satisfy thirst without producing
other sensations. 
PART  II.
DISEASES   OF   CHILDREN.
  Children are exposed to the greater  part of the
diseases which attack  adults.   There are, however, a
certain number which are peculiar to them, or which
assume in them  a gravity that they have not at a
more  advanced age.  These last will naturally form
the special object of our attention.   As  to the order
which I propose to follow in their description, I con-
fess it is almost arbitrary.  I have said,  in my Intro-
duction, that a philosophical classification  of diseases is
not yet possible.  I shall, therefore, content  myself
with grouping those of which I shall give the history,
according to the sensible analogies of their prominent
symptoms.  This mode of proceeding, vicious without
doubt, in this, that it brings together, upon the faith
of  physical notions, sometimes  illusory,  affections
probably very dissimilar in their essence, is without
inconvenience, from the moment we admit it as purely
conventional.
                                       (115) 
116
acute exanthemata.
       DISEASES  OF  THE  SKIN.

  The generic name, exanthemata, is given to all dis-
eases of the skin.  A  very small number of these
exanthemata result from  an irritating  action,  exer-
cised upon the cutaneous envelope:  the greater part
are only the apparent symptoms of miasmatic affec-
tions diffused in the economy.
  The  means employed by the Old School to  combat
these  exanthemata are generaHy pitiable  and some-
times  monstrous.  I shall not stop to describe them;
but, I do not hesitate to attribute to them a great part
of the incurable diseases and infirmities, which we so
often meet with in old people, and even in  individuals
still in the flower of their age.
            ACUTE  EXANTHEMATA.
                  erythema.
  This name is given to the partial and circumscribed
redness of the skin, caused either by  the  constant
attrition of two contiguous surfaces, or the contact of
acrid or irritating matter, such as urine, perspiration,
and even faecal  matter,  when  in  nursing  children
these are not promptly removed; it is also caused by
exposure to the sun.
  In the former instances, the erythema has received
more especially the name of intertrigo.  It is observed
most frequently in the  arm-pits, between  the thighs,
on the  neck, at the anus and in the groins.  It is often 
Erythema.
117
accompanied by an albuminous secretion of a disa-
greeable odor ; but sometimes also, the affected places
are dry, and are  then attended by the production  of
scales or scabs.
  Frequent lotions of  tepid  water,  almost  always
suffice to  prevent and to cure  this  species of ery-
thema ; if  this,  however,  is ineffectual, we  should
have  recourse to medicine, and  that which deserves
the preference, is chamomilla.
  The efficacy of chamomilla, in this case, is proved
by the frequent result of the abuse which is made of
it.  Nothing is  more  common  than  to  see  in little
children, an intertrigo come on after they or their nurses
have  taken an infusion of the  flowers of this plant.
The  natural remedy then is, the antidote  of chamo-
milla, that  is to say,  ignatia  and pidsatilla, taken
alternately  in small doses at short intervals.
  Mercurhcs sol., thirtieth dilution,  a  few globules
in a  glass of water, taken by teaspoonfuls, every six
hours, would suit  in a case where  the intertrigo is
very painful, and the parts affected are raw.
  The erythema caused by insolation, is commonly
manifested  on the face, neck and hands;  that is to
say,  on the parts most  commonly exposed to the sun.
The  redness in  which  it consists, turns readily to a
copper brown or purple, and  is accompanied by  an
intense burning.  Abandoned  to  itself, this affec-
tion  lasts  two or three days, and terminates by  de-
squamation of the epidermis.   It is  not dangerous; 
118
Acute Exanthemata.
it is, however, of sufficient importance to be treated,
especially when  seated  upon the face  or scalp.   We
have seen it, in  this last case, occasion delirium, and
all the symptoms of meningitis, and this disagreeable
complication  sometimes develops itself  before  any
remarkable redness of the skin has been observed—a
circumstance to  which we would  call the attention of
physicians.
  Rhus  toxicodendron, of a  medium  dilution, in
repeated doses, is the specific for erythema  produced
by insolation.
                    c RAC KS.
  Cracks in young children have the same cause, and
call for the same treatment as intertrigo.   Mercurius
sol., when they are very painful, and Pulsatilla, when
we may attribute the febrile state, which accompanies
them, to the use  of lycopodium, with which they may
have been powdered.

                    burns .
  As this disease, or rather the affection produced by
it, is not more common to childhood than to any other
age, we shall not give   the subject the extension it
would  admit of in a  treatise  upon surgery.   That
which especially  characterizes  the species  of disorga-
nization caused by burns, however slight, is the intense
pain, which accompanies  it, and  the  slowness with
which this disorganization is repaired ;  but it must be
observed also, that the various modes of treatment 
Burns.
119
adopted by Allopathy for  these  accidents,  contribute
not a little to their gravity and  to the persistence of
their effects.
  I have already pointed out, in my Introduction, the
objection to immersion in cold water.  I return to this
point, for it is of the first importance, and comprises
in itself the whole spirit of the Old School.  Whether
the burn has caused only erythematous redness of the
skin,  or  has produced phlyctsena, or destroyed the
whole  thickness  of the cutaneous membrane, I pro-
nounce, in all these divers cases, cold applications an
error.
  As to  astringent or acidulated  lotions, compresses
or pledgets saturated with lead  or opiate  ointments,
etc., I have seen  them  employed a thousand times
without any decided advantage.
   The only local application of which  I  recommend
the use, is a layer of cotton moistened with sweet oil
of almonds, renewed twice a day.
   In a case, however, where the falling off of the blister
has exposed a large surface of the true skin, it is better
to apply the oiled  cotton mediately, that is to  say,
over a compress of fine linen perforated and saturated
with cold cream prepared without the essence of roses.
   The homoeopathic treatment of burns is very simple
and  comprehends,  complications  excepted,  but two
medicines; rhus  toxicodendron and  tinctura  sul-
phuris.
   Rhus should be administered from the beginning,
      11 
120
Acute Exanthemata.
every three hours, from the sixth to the twelfth dilu
tion; from six  to  eight globules,  or  a drop to four
ounces of vehicle.   This medicine will suffice in cases
of erythema and of phlyctsena.
  Its employment should be followed by that of tine-
tura sulphuris  when, the first  pains  being relieved,
and the disorganization being more profound, it is im-
portant to hasten  the  cicatrization.   Tinclura sul-
phuris is commonly administered, of the thirtieth di-
lution.  The doses, repeated at first two or three times
a day, should be given less frequently,  as the affection
approaches its termination.

                 fro st-bi te s .
  The effects upon organized tissues, of rapid addition
to, or abstraction of caloric from, a part, is attended,
under  these  two opposite  circumstances, by identical
results; thus  there exists between burns and frost-bites,
in their different degrees,  the most striking analogy.
  If, in ordinary cases,  the symptoms of both are not
absolutely the same, it is only because  the cold, which
causes the latter, does  not act  as  instantaneously  as
the artificial heat,  which  produces the former;  they
are in reality the same disease, under a form more  or
less acute, and the same treatment applies to both.
  It has been recommended to employ rhus externally
for frost-bites; in other words, to foment, with the tinc-
ture  of this plant, the congealed parts.   We are little
in favor, generally,  of  external applications, and we 
STINGS.
121
are the more disposed to believe ourselves in the right
in discarding them  in  this case, as, most frequently,
frost-bites depend  much less upon the violence of the
cold to which the  individual has been exposed,  than
upon a  general disposition  of the economy to suffer
from its effects; a tendency which should be combated
by general means.
  Beside, rhus taken internally, almost always proves
so promptly, and sometimes  so marvelously efficacious,
that we  do  not see wh\  one should  seek any other
mode of administration.
  We prescribe it at from the twelfth to the  fifteenth
dilution, once or twice a  day, taking  care to discon-
tinue its use, as soon as the itching of the chilblains
disappears, and their redness begins to abate.
   Sulphur is recommended for frost-bites that  have
ulcerated, and passed as it were, into a chronic state.
   Chilblains are very often the sign  of a debilitated
state of the health; of an impoverished blood ;  in  a
word, of a languishing vitality.  It is for the physi-
cian to ascertain the cause  and the  nature  of  this
cachexia, and apply the proper remedy.

                    STINGS.
   The sting of a gnat, or even  of a bee, is certainly
not a very serious  evil;  but it is nevertheless some-
times very inconvenient, and the homceopathic means
of treating them,  recommended up to this time, are
very insufficient, not  to say absolutely inefficacious. 
122            Acute Exanthemata.
We are glad then to be able to point out, for the stings
of all  kinds  of insects,  a medicine whose  curative
effect  is produced  in a few minutes, often in a few
seconds: it is ledum palustre, taken  internally,—a
teaspoonful of a glass of water, in which are dissolved
seven or eight globules of the fifteenth dilution.  In
case of a sting of the wasp or bee,  the dose should be
a little stronger, and repeated several times.*

                   ERYSIPELAS.
   Erysipelas is one of  the  cutaneous affections, with
which children are the most frequently attacked.
   In very  young children, it often succeeds erythema,
and then only appears  to be  an aggravation of  that
disease; most commonly, however, it assumes at the
commencement its  own character,  without  passing
through the erythematous form,  and  acquires in a
very few days, a  high  degree of  intensity.   In this
case  it is  preceded by fever,  with somnolence  and
constipation, or bilious  diarrhea.
   It is to be remarked,  that the disturbance in the di-
gestive organs which accompanies erysipelas in  chil-
dren, manifests itself rather in the intestines than  in
the stomach.  It is the contrary with adults.
  » This  remarkable  specificity of  ledum, induces me to believe,
that it might succeed against  the bite of venomous reptiles. One of
my friends, a planter of Martinique, has offered to try it upon ani
mals that he would cause to be bitten by the viper. I shall be happy
to be able to  report the success of these experiments in another edi
tion of this work. 
Erysipelas.
123
  The fever  of incubation, lasts from  two to  three
days, and habitually disappears on the appearance of
the eruption;  it  nevertheless,  in very  serious cases,
persists after the appearance of the cutaneous affection,
and sometimes assumes an ataxic character.
  That portion of the skin affected by  erysipelas  is
red,  tense,  slightly  swollen, shining, hot and very
painful; it becomes white, under the pressure of the
finger, but resumes its red color, the moment that the
pressure ceases.
  Unlike what takes place in adults,  erysipelas  in
chHdren manifests itself less frequently on the face
than on the trunk and limbs.   In the newly born we
frequently see it commence at  the umbilicus, and
spread little by little over the whole abdomen.   One
of its peculiarities, is a remarkable  tendency to  move
from place to place; it sometimes,  as it were, jumps
from one part to another, disappearing, from its for-
mer situation, at  the instant it  appears in a new one.
Its ordinary duration, When left to  itself, is from six
to ten days.
  Erysipelas is said  to be simple when it occupies
only the superficial layer of the skin ; vesicular, when
it is accompanied by  the  elevation of  the cuticle  in
watery  blisters;  phlegmonous, when  it  affects the
whole thickness of the skin, and determines the forma-
tion  of abscesses in the subcutaneous cellular tissue.
  Erysipelas is always, in children, a serious disease;
that  of the face especially, readily extends to the 
124
Acute Exanthemata.
brain, if not promptly and properly treated.  It is
more  serious in very young children than  in  those
more advanced.   Its  different modes of termination
are desquamation, induration, suppuration and gan-
grene.
  Treatment.—A great number of medicines  have
been employed, and extolled for the treatment of ery-
sipelas, such as aconite, bryon., acid, phos., bellad.,
calcar., sulphur, pulsat., etc.  In order to avoid con-
fusion in the minds of our readers, we shall content
ourselves with pointing out the medicinal substances,
which, according to the circumstances, deserve most
confidence.   These substances are in the order of their
importance,  rhus  toxic, bellad., bryon., pulsat.,
sulph., and arsenic.
  Rhus is  the remedy par exceUence for erysipelas.
It is proper in almost all cases.
  Belladonna is called for by a complication of high
fever with delirium or extreme agitation.
  Bryonia corresponds to erysipelas of the articu-
lations, with considerable aggravation of the symptoms
upon the least movement
  Pulsatilla should be given  in erratic erysipelas;
that is to say, when it  manifests a great tendency to
move from place  to place.
  Sulphur  should be rarely used at the commence-
ment.   It  is appropriate only in  infants of a feeble
constitution, or in cases where the disease terminates
by suppuration. 
Zona — Shingles.
125
  Arsenic, indicated especially by hectic fever, or by
a fever of bad  character, is particularly adapted  to
erysipelatous inflammation of the scrotum,  pecuHar to
chimney-sweepers, and which has a great tendency to
degenerate into gangrene.
  Erysipelas does  not  require  absolute  abstinence
from food, except during its febrile period; it is better,
however, that the patient should eat but little until
after the disappearance of the eruption.  Toast water
is, as in all acute diseases, the  drink which should be
preferred, if the patient is thirsty.  It may be taken
at the ordinary temperature.
  As to cataplasms so called, emollient fomentations,
or local applications of any kind, we attach no import-
ance to them.   A layer of cotton, saturated with  oil
of  sweet  almonds,  such as we  have recommended
for  burns, is  the only one which  appears to us admis-
sible.
                 ZONA — SHINGLES.
  Zona or  Zoster, very much resembles  erysipelas.
It is  an exanthem forming, ordinarily, a semicircular
band, of a hand's width, around  the body or a limb.
The eruption is very burning, itching and lancinating.
It is  composed of little pustules upon an inflamed
surface and is accompanied with  fever.
  Zona is a disease which is very rare in  early infancy.
Its  treatment does  not differ essentially  from  that  of
erysipelas.  (Mercury is its specific.  Ed. 2d edit.) 
126
Acute Exanthemata.
                    PEMPHIGUS.
  Pemphigus, is  characterized by the  development,
upon various parts of the body, of erythematous spots,
upon the surface of which soon appear blisters, which
burst  and  discharge a  viscous, yellow fluid, which
hardens and forms  on the surface of the skin, a not
very prominent crust, often granulated, and yellowish
like honey, or inclining to a fawn color.
  This eruption is  sometimes accompanied by fever,
and is sometimes without it.   It is most frequently of
short  duration ; but occasionally, also, it shows itself
extremely persistent.  I have seen it manifest itseH'
almost  instantaneously in  consequence of fright.  I
have  twice  had occasion to  observe it in a  chronic
form.   Rhus, is its specific.

             URTICARIA, OR  NETTLE-RASH.
  This exanthem, the most ephemeral of all, manifests
itself  under  the form of lenticular vesicles, precisely
similar  to those which result from  the sting of the
nettle, and is accompanied by a similar sensation.
  This eruption, sometimes persistent in adults, never
lasts  more than a  few hours in children.  It disap-
pears instantly after a single dose of croton tiglium.

               FURUNCLES,  OR BOILS.
  A boil consists in a small, red and  circumscribed
elevation of the skin, accompanied by smarting, itch
ing,  and  afterward by  burning; a swelling is de- 
                     Measles.                  127
 veloped  around it;  the  redness changes to a brown
 color, and upon looking closely, a yellow point is per-
 ceived in the middle, which when it approaches its
 termination, breaks and  discharges a lump of thick
 pus, called the core.   The pain,  until then intense,
 and often even accompanied by fever, soon  ceases.
   When the boil is large, and the sloughs numerous and
 confluent, the disease receives the name of  carbuncle.
   Boils and carbuncles are almost always  coincident
 with a more or less marked derangement of the diges-
 tive organs.
   Treatment.—Cina, from the ninth to the fifteenth
 dilution, two drops in  four ounces of vehicle, admin-
 istered three or four times a clay, until resolution takes
 place.
   Dulcamara  and sulphur are sometimes  necessary,
 in cases where the periodical  reproduction  of boils
 gives reason to suppose the existence of a  particular
 diathesis ; but cina, even in this last case, will almost
 always  suffice.  It may,  however, be necessary  to
 have recourse to rhus, in cases where the  boils  are
complicated with erysipelas.  Lastly, ledum palustre
is preferable to any other medicine, when the disease
 appears upon the feet or upon the fingers.

                   measles .
  Among  affections  of an incontestably  miasmatic
nature,  measles figures as  one  of a  type  the  most
known and best characterized. 
 128          Acute Exanthemata.
   It seldom  attacks the same individual  twice, and
 appears  epidemically, more especially in the spring
 and autumn.  Although neither adults nor old people
 are exempt from it, it is, with reason, considered as
 one of the diseases peculiar to children.
   According to Rosen,  the virus  of measles, which
 impregnates the body and the clothes of the individ-
 uals whom it  attacks, does  not pervade the atmos-
 phere ;  so that during the course of an epidemic, one
 can be sure, by absolute separation, of protecting chHd-
 ren from infection.  Unfortunately, this  opinion ap-
 pears to  us ill-founded.
   Measles is commonly  a mild disease, but it some-
 times, however, assumes  such malignity as to  prove
 fatal in  a majority of cases.   This is why the ancients
 called it  morbilli ', that is to say, little plague ; but it
 may be affirmed without  exaggeration, that the disco-
 very of  Homoeopathy has  reduced to  one-tenth, the
danger from the most serious epidemics of measles.
   This  disease  presents three distinct periods: the
catarrhal, the eruptive, and the period of  resolution.
We shall point out the  symptoms which characterize
each of  these.
   Catarrhal period.  This generally lasts three days,
but occasionally longer.  It commences by prolonged
chills, which are  soon followed  by febrile reaction.
From the second  day the fever  becomes continuous.
There is  redness, heat and painful sensibility of the
eyes,  with dread of light, and  partially closed and 
Measles.
129
swollen lids, lachrymation, frequent sneezing, coryza,
headache, and  dry,  short  cough,  with pain in  the
throat, chest and loins;  vomiting, sometimes in the
day, sometimes in the night; white,  moist  tongue,
thirst, disgust for food, colic, relaxation of the bowels,
anxiety,  chagrin,  and sometimes  continual  drowsi-
ness ; such are  the symptoms which precede the cuta-
neous eruption, but  which do not disappear as  in
variola, when the eruption takes place.
  Eruptive period.  There  appear,  first  upon the
face, a great number of small, bright red spots, of an
oblong, square, semilunar, but not very distinct form,
slightly prominent, and  having toward the middle a
small,  hard point, upon which one may discover, by
the aid  of a magnifying glass, a vesicle filled with
serum.
   The  number and  size  of these  spots  gradually
increase.  They soon appear upon  the throat, chest,
arms, shoulders, epigastrium, loins, and lastly upon
the legs, where they are perfectly smooth ;  that is to
say, without vesicles.
  On the  sixth day of  the  disease, two days after
the appearance of the first spots,  they begin  to dis-
appear in  the  order in  which  they  came,  leaving
behind them a  little  roughness of the  skin.  On  the
eighth or ninth day they are entirely gone.   The epi-
dermis scales off, and the entire body is covered with
a scurfy powder.
  But  it is important to remark, that  things do  not 
130           Acute  Exanthemata.
always pass exactly as we have here related;  for if
the cutaneous eruption is a characteristic phenomenon
of the disease,  it is not an essential condition of
its existence,  as we  often see,  during epidemics of
measles, general affections, evidently produced by the
miasm, without any affection of the skin.
  Period  of resolution.  The greater  part of the
time, a sort of crisis, consisting  either  of diarrhea,
sweat, or a bleeding from the nose, follows immedi-
ately after  the  disappearance  of  the  exanthem, and
dissipates, in a few days, what still remains of the bron-
chial inflammation,  and of the  febrile  symptoms.
Sometimes, however,  this crisis  does not  take  place,
or occurs  irregularly, and great danger may then be
apprehended.
  1st. If the diarrhea continues too long, some  weeks
for example, we may fear, not only dropsy, but  the
formation of tubercles in  the mesentery, hectic fever
and consumption.
  2d. If the fever and cough continue, and if the res-
piration becomes frequent, difficult and  burning, at
the same time that one or both of the cheeks becomes
injected with  blood,  pneumonia  is  impending, if it
has not already taken place.
  3d. And lastly; if there remains a slow fever, recur-
ring daily, with hurried respiration, emaciation, and ex-
pectoration of pus, there is certainly disease of the lungs.
  " In measles," says M. Rapon,  " the  cutaneous
eruption is valueless as elucidating the prognosis ; the 
                     Measles.                 131
worst symptoms appear only after its total disappear-
ance.  Such  are otorrhcea, chronic inflammation of
the eyelids, etc.; but that which is undoubtedly most
to be  dreaded, is  the development of pulmonary
tubercles.  This deplorable influence of measles, is so
marked, that it may serve as a criterion by which to
judge of the  state of the chest."
  Treatment.—The principal medicines called for in
the treatment of measles,  are aconitum, Pulsatilla,
bryonia, belladonna, phosphorus, nux, ignatia, cin-
nabaris, mercurius, causticum,, and sulphur.
  Aconitum.  " The efficacy of this  plant, in  mea-
sles, says Hahnemann, is almost miraculous."  Aco-
nitum then should be prescribed from the commence-
ment of the disease, at a medium dilution, (the twelfth
for example) two or three times a day, during the first
two  days at  least of the  first period, and  it will be
well to return to it during the progress of the disease,
as an intercurrent remedy, whenever the febrile symp-
toms become  severe.  In vigorous children, of a san-
guine  temperament, aconitum is,  during the entire
course of the disease,  the medicine  upon which we
should principally depend.
  Pulsatilla.  According to M. Auguste Rapou, the
fundamental remedy for measles is Pulsatilla.
  " This substance," says he, " constitutes its princi-
pal therapeutics.  It prevents the consequences of the
virus, destroys  every germ of it, and  preserves those
who are exposed from its attacks."  I confess that this 
132            Acute Exanthemata.
assertion appears to me very unreserved.  It is incon-
testable, however, that pulsatilla is clearly indicated
after a few doses of aconite shaU have abated the vio-
lence of the inflammatory symptoms.
  The predominance of vomitings calls  particularly
for  its use, and its administration, in a  majority of
cases, should succeed to that of aconitum.  The two
medicines, during the  second period, may be taken
alternately at six or eight hours' interval, if nothing
appears  to  contra-indicate this medication.  A  con-
tinual and ardent  thirst would  be  a reason for  ex-
cluding pulsatilla.
  Bryonia, several times repeated, at a few hours' in-
terval, is the best means of recalling the eruption to
the skin, when it is accidentally suspended or repeUed.
  Belladonna is indicated after aconite,  either by a
strong constriction of the throat and  chest, or by  ex-
treme agitation, and lastly, and above aU, by delirium.
  When these  symptoms  succeed the abrupt disap-
pearance of the eruption, belladonna and bryonia
should  be administered alternately.   But,  excepting
under  the circumstances indicated, belladonna is, in
the treatment of measles, but an accessory remedy,
whose use should not be prolonged more than one or
two days.
  Phosphorus is rarely called for if the disease  has
been  properly  treated from  the  beginning.  It  cor-
responds to pneumonia, always  very serious,  which
sometimes manifests itself after the eruption. 
                      Measles.                  133
   Nux and ignatia are indicated by the persistence of
 a hoarse cough, with constriction of the chest, without
 great frequency of the pulse.   Ignatia suits especially
 little girls, and children of a mild and tranquH char-
 acter.
   Cinnabaris  corresponds,  toward  the  end  of  the
 disease, to oedema of the glottis, with indolent tume-
 faction of the palate, uvula, and tonsils.
   Mercurius serves to moderate the excessive sweats,
 and to combat the relaxation  of  the bowels, if it
 should continue more than a  few days after the disap-
 pearance of the eruption.
   Causticum  is  a precious  medicine when there  re-
 mains  a  dry cough, with constipation, but no fever;
 or when there is swelling of the epigastrium, or symp-
 toms of gastralgia.
   Sulphur, very rarely indicated in the treatment of
 measles,  is sometimes, however, indispensable in com-
 bating its consequences, such as otorrhoea, (which  the
 opportune administration of pulsatilla will almost al-
 ways prevent,) inflammation of the eyelids, etc.
   The treatment of measles does not  call for the  ex-
 cessive hygienic precautions with which it is but  too
common  to harass the little patients.  Nothing  is
more dangerous, for example, than to load them with
blankets, with the idea of keeping them warm.  Cur-
rents of air, especially cold air, are certainly fatal; but
there are no surer means of exposing  them to a chiH
than to make an oven of their chamber. 
134
Acute Exanthemata.
  From sixty-two to sixty-four degrees of Fahrenheit is
the temperature adapted to their state.
  Complete abstinence for one or two days, and a very
light diet during the whole  course of the disease,  is
the proper regimen.  If measles is methodically treat-
ed, children may,  after ten or twelve days at the
utmost, return  with impunity to their habitual mode
of life, and expose themselves to the external air,
whatever be the  temperature.   Such  are the results
attained by Homoeopathy.

                    roseola.
  Roseola is a  name given to a very superficial affec-
tion of the skin ;  it is never as extended as erythema,
has some points  of resemblance with measles, and  is
very often complicated with  other eruptions, such as
variola, vaccinia, etc.  It is frequently observed in
children.
  It  is especially during the summer that this sHght
disease shows itself.  Its duration is extremely varia-
ble.  It consists, most frequently, of little spots  of a
delicate rose color, irregular,  and  not prominent, and
which  are  seen to come and go every instant in the
day.
  Roseola,  which is  rarely  accompanied with  sore
throat, and  more seldom  still with gastric affections,
would  often pass unperceived, were it not for the cries
and wakefulness it  occasions.  It  shows itself princi-
pally during first dentition. 
                    Scarlatina.                 135
  Treatment.—A few doses  of coffea—mercurius,
if there  is  angina;  belladonna, if, as an  exception,
there should appear cerebral symptoms.

                   SCARLATINA.
  Scarlatina  is a  contagious and epidemic disease,
rarely occurring sporadically,  attacking persons but
once in their life, variable in its character, and most
frequent in children of from five to twelve years.
   This disease does not, like measles, seem dependent
upon prevailing temperature.  We see it in all seasons,
in the depth of winter, as well as in the heat of summer.
As an epidemic, it is always propagated slowly, does
not  attack  all individuals, and is, beside, rarely seen
at the present day. *
   Scarlatina has, like  measles, with which it has been
 sometimes  confounded in the  beginning of the epi-
 demic, three marked  periods, of which we here give
 the description:
   First  Period.—-There is, from the beginning, a
 6oreness in the throat, followed  by depression, and an
 extreme sensibility of the whole body, disgust, bilious
 vomiting, chills and cephalalgia.   During the whole

   *  This remark, as must be well understood, is not at all appli-
 cable to the United States, in which it forms one of the most frequent,
 as well as most dreaded, scourges of childhood ; neither is it always
 true, although generally so, that it occurs but once in the lifetime of
 an individual, well authenticated cases having been observed of its
 occurrence a second and even a third time.—Tr.
         12 
136
Acute Exanthemata.
of the  first  day,  the drowsiness is sometimes insur-
mountable.   It  is frequently accompanied with de-
lirium, much more rarely with convulsions, during the
two following days.  The angina, which rapidly ac-
quires a great intensity, is, with an excessive accelera-
tion of the pulse, the dominant symptom of the period
immediately preceding  that  of  the eruption.   This
period, much more limited, as we see, than the cor-
responding period in measles, does not manifest itself
by the watering of the eyes, nor by fluent coryza, nor
by the  frequent  cough which characterizes the latter
disease.   There is dyspnoea, and  great frequency of
respiration in the majority of subjects, especially on
waking in the morning, but this is principally in con-
sequence of the  fever and the swelling of the tonsHs.
These symptoms only precede two  or three days, at the
utmost, the  appearance of the eruption.
   During this first period, and sometimes during the
whole course of the disease, the bowels are constipated,
and the thirst bears no relation  to the violence of the
fever.
   A bad sign,  and one indicating that the disease
will  be very serious, is the smallness, as weU as the
extreme frequency, of the pulse.
   Second Period.—The  eruption  commences in ac-
cordance with the particular character of the reigning
epidemic—sometimes on the face,  sometimes  upon
the hands  and  fore-arms.  It  consists in  Httle red
spots, smooth, that is to say, without the vesicles pre- 
Scarlatina.
137
sented by those in measles.  These spots deepen in
color,  and enlarge rapidly, so  as  to become con-
founded.  They soon cover almost the entire  body;
but as they disappear, as  in measles, in the order in
which they came, it happens that the parts of the skin
where they  first  appeared,  begin to pale, when the
other parts are but commencing to redden.
   The angina and the fever persist during the  whole
time of the eruption.   On the fourth or fifth day, it is
often  accompanied by fatiguing hiccup.  The voice of
the patient becomes hoarse and nasal, he no longer re-
plies  to questions addressed to him, or replies with
great  difficulty.
   An abundant glairy expectoration, a bleeding of the
nose,  or  a  slight  diarrhea, phenomena  which fre-
quently supervene toward the sixth day of the disease,
appear to give great relief.
   Inflammatory affections of the internal organs fre-
quently manifest themselves  at this  epoch  of  the
disease, especially when the  exanthem has disappeared
abruptly, which require the prompt attention  of  the
physician.
   A  fact worthy of  remark,  is the  absence  of all
moisture upon the surface  of the scarlatinous spots.
The  patients  absolutely  perspire only through  the
portions of the skin  which still remain white.   M.
Auguste Rapou  attributes  to  this circumstance  the
disposition to the subcutaneous serous effusions, which
forms one of  the characteristic  phenomena of scar- 
138
Acute Exanthemata.
latina.   This  opinion  of Rapou  is  at least  very
specious.
   Third Period.—The  fever and  angina disappear
with the desquamation.   This commences from the
sixth to the ninth day; but it does not take place as in
measles: the epidermis, instead of falling off in scurfy
scales, detaches itself in large plates ; this continues
for several  days, and is often several times repeated.
It is at this period that the critical phenomena of
which we have spoken, commonly occur, sweat, epis-
taxis, etc.
   The slightest chill is then to be dreaded.  Dangerous
lesions  of  the  eye,  of the ear, of the ganglionic
system, and  especially dropsy, might be  the conse-
quence.
   "There is not," says Hartmann, "a more insidious
disease than  scarlatina.   In  some epidemics,  it  is so
mud that there is not a single victim, whHe in others,
notwithstanding its apparent mildness, and in  spite of
the most desirable manifestations of the  exanthem, it
often compromises life, and frequently proves fatal by
metastasis  to  the  brain.  It is  compHcated with  all
kinds  of fever, and  acquires thus the danger which
belongs to them.
   Treatment.—When scarlatina is free from aU com-
plication, which unfortunately rarely happens, a few
simple hygienic precautions will almost always suffice
to bring it to a happy termination.  Allopathy has no
right to boast of curing scarlatina, since in reality the 
Scarlatina.
139
curative force in nature, is the  sole cause of the suc-
cess to which it lays claim.  The treatment of the Old
School is as absolutely useless in modifying the severity
of this disease, as in other miasmatic affections.  Allop-
athy  has  never abridged  one hour the duration of
these affections.
  This is  far from being  the case with Homoeopathy.
Its  triumph is in the treatment of the essential diseases.
  The salutary modification that it  exercises over
their  symptoms  is  so  evident, that only the grossest
bad faith would  affect to deny them.
  It is true  that, in unusual and complicated cases,
the imperfection  of our  materia  medica,  still in its
infancy, does not always leave us free from uncertainty
upon  the  choice of the best medicine to prescribe.
But what does that prove,  if not that science has
not yet made  to us  her last revelation,  and that
medicine  is, of  all the  arts,  the most  difficult to
practice 1
  Homoeopathy would proceed, we may affirm, with
a mathematical precision, if the  correlation  of the
remedy and of the symptoms was as definite and clear
in all diseases as it is in simple scarlatina.
  Belladonna  is literally the  specific for  this  erup-
tive fever.   It is  appropriate to it in all its  periods;
it adapts itself* to all its  symptoms  and corresponds
even  to the greater part  of its  consecutive effects,
such as indurations of the face or of the extremities,
painful swelling of the parotides,  discharge  from the 
140
Acute Exanthemata.
 ears,  etc.   Some authors assert, that belladonna,
 administered in high  dHutions  and very small doses
 every two or  three  days,  is  a certain  preventive
 against the scarlatinous infection.
   Belladonna, then,  should be prescribed from  the
 beginning  of the  disease.  The  doses should  be
 stronger, more frequently repeated, and of lower dilu-
 tions, in proportion to the  intensity of the  precursory
 inflammatory symptoms.   The  amendment  of  the
 symptoms will soon become a reason for lengthening
 the intervals between the doses, and for the use of  the
 higher dilutions.  In fact,  one might often treat scar-
 latina, from the beginning to the end, with belladonna
 alone, and obtain from this medicine, the same success
 that some homoeopathic  physicians have met with in
 the exclusive use of aconite in epidemics of measles.
   Unfortunately the frequent complications presented
 by scarlatina, forbid  us to  count  always upon  a treat-
 ment so simple.
   It is beside, like all serious  fevers, subject to irreg-
 ularities, which require each a special treatment, and
 exact  on the part of the physician, a precise and ever
present idea  of all  the  pathogeny recorded  in the
materia medica.
   To avoid the confusion and vagueness of doubtful
indications, we shall content ourselves with  pointing
out those medicines  which answer best  to the anom-
alies, or the secondary  symptoms, the  most generally
observed  in the epidemics of scarlatina. 
Scarlatina.
141
  These medicines  are:  Aconitum,  baryta  carbo-
nica, opium, ipecacuanha, cinnabaris, spongia tosta,
hepar sulph., acidum nitri, dulcamara,  lycopodium,
calcarea and sulphur.
  Aconitum should be prescribed at a  low dilution,
and in frequent doses before belladonna, when one
is not yet very certain of  the nature of  the disease;
if  the  fever is very intense; if the  pulse is more
remarkable for fullness than frequency, and if in short
the miliary fever of which we are about to speak, is
complicated with scarlatina. In this last  case, aconite
and belladonna  should be administered alternately
during the whole course of the disease, always taking
care however, to leave belladonna some  hours longer
than aconite to exercise its influence.
  Baryta carbonica, from  the twelfth to  the  eight-
eenth dilution, is preferable to belladonna in the case
of  lymphatico-nervous  children, disposed  to  chills,
when  there exists a considerable tumefaction  of the
tonsils, at the same time that these glands are  rather
rose-colored than of a vivid red, with frequent expecto-
ration of mucus,  pressing  and lancinating pain in
swallowing.  Baryta succeeds, especially when there
is joined  to  the  preceding  symptoms incomplete
stools, at first hard, afterward soft, small in quantity,
without form, and light-colored without  being abso-
lutely white.
  If a burning heat  supervenes, with  stupor, somno-
lence, agitation, vomitings, diarrhea or  constipation 
142
Acute Exanthemata.
and convulsions, opium wiH be found of the greatest
utility.
  If there is increase of fever toward evening, wake-
fulness, nausea, total absence of appetite, great dispo-
sition to weep, ipecacuanha is indicated.
  If there  are oedema  and swelling of  all the tissues
of the neck, visible externally, with a tainted breath
and tendency to  bloating, cinnabaris is  a  precious
medicine, and much preferable in such  a  case, to  aU
other mercurial preparations.
  Spongia  and hepar sulph. are  called  for, each in
their sphere of action, in symptoms of croup occurring
incidentally.
  If the angina is accompanied by nervous fever ; if
there are  numerous  little fetid  ulcerations in the
mouth and throat, with general depression, great dry-
ness of  the mouth, and  continual thirst, acidum nitri
is indicated.
  Dulcamara  corresponds to the rheumatic pains,
which sometimes succeed the eruption.   Lancinating,
beating or pinching pains in the chest, the region of
the  liver and lower abdomen, with dry cough, hard,
rumbling  stools, and  congestion of blood  toward the
head,  call for the use of lycopodium.
  Calcarea and sulphur are the principal remedies
for dropsy, engorgements, ulcerations and  the greater
part of the secondary  symptoms of scarlatina;  but
it is very important not to repeat the  doses  too  fre-
quently. 
Purpura.
143
                     PURPURA.
  Purpura, or miliaria purpuralis, is an eruptive
fever,  which  very  much resembles  scarlatina,  but
which, nevertheless, differs from it enough to be con-
sidered as a special affection.
  This distinction is even so  much the more  im-
portant,  as  the two  cases  demand a  very different
treatment.
  Instead of proceeding, as in the eruptions of scarla-
tina and measles, the spots of purpura  develop them-
selves irregularly, now here, now there, and sometimes
simultaneously over distant  parts  of the body.   In-
stead of being smooth, temporarily rendered white by
pressure, and especially, dry like  those of scarlatina,
they are interspersed with little papulae, of a dark
color, remain red under the pressure  of the finger,
and are  almost always moist.   The patient only per-
spires through these spots, and, in consequence,  does
not perspire much, excepting when the body is covered
with them.
   Purpura has not a regular and  determinate course,
like other exanthematous fevers.  It often persists for
several weeks, and no particular sign indicates an ap-
proaching termination.   It may suddenly disappear,
and thus place the life of the patient in great danger;
its malignity has no relation to the abundance of the
eruption.
   This disease may attack  the same  person several
         13 
144            Acute  Exanthemata.
times,  and even return again  in  the course of the
same  epidemic.    The angina  which precedes  the
appearance of the eruption, returns when the latter
has disappeared.
  Aconite is the specific for purpura.

                    MILIARIA.
  Miliaria is characterized by an eruption of whitish,
pearly vesicles, of the size of a miUet  seed, which de-
velop themselves in great numbers, and  exists as an
epidemic; it is accompanied by fever, gastro-intestinal
inflammation, extreme agitation, sometimes delirium
and spasms, fetid and abundant sweat, and lastly, by
great irritation of the skin.
  The premonitory symptoms of this disease, are those
of typhoid fever;  its course is very irregular, and one
cannot specify, in a precise manner, the epoch of the
eruption, which commonly, however,  manifests itself
between the third and the sixth day.
  Abandoned to itself, or treated by allopathic meth-
ods, miliaria is  always  a  serious disease.   Many
patients  sink and die after  a prolonged  attack of
delirium.
  Arsenicum, administered from the beginning, every
three hours, at a high dilution, is the principal remedy
against this disease.   It should be given of the twelfth
dilution, if the diarrhea is abundant;  at the thirtieth,
if the  nervous symptoms predominate over the  in-
testinal. 
SUDAMINA.
145
  Belladonna should be administered, as an intercur-
rent remedy,  if there  is delirium with  congestion
to  the  head, puffing  of  the  face,  and  red  and
brilliant eyes.
  Bryonia  and chamomilla  are the  best medicines
against a sort of sporadic miliaria, which sometimes
attacks women in child-bed, and infants at the breast.
  Ardent thirst, anorexia, throbbing pain in the  tem-
ples,  dry tongue,  yellow at  the  base,  epigastrium
painful to the touch, constipation;  such are the symp-
toms  which indicate  the  employment of  bryonia.
Chamomilla would be preferable, especially in  little
children, if, in  addition to the eruption,  there are
green, watery stools, like beaten eggs, which corrode
the anus.
  In  cases where the use of chamomilla is not fol-
lowed by prompt improvement, it will be necessary to
have  recourse to sulphur,  thirtieth dilution; some-
times, also,  to arsenic.

                   SUDAMINA.
  It is thus  we name little pearl-like vesicles, whether
transparent  or opaque, that are observed in new-born
children, especially in those of a weakly constitution,
and during the warm season.
  This eruption, which, the  greater part  of the time,
is caused only by too warm clothing, is rarely accom-
panied by dangerous  symptoms ; a few warm baths,
and, at most, a small dose of  aconite,  dulcamara, 
146
Acute Exanthemata.
bryonia, rhus,  or chamomilla, according to circum-
stances, suffice to dissipate it.

            VARIOLA--SMALL-POX.
  It is difficult to conceive the terror which must have
been felt, before the discovery of vaccination, by the
the epidemics of small-pox.   Perhaps no disease has
made greater ravages upon the human race.  At each
of its invasions, the number  of its victims was  enor-
mous,  and the hideous scars left behind it, when it
spared the life even of the patient, inspired, especially
in women, almost as much horror as death.
  The small-pox, like all the great epidemics, comes
to us from the East.  We are unable to trace its his-
tory farther back than the seventh century.  We know,
without, however, being able exactly to fix the dates,
that it passed from  Arabia into Egypt, in 622 or 640,
and from Africa to Spain in 714.  Rhazes, an Arabian
physician, describes it in his Treatise of the Plague,
toward  the -end of the ninth  century.  A short time
after this epoch, it ravaged the south of France.  In
1280, it was generally known in England, from whence
it passed  to  Denmark, and, a little later, into the
other countries  of the North.
  We  find,  in  fact, that  the most  ancient date  of
variola in Sweden, does not go farther back than 1578.
Benedictus Olai, physician to Eric XIY, and to Jean
ni, mentions it under the name of measles; but the
description that he gives of it, proves beyond a doubt, 
Variola—Small-Pox.
147
 that he is speaking of variola, and, what is more, even
 of its different species.
   At length, in exchange for the syphHis,  of which,
 according to popular opinion, the sailors of Christo-
 pher  Columbus brought  us the germ,  Europe  be-
 queathed the smaU-pox to America, where it has since
 shown itself in almost all latitudes.
   Small-pox, like all the other eruptive fevers, seldom
 attacks the same  individual more than once.   It is
 not  precisely a disease peculiar to childhood, for it
 attacks equally individuals of all ages. It is, however,
 more frequent in the second  period of childhood, than
 in infants at the breast, or in adults.  The diversity
 of age, beside, produces no other differences in it
 than those which belong to  the nature and seat of its
 complications, for the character of the eruption remains
 always the same.
   The  history of  this  disease   contains nosological
 details of the highest interest; and the labors to which
 pathologists have  devoted themselves in tracing its
 origin,  and in  endeavoring to  appreciate  the  real
nature of its varieties, would of  themselves  make the
subject of  a long  monograph.   But  I shall content
myself, in the cursory glance I am able to give it here,
in stating the facts  most generally  admitted.  Let us
observe, beside, that since  the  first  descriptions of
smaU-pox left us by the Arabian physicians, the essen-
tial phenomena of  this disease  have not  changed. 
148
Acute Exanthemata.
It shows itself, in our day, the same as in the time of
Rhazes.
  In the eighteenth century, the persuasion that  an
attack of smaU-pox was for all men without exception—
a fatal necessity—suggested to physicians  the mon-
strous idea of inoculating this disease.  Their object,
they said, was to protect communities from its imme-
diate dangers  and  consequences, by producing the
disease in individuals at a favorable  time, and in pre-
paring the patient for it by a regimen and appropriate
remedies.  This folly, which characterized the  med-
ical  spirit of that epoch, (and of almost aU epochs)
was  rapidly propagated from the schools of the north
to the schools of France, and gained, one knows not
how, the assent of the most intelligent men.  Rosen
of  Rosenstein,  whom  I have  already often cited,
because his name  gives  authority, expresses  him-
self  in  the  foUowing manner on the subject of inoc-
ulation :
   "  The sure means of  avoiding the danger of small-
pox, is to inoculate children when  they are  young,
and  beside, to perform this  operation as it  is done in
England.  It is  in fact, disagreeable, at  each epi-
demic, to take, as long as  it lasts,  Ethiop's mineral,
preventive  piHs,  or tar-water;  and it is risking  too
much to expose one's-self to be surprised by so fatal
a  disease, without being prepared for it.  The  older
one  grows the more dangerous it becomes. 
Variola — Small-Pox.
149
   " One is always liable to be attacked with it in tra-
veling, or in places where there is no physician within
call, or where it is even difficult to procure medicines
and the attendance required.  One may take it during
the heat of summer,  after being already exhausted by
another disease, or by labor, or long watchings,  and
when other diseases  are prevailing, as purpura, pleu-
ritis, inflammations of the lungs, or typhoid fevers;
or perhaps even when fire has been carried into the
body by incendiary drinks, or overloaded with a super-
abundance of food.
  " Women, especially, should not  fail to be  inocu-
lated.  They see every day how much their  beauty
suffers from natural  smaU-pox.  Beside, they are lia-
ble to be attacked during pregnancy, or in child-bed,
so that they and their offspring are in danger of their
lives.   The numerous examples of persons who have
lost their  sight, hearing, the use of  speech or a limb,
in consequence of this disease, should induce aU to
avail  themselves with  avidity and gratitude  of the
means of avoiding these  dangers, and even a prema-
ture death."
  Thus, then, in order to avert  these dangers and a
premature death from a child who is in perfect health,
the physician  takes possession of  him,  keeps  him
apart for two or three weeks, nourishes him with light
meat  and vegetables, to  cool his blood, gorges  him
with purgative pills, generally made of calomel  and
camphor, and lastly, inoculates him with  smaU-pox, 
150
Acute Exanthemata.
 which the unfortunate child would perhaps  never
 otherwise have had.
   This barbarous practice, excusable only in a people
 in its infancy, was nevertheless  in vogue for several
 years in all the capitals of Europe.
   At last, however, it began to be suspected that the
 advantages of inoculation were not so great as to be
 absolutely incontestable.   A few  physicians, at  the
 head of whom we should cite Van  Swieten, bethought
 themselves of submitting to the test of rigorous  sta-
 tistics, the results of cases of natural smaU-pox, and
 those of  inoculated  smaU-pox, terminating fataUy.
 They found that, notwithstanding  the advantages of
 the choice of season, the favorable age of the patient,
 diet and  calomel, that  the number of the victims of
 inoculated smaU-pox was very nearly in  the same
 proportion as  that of the  disease, spontaneously con-
 tracted.    The good sense of the public did the rest,
 and the inoculation of smaU-pox feU into disuse.
   However, to be just toward these physicians, we are
 compeUed to acknowledge that this disastrous sophism
 maintained its place in science, and would perhaps
 have done so to the present day, but for an admir-
 able  discovery which  overturned it  from its very
 foundation.
  An English physician  had  the good fortune  to
imagine that, in order to preserve men from the small-
pox, it was not necessary to give it to them—which
was plunging them into a river to protect them from 
              Variola — Small-Pox.           151
the rain—but only to inoculate them with an analogous
affection, incomparably more mild.   This ingenious
conception was, as we see, an anticipated  glimpse of
the  great  law of Homoeopathy.   Experience  soon
verified the theory of Jenner, and inoculation  with
vaccine succeeded, at last, in supplanting  inoculation
of the small-pox.
   Since this discovery, small-pox has lost  more  than
three-quarters of  its inauspicious prestige.   With the
exception of the  inhabitants of those countries-where
prejudice  and ignorance still oppose a free  access to
vaccine,  nobody  is  disturbed  at its  approach.   It
sometimes traverses our cities almost without leaving
a trace.  Nevertheless, we  sometimes  see  it appear
with a  certain degree of violence, and attack even
vaccinated  subjects;  but, in these  cases, especially
if they are  children, it rarely assumes a serious
character.
   I confess,  it is  not absolutely the same with respect
to adults.   I have several times seen, especially a few
years ago, in the practice of Professor Rostan, men of
from twenty-five   to  thirty, very seriously  attacked
with small-pox, although they  had been  vaccinated
in their infancy.   Can it be  that  at the end  of a
certain number of years the principle of the vaccine is
exhausted in the  economy, and  is divested,  little by
little, with the renewal of our organs, of its  preserv-
ative virtues ?  This opinion, which  is that generally
entertained by German physicians, merits,  it must be 
152
Acute Exanthemata.
confessed, experimental  proof.  I have, myself,  vac-
cinated  in  1846, a dozen persons already vaccinated
eight or ten  years before, in none  of whom  did the
eruption make its appearance.  It is, in consequence,
extremely probable that in these dozen persons, the
aptitude to receive the variolous infection was com-
pletely destroyed, or  at least  had not yet been repro-
duced.   I saw,  the  following year, however,  the
vaccine take  again  very well  in  a young girl of
seventeen,  who bore  upon  both arms the  scars of a
vaccination made, as  I  was told, in 1832.  The im-
portant question of re-vaccination  remains, then, up
to this time, in the most complete uncertainty.
  The characteristics of variola are extremely marked.
  After  the  symptoms of  a gastro-pulmonary and
intestinal irritation, which lasts two or three  days,
the pustules begin to appear, at first pointed, but soon
becoming  umbilicated, sometimes  few  and distinct,
and at others numerous and  confluent.  At the same
time that these pustules acquire the  umbilicated form,
and their center the puriform aspect, the skin  reddens
and tumefies in a remarkable manner.   At  the end
of eight or ten days the pustules begin to dry, and are
covered with yellow or  blackish crusts,  after  the faU
of which we  find upon the  skin circular spots of a
brownish-red color, then scars more or  less regular:
there sometimes supervenes an abundant salivation.
In  general, the  duration of these pustules is  from
ten to twelve days. 
              Variola — Small-Pox.           153
  " Variola,"  says Hartmann, " cannot  be  mis-
taken ;  at  most, it can only  be  confounded  with
varicella, from which  only this disadvantage could
result, that as, in general, persons have the smaU-pox
but once in their lives, one might believe themselves
thenceforth  safe  from  it while  in  fact they would
not be so."
  This  disease presents, in its  course, four  periods
more or less distinct.
  The first, or febrile period, commences by a simple
irritative fever, and terminates when the  first  spots
appear  upon  the skin.  The  fever, at first slight,
increases from day to day in the form of a remittent
continued; there is  headache, ill-humor, lassitude,
disposition to sleep, a marked congestion of the blood
toward  the brain and face, epistaxis, sometimes deli-
rium, nausea  and  bilious vomiting,  a peculiar  and
disagreeable  odor of the breath, and  of  the urine,
epileptiform  convulsions  in  little  children, colic,
drawing pains in  the  limbs, stretching, pain in the
loins, etc.
  "The precursory signs of small-pox," says Rosen,
" are not as decisive as some have thought; thus one
can almost never affirm, with certainty, that a subject
is on the point of having it.   The following  circum-
stances, however, will  commonly enable us to fore-
tell it:
  "1st. If the disease  exists in the vicinity of the
patient: 
154
Acute Exanthemata.
  "2d. If  the  patient has never  had it;  if he  has
been  in  an apartment where some one  has had it;
if  he  has  been near a  person who  has  been with
one of these patients, or has  touched  their clothes or
linen:
  " 3d. If we observe the symptoms which ordinarily
precede eruptive fevers; as, a certain languor; enerva
tion without manifest cause; a chill, followed by heat;
pain in the loins, an oppression of  the chest, sighs.
  "4th.  If the face is bloated, the  eyes heavy, with a
slight  flow of tears, especially from the  left eye, the
tears not so hot as  in measles; if the patient feels pain
in the pit of the stomach upon slight pressure of the
finger; if there is desire  to sleep  at  unseasonable
hours; if he  is  agitated  during sleep  and vomits
often: if, I say, we observe these different  symptoms,
we may presume, with confidence, that the patient will
have  smaU-pox.   The fever continues, but not with
the same force, up to the moment  of the eruption.
At this  period, some patients, especially little child-
ren, are  attacked with epileptic convulsions; and  if
dentition contributes nothing to it, it is commonly the
sign of  a  favorable form  of the  disease.   This, the
first period of variola, lasts  as long as seventy-two
hours, and even four days."
  I do not know how far epileptic  convulsions,  in
children, may  be  considered, as  Rosen  asserts, of
good   augury.  The truth  is,  that Kirkpatrick  and
Van  Swieten  have seen  some  patients,  after  this 
             Variola — Small-Pox.           155
symptom, remain speechless, or with paralysis  of a
limb, for several weeks.
  We know, at least, that these  symptoms, frequent
enough in children attacked with  typhoid fever, have
hardly ever bad consequences, and disappear of them-
selves  after  a certain time, which, beside, may be
abridged by appropriate remedies.
  The second period is  that of the eruption.   It is
immediately  preceded  by a febrile  exacerbation, but
which abates from the moment that the first pustules
appear.  These appear first upon the face, more par-
ticularly on the upper lip,  and on each  side of the
nose, in  the form of little  nodes, which  cause  under
the finger, says Hartmann, the same impression as
grains of millet.   These papulae  enlarge rapidly, al-
most while we look at them, and  assume the appear-
ance we have described.  From the face, they spread
over the neck,  chest, arms, loins, and  inferior ex-
tremities.  They rarely appear on  the abdomen, still
more rarely on the soles  of  the feet.  The eruption is
completed  in three  or  four days,  at the  most; the
febrile  excitement, although less than at  an earlier
period,  continues, nevertheless, during the whole time
of its appearance, but does  not persist longer, except-
ing  in anomalous cases.   Sometimes, even, when the
variola  is mild, the  eruption  takes  place  without
fever, the patient then only complains of itching and
burning of the skin. 
156
Acute Exanthemata.
  When variola  appears  during dentition, there is
always a more or less violent fever, which does not
cease with the appearance of the pustules, and which
is liable to assume a variety of forms.   There are fre-
quently congestions to the head  or chest; in the first
case, there is delirium, accompanied with great thirst,
wakefulness,  and  constipation,  the  hands may  be
cool, or of  a normal temperature, but  the rest  of
the body  is burning: in the second case,  there is a
short and  fatiguing cough, with  great  thirst, pulse
strong and frequent, and extreme agitation  ; pneumo-
nia is to be feared.
  It is at this period,  small-pox has the greatest
tendency to become malignant;  that is to say,  to be-
come complicated with ataxic  symptoms, or to  disap-
pear suddenly, and fix itself upon the internal viscera;
a circumstance which is always very serious, and calls
for the most prompt attention.
  The third  period, or period  of suppuration,  com-
mences from the sixth to the eighth day ;  that is, from
the time when the eruption appears on the face, and
continues  to the time when the first pustules begin to
dry.  The commencement and the termination of this
period is  no more marked than those of the others,
because, as the  eruption is not effected aU at once,
but spreads,  little by little, from region to region, it
results, that the first pustules  are almost  dry, when
those  on  the legs but just begin to show themselves. 
              Varioia — Small-Pox.           157
   When these  pustules  have attained  their perfect
development, the transparent lymph which fills them,
becomes,  soon,  opaque  and  yellowish; and this,  if
the disease progresses regularly, is  a veritable  stage
accomplished.   The base of each pustule is red and
painful.  The swelling of the face is then so consider-
able, that the patient can hardly open the  eyes, and
appears blind.  The febrile  affection commonly in-
creases a little at this period,  constituting the suppu-
rative fever ;  it manifests itself, however, only  when
the pustules are numerous.   The more violent  it is,
the more thick and turbid is the urine; and if this,
ordinarily  of  a brick-red color,  becomes bloody, it
must be regarded as a serious symptom.  It only ac-
companies an eruption of bad character; that is to say,
one in  which the pustules are flaccid before their time,
not umbilicated and filled with blood instead of serum.
It is during this third period that the peculiar odor
of variola is strongest; and persons not remaining con-
stantly with the patient, find it almost insupportable.
   The period  of  desiccation and of desquamation
terminates  the  disease; with it, all the  symptoms of
the preceding period, progressively diminish.
   The humor contained  in  the pustules,  gradually
dries  into  a brown  crust, which  afterward  falls off,
leaving behind  a  cicatrice, whose depth and extent
depend upon the suppuration, more  or less consider-
able, of which the skin has been the seat;  and this
latter,  for a long time, remains marked with large red 
158            Acute Exanthemata.
spots, and very sensitive to  the impression of the at-
mospheric air.
  " When  the  desiccation is  once  achieved  on the
face,"  says Hartmann,  " there  is no more danger.
But the beginning of this operation marks one of the
most serious periods of the disease; for it is then that
the greatest number of deaths occur, by putrid disso-
lution, gangrene of the pustules, hemorrhages, in-
flammations of the lungs, of the brain,  of the abdo-
men, etc."
  The sequelae  of small-pox are frequent and varied.
Independently of the cicatrices, which time only to a
certain degree effaces, this terrible disease leaves often
after it chronic ophthalmia, deafness, large and  very
painful furuncles, which are liable to be  reproduced,
and sometimes, in  short, pulmonary tubercles, whose
softening immediately succeeds, in many  subjects, the
disappearance of the cutaneous  eruption.  Each of
these  secondary affections caUs  for the special treat-
ment  appropriate to  it.  The treatment of  variola
proper, must alone occupy us here:
  Treatment.—I am happy in being able to point
out to practitioners, against the different phases of
variola, indications which  are  absolutely  new, and
whose efficacy  will, I venture to say, astonish  those
who put them in practice.
   " In foUowing the course of natural variola," says
Hartmann, " I perceived, what has not escaped other
homceopathic physicians, that this disease, especially 
             Variola — Small-Pox.           159
at the beginning of the second period, bears a strong
analogy to the itch, and that it would not be without
reason, if we should caU it acute itch.   This remark
started with me, the question,  whether it was not
possible that a  dose of  sulphur, administered after
the febrile  symptoms had been diminished, during
the first period,  would preserve  the  subject from the
complete eruption of the variola, and whether it might
not also be employed as a preventive for other members
of a family, who had not  had the small-pox, and who
had never been vaccinated, and who would not now
have time to have recourse to it.  Circumstances have
not yet permitted me to put this idea into practice;
but  I  propose  to  embrace the first opportunity  of
doing so.
   I am sorry to  be forced to predict  for our estimable
coUeague, that when the occasion shall present itself,
of  putting  this idea to  the  proof, he  will  be but
very moderately satisfied with the result.
   But I confess  that I ask myself in vain, what rela-
tion M. Hartmann and those of  our  brethren, who he
says, coincide in this opinion, have  been able to find
between the itch and variola.  Of these affections, the
one is  essentiaUy acute and febrile, the other is essen-
tially chronic and  non-febrile.   The one  is pustulous,
the other vesiculous.  Variola manifests  itself first on
the face; the itch, on the hands and bends of the arms.
The contagion of the first invades the entire economy
before breaking out  in an eruption ;  the second shows
        14 
160
Acute Exanthemata.
itself primitively  on  those parts of  the  cutaneous
envelop, which have been  exposed to the infecting
contact.  Lastly, the itch is, above all, characterized
by  the  presence  of an  acarus, which although  it
escaped, one  knows  not how, the microscopic re-
searches of doctors Alibert and Biett,  is very easHy
to be discovered with the naked eye.  Variola  and
the itch have then, between them, no other points of
resemblance, than  that both are contagious ; but this,
as we know, is also common to a host of other  dis-
eases.
  Admitting, however, for the moment, the  hypothesis
that variola is really an acute itch, as Hartmann says,
is this a reason why sulphur should act as its prophy-
lactic, or be  capable of arresting its progress ?  Sul-
phur is by no means  the specific for true itch ; we
see at least, that if it cures it, it cures it very  slowly.
The medicines I shall point out for it, demonstrate an
incomparably greater efficacy than those of any sul-
phurous  preparations whatever; so that, if sulphur
has its place in the treatment of small-pox, I venture
to affirm, that it is not the first  period of this disease,
which calls for its  use.
  But  there is another remedy of which  M. Hart-
mann incidentally  speaks, and  praises for the con-
vulsions of children during the eruptive period, which,
if he will consent  to make trial of, upon the  indica-
tions we give, will realize the hopes he has founded
upon sulphur / it is Zincum. 
              Variola — Small-Pox.            161
  Yes,  when  during an epidemic of variola, a  pa-
tient, whatever  be  his  age,  presents  evident  pre-
monitory symptoms of this affection, zincum admin-
istered three or four times a day, not of the third or
fourth dilution, but of the thirtieth, will in all proba-
bility, arrest the development of the eruption.  The
disease will be throttled, to speak after the manner of
certain  AUopathists,  but it will be effectually accom-
pHshed, and above all, without danger to the patient.
Let  us  remark,  however, that although the patient
shall take the  medicine 1 indicate, for a couple of days
only, he ought to observe,  for a  week at least,  the
same hygienic precautions as if the eruption  had
taken its course;  he should above all, avoid exposure
to cold air.
  But though zincum be the real preservative from the
variolous  eruption, when it is  administered  before its
development, it ceases to be efficacious from the  mo-
ment when the first pustules have  made their appear-
ance.  It, in a word, is not the specific for variola.
  This  specific, nevertheless  exists,  or  at  least, we
have the right to consider as such, those means which
we are about to indicate. But let us, beforehand,  cite
a few important lines from M.  Rapou :
  " In the beginning, (it is of variola he speaks),  it
is proper to administer a few doses of aconite;  but
as soon as the papulae are developed, we should have
recourse to mercurius, at one of the lower potencies,
and  adhere to it as the remedy constituting principally 
162
Acute Exanthemata.
the therapeutics of variola.  Mercurius is but little
recommended  in this  case; but the results obtained
in the  practice of my father, convinced  him that this
substance was the specific, above all others, for simple
variola.  Under the  influence of this remedy, the
eruption is regularly effected ; no serious complication
intervenes; its evolution  is greatly accelerated, and
the suppuration is not abundant.   In a word, if the
disease is  taken in the beginning, it always  shows
itself mild, and loses  the  dangerous  character which
has made it dreaded up to this time."*
   Thus, of the divers medicines tried, without doubt,
by M.  Rapou, the father, mercurius  is beyond com-
parison, the one which has succeeded best.
   Hartmann also speaks  of mercurius, but in much
less  explicit terms.  He only  recommends  it for the
third period, and  as a means of combating salivation:
M. Rapou  is much nearer the truth.
   Mercurius,  in fact, or at least one of its combina-
tions, «was  ordained  by destiny to play an  important
part in the treatment  of variola.
   Mercurius  corrosivus,  (but  not the  metallic mer-
cury recommended by Rapou)  is, with the aid of cau$-
ticum, a heroic remedy for smaU-pox.  Let us pre-
scribe, for  example, either on  the  appearance  of the
first pustules,  or  in the  course  of  the  second,  or
  * Vaccinin, 200d potency, is, according to our experience, the true
specific against Small-pox in all its stages. Ed. 2d edit. 
              Variola — Small-Pox.           163
 even the third  period, if one is not called until that
 time:
  1st.  Caustic. 30th, eight  glob., in  four ounces  of
 vehicle, two teaspoonfuls to be taken in the course of
 the morning at an interval of three or four hours.
  2d. Merc, corrosiv., 30th, eight glob., in the same
 quantity of vehicle, two  teaspoonfuls at the same
 intervals, in the afternoon :
  And we shall see, in an immense majority of cases,
 that under the  influence of this medication, the exan-
 them,  and all its  concomitant  symptoms,  wUl  be
 extinguished as if by magic.
  When the disease pursues  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
 we should have recourse, but to sulphur.
  In this case,  causticum should  be continued in the
morning, and sulphur at  a high potency, 30th, for
example, should replace mercurius cori'osivus, in the
afternoon ;  but we should return to the latter as soon as
the symptoms have resumed their normal course.
  These  three  medicines :  caustic,  mere cor.  and
sulphur will almost  always  suffice for  the  treatment
of variola.  The  two  first  will abridge more than
half the whole  duration of the disease, and prevent 
164
Acute Exanthemata.
the secondary  symptoms, which it would be the mis-
sion, principally, of sulphur to repair.
  Belladonna, which  has been  much  extolled  for
small-pox, is not, nevertheless, appropriate to it,  ex-
cept as an accessory, and only in cases where cerebral
symptoms manifest themselves.
  When, on the contrary, there is no tendency to deli-
rium, belladonna has  the disadvantage of exciting,
and  that  without  any benefit, a  painful degree of
agitation.
  Lastly, under very rare circumstances, it is possible
we  may be obliged to  have recourse to  lachesis,
arsenicum, and to muriaticum acidum.   The well
known symptoms of these medicines  sufficiently indi-
cate the circumstances which would call  for their use.

                  VARIOLOID.
  Varioloid is a mild and modified variola; it passes
through the same periods, but leaves  no  scars.
  M. Moreau  de Gones (in  a memoir read  at  the
Academy  of Sciences, in October 1827,) asserts that
the varioloid is distinct  in its symptoms, its effects
and its origin,  from common variola;  that one is  not
preserved   from   its contagion  either  by  that  of
ordinary small-pox, or  by the power  of  vaccinia;
the vaccine-virus,  however, modifies its  pernicious
influence.
  I have seen varioloid declare itself  in children  re-
cently vaccinated; but it is probable that, without  the 
            Varicella — Chicken-Pox.        165
influence of the vaccine, it would have been the smaU-
pox.
  "It  is in fact  proved," says M. Billard, "that the
kinds of variola which occur  in  spite of vaccine, do
not differ, in their anatomical character, from those
which  attack patients not vaccinated;  that they fre-
quently even offer the same complications, and that
in general they have neither  appeared  more mild or
more fatal."  This last observation, I venture to say,
has no foundation excepting in relation  to individuals
who had been vaccinated  many years before.
  Be that as it may, varioloid does not differ essen-
tially from variola, and the same  treatment is adapted
to both.
             varicella — chicken-pox.
  Varicella differs somewhat  from variola, in its pa-
thological character.  The fever  which  precedes the
eruption of this exanthem is never prolonged beyond
thirty-six or forty-eight hours.  In combination with it
there are more  or  less marked symptoms of gastroin-
testinal irritation.  The pustules, instead of being regu-
larly umbilicated, like those of small-pox, are sometimes
conoid, sometimes globular, sometimes, in fine, umbili-
cated, but present the same type in the different periods.
  I have reason to believe  that vaccina does not act
as a preventive from varicella; and that, in turn, vari-
cella offers no protection from the small-pox;  i.t is for
this last reason, especially, that it is important not to
confound them together. 
166           Acute Exanthemata.
  Varicella is one of those diseases that are left, the
greater part of the time, to the efforts of nature alone.
Nevertheless, if it appears during dentition, it might
give rise  to cerebral, or  nervous  symptoms, which
would require, according to circumstances, the use of
belladonna or coffea.
  When varicella is a simple, non-complicated dis-
ease, a dose of pulsatilla,  administered in the begin-
ning, greatly abridges its duration.   It  is also recom-
mended as a prophylactic.

 VACCINA  AND VACCINELLA — COW-POX, AND SPURIOUS
                     COW-POX.
  The name Vaccina is given to  the eruptive disease,
which  results from the insertion,  under the epidermis,
of the vaccine virus.
  Vaccinella, or false vaccina,  is a minor disease,
nearly resembling it, and  consecutive, also, to inocu-
lation, but which does not possess, as does  the first,
the virtue of preserving from variola.
  We  see, then,  how important  it  is not to  confound
vaccina with vaccinella; and the more readily to dis-
tinguish them, let  us recaU here  the  characteristics
of the  two affections.
   Characteristics of vaccina.—Eight days after inocu-
lation reddish pimples appear, which soon become filled
with a fluid, first transparent, then  turbid,' the centers
of these pustules become depressed, their base inflamed
and swollen, and  lastly,  the humor they contain is 
Vaccina and Vaccinella.         167
transformed into a brownish crust,  which detaches
itself at the end of two or three days, and leaves after
it a cicatrice.
  Characteristics of the vaccinella.—After the inser-
tion of the vaccine in subjects already vaccinated, or
who have had the small-pox, or indeed, when the
virus inoculated is not in a proper state, we see also
developed pustules, but  which appear from the  third
to the fourth day, whose centers are not depressed,
and  whose flattened and  unequal  edges are not
swollen.  The humor contained  in these  pustules is
of a limpid yellow color.   An insupportable itching,
accompanies them  toward the  seventh or eighth day.
Crusts are also formed, but they fall without leaving
scars.
  We may vaccinate at all ages.   However, the con-
gestion  of the integuments,  during the first days of
life, seems to contra-indicate vaccination at this period.
" I  have several times seen," says M. Billard, " at the
hospital of the Enfants trouves, where they vaccinate
children very young, a  very intense  erysipelas devel-
oped upon the vaccinated limb."
  Hartmann has made, on the subject of vaccine, an
observation  which  deserves to be cited:   " The vac-
cine," says he, " does not preserve subjects to whom
the contagious principle of  variola has been  already
communicated, and who are susceptible to the action
of this  principle.   But  as one cannot know the period
of this infection, because, during its incubation, the
         15 
168          Chronic Exanthemata.
person feels well, so we cannot fix upon any time, up
to which only, it will be  useful to vaccinate.   In the
instance where a member of a family is  attacked with
small-pox, and the family contains several individuals
who  have never been vaccinated, the vaccination of
these would be of no use : experience has taught me
this.   But  this is not saying that vaccination would
be useless  for  the  whole community: far from it;
recourse  should be had  to it at once, in order  that
many may  be protected  from the contagion.   This is
rarely  propagated with such  rapidity as  to  make it
impossible  to preserve  those who do not come  in
contact with the persons affected."



           CHRONIC EXANTHEMATA.
  Chronic  eruptions  are external  manifestations of
probably very different essential diseases, which, when
they do  not  reveal  themselves under  the  eruptive
form, are only the more to be dreaded.
  Sooner or later, in fact, they break forth internally,
and then cause  ravages, so much the more difficult  to
arrest because it is nearly impossible to penetrate their
nature, and to  ascertain  the  remedies appropriate  to
them.
  This is what  often happens in cold and damp coun-
tries, where the skin performs its functions imperfect-
ly, and where cutaneous diseases are  rare, but where, 
CnRONic  Exanthemata.
169
 by way of compensation, we meet, at  every  step,
 tuberculous affections of the lungs, of the mesentery,
 of all  the internal organs, and a host of other analo-
 gous  lesions, having each, without doubt, its  special
 character, but  of which no  one  suspects the  prin-
 ciple.
   Now, it  is extremely  probable, that  all these im-
 penetrable,  and so often fatal, hidden  diseases, cor-
 respond to those which,  in warmer climates, manifest
 themselves under the exanthematous form.
   The determination of these morbid entities, internal
 or external, according to the  latitude, and especially
 the determination  of the signs,  by which we may
 recognize them, when they do not show  themselves on
 the skin, or when one has had the imprudence to repel
 them,  would, assuredly,  be an immense acquisition,
 for medicine and humanity.
  But,  unfortunately,  up to  the  present time, the
 closest, the most assiduous, and the most persevering
 observation, has afforded  us, with respect to them, but
very vague notions, from which practice  has  hardly
been able to derive any advantage.
  However  it  may  be,  it results from  what  pre-
cedes :
  1st.  That we  can scarcely attach  too much import-
ance to the treatment of chronic exanthemata ; since,
in abandoning them to themselves, or in treating them
improperly,  we infallibly expose  the patient  to the
most dangerous metastases. 
170          Chronic Exanthemata.
  2d. That  it is absurd, monstrous, to treat  these
diseases with local applications, which, in despoiling
them of their only apparent symptom, leaves to  the
practitioner, not even the resource of following their
progress.  So, it is  with the most profound  disgust,
that I go over, (as I still occasionally do,) the allo-
pathic therapeutics of the diseases of  the skin.
  In  consequence of the opinion I have formed, not
precisely upon psora, in the absolute sense in which
Hahnemann understood it, but upon  the multiple and
polymorphous 'nature  of chronic miasms,  I am  not
indisposed to  regard, as a  happy circumstance,  the
appearance of cutaneous affections in  children.
  I do not suppose, according to the vulgar  opinion,
that, in having this eruption, they thus pay nature a
tribute, by  which  they are thenceforward, forever
affranchised  from her;  but,  what appears evident to
me, is, that when they have been once cured, by sure
means, of a  tinea, of a  herpes,  or impetigo, they will
be forever delivered from malignant principles, whicb
might have remained latent  for a series  of years, and
finally have shown themselves in an incurable form.
  During the five  years that  I was  resident phy-
sician at  the baths  of Bagnoles, in Normandy, I
treated a very considerable  number  of  chronic erup-
tions.
  Independently  of  the bathers,  submitted to  my
daily observation, I had, in  the country, an extensive
practice, which gave me an  opportunity to  test, aside 
                     The  Itch.                 171
from the action of the waters, the  curative properties
of the remedies I employed.
  Thanks  to the co-operation of  some friends, who
were  good  enough to  aid me in my pathogenetic
researches, touching several new medicines, or medi-
cines  yet  but little known, I  have succeeded  in dis-
covering,  for chronic exanthemata, a treatment,  far
superior to that in general  use.
  To  make known, without reserve, the results of my
experience, is, for me, a duty full of charms.
  It is my intention to publish, some day, in extenso,
the homceopathic treatment of cutaneous affections ;
but it is evident, that I must here confine myself to a
limited view, and  especially  speak of the  eruptions
peculiar to children.

                    THE ITCH.
  This exanthem, almost always apyretic, consists in
an  eruption of vesicles,  very slightly elevated above
the level  of the  skin,  sometimes  of scarcely  any
marked color; transparent at the top, and accompanied
with an itching, which forces  the  patient to  scratch
continually, and  generally developing itself in the
folds of the joints.
  The itch commonly first shows itself between the fin-
gers, upon the wrists, and at the epigastrium.  Thence
it extends, little by little, until it covers  the whole
body, with the  exception of the face,  where it never
appears. 
 1*2          Chronic Exanthemata.
   When it is communicated from  the nurse, which
 often happens, it is  on the breech and thighs of the
 child that it first appears, because these parts come in
 contact with the arms of the nurse.
   The itch has  this peculiarity, that it is never spon-
 taneously cured.  As the vesicles ripen and disappear,
 new ones appear.
   The change from cold to  heat, especially the heat
 of the bed, increases the itching and renders it almost
 insupportable.
   When the patient, in scratching  himself, has torn
 open the vesicles, as almost always  happens, at  least
 in children of a certain  age, there  issues a mixture
 of blood and  serum, which in  drying,  forms  rather
 thick crusts of a dark red, and which give the patient
 the appearance of  having been scourged.
  When the disease is recent, and its nature has not
 been changed  by an external treatment, it is easy to
 perceive, especially between the fingers, little  regular
 red lines, of which each beginning in the vesicles, is
 prolonged under the epidermis, and  terminates  in a
 little brown point.  If, on introducing the point of a
 needle under the epidermis, we  extract this point, we
discover the acarus or sarcopte of man.
  This animalcule is about one two-hundredths of an
inch in  diameter.   Its body is rounded and  com-
pressed on the  sides; seen  through the  microscope,
its  form reminds  one  of that of the tortoise.   It is
 white, striated,  bristling  upon  the  back with  rigid 
The Itch.
173
papillae.   Its feet are eight in number, four anterior
and four posterior.  The former, placed on each side
of the head, and, as it  were,  webbed, are  furnished
with  cup-shaped  caruncles.   The  four   posterior,
fixed to the  abdomen, are shorter and more separated
than  the  anterior,  cylindrical  and unprovided with
the cups. The front feet and the head can, by bending,
be hidden under the body.
  The itch  is essentially contagious.   Some authors,
among whom I will cite Morgagni, attribute its devel-
opment exclusively to the presence of the acarus, and
regard, in consequence, this insect as the only vehicle
of contagion.   I am ignorant as to how far  this opin-
ion is tenable.
  According to Hahnemann, the psoric or itch miasm,
is the most contagious of all the chronic miasms.
  " It is communicated," says he, " with such facility,
that in passing from one  patient to another, to feel the
pulse, a physician often inoculates  several persons
without knowing it.  Linen washed with the clothes
which had  been worn by one who has the disease—
gloves, new, but which  an itch-patient had already
tried on ; a towel used for the purpose of wiping—have
sufficed to communicate the principle of infection.   It
often  happens that a new-born  child  contracts it  in
passing the  external genital parts of its mother, who is
affected with it, or that it receives this baleful present
from  the  midwife,  who had  caught it in  attending
another woman in labor, or contracts it, either at the 
174           Chronic Exanthemata.
breast of the nurse, or in the  arms and through the
caresses of those who have  charge of it, without enu-
merating the thousands of  other  occasions to be met
with in life,  of touching objects invisibly sullied with
this miasm."*
  Notwithstanding the authority of Hahnemann, it
is impossible to admit that the itch is communicated
with the facility he asserts.   But, it is well known,
that in his theory of psora, the itch plays the important
part,  or rather  the only  part.   The itch-eruption,
according to him, was  the primitive form  of  psora.
Now as he referred to psora, all the chronic  diseases
not syphilitic, he was forced to admit that the majority
of men had  had the itch; an hypothesis which could
only be sustained  by supposing, in this exanthem, a
prodigious tendency to communicate itself.
  Thus  Hahnemann, under the influence  of his fixed
idea, saw the itch everywhere.
  "In  1817  and  1818,"  says Hartmann,  "I  was
present  almost daily, at Hahnemann's consultations,
and I very often  heard him ask  his  patients if they
had ever had the itch.  At last he would say to them,
in a very positive manner: ' You have at some time
had the itch.'  I was very much surprised at the affirm-
ative reply of a majority of the patients.  Since that
time, I  never fail to put this question to those who
  * Doctrine et Traitment Homoeopathiques des Maladies Chron-
iques, torn, i, page 56, et suiv. 
The Itch.
175
 come to me for advice, and before Hahnemann had
 published his  Traite des Maladies Chroniques, I had
 very often found in sulphur and in hepar sulph. the
 appropriate remedy."
   1 do not know whether the patients, so affirmatively
 interrogated by Hahnemann, perfectly comprehended
 his question, when they replied that they had actually
 had the itch.  I do not know either if  the itch is more
 common in Germany than among us ; but what I can
 affirm is, that  in France, especially among the rich, or
 even among those in easy circumstances only, out of
 every  ten  interrogated,  nine positively declare  that
 they have never had the itch ; which however does not
 prevent them from complaining of chronic affections.
   I have seen, on the other hand, a great number of
 individuals, who  have had  the itch, and who have
 never been treated, except by external means, enjoying
 excellent  health.   Hahnemann  could have  found
 many, and striking proofs of this assertion, among our
 6ailors.
   But if, instead of asking patients this explicit ques-
tion :  Have you  had  the itch ? we content ourselves
with simply asking, if they  have had  any disease of
the skin, almost  all  reply in the affirmative.  Must
we consider all cutaneous  diseases but  transforma-
tions  of  the itch?  I am quite  convinced that this is
not the case.
  However it be, Hahnemann did not fail to attribute
to the repercussion of  itch pustules,  however little 
176          Chronic  Exanthemata.
apparent they might have been, and even when there
was no proof that they had ever existed, the immense
majority of the diseases submitted to his observation.
  The state of vague suffering that physicians are in
the habit of naming cacochymy, was equally, for him,
but the result of repelled itch, or  a latent psora, of
which he thus traces the principal symptoms:
  " Frequent excretion of worms ;  insupportable itch-
ing in the rectum, especially in children; in many
cases, sweUing of the abdomen; sometimes, insatiable
hunger, and sometimes, no appetite at all;  paleness,
and flaccidity of the muscles ; frequent ophthalmia;
styes; swelling of  the glands  of the neck;  sweat  on
the head; bleeding of the  nose in young girls and
young  boys, more  rare in adults ; hands generally
cold, or moistened with perspiration, or burning heat
in the palms;  feet  bathed  in a fetid sweat; frequent
numbness of  the   limbs;  frequent  cramps  in  the
muscles of the arms and hands ; subsultus  of  certain
muscular parts;  frequent  catarrhs;   dry  or  fluent
coryza;  obstruction of the nostrils ; painful  dryness
in the nose; ulceration of the nostrils, frequent  an-
gina ; frequent hoarseness of the voice ; short, hacking
cough;  frequent attacks  of asthma;  liability to  be
chilled;  great  tendency to sprains in  the back; fre-
quent headache  and toothache, of one  side ; frequent
flashes of heat;  falling  of the hair;' scales upon  the
scalp ; tendency to erysipelas ; disorder of the menses;
convulsive movements of the limbs, at the moment of 
The Itch.                  177
falling asleep, lassitude after sleep; perspiration during
the day;  tongue white, or, at least, very pale, and
cracked ; a  great deal of mucus  in the throat;  fetid-
ness of the mouth, acid taste ; nausea in the morning,
feeling of emptiness in the stomach; repugnance for
warm food,  dryness in the mouth; frequent  pains in
the bowels, hard or loose stools, hemorrhoides dry, or
bleeding; urine, dark colored; veins swollen with dila-
tation in the legs, (varices) ;  chilblains, even  in sum-
mer ; pains in the corns, without external pressure of
the shoe ; extreme liability to  dislocation of the joints,
cracking  in the joints  during  movement;  drawing
pains in  the nape of the neck, the back, the limbs,
and especially in the  teeth; renewal, during  rest,
of  the  pains  dissipated  by  movement;  renewal,
or  aggravation, of a  greater part of the symptoms,
during  the night, when the  barometer is very low,
during  north and northeast winds,  in winter,  and
toward the  spring;  too vivid and agitating  dreams ;
unhealthy  skin, frequent  furuncles,  whitlows ; skin
dry in the limbs, often, even, in  the cheeks; desqua-
mation of  the  skin,  in different places, sometimes
accompanied with burning and itching; appearance
of  isolated vesicles,  which  fill  with  pus,  and  oc-
casion  a voluptuous  itching, followed  by  burning
heat." *
  » Doctrine et Traitement  Homaopathique des Maladies  Chroniques,
tome i, page 66, et suiv. 
178           Chronic Exanthemata.
  I have no doubt whatever, that these minor disor-
ders, as well as  the more serious affections, of which
they are commonly but the precursory signs, are the
consequences of congenital, or  contracted  miasmatic
infections.    But,   that  these   morbid   phenomena
have  all  one common origin — that they may  be
all  referred  to  the same principle, and that that
principle  is  the  itch — is  what,  I  repeat, very
far   from  being   proved, is  extremely  improba-
ble.
  The itch is the disease of the poorer  classes;  or,
rather,  of uncleanly  people.   Thus,  a  sort  of dis-
grace is connected  with  it.   I  do  not  mean to
say,  that  persons  of  an elevated  condition,  and
who  take   great  care  of  themselves, are  alto-
gether  exempt   from  its  attacks:  but they  are,
it  will  be  admitted,  much   less  likely  to con-
tract it.
  May the itch be spontaneously developed ?   It is a
question not easily answered.   The causes of infec-
tion, in fact, are so diverse, and so numerous, that it
is nearly impossible to  be certain  of having avoided
them all.   As for myself, it is my inmost conviction,
that even, without necessarily admitting the interven-
tion  of a congenital  virus, the itch  exanthem may
result spontaneously, from a miserable alimentation,
joined to the sad necessity of wearing always the same
linen, and other garments. 
The Itch.                 179
  What is there astonishing in the idea, that the
acarus, like so many  other  animalculae, should  be
developed from the decay of dirty wool %
  This is so much the  more probable, because greasy
wool, or even  the woven wool, but more particularly
greasy wool, seems  endowed with the property of en-
gendering this  insect:  a circumstance which  explains
the  frequency  of the  itch among workmen—tailors,
drapers, scourers, spinners, etc.
  What is incontestable, is, that if the itch was only
transmitted by contact with those affected with it, no
persons in the  world  would be more exposed than
physicians, who pass  their whole  lives in  touching
patients  of all conditions.   Now, is  this exanthem
more frequent among  our brethren than  in any other
class of  society ?   I  venture  to  affirm  that it is
not.
   I admit, then, as origins of the itch exanthem:
   1st. Certain hygienic conditions, to which  misery
 too often  condemns the unfortunate ;
   2d. The itch infection, proceeding from immediate
 contact with one affected with it;
   3d. Its transmission through objects,  principally
 linen, sheets, or infected garments ;
   4th. The  spontaneous formation of the  acarus in
 woolen stuff, and some other substances,  such, it is
 said, as copal  varnish, pitch, and hemp;
   5th.  And lastly, The vicinity, and above aU, the
 contact of domestic animals, having this disease. 
180           Chronic Exanthemata.
  Whatever be the origin of the itch, its pathological
characteristics offer little difference.
  They take constantly one of the two forms, known
under the names, papulous itch and  purulent itch /
forms beside, scarcely sufficiently distinct to constitute
true  tj'pes,  and to  which  the same homceopathic
treatment is applicable.
  The papulous itch, (common dry  itch), is  charac-
terized by  elevations,  which produce an  intolerable
itching  at  every change  of temperature.  It shows
itself more particularly in the  dorsal region, on  the
arms, thighs and abdomen.
  The purulent itch, whose pustules are more devel-
oped than in  the preceding form, is also more violent.
It shows  itself more especially on the fingers, and  the
metacarpo-phalangial  articulations.   I have never
met with it in chHdren.
  The prognosis of the itch, depends upon  its origin,
and  especially upon the  degree of its  development.
The spontaneous itch, and that  which has  been com-
municated by animals,  are the slowest in being cured.
  Upon the  whole, the itch  is not a  serious disease;
it can only become so by being indefinitely abandoned
to itself, or worse still by being repelled.  But is it
not absolutely the same with the greater part of  the
diseases of the skin ?
  Treatment.—"When the  physician,  says  Hahne-
mann, " has recognized the  symptoms of the itch, it
suffices, avoiding all external application, to administei 
The Itch.
181
one or two globules of sugar the size of a poppy seed,
saturated  with tincture of sulphur,  dynamised, to
completely cure a  child, in two, three, or four weeks,
of the entire psoric disease;  that  is  to say,  of the
eruption, and of the internal psora.  In some cases, a
dose of carbo-vegetabilis, properly dynamised, may be
necessary ; in others, a similar doze of sepia." *
   The respect I  feel for the  genius of  Hahnemann,
retains, on the point of my pen, the reflections  with
which this  passage inspires  me; but, let one of his
pupils speak:
   " Hahnemann devotes but  a few lines to the treat-
ment of the itch.  From this, we  should be tempted
to believe, that nothing was more easy than the cure
of this  infection.   In  fact, it  is very natural that the
disease,  regarded by  Hahnemann  as the primitive
form of all  chronic diseases,  excepting those  derived
from syphilis and from sycosis, should be  dissipated
in  the surest and most prompt manner, in order to
save  Homoeopathy from  the  charge of insufficiency,
which, without that, one would have a right to make.
But, it  is not altogether so ;  at least, the homceopath-
ists  will  do well,  not  to  foUow  too rigorously the
precepts of Hahnemann, in order not to discourage the
patient, by  the excessively slow progress of the  cure.
It is precisely in  the itch, as the  primitive form of

  * Doctrine et Traitement Homceopathique des Maladies Chron.
iques, tome i, page 139. 
182           Chronic  Exanthemata.
chronic diseases, that it  should  be indifferent to the
physician, whether it is of recent or ancient origin ;
he should know how to cure  it,  and the cure should
not be  prolonged to infinitude, though it requires
much more time in this case than the other." *
  Thus,  M.  Hartmann  confesses, that, under  the
influence of the treatment recommended by Hahne-
mann, the cure of the itch is prolonged almost inde-
finitely.   My own  opinion,  on this  subject,  is  stiU
more decided.
  Nevertheless, while counseling practitioners to dis-
trust a little the precepts of the master, M. Hartmann
still considers sulphur as the specific for the itch:
  "The Hse  of it," says  he,  "should be continued,
until  the eruption  that  it induces, as weU as that
which preceded it,  gives place to the characteristic
Bensation of sulphur."
  M. Hartmann uses the tincture of sulphur, and its
dilutions, in recent  itch, and sulphur  in itch of long
standing, when the first  is  insufficient; " that is  to
say," says he, "if, at the end of fifteen days, it has
not produced at least,  an appearance of improve-
ment."
  In children under five years, he generally prescribes
tinct.  sulph., in  doses of two or three globules, re-
peated  every  other  day, and whole  drops, once  or
 * Hartmann: Therapeutique Horn, des Maladies Chr., tome ii
page 21. 
The Itch.                  183
twice a  day, if there is no change in the state of the
patient.
  In short, M. Hartmann confesses, that he frequently
unites, with the internal  treatment, " frictions, with
an ointment, composed of a half scruple of flour of
sulphur, and one ounce of hog's lard ;" an accessory,
not  very orthodox,  to  use his own expression, but
which  proves  the  insufficiency,  admitted  by  the
author,  of dynamised  sulphur, administered  inter-
nally.
  Thus,  I believe I have already declared, although I
am not in any case, and  less, perhaps, in the treat-
ment of cutaneous  diseases than in  any other, the
partisan  of external  remedies,  nevertheless, I do not
believe these remedies are always as dangerous as has
been supposed.
  When, for example, the itch, recently communicated
by the accidental adhesion of an acarus to  the skin
of a healthy man, is, as  yet, whatever  Hahnemann
may say,  but  a local affection, what can  be the
danger, in  stopping the disease, by killing the  insect
which propagates it, by the use of lotions, or sulphur
frictions ?
  I know, that the greater part of the time, the acarus
is the product, and not the cause, of the itch  eruption,
the same as lice are the  product of favus; but, in
short, when we have reason to believe that the contrary
is the case, must we then necessarily admit, out of
respect to the theory of psora—- a chimerical theory, (in
       16 
184           Chronic Exanthemata.
my opinion)—that, from  the  appearance of the first
vesicle, the disease has become generalized, and abso-
lutely requires an  internal treatment ?  Frankly, I do
not think so.
  I declare, however, that I employ no other ; but, at
the same time, feel  very much inclined to  absolve
those  homoeopathists, who, after the  example of M.
Hartmann, have  recourse to  sulphur  ointment,  in
consideration of results  so equivocal, and  always  so
slow,  from sulphur taken internally.
  Sulphur, I say it boldly, is a medicine, of which an
abuse is made; and this abuse is founded upon  a
strong prejudice.
  The theory of psora has made of sulphur the anti-
psoric, par excellence;  and the various properties of
this medicine, extremely precious, beside, and essen-
tially polychrest, have naturally contributed to prolong
this  iUusion.   But,  it is time that we  admit,  that,
though sulphur, in numerous cases, is one of our most
powerful agents, this is  no reason why it  should  be
always  prescribed, (as it is  every  day,) in  preference
to all other medicines, when the symptoms presented
by the patient, are not, clearly, in  the known sphere
of the symptoms it produces.
  The medicines  that I prescribe, against the itch,
whatever its origin,  form, or  duration, are lobelia
inflata and croton  tiglium, administered alternately,
and continued seven or eight days after the complete
disappearance of the exanthem. 
             Eczema — Humid Tetter.          185
  The tincture of sulphur, I only use in case of con-
secutive ulcers, with or without loss  of substance of
the skin ;  and then its use should be preceded by that
of the two medicines, that  I signalize as specifics for
the itch.
  Lobelia, at the sixth dilution, should be given, in
water, of  which  the patient will take three teaspoon-
fuls the first day.
   Croton-tiglium,  of the twelfth dilution, should be
administered, the next clay,  in the same manner.
  The third day, we  should return  to  lobelia;  the
fourth, to  croton, etc.
  From the  third  to the fourth day, at the farthest,
the itching   will have almost  entirely disappeared.
The total  duration  of the eruption, in ordinary  cases,
will not be prolonged beyond a week.

              ECZEMA--HUMID TETTER.
  Eczema, which nearly resembles the itch, and with
which it  has   sometimes   been confounded,  differs
from  it, nevertheless,  in certain well marked  pecu-
liarities.
  1st. It  is not contagious.
  2d.  As it  is not complicated, by the production of
the acarus, we do not see, in the intervals between the
vesicles, the little red lines traced by  them.
  The vesicles  of  eczema  are more resistent than
those of the  itch.   The  limped serosity they contain,
is very often re-absorbed.   They present themselves, 
186          Chronic  Exanthemata.
closely grouped  together, upon a circumscribed part,
most generally on the front part of the wrists and the
fore-arms, the inner and  upper  part of the thighs,
and on  the  heel.  If the eruption ever shows  itself
between  the fingers, it is only as a  single vesicle or
two, and, most frequently,  we see it appear, in this
isolated  way,  on the palms of the  hands, where it
excites an incessant itching.
  It is not uncommon to see the eczema suddenly dis-
appear from one part of the body, to  show itself upon
another.   Sometimes it  even entirely disappears for a
time, so  that the patients believe themselves quite rid
of it, and then returns, worse than  ever, in consequence
of some change of diet, or a few days of heat.  I have
seen eczemas which had lasted, in this way, for ten or
fifteen years, and even longer.
  I am, then, inclined to believe, that this exanthem,
always spontaneous, is rooted in the economy, at least,
as profoundly as the itch.
  It is not uncommon to see its disappearance accom-
panied by symptoms  of metastasis,  such, especially,
as rheumatic  pains, neuralgia, hoarseness,  and dry
cough.
  Eczema is more frequently met with in adolescents
and adults, than in children.  I have, however, seen
it in children at the breast, who, probably, were born
with it.
  The tingling itching  caused by this disease, in the
evening, and  during  the  night, is  insupportable. 
Herpes — Tetter.
187
Children and adults, attacked with it, lose their sleep,
in  consequence  of  it, for months  together.   The
former  cry  incessantly,  and weary  extremely their
nurses.
  The Allopathists treat eczema with sulphurous and
alkaline baths.
  The last, when they are highly charged with car-
bonate  of soda, cauterize, in a manner, the vesicles,
and allay, momentarily, the itching, which  the sulphur
baths but increase ; but, neither one  nor the other
cures eczema.
  Homoeopathy, up to the present time, had not found
the specific for this exanthem : I have  been fortunate
enough  to discover it.
  Rhus and ledum palustre, administered alternately,
in the same clay, the one (ledum) in  the morning, the
other in the evening, constitute  a  sure  means, heroic
in all cases, and followed by immediate success.
  I prescribe   these  two  medicines  at the fifteenth
dilution, and  in  intervals  longer  than stated above.
Ed. 2d edit.
  It is  well to continue the use of these remedies for
several days after the disappearance of the eruption,
which, in fact, almost instantaneously disappears.

               HERPES--TETTER.
  Willan, Bateman  and M. Rayer  have designated
under this name of herpes, an affection different from
that which bears the  same name in the works of Lorry
and Alibert. 
188           Chronic Exanthemata.
   In conforming to the definition given by these three
nosologists, I mean here by herpes a disease charac-
terized by globular vesicles, filled with a colorless or a
lemon-colored liquid of the size of a millet seed, ap-
pearing in  groups  more  or less  numerous  upon
different parts of the body, accompanied  by tingling,
and separated by intervals where the skin is often in
an erythematous state, which  only spreads in the in-
terstices of the vesicles forming each group.
   The groups of vesicles are irregular, or disposed in
circles.   Thence, the distinctive characteristics of the
different species of herpes, of which varieties have also
been established from the regions they occupy.
   Herpes, with the exception, perhaps, of the variety
known  under the name  of  herpes  circinnatus,  is
not  more common to childhood than to other  ages
of life.
   The herpes phlyctxnodes, is characterized by vesi-
cles disseminated, colorless, yellow or brownish, upon
small  erythematous  spots, whose appearance, which
commonly precedes that of the eruption for one or two
days, is almost  always  accompanied with  a little
fever.
   The  liquid  contained in  these vesicles, at first
limped,  becomes  after  a few  days  yellowish  and
turbid.   It  thickens  little by little,  and  forms yel-
lowish or brown crusts, which at the end of a week or
a little more,  fall off, leaving a red, and very irritable
surface, which assumes but slowly its normal aspect. 
Herpes — Tetter.
189
   This form of herpes is never serious; the upper lip,
 and the corners  of the  mouth  are  its most habitual
 seat.   The  disease, generally, disappears spontane-
 ously, although  it is sometimes sufficiently obstinate
 to require treatment.
   Ferrum chlor. and rhus tox. are the two medicines
 whose  alternate  use has  given  me the  most satis-
 factory results.
   Ferrum chlor., twelfth or fifteenth dilution,—a few
 globules, in about four ounces of  water,—will  at first
 be administered, two days in succession, a teaspoonful
 morning and evening.
  Rhus tox., same dilution, and prepared in the same
 manner, will be given the two following days, three
 teaspoonfuls in the twenty-four hours.
  This course may be several times repeated, in the
 same  order, in those cases which I affirm will be very
 rare, where the four first days of treatment shaU not
 have very sensibly modified the eruption.
  Herpes circinnatus, or  ringworm, which is very
 common, even in infants at the breast, bears much
more than the preceding  variety, the  stamp of a prim-
itively chronic affection
  The  specific nature of the eruption, is also more
 clearly implied:  it seems derived from the singularity
 of its  form.
  Herpes circinnatus, although we  sometimes see it
spontaneously disappear  at the end  of a  few  weeks,
has also a tendency, in  general,  to last a long time, 
190          Chkonic Exanthemata.
and  above  all to be reproduced.   Like eczema, it
sometimes disappears during the winter to return with
the heat of summer.
  This tetter  manifests itself in circular  spots on the
circumference of which is developed a row of vesicles.
  These  opening at  the end of four or five days, dis-
charge a  lemon-colored liquid, which in drying  form
little brownish  scales around which  soon arise a new
crop of vesicles, similar to the first, and which run
through the same periods.
  This process  is continually renewed,  the  herpes
increases in extent, and presents  at  its center a kind
of islet, where the skin, wrinkled, cracked,  and of a
violet red, at length scales off.
  The groups are more or less numerous; I have seen
a child of five years whose whole body was covered
with it.  Sometimes, on the contrary, there will be but
one  group, and in  certain cases even it is so  little
apparent that the disease might pass unperceived.
  Baryta  carbon., of a medium dilution, the doses
repeated  several times a day,  is the specific for this
tetter.  I need only observe  that it is  necessary to
omit one day in three the use of this  medicine.
  Hopes prceputialis only differs from the preceding
in the region it occupies.  It is important not to con-
found it in the new-born with a syphilitic affection.
  Having never had occasion to make a special study
of this affection,  I  borrow from  M. Hartmann, the
treatment he proposes for it. 
Crusta Lactea.
191
   "Cleanliness," says he, "is here of the first im-
portance.   If the herpes is on the external surface of
the prepuce, it should be protected from friction by an
envelope of linen spread  with  an ointment of marsh
mallow; if it is on the internal surface, repeated injec-
tions should be made of warm milk or a decoction of
marsh mallow, and the parts be carefully washed after
each evacuation of urine.
   Mircurius prcecipitatus  rubr., 2d  or 3d  tritura-
tion, morning and evening, is a capital remedy in an
advanced stage of herpes of the internal surface of the
prepuce; if after three days, this remedy has not dis-
sipated the disease, and it produces a violent itching,
it  should be succeeded by acidum nitri.
   Acidum phosphoricum, will   be  preferable when
the eruption is  principally concentrated  around the
fraenum.
   Hepar   sulph., silicea and  sepia, are  indicated
when the eruption occupies the  external surface, and,
in this case especially, petroleum, if it is  accompanied
by a continual diarrhea.*

           crusta lactea — milk crusts.
   This exanthem, to which the vulgar have given the
name milk crusts, and in certain countries milk itch,
is  described by authors under the  denominations of
achores, porrigo and  tinea mucosa.
   'Hartmann, Onv. Cit., tome ii, page 66.
17 
192          Chronic Exanthemata.
  It is characterized by little pustules  disposed  in
irregular groups, developing themselves upon the face
and the scalp, and furnishing abundantly a viscid fluid.
These pustules, at first white and  very  slightly ele-
vated, are surrounded by a red, inflammatory areola.
The yellow or greenish humor discharged  from them,
is transformed, in drying, into thin  and yellow scabs,
which  by their successive accumulation spread some-
times to such a degree as to form a veritable mask.
  Tinea  mucosa  is very frequent in children at  the
breast; it commonly appears  at the age of three, five
and  eight  months.  It is neither dangerous nor con-
tagious,  and  it  is  very seldom, among the great
number of children affected by it, that one dies.
  The vulgar, perhaps, with reason, regard this affec-
tion as a salutary depuration.
  "I have seen," says M. Billard, "agreat number of
children  at the breast  attacked with tinea mucosa, at
the hospital of Enfants-trouves; very few among them
died, and the greater  number of them, after the dis-
appearance of this  inflammation, acquired a  fresh-
ness and embonpoint which confirmed  the popular
belief.*
  Crusta lactea, generally shows  itself first upon the
forehead and cheeks, whence it spreads over the rest of
the face, to the ears, scalp,  sometimes to the neck and
shoulders, seldom beyond.  I have seen it exist simul-
* Billard, Ouv. Cit., 151. 
Crusta Lactea.               193
taneously with various  other exanthemata, and  espe-
cially with herpes phlyctenodes.
  The pruritus it  occasions, is relatively inconsider-
able, at least, when it does not occupy the scalp, and
becomes complicated with the existence of lice, which
rarely happens in very young children.   The  greater
number of children affected with this disease, neither
lose sleep, appetite, or even  their  gayety, in conse-
quence ; but  their condition  does not fail, greatly to
annoy their  mothers and nurses,  on account of the
disagreeable appearance they present, and the rancid
and fetid odor they exhale.
  Treatment.—Hartlaub  extols, against tinea  mu-
cosa, aconitum, followed by a single dose of viola tr.,
of the third dilution.  " This  treatment,"  says  he,
" soon ameliorates  the condition of  the child ; and the
disease, commonly, entirely disappears at  the  end of
a fortnight.   If the progress of the cure is arrested,
a second  dose of viola  should  be administered ; and,
in  case  this  does not procure as  complete  a resto-
ration of health  as was expected, it will be infallibly
obtained by means of a dose of sulphur, of the 30th
attenuation."  *
  Hartmann recommends  viola  tricolor,  when  there
is an  insupportable burning itching, especially during
the night, with the characteristic odor of the urine.
" Before  I  was  acquainted,"  says he,  " with  the
superiority  of this medicine,  I  obtained,  although
    * Hartlaub : Le Mddecin Homaeopathe des Enfants, page 59. 
194           Chronic Exanthemata.
much more slowly, the cure of the disease, with other
medicines, principally with staphysagria, rhus,  and
sulphur."
  As for myself, experience  has proved  to  me, that
the several  medicines mentioned by MM. Hartlaub
and  Hartmann, may be,  in almost all cases, replaced
with advantage, by a single substance, which I have
reason to consider the specific for tinea mucosa.   I
speak of sepia, which I prescribe at the 30th dilution,
and  in doses repeated three times a day.*

             CRUSTA SERPIGINOSA.
   This eruption, ranged  by Wichmann in the class of
herpetico-syphilitic exanthemata, by the side of psori-
asis, and considered by  Hartmann, with Autenreith,
as being of a scabious  nature, presents the greatest
resemblance to the one I have  just described.  But it
is more  painful,  more  obstinate,   more essentially
chronic.  The itching accompanying it,  is extremely
troublesome.
   The vesicles which form these crusts, almost always
show themselves in front of the ear, in the  neighbor-
hood of the parotid.  They are  surrounded with an
areola, of a clear  red color,  and cause, from the first,
great itching, especially  during the night.
   These vesicles are smaller than those of crusta lac-
tea.  They are constantly renewed  under the scabs.
Lastly,  (distinctive characteristic,) crusta serpiginosa
       *  Has been found practically correct.  Ed. 2d edit. 
                     Impetigo.                 195
is constantly developed in cacochymic, thin, debilitated
children, the  reverse  of crusta lactea, which most
commonly  attacks the robust.   We have seen it last
for years :  it is never cured spontaneously.
  Treatment.—Although crusta serpiginosa is  con-
sidered as  one  form of the itch exanthem, sulphur is
absolutely  without effect in this disease.
  Sepia  sue, at repeated doses, sensibly ameliorates
the state  of the  patient, but does not  always cure
the disease.
  The fundamental remedy, the one we would espe-
cially point out to  the attention of physicians,  the
only one,  perhaps,  upon which  we  can depend, is
silicea.
                    IMPETIGO.

  " Impetigo,"  says M. Billard, " is a disease, much
more frequent  in  adults than  in children.   Authors,
nevertheless, range among the predisposing causes of
this disease, the first  and second dentition.   I  have
never  seen it in children  at the breast, who are, on
the contrary, very subject to different species  of tinea,
and principally to tinea mucosa, between which  and
impetigo sparsa, it  is very difficult to trace a distinct
line of demarcation." *
   The truth is, that impetigo sparsa, which does not
differ  essentially  from  impetigo figurata, is exactly
* Billard :  Traite des Maladies des Enfants Nouveaux-ncs, p. 145. 
196           Chronic Exanthemata.
the same disease  as  tinea  mucosa, modified  only,
either by the age of the patient, or by the part of the
body affected.
  If, in effect,  tinea  mucosa is  almost always, in
children at the breast, limited to the face  and scalp,
it is not so with older children and with adults.   It is
not uncommon to  see it appear upon the shoulders,
upon the arms, and even upon the  lower  extremities
of the two latter.   It shows itself then in the form of
spots,  circumscribed  and  of different  dimensions;
those of the upper limbs are usually small and round;
those  of the lower, on the contrary, large, oval, and
irregular.   These spots, which are of a dark-red, have
appearing  upon  them numerous  yellow  pustules,
which, at the end  of a few days, open, and discharge
an acrimonious  sanies, which corrodes the surrounding
parts,  causes  an  intense and painful  itching, and
forms  afterward,   yellowish   or  dirty-green crusts.
These crusts fall off within three or four weeks, and
leave a rough surface,  which is disposed to crack, and
become excoriated, in  such a way as that the disease
may be prolonged for several months.
  Treatment.—Although tinea mucosa and impetigo
are fundamentally, as I have just said, identical affec-
tions,  the different conditions under which the two
forms  of  this  disease are produced, call for  some
difference in their treatment.  Dulcamara and clematis
are the medicines which have succeeded  best with us
in the  treatment of impetigo.  The use  of these two 
Tinea Favosa.
197
medicines should be simultaneous.  They should both
be prescribed at a medium dilution, and the doses be
frequently repeated.   Dulcamara should  be admin-
istered twice,  in  the forenoon, and  clematis once, in
the evening.
   Silicea will be  necessary in the case of lancinating,
very intense  itching pains, and  in  abundant suppu-
ration.
              IMPETIGO RODENS.
   This affection is  unknown  to  childhood.  I only
mention it here, in order to have occasion to point out
to practitioners three medicines, whose successive use,
continued for several weeks, (eight days for each), has
procured me the most happy results, in the treatment
of this exanthem.  The three medicines  are, in  the
order in which I  have used them, (in doses repeated
several  times  a  day), copaivce  balsamum, cuprum,
and digitalis.

        TINEA FAVOSA — SCALDHEAD.
  Tinea favosa is characterized by an eruption  upon
the scalp, and sometimes, but very rarely, upon  other
parts  of the body, of numerous  small red pimples,
which hardly rise  above the level  of the skin, to
which promptly  succeed little  yellow pustules, of
which the summits become almost  immediately cov-
ered with very adherent, irregularly circular crusts,
at first  yellow, then brownish  or gray, and always 
198
Chronic  Exanthemata.
depressed in the center, in the form of a cup.   These
pustules are sometimes isolated, sometimes agglomer-
ated.   The  crusts, when  taken off,  exhale  a pene-
trating and disagreeable odor.
  This disease is  much more frequent in children of
seven  or eight  years  of age, than in infants at the
breast.
  Like tinea mucosa, it may exist with aU appearances
of general good health; but I have  found that the
greater number  of those affected with it were pale,
feeble, languishing, and suffering from a sort of caco-
chymia, that in many among them might, perhaps, be
attributed  to defective or even insufficient  nourish-
ment.
  As to the temperament or constitution, which pre-
disposes children to tinea favosa, I confess that I have
no fixed opinion upon the subject.
  " We have but seldom seen," say  the authors of a
voluminous work upon  the  diseases of children,*
" tinea developed in consequence of, or during the
convalescence from, a serious disease."
  We  remember, however, several cases in which a
febrile  disease had  temporarily checked  the progress
of favus, or even  caused it  to disappear;   but  no
sooner  was the internal inflammation cured, than that
of the  scalp returned with  the same  intensity  as
  *MM. Rilliet et Barthez : Traite Clinique et Pratique des Mala-
dies des Enfants, vol. 3, Paris, 1848, page 125. 
Tinea  Favosa.
199
before.  It has been generally asserted, that scrofulous
subjects were  especially liable to favus.   We cannot
confirm this remark.   The greater part of the children,
who occupied  the scrofulous wards, were not affected
with tinea; and the greater part of those who occupied
the tinea wards, were not scrofulous."
  Tinea favosa, is at least as contagious  as the itch.
Not only is it transmitted by immediate contact, but
by the dress, linen, combs and brushes used upon the
heads of affected children.
  M. Rayer has reported an observation of Gallot, of
a  child inoculated   with  tinea, by means of a  cata-
plasm, which  had been used upon another child, and
to which still  adhered the crusts of the favus.
  When this  disease continues for a long time, (as it
always does when badly treated, or when left to itself)
it at  length   affects  the bulbs of the hair,  so  as  to
produce  its fall.   The  portions of  the skin  thus
denuded,  remain white and smooth.    As with  all
other obstinate  ulcerations of the scalp, tinea  favosa
gives rise  to  more or less considerable  engorgement
of the ganglions of the neck, and sometimes even  to
abscesses, it is  not  uncommon  to see it complicated
with ophthalmia, coryza aud irritation of the digestive
organs.
   The untimely  disappearance of  this  exanthem,
when  produced either by injudicious treatment,  or
occurring spontaneously, is always a serious symptom, 
200
Chronic  Exanthemata.
 though its consequences are not in all persons imme-
 diately manifested.
   Treatment.—It is not absolutely with tinea as with
 the itch.  The  first  may be cured, or at least  disap-
 pear  spontaneously.  This even often happens with
 children upon  a change of regimen, as  in returning
 home, for example, from boarding-school.
   Notwithstanding, it is far from being always so.   It
 has been supposed, that tinea acquired by  contagion,
 was, in general, more tenacious than that  which was
 spontaneous.
   The  treatment of this affection is the triumph of
 Homoeopathy.
   When one is so fortunate as to  have  to  treat chil-
 dren,  who  have  not  been gorged  with  allopathic
 remedies, the rapidity with which infinitesimals cure
 favus, is at times marvelous.
   There are, however, cases where the disease  resists
 and demands the successive use of several  medicines.
   Sulphur,  dulcamara,   viola  tricolor,  oleander,
 hepar  sulph., form the  basis of the therapeutics ap-
 propriate to the different shades of this exanthem.
   Among  these first medicines, the first  two have
 especially succeeded with me, and in cases precisely
 similar.  They  are both adapted to the humid form
of the disease in children of blond and fresh complex-
ions.   I prescribe sulphur, in very small doses, and at
the thirtieth dilution ; dulcamara, in a little stronger 
Tinea  Favosa.               201
doses, and at a medium dilution.   It has seemed to
me several times, that sulphur, even  so  attenuated,
irritated the chest, an effect never produced by dul-
camara.
   Viola  tricolor may be  alternated with  sulphur or
didcamara when the itching is veiy violent.
   Oleander is,  according to M. Hartmann, a  medi-
cine upon whose efficacy we may rely ;  "if the erup-
tion, which  has a great resemblance to the vesicles of
the itch, is characterized by an intense itching, and by
an insupportable nocturnal burning after scratching
the  head; and if at the  same time, the  mesenteric
glands appear to be affected, which is  seen in the
swelling, hardness and tension of the abdomen, as well
as in the stools, which are sometimes hard, more fre-
quently loose  and undigested, like a sort of lientery."
   Hepar sulphur corresponds to  cases  where the
exanthem, instead  of  being limited  to the  scalp,
extends to the nape of the neck or the face; and to
cases also,  where ophthalmia  supervenes,  with or
without ulceration of the cornea, etc.

               TINEA GRANULATA.
   Tinea granulata  consists in little pustules,  super-
ficial  and irregularly disseminated  over the scalp.
These pustules, at first  humid and irregular,  give
place to gray or  brownish crusts, which are never de-
pressed in the center, and whose fragments are often
found  scattered through  the  hair.   When the crusts 
202           Chronic  Exanthemata.
agglomerate and dry, they harden and adhere strongly
to the hair.
  Authors say that tinea granulata is not  contagious.
  This   exanthem,  which  never  attacks children
before their fourth year, seems to show itself  in pre-
ference, in brunettes,  and in subjects of a dry con-
stitution.
  I believe that this form of tinea does not differ essen-
tially from  favus, and that  the same treatment  is
appropriate to both.

              TINEA ANNULARIS.
  Tinea annularis, first described by Alibert, under
the name of favus  squarrosus, and  since, under that
of favus scutiformis, is only, as well as tinea granu-
lata, a variety of tinea favosa.
  " It presents in the beginning," says Doct. Baumes,
" elementary crusts, rounded, yellowish,  depressed in
their center, precisely like those of favus vulgaris.*
  " But here, the depression  in the center soon disap-
pears,  and  the  crusts, ranged circularly,  are more
crowded  and more  prominent on the circumference
than in the center.   They are very dry, of a yellowish
white, and form by their union in round spots, a kind
of  incrustation sometimes much elevated above the
skin.
  "When one continued crust covers the whole head,
* Tinea favosa. 
Tinea Annularis.
203
forming  a kind  of cap, in the favus vulgaris, we
alwajrs perceive here and there a few cup-like depres-
sions, while in the favus annular., it is all one gray-
ish-yellow crust,  clearly circumscribed  by a line, or a
group of circular lines."
  This variety of tinea, fortunately rare, is one of the
most obstinate affections with which 1 am acquainted.
  In the month  of July, 1847, I was consulted for
three little boys of the same family, all affected with
an  eruption  of the scalp, of which I dared not pos-
itively state  the  precise nature, but which  probably
belonged to the  variety of the tinea, of which we
are now  speaking.
  The oldest  of  these children was  thirteen,  the
youngest, nine.
  The three  brothers  were  strikingly alike.  They
were rather tall and thin, not lymphatic, quick, alert,
gay, and apart from the railleries of other  children of
their village, were, to  all appearance, very little con-
cerned about the disease for which their parents had
called me ; a disease which caused  them  no pain, no
uneasiness, not even, as they assured me, the slightest
itching.
  It was a sort  of cap, of a  greenish  yellow, resem-
bling dried honey, gluing  down the hair to such a
degree as to leave it free only at the temples and the
occiput, presenting a regular surface, hardly wrinkled,
thinning at the  circumference, and   presenting the
greatest  thickness at the top of the head. 
204          Chronic Exanthemata.
  This irregular crust, which prolonged lotions only
detached in great  scales, and which were reproduced
in a few days, appeared to be rather the product of a
uniform exudation, than the concretion of a humor
furnished by pustules.   There were, beside, no traces
of pustules.   The skin beneath  was red, slightly
inflamed, but not ulcerated.
  This disease was certainly neither an eczema,  an
impetigo, nor a favus.
  I at first supposed that it might be the disease that
Alibert  has described, under the name of tinea ami-
antacea ; but I have since recognized my error.
  Some one, more  skillful than myself, may give it  its
true name, or a  new  name, if they think proper.
What I have to do, is to point out to practitioners the
medicines that effected the cure.
  Dulcamara, sulphur,  staphysagria, and baryta
carb., administered by  turns, for several weeks, had
produced  absolutely no effect,  when, guided  by con-
siderations which  it would take  too long to explain
here, I prescribed successively,  spigelia,  tabacum,
and, lastly, ferrum magneticum.
  Spigelia and tabacum were each administered for
one week, the first at  the twelfth, and the  second  at
the sixth dilution,  in doses repeated four times a day.
From the third week I gave ferrum magnet., at the
sixth dilution, for fifteen days, morning and evening.
  The same treatment  succeeded with my three little
patients.  In less  than six weeks, every sign of crust 
             Pityriasis — Strophulus.          205
had disappeared from the head, and the hair began to
grow  abundantly.   I have  not seen  these children
since ; but I  heard from them the following summer.
Their tinea, (was it tinea ?) had not re-appeared.
  Perhaps the same treatment, which succeeded with
them, would  be applicable, or would deserve to be
tried, in other analogous and intractable affections of
the scalp.
                   PITYRIASIS.
  The desquamation of the epidermis  is thus named.
It is the herpes furfuraceus of Alibert, and the scaly
tetter of the  vulgar.
  No  one, assuredly, would  call  a physician for so
trifling a disease;  and yet light  as it is, the disease
might embarrass more than one  conscientious physi-
cian ; for, when seated on the scalp, where its presence
is excessively  annoying  to young females who are
affected with it, it obstinately resists the greater part
of the known remedies.
   Reiterated experiences  have,  however,  convinced
me, that cantharis is the specific for pityriasis.
   A  few globules,  of the  thirtieth dilution  of this
medicine, in a glass of water, of which a teaspoonful
should be  administered,  morning  and evening, for
three or four days.
                   BTRO P HULUS.
   We so call an  eruption of little pimples,  that are
 hard to the touch, compact, red or whitish, developing 
206
Chronic Exanthemata.
themselves, first on the face, then on the limbs, never
terminating in pustules, crusts, or ulcerations, but
sometimes leaving behind them a slight efflorescence,
which  is  commonly accompanied  by great itching.
These pimples may be rare or numerous, disseminated
over the whole body, or accumulated together upon a
part, and are sometimes intermixed with erythematous
spots.
  Strophulus, a disease very common among children,
shows itself, principally, on the face of chHdren at the
breast.
  This  exanthem almost constantly coincides with a
more or less marked irritation of the digestive organs,
an irritation on which the affection of the skin seems
exclusively to depend ; so that a judicious treatment
of the former, is certain to be followed by the disap-
pearance of the latter.
  The medicines from which we  have to  choose, are,
consequently,  according to the nature  of  the case,
ipecacuanha, pulsatilla, rheum, antimonium crudum,
and, more especiaUy, causticum and chamomilla.

                    prurig o.
  Prurigo  is  an  exanthem, characterized by  hardly
visible papulae, accompanied by a severe itching.
  Authors distinguish two species : the prurigo of old
people, and the prurigo  of children—a badly founded
distinction, since it  rests only upon  the age of the
patient, and not at all upon the anatomical character 
               Psoriasis — Scrofula.            207
of the disease.   M.  Billard thinks that prurigo, in
young children, may arise from  want and  uncleanli-
ness.
  It is, indeed, rare that  this disease manifests itself
in children who have good care and suitable nourish-
ment.   It is, like the greater part of the affections of
the skin, simple,  or complicated, spread  over the
whole body, or limited to a single part.
  Treatment.— Calcarea, mercurius, hepar sulphur,
etc., have been recommended for prurigo ; the reme-
dies from which I have obtained the best results, are
causticum and  mercurius solubilis.  (Conium,  Ed. 2d
edit.)
                   PSORIASIS.
  Psoriasis, is  not a disease peculiar to children; I
shall, therefore, abstain from giving a description of it
here.   It has, nevertheless, been  seen in children at
the breast.   I  would suggest to  practitioners, should
such a case present itself to them, the use of mercurius
solubilis, a medicine whose remarkable efficacy I have
proved but upon adults only.

                   SCROFULA.
  Some  readers will  perhaps be  astonished  to see
scrofula  figuring  among  cutaneous  diseases, from
having for a long time been accustomed to consider it
a disease essentially general  and  constitutional.  The
impression is so strong, that when it shows itself on
the skin, it  is  only accidentally,  that  in these  latter
       18 
208           Chronic  Exanthemata.
times  nosologists  have purposely  blended  it with
tuberculation of the  lungs, of the mesentery, and of
all the internal viscera.
  But, in recalling what I have said in my introduc-
tion  of diseases  in  general, and more particularly
chronic diseases, one cannot but concede that all the
exanthemata are in exactly the same case as scrofula.
  All, in  fact, as well as this last  are but the efflo-
rescence  of morbid  principles deeply rooted  in the
economy,  and hence,  capable  of  exercising their
ravages elsewhere, as  well  as upon  the cutaneous
envelope.   I am equally well convinced that they have
often  a large  share  in the development  of internal
diseases, that, for want  of more  precise  information,
nosologists attribute without distinction to scrofula.
  There are even among them, those, who are not far
from referring in  mass to  the principle of which we
speak, all affections  of a protracted nature, whether
internal, or external, of which no inflammatory symp-
tom marks the existence, and which they, nevertheless,
name (antiphrastically, no doubt) chronic phlegmasia.
  Thus, for  many physicians, impetigo, herpes, all
the forms  of tinea, etc., are, as well as rachitis, dropsy
and tubercles, only particular forms  of scrofula.
  This bold generalization of incongruous phenomena,
a sort of abstract and conjectural synthesis of which
psora is after all but the broadest expression, has had
little other result, up to the present  time, than to fill
with doubt and confusion the minds  of practitioners. 
Scrofula.
209
  What  matters  it to us, in  fact,  that  the different
manifestations  of the same disease are  called by the
same name, if inexorable  experience every day proves
to us that each  of these manifestations  requires a par-
ticular, and quite as special a  treatment,  as if it really
constituted a distinct affection ?  What  matters it to
us that  the gout, breaking out  in the  great  toe, in
the knee or anywhere else, does not cease to be the
gout, if we are ignorant of the treatment it calls for,
according to the region it occupies %
   Similar considerations  had in  the beginning, so
forcibly struck  the founder of Homoeopathy, that in
publishing his  doctrine, he commenced by suppressing
all morbid individualities admitted before him.  He
eventually saw that he  had gone too far, and retraced
his steps ; but  psora led him  astray.
   I have,  however, expressed  the thought  (and  I
 cannot refract  it), that it would be fortunate for medi-
 cine and for humanity if all the  pathogenetic  miasms
 were sufficiently known  to be classed according to  a
 complete ensemble of their respective  symptoms.
   I do not doubt, in fact, that  such  a  classification,
 from the instant that it should present  in all its parts
 the criterion of  certainty, would cause  great progress
 in therapeutics.   But we are yet a great way off from
 this.
   Let us not forget, beside, that the specificity of our
 remedies  corresponds,  perhaps, still less to the actual
 properties of morbid agents,  than  to the idiosyncratic 
210           Chronic Exanthemata.
nature of the  disorders they produce.  Let  us not
forget, above all, that the modifying power of each of
our medicines has its  sphere of activity, and  its seat
of election;  such  a one acts upon the skin, and pro-
duces no effect  upon the bones, nor upon the nervous
centers.
  Thus then, scrofula, in the limited sense it suits us
to regard it, is an affection essentially chronic, affect-
ing especially the lymphatic ganglions, and more par-
ticularly those of the neck, the armpits and the groins.
The external and  general habit of the subjects who
are attacked with it, is characterized by the following
Bigns:
   Scrofulous subjects  have  large  heads,  especially
behind; the  temples depressed; the neck  thick and
short; the  face puffed, the nose and  upper  lip fre-
quently swollen.   Their skin  is white, fine and rosy,
transparent, or muddy.  They have commonly light
hair and blue eyes, with dilated pupils.
   A kind of embonpoint of a bad quality, seems  at
first sight, to indicate in them a rich nutrition; but
upon closer  observation, we soon recognize a defective
structure.  Beside the flesh being soft, flabby, and as
it were spongy, the hips are too large in proportion to
the chest, and the abdomen too prominent.
   Lymph is superabundant in all parts of the body.
All the mucous membranes secrete beyond measure,
and if these subjects chance to wound themselves,  the
wound suppurates, and is long in healing. 
Scrofula.
211
   They are subject to epistaxis, and catarrhal affec-
tions of the nasal  fossae, of the bronchiae, or of the
digestive organs, upon the slightest cold.
   It is  not necessaiy to say that  these general signs
are not  absolutely constant in scrofulous subjects.
   I have seen those of this class, who had well-formed
bodies and dark, or even  absolutely black hair, and
who in  a word, presented only the local symptoms of
the disease.
   These consist in the presence, more or less appreci-
able to  the touch and sight,  of glandular indurations
in front of the ears, under the  jaws, on  the neck, in
the  armpits, more  rarely in the  groins, and other
parts of the body, largely provided with lymphatic
glands.
   These tumors, which are almost always developed
very slowly, are  at first isolated, movable under the
finger, soft, and with but little sensibility.
   The skin which covers them  is of a normal  color.
They are, in the same region, solitary or multiple.  It
is  not uncommon to find them, in the neck, for exam-
ple, united in great numbers, and forming a sort of
subcutaneous necklace.
   If the disease makes progress, these tumors enlarge,
little by  little ;  sometimes  several  uniting in  one,
harden, cease to be  movable,  and become painful.
Lastly,  the skin reddens, corrodes  and ulcerates, often
in several places  at once. 
212           Chronic Exanthemata.
  Scrofulous ulcers have  no end, when left to them-
selves.  If, at length, one closes, another soon  suc-
ceeds to it.
  The discharge from them is rather a thin and turbid
serum, than true pus.
  These abscesses always leave behind them cicatrices,
more or  less apparent,  but always  greatly to  be
dreaded, because, always bearing with them  the seal
of their origin, they often become, subsequently, even
for  the most  radically cured patients, a subject  of
reprobation, in important circumstances.
   The  majority of families, in fact, have a great  re-
pugnance to an alliance with a  scrofulous  person;
and, I confess, to be sincere, that  this repugnance is
not  ill-founded, for, of all hereditary diseases, scrofula
is, perhaps, the one parents the most infaUibly trans-
mit  to their offspring.
   It is rare, however, that  children bear, from  their
birth, the flagrant signs of this sad inheritance.
   They seldom present the first symptoms of it before
the second or third year.   But, it is especially between
the period of the second  dentition and puberty, that
scrofula most frequently shows itself.   We may, then,
consider it an affection peculiar to second childhood.
Both sexes are equally exposed to it.   When it is not
very intense, when, especially, it has not impressed its
stamp upon all the systems of the organism, the epoch
of puberty sometimes cures it.   I believe, beside, that 
Scrofula.
213
this disappearance of scrofula, under the influence of
sexual evolution, occurs more frequently in girls than
in boys.
  There  are  scrofulous children,  who appear of a
remarkable intellectual  precocity.   But, perhaps this
observation,  made by  the  majority of writers, arises
from  the  surprise experienced by  the contrast of an
even  ordinary mind,  with an  infirm body,  which
would seem to belong to a more  tender age than  that
the little patients have really attained.
   I believe, on the  contrary, with Hufeland,*  that
scrofula,  at an advanced period, impairs the intellec-
tual faculties.  I  would cite, as a proof of this, the
Cretins of the Valais,  who are  certainly only scrofu-
lous subjects.
  It is true  that in  these  last,  the disease is no
longer limited to  engorgement, or ulceration  of a few
ganglions:  it has  taken possession of  the whole econ-
omy,  and reached  even the brain.
  It is, in  fact,  the characteristic of scrofula, when
art does not arrest its  progress, when,  above all, a
humid atmosphere and bad  nourishment favors its
development, to spread its ravages,  not only to all
parts  of the body  where lymph circulates, but to carry
disorganization into organs  the most dense, and which
would seem the least liable  to its attacks.
  It  is thus  that, like the  syphilis,  it attacks the
osseous system, and produces,  at  length, softening,
        » Traite de la Maladie Scrofuleuse : Paris, 1831. 
 214           Chronic Exanthemata.
 distortion,  and caries.  Rachitis, of which we shall
 have, in the sequel, but a few more words to  say, is
 very often one of its consequences.   But, setting aside
 for  the present,  these secondary  symptoms,  which
 require each  a special treatment, we shall only here
 occupy ourselves with  the  primitive form  of this ter-
 rible  disease; that is  to  say, with  hypertrophy, and
 ulceration of the subcutaneous ganglions.
   Etiology.—Those of our brethren  who  perfectly
 agree with the ideas of Hahnemann, relative to psora
 seem to me inconsistent, in seeking, in surrounding
 conditions, the first cause of scrofula.  As for myself
 I confess  that I cannot look upon this disease as a
 mere transformation, however far removed, of the itch.
 I believe, on the contrary, that if scrofula is, as I have
 already said, very often hereditary, it  may also, (al-
 though, perhaps,  more rarely,) result immediately,
 either from accidental circumstances suddenly affecting
 the  health of the individual, or from hygienic influ-
 ences, which gradually undermine the constitution.
   We see, for example,  scrofula  succeed  eruptive
 fevers, especially variola and  scarlatina,  in subjects
 who, until then, had shown no symptom of it.
   As to humid cold, want of cleanliness, the exclusive
 use of unfermented fecula  for nourishment, or melted
 snow for  drink ; poverty,  in short, with all  its con-
 comitants,  it  is  impossible not  to see, in all these
 circumstances,  so often united   and  accumulated,  a
sufficient cause for the development  of this  disease 
Scrofula.                  215
without the necessity of explaining it by the interven-
tion of a congenital miasm.
   What, in fact, after all, is scrofula,  if not an exag-
geration  of the lymphatic  temperament ?  but  the
lymphatic temperament, which consists solely in the
relative preponderance of the white vessels, is not a
disease, although one may easily conceive that it may
.become such, under  the permanent action of a  dis-
solving medium.
   Lastly, authors mention, in addition, as causes of
scrofula:  the misfortune  of  being  born of parents,
infirm, aged, or exhausted  by excess ;  the deprivation
of the maternal milk, of pure air, of  light and exer-
cise ; the  over-excitement, in  children, of the intellec-
tual faculties ; the presence of worms in the intestines,
(which is, perhaps, to take the effect for the  cause),
etc., etc.  It is certain,  that if these causes do not en-
gender scrofula, they must, at least, greatly facilitate
its development.
  But there is  one  last point upon which, I am far
from having a fixed opinion, and which merits, in my
opinion, a serious analysis, for in a  dogmatic view at
least, it is of the first importance:
  Is it true, or not, that syphilitic non-scrofulous pa-
tients, may  sometimes transmit to their children scro-
fula, without a mixture  of syphilis ?  In other words:
is the  syphilitic miasm, in passing from  one genera-
tion to another, transformed  to  such  a degree as to
       19 
216
Chronic Exanthemata.
serve as the germ  of  a disease essentially different
from the venereal disease.  This, I repeat, is an im-
portant question, and I would bespeak for it the atten-
tion  of philosophic  physicians.
  Treatment.—Scrofula, whether viewed in the man-
ner I have just indicated as a pure and simple  exag-
geration of the lymphatic temperament, or considered
as a morbid entity, having as well  as the itch  and the
syphilis, its peculiar individuality, scrofula is not the
less in the two cases grafted, so to speak,  upon a par-
ticular state of the organism,  which, if  it does not
constitute the disease  itself, is at least the condition
sine qua non of its existence.
  It follows  then,  that the treatment of scrofula im-
plies, from the first, two  orders of means to  be em-
ployed, since there exists in some  sort, a double end
to attain : to modify the temperament and extinguish
the disease.
  Now, if the medicines succeed  in curing the dis-
ease, the change of the temperament can be but an
affair of time and regimen.
  The  radical  cure of scrofula, can then  only be
slowly obtained.
  The kind of  life  to be adopted by these  patients, is
extremely simple.  Frequent exercise in the open air;
the habitual use  of broiled  meats ; abstinence, on the
contrary, from preparations of milk, from pastry, from
badly-cooked  bread — particularly  the soft  part  of 
Scrofula.
217
bread—from green fruits, watery food, highly-flavored
condiments, and above all, pure  wine  and strong
liquors ;  such is the basis of their regimen.
  But we are not to imagine that these little patients
must  eat more  than if they were  in  good  health.
This is a  sad prejudice, and the bad consequences of
which I have often had occasion to combat.   Expe-
rience has proved to me, that abstinence, is less inju-
rious  to  scrofulous  subjects than  a  too  abundant
nourishment.
  The regimen  I have just  pointed out, and which
should be rigorously followed through  all the periods
of the disease, constitutes, almost alone, the treatment
of the scrofulous diathesis ; that is to say, of scrofula
before its local manifestation.
  Medicines, however, have  been administered with
success  in this  first period of the disease, and  those
whose efficacy  is especially  extolled by some practi-
tioners,  are:  cina, arsenicum, sulphur,  calcarea,
aurum, dulcamara, bovista and silicea.
  Sepia, is particularly called for by the swelling of
the nose and upper lip.
  Lastly, M. Hartmann praises very highly, a medi-
cine which has  not found  place in the homceopathic
materia medica, but which allopathic physicians have
used for several  years past; it is Cod liver oil.
  "I have given it," says he, "with great advantage,
for the  scrofulous  disposition, when, as yet, there
existed no decided  affection of any  particular organ^ 
218
Chronic Exanthemata.
 and where the  only  appreciable  symptoms  wer%
 paleness, an air of suffering, flaccidity of the muscles,
 disposition to emaciation, aversion to all nourishment
 animal or Vegetable, with the exception of bread and
 butter.  I prescribed it in the dose of a medium-sized
 spoonful, morning and evening, and, after a certain
 time, I almost always  succeeded in  obtaining a cure.
 I obtained the same result in  disease of the  bones
 but much oftener in the other forms of the malady."
   But the physician is not  generally called to pre-
 scribe for a scrofulous child, until after the disease has
 declared itself,  and the medicines to which he should
 then  have recourse, are, in the  proper order of their
 use:  Rhus toxicodendron, mercurius solubilis and
 tincture of sulphur.
   The second volume of the Homoeopathic Therapeu-
 tics of Acute and Chronic  Diseases, had  not yet
 appeared in  France, and I was consequently ignorant
 of the great importance attached by  M. Hartmann, to
 rhus  toxicodendron, in  the  treatment  of  scrofula,
 which certain ii.ferences, drawn from  the pathogenesis
 of this medicine, had already led me to prescribe for
 this disease; and the success I obtained  justified, in
 my eyes, the eulogy of our colleague.
  "Rhus  toxicodendron,"  says he, "is  superior
 to all  other  medicines, when, a gland of the neck,
 of  the nape  or  of  the  lower jaw,  is  inflamed,
swollen and hard as a stone, while other neighboring
glands are less appreciable to the touch.   Often  after 
                     Scrofula.                 219
 only a few days' use, all inflammatory redness disap-
 pears, the gland becomes softer, and at the end of a
 few weeks, entirely disappears.  While this is taking
 place, the adjacent glands become more palpable;
 but  these disappear with  the other.  Some  time
 since, I succeeded, with  a single dose of rhus, in
 procuring within the space of six weeks, the complete
 resolution of a gland, hard as a stone and large  as a
 nut,  in  a child about  five years old.   Three days
 after the use of this remedy, the amelioration began
 to  manifest  itself,  and continued until  the complete
 disappearance  of  the   gland.   This   cure  proved,
 like  many  others,  the  value of  the precept of
 Hahnemann;  never to give  a new remedy  before
 an   amelioration  was   sensibly  arrested.   On  the
 other hand, the excessively long duration  of rhus in
 this case, confirms  the opinion I  have  elsewhere
 expressed  upon the duration  of action of medicines
 in general."*
  I use rhus at the second dilution and in  solution,
 to  be taken by  teaspoonfuls  three  or four  times
a day.f
  It is by the administration  of this medicine,  that
we  should invariably  commence  the   treatment of
developed scrofula.
  * Therapeutique Homceopathique des Maladies Aigues, etc., torn
ii, page 82.
  t In adults, rhus is advantageously replaced by colchicum. 
220          Chronic Exanthemata.
   As soon as there supervenes a marked cessation in
 progress of the amelioration, that it almost invariably
 produces, I suspend its use, and prescribe in its place,
 mercurius  solubilis,  thirtieth   dilution,  in  doses
 repeated several times a day, sometimes for several
 weeks.
   Lastly, sulphur, or still better, tincture of sulphur
 if there is ulceration, completes the treatment.
   Some years ago, I was in  the habit of prescribing
 sulphur  at the outset, and obtained some advantage
 by the use of it; but, in the great majority of cases,
 it happened that at about the eighth or tenth day of
 an extraordinary amelioration, this apparent progress
 toward  a cure, was suddenly arrested, and I  in vain,
 insisted then upon  the same medicine, from  which I
 endeavored to obtain new effects, by varying the dilu-
 tions and  the doses: the patients remained thence-
 forth refractory to its action,  and left me discouraged.
 The idea  of previously  using rhus  and  mercunus
 solubilis, was fortunate for me ; but it was only after
 Beveral unavailing attempts  that I bethought myself
 of doing so.
   Dulcamara, belladonna, baryta carbonica, aurum
foliatum, lycopodium,   conium  maculatum,  and
spongia  marina tosta have been extolled  against
various secondary symptoms of scrofula.   The patho-
genetic study of these substances, can alone guide  the
physician in his choice of them, according to the cir-
cumstances of the case. 
         Syphilis of New-Born Children.     221

         syphilis  of  new-born children.
  Boerhaave was  among the first who  admitted the
hereditary  transmission  of syphilis, as well as its
communication by  the maternal milk.  Gardane and
Doctor Bertin, who shared upon this point, the opin-
ion of  their  celebrated predecessor, think  beside,
that the infection may take place during labor, when
the child, whose skin is tender and delicate, comes  in
contact  with the parts of the  mother affected with
gonorrhea or venereal ulcers.
  Bell has  observed cases of children born with syph-
ilis, although there was  no external  appearance of it
in the father or mother.   The same author thinks,  as
well as  Boerhaave, that  the mother's milk is often a
means of  its  transmission, which  may happen, he
says,  "without the disease manifesting itself by any
previous local  symptoms,  but  the  infection  of the
entire system."   This  is  also  the  opinion  of Dr.
Cullerier.
  M. Richond, who has  written three volumes upon
the  non-existence  of  the  venereal  virus, (in  how
many volumes was it not proved that the blood did
not circulate!), M. Richond  is, nevertheless, a par-
tisan of the hereditary transmission of syphilis.  " It
is easily conceived," says this author, "that  a father
or a mother, who  present well  characterized venereal
symptoms  at the moment of the fecundation of the
germ, may transmit the  disease to the  foetus ; many 
222           Chronic  Exanthemata.
affections,  in fact,  beside  those attributed  to this
virus, are transmitted in the same manner.  Thus, M.
Broussais says,  "that he  possesses  a host of facts,
which  authorize him in believing, that mothers suf-
fering  from chronic gastritis, communicate  this affec-
tion to their foetus ; that it is the same with catarrhs,
herpes, leucorrhoea, non-venereal ophthalmias," etc.
  This question,  however,  is  now  settled, and the
examples of congenital syphilis are so numerous, and
so incontestable, that it would be absurd to deny its
transmission.
  I know nothing more sad, more humiliating, more
heart-rending for parents, than to give birth to a child
infected with syphilis.
  Unfortunately, the new-born child does not always
bear marked signs of this infection;  I  say unfortu-
nately, for  the disease,  escaping then  the  necessary
treatment,   will infallibly reveal itself subsequently,
but, perhaps under a form less easy to recognize, and
consequently less  easy  to cure.  It  is  affirmed, that
syphilis  acquired hereditarily,  may develop itself at
aU periods  of life ;  that it waits for its  manifestation,
the circumstances  which,  by  a reaction  impressed
upon the organism, are capable of reproducing it in a
palpable  manner.   Some physicians, among  them,
Bell, have  asserted that the  disease might  remain
latent until puberty, and even until the epoch of mar-
riage, or of a confinement, which they regard as a kind
of crisis likely to cause its appearance. 
        Syphilis of New-Born Children.      223
  These opinions relative  to  the venereal  infection,
are exactly those we  profess with regard  to all the
miasmatic affections,  that  is  to say, to an immense
majority of diseases.
  However this be, it is indubitable, that the earlier
we recognize in a child the existence of a hereditary
miasm, and  especially that of syphilis, the  greater
will be our chance of avoiding its terrible effects.
   Among the signs by which we recognize congenital
syphilis, there  are  some  which are conclusive; but
there are others, which may leave us long in  uncer-
tainty.  "Asa general rule," says  MM. Rattier and
CuUerier, " we should be circumspect in pronouncing
upon the existence of syphilis in the new-born.   In
times  past, it  sufficed  that a child was small, thin,
with a withered skin, and  presenting the appearance
of old age, to  induce the declaration of the presence
of hereditary syphilis :  especially if there were  a few
red  spots  on  the breech, or near  the  sexual  parts.
Purulent ophthalmia,  to which children  are subject,
was still another reason for the anathema.  At present,
when we  make our  observations with  a  little more
care, we know that  frequently  children having this
unpromising   appearance,  have  been  sick  during
intrauterine  life,  and  that  this  aspect  no  more
characterizes   syphilis,  than  a  beautiful  carnation
and  unusual  embonpoint  excludes the idea  of  it,
when  there exist other  characteristic symptoms  of the
disease." 
224           Chronic Exanthemata.
  Now, these characteristic symptoms, at the time of
birth, are almost  entirely reduced to the signs fur-
nished by an examination of the skin.  This is then
of a beautiful uniform red, or  of a dirty straw color.
The epidermis is easily detached, as in the commence-
ment of putrefaction, or  is  elevated  by serosity, and
forms  pustules, more  or less  numerous  and  volu-
minous, but  almost always surrounded by a violet or
copper-colored areola.
  Exceptional cases aside, children affected with con-
genital  syphilis, are feeble, thin, of a wretched, and,
in some manner, old appearance.   Their muscles are
thin and flabby; their cry is tremulous.  The greater
part have the nostrils obstructed, and the commissures
of the lips eroded.
  But, if the disease does not declare itself until after
birth, it, according to M. Hartmann, commonly does so
about the second month, and almost always manifests
itself under  the form  of red or copper-colored spots,
succeeded by little pustules, confluent or discrete, whose
humor is soon converted into scales, so  thick,  that the
eruption might  be  taken for leprosy or psoriasis.
  The pustules show themselves upon the  face, trunk,
and  breech;  where, in  infants badly nourished, and
badly cared  for, they  rapidly degenerate  into ulcer-
ations.
  " When the affection shows  itself still  later," says
Wallace, " we perceive condylomata upon the genital
parts, cracks in the corners of  the mouth, an artificial 
         Syphilis of New-Born Children.      225
suppuration upon the mucous membrane of the lips
and the mouth, ulcerations in the pharynx, and almost
always  an alteration  in the voice.  The frequency of
the condylomata, of the cracks in the corners of the
lips, and of the ulcerations in the  pharynx, and  upon
the buccal membrane, is  in  direct proportion to the
age of the child."
  The prognosis of congenital syphHis, always serious,
is beside dependent upon the nature of the symptoms,
and above all upon the strength of the child.
  Treatment.—The necessity for  mothers or nurses
to take  themselves the  medicines  demanded for the
health of the child, is, I repeat, once for all,  an  allo-
pathic prejudice, from which  it is time we were deliv-
ered.  It is impossible for me to admit,  in fact, that a
nurse in good health can take, with impunity, for whole
months, an active substance of which she has no need.
  The medicine I shall  point out, as the specific for
syphilis in nursing children, whether  congenital or
contracted from the mother's milk, is not a mercurial
preparation—it is kreosote.
  I can easily conceive that practitioners, ignorant  upon
what  grounds this recommendation rests, will receive
it with reserve.   I believe I have  already said that I
should some day explain by what association of ideas,
experiments, and clinical observations,  I have arrived
at the therapeutic innovations recorded in this work.
  We assuredly do not find in the pathogenesis of
kreosotum, as published by M. Wahle, and reproduced 
226           Chronic Exanthemata.
by M. Jahr, in his manual—a pathogenesis, undoubt-
edly conscientiously recorded—indications  sufficiently
marked to justify the use I propose to make, and have
myself made, with the greatest success, of this medi-
cine.  But what does this prove,  except  that the
pathogenesis of kreosotum is still incomplete, as well
as  that  of  many other precious medicines, such as
coralia  rubra, chelidonium  majus, lobelia inflata,
copaivce balsamum, and several  other medicines, des-
tined, when  they shall be better  known, to play in
practice most important parts.
   Kreosotum is  certainly a capital remedy in the
treatment of  syphilis  of the new-born, when  this dis-
ease manifests itself  under the  exanthematous  form.
It suffices, alone, and without the intervention of mer-
 cury, for a radical cure.
   Kreosotum is  then administered,  of  the twelfth
 dilution, and in mild doses, once a  day, for several
 weeks.*
   I  have reason to  believe, but without, however,
 being certain of the fact, that  it will  also effect the
 cure: 1st. Of syphilis in the scrofulous form ; 2d. Of
 condylomata: 3d.  Of mercurial stomatitis.
   Acidum muriaticum is, however so efficacious in
 this last case, that one  would  do wrong to try any
 other medicine.
   * Kreosotum also cures pustulous syphilitic eruptions in adults,
 Dut with the aid of mercurius corrosivus.  The two medicines are
 administered alternately, one, one day ;  the other, the next. 
Syphilis of New-Boen Children.     227
  It is to be remarked that in cases of congenital
syphHis, and of eruptions resembling syphilis, homoe-
opathic physicians, when  they have been  preceded in
the treatment of  these little patients by the practi-
tioners of the old school, have often much more to do
to repair the mischief caused by them, than to make
themselves  masters of the  primitive  disease.   The
effects of mercury in large doses are, in fact, little less
to be feared than  syphilis itself.  One should  then
never fail to inform himself caretuUy, and if necessary
to insist upon the  question,  whether the child has al-
ready been treated—if it has taken mercury, and if the
disease was aggravated under  the influence of  this
medicine.   There is no doubt, in this last case, of the
presence of a mercurial  disease.
  It is my conviction that kreosotum will one day, in
these  cases, be fully appreciated.  I do not hesitate,
for  my own part, to prescribe it in cases of angina, of
mercurial salivation, and of congestion  of blood to
the face.  We, furthermore,  would  be at liberty to
give  the preference, in the  same circumstances, to
aurum foliatum, third  dilution, as recommended by
M.  Hartmann.
  "When," adds  the  same author,  "there exists a
disease of the periosteum, especially of the superficial
bones, or already,  even caries  of the bones of  the
nose,  gold is less  specific than asafcetida."
  To  sum up;  1st. Mercurius  corrosivus, in  mild
and repeated  doses, corresponds, in  preference to all 
228    Diseases of the  Digestive  Organs.
other  forms of mercury, to  clearly defined syphilitic
symptoms different from the exanthemata to which
kreosotum is exclusively adapted.
  2d. Acidum muriaticum, aurum,  asafcetida;  then
in the second rank, belladonna, dulcamara, Pulsa-
tilla, nitri acidum, china  and silicea are  the prin-
cipal medicines called for by mercurial symptoms.
        DISEASES OF THE DIGESTIVE  ORGANS.

   The mucous membranes which line the  intestinal
tube, as weU as that of the respiratory organs, seem
to fiU, in our diseases, as well as in the normal order
of the great functions of the economy, a role correla-
tive to that of the skin.
   They both take an active and constant share in  all
the  general perturbations which  take place in us.
The  immense  majority  of pathological symptoms,
which show themselves in the mouth, stomach,  or
other parts of the digestive tube, are only then like
the greater part of the  exanthemata, the local efflo-
rescence of diffused affections, whose  veritable seat is
the entire organism.
  The intestinal exanthemata, if I may so speak, are
perhaps as numerous as  the cutaneous exanthemata;
but, for a very simple reason, are much less known.
  Among the  affections probably so  diverse, and  so
multiplied,  whose  dominant  symptoms show  them-
selves in the digestive organs, but  a small number 
Stomatitis.                229
are pecuKar to childhood, and of these only I shall
speak.

STOMATITIS--INFLAMMATION OF THE MOUTH--MUGUET.
  This disease, confounded by many pathologists with
aphthae,  is  characterized  by  the  concretion  of  the
mucus upon the surface of the inflamed mucous mem-
brane, whether these membranes have an epithelium
or not.
  This concretion may be  observed in the mouth, the
oesophagus, stomach, the small and  large intestines.
The symptom is  always serious in proportion to  the
extent of surface it occupies.
  This species of stomatitis may manifest itself under
three  different aspects;  1st. Under  the form of very
small white points, scattered over the tongue, or  the
sides of the mouth; 2d. Under that of shreds, more or
less large;  3d. Under the form of a membrane, which
entirely covers  the  tongue, or  extends  over  the other
parts  of the buccal cavity.
  The dotted, caseous or membraniform excretion of
which we speak, is commonly preceded by an erythe-
matous inflammation of the surface of  the tongue, or
the sides of the mouth.   "I have given the  closest
attention," says M. Billard, "to the examination of
the seat  of this excretion, and I  have never found
it  below the epithelium, upon  the surface   of which
it  is  always seated.   It  is  external  to  the  mem- 
230    Diseases of the Digestive Organs.
brane, and coats  it over  like the  mucus, of which
the muguet is, reaUy, but  a morbid  concretion."
  When the disease makes progress the white points
unite,  and  enlarge, and   thus  form  little patches,
either  on the surface  of  the tongue, or on  the in-
ternal  surface of the lips  and cheeks.   These  patches
thicken more and  more, and finish by exfoliating or
detaching themselves, and leaving in their place an
inflamed surface, which is soon  covered with a new
concretion, until at last the disease  disappearing, the
production of which it was  the  cause is  no longer
renewed.
   If, lastly, the muguet acquires a high degree of in-
tensity, the patches of which I have spoken, unite in
one and form a pellicle more or less large, and more
or  less thick, which spreads over the whole  tongue,
the sides of the mouth and velum palati.  Under these
circumstances, as under the  preceding, the muguet is
called confluent or malignant.
   This disease  has hardly any general symptoms in
very young children, especially if the seat of the local
inflammation is not extended.  There is rarely in this
case  much fever.  However, the skin is commonly
warm  and dry.
   It is, especially, during  early infancy that  muguet
is developed.  Infants  at the breast are  much more
subject to it  than children at a more advanced age.
It  is  above  all severe among  children  assembled 
Stomatitis.
231
together in great numbers, who are born feeble and
miserable, or lack an  appropriate alimentation.
  M. Baron affirms  that  muguet is not contagious,
and M.  Billard says, "that he has seen children  not
affected  with muguet, drink from the same spoon with
children who had it, without contracting the disease."
  Treatment.—When muguet arises from a vicious
alimentation, the first thing to be done, is to submit the
child to a suitable regimen.   If there is reason for
attributing the  disease to  the scarcity or  bad quality
of the milk, the nurse should be changed.  If, on the
contrary, the child is fed  with the  sucking bottle, it
will be still more easy to  make the necessary modifi-
cations in its food by conforming to the precepts laid
down in the first part of this work.   (Page 72.)
  I do  not know of anything in  our homceopathic
literature, which has  direct  reference to   muguet;
authors   in  general,  confound  this  affection with
aphthae, which does not demand precisely the same
treatment.
  Cinnabaris,  at a  high dilution,  and in  mild and
repeated doses, is perhaps, of all the mercurial prepa-
rations,  that which best corresponds to muguet of the
mouth and oesophagus.  Mercurius solubilis may bo
administered in the same manner, and later, china, if
there is  reason to  believe that the disease has invaded
the stomach and intestines.
      20 
232     Diseases of the Digestive Organs.

              aphthae--thrush.
   Aphthae  differs  essentially from  muguet in this
respect, that in the latter, the buccal mucous  mem-
brane remains always intact, while in the former, veri-
table ulceration is present.
  Pathologists are  still far from being of the  same
opinion with regard to the  anatomical seat, and real
nature of aphthae.  Whether or not,  as some modern
authors assert, it consists in congestion, and subsequent
ulcerations of mucous  follicles, is a question of minor
importance to the practitioner.
  What is certain  is, that aphthae may be produced
upon  different points of the gastro-intestinal mucous
membrane, and  occupy, in certain cases, almost the
entire extent of this membrane, from the mouth to the
rectum inclusively.
  It most commonly shows itself only on the mucous
membrane  of the mouth, in the form of little larda-
ceous ulcers, with borders sometimes cut perpendicu-
larly, and secreting a whitish cheesy humor, more  or
less adherent to the surface.
  When the  aphthae are isolated,   they  commonly
occupy the internal surface of  the under lip, the frse-
num of the tongue, the internal surface of the cheeks,
and the summit of the gums, when the teeth have not
yet pierced them.
  When the aphthee are numerous and closely approx-
imated, their  edges unite — the  matter which  they 
Aphtha —Thrush.
233
secrete, extends from one to  another, and  forms a
layer more or less  broad and thick.   It is then that
the  aphthae  might  be  confounded  with  muguet.
However, M. Billard  affirms, that  even in this case,
one may still distinguish the two diseases, by taking
into account the mode of development  of the  inflamed
follicles and  the solution of continuity, which does
not exist  in muguet.   Beside, says he, the excretion
which  accompanies aphthae is always consecutive to
the ulceration, and is almost always observed on  the
internal part of the lips and cheeks, while the white
points  of  muguet appear first  upon  the lateral
parts, and toward the point of  the tongue.
   Notwithstanding these  differential signs,  I  am
forced to admit, that in certain stages of these diseases,
aphthae is very apt to be confounded with muguet.
   The  aphthae, even when they are in  small numbers,
almost always  cause severe pain.   They suffice con-
sequently,  to  hinder  children from nursing, and to
bring on, if they persist, serious derangements of  the
health.  But they only constitute a really serious dis-
ease when they have a tendency to become numerous,
and  especially to penetrate  into the  trachea,  the
oesophagus, the stomach, etc.
   When they occupy the pharynx, they render degluti-
tion extremely difficult.  They are then almost always
accompanied  with  turns of vomiting,  and an almost
continual  hiccough.  These symptoms are especially
observed when the  disease  has its seat in the stomach. 
234     Diseases of the Digestive Organs.
  As to aphthae of the intestines, when  there  are
none in the buccal mucous membrane, it is  extremely
difficult to diagnose their presence,  for the  relaxation
of the bowels  they occasion, may easily be  attributed
to any other cause.
  Fortunately,  the disease  usuaUy  commences  in
the mouth, if it is not  always limited  to  this part;
it may be considered extremely serious when it foUows
a contrary course, that is to say, when instead of being
propagated from the mouth to  the  other parts of the
digestive tube, it mounts  from the  digestive tube to
the mouth.
   Aphthae is  not, like muguet,  a  disease belonging
exclusively to  the first period of  childhood; adults
even are exposed to it.  We observe it  more particu-
larly in  very feeble, pale,  lymphatic children some
months of age.
  " I have  observed in the hospital  of the Enfants-
trouves," says  M. BiUard,  "that while muguet pre-
vailed very generally in chHdren newly born, aphthae,
on the contrary, showed itself more frequently among
those who  had  attained  the  period  of the  first
dentition."
  As in muguet, the febrile phenomena accompanying
aphthae, have  rarely any intensity.  We  may  even
affirm, that in the majority  of cases  the pulse presents
no sensible alteration
  Gangrene is the most fatal termination of aphthae,
but is  happily also the most rare.  Gangrene of the 
Aphthae — Thrush.              235
mouth,  of which we  shall  soon treat,  is  almost
always developed  under especial conditions, having,
with the disease of which we at present  speak, but
remote and fortuitous relations.
  Treatment.—Borax  is  generally considered  by
homceopathists as the specific for aphthae.  It is in
fact, a good medicine, and one whose curative  action
is  sometimes  very  prompt,  especially when  it is
administered at the beginning of the disease.
  Borax suits best, according to M. Hartmann, when
the child is very cross, cries  and weeps much, starts
in his sleep, and seizes objects around him ; when the
complexion  is  pale  and  earthy,  the  skin soft and
flabby;  when he  refuses the breast, and the mucous
membrane of the palate and tongue, upon  which are
perceived red  vesicles  and aphthae,  appears   as if
shriveled.
  The same author extols acid, sulph., in large doses,
(a few drops to an  ounce  or an ounce and a half of
water),  or at  high  dilutions;  mercurius  solubilis,
if  the disease occupies  the  throat  especially, and
lastly sulphur.
  For myself, if I decided to prescribe for the aphthae,
an acid in large doses, I should certainly not give the
preference to acid, sulph., but rather to hydrochloric
acid, which I have heretofore used in similar cases
with the greatest success.
  A few drops  of  this acid, mixed with a teaspoonful
of honey, form a mixture  with which (taking  care 
236     Diseases of the Digestive Organs.
that the child does  not swallow  it), the aphthae may
be  lightly washed,  by  means  of a little pencil made
of lint; this  relieves  the smarting  almost instanta-
neously
  Lastly, the same  acid, but  dynamised, is the only
medicine I use  internally, in all cases, that  is to  say,
wherever the seat  and whatever the intensity of  the
disease.
  It is  not  necessary  to  have recourse to very high
dHutions  of  this  medicine.   I generally prescribe
it in water,  from the third to the sixth  dilution ; a
few globules  in a tumbler of  water, a teaspoonful to
be given every  three or four hours.

             GANGRENE OF  THE MOUTH.
  Of all parts of the body, the mouth is certainly the
one most subject  to be invaded  by gangrene.   An
affection peculiar to childhood, and almost necessarily
fatal, gangrene of the mouth is justly the terror of all
those who have occasion to see it.
  According to Doctor Baron,  it is  never primitive,
and only manifests  itself in chHdren already enfeebled
by previous disease.
  Measles is, perhaps, of all diseases the one to which
it most frequently succeeds.   It  appears, nevertheless,
but much more rarely, as a sequel to scarlatina, vari-
ola, pneumonia and hooping-cough.   Lastly, it is be-
yond a doubt that this serious  affection may be imme-
diately produced by an untimely or excessive use of 
             Gangrene of  the Mouth.         237
mercury.   Doctor Bretonneau reports several cases of
this kind in his Traite de la Diphtherite.
  We borrow  from  MM.  Rilliet  and  Barthez, the
picture, as true as it is striking, which these authors
have  drawn of gangrene of  the  mouth, in the second
volume of their Traite des Maladies des Enfants.
  " Gangrene of the mouth  begins, during the course
of convalescence  from another acute or chronic  dis-
ease,  by ulceration, aphthae, or more rarely by oedema
of the  part where  the  gangrene is about to be de-
veloped. At this  time the face is pale, the breath fetid,
the fever not very intense,  unless there also exists a
febrile disease, and then the pulse may be considerably
accelerated ;  the  child becomes  more sad, ordinarily
complains  little, or none at all  of the mouth; some-
times, though rarely, he suffers severe pain.
  " The ulceration, slight at first, and with a grayish
base,  situated upon the middle of the internal surface
of the mouth, or in the fold  between the gums and
the cheek, or the gums and the lips, is soon covered with
a grayish putrilaginous  excretion of a fetid and pecu-
liar odor.  At  the same time  an infiltration of the
diseased cheek, or lip, takes place;  the oedema is soft,
rather regularly circumscribed;  it  soon becomes in-
creased; and, there is  formed  deep  in its center  a
hard,  regular, round  nucleus.   Then  the  cheek be-
comes tense, shining and  pale, or marked  with  a
violet-colored marbling, more decided upon the prom-
inent  parts of the tumor ; in the  interior of the mouth 
238    Diseases  of the Digestive Organs.
the eschar has taken a brown color; it has  spread
considerably, has reached the gums; it is sometimes
surrounded by a violet-colored circle.
   " The child is seated in his bed, and occupies him-
self with the objects around him ; sometimes, without
strength, he lies  in a state of indifference; his face
puffed, and without expression on one side, is sad and
depressed on the other; a bloody, or already blackish
saliva flows  from his half open lips;  he asks, how-
ever, for food, and takes with avidity what is offered
him, and swallows together, his food and the  putrid
matter detached from the gangrenous parts. His skin
is cool,  and  his pulse  but little developed,  and of
moderate frequency, unless  there exists some serious
febrile complication;  his  mind  is  clear, but some-
times, during the night, he has a more or less intense
delirium.
   " From the third  to the  sixth day of the disease,
the scene changes ; an eschar is formed upon the most
purple and prominent part  of  the tumor, either upon
the  cheek, or upon the under lip ;  small, black, and
 dry, this eschar extends itself from day to day, and
 sometimes attains considerable dimensions, invading
 almost the whole side of the face, or even descending
 upon the neck ;  at the same time, that of the mucous
 membrane is increased in the interior.   The aspect
 of the child is  as sad  as  it is  hideous to the sight;
 sometimes, in a sitting posture, and availing  himself
 of all his strength, he  tears from the interior of his 
            Gangrene of the Mouth.          239
mouth the gangrenous fragments ; sometimes, lying
dejected  and depressed, he allows  to flow  out  and
cover him, a blackish and fetid sanies.
  " This  appearance,  however,  may  become   still
more repulsive, when the slough is partially detached,
and  the  mass is seen hanging from the  cheeks, or
even worse, when, falling off, it leaves  a perforation
through which  the bare and loosened teeth, and the
blackened maxillary bones are visible.   The odor is
then of the  most ofiensive character ; the child  still
retains some strength, and  asks for food, or, in the
last  state of prostration, he refuses all nourishment;
there is  always great thirst, and the patient drinks
with avidity ; he  does not vomit, but there is great
relaxation  of the  bowels ; he becomes  rapidly more
and  more  emaciated ; his skin is  dry, but not very
warm;  his pulse, very small,  becomes  insensible,
and  death arrives without other phenomena."
  It most commonly takes place before the deteriora-
tion is so  profound, and before  the  perforation is
effected,  in from eight to fifteen days.
  Gangrene of the  mouth, very  rare in adults, and
perhaps  still  more  rare  in  infants at  the breast,
usually attacks children between  the  ages of two and
ten.
  It is not contagious, and never prevails epidemi-
cally.   It  is one  of those diseases which physicians
have less frequent occasion to observe in their private
practice than in hospitals.
        21 
240    Diseases  of the Digestive Organs.
  In the  rare, and, we  may  even say, exceptional,
cases, where a cure is effected, it is always in the first
period,  before  the  manifestation  of the  cutaneous
eschar, and by the separation of the mortified portion
of the  mucous membrane.  There then remains an
ulceration, with  a  grayish bottom, whose tumefied
borders subside little by little, and whose cicatrization
is accomplished  at  the  same time that the general
symptoms amend and disappear.
   Treatment.—Homoeopathy as yet knows no speci-
fic for gangrene of the mouth, which seems, however,
to enter into the sphere of action of several medicines
known;   at the  head of  which, Hartmann places
secale  cornutum.
   I have seen the disease arrested in the beginning by
ipecacuanha,  at a  low dilution, and  in doses  fre-
quently repeated, (a  teaspoonful  every hour, of  a
solution  of three drops of tincture, third dilution, in
four ounces of water).
   In a more advanced  period of the disease, I should
not  hesitate to prescribe, alternately, acid, muriati-
cum and kreosotum,  at low dilutions, and at short
intervals, and even, if necessary, slight cauterizations,
with muriatic acid,  diluted with a  little honey.

                   dentition.
   In one of the chapters upon the hygiene of children,
(see p. 77,) I have already mentioned  the  medicinal
agents called  for by the majority of the sympathetic 
Dentition.
241
 affections occurring during the  period  of dentition.
 There remain for me, but  a few words to say on this
 subject.
   "The greater part," says M. Guersant, "of the dis-
 eases of children, are attributed to the process of den-
 tition.  The difficulty in  observing  the diseases  of
 early infancy,  and the little  positive knowledge we
 possess upon this part of pathology, have contributed
 to propagate this opinion ; and this prejudice, result-
 ing  from our ignorance, has  eventually become pop-
 ular, like all other prejudices in medicine."
   The notion  has  this  mischievous  effect, that it
 often imposes upon physicians with regard to the real
 existence  of diseases independent  of dentition; dis-
 eases which they allow to take root  under the false
 persuasion, that they are but  normal manifestations
 of a purely physiological phenomenon.
   The first  teeth  (the  incisors)  commonly  appear
 toward the  end  of the  fourth  month,  sometimes a
 little sooner, but  sometimes also a little later.
   The importance and sort of  vain-glory that mothers,
 and  especially  nurses, indulge in  on account of the
precocity of children in this respect, seems  to me iU-
founded.   1 have in fact, remarked, that the teeth had
far more  permanence when the period of their  erup-
 tion was  somewhat delayed.
  However this be, it is certain that the evolution of the
 teeth, which is  sometimes accomplished without caus-
ing any serious trouble, becomes also in certain cases, 
242     Diseases of the Digestive Organs.
a real disease, and a sufficiently serious one to require
all the attention of  the physician.
  This  takes place,  especially  in  nervous,  irritable
and debilitated subjects, when several teeth are about
coming through at the  same time.  It  is then, com-
mon enough to see  high fever, with almost continual
wakefulness,  extreme agitation during the rare inter-
vals of  sleep, spasmodic movements of  the eyes, con-
vulsions of  the  limbs, cough,  hiccoughs, and  even
letnargy,  if  things  take  a  bad  turn;  for this last
symptom  is  of very  bad  omen; the gums  are red,
swollen, hot  and very  painful; the inflammation of
which  they are tne seat, extends itself to the tonsils,
cheeks and the whole face.   In short, if this state is
prolonged  beyond a certain  time, even the germs of
the teeth  undergo  a notable alteration;  they soften
and corrode to such an  extent, that the destruction of
the teeth  is, as  it were, consummated  before their
appearance;  at least such  seems  clearly the  result
of several anatomo-pathological observations,  made
by Dr.  Billard,  in  the  hospital  of  the   Enfants-
trouves.
  As to the diarrhea, which is   almost always  added
to the other symptoms of dentition, and which Rosen
seems  to  regard as  the  result of the  acrid saliva,
which   the child   almost  necessarily  swallows, it
is  evidently  like  the cough,  amygdalitis, etc., but
a sympathetic  phenomenon of the  buccal  irrita-
tion. 
Gastritis.
243
  To sum up, it is not then impossible that dentition
may constitute in  itself, as  1 have just  said, a real
disease.
  Now this disease  has its  specific, and I am happy
in being  able to sustain  myself by numerous facts, in
pointing  out  to  practitioners, the medicine which
answers explicitly to all the symptoms it is susceptible
of presenting.
  Kreosotum, which will  certainly one day  be con-
sidered as one of the most precious and reliable medi-
cines of our materia medica, is the substance to which
I now allude.
  I prescribe it at the twenty-fourth dilution, in mild
and repeated doses.
  Kreosote, which I  recently saw completely arrest,
in the  course of a few weeks, a painful caries of the
incisor teeth, in the case of a lady forty years of age, is,
in children of all ages, as well as in adults, the chief
remedy for odontalgia, when it  is caused by caries
of the  teeth, especially  when the  pain is accompanied
by turgescence of the gums and facial congestion.

                   GASTRITIS.
  Time  has  executed justice upon the sophisms  of
Broussais.   It is hardly twenty years since gastritis, a
multiform monster invented by the physiological school,
controlled  the whole of pathology.  It was  the pro-
totype of inflammation—the primitive phenomenon of 
244     Diseases of the Digestive Organs.
all other diseases, which were, it was asserted, but its
more or less certain consequences.
  The public even, which commonly  troubles itself
but little about the names of the diseases which deci-
mate it, talked about gastritis, as  it has since done
about cholera.  From  the  eloquence  of a man  of
genius, this bugbear assumed the appearance of real-
ity, and  made people  believe  in the  existence of a
fact that every day's observation belied !
  It is now universally admitted, that  if the stomach,
like  the other  parts of the digestive tube, takes a
sympathetic part in all the somewhat acute affections
of the organism, primitive gastritis  is  a rare disease.
Thus it occupies a very small  space in modern  myo-
graphies.   It  is to be  remarked, however, that it is
rather more frequent in children than in adults.  It is
from the third to the twelfth year that  it is most fre-
quently observed.
  Inflammation of the stomach,  or,  to  speak with
more precision, erythema of the mucous membrane of
the stomach,  (for gastritis is  nothing  else), is  recog-
nized by the following signs :
  Frontal  cephalalgia; fever, with fullness of the
pulse; acrid heat of the skin, especially in the fore-
head and in the hollow of the hands, to which succeed
abundant sweats; sensibility of the epigastric region;
burning regurgitation ; bilious vomiting, with loss of
appetite; thirst, more or  less intense; disgust  for 
Gastritis.
245
 warm or  alcoholic drinks;  great  desire for  acid  and
 cold drinks ;  mouth  bitter; tongue  moist,  white or
 yellowish, at the base, with bright red dots at the
 point and on the borders.
   The patients are generally constipated ; but often,
 also, as the vulgar say, the disease  takes its course
 downward,  and two  or three  evacuations, at short
 intervals, announce the termination of the disease, or
 a change  in its character.
   The common  causes of gastritis are :
   1st. Overloading  the  stomach with  food, taken
 either in too great quantities  at a time, or at too fre-
 quent intervals ; 2d.  The introduction into this organ
 of crude substances,  such  as grease and acids;  3d.
 A sudden fright, vexation or  anger;  4th.  A chill;
 5th, and lastly,  The  introduction into the stomach of
 inert  foreign  bodies, refractory to the gastric action,
 and, for a stronger reason, all  irritating or actually
 poisonous substances.
   I find,  in  reference to this last cause, in the work
 of MM. Rilliet  and  Barthez,  an avowal, which does
more honor to the frankness of these writers, than to
the therapeutics of the  school to which they belong:
 " One of the principal causes," say they, " of gas-
tritis  and of softening of the stomach, has  been, in
the children who have come under  our observation,
the use of an  energetic medicinal action,  upon  the
gastro-intestinal  mucous membrane."   I add  with
pleasure my testimony to that of the two physicians I 
 246    Diseases of the Digestive Organs.
 have just cited : the majority of the cases of gastritis
 I have had occasion to treat, were the direct work of
 Allopathy.
   Gastritis, like  other diseases, has its degrees of
 intensity, and its  symptomatic shades.   The  pre-
 cursory symptoms of the eruptive fevers, or of typhoid
 fever in its  commencement, are the only pathological
 conditions with which it would be possible to  con-
 found it; and yet, with the history  of the disease that
 we have under our eyes, and the recital of the facts
 anterior to  its manifestation, it is  very rare that aU
 error in diagnosis is not avoided.
   Treatment.—Gastritis  is  generally  a disease of
short duration, and  one which  the curative force of
nature alone,  almost always suffices to cure.  How-
ever, it might be dangerous to abandon it to itself,
 and  I am  convinced  that in  treating it  properly
 Berious affections have often been prevented, of which
it  was only the precursory sign, or  rather the  first
symptom.
   Gastritis,  whatever its cause, is one of those affec-
tions which  the most imperiously exact a few days of
diet.
   Patients so much the more willingly resign them-
selves to this,  as they feel a repugnance to food.   To
wean a  child at  the  breast  will often   suffice to
effect an  instantaneous cure.   A  little  gruel  may
for a day   replace the milk of which  he  is  de-
prived. 
Gastritis,
247
  As to  children more advanced, they may be put
upon the use of sweetened water, of the temperature
of the apartment.
  If the stomach is  still surcharged with food, or if
some poisonous  substance  has been swallowed, the
patient  should  be made to vomit, either by means of
tepid water, or tickling the fauces;  after which we
may prescribe,  according to the circumstances, aconi-
tum, pulsatilla, nux, arsenicum,  chamomilla, bry-
onia, phosphorus, or causticum :
  Aconitum, if the dominant symptom is a high, full,
and  frequent  pulse,  with  heaviness of the  head,
pain in  the forehead,  and considerable  heat in the
face; especially if the indisposition has succeeded a
fright;
  Pulsatilla, if greasy food, such  as  goose or pork,
has provoked the indigestion, or if the patient is tor-
mented  with frequent sour, and watery regurgitations;
if he vomits without effort; if he experiences vertigo,
or in short, and above all if these  symptoms occur in
the evening and night;
  Nux  vom., if the  child  is of a  nervous, dry, and
irritable temperament; if the pain  at the epigastrium,
and'  the agitation are  very intense;  if there is con-
stipation and  but little  sweat; if in short  the  dis-
ease has been caused  by coffee, wine,  or any other
alcoholic drink, or again by a fit of  passion ;
  Arsenicum, if the gastritis is in consequence of a
chiU or of an indigestion of fruits, raw roots  or herbs; 
248    Diseases of the Digestive Organs.
   Chamomilla, if there  are  bilious vomitings, and
 especially if the patient is a little girl, or an infant at
 the breast;
   Bryonia, if the  indigestion has  been produced by
 cabbage;  if the epigastrium is  very sensitive  to the
 touch, and  if the  slightest movement increases the
 pain, and if there is constipation ;
   Phosphorus, is indicated when there is a  pressing
 and cutting burning in the stomach—a sensation as if
 a  warm gas was  escaping from the mouth;  ardent
thirst; burning in the precordial region; anguish; con-
vulsions of  the face; violent chills,  or when the limbs
are cold, the  eyes  clear  and tearful, the lips pale,
the pulse accelerated, small and feeble, the strength
prostrated;
   Causticum, whose use in the treatment of affections
of the stomach, seems to me susceptible of being much
extended, is  the  specific  for suffocative gastritis; a
form  very rare in  children.  The  symptoms  which
call for its use, are: spasmodic distention of the epi-
gastrium, with burning and  inodorous eructations;
bilious coloration  of the  face; absence of sweat; and
even of  heat in the  forehead and hands; constipation ;
lastly, tickling in the  throat, which provokes   a  dry
cough.
   The different medicines I have just mentioned, are
administered stronger, and in doses more  frequently
repeated, in  proportion to the intensity of the  symp-
toms.  The  nature  of  these last, as well as the kind 
Enteritis.
249
of medicine to which  we have recourse  decides, as
usual, the choice of the dilutions.
  In general, aeon., pulsat., and chamom.,  are pre-
scribed  from the sixth to the eighteenth; phosph.,
arsen., and  caust., from  the eighteenth to the thir-
tieth. With the exception of the cases to which caus-
ticum and phosphorus correspond, it is seldom that
gastritis requires a treatment of long duration.

                  ENTERITIS.
  Enteritis is the inflammation of the intestines.  It
manifests  itself as a sympathetic affection of almost
all the organic and functional lesions of  the economy;
but as a primitive  disease, it is  rare.  In  children,
however, it is  more common than gastritis, to which
beside it often succeeds.
  Authors have  described  a multitude of varieties
of enteritis.   Some  have founded those  they have
admitted  upon  the  different  degrees  of intensity,
which this disease may present without changing its
nature ; others, more logical, no doubt, have deduced
theirs from notions furnished by pathological anatomy.
It is thus that these last have admitted:
  1st. Erythematous  enteritis, or inflammation of
the mucous membrane;
  2d. Phlegmonous enteritis, or inflammation of the
muscular tissue of the  intestine ;
  3d. Follicular enteritis, or inflammation  of  the
foUicles; 
250    Diseases of the Digestive Organs.
  4th  and last, Serous  enteritis, or perienteritis ; in
other terms,  inflammation of the peritoneal envelop
of the intestine.
  Of these four varieties of enteritis that I willingly
adopt, with the exception of the last, which appears
to me  problematical, if we consider it otherwise than
as representing the highest degree of intensity  of the
others, I shall  only speak here of the first—mucous
enteritis.  The second,  in fact, is  evidently only a
more  violent  degree  of the   first,  as phlegmonous
erysipelas  is  only  the  aggravation  of simple  ery-
sipelas.
  As to folliculous  enteritis, which constitutes, as
everybody  knows, the characteristic  lesion of typhoid
fever, I shall  speak of it  later, under the head of this
latter disease.
  Mucous  enteritis, an  affection often  disregarded,
may be observed  from the earliest period of life.  It
commonly begins  without appreciable fever, by  a sim-
ple  relaxation  of the bowels; but  the  stools soon
become more frequent, and undergo a change.  They
are  preceded by moaning and anxiety, cries, and even
convulsions.  The moaning and crying are renewed
during the evacuations.   The evacuations  soon  lose
their  normal  color and odor.   They are of a reddish
brown, or  green tint, sometimes aqueous  or  slimy,
sometimes bloody, purulent, and containing pieces of
membrane, and  sometimes, finally,  of a dark color,
and mixed with indigested food. 
Enteritis.
251
  Excoriation and  oedema  of the anus, often,  even
falling of the rectum, add  to the discomfort of the
child.  It experiences alternations  of tenesmus and
constipation ;  the skin is burning, the pulse frequent.
The  tongue, white  and moist in the beginning, be-
comes dry, and sometimes passes from  a dark-red to
a blackish brown; the patient drinks incessantly ; the
abdomen  is distended; his  strength diminishes; the
features change, shrivel up, and take the appearance
of old age.  Soon he has no longer strength to cry,
but  continues  a plaintive  moan;  lastly,  the  stools
stop, the meteorism increases, feeble convulsive move-
ments manifest  themselves, and the patient dies, if
art has not succeeded in arresting in time the progress
of the disease.
  This  form  of enteritis, always very serious in in-
fants at the breast, is more  to be dreaded  in propor-
tion as the children are young.
  Generally more benign in children of from five to
ten years, mucous  enteritis  rarely  assumes in  them
the alarming  character  I have  just described.  In
cases at this  age,  it  has two  w^ays  of  begin-
ning:
  In some instances, a child is taken with  a not very
abundant diarrhea, which  does  not seriously  affect
him.  He continues to play and amuse himself; his
appetite  continues, or  only insensibly diminishes.
This state lasts eight or ten days, sometimes longer; 
252    Diseases  of the Digestive Organs.
then supervene acute symptoms; fever, pain  in  the
bowels, thirst, anorexia, augmentation  of the diar-
rhea.
  At other times, the commencement is abrupt, and
characterized by cephalalgia, vomiting of food or bile,
epigastric or umbilical  pains, thirst, and  loss of  ap-
petite.
  We have then, during an interval of from four to
ten days, the following symptoms :  The face has some
color, the features are drawn; there is heat, and often
moisture in the skin ; the pulse is frequent, a hundred
or a hundred and twenty pulsations to the minute:
the  abdomen is  sensitive to pressure, either  in  the
umbilical region,  or in  the sides  and iliac  fossae,
rarely in  the epigastrium; it is large, sometimes a
little tense, warm, and sonorous; very rarely one may
perceive gurgling ; the stools are sometimes very abun-
dant, very numerous, very  liquid, and seem then to
come from the small intestine, or they are  more rare,
less  liquid, and vary from two to six in the twenty-
four hours;  they  are  mucous  and  bilious,  rarely
green, more  frequently  various  shades  of yellow or
brown.
  The vomitings that take place in  the  beginning,
discontinue  after one or two  days, and  are, at  the
most, replaced by nausea.  The  t^gue is  moist, very
rarely dry, red at the point and upon the sides, cov-
ered at the base with a white  or yellowish coating, 
Enteritis.
253
more or less thick; the mouth is sometimes offensive,
the breath sometimes fetid.
  The child does not sleep, or sleeps badly; its sleep
is agitated ; he does not, however, complain of head-
ache.  The delirium, always flying and of short dura-
tion, is an exceptional and very rare phenomenon.
It  may,  nevertheless,  manifest  itself without  being
any proof that the disease is degenerating into typhoid
fever.
  There  are  sanguine-nervous  children so liable  to
delirium, that they present this symptom  in  almost
all their diseases.
  This state continues  for a few days, when the fever
abates, the skin returns to its normal temperature, the
pulse falls, according to the age, to seventy or eighty
pulsations a minute; the face becomes pale, and even
emaciated; the child  is a  little  enfeebled, but  the
appetite  returns; the  looseness of the  bowels still
continues, but gradually diminishes;  the bowels re-
cover their elasticity, and  lose their sensibility.   All
the symptoms, in  short, gradually disappear, and  the
child returns to its  natural state, after an  illness of
from twelve to twenty days, retaining no other trace
of it than a little feebleness and emaciation.
  Such  is the  normal course of  primitive  mucous
enteritis, during the second period of childhood.   It
is  easily understood, that  the constitution of the  pa-
tients, the more  or  less  judicious  attention they
receive, and perhaps, above all, the influence,  always 
254     Diseases of the Digestive Organs.
so marked in all  our  diseases of the hygrometrical
and barometrical state of the atmosphere, may vary
almost infinitely the intensity of the symptoms and
the duration of this affection.
  Finally, the  intimate  cause  of the disease, that
which the most frequently escapes us, necessarily im-
presses  upon it a particular stamp, so that  between
ephemeral enteritis, the accidental consequence of  an
indigestion, and typhoid enteritis, there exist innu-
merable shades.
  Should enteritis be  classed  among essential dis-
eases ?   This question,  to  be  explicitly  answered,
requires  more  precise notions than  we yet possess
upon the  disease in question.  It is clear, on the one
hand, that a sudden chilling of  the  skin, or the pas-
sage into the intestines of a  badly elaborated  chyme;
that is to say,  of substances which have resisted the
dissolvent action  of the  stomach, may cause imme-
diately, and without the intervention of any miasm,
erythema of the intestinal mucous membrane.   But,
on the other hand, it appears to me not less  evident,
that certain forms of enteritis, that, for example, of
children  at the breast, which  develops  itself, and
passes through  its different stages, to a fatal termina-
tion, in spite of the most judicious hygiene,  and the
most rational treatment, depends upon a cause more
active and profound than a temporary suppression of
the perspiration, or the transient contact of indigested
food.   What physician  has not seen several chHdren 
                     Enteritis.                 255
of the same family die  successively, at the same age,
of this disease ?  Was it the mother's milk which wa3
fatal to them ?   This is  not impossible : nature has its
caprices.  However, I have seen in families where the
children  had succumbed in this manner, two cases in
which  the milk of a good nurse was vainly substituted
for that  of the  mother, for this  precaution  did not
prevent a new catastrophe.  The  children, then, bore
in their blood the  germ of the disease of which they
were to die.    Such facts  are  not, unhappily, as rare
as might be supposed.
  TREATMENT.^-The following medicines  have  been
recommended against  enteritis  in  children  at the
breast: aconitum, chamomilla, pulsatilla,  bella-
donna, hyoscyamus, etc.
  "Numerous observations," says Hartmann, "have
taught me that aconite should always be given at first
in the diseases of children, from the moment that there
exists in them the least trace  of  vascular irritation."
This is perfectly just.  '; I  have, in fact, observed,"
adds the same  author,  " that  aconite,  given at the
commencement of  the majority of the diseases of chil-
dren, not only calms the violence  of the symptoms,
but often entirely  dissipates  the disease."   To  this
again,  I have no serious objection to make, if it is not
that the physician is  far from being always called at
the commencement of the disease, that he is often in
fact, only consulted at a period when aconite ceases
to be indicated.
       22 
256     Diseases  of the Digestive Organs.
  "Chamomilla,"  continues Hartmann,  "merits  a
place after  aconitum, if the  stools  are watery, or
slimy, whitish or green,  and are passed with violent
pains, especially if they  are more frequent  at night,
and  if the light  sleep of the patient is often  inter-
rupted by sudden starts;
  "Pulsatilla is equally indicated when heat alter-
nates with sudden chills ; when there is wakefulness,
or simply a little  sleep in the morning, with  continual
moans,  diarrheic, mucous,  acrid, and frequent stools,
with vomitings;
  " Nux  and bryonia,  in  cases  where the patient
is constipated ; the latter, especially, when the abdo-
men is very sensitive to the slightest pressure;
   "Belladonna and hyoscyamus, when, instead  of
actively marked inflammation,  the disease  presents a
sub-inflammatory state:  these medicines, also merit
consideration, if to these inflammatory symptoms are
added,  spasmodic  symptoms,  which  are  especially
distinguished by their periodicityi
  " Coffea  is an indispensable  remedy,  when the
nervous system greatly predominates  over the vascu-
lar system."  After this quotation, which  embodies
nearly  the  whole  of the  therapeutics, followed  by
homceopathic  physicians  in the treatment of enteritis
in infants at the breast, I will in turn, give  the result
of my own personal experience.
  Now, it is with the profound  conviction, left me by
the painful recollection of the many reverses I have met 
                     Enteritis.                 257
 with, that I venture to affirm, that in serious enteritis
 in children at the breast, aconite, chamomilla, pidsa-
 tilla, bryonia, nux vomica, belladonna, hyoscyamus
 and coffea, are medicines absolutely powerless, hardly
 modifying the course of the disease, never arresting its
 progress, and much less preventing its fatal termination.
   There exists in my knowledge, against serious ente-
 ritis of infants, but one really efficacious remedy upon
 which we may depend.  I have the consciousness of
 rendering  to art, and to humanity a real service in
 pointing it out: this medicine is lycopodium.
   Thus  then,  when the  enteritis  of which I have
 given the  description, does not immediately yield to
 chamomilla, which seems indicated by the dominant
 Bymptoms, we should hasten to suspend this  and  pre-
 scribe lycopodium.
   An important remark is, that this  medicine  will
 only  be followed  by good  results, when  given in
 extremely feeble doses.   We should prescribe two or
 three globules of the thirtieth dilution, in four ounces
 of rain water, of  which one teaspoonful is to  be given
 to the child in the morning.
  It is useless to  add to  this treatment, either injec-
 tions or poultices  ; but what is naturally indispensable
 to its success, is  a proper regimen ; great care then
 should be taken in this respect.  We may judge from
this specificity of lycopodium, how dangerous  and
deplorable  is the abuse  made  of this  substance  in
using it as a powder for children. 
 258    Diseases of  the Digestive Organs.
   Lycopodium does not correspond  to enteritis in
 children, of from five to ten years.  It is against this
 form that we may, according to the symptoms, use the
 medicines indicated by Hartmann; medicines to which
 arsenicum should be added, which is the specific for
 enteritis, with  mucous diarrhea, caused by a chiU.

        GRIPINGS IN INFANTS AT THE  BREAST.
   "A child,"  says Rosen,  "has gripings when  it is
 agitated, unquiet, cries  much, agitates its feet, smiles
 in his sleep, or seizing the breast when it is presented
 to  him, immediately lets  it go again.  The stools
 are then green  or soon become so.   His swaddling
 clothes  are tinged with a greenish color, when they
 are dry.   The chUd has a sour smell, as well as his
 occasional eructations.  If this state  continues for a
 certain time, dysentery is to be feared."
   These pains almost always depend upon an impru-
 dence in regimen committed by the nurse (see p. 61,
 chapter on Nurses, etc.); but they also often proceed
 from leaving the child in the linen wet with his urine.
 Whatever be their cause, we  should hasten to relieve
 them by administering  a few teaspoonfuls of a  glass
of  water,  in  which  has  been  dissolved  three or
four globules  of chamomilla of the twelfth  dilu-
tion.
   " It is remarkable," says Rosen again, "that a child
who has  these  pains and will not  suck, takes the
breast willingly and sucks without difficulty to satiety, 
                        Colic.                   259
 when some one holds him in an upright position before
 his nurse."
   This  is perfectly true.  It is, perhaps, because the
 vertical position  of the  child keeps the acid humors
 contained in  the stomach,  away  from  the  cardiac
 orifice,  and makes  them  fall into its lower  part.
 But  it  is  understood,  that  especially in the  cases
 where  the pains  have been  caused   by the nurse's
 milk, it is important that the child  should not receive
 the breast immediately.

                      COLIC.
   Colic, like diarrhea, forms a part of the symptoms
 of enteritis, and like it, yields to the treatment which
 cures the latter.   But colic, in second childhood, may
 exist without  enteritis, and  even  without  diarrhea.
 It often, for example, shows itself in consequence of a
 chill in the feet.   The child tries, but in vain, to go to
 stool.   At the most, he succeeds in the expulsion 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, some-
 times a  little  frequent;  but  the  face is pale  and
 pinched.
  Cina, is the specific for this sort of colic.  It should
be given from the ninth to the twelfth dilution; a few
globules in a glass  of water; four teaspoonfuls in the
space of an hour. 
260     Diseases  of the Digestive Organs.

               constipation.
  This again is a symptom rather than a disease.   A
bad diet, either in the nurse, or child,  is generally its
cause.   Thus it is frequent in children raised with the
sucking bottle, without conforming to the precepts I
have laid down (see p. 72).
  It is not impossible that it may also be an effect  of
lycopodium, when the nurse is so imprudent as to use
this substance as  a powder for cracks.
  When this is not the case, lycopodium, thirtieth di-
lution, in feeble doses once a day, or  every other day
for  a week, is  one  of the  best  modes  of combating
obstinate constipation, even those forms which do not
yield  to a  change of regimen.  Tepid baths, when
nothing  contra-indicates their  use,  conduce to the
same end.  As to the injections of milk and honey,
recommended by  Hartmann, they are  real purgatives,
to which I would have  recourse, in cases only of the
most pressing necessity, and when homceopathic means
had positively failed.
  Constipation may be within certain  limits a natural
state.   Children of nervous  temperaments are subject
to it, but they should be always watched, for it is a
serious  symptom  in the  greater part  of the  diseases
of children.  When  accompanied by fever,  there is
danger of cerebral symptoms.  Bryonia is one of the
surest  means of combating the accidental consti- 
LlENTERY.
261
pation in children, of all ages, which coincides with
sourness of the stomach and heat in the forehead.

                   LlENTERY.
  We  thus  name  a sort of diarrhea whose existence
is most commonly dependent upon another disease,
aphthae for example, in infants;  but which may also
constitute an independent  affection, of which the fol-
lowing are the symptoms:
  Excretion of solid or liquid aliments, a short time
after their reception into the stomach, without their
having undergone any alteration, either in their con-
sistence, color, or even odor;
  The  patient experiences, immediately after the re-
past, a sensation of coldness  in the epigastric region,
which  swells, is distended  a little with flatulence,
and  soon subsides.  Hiccoughs, soon  succeeded by
loud borborygmus, and a few gripings announce that
the food has cleared the pylorus and is passing through
the windings of the small intestine.   Soon, in fact,
the pain moves about, here and there in the abdomen,
and at  the same time the patient  experiences a sensa-
tion of emptiness in the stomach, and almost imme-
diately a desire to go to stool;
  The  evacuation  is effected without  pain, or at the
most, with  slight  colic; but it  is followed by great
prostration, some moments of vertigo, and an excessive
desire  for food, which soon  produces  syncope, if it
is not  immediately satisfied; the tongue is  clean, a 
 262    Diseases  of the Digestive Organs.
 little whiter than  in the normal state.  The thirst is
 great.
   Lientery  may last several  days,  weeks, months,
 years  even.   I  saw in Oct. 1849, a poor tailor, who
 had been afflicted with it since 1832, when he had
 had the cholera.
   When the disease  has passed into a chronic state,
 the general health is profoundly affected ; the patients
 have a yellow, harsh,  and  wrinkled skin.   In the
 majority, the  emaciation is extreme;  the strength is
 so much exhausted, that they can hardly sustain them-
 selves ; they have three, four, or even  five and six
 stools in the twenty-four hours, which exhausts them
 so much the more, as a part of these stools occurs in
 the  night.   They  have  beside, no  sleep;  the mind
becomes very much  affected; they are sad, taciturn,
irritable, hypochondriac.  I know of nothing, in fact,
more discouraging  than their  condition;  yet there
are, nevertheless,  some who  seem  to pay but Uttle
attention to  it.
   Lientery certainly  depends upon a particular idio-
syncrasy : I have  many times observed it in children
addicted to onanism.   Was the irritation of the intes-
tine, in these cases, the cause or the effect ?
   Authors cite, as causes of this disease, the habitual
use  of  indigestible  and unsubstantial food; such as
raw, fermentable vegetables, acid wines,  the abuse of
purgatives,  humidity  of habitations, or  of certain
climates.  They add, in short, what is very true, that 
Lientery.                 263
lientery may succeed to mucous enteritis;  to typhoid
fever, and  especially to cholera.  It is  observed  at
all ages.
  Treatment.—The first condition for the cure of this
disease  is,  a substantial regimen, and  especially the
abstinence  from roots,  milk food, and above all, from
dried vegetables, unless prepared in a meat soup ; still,
meat itself, especially roast meat, is always preferable
for them.   It results from this, that lientery is almost
incurable  among the poor.  I saw it once, about five
or six years since, yield  rapidly and  without the aid
of any medicine, to a fortifying alimentation, and the
moderate use of old Bourdeaux wine, in a patient, who
had  been  kept for a year on low diet,  and for two
months on ass's milk,  which was a little less absurd,
but which was still a contradiction.
  Arsenicum,  china  and oleander  are  almost the
only medicines which ought to enter into the treat-
ment of lientery.
  Arsenicum is the remedy par excellence;  but  it
only shows itself truly efficacious when administered
in rather low dilutions, at the twelfth, for example,  or
even at the sixth.   At the higher attenuations, arsen-
icum acts  more upon  the nervous system, than upon
the  intestinal mucous membrane.   Thus, in the last
cholera epidemic,  the  homceopathists who made the
mistake of prescribing it at the thirtieth dilution, had
occasion to  remark, that it was badly borne by the
       23 
264     Diseases of the Digestive Organs.
stomach, and that it produced but  imperfectly the
hoped-for results.
  Arsenicum, in the treatment of lientery, should be
prescribed in drops, with water, (two or three drops to
four  ounces of water), of which the patient wUl take
two or three teaspoonfuls a day.  It  should be con-
tinued until the stools are reduced to a normal con-
sistency.
  If there  still remains thirst, acrimony and  styptic
taste in the throat, with indifference to food, china
will  procure the  immediate disappearance of these
symptoms.
  The amelioration  produced by arsenic, is  instanta-
neous and nearly constant; but it is not always dura-
ble :  relapses are frequent, especially when the disease
has already existed for years.
  There will then be occasion to have  recourse to ole-
ander, of which Hartmann recommends the admin-
istration  from the beginning; and which he  seems to
prefer to arsenic.
  May not this predilection arise  from  the  provings
made by Hartmann upon  oleander?   "This medi-
cine," says he, " is the sovereign remedy for lientery."
I am  assuredly far from denying  this  specificity  of
oleander, which  seems beside,  justified by  what we
know of  its pathogenesis;  but  I confess that  I have
not yet verified it for myself. 
Dysentery.
265
                   DYSENTERY.
   Dysentery is an inflammation  of the rectum, with
 increased secretion of mucus,  and  an exudation of
 blood.  It is either sporadic, or  epidemic, primitive,
 or secondary:  in this  last  case,  it  almost  always
 succeeds enteritis.
   Primitive dysentery commonly shows itself in the
 latter part of  summer, while the days are still very
 warm, and the  evenings and nights begin to be cool.
 This alternation of heat and cold, seems to be the true
 cause, or at least the most frequent cause, of dysentery,
 for this disease prevails principally in countries where
 this perpetual contrast of  warm days and cool nights
 characterizes the climate.  Thus,  dysentery is epi-
 demic in Algeria.
   Children  are  more  subject  to this disease  than
 adults.  It always presents  a certain  gravity, but is
 hardly  ever fatal, except  under the  influence  of a
 vicious treatment.
   When  dysentery succeeds  to enteritis,  the mucous
 or bilious stools of the  latter,  become sanguineous,
 and tenesmus takes the place of diarrhea.
   Primitive dysentery  begins with  a violent  chiU,
 followed by  strong febrile  reaction,  with a dry and
 burning  skin,  thirst, dry tongue, extreme desire for
 cold  drinks, urine scanty,  burning, reddish,  and
depositing a sediment.
   Bilious vomitings soon supervene, which are often 
266    Diseases of the Digestive Organs.
renewed during the course of the disease ; then appear
the  local symptoms:  tumefaction  of the abdomen,
whose sensibility is so great, that the patient cannot
support the weight of  his coverings ; violent griping
pains; continual  and  never satisfied desire to stool.
The child, who would  remain almost indefinitely on
his close stool, if  left there, only evacuates, each time,
a little bloody mucus,  or a few drops of pure blood ;
he experiences an extremely painful sensation of burn-
ing in the anus ; sometimes, in  short, the efforts he
makes to go to stool, produce prolapsus of the rectum,
an occurrence, beside,  which is  frequent  enough in
children at the breast, and which we also see produced,
although much less frequently, during the course of a
simple mucous diarrhea.
  The duration of dysentery is very variable.  When
the termination is to be favorable (which  most com-
monly is the case), it almost always  happens that a
few days of mucous diarrhea succeed the tenesmus,
which itself rapidly diminishes.  When on the con-
trary death supervenes, its approach is announced by
the sudden cessation of  the severe "pains felt by the
patient, by the sinking  of the features, coldness of the
extremities, smallness and intermittence of the pulse,
the involuntaiy emission and extreme fetidness of the
evacuations.
  Treatment.—Two  medicines  control  the  thera-
peutics  of dysentery,  whatever  be the age of the
patient, or  the  cause and intensity of the disease; 
Dysentery.                 267
 these two medicines are ipecacuanha and petroleum.
 One  or  two doses of aconite, at the utmost, might
 precede their use in case of intense fever.  It is almost
 always more advantageous to prescribe them from the
 first, together; that is  to say, one (ipecacuanha) in
 the morning, the other in the evening.
   I commonly  use ipecac, at from  the  sixth to the
 twelfth  dilution,  and petrol., at  from the twelfth to
 the twenty-fourth.  I prescribe of each seven or eight
 globules in four  ounces of water, to be administered
 by dessert or teaspoonfuls, according to the age of the
 child.   The same medication is  renewed every day,
 until the disease is completely cured.
   It is to be remarked that among the numerous med-
icines extolled  for dysentery, no practitioner, that I
 know, has mentioned petroleum.   Those  to which,
until  now, the  preference has been  given, are: mer-
curius  corrosivus, colocynthis, nux  vomica, carbo
vegetabilis, sulphur,  hepar sulphur,  belladonna, ar-
senicum, veratrum, capsicum, china, and lastly aloes,
which few persons, I believe, have used wTith success.
   I shall only say a few words of the two first.
   Merc, corros., is indicated  by the  following symp-
toms : almost continual pains, day  and night; frequent,
but  scanty,  bilious,  fetid, green  or brown  stools;
insatiable thirst;  white  tongue, with a  tendency to
become dry on the edges; anxiety; heat; wakefulness;
feeble and frequent pulse.
   Colocynthis  may be  prescribed,  if the stools  are 
268     Diseases of the Digestive  Organs.
yellow, aqueous, mucous and mixed with pure blood;
if the colic, which accompanies, them, disappears
immediately after, but  returns as soon as the patient
takes any food or drink whatever;  if, finaUy, the heat
is moderate and the pulse almost natural.
  However, in conforming  to our indication touching
ipecac, and petrol., we  shaU hardly ever have occasion
to have recourse to any other medicinal agent.
  The regimen required by dysentery is almost com-
plete abstinence from food (excepting in children  at
the breast), for a day or two, after which the patient
may be put upon the use of thin soup—then soup of a
better quality, and lastly light meats, such as poultry
and lamb chops.

               TYPHOID  FEVER.
   Typhoid  fever, which in many  respects, may be
considered as  the correlative of variola, is a serious
disease,  essentially constitutional, and whose anatom-
ical characteristics  consist; 1st, in  turgescence, then
in  ulceration of  the follicles of the small intestine,
especially the glands of Peyer; 2d, in the sympathetic
engorgement of the mesenteric glands, and sometimes
of the spleen.
   Typhoid fever, whose contagion is, it  seems to me,
only transmitted by  the  atmospheric  air,  prevails
 almost always epidemicaUy.
   Children are much more  exposed to it than adults.
 It is especially frequent between the ages of nine and 
Typhoid Fever.              269
fourteen, less frequent from five to eight; rare in the
first years of life.  It oftener attacks boys than girls.
  The general symptoms  of this disease are nearly
constant; but, like all  other  miasmatic  affections,
they present  themselves  to the eyes of  the observer
under a multitude of different aspects, which evidently
only results from its greater or  less intensity.
  It foUows from this that it is impossible to point out,
in absolute terms, its duration,  which may Umit itself
to a few days, or be extended  to a month.  But it is
to  be  remarked, that mild typhoid  fevers  have the
same relation to the serious forms of the disease, that
varioloid  has  to variola; the same symptoms are
present in each case, but in the  former are attenuated
in severity, and limited to a shorter time.
  Relapses, during convalescence from typhoid fever,
and even  the  reproduction of this  disease at short
intervals, in the same subject,  are  not without exam-
ples.   These instances,  however,  are very rare,  as
rare, perhaps, as the relapses of variola.
  To facilitate the description of typhoid fever, I shall,
after the example of MM. Rilliet  and Barthez, admit
three different forms of this disease; but this distinc-
tion, be it well understood, is purely arbitrary, and im-
plies no essential difference, either in the nature, or as
we shall soon see, even in the treatment of this disease.
   Mild  Typhoid Fever, is sometimes announced by a
few days of depression, of general lassitude,  of want
of appetite, and ill-humor; sometimes it begins ab- 
5470     Diseases of the Digestive  Organs.
ruptly with moderate fever, slight headache, anorexia,
thirst, slight diarrhea, abdominal pains, and  very
rarely with constipation and vomitings.  The tongue
is  moist, covered with  a not very thick whitish  coat-
ing; the abdomen is soft.  The chHd is prostrated, his
strength is gone; there is a darkish circle round his
eyes; the nostrils are dry ;  his nights are good, some-
times, however, troubled with  transient delirium ; his
face  presents, when he  awakes, a sort of dull and
unusually stupid  expression, and  the forehead is
bathed in perspiration.
   This  state continues from four to six days without
observable change; but from  the sixth to the eighth
day the headache ceases, and a few red spots appear
upon the abdomen, and the internal parts of the
thighs; then, but not  constantly, sudamina upon the
sides of the neck, or upon the  abdomen.   The tongue
is  now  a  little  less moist,  the gums a little  swollen,
and covered with small white patches; the abdomen is
prominent and sonorous; gurgling is felt  in the right
iliac  fossa.  If there is a cough, it increases, and we
hear a distinct  sibilant rale on the posterior part of
the chest.  These symptoms remain stationary for sev-
eral days, then  successively  disappear.   The tongue
again becomes moist; the abdomen recovers its pli-
ancy ; the diarrhea ceases; the  fever diminishes; the
agitation  disappears, and the  patient enters  upon his
convalescence,  after  an  illness of  from fifteen to
eighteen days, sometimes even much less. 
Typhoid Fever.
271
  Serious Typhoid Fever.—It commences sometimes
after several days of indisposition ;  sometimes unex-
pectedly  by  an  intense fever,  severe cephalalgia,
constipation  and  bilious vomiting.   Diarrhea soon
succeeds  to  constipation,  especially in very young
children.  The tongue is thickly coated, often dry, and
red at the point.  The abdomen  is painful, especially
at the umbilicus, or in the [right] iliac fossa; sleepiness
during the day, agitation and  delirium at  night;  the
sudamina are proportionally more numerous than the
red spots ; the cough is very severe ; the sibilant and
sub-crepitant rale are very extensive, sometimes there
supervenes one or several attacks  of  epistaxis.
  After a longer or shorter duration  of these divers
symptoms, they either diminish  little by little,  or
become complicated with an organic  lesion, such  as
otitis, pneumonia, pleurisy, perforation of the intes-
tine, etc., which carries off the  young patient.
   Very  serious Typhoid  Fever.—This form some-
times begins like the preceding,  and the symptoms it
presents, are but the progressive exaggeration of those
I have just described.   But at other times, it reveals
from  the first, by the violence  of  its invasion,  the
gravity of its nature.   Thus, from the beginning, the
fever  is  very violent;  the skin burning;  the cepha-
lalgia intense; the prostration extreme.  Constipation
is then a constant phenomenon,  as  well as abundant
vomitings.   "The face," say MM.  Rilliet and Bar-
thez,  " expresses extreme dejection ; after a few days, 
272     Diseases of the Digestive  Organs.
there  supervenes  the  most  intense  delirium,  an
extreme agitation soon followed by profound depres-
sion  ; new exacerbations of delirium and  agitation;
the head  is then bent backward, the eyes  are  some-
times shut, sometimes half open, sometimes turned,
convulsed, upward;  the  pupils  sometimes  dilated,
sometimes contracted;  the  lips  are  agitated  with
movements and tremblings ; the face red and pale by
turns; the  countenance  changes expression  every
instant; there is sometimes a very wild expression, at
other times the child appears  sleepy;  the eyes  are
shut; a few moments after he arouses from this leth-
argy, to utter the most piercing, prolonged, and plain-
tive  cries; he changes every instant the position in
which he lies ; sometimes on the  back, sometimes on
the  side; his cries  increase: abundant evacuations
fill the bed of the young patient;  the urine is passed
involuntarily.   Complete prostration,  and  insensi-
bility finaUy prevail; the trunk has  the rigidity of a
bar  of iron;  intelligence is abolished, the face is
covered with a cold sweat, and death supervenes at
the end of from seven to nine days.  But the disease
may be prolonged  to a much later period; there then
persists a  very active  delirium,  alternated with  drow-
siness—the pupils are dUated;  we sometimes observe
subsultus  tendinum  or  carpologia; the  tongue is
covered with a thick fuliginous coating; the teeth are
incrusted ; the lips  red, excoriated and blackish ; the
nostrils dry ;  the features drawn ;  the pulse small and 
Typhoid Fever.
273
wiry;  the  stools  are always  involuntary ;  the abdo-
men much distended,  or on the contrary, retracted.
Eschars are produced on the sacrum, and death occurs
from the fifteenth to the thirtieth day." *
  I venture to affirm, that it is infinitely rare, I wiU
say, almost unknown,  that under the influence of a
well-directed  homceopathic treatment, typhoid fever
pursues such  a course.
  To sum up, the dominant symptoms of this disease,
are vomitings in  the  beginning,  (although they are
sometimes  wanting);  diarrhea,  which is  constant;
pains and tension in the abdomen; general stupor and
delirium.
  Of all diseases, that  with which typhoid  fever may
be most easily confounded, is  meningitis.  In fact,
fever, vomitings and cephalalgia, are the  symptoms
which belong to the beginning  of both diseases;  but
the abdominal  symptoms present remarkable differ-
ences.   Thus, in  meningitis, the abdomen,  instead of
being distended,  flatulent and  prominent,  is  almost
always retracted, hollowed even in the form  of a boat.
On the other hand, it very rarely happens, in typhoid
fever, that we see manifested in the beginning,  the
extreme agitation  and  the delirium which  mark  the
commencement of meningitis.   Lastly, the cough and
the sibilant rale, which we observe almost  constantly
  * Rilliet et Barthez : Traite Clinique et Pratique des Maladies des
Enfants, tome ii, page 377. 
274     Diseases of the Digestive Organs.
in typhoid fever, is hardly ever  seen in the cerebral
Affection.
  Treatment.—The treatment that I  myself have
adopted, and which  I  most earnestly recommend to
other  practitioners, because  it  has constantly  suc-
ceeded with  me, rests upon  three medicines only:
ipecaauanha, belladonna, acidum muriaticum.
  Ipecacuanha is administered  from the  beginning,
even when there are no vomitings.  I give it at from
the sixth  to the twelfth  dilution, three  times  in  the
day, and renew this prescription on the next  day if
no cerebral symptoms are yet manifested.  But gen-
erally the use of ipecacuanha should  not be con-
tinued beyomd the third day.
  Afterward, administered concurrently, belladonna
and acidum muriaticum, the first at from the sixth
to the twelfth dilution, twice in  the morning;  the
second,  at a low dilution—the third for example—once
only,  in the evening.
  Belladonna  corresponds to the affection  of  the
nervous system /  acid, muriaticum to the intestinal
ulcerations, for which it is the specific.
  The use of these two medicines, should be contin-
ued until  a decided amendment  occurs,  I will  almost
say, until  the resolution of the disease.  However, if
after  the first few days,  the  agitation, delirium and
stupor completely disappear; if  there is no constipa-
tion, cough, or angina; if the face, instead of being
injected, resumes its normal color, we  may at  first 
Typhoid  Fever.
275
reduce belladonna to a single dose per day, then dis-
continue its use.   Acid. mur. may then be admin-
istered alone,  morning  and evening, for one or two
days.
  But as the violence of the cerebral symptoms is  in
direct  proportion  to the intensity  of the  intestinal
affection, the  alternation of bellad. and acid. mur.
will hardly ever need to be interrupted.
  When, toward  the termination of the disease, the
diarrhea no longer exists, or has almost disappeared—
if the patient still has dryness  of the tongue and lips,
with a brownish tint upon the latter—we may prescribe
china for one or two days.
  One need not be anxious about the partial paralysis
which may stiU persist during convalescence.  Deaf-
ness, for example, loss of speech, or paralysis of a
limb, are,  in  these cases, unimportant phenomena;
and beside, a few doses of nux vomica will effect their
prompt disappearance.  The suspension of taste and
smell, (phenomena which it is very difficult, not to say
impossible, to  verify in children,) calls more especially
for the use  of causticum.
  Lastly, cases may present themselves when it would
be proper to administer bryonia, rhus toxicodendron,
phosphorus, and sulphur.
  It is for  the sagacity of the physician to decide, ac-
cording to the totality of the symptoms, when the use
of one or other of these medicines is demanded. 
276     Diseases  of the Digestive Organs.

             ic terus--jaundice.
  By the name of icterus, or jaundice,  is  desig-
nated the yellow coloration of the skin and  of the
tunica albuginea,  with or  without  disturbance  of
the circulatory apparatus.  New-born infants are sub-
ject to it; but  it is then of no importance, and com-
monly disappears of itself, at the end of seven or eight
days, by copious evacuations.
  When icterus is accompanied  with fever,  it lasts
longer, and  there is danger of its  degenerating into a
chronic afiection of the liver, with emaciation of the
body, dropsy, or tuberculation of the mesenteric glands.
  Treatment. — Aconitum, chamomilla, bryonia,
and nux vomica are the principal medicines caUed for
in the treatment of icterus.
  We prescribe:
   1st. Aconitum,  during  the  febrile  period.  This
medicine will often suffice to cure  the disease;
   2d. Chamomilla, if the icterus  is without fever;  if
it is in consequence of a fit of anger; if it is accom-
panied with bilious diarrhea;
   3d. Bryonia from  the first, but  most  commonly
after aconitum,  if we  observe  gastric  symptoms,
thirst, heat in the forehead and palms of the hands ;
   4th. Lastly,  nux vom., under circumstances nearly
 analogous  to  those  which  call  for  bryonia;  but
 especiaUy if there is  constipation, with hot  and dry
 skin . 
Peritonitis.
277
  Dr.  Hering recommends, in  addition,  against ic-
terus, mercurius  vivus, sulphur, lachesis, and ipeca-
cuanha ; perhaps the last of these may be preferable
to bryonia, in the cases where this has been proposed
by me.   Having  had no experience with it, I am un-
able to affirm anything in regard to it.

                 peritonitis.
  Peritonitis is a general or partial inflammation of
the  peritoneum.  It is a disease rarely occurring in
children, especially as a primitive affection.  Its char-
acteristics are: intense pungent pain in the abdomen ;
pulse small  and frequent;  great paleness  of the face.
The vomitings, which almost always accompany peri-
tonitis in adults, are very rarely observed in the peri-
tonitis of children.
  The pain  in the  abdomen, at first circumscribed,
Boon spreads over  all  the  surrounding region ; the
abdomen is then  distended,  tympanitic, and the least
movement,  the  slightest  change of position, causes
the patient to cry out with pain.
  Peritonitis, frequently mortal in a few days, some-
times, also, passes into a chronic state.  An effusion
of serum then takes place in the abdomen, of which it
is easy to perceive the fluctation.   Chronic peritonitis
is not essentially incurable, but  it requires time, and
great care.
  Treatment.—Aconitum,  in repeated doses, during
the  acute period ; spongia tosta, lachesis, causticum, 
278     Diseases of the Digestive Organs.
calcarea carbonica, and,  lastly,  china,  in chronic
peritonitis.

             intestinal worms.
  Intestinal worms are, like the other parasites of the
economy, the products  of certain morbid states, exist-
ing previously to their formation.  Hence it follows,
that the existence of entozoa should be considered as a
symptom, not as a disease.  This consideration is im-
portant, in a therapeutic point  of view.  It is easily
understood, that it cannot  be a matter of indifference
whether we direct the treatment against  the disease
itself, or against the product it  engenders.  I believe
I have  already made the importance of this distinc-
tion felt, apropos of tinea and lice, and again, farther
on, of the itch and the acarus.
  The digestive  tube, in chHdren, is susceptible of en-
gendering the different species of intestinal worms de-
scribed by writers on the subject; but the proportional
frequency of these  parasites  is very different.  Thus,
we observe the  ascaris  lumbricoides, and the ascaris
vermicularis, more frequently  in childhood than  at
any other period of life ; the trichocephalus exists, in-
differently, in children and adults ; lastly,  the bothrio-
cephalus, and  the tcenia, are extremely rare in chil-
dren.
   As the symptoms which correspond to the presence
of trichocephalus  are  very vague, very obscure, and
very little  known, we  shall abstain from describing 
Intestinal Worms.
279
them,  and  speak only of ascaris lumbricoides and
ascaris vermicularis.
  Ascaris Lumbricoides.—The ascaris lumbricoides,
[long round-worm,]  has a length of from six  to six-
teen inches, and  a diameter of from one-fifth to one-
third of an inch.   It is cylindrical,  almost equally
tapered at the two extremities ; a little  more, however,
toward the head, which is distinguished  from the
rest of the body by a  circular depression.   Above
this depression are seen three little elevations, or ra-
ther three valves, which are capable  of opening and
closing; when they open, we discover  between them,
a tube, which  is, in fact, the mouth of  the animal.
  These worms are of a more or less dark rose color;
according to the nature of the food with which they are
gorged.   Their  alimentary canal, recognized  by its
brown color, is terminated  by a transverse slit situ-
ated a  little forward  of the posterior extremity of the
body.
  The  two  sexes  are  separate;  the  male  is - distin-
guished  from the female  by  its  curved tail, upon
which  are visible its  organs of generation  The geni-
tal organs of the female are whitish ducts, easily to be
perceived by  the transparency of the  envelope; and
the contrast of their  color with that of the  intestinal
canal.
  The small intestine is the favorite locality of ascari-
des  lumbricoides; but they traverse all parts of the
        24 
280    Diseases of the Digestive  Organs.
alimentary canal.   They are found in the large intes-
tine, from which  they are often  expelled  by stool.
They sometimes rise  into  the stomach, oesophagus,
and  even  the pharynx, and it is not very uncommon
to see children eject them by vomiting.   Finally,
authors cite examples of their presence in the trachea,
bronchiae,  nostrils, frontal sinuses,  and even under the
skin of the abdominal parietes, where they form ab-
scesses, upon the opening  of which they are thrown
out externally.
  The number  of ascarides in the  intestines is infi-
nitely variable.  We sometimes see them accumulated
by hundreds and forming balls of  the size of the fist.
MM. Rilliet  and  Barthez  report  on this subject an
observation  inserted by Daquin, in the thirty-fourth
volume of the  Journal de Me'de'cine, Chirurgie et
Pharmacie, which deserves to be  quoted.  " We first
opened the stomach," says the author, " and found
there a single round-worm, almost as long as the fore-
arm, extending through  the cardia and  along the
oesophagus.  From thence coming toward the pylorus
and following the duodenum, we found it crammed
(if  one may be permitted the  expression) with the
same worms, great and smaU, to  such a degree as to
have become hard and  resistent,  and  distended to
a much greater volume than it  naturally  possesses.
The worms  were mixed  with a  greenish substance,
which I recognized as herbage, and which, judging 
                 Intestinal Worms.            281
 from the fetid odor it exhaled, must have been a long
 time in the intestine.
   " We continued our search through the rest of the
 canal, and  the jejunum, the ileum,  and the caecum
 were so filled that  I could compare it to nothing but
 force-meat; it seemed as if they had  been stuffed in.
 We found some in the colon, mixed with the fecal
 matter, but in less quantity."
   In the post-mortem examination of children, who
 have died of verminous  affections, we almost always
 discover traces of erythematous enteritis, that is  to
 say,  a  vascular injection of the intestinal  mucous
 membrane, which in certain cases, rare it is true, had
 lost sensibly its natural consistence.   As to perfora-
 tion of the intestines, coincident with the existence of
 lumbrici, MM.  Scouteten,  Cruveilhier, and Jules
 Cloquet, do not hesitate to attribute them to a morbid
 state, independent of the action of these worms; an
 opinion which coincides with that of all homceopathic
 physicians.
   It is especially between the ages of three  and ten
 that children  are subject to  verminous affections.
 According to authors, little girls are more subject to
 them than little boys;  I am not aware how far this
 opinion  is well-founded; but what I believe to be cer-
 tain is, that these worms are more common in blond
 children, of a delicate and rosy complexion ; to those,
in a word, who present  the  signs of  the lymphatic
temperament. 
282     Diseases of the Digestive Organs.
  We will not stop here to seek for the  cause  of ver-
minous affections.  They are, like the majority of other
diseases, the result of a specific and hereditary miasm.
It is nevertheless  certain  that a miserable alimenta-
tion ; an exclusive  milk diet; sweet or feculent dishes,
herbs and fruits favor their development.  It is not
impossible, lastly,  that certain atmospheric states, as
yet little understood, or perhaps even  a  real miasm
pervading the air is sometimes the first  cause  of ver-
minous enteritis.
  On this subject MM. Rilliet  and Barthez say that
"intestinal  worms have been observed  compHcated
with certain diseases which  prevail epidemicaUy; and
it has been thence concluded that there exists an epi-
demic verminous disease.  While we deny the justice
of this conclusion, we ought, nevertheless, to acknow-
ledge that the conditions under the influence of which
certain  diseases  prevail epidemically,  and  perhaps
even the nature of these affections, evidently contri-
bute to the multiplication of worms."*
  The  symptoms to which the  presence of asca-
rides in  the  intestines, or the disease  which  pro-
duces them, may give rise, are  so various  and so
numerous, that it is difficult to  present  summarily
a general view  of  them.   I   may   add,  that in
consequence of the great  number and diversity of
these symptoms, it  is  less easy  than  may be  sup-
* Ouv. cite, torn, iii, page 628. 
                 Intestinal Worms.            283
 posed to point out the certain  and  pathognomonic
 signs of verminous enteritis.   Perhaps the only irre-
 fragable sign  is  the  presence in the stools,  or  in
 matter  vomited,  of one or  more  lumbrici; but  as
 this circumstance  is very far from  always present-
 ing itself, except in  cases where there  exist  enor-
 mous masses  of worms in  the smaU intestine, we
 here give the groups  of symptoms which  render the
 existence of this disease the most probable:
   Sudden  and frequent changes in the color  of the
 face, which is  sometimes red, sometimes pale, some-
 times lead-colored; bluish  semicircles circumscribing
 the lower eyelid;  increase or diminution of the bril-
 liancy of the  eyes; uncertainty or momentary fixed-
 ness of the look, dilatation of the pupils;  itching of
 the nostrils,  bleeding  of the nose,  cephalalgia after
 meals ;  flow of saliva in the  mouth, especially during
 the night; tongue a little dry, with red dots upon the
 point and edges ;  insipid,  acid, or fetid odor  of the
 breath; thirst on waking;  capricious appetites, great
 hunger,  or dislike  to  food;  uneasiness increased  by
 abstinence;  enlargement of the abdomen,  from time
 to time a pinching pain, or twisting sensation  in the
 abdomen ;  frequent borborygmus, sudden  vomitings
 without apparent cause; slight diarrhea;  from time
 to time very abundant  and  fetid stools ;  itching in the
 anus;  short dry  cough, or even violent  attacks  of
 cough  like  that  of a  severe  cold,  with or without
glairy expectoration ; sorrowful, unequal and fantastic 
284     Diseases of the Digestive Organs.
humor; attacks of fainting, which may return a great
number of times in the same day ; disinclination for
labor;  agitated sleep, talking in the sleep, nightmare,
somnambulism; aggravation  of the  symptoms  in
the morning,  especially when fasting; propensity to
onanism ;  leucorrhcea ; lastly, convulsions, delirium,
epileptiform attacks, etc., etc.
  It  is not necessary that  children attacked  with
verminous  affections  should  present  all  the  symp-
toms I have described, but in taking  care to proceed
with prudent reserve, as to the exclusion of other dis-
eases, represented  by some of these  symptoms,  it is
rare that we do not succeed in clearly establishing the
diagnosis of verminous enteritis.
  Treatment.—A multitude  of  medicines have been
recommended  against  ascarides  lumbricoides, in the
number of which I shall cite from Hering, ipec, carb.
veg., pulsat., china, nux vom., aeon., mercur.  viv.,
sulph., bellad., lach., and above all cina, which reaUy
possesses the properties of a  vermifuge, but which is
not, as is  generally supposed, the remedy par  excel-
lence, for verminous affections.
  My whole therapeutics in this respect  turns almost
exclusively upon two  medicines, of which one is very
little  known,  and  the other  but  little used, so far
as I am aware, in similar cases, except by our worthy
and  learned friend Doctor Petroz.   The  two med-
icines  of  which  I speak  are  viola odorata and
stannum. 
Intestinal Worms.
285
   Viola odorata, of which cina (the pathogenesis of
these two medicines offers many points of analogy) is
only for me the succedaneum, suits in all cases with-
out exception, in which we are certain of the existence
of the lumbrici.  I  give it at the sixth dilution, doses
repeated several times a day.
   Stannum, is a capital  medicine if the verminous
enteritis is complicated with  nervous  symptoms, such
as melancholy, violent cough, sudden faintings, tetanic
rigidity, partial or  general  convulsions,  epileptic at-
tacks, etc.  I only use stannum at the thirtieth dilu-
tion, and  always with a eci-tain reserve.  I think, for
example, that the doses of this medicine should not be
repeated more than once a day.
  Neither viola odorata  or stannum,  will  always
produce the expulsion of worms, but they will not the
less  dissipate  all the  symptoms  which  mark  their
presence.   It is  hardly necessary  to add  that a suit-
able regimen, above all, the complete abstinence from
all  preparations  of milk, green fruits, confectionary
and  pastry, is an indispensable auxiliary to the rem-
edies I have pointed out.
  Ascaris Vermicularis.—The  name ascaris vermi-
cularis is given to a little worm, observed exclusively
in the inferior part of the rectum, ordinarily known
as pin-worm..  Bresmer, in his Traite des Vers Intes-
tinaux, gives the following description of it:
  " The male is a line or a line and a half in length,
its body slender  very elastic and of a white  color. 
286    Diseases of the Digestive Organs.
The  anterior part is obtuse  and surrounded  by a
transparent  membrane,  through which we perceive,
forming a species of bladder, a straight tube, which is
the oesophagus, and which  becomes  club-shaped  at
the place where  it is lost in  the globular stomach.
The intestinal tube extends  through the whole length
of the body, which becomes gradually larger, and
assumes a spiral form toward the tail.
  " The female is larger than the male, and attains a
length of four or five lines.  The conformation of the
anterior  part resembles, in  its internal and external
construction, that of the male, up the place where the
oesophagus  terminates.  From this  point the  ali-
mentary  canal  is  surrounded  on  all  sides  by  the
oviducts."
  This species of worm, which is generated with an
astonishing rapidity, is  the  despair of the aUopathic
physician, who,  never attacking, by  the  agents di-
rected against them, the true  cause of the reproduc-
tion, leaves them to exercise their ravages for years.
  The itching, caused  by the ascarides, is especiaUy
felt in the warmth of the bed.  It is insupportable,
and sometimes causes very violent nervous symptoms.
As these symptoms occur  every night almost  at the
same hour, they are  sometimes taken  for fevers, or
intermittent nervous affections. But, on examining
with care the  anus of the patient,  we easily discover,
in the folds of the  mucous  membrane, the worms of
which we speak.  They are seen moving with vivacity. 
Intestinal Worms.
287
entering the  rectum,  reappearing, and  then  again
disappearing.
  It is these worms, above all, which cause in young
girls a vaginal discharge, and provoke masturbation
in children of both sexes.
  The therapeutic agents extolled by homceopathists,
against  the affection which generates the ascarides,
are of more than doubtful  efficacy.  We may judge
of it by  this passage from Hering:
  "When the itching  in the anus is caused by asca-
rides, and nux vom. does not suffice, if the children
are very restless at night,  if they are fearful,  give,
morning and  evening,  aconite,  and  if  that  does
not  suffice,  ignat. in the  morning ;  mar.  ver.,*
sometimes  succeeds, but still  more frequently urt.
urens;  but, if from time to time children are tor-
mented  by this affection, especially  at  the  full and
new moon, give sulph. at every full moon, and  silic.
at each  new moon ;  if one dose has not been sufficient
give  it the  next time in  dilution,  by  teaspoonfuls,
seven mornings in succession.  If at the following full
moon there is no amelioration, give in the same man-
ner calcar. carbon., which may be repeated for seven
days in  succession.  The children should not be per-
mitted to eat pork or pastry.  If all this is without effect,
give fer. acet., every other day; if a diarrhea comes on
stop the medicine, if the diarrhea persists, give china.
           * Teucr. mar. ver.
25 
288     Diseases of the Digestive  Organs.
  " There is no objection beside to giving  a little in-
jection  of oil, and if that even does not yet  suffice,
injections of cold water every evening: there is nothing
in this  to interfere with the action  of the remedies.
This treatment having no effect, we may try, especiaUy
in children who have inherited this affection, injections
of water slightly salted ; if they do not suffice,  and oc-
casion diarrhea, we  may give  acidulated  injections.
In case of a  new failure, we have seen frictions, re-
peated morning and evening, with the half of a lemon,
give relief."*
  Let us be  frank, and confess, that an  allopathist
who should read this fragment, would have a  right to
say to us, that our treatment was still more miserable
than  their own.   Happily, this  apparent impotence
of Homoeopathy in no way compromises the exceUence
of its principle;  it only proves, that the inductions
furnished by the pathogenetic study of remedies, need
to be completed by clinical experience, which can only
be done with time ; but, let each one bring his stone,
and  the edifice wHl  be completed.   As for  myself,
here is  mine:
  Three medicines are required to cure the affection
which generates the ascarides ; they are, lycopodium,
veratrum album, and ipecacuanha.
  The first should be administered for two days only,
at the  thirtieth  dilution, three dessert-spoonfuls,  or
* Hering : Medecine Homaopathique Domestique, page 251. 
                 Intestinal Worms.             289
 three teaspoonfuls, (according to  the  age oi the  pa-
 tient,) of a potion in which has been  dissolved seven
 or eight globules to four ounces of vehicle.
    Veratr. alb. may be prescribed in the same man-
 ner, (at  from the fifteenth  to the eighteenth dilution,)
 during the four following days.
   Lastly,  ipecac, should  succeed  to  veratr.,  at the
 ninth dilution, for three or four days, at the most, and
 aU wiU be finished.
   In the majority of cases, the itching  will have been
 removed by lycopodium, but we should, notwithstand-
 ing, make use of the two auxiliaries of which I have
 6poken.   Nineteen  times  in  twenty, at least, this
 treatment wiU succeed.  If one should be so unfortu-
 nate as to fail in this treatment, we have still, as a
 resource, the interminable  series of means collated by
 Hering; but, for myself, I confess, if I had in per-
 spective  the necessity  of  running such  a round, to
 arrive at last to injections  of salt water and frictions
 with the  half of a lemon, I should prefer to abandon
 myself at once to the frictions of mercurial ointment,
practiced by Professor Cruvelhier in such cases,  or
even to the injections of oUve oil and mercurial oint-
ment,  recommended by M.  Jules Cloquet, in  his
Clinical Lessons 
290     Diseases of the Digestive Organs.

    tabes mesenterica-- atrophy of children.
  The name  tabes mesenterica, or phthisis mesentcr-
ica, is applied to the scrofulous engorgement, or, still
better, to the tuberculation of the mesenteric glands.
Tabes mesenterica  is only then, properly speaking,
one of the  internal  forms of scrofula, whose general
symptoms,  as we have described them, (p. 207,) char-
acterize, in fact, the external appearance of children
affected with phthisis mesenterica.
  Tabes  mesenterica, which is very  rare  in children
under  three,  and over twelve  years  of age, is most
common between the ages of five and ten.   Statistics
seem  to  prove that it affects boys more than girls.
Like all other forms of scrofula, it is  frequent in cold
and  damp countries, and almost unknown in dry
and warm climates.
  It is a very serious disease ;  so  much the  more
serious, that it  is  often  not  recognized until it  is
already far  advanced.   I am, at the same  time, far
from considering it incurable, even when it has already
produced extreme emaciation.  My  opinion, on this
subject, is based upon unquestionable facts.
  I admit,  however, with all other practitioners, that
it is very unfortunate  that we cannot diagnose this
disease from the  beginning,  for it  would be then
almost always easy  to arrest its progress.  But it re-
veals itself by such  obscure symptoms, and progresses
so slowly, that it may for months, and even for  years, 
Tabes  Mesenterica.
291
escape the most  attentive observation.   Its general
symptoms, in fact, are common to the majority of
chronic diseases, and its local signs only become really
characteristic at a period when the disease has already
made great progress.  Nevertheless,  here  is a  sum-
mary of the  symptoms which properly belong to it,
but which, however, are not always equally evident:
  Stools  more frequent than  in healthy children;
sometimes  liquid,  often  colorless,  whitish,  slimy,
looking like  clay mixed with water;  acid odor, not
only of these evacuations, but also of the breath and
perspiration  of the patient; insatiable  hunger, but
with  repugnance for  nourishing food, such as  meat
and  soup; great appetite, on the contrary, for sour
and farinaceous food ; urine turbid, whitish, as it were
mucilaginous ; tumefaction of the abdomen, which is
Boft  enough  at  first,  but  which gradually hardens,
presenting, when examined, isolated tumors, or tumors
in groups, varying in size, from that of a pigeon's
egg to that  of the fist of an  adult; the abdomen
finally acquires an enormous volume, in proportion to
the rest  of the body ; gradual increase of feebleness
and emaciation ; lancinating pains, from time to time,
in the abdomen ;  the  child is  gloomy, silent, apathe-
tic, and weeps upon  the slightest occasion.   Lastly,
when the disease  approaches a fatal termination, hec-
tic  fever supervenes, exacerbated during  the night,
and  accompanied by ardent thirst, wakefulness,  and 
292     Diseases of the Digestive Organs.
anxiety.   The fever remits during the day, although
the pulse always preserves a certain frequency: but,
in the evening, the  face of the  patient is very much
flushed.  A colliquative diarrhea exhausts the strength,
and the disease terminates in marasmus and death.
  Treatment.—Chamomilla,  sulphur, hepar sulphur,
cina,  china,  nux vomica,  bryonia, belladonna,  ar-
senicum, pulsatilla, rhus, mercurius, magnesia  car-
bonica,  phosphorus  or phosphori  acidum,  baryta
carbonica, conium maculatum, sepia, petroleum,  and
iodium, have all been recommended in the treatment
of tabes  mesenterica.   Certainly, many of these
medicines,  and  perhaps  all,   correspond  to some
of its  symptoms,  but neither of them  is its speci-
fic.  Tabes mesenterica is, however, one of those
diseases, whose  principle is sufficiently well known
to be attacked in its  essence even;  that is  to say,
in such a manner that the virtues of the remedies
opposed to it, should arrest its development, whatever
the diversity of the accidental symptoms it produces ;
at least, it was with this conviction that I commenced
the search  for  a  therapeutic  combination,  which
might be considered  as its specific, in all cases;  and
I am happy in being now able to affirm, that I almost
feel the certainty, based upon  numerous facts,  of hav-
ing attained my object.
  Whatever be the age of the patient  or the intensity
of the disease, I combat it  with three medicines: 
Tabes  Mesenterica.               293
sarsaparilla,  aloe*  and  in  the  last  place, colchi-
cum.
   I administer sarsapar.  at the  eighteenth, aloe, at
the sixth,  colchicum, from the twelfth to the fifteenth
dilution ;  each  two or three  drops to  eight  ounces of
water.
  »I have experimented with sarsapariMa and aloe upon myself and
upon six other persons, for several  months.   Sarsaparilla is a pre-
cious medicine.  As  for aloe, whose pathogenesis  is very poor, I
do not believe that, with the exception of tabes mesenterica, in which
it plays  a chief part, there exist many diseases in which its em-
ployment would be useful.
  These  two medicines both  exercise a very singular modification
upon the coloration of  the hair.  When a child with red hair takes
sarsaparilla for  three months (three teaspoonfuls a day of a solution
of four ounces of distilled water, with three drops of the tincture at
the eighteenth), his hair absolutely changes color.  From  red, that
it was, it becomes a light flaxen.  It is to be remarked that sarsapar-
illa in such a case causes no appreciable organic trouble ; the health
of the child is  in no way affected.  Aloe, in stronger doses (twelve
or thirteen drops of the sixth solution, to a pint of  common water,
four teaspoonfuls  a day), produces  and cures falling  of the  hair in
adults.  Upon one  of  the persons who lent himself to my experi-
mentation, this  phenomenon was so marked, that a lock  of white
hair that this person had on the top of his head, in consequence of
a blow received on this part twenty years before, completely recov-
ered its  black hue, like the rest of his hair.  But, in compensation,
the temples were garnished with white hair, which, however, disap-
peared the following month.  Upon the whole, hair which had  re-
mained  white for a long time, became black, but  there remained
some white hairs here  and there, where there were none before.   I
give these facts  for what they are worth ; they seemed to me strange
enough to merit publication. 
294    Diseases  of the Digestive Organs.
  These three medicines  are administered alternately
for one week or a little more, commencing with sarsa-
parilla and finishing  with colchicum.   It  is  indis-
pensable that the doses, proportioned beside to the
age of the patient, should  be renewed  three or four
times a day.
  Such is the basis of the  therapeutics by means of
which I have obtained for several years past the most
surprising results.
  Perhaps this medication would not always prevent
the subsequent transformations of scrofulous disease;
but I can at least affirm that there exists nothing su-
perior for the treatment of tabes mesenterica.
  Phthisis peritonealis, of which some  authors have
made a separate  disease, and different from tabes me-
senterica, does not require  a  different treatment.  It
is, however, weU understood, that the treatment of
such contingencies  as may arise is left to the sagacity
of practitioners.  As to  the regimen, it is evidently
the same as  that  caUed for in  the  scrofulous dia-
thesis. 
Coryza.                  295
      DISEASES  OF  THE  RESPIRATORY  ORGANS.

  Although children do  not suffer as seriously from
the affections of the respiratory organs as from those of
the abdomen, they, as well as  adults, are frequently
subject  to  their attacks.   Some of these,  however,
such as phthisis pulmonalis, are far from  being as
frequent in early infancy  as in adolescence, or at'a
more advanced period of life; but others, on the con-
trary, such as croup and hooping-cough, belong to an
early age.    We shall, therefore, dwell more upon
the latter than upon  the  former, to which we shaU
devote but  a few passing lines.

                    CORYZA.
  Coryza is, in adult age, so slight an affection, tbat
a physician is seldom called upon to prescribe for it.
But  it is not  absolutely the same with  early infancy.
Independently of the  coryza which  makes  a part of
the premonitory symptoms of measles, scarlatina, and
hooping-cough, there exists an idiopathic form of this
disease  sufficiently grave  to  cause death, and  conse-
quently to  be worthy the attention of the practitioner.
  I speak  here of purulent and pseudo-membranous
coryza, which, without being a very common affection,
nevertheless sometimes manifests itself, principally in
the new-born, or in  very young children.   It com-
mences, like simple coryza, by sneezing and stoppage 
296   Diseases of the Respiratory  Organs.
of the nose, soon followed by a discharge from  the
nostrils  of mucosities,  at  first ropy and clear, then
yellow-greenish,  and at  last puriform.  The child,
who  was in the habit of sleeping with the  mouth
closed, can no longer sleep without holding it open;
his respiration is noisy and accompanied by a whist-
ling in the nasal  fossae.  The mucosities, by thicken-
ing and drying, aggravate the symptoms.  Then  the
agitation, the cries, and the physiognomy of the child
express the excessive discomfort he feels.  When  the
breast is presented to him, his anxiety and suffocation
are redoubled;  he abandons the nipple, immediately
after taking it, because breathing  but by the mouth,
he can no longer suck, and  continually tormented by
hunger without being able to satisfy it, he soon sinks
exhausted with fatigue, suffering, and inanition, and
perishes even before having arrived  at an advanced
stage of marasmus.   The progress of  this affection is
sometimes very rapid:  a child  may die of coryza in
three or four clays; the disease is always more serious
in very young children.
  The formation of false  membranes,  which does not
cause different  symptoms from  those I have  just
described, has hardly ever been discovered before the
post-mortem examination.
  Treatment.—The child, first of all, should not be
in the least exposed  to the  cold air,  or permitted to
remain wet with his urine.  In  the second, place the
mother  should cease to nurse the child because  the 
Coryza.
297
action  of sucking is very painful, increases the diffi- ■
culty of respiration, and may augment the gravity of the
general symptoms which accompany the inflammation
of the  nasal  fossae.  "Beside," says M. Billard, "a
child in this  case, sucks so badly that the quantity of
milk it takes  is always insufficient for its nourishment;
so that it is in danger of dying of hunger and exhaus-
tion."   One  should try then to make  them drink by
pouring, with precaution into the mouth, teaspoonfuls
of cow's milk mixed with water and meat broth.   If,
at length, deglutition becomes too difficult, one may be
obliged to have recourse  to nutritive  injections, that
is to say, injections composed of meat broth (without
milk).  The popular custom  of greasing the nose with
some fat substance, such  as tallow, is positively ad-
vantageous.  We should then have recourse to it, for
according to  the precept of Hippocrates, nothing is to
be despised; but it is  especially upon the action of
medicines that we must depend.  Those called for by
coryza are, according to the circumstances: aconitum,
belladonna,  dulcamara,  and ipecacuanha;  aconite
during the  period  of obstruction, especially  if there
is heat in the skin;  bellad., if there is turgescence of
the face, fever and great agitation; dulcamara during
the  fluent  period;  ipecac,  if the obstruction resists
aconite and continues  after the disappearance of  the
fever.   All these medicines  should be given at repeat-
ed doses; dulcamara is the  one which we have often-
est occasion to use. 
298   Diseases of the  Respiratory Organs.

       epistaxis — bleeding from the nose.
  Nasal  hemorrhage is  extremely common in  child-
hood, but is never serious; when,  however,  it  as-
sumes  a sort of periodicity, it  deserves attention.
The medicines to which we should have recourse  are
arnica and phosphorus.   The first is given in  potion
or in globules, two or  three  days  in  succession, from
the sixth to the twelfth  dilution; phosphorus  should
only be prescribed in  the  case  where  arnica  has
failed.   In very  abundant  and prolonged  epistaxis,
the two medicines should be administered alternately
in the same day.
                   ANGINA.
  We comprehend under the generic name of angina,
the diseases  that authors, and  especially the  physi-
cians  of the Paris school, designate  by the  words
amygdalitis, pharyngitis, laryngitis and  even tra-
cheitis—denominations  which seem to specify essen-
tially distinct affections, but which are really applied
to one  and the same  disease, occupying  neighboring
regions, and deserving sometimes even simultaneously
all the names given to  it, on account of its seat.  I
call angina, in a word, the erythematous inflamma-
tion of the tonsils, pharynx, larynx and of the superior
part of the trachea.
   As with  coryza, angina  is  sometimes primitive,
Bometimes, and more  frequently,  secondary.  It most
commonly succeeds to coryza, precedes bronchitis, or 
Angina.
299
 jxists concurrently with  these two diseases.   In cer-
tain cases, however, it manifests itself alone, and even
limits itself to one or  another of the different parts it
is susceptible  of invading.  Angina presents, in this
last case, certain  symptomatic  shades naturally de-
pendent upon the organ more especially affected;
shades almost always readily appreciable.  Thus the
enlargement  and  redness of  the tonsils announce
amygdalitis; the redness of the  pharynx, difficulty
of deglutition, and the engorgement of the submaxil-
lary  glands,  characterize  pharyngitis;  hoarseness,
laryngitis, etc.
  Angina, unless it assumes the serious form of which
we  shall hereafter  speak under the  name of Mem-
branous Angina, or Croup,  is rarely  accompanied
with  much  danger;  I will  even say that it may be
 considered as a slight affection, if it is purely local
 and not the precursory sign, or the consecutive symp-
 tom of an essential disease, such as measles, scarla-
 tina,  etc.
  The  most common cause of this affection is cold
 and dampness, and  more particularly taking  cold  in
 the feet.  It rarely shows itself primitively in children
 at the breast, and hardly begins to be common before
 the age of five years.  A congenital predisposition,
 the lymphatic, or sanguine-lymphatic temperament,
 render it very frequent  in some  children, who  are
 beside  so much  the more  disposed  to  contract it as
 they have been before more or  less frequently  affected 
300    Diseases  of the Respiratory  Organs.
by it.  In this last case, the pharynx remains some-
what  red ;  this  permanent  redness  is  accompanied
with increased mucous secretion ; the amygdalae have
more volume than in their normal state: it is chronic
angina.
  Treatment.— Aconitum,  belladonna, dulcamara,
Pulsatilla, ipecacuanha, baryta carbonica, causticum,
copaiv. balsam.,  hepar  sulphur, and  lycopodium, are
the medicines called for in the treatment of angina.
  Aconite, administered  at a medium dilution (from
six to twelve), in doses  frequently repeated, very often
arrests angina at its commencement, when it is accom-
panied by a febrile action, when the  weather  is dry
and cold, and the subject rather sanguine and nervous
than lymphatic.
  Belladonna suits under circumstances nearly simi-
lar, if there is great agitation  and vivid redness and
constriction of the  throat.  Its use wHl almost always
be more efficacious if preceded by one or two doses of
aconite.
  Dulcamara frequently cures  slight angina,  caused
by moist cold, extending without particular swelling
of the tonsils to  the bronchia, and threatening to de-
generate into bronchitis.
  When angina,  more intense and not less extended, is
characterized by a vivid redness of the affected parts,
with obstruction of  the nose,  cephalalgia, burning
fever without much thirst, voice hoarse or nasal, when
above all, there is  sympathetic  irritation of the stom- 
Croup.
301
ach, which is manifested by regurgitation or vomiting
of aqueous or bilious matters, pulsatilla is indicated.
  If the sweUing of the  mucous  membrane is such
that the difficulty of breathing is very considerable;
if suffocation is threatened, with excretion of caseous,
white, thick, and fetid matter in the throat; if, in
short, there is imminent danger of gangrene, and even
a commencement of it, we must have recourse to ipe-
cacuanha.
  I have indicated, in the chapter on Scarlatina (see
page 141), the circumstances which call for the use of
baryta carbonica.
   Copaiv. balsam., causticum, hepar sulphur, and
lycopodium are to be tried in the treatment of chronic
angina.
   Copaiv. balsam, frequently succeeds, if the disease
consists only in  a slightly increased mucous secretion,
with or without  hoarseness.   I have  seen causticum
and hepar sulphur, administered by turns,  bring back
the tonsils to their natural  volume, although  in this
case I prefer to  these medicines baryta carbon.  Ly-
copo. corresponds to the hoarseness of nervous, habit-
ually constipated persons.

                     c ROU P.
   All the mucous membranes are susceptible of be-
coming the seat of a peculiar inflammation,  during
which there takes place an exudation  of plastic matter,
organizing itself in pellicles, or in  false membranes, 
302   Diseases of the Respiratory Organs.
more or less dense, more  or less  thick, and more or
less adherent to the inflamed mucous membrane, and
under which this last presents, on a post-mortem ex-
amination of the  body, a red, smooth surface, rarely
granulous,  and almost  always  destitute  of  ulcera-
tions.
  Muguet, whose history we have given (see page
229), is the most familiar type of these kinds of in-
flammation, to which the mucous membrane  of the
intestine is not less exposed than that of the  mouth,
as is proved by the fragments of membrane, abund-
antly mixed with the substance of the stools, in certain
forms of enteritis.
  But  if the formation of .the false membranes is only
an accessory and comparatively unimportant phenom-
enon  in the buccal  and intestinal phlegmasia, it is
quite otherwise when  these morbid products develop
themselves in the respiratory organs, and especially on
the surface of the laryngeal mucous membrane; that is
to say, the narrowest part of the windpipe.  Dyspnoea,
aphonia, a convulsive cough, and  even death,  if the
disease is not arrested in time, are, in this case,  conse-
quences easily enough comprehended.   Such  is the
nature of the croup, and such the very simple mechan-
ism of the formidable symptoms which  characterize it.
    It is to  be observed  that the false membranous
exudation is much more frequent in the digestive tube
than in the respiratory organs, during early infancy ;
that is to say, nursing children  are much  more sub- 
Croup.
303
ject  to attacks  of muguet than  to croup,  which is
hardly to be feared before from two to eight years.
  Croup, which  seems sometimes to  prevail  under an
epidemic form, is most common during the spring and
autumn,  and  appears  concurrently  with other epi-
demics, such  as measles  and hooping-cough,  with
which it is sometimes complicated.   In this case it is
Beldom so violent or so rapid in its  progress, as when
it constitutes a primitive affection.
  In this last case it is of the first importance that the
physician should recognize it in time.
  It unfortunately too  often happens that its charac-
teristic symptoms  only appear at  the period  of its
greatest intensity; there are, however, almost always
premonitory symptoms which, according to the point
the disease first attacks, are more or less obscure, or
more or less manifest.
  Croup, or the plastic exudation which is its domin-
ant  circumstance, sometimes  begins in  the  throat,
sometimes in  the larynx, sometimes  in the trachea,
or even in the bronchia.
  In the  first case, beside  the  probability of the dis-
ease  being  limited  to the  pharynx,  and running
through  all its periods without extending below the
epiglottis, there is the  great advantage of  its being
visible almost from the moment of its commencement.
In examining the pharynx, traces of the false  mem-
brane are soon perceptible, first on  the tonsils, then
upon the neighboring  parts.   These false membranes
         26 
304    Diseases of  the Respiratory  Organs.
commence by yellowish-white,  sometimes,  but more
rarely, grayish spots, which extend and  assume a
lichenoid or lardaceous aspect.
  There is sometimes fever at this period, but not in
all subjects;  the strength and appetite  of the patient
is not sensibly diminished; he complains of a pain
in the throat, but it is not severe; the thirst is mode-
rate.  Deglutition, however, soon becomes painful and
difficult; saliva flows abundantly from the lips;  the
ganglions of  the neck increase in  size, and the neck
becomes at last considerably swollen.  This state lasts
from  two to  six days, when the symptoms begin to
amend by the fall or disappearance of the false mem-
branes, or is  suddenly aggravated  by its invasion of
the larynx.   The disease, in this last case, presents
alarming symptoms, which I shall soon describe.
  When the  false  membranous angina begins in the
larynx,  the examination of the throat offers nothing
abnormal.  The child is first taken with hoarseness,
he  loses  his  gayety  and  becomes  morose  and
depressed.   The face has more color than  usual  and
seems a little bloated; there is heat in the skin, but
without thirst or great frequency  of the pulse;  the
patient  complains  of pain  in  the larynx or indicates
it by his  gestures.  He often  puts his hand to  his
neck, which  appears a little prominent and sensitive
to the touch, especially below  the os  hyoides; there
are, from time to time, little attacks of a hoarse cough,
of which  each concussion  is preceded by a  peculiar 
Croup.
305
whistling.  Authors  mention the expulsion by the
cough, of fragments of the membrane;  but this sign
is  not always present, and  never occurs except at an
advanced stage of the disease.
  When the  inflammation  begins in the trachea the
symptoms are very nearly the same as those I have
just described, with  the exception of the alteration of
the voice, which does not yet exist.
   Lastly, if it is developed primitively in the bron-
chia,  there is from  the beginning an intense fever, a
considerable  acceleration of the pulse and respira-
tion,  and a purple color  of  the face.   The sub-crepi-
tant rale is heard upon both sides behind, upon aus-
cultation ; then, after a variable  time,  comes hoarse-
ness,  aphonia, and the croupy cough.
   The obstruction of the larynx constituting, in aU
cases, the principal fact of the disease, it is understood
that its progress must be so much the more  rapid as
this organ is primarily affected.
   The character beside, of the prevailing diseases, de-
cides the greater or less promptitude with which the
pathognomonic  symptoms  of croup  are manifested.
These sometimes only declare themselves after five or
six days of  premonitory symptoms; sometimes they
make their appearance  upon the second or  even the
first day of the disease.
   It  is commonly during the day, and not the night*
that  the first attacks of suffocation  occur.   They are
terrible to  witness.  The  fever  is  very violent,  the
        * We know the reverse to be true.  Ed. 2d edit. 
306    Diseases  of the Respiratory Organs.
voice is  extinguished, the cry, properly speaking, is
no longer heard, or only returns for an instant, or if it
continues it is entirely changed.  Its  sound is only
perceptible during the inspiration:  it is  shrill  and
abrupt, like the crowing of a young cock;  sometimes
even it is stifled and muffled.  " The dyspnoea," says
Jurine, " is fearful, the respiration is  stertorous and
the suffocation, with all its fearful agony of anxiety
and suffering, threatens every moment the life  of the
child.
  " During these moments he in vain throws his head
backward,  in  order to lengthen the trachea and  thus
open a larger passage for the air; his neck swells, his
pulse is  feeble and intermitting, his eyes  sunken in
their orbits and his body covered with a cold perspira-
tion."  We will  add, to complete  this picture,  that
the child,  at the instant of  the attack, suddenly
assumes  a sitting posture;  his face, purple and swol-
len, expresses  extreme anxiety; the eyeballs, rolling
to the right and  left, are sometimes turned upward in
convulsions.   Lastly, if the attack is  prolonged,  the
respiration becomes slower; the Httle patient exhausts
all his strength  in making a few feeble inspirations,
the extremities become cold, the pulse smaller and
smaller,  and asphyxia impends.
  Death, occasioned by croup,  is exactly simHar to
that by strangulation.   Thus we commonly find upon
the bodies of children, who have died of this disease,
traces of cerebral  congestion or even of acute hydro- 
Croup.
307
 cephalus;—dangerous complications which are mani-
. fested in the patient by a  sort of sleepiness or  coma
 in the intervals of the attacks.
   Croup, however  violent it be, almost always pre-
 sents longer  or shorter and more or  less complete
 remissions.  At the same time the hoarseness and the
 aphonia persist during these remissions, and the diffi-
 culty of respiration continues considerable.
   It is  not  even very rare to see the patient, during
 this suspension of the most alarming symptoms, sud-
 denly grow pale and swoon, the pulse then diminishes,
 the extremities become cold, and death ensues. Some-
 times all this  passes very rapidly.  "A child," says
 Rosen,  "was running to and fro in the apartment; his
 mother took him upon her knees—he died in her arms."
   When, after great effort and a violent fit of cough-
 ing, the child succeeds in expectorating a quantity of
 false  membranes, there  generally  succeeds a  very
 marked, but unfortunately often an illusory remission.
 "The febrile  action," say  MM. Rilliet  and Barthez,
 " is then diminished; the respiration is more easy, the
 face is  more  natural,  the  venous congestion  has in
 part disappeared; the child returns to his play, every-
 thing seems to indicate a happy termination.   But
 most commonly the symptoms soon re-appear in the
 order we have assigned  them; the voice, which had
 become  momentarily clear, is again completely ex-
 tinguished; the cough is very hoarse;  the laryngo-
tracheal whistling  approximates  a  veritable stertor; 
308    Diseases  of the Respiratory Organs.
the attacks of suffocation become more frequent, more
intense, and arrive, at last,  at  their greatest height .
Asphyxia is threatened, the pulse is extremely small,
often imperceptible; the eyes are convulsively turned
upward or oscillate in their orbits;  sight disappears
and  the  body is covered with a cold perspiration.
These  attacks, however,  are  again suspended, and
return with less  intensity; the child exerts  all his
strength to breathe, makes a few difficult inspirations
and dies."
  When  croup  terminates  favorably, it sometimes
happens, although seldom, that the cure is  suddenly
effected by the expectoration of a tube of false mem-
brane.  In the majority of cases, the greater intervals
between the attacks, joined to the amelioration of the
general symptoms, give notice of the termination  of
the disease.  Relapses are  to  be feared  as long as
cough remains, and the breathing and voice have not
resumed  their  natural  tone.   The voice sometimes
remains changed for a long time.   There are exam-
ples  of aphonia, in consequence of  croup, which has
continued for months.
  Treatment.—" This dreadful disease," says Hering,
" may, in the majority of cases, be easily and promptly
cured by homceopathic remedies.   We hardly lose a
fifth of the number of those who die under the old
treatment."
  I consider this assertion of Hering as very true, and
fuUy justified by  facts ; and  nevertheless,  I do  not 
Croup.
309
hesitate to say, that the homceopathic medication for
croup, is by no means definitely fixed :  almost every
practitioner has his own exclusive mode of treatment.
Fortunately, all these modes are comprised within a
certain number of analogous means, so that in using
one instead of another, there is no danger of a capital
error.  It  is,  nevertheless, beyond a doubt, that if
homceopathic physicians chose always the best of the
various modes in use, the results,  already so satisfac-
tory, would become still more brilliant.
  A German homceopathist,  Dr. Attomyr, in  a trea-
tise upon croup, of which M.  Aug. Rapou has given
us an analysis, considers bromine  as the specific, par
excellence, of this disease.   Attomyr founds his opin-
ion upon this, that bromine is  the only  medicine
which produces the false membrane in the larynx and
trachea of the healthy ; hepar  sulph., spongia tost.,
and iodium, only produce,  according to the German
physician, the symptomatic phenomena which charac-
terize the croup angina.
  According  to Elwest, (another  German homceo-
pathist,) the efficacy of the following treatment against
croup, is  more and more confirmed: Aeon., 1st, alter-
nated with iod. or  spongia, 1st, dissolved in a few
ounces of water, and administered, at  the outset, a
teaspoonful every ten minutes.
  Gross asserts, that in twenty-five years' practice, he
had not lost  a single case of  croup, which was taken
in time, (what did he mean by taken in time ?)  He 
310   Diseases  of  the Respiratory  Organs.
begins with hepar sulphur, from the first to the third
trituration, which he follows with aeon., 3d ;  he then
administers, alternately, hepar and spongia tosta.
  " When  the cough is hollow and whistling," says
Hering, " hepar  sulphur is always the best remedy ;
afterward we administer  samb. nig., hyosc, cina ;
sometimes, also, nux vom.,  veratr. alb., chin., dro-
sera."
  Hering recommends these medicines only during
the first period of the disease.   When the attacks of
suffocation  come on, he  prescribes tart,  emetic, in
large doses, followed by spongia ; then  an arm-bath
of very warm water ; then aeon., then spongia, then
hepar sulphur,  then, arsenic, bellad.,  carb. veget.,
aconit.,  etc. ; in despair,  a few leeches to the tra-
chea.   I  ask his pardon; but this treatment is miser-
able.  (We say so too: Ed. 2d edit.)
  Hartmann  uses, during  the first period, the  medi-
cines prescribed  by Hering; after which, he adminis-
ters,  at  the moment of the  attack, aeon., spongia,
hepar sulph., iod.,phos., mercur., rhus,  etc.
  As for me, I shall give my treatment of croup in  a
few words : it is very simple, very sure, and com-
prises but a limited  number of medicines.
  First,  having  never used bromine, I can  say  no-
thing of it.
  Aconite  is only indicated in croup in  the rare cases
of violent fever  in  the beginning ;  from the moment
that  the  febrile  symptoms diminish a little, or when 
Croup.
311
after one or two doses, it  seems to produce no effect,
it  should  be  discontinued,  and  that  finally, under
penalty of losing precious time, when often the  min-
utes are to be  counted.  Aconite  is not a specific for
false-membranous angina.
  The good effects of spongia marina  tosta, are
incontestable;  but  they have been   exaggerated.
Spongia corresponds to the first period : I do not
use it.
   Cinnabaris covers the greater part of the symptoms
of false-membranous pharyngitis; but  its  action is
Blow.  I used  it a few years  since; but have  since
renounced it.
  Hepar sulph. corresponds to the commencement of
croup in the bronchia or trachea ; it is  powerless at
the moment of the exacerbations, and beside, exerts
no  modifying  influence  upon  the plastic secretion,
which constitutes the real  danger of croup.
  Ipecac, and bryonia, (but given concurrently, for
both would  be inert alone,) are in all cases, whatever
be the form of the attack or intensity of the disease,
the great modifiers of croupal angina.
  These medicines need not be prescribed at very low
dilutions: from six to twelve will suffice.
   The two solutions prepared,  they should be admin-
istered  alternately, a teaspoonful every two hours,
during  the period of invasion; every  ten  minutes
during  the exacerbations, and  at intervals graduaUy
increased, when these are  passed.
         27 
312    Diseases  of the Respiratory Organs.
  It may be necessary, in place of these solutions, to
substitute globules, which may be easily  introduced
into the mouth of the child when deglutition has  be-
come impossible.
  It would take  me too long to explain here, by what
course of experience I have come to adopt, exclusively,
this combination of bryonia  and ipecacuanha, in  the
treatment of croup ; but practitioners  who will venture
to use it upon my testimony, will acknowledge that it
is good.  If, however, they would avoid reverses, they
should be careful  not  to confound  croup with  the
disease of which I am  about to speak.

             ASTHMA  OF  MILLAR.
  This disease, first clearly described by Millar, and
to which he gave his  name, differs  essentially from
croup; with which, nevertheless, it  presents such
symptomatic relations, as to cause them to be some-
times confounded.
  The asthma of Millar, the spasmodic or stridulus
laryngitis of some authors, is only, properly speaking,
the  suffocating asthma of adults, aggravated in chH-
dren by the narrowness of the trachea, and especially
of the  larynx.   In a word, the asthma of Millar, in-
stead of  being, like croup, a  special  inflammation, is
only a nervous affection.
  It is, beside,  easily understood,  that  the general
symptoms of this nervous disease, are very similar to
those  of croup,  since,  in both cases, the symptoms 
Asthma of Millar.
313
have the same cause—suffocation.   But  that  which
constitutes  the  symptomatic  difference in the  two
affections, is the almost complete  absence, in  asth-
ma, of the  premonitory symptoms  of croup,  and so
entire a suspension  of all  the symptoms during the
intervals of the attacks, that  the little patient often
enjoys,  during  these  periods,  the  most peaceful
sleep.
  " The distinction between these two morbid states,"
Bays M. Rapou, "is very easily established when one
discards all  ideas of systems, and is satisfied with ob-
serving.  Thus, croup is  more  common  in  healthy
and well-nourished  children;  asthma, in  feeble, deli-
cate, nervous and excitable subjects ; in those disposed
to scrofula, or who have badly-formed chests.   Croup
gradually increases in intensity ; it is  generally epi-
demic  and   accompanied  with fever.    Asthma is
sudden  in  its attacks, is  always sporadic, and unac-
companied by fever.  In croup,  there is a dry cough,
a characteristic tone of  voice, not presented by spas-
modic dyspnoea ; and this latter is also without the
sensibility of the larynx.   Croup offers all the general
characteristics  of inflammatory affections, and the
asthma of MUlar but the phenomena of nervous ex-
citability.
  The following are the differential signs of the croup
and  asthma of children, arranged in  tabular form, as
presented by Millar himself: 
314   Diseases  of the  Respiratory Organs.
          ASTHMA.
  1st. Its  attacks are sudden,
and the first attack occurs gen-
erally in the night.
  2d.  It is always sporadic.
  3d.  The cough, when  it ex-
ists,  is  dry, and without  any
expectoration.

  4th. There  is  no pain ;  this
is replaced by a  constriction  of
the whole thoracic cavity.
  5th. The voice is hoarse and
hollow.
  6th. There is no fever.
  7th. The  attacks   alternate
with   intermissions,   during
which the child has the appear-
ance of perfect health.
  8th. The disease is  of a con-
vulsive nature, and requires an
antispasmodic treatment.

   To tell the truth, I am
line of demarcation betw
            CROUP.
   1st. It comes on slowly and
 gradually : the first attack com-
 monly occurs during the day.
   2d. It generally prevails epi-
 demically,  and  is seldom spo-
 radic.
   3d. Layers of puriform matter,
 or  cylindrical concretions, are
 expelled by the cough and vom-
 iting.
   4:h. There is pain  in the air
 passage, and we discover, by the
 touch, a slight tumefaction, on  a
 level with the painful spot. The
 tumefaction is not perceptible to
 the sight.
    5th. The voice has a very pe-
 culiar whistling tone.
    6th. There is fever.
    7th. The symptoms continue,
 without interruption,  so that
 there  are  no perceptible inter-
  missions.
    8th. The  disease is of an in-
  flammatory nature, and calls for
  an antiphlogistic treatment.

obliged  to  declare, that the
;en the symptoms  of croup 
Asthma of  Millar.
315
and asthma, is not so well defined as M. Rapou and
Millar seem to consider it; and I would not venture
to assert, with our estimable colleague of Lyons, that
" the  distinction between these two morbid states is
very easily established."  Croup, as we have seen, is
often without premonitory symptoms, almost apyretic,
and  presents  marked remissions.  As to the other
contrasting symptoms, several of them are sometimes
wanting—almost all are inconstant.  It would then re-
quire great experience, tact, and circumspection—I
may almost say, good luck—to avoid, in badly-defined
cases, mistaking one  for the other  of these two dis-
eases.  As a general rule, however, a good observer
will succeed in doing so.
  The asthma of  Millar  is, like croup, a very se-
rious  disease, but  one over which  we are  certain
to triumph, by means of the treatment I shaU point
out.
  Coralia  rubra and opium, administered  in exactly
the same manner as bryonia and ipecac, in  croup, are
heroic agents against this disease.
  I prescribe coralia  at  the  thirtieth, and  opium  at
the third dilution.  The  last is given  alone,  every
six hours, for a day or two after the resolution of the
last attack. 
316   Diseases of the  Respiratory Organs.

                 bronchitis.
  The majority of children are very subject to irri-
tation of the bronchia;  but  this irritation is com-
monly but a  sympathetic symptom  of another af-
fction.  Thus, we see dentition,  or the presence of
worms in the alimentary canal,  occasion cough.  This
cough, in the first case (dentition), yields to kreosotum;
in the second, to viola odor.,  or to stannum.
   As to primitive bronchitis, almost always caused
by a chill, it presents the same general symptoms as
erythematous angina, and requires  the same treat-
ment.
   This disease only becomes really serious when it
attains a high degree of intensity.  There is then an
intense fever, a burning skin, great thirst and no ap-
petite.  The cough  recurs frequently, in short fits;
sometimes, but not always, followed by a slight whist-
ling; after a few days there is  a yellowish expectora-
tion, difficult to verify,  in very  young  children.  We
perceive by  auscultation  a mixture of the sonorous
and mucous, and sometimes  a  subcrepitant ronchus.
There is considerable oppression, frequent pulse, pale
or purple face after the  cough:  pneumonia is then to
be feared.   But even without this complication, bron-
chitis, in  this degree of intensity, is dangerous, and
may become mortal.
   Treatment.—The medicines upon  which we may
 most safely rely in  the  treatment of acute bronchitis 
Pneumonia.
317
are dulcamara and pulsatilla, preceded, if necessary,
by  aconitum,  and  followed  by  ipecac, and  hepar
sulph.   Silicea is recommended in chronic bronchitis.

                  PNEUMONIA.
  Pneumonia, or inflammation of the parenchyma of
the lungs, is seldom a primitive affection in childhood;
but it  often  supervenes  as  a complication, either in
typhoid fever,  eruptive fever,  or  finally in hooping-
cough,  of which we  shall soon  speak.   Its general
symptoms are the same  as  those of very acute bron-
chitis ;  it  is  not always  easy to distinguish between
these two diseases.  The continual crying and moaning
of children often render the signs furnished by auscul-
tation very obscure ; beside, the rusty-colored expecto-
ration, which, in adults, constitutes one of the distinc-
tive features of pneumonia, almost never takes place in
children.   We  know that very young children never
expectorate by the mouth, and it  is consequently im-
possible to  draw any inductions from  the  nature or
consistency of their pulmonary secretions.
    When,  however, one  can  succeed in  obtaining
a few  moments of calm and silence in these  little
patients, auscultation, and  above all, percussion, are
the best,  or, perhaps, rather the only means of  esta-
blishing the  different diagnosis  of bronchitis  and
pneumonia.   In the latter, the crepitant ronchus is
distinctly mixed with the sibilant and  mucous, the
respiratory murmur ceases to be perceptible in divers 
318   Diseases of the Respiratory Organs.
points  in  the thorax,  especially  behind, where it  is
sometimes replaced by the bronchial respiration.  By
percussion we discover the hepatized portions  of the
lungs by the dullness of the sound.
  In an immense majority of cases, pneumonia suc-
ceeds to bronchitis, and the existence of the two dis-
eases are simultaneous.
   Both, fortunately,  require very nearly the  same
treatment.   However, if the engorgement of the pul-
monary parenchyma is clearly  defined, we run great
risk  of an  unfortunate  termination,  if  we  do not
hasten to employ the special therapeutics called for in
pneumonia.
  Dr.  Tessier, who  has just published the result  of
a clinical experience of great interest, upon the treat-
ment of this disease,* combats  it principally with
aconite,  bryonia, phosphorus,  sulphur,  beUadonna,
arsenic and  iodium.
  Certainly these various substances correspond to the
different symptoms of pneumonia; but neither of them
contains them in their totality.    I would then ear-
nestly recommend  M. Tessier to substitute  for his
therapeutics,  which  is also that of the  majority  of
homceopathists, the medicines I  am about  to make
known, and whose prompt  efficacy will surprise him
if he consents to make trial of  them.

  * Recherches Oliniques sur le Traitement de la Pneumonia et du
Cholera, suivant la M6thode de Hahnemann; par le Doct. J. P. Tes-
sier, Medecin de l'Hopital Sainte-Marguerite, in 8vo„ Paris, 1850. 
Pleurisy.
319
  The first of these medicines is chelidonium majus;
it alone replaces aconite, belladonna and phosphor.
  Chelidon.  maj. should be administered  from  the
first, whatever be the intensity of the symptoms, but
only for  a few hours, and  in  doses  repeated  at very
short intervals.   Seven  or eight  globules of  chelido-
nium, of the sixth dilution, may be dissolved in four
ounces  of vehicle,  of which the  patient may take a
teaspoonful every quarter of an hour, but for one hour
or an hour and a half only.   This done, 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.  This remission once
obtained, we should  discontinue  chelidonium,  and
administer alternately, every two hours,pulsatilla and
spongia marina tosta—pulsatilla, from  the  sixth to
the twelfth ; spongia, from the  twenty-fourth to  the
thirtieth.  These two medicines,  whose use should be
continued until  the resolution of the  disease, should
be given at lengthening  intervals, as the amelioration
is more apparent; and this, I venture to predict, will
not  be long delayed,  excepting  in cases of  unusual
complications.  (This treatment  has been found  very
efficacious.  Ed.  2d edit.)
                   PLEURISY.
   Primitive inflammation of the pleura is  so rare in
the  first  years of life, that it cannot be considered as
a disease of childhood.  I shall not, therefore, stop to
describe its symptoms, which are beside the same in
children as in adults.  Spong. marin. tost, and lache 
 320   Diseases of the Respiratory  Organs.
 sis, both  at the thirtieth dilution, are the medicines
 which control the  therapeutics of pleurisy.   I should
 not know how to recommend too earnestly the em-
 ployment of these two substances.  They should be
 administered  simultaneously;  spongia once  in the
 morning;  lachesis  once in the middle of the  day and
 once in the evening.  We may remark, by the way,
 that this treatment, which is also that of peritonitis,
 seems adapted to inflammation of all the serous mem-
 branes, with or without effusion.

               h o o p i n g-c o u gh .
  Hooping-cough  is a disease incontestably essential,
 contagious, epidemic, commonly apyretic, and is char-
 acterized by a convulsive cough, recurring in parox-
ysms at irregular intervals.  This cough consists in a
series of abrupt and  very short expirations, followed
by  a long whistling and sonorous inspiration;  it is
accompanied by a considerable congestion of the face,
and terminates  by  the expectoration of a ropy muco-
sity.  Very  frequently, especially after eating, these
fits  of coughing produce nausea  and even  vomiting;
but these are epiphenomena, which are by  no means
characteristic,  and  which may occur  in all  violent
irritations of the bronchia, and whenever there exists
much dyspnoea, whatever be its cause.
  Hooping-cough is an affection peculiar to childhood,
and especially frequent from the second to the sixth
year.   Statistics seem to prove that girls  are more 
Hooping-Cough.              321
subject to it than boys.   Like all other epidemics, it
passes from one country to another—braves all  cli-
mates, and  shows itself in all seasons of the year.
However, it is especially in the spring and autumn,
that is  to say,  in  the  most  humid  months  in  the
year, that the epidemics of hooping-cough habituaUy
appear.
  This  disease,  however unimportant it  may be in
itself, when not complicated,  is nevertheless  one of
those which most  clearly  show  the inadequacy, or
rather the complete impotence of the allopathic rou-
tine : which never abridged one week the duration of
this disease.
  Hooping-cough sometimes commences by a catar-
rhal state (coryza, watering of  the eyes, bronchitis,
etc.), which continues, according to the idiosyncrasy
of the patient and  the  kind of  epidemic prevailing
from twenty-four hours to six days and more, some
times by spasmodic fits of coughing at  the  outset.
Symptoms of simple  bronchitis  mark the decline of
the disease.  Hence the three  periods of the disease,
pointed  out by authors.  But of these three  periods
the second only is  characteristic, as the first may be
wanting, and the two others are often confounded.
  The old  school physicians  are  as far  from being
agreed  upon the duration of each of these periods,
as upon the total  duration of the disease, or upon
the  treatment best  adapted to it.   What is  certain
is,  that   hooping-cough, left  to  itself, or treated  by 
322  Diseases  of the Respiratory Organs.
Allopathy, which comes to about the same thing (with
the exception of symptoms caused by antiphlogistics),
lasts always from three to four months and often longer.
   If the coughing-fits in this disease vary but little in
form, it is  not the same with regard to their number
in a given time. Laughing,  eating, drinking, or walk-
ing—every species of movement—odors, mental emo-
tions, reproduce them the more readily in proportion
as the disease is near its height.    " We have seen
them  broken  or cut  in two," say MM.  Rilliet  and
Barthez, " in such a manner, that a  complete fit  was
formed by the two half-fits, separated by a very short
interval,  during which  the  respiration was  natural.
This form must  be rare, as  I  have only met with it
once."
   Lastly, in very young subjects, the coughing-fits
often  provoke convulsions, in  consequence of which,
or during which, ini'ants sometimes die with  cerebral
congestion ; but these accidents are fortunately rare.
  Spasms of the glottis,  pneumonia, and lastly, tuber-
culation of the  lungs, are,   with the  convulsions of
which I have just spoken, the most frequent complica-
tions of hooping-cough.
  As  to bronchitis, we may consider it, as  it were, in-
herent in the disease; it marks its beginning and its
termination.   It  is not always easy to  distinguish
bronchitis from hooping-cough ; however, the  spasmo-
dic form of the cough, the whistling  sound which ac-
companies  the inspirations, the ropy  expectoration 
                 Hooping-Cough.              323
the ordinary absence of  fever,  lastly, the freedom
and the preservation of the normal rhythm of the res-
piration in the intervals of the cough, sufficiently char-
acterize the latter to prevent the  attentive observer
from falling into error.
  Treatment. — Ipecac,  dulcam., bellad.,  cuprum,
drosera, ambra, arnica, etc.,  have  been recommended
for hooping-cough.    Now, with the  exception,  per-
haps, of belladonna  and  drosera, whose pathogenesis
one may  consult at need, none of  these medicines
have a direct influence upon  this disease.   But there
are in our materia medica two substances which con-
trol the therapeutics  of hooping-cough.  I speak of
coralia  rubra  and of chelidonium majus.   I have
already  mentioned  chelidonium maj. as the specific
for pneumonia, at the height of its  acute period.   Ex-
perience has convinced me that it  will find its place,
though  in  the  second  rank, in  the treatment of
hooping-cough.
  From the moment that the coughing-fits have as-
sumed the convulsive form, and even before that time,
that is to say, during the  catarrhal  period; as soon, in
a word, as one is sure of having to deal with a hoop-
ing-cough instead of simple bronchitis, we should im-
mediately prescribe coralia rubra of the thirtieth dilu-
tion, for three or four days in succession, four doses
in the twenty-four hours.  "It is like water thrown
upon fire," said one of my patients to me, one  day,
after I had  given him this medicine for attacks  of a 
324   Diseases of the  Respiratory Organs.
convulsive  cough which had  passed into  a chronic
state.
  As soon as the amelioration produced by coralia
ceases, that is to say, at the  end of  four  or  five
days  at  the  most, it should be discontinued,  and
chelidonium  majus administered,  of the sixth dilu-
tion, three doses in twenty-four hours, and continued,
unless there  is a  renewal of  the violent spasmo-
dic coughing-fits, or convulsions in little children,
or spasms  of the glottis (all  of which circumstances
would call for  a return to coralia), until the evident
transformation  of hooping-cough into  simple bron-
chitis.
  At this  period of the disease, neither coralia nor
chelid. should be employed, but pulsatilla.
  Lastly, if we add  to these  three medicines, causti-
cum, in the decline  of the disease, when there re-
mains only a dry cough; then lachesis, if with the
bronchial cough  there  is extreme depression, which
sometimes  happens, we shall have completed, apart
from absolutely unforeseen accidents, the therapeutics
of hooping-cough.

   PHTHISIS PULMONALIS—PULMONARY CONSUMPTION.
   Phthisis pulmonalis, so common and so much to
 be dreaded during  adolescence and in adult age, can-
 not be  classed among  the diseases of children.   We
 see,  it is  true, especially after measles,  variola, ty-
 phoid fever, etc., children die of marasmus, foUowing 
Phthisis Pulmonalis.
325
abscesses formed in the lungs ;  but these abscesses do
not proceed, like those of consumptives, from the soft-
ening of tubercles.   Their seat is the base or the mid-
dle lobe of the pulmonary parenchyma, and  hardly
ever the superior lobe, the most frequent location of
tubercles.  They are, in a word, the immediate con-
sequences, and without necessary preliminary tubercu-
lation of an active or  congestive inflammation of the
respiratory organs.   Chelidonium, phosphorus, and
carbo vegetabilis, are  the appropriate  remedies for
these symptoms.
   But if children rarely die of phthisis pulmonalis, it
is not the less certain that it is from childhood that
this terrible disease silently prepares itself.   Unfortu-
nately the process of pulmonary tuberculation is affect-
ed in so slow, so hidden, so completely latent a man-
ner, that it is hardly ever possible to affirm  its ex-
istence  until it has burst out in very often incurable
 symptoms.   The  following are  the most  common
signs of this morbid condition :
   Narrowness of the chest, paleness of the face, with
slight coloration of the cheeks,  general emaciation,
frequency of the pulse  and of  the respiratory motion,
dry cough, oppression, great disposition to bronchitis,
perspiration upon  the least exercise and  at  night;
obscurity of the respiratory murmur and more or less
marked dullness on percussion of one of the two sides
of the thorax, especially at the summit of the lungs ;
vaginal discharge in little  girls, habitual constipation 
326  Diseases of the Circulatory Apparatus.
or frequent return  of slight diarrhea,  irritable and
capricious humor.
  A good regimen,  gymnastics in  the open air, daily
cold bathing; and if there are times of a marked
exaggeration of  this state:  chelidon., carbo. veget.,
lycopod., etc., administered with  great  reserve and
according to the totality of the dominant symptoms,
are the principal hygienic and therapeutic means to
combat an unfortunate diathesis, which, when heredi-
tary is but  too  often rebellious to the most skillful
treatment.
     DISEASES OP THE CIRCULATORY APPARATUS.

  As fever in an immense majority of cases can only
be considered a secondary, and symptomatic  pheno-
menon of an affection, more or less appreciable, but
primitively independent of the vascular system, there
are properly speaking no other diseases of the circu-
latory apparatus than arteritis, phlebitis, endocarditis
and vicious conformations of the heart, or of the prin-
cipal  vessels.  Arteritis, phlebitis  and endocarditis,
are almost unknown in childhood.  Vices of conform-
ation, such as non-obliteration of the foramen ovale
in children  newly-born, or aneurism,  either  of the
heart, aorta, or  of the large branches of this  artery,
are diseases  against which art is often only too evi-
dently powerless. 
             Circulatory  Apparatus.          327
  With regard to aneurisms, I give here what I find
in the notes prepared by myself, and for my particular
use,  some  years since:  "Castoreum, rhus and sam-
bucus,  are  the best remedies for the treatment of
aneurisms.   But these diseases being  always essenti-
ally chronic, require great caution in the use of medi-
cines.   Castor, should  be  prescribed, in  the com-
mencement, of the ninth  or  tenth dilution,  a  few
globules in a glass of water, a teaspoonful  morning
and evening.   Then after an interval of two or three
days, rhus  toxic, may be administered  in  the same
manner, and  lastly sambuc,  which  will allay the
sometimes very acute  pain,  occasioned by aneurism.
The regimen required in these diseases is very severe;
absolute abstinence from wine and  all  fermented
drinks  is indispensable.
  As for the  inflammatory fever, the constant  pre-
cursor  of all the phlegmasias, everybody knows  that
aconite, our antiphlogistic par excellence, is the sov-
ereign remedy.
       28 
328 Diseases of the Cerebro-Spinal Apparatus.
   DISEASES OP  THE CEREBRO-SPINAL  APPARATUS.

  It is weU known that the relative predominance of
the encephalic  mass in children singularly predisposes
them to cerebral affections.  However, these affections
are much more rarely primitive than is generally be-
lieved.  Encephalitis, that is to say, inflammation
and  softening  of the brain, properly speaking, is un-
doubtedly less  frequent in childhood than at any other
time of life.   As to meningitis, it is the greater part
of the time a secondary symptom; in other words, the
sympathetic complication of a disease, whose principal
seat is  not in the membranes.  Nevertheless, in cer-
tain  cases, they are first affected, and of all the primi-
tive  affections of  the  cerebro-spinal apparatus, we
may consider  it as the one with  which children are
most frequently attacked.   It is beside almost impos-
sible to distinguish it from encephalitis, and it is very
frequently only  by a post-mortem  examination, that
we discover whether  death has  been caused by an
inflammation of the cerebral pulp, or by an inflam-
mation of its envelopes.  I shall then  describe, under
the generic  name  of cerebral fever,  which  does not
prejudge as to the  anatomical seat of  the disease, the
totality of the symptoms common to encephalitis and
meningitis; a so much the more legitimate mode of
proceeding as the two affections, the greater part of 
Cerebral Fever.
329
the time simultaneous and  confounded, do not require
an essentially different treatment.

                 CEREBRAL FEVER.
  Cerebral fever commences with considerable dis-
turbance of the circulation, violent headache, frequent
bilious vomitings, thirst, absolute  loss  of appetite,
generally constipation.  From the first day a profound
alteration takes place in the expression of the face
and in the intelligence, alternations of drowsiness and
uncontrollable  agitation, coma  and very acute deli-
rium.  The  disease generally progresses with  great
rapidity.  The violence  of the symptoms increases
with the  progress of the disease.  There may, how-
ever, occur remissions of the febrile  action;  but  the
pulse remains irregular.  The respiration is sometimes
accelerated, and sometimes retarded.  The face is dis-
torted, extremely pale, or with a purple color in  the
cheeks.  The abdomen  is  retracted, constipation is
permanent; there is carpologia, subsultus tendinum,
rigidity of the  trunk, of the  jaws or of the limbs;
strabismus, dilatation of the pupils ; lastly, sensibility
becomes obtuse, the pulse  increases in  frequency,
becomes imperceptible, and coma, or  a last paroxysm
of convulsions terminates the scene, after a total dura-
tion of thirty-six hours  at the least, or nine days at
the most.
  The absence of intense cephalalgia, vomitings, con-
stipation and the retraction of the  abdomen, distin- 
330  Diseases of the Cerebro-Spinal Apparatus.
guishes secondary meningitis from idiopathic menin-
gitis.  The former, when  it supervenes in the course
of a febrile disease, presents no remission of symptoms
and  continues until the death of the patient, if art
does not succeed in preventing the catastrophe.
   The  causes of cerebral fever  are  not  always ap-
parent ; it has been known  to prevail epidemically.
It is said  that onanism predisposes to it, which is at
least probable.  Many times, in short, as I  have  al-
ready said, apropos of erythema (see page 116), it has
been brought on by insolation.
   But the most frequent cause of cerebral  fever is,
without doubt, the presence of tubercles in the brain,
or in  the  membranes.   The disease, in  this last case,
is incurable.
   Tuberculous  meningitis, (the  acute hydrocephalus
of authors,) is  slightly distinguished in its symptoms
from simple meningitis.
   It commonly begins at a time of apparently perfect
health,  by cephalalgia,  vomiting, constipation, and a
slight acceleration of the pulse, much  more  rarely by
agitation  and  delirium.   The turns of vomiting are
not very numerous, and  rarely  last  beyond two or
three days.  In rare cases,  however,  they may con-
tinue for  several weeks.  The constipation  persists,
the pulse becomes slower and irregular.   The child is
Bad, depressed,  and  occasionally grinds his  teeth;
his look,  which shuns  the light, is  uncertain, and
as  though  astonished, sometimes  fixed,  and this 
Cerebral Fever.
331
appearance of the  face  contrasts  in  a remarkable
manner with the clearness  of intelligence, which al-
most always remains intact.
  Delirium finally comes on, but it  is rather tranquil
than agitated ; drowsiness and coma predominate, and
become permanent as death approaches.  The pulse
is then small and quick ; the skin warm, often covered
with perspiration; the respiration  is  irregular;  the
eyes sunken, the sight  extinguished, the cornea dull;
the nose pointed, and the abdomen  so depressed that
we   can  feel the beating of the  aorta  through its
parietes;  the urine  and stools  pass  involuntarily:
the  patient generally dies  in an  attack of convul-
sions.
  This species of meningitis is very  insidious.  In its
beginning, especially, it is liable to be mistaken for a
slight affection ;  it  is very  different, in this  respect,
from cerebral fever, so clearly inflammatory, and  the
violence of whose first symptoms reveals the serious
nature of the disease.  The progress of tuberculous
meningitis  is also  less rapid than that of simple
meningitis.  The  first  never lasts  less  than seven
days, and  is sometimes prolonged to fifteen,  twenty,
and  even forty days.
  The existence in the patient of the tuberculous dia-
thesis, the persistence of constipation, the severity of
the cephalalgia, the slowness of the pulse shortly after
the  commencement, lastly, the retraction of the abdo-
men—such are the signs which distinguish tuberculous 
332  Diseases of the Cerebro-Spinal Apparatus.
meningitis from typhoid fever, with which it has been
sometimes confounded.
   Treatment.—Cerebral fever calls  for prompt and
energetic means.   Two medicines control  its  thera-
peutics: they are belladonna and bryonia.   We may
even  assert, that  these two medicines are the only
ones upon which we can depend.
   Belladonna  is  administered from the beginning,
at from the twelfth to the fifteenth dilution, in solution,
of which the patient should take a teaspoonful every
two or three hours, according to the violence  of the
delirium.   From  the  second  day,  bryonia  may be
given with it, at from the 6th to the 12th.  Two doses
of belladonna, given in the morning,  two doses  of
bryonia in the evening, and a  single  dose of bella-
donna in the night.
   This treatment will almost always succeed in simple
meningitis.*
  * We would earnestly recommend to practitioners, in the menin-
gitis of children, of from six to eighteen months, the  treatment
adopted by Dr.  J. H. Pulte.  As  soon as the first symptoms of
oppression, drowsiness, and sleep with half-opened eyes, announces
an impending effusion, he prescribes bryonia and helleborus nig., in
alternation.  Of the third dilution of each of these remedies, he dis-
solves ten or twelve globules in half a teacupful of water, and gives
a teaspoonful alternately from the  solutions every two hours.  As
the symptoms improve, which they are generally observed to do,
within the first twenty-four or thirty-six hours, the frequency of the
doses is diminished, and the solutions are  made weaker, by the ad-
dition of a larger quantity of water to each preparation.]—Ed. 
Spinal Meningitis.
333
   As to cold ablutions upon the head, sinapisms upon
 the legs, etc., etc., we make no use of them.  We do
 not prescribe them, not because they belong to tha
 allopathic methods, but because they are, at the  least,
 useless, if not dangerous.

             spinal meningitis.
   Primitive inflammation of the membranes of the
 spinal cord, is certainly a very uncommon  disease, in
 the  first as well as in the second period of  childhood.
 Convulsions, and especially tetanic  rigidity  of the
 trunk, are almost the only symptoms which character-
 ize  it; and, as these symptoms may  exist without
 organic lesions, it follows  that the diagnosis of spinal
 meningitis is always very  obscure.
   The most that we can say is, that the febrile action
 which accompanies it, and the  persistence of the ner-
 vous attacks which it  produces  are of such a nature
 as to distinguish meningitis from  an essential or  sym-
 pathetic nervous affection.
   Treatment.—Belladonna,  from  the  12th  to the
15th, in  water, a teaspoonful  every hour during the
first day.
  Belladonna and thuja, taken alternately, from the
second day, lengthening  the  intervals between the
doses as the symptoms improve. 
334  Diseases of the Cerebro-Spinal Apparatus.


myelitis--inflammation of the  spinal
                   MARROW.
  Myelitis is, perhaps, still more rare in childhood
than spinal  meningitis: its symptoms are, paralysis
of the abdominal extremities ;  and convulsions, when
as almost always  happens, it is  complicated  with
meningitis.
  The  treatment of this disease is the same as of the
preceding.
       HYDROCEPHALUS.   (CHRONIC.)
   By  hydrocephalus is  understood  an  accumula-
tion  of water on  the brain,  with  a  more or  less
considerable separation of the  bones  of the cranium.
This disease  is  sometimes  congenital — i3  some-
times developed several months, and even  several
years after birth.   The children attacked with it, sel-
dom present any  other morbid symptom than the
abnormal, and, in certain cases, enormous volume of
their heads.  The  disproportion of this  part to the
face  and the rest of the body, gives to the young pa-
tients a strange aspect.  Some of these children are
remarkable for mental precocity ; but,  after a certain
time, their sensitive and intellectual faculties simulta-
neously decline.  This alteration of the cerebral func-
tions, is first observed in  the  senses of hearing and
sight.  The  patient may become completely blind and 
Hydrocephalus .
335
deaf, before  any other symptoms give notice of the
progress of the disease.   Soon, however, paralysis of
motion, and  of sensibility in various parts of the body,
are added to these symptoms.  At last, the patient
takes to his bed;  a febrile action sets in ; somnolence,
coma,  convulsions, or attacks of tetanus, and death
succeed.  The  duration of this disease  is extremely
variable.
  Hydrocephalus  is not  an incurable  disease;  the
curative  force  of  nature  alone  has  been sufficient
to restore to health  children affected with this ma-
lady, some of whom  afterward became distinguished
men.*
  Treatment. — It requires time  and perseverance.
Staphysagria, ferrum chlor., and camphora, are the
medicines upon which we must depend.
  The  first two medicines may be administered simul-
taneously for two weeks, two doses  of  staphysag.,
from the twelfth to the fifteenth dilution, in the morn-
ing, and  a single dose of fer. chlor., from the 6th to
the 9th, in the evening.
   Camphora, at  a medium dilution, should  succeed
these two medicines, and be continued, at three doses
a day,  for several weeks.
  In case the disease  should  take an acute form, the
treatment for meningitis should be adopted.

     *  George Cuvier had hydrocephalus in his childhood.
       29 
336  Diseases of the Cerebro-Spinal Apparatus.
  Arnica may be given  intercurrently, in the treat-
ment of hydrocephalus;  but the three medicines I
have indicated are infinitely preferable.

                 CONVULSIONS
  Convulsions and worms  formerly  constituted the
pathology of children; but we now know, that convul-
sions, far from always being a separate affection, are
only, in an immense majority of cases, a symptom, or
a complication, of another disease;  so that an effica-
cious  treatment of the latter is the only way of re-
moving the former. Thus, we see convulsions result:
1st. From difficult dentition; 2d. From lumbrici in the
small intestine, or ascarides in the rectum ; 3d. From
severe hooping-cough.  We have seen them, in short,
Bhow themselves in eruptive and in  typhoid fevers, as
a first symptom in meningitis, and terminating the ma-
jority of mortal maladies.   Convulsions do not in any
case call for a special treatment; the only one adapted
to them is that of the disease which  produces them.
  There exist, however,  essential convulsions :  epi-
lepsy is of this nature, when it  is not occasioned by
an organic lesion.  It is very important to distinguish
essential from symptomatic convulsions, but it is not
always easily done.  The age and general health of
the subject, are  the first circumstances to be taken
into account.  1st. Symptomatic convulsions, except-
ing the cases of  very marked cerebral affections, are 
Convulsions.
337
rare after seven  years ;  2d.  The  disease upon which
they depend, is more or  less  evident.  Consequently,
when a child over seven years, and, to all appearance,
in perfect health, is  attacked with convulsions, with-
out appreciable cause, we have every reason to believe
that it  is a first attack  of epilepsy.   But  if, on the
contrary, we learn that for several weeks, or even for
several  months,  the child has been losing color, flesh,
and strength; that it has  had a capricious appetite,
irregularities in digestion,  and occasional vomitings ;
if we know at the same time that  it is born of phthi-
sical parents, the  prognosis is serious, for nothing is
more probable  than the  existence of a tuberculous
meningitis.
   Sympathetic convulsions are  always  a highly un-
favorable complication; they may cause  death by
asphyxia.  As for epilepsy, everybody knows what a
legitimate terror it inspires;  but it is far from being
always   incurable, especially when  it  is  not  here-
ditary.
   Treatment.—I  have pointed out the cases in which
convulsions  should be combated  by kreosotum, (see
page 243,) by coralia rubra,  (see page 323,) by stan-
num, (see page 285).
   When convulsions in nursing children appear to be
idiopathic, the only  medicine to  oppose to them  is
helleborus niger, from the ninth  to the twelfth dilu-
tion, at  small  and repeated doses.   (Prefer 2d dilut
Ed. 2d edit.) 
338  Diseases of the Cerebro-Spinal Apparatus.
  When, lastly, we  have to combat a declared epi
lepsy, that  is to say, idiopathic convulsions, and in  a
chronic state,  our principal  agents are  belladonna,
opium, and secale  cornutum.   Opium  and  bella-
donna should  be given first, for an entire month,—
opium twice in the morning, belladonna twice in the
evening ; the second month, opium  and secale cornu-
tum; the last,  replacing belladonna.   The result of
this treatment will astonish those who employ it.

       CHOREA--ST. VITUS'S DANCE.
  Chorea, or St. Vitus's dance, is rather a disease of
youth than  of infancy ; I shall not describe it here, but
I recommend to practitioners the use  of coffea and
colchic,  in the treatment  of  this disease, whether
acute or chronic;  to be followed by cocculus.   In  a
chronic chorea,  for example, coffea should be taken in
the morning, and  colchic. in the evening, for one or
two weeks ; after which, coccul. should  be adminis-
tered, morning  and evening.

         BALBUTIES— STAMMERING.
  This infirmity, almost always congenital, and often
hereditary,  proceeds  from a fault of innervation, for
the cure of  which,  Allopathy has found nothing better
than various surgical operations, whose stupid barbar-
ity and continual failures have scarcely yet disabused
the credulous.   The  proof that  it is a functional aber- 
Balbuties.
339
ration of the brain which produces stammering,  is,
that all moral emotions, that is to say, actions purely
cerebral, instantly increase the infirmity of which  we
speak.   For myself, I venture to affirm that stammer-
ers can be cured, provided the treatment is applied in
infancy, or at least before the age of puberty.  The
use of a single medicine, stramonium, constitutes the
whole  treatment.  It should be administered at the
ninth dynamisation,  eight  or ten globules to four
ounces of water, a preparation that may be renewed
as often as  necessary, and of which the patient should
take three  teaspoonfuls a day for six or seven weeks
at least. 
340     Diseases of the Organs of  Sense.
       DISEASES  OF  THE  ORGANS  OF  SENSE

  As these diseases offer nothing which is peculiar to
childhood, I shall say very little concerning them.
  Ophthalmia and otitis are frequent complications of
variola and measles, their treatment is then that of
these diseases.
  Simple ophthalmia of the new-born (redness of the
conjunctiva, photophobia, then agglutination of the
lids), quickly  give  way to a  few doses of osthusa.
Camphora. or coffea  are the specifics for ophthalmia,
caused by a contusion of the globe of the eye. These
two  medicines are, in this case, preferable to arnica,
which is  generally used.
  Kreosotum, in doses repeated at short intervals,
should be given to the new-born, attacked with syphil-
itic ophthalmia.
  Otitis is an inflammation of the auditory canal.  It
is sometimes very painful.  Belladonna is the princi-
pal medicine for the  acute period.   Lycopodium is a
precious  remedy against chronic otitis, with  purulent
discharge;  sepia  would, however,  be  preferable, if
there was a relaxation of the bowels. 
Diseases of the  Locomotive  Apparatus.  341
      DISEASES OF THE  LOCOMOTIVE APPARATUS.

  As it is not my intention to treat  of vices of con-
formation and external lesions, which require surgical
operations,  I shall here  speak only of  hernia  and
rachitis.
  Hernia is  most  commonly  caused  by the  efforts
made by  children  in crying.   A simple band gen-
erally suffices for the cure  of umbilical  hernia, but
inguinal hernia, in little boys, requires internal reme-
dies.  Nux. vom., and if this medicine fails, coccul.,
are the substances to be prescribed.   The same treat-
ment is adapted to the falling of the rectum.
  Rachitis, an affection  very common in childhood, is
undoubtedly a form of scrofula, and presents  aU the
general characteristics we have assigned  to that dis-
ease.  (See pages 207 and following.)
  The predominant symptom in rachitis, is the soften-
ing, and  consequent  deformity of the bone.   The
spongy bones, such as the vertebra? and the articular
extremities of the long  bones, are more  particularly
the seat of this morbid  action.  Hence, the impossi-
bility of walking, and the curvatures of the spine of
rachitic chHdren.
  When  the disease  has made great  progress, the
bones may ulcerate, and if this caries takes place in 
342   Diseases of the Locomotive Apparatus.
the vertebra of the cervical or dorsal regions, the pus
that  is formed makes for itself a passage along the
vertebral column, and forms an abscess in the soft
parts of the pelvis,  an abscess which  finally opens
and does not close again.  {Cold abscess of authors.)
  The causes of rachitis are those of scrofula in gen-
eral:  the  most  common of  all is  hereditary trans-
mission.
  Rosen devotes a long chapter of his Traite des Mal-
adies des Enfants, to prove that rachitis is of syphil-
itic nature.   For my part, I have  already  expressed
my doubts upon this transformation of the venereal
disease.  I have also  pointed  out, in the chapter on
Scrofula, the regimen to which scrofulous  children
should be rigorously subjected, whatever be the special
form of the  affection.
  Mercur. solub., colchic. and sulphur, are the funda-
mental remedies for the treatment  of  rachitis.  The
doses should  be frequently repeated  (several  times  a
day), each in  the order in which  I have mentioned
them, for a  longer or  shorter time, according to the
circumstances  of the  case.  Their  efficacy is noto-
rious, and with their aid I do  not regard  rachitis as
incurable.
THE  END. 
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