WBK "J MOZSTO&E^lPH V 1* O N GEL8EMINUM: I T S THERAPEUTIC AND PHYSIOLOGICAL EFFECTS TOGETHER WITH ITS USES IN DTSEASE. EDWIN M. HALE, M. D., Associate Editor of the North American Journal of Homaopathy ; Author of a Practical Work on Abortion ; Vice President of the Michigan Homoeopathic Institute, $c, ftc. WITH AN INTRODUCTORY LETTER BY J. S. DOUGLAS, 1. M„ M. I)., Late Vmfa*or nf Mflterin Medica. n<:.. in Western "HMiinopatlii.': Medico! College. i- DETROIT: I)K. LODGE, HOMEOPATHIC PHARMACY, 266 Jefferson Ave. Philadelphia, W. Radde, Jr., F. E. Boericke ; Boston, Otis Clait ; New York Y\\ Radde ; Rochester, N. Y, Dr. T. C. White : Brooklyn, J. T. P. Smith ; St. Louis, R. & H. Luyties. SOLO BY HOMOEOPATHIC PHARMACEUTISTS GF.XKRALI.V. 1862, n(oZ fidrrrx AU • Ift/f If 7U>'2/ Entered according to Act of Congress, in the year 1861, by Edwin A. lodge, in the Clerk's Office for the District of Michigan. S. D. GREEN'S •Transcript & Journal " Print, tVhw.t. N". 0. Jamikpon, Pr. TO JOHN ELLIS, M. D., Professor of the Principles and Practiceof Medicine in the Western Homceopathic College; and Professor of the Theory and Practice of Medicine and Therapeutics in the New York Homoeopathic Medical Collage; Author of "Avoidable Causes of Disease,"; etc , Dear Doctok: — Permit me to dedicate this little treatise to you, in consideration of your eminent services to the Homceopathic cause, as a pioneer of our System in the "West, and a suc- cessful teacher of Practice and Materia Medica in our Colleges. Yours, sincerely and respectfully, E. M. HALE. i > r e jt a o p.: . In writing this Monograph, let me assure the reader that I have aimed to he candid and conscientious in all my statements; and have sought, in making my selections from various medical writers, to let no sentiment of bigotry interfere with a just appreciation of the opinions of others. T wish the homceopathist to bear in mind, while testing the merits of the medicine upon the healthy and the sick, the throe following state- ments of its qualities and powers :— 1. All the symptoms in the Proving have been obtained from Mother Tinctures of various strengths from our own Pharmacies ; the Fluid Ex- tracts and Oelsemin of Tildcn; the Concentrated Tincture and Qelsemin of Keith, and some minor preparations. The quantities used varied from one-tenth to 25 drops of Mother Tincture, one-tenth to 5 drops of Fluid Extract or Concentrated Tincture, and one-tenth to 1 grain of the Gelse- min. In but one case can I find that the dilutions above the 1st, caused nny pathogenetic symptoms ; nor should I consider them of much practical importance if collected. In the proving of drugs wc should give enough to produce its peculiar primary characteristic symptoms, and its reactive or secondary symptoms, and with Gelseminum this requires the use of material doses. 2. I wish to impress upon the minds of my colleagues the importance, in practice, of the Law ok Dose, as explained in my Article on Dose, in the North American Journal of Homoeopathy of 1861. I firmly believe that a strict adherence to that law is the only wa}' to attain success in the treat- ment of diseases by medicines. The careful observance of several years convinces me of its truth. For the benefit of those who may not have access to those articles, the general axiom of the law will be thus stated : (a) When a group of symptoms, or a pathological state, constituting a dis- easc, resembles^ the primary symptoms and conditions of a, drug, such drug should be administered in the smallest consistent doses, (b) When a group of symptoms, or a pathological stale, resembles tJie secon- dary effects of a drug, such drug should be administered in quantities as large ns is consistent with perfect safety. By adhering to the requirements of this law we may obtain the best success of the homceopathic and allopathic systems of medicine. All the veritable cures made by the different schools of medicine, have been made under this law. By virtue of this law we can account for the suc- cessful use of all drugs now in use in any school. 3. Gelseminum has one peculiarity which but few drugs possess, viz.: It requires widely different doses to affect different constitutions. In this it somewhat resembles Alcohol, Chloroform, Opium, Spigelia and a few- others. I have the testimony of the best Homcoopathists, the most pro- minent Eclectics, and the really reliable Allopathists, that there are some organisms so susceptible to its influence that all the primary effects can be induced by a few drops—from 1 to 10—of the Tincture, while others fail to be affected by the most massive doses, one man, known to Prof. King, taking one ounce of good tincture, while a delicate pregnant female felt many ot the unpleasaut symptoms of the drug from a fractional drop '. No perfectly reliable rule can be given to guide in the selection of the dose, but wc may consider an approximation to such a rule to be in this general indication, viz.: Those persons who by constitutional or acquired disease, have lost the healthy vitality and tone of their rndml nervous systems ir.rf'motf'■ susceptible, to thearticm of Gelsemtvttm. ' H '' CONTENTS. Introduction, Botanical Description, Historical Description, Various Preparations, Authorities, Toxicological Effects. Antidotes, Effects upon Dogs, Pathological Appearances, Therapeutical Deductions, GENE EA L E F F E C T S. On the Nervous System. Nerves of Sensation, Nerves of Motion, Muscular System. Vascular System. Heart and Arteries, Fever, Venous System, Lymphatic System. P A T HOGENESIS. Mind, - Head, Eyes, Ears. 1. 2 CONTENTS. Nose, - . - - 34 Face, ... - - 35 Teeth and Jaws, - - - - - 36 Mouth and Tongue, - - - - 36 Throat, - - - - - - 36 Taste, Appetite, Gastric Symptoms, &c, - - 37 Stomach, - - - - - 38 Abdomen and Stool, - - 39 Liver and Spleen, - - - 41 Urinary Organs, - - - 42 Male Genital Organs, . . . - 43 Female " . . - 45 Air Passages, - . . - 48 Thoracic Organs, - - 49 Back, - . . - 51 Upper Extremities, - . . - 51 Lower Extremities, . . . - 52 Skin, - 52 Sleep, - - . .53 General Symptoms, - . - 54 Analogues, - . . - 55 List of Diseases in which Gelseminum has been employed, &c, 56 INTROmiCTORV LETTER. Milwaukee, Nov. 23, 1861. E. M. Hale, M. D. :— Dear Sir:—I have read the sheets of your " Monograph upon Gelseminum" as they have come from the press, with great satisfac- tion. Having been the first Homoeopath, so far as I know, to make a proving of this precious drug and publish the results of therapeutic applications based upon this proving, I have not unnaturally felt a sort of paternal solicitude for its reputation. That solicitude is re- lieved and the paternal feeling gratified by the perusal of your work. My own experience has confirmed a large portion of the pathogen- etic indications and therapeutic results which you have collected with so much industry, and I shall be disappointed if your Monograph is not accepted as a boon and a rich addition to our Materia Medica by the profession, and if the Gelseminum is not soon placed, by general consent, in the category of our most valuable polychresfc. My experience does not perfectly coincide with your remark upon the action of the Gelseminum upon the nerves of sensation. It does not, certainly, " cause the numbness, tingling, prickling and crawling sensations" of Aconite, but, in my individual experience, it causes the pains. In my own provings I have frequently experienced a succession of acute, sudden, darting pains evidently running along single nerve-branches in almost every part of the body and limbs, sometimes so sudden aud acute as to make mc start. At one time a quick succession of.these acute sudden pains coursed down the out- side and front of the tibia for over half an hour, leaving a line of con- siderable tenderness marking its track. These pains which seemed clearly neuralgic, gave me the palpable indication for its employment in this disease. Aud it has certainly been successful. But while it has promptly cured sonic distressing cases of neuralgia, in which Aco- nite had been fully tried without benefit, there have occurred some other cases in which it has failed and Aconite has succeeded. What is the explanation of this? If we suppose that in some cases of this disease there exists a real inflammatory state of the nerve, and in others a mere excess of sensitiveness, the explanation is easy : Aconite cures the first, and Gelseminum the last. This topic suggests some other thoughts of practical importance. You and Dr. Lazarus both remark that you have not been able to elicit such marked symptoms in your provings as were experienced by me. The symptoms particularly referred to are the chills, the reactive febrile heat with headache, and swreat. Dr. L. suggests that I am probably very susceptible to the action of this drug. This remark suggests an important fact which has gradually unfolded 4 INTRODUCTION. itself in my successive fragmentary provings on some seventy persons, and on myself. The fact, of which I have, at length, become clearly convinced, is this : The degree of chill, of febrile reaction, of head- ache, and of neuralgic pains, bear a very uniform ratio to the ner- vous sensitiveness of the patient. My temperament is decidedly nervous and sensitive. In all the subjects of a nervous, sensitive temperament, the above symptoms are strongly marked. In those of an opposite, insensitive temperament, while the pulse is depressed, and the extremities cool or cold, there is no chill or it is very slight, little or no headache, and slight febrile reaction, and consequently little sweat. In several highly sensitive subjects the chill has been equal to a respectable fit of ague, the reaction and pain of head cor- responding, and the sweat profuse. These symptoms have been most strongly developed in some female provers of highly sensitive tem- peraments, by half-drop doses. Some persons seem almost insensible to its effects. One man who had taken several drugs for proving, without any marked results, took three teaspoonsful in one day, of the strong tincture, which I know to be good, and reported, the next day, no symptoms. From all this, the practitioner will draw two highly important practical inferences: 1st. Gelseminum is peculiarly adapted to nervous, sensitive tem- peraments, and hence to women and children. 2d. It requires to be given to those of such a temperament in much more attenuated form and much smaller doses than to those of opposite temperaments. In the first class of patients, I have witnessed the most beautiful effects from three or four drops of the 3d dilution in a tumbler of water, in teaspoonful doses. To a patient of the latter class in a feb- rile attack with distressing chilliness, severe pain of the head, back and limbs, and constant tossing and groaning, I gave a drop of the tincture with the confident expectation of a speedy effect. In this I was disappointed. At the end of half an hour he took two drops, then three, then five, without the least perceptible effect. Confident that the remedy was clearly indicated, I gave him ten drops, when the chill almost instantly ceased, and in about fifteen minutes perspi- ration commenced, which soon became profuse and continued sd for more than twelve hours, when the last remnants of his fever and sweat disappeared together. Only the same effeets and to the same degree were experienced in this case from ten drops that I have a hundred times witnessed from one-half and one-fourth drop of the tincture, and from the fractional part of a drop of the first, second and third dilutions. These facts indicate a rule for administering this drug which I have long regarded as ihe rule for giving all drugs, viz: The decree of sensitiveness of the patient is the only measure of the dose, and these degrees are sufficiently variant to correspond to all the poten- cies from the mother tincture to the 1000th dilution. INTRODUCTION. 5 A word in regard to the Homoeopathicity of Gelseminum in in- flammations, as pneumonia, &c., &c. In all local inflammatory dis- eases, there is a forming or congestive stage, characterized by chilli- ness, depressed pulse, &c. According to my view, to this stage and this only is Gelseminum Homceopathic. When this stage is passed and congestion gives place to inflammation, the indication for Gelsem- inum ceases and that for Aconite begins. This is the clear distinc- tion which I make between these two invaluable drugs. I do not, however, mean to exclude Aconite from the congestive stage of in- flammatory diseases, but I believe Gelseminum still more strongly indicated. As your work is designed to embody all that is known of this drug, I beg to add to what you have collected, my very recent experience of its effects in two very interesting cases. Case 1st. On the night of the 3d inst., (Nov. 1861) a young married woman, of highly nervous temperament, and seven months pregnant with her first child, was attacked with violent convulsions, frequently repeated, and soon followed with complete unconsciousness and the wildest delirium. This state of things continued till the afternoon of the 5th, when she was delivered of a dead foetus. The convulsions now ceased, but she continued in a state of wild delirium, incessantly talking and without a moment of sleep for some three days and nights. During the next half day her delirium was somewhat more subdued, the incessant talk less furious, and she seemed to sleep once or twice for a minute or two. During all this time, the arterial action was inclined to be excessive, as in acute inflammatory disease, though no such state could be detected. This excessive action was successfully con- trolled by the Irequent use of Aconite. I now resolved to try the effect of Gelseminum. She accordingly took teaspoonful doses of a mixture of three drops, 3d dilution in one-half a tumbler of water. During the night, after two or three doses, she had three sleeps of from one to two hours, and in the morning gave the first evidence of consciousness. This, however, was of short duration. A few minutes of mental effort seemed to exhaust the power of the brain and she relapsed into wakeful delirium. But whenever she has become delirious and sleepless, the Gelseminum, in the above doses, has uniformly and promptly procured qui- etness and sleet). The intelligent nurse has come to rely implicitly upon it whenever needed. The patient has steadily improved from the above date to the present, Nov. 23d, though it has been necessary to give occasional in- termediate doses of Aconite, which alone has controlled the excessive ar- terial activity. She now leaves her room, though her mind is weak and still wanders when too long excited. In this case it is evident that Gelseminum has uniformly and per- fectly succeeded in quieting excessive nervous irritability and delir- ium aud procuring sleep, where Aconite, Belladonna, Chamomilla, Coftea, Hyoscyamus, Ignatia, Pulsatilla, Stramonium, &c. had proved powerless. Cask 2nd. On the 5th inst. I was called to see a lady eight months preg- nant, the mother of four children, the two last of which had been born at about the same period of eight months. All her labors had been exceedingly tedious, from three to six or seven days, apparently from the great rigidity and unyieldingness of the os uteri. In her last confinement she had violent puerpural convulsions. When I was called on the 5th she had had regular labor pains for three days, but, accustomed to protracted labors, she had not thought it time to send for me till she was seized with a convulsion, 6 INTRODUCTION. which was repeated before my arrival. I found the pains quite active and frequent, but on making an examination not the least result was observable. The os uteri was not in the least developed, but rigid and perfectly closed. With the vivid recollection of her last two labors at the same period of eight months, their extreme tediousness, the violent and alarming convul- sions which now bid fair to be continued through a labor of days—perhaps many days ; of all the exhaustive appliances formerly employed to subdue the convulsions and to stop or hasten the premature labor, with nearly all my time necessarily occupied with the case above related, no one will marvel at my extreme anxiety and perplexity. On reflection, as all other known means had, on the former occasions, proved so fruitless, I resolved to try the effect of Gelseminum. It might, by its great sedative power, subdue the spasms ; it might allay and put a stop to the premature labor pains. If it failed of accomplishing these objects, it might relax the rigidity of the os uteri and thus facilitate the labor. She was not of a nervous, but a bilious temperament. I gave five drops of the tincture, directing it to bo repeated after each spasm, or if no spasm occurred, every hour unless the pains were abated or she experienced some of the characteristic symptoms of the drug. After three doses I saw her. No more spasms had occurred. The pains were unchanged. Directed one drop every two hours. Six hours after, the pains were nearly the same, but a very palpable change was effected in the state of the os uteri, which was now soft, relaxed and sufficiently dilated to admit the finger easily. I had now no doubt that the labor would goon, and from the much more rapid relaxation of the os uteri than on former occasions, would be much less tedious. I left to call again in six or eight hours, or to be notified if needed sooner. At my next visit the pains were much less fre- quent and much lighter. No symptoms from the drug. Continued one drop every four hours. On the following day, the pains had altogether ceased and the patient was feeling entirely comfortable. Three days since she was in her usual good health and attending to her usual duties, since which, (Nov. 23,) I have not heard from her. Others can draw their own inferences from this case, and I will not comment upon it except to say, it is obvious that Gelseminum accomplished in it what every hitherto known means had entirely failed to effect on two precisely similar occasions with the same patient. I have thus, my dear sir, protracted these remarks, knowing that it was your design to make your work exhaustive—to collect all that is at present known of this truly precious drug, and I have extreme pleasure in saying that I think you have ably accomplished what you have so praiseworthily undertaken. I do not mean to be understood that I think the wealth of this drug is exhausted by our present prov- ings and therapeutic experience. On the other hand, one of the great merits of your work is, that while it has furnished the profession all that is at present known, it so clearly indicates just what we have yet to learn in regard to it. In conclusion, I cannot doubt that the general diffusion of your monograph among the profession will lead others to make more ex- tended and cautious provings, especially with the higher dilutions, and you will have the satisfaction of seeing the drug on which you have expended so much labor, and largely in consequence of that la- bor, universally recognized as one of the most valuable of our Ma- teria Medica. Yours truly, J. S. DOUGLAS. GELSEMINUM SEMPERVIREN& Nat. Oed. Apocynactce. Sex. Svst. Pentandria Uigyaia. The Boot is the officinal part, and yields its virtues to water or alcohol. Description•■■—This plant is likewise known by the name of Field Jessa- mine, Yellow Jessamine, Woodbine ; it is the Bignonia Sempervirens of Lin- naeus, and the Gelseminum nitidum of Michaux and Pursh ; it is named the Gelsemnwn. nitidum by some authors, by what authority I cannot im- agine. It has a twisting, smooth, glabrous stem, with opposite, perennial lanceolate, entire leaves, which arc dark above, pale beneath,and which stand on short petioles. Thefloicers are yellow, having an agreeable but rather narcotic odor, and stand on axillary peduncles. »The Calyx is very small, with five sepals ; the Corolla is funnel-form with a spreading border, and five lobes nearly equal, Stamens five, Pistils two, Capsule two-celled, compressed, fiat, two-partible. Seeds flat, and attached to the margins of the valves. The berries are black. This is one of the most beautiful climbing plants of our Southern States, ascending lofty trees, and forming festoons from one tree to anoth- er, and in its flowering season, in the early spring, scenting the atmos- phere with its delicious odor. On account of its gorgeous yellow flowers, and the rich perfume which they impart, as well as the deep shade it affords, it is extensively cultivated in the gardens of the South as an or- namental vine. It grows in the North as an exotic. The author has one ^rowing in his office. It begins to blossom about the first of March, and its blossoming season lasts until the end of May. The root is several feet in length, with scattered fibres, and varies from two to three lines in diameter, to nearly two inches. The internal part of the root is woody, and of a light yellowish color, the external part or bark, in which the medicinal virtues are said principally to reside, is of a light snuff color, and from half a line to three lines in thickness. A vine, the root of which is sometimes gathered for the Gelseminum, resembles it very much in appearance, though it is of a lighter color, and the outer bark is covered with white specks or marks somewhat similar to those on young cherry or peach limbs, and the lower part of old vines become rough and have small tendrils that fasten upon the bark of trees, and which are never seen on the Gelseminum. The bark of the vine is also more brittle, and the leaves are always on long footstalks, which are opposite, at the end of which are two opposite leaves, almost exactly re- sembling the leaf of the Aristolochia Serpentaria. The root is almost white, very tough, strait, and about the same length of the medicinal root, and has a slightly bitter, disagreeable nauseous taste. I never saw any of the flowers, though they are said to resemble the others in shape, but are s A MOM0GHAP11 UPON GELSEMINUM. snowy white, with a slight unpleasant odor. The vine is called the White Poison Tine and Wliite Jessamine. I am thus particular in giving a correct description of this plant, in or- der that there shall be no mistake about the matt. r. Homoeopathic Pharmaceutists, above all others, should be scrupulously careful to pre- pare the medicines we use, in their utmost purity. The Gelseminum, more than any other vegetable remedy, demands the most caieful prep- aration. It is not known to me whether the leaves, stem, or flowers, pos- sess any medicinal qualities. I cannot learn that any tincture has ever been prepared from other parts than the root. But I should suppose from analogy that they possess as much comparative power, as the leaves &c, of Aconite, or Veratrum Viride. MEDICAL HISTORY. Doctor 0. H. Cleveland, of Cincinnati, has kindly favored me with the medical history of the Gelseminum, going back to a remote time. "Dodojleus wrote about the White Gelseminum under the name of " Apiana." Martholus wrote also about the plant under the name of " Gelsaminum," and also called it the " Jassaminum Yulgatus flore albo" Caspar Baubino, calls it the " white flowered Jessany." Johjt Quincy, author of the " Complete English Dispensatory," published about two hundred years ago, also speaks of the White Jessamine." (This would seem to show that the Yellow Jessamine was not known in the old world. A plant possessing such remarkable properties could otherwise not fail of notice. Tho White Jessamine is found in America, but what its medical qualities are, save that it is poisonous, I cannot as- certain from any authority to which I have access.) '• A very good series of reference to the modern literature of the Yellow Jessamine will be found on page 1415 of the last edition of the U. S. Dispensatory. My articles in the Charleston Medical Journal, 1857, page 180, and in the American Medical Gazette, Vol. IV, page 154, will give all my views of its action. I am not positive, but feel quite sure, that the Yellow Jessamine is a native only of the Southern States." Dr. B. L. Hill, then Professor of Surgery in the Cleveland Homceo- pathic College, was, in 1856, the first homoeopathist to use and recom- mend it. His previous connection with the Eclectic School as Professor of Surgery in the Cincinnati Eclectic College, probably led to its use by him. The first notice of it in Homoeopathic literature was made by the late James W. Metcalf, M. D., of New York, in Vol. 3 of tho North American Journal of Homoeopathy. Dr. J. S. Douglas noticed the drug in an appendix to Dr. Hill's " Domestic Practice, " about the same time that the attention of the profession was called to it by myself in the above named Journal. Dr. Douglas soon followed by a fragmentary, but sug- gestive proving, in the first volume of the United States Journal of Hom- eopathy. About the same time I wrote a lengthy article on the. " Use of Gelseminum in Fevers," for the forthcoming numbers of " Peters' Prin- ciples and Practice of Homoeopathic Medicine," but at this date it has not yet appeared. Dr. Peters has however noticed the remedy in Vol. 1, No. 3, page 212, of that work. Dr. J. C. Morgan, of Illinois, communicated a partial proving to Dr. Shipman, who published it in the April number, 1861, of his Journal of Materia Medica. VARIOUS PREPARATIONS. 9 VARIOUS PREPARATIONS. King in his Dispensatory only mentions one officinal preparation, the Tinctura Gelsemini. The U. S. Dispensatory mentions only a tincture, but is very indefinite about its preparation, viz : " macerate for two weeks the fresh bark of the root [how much?] well bruised in diluted alcohol, and then expressing and filtering. The dose is from ten to fifty drops [!] every hour or two. * * * Dr. Jenkins gives from half a teaspoonful to three times the quantity." We are not told how strong this tincture is, but it must have been very weak, or none of " Dr. Jenkins'" patients would have been left to " tell the tale." For although some persons seem to possess a strange immunity from its effects, I doubt whether many could bear such doses safely. King.—Dr. King, in his Dispensatory gives the following directions for the tincture :—" Fresh root of Yellow Jessamine, cut into small pieces eight ounces; alcohol two pints; macerate fourteen days, express and filter. This forms a saturated tincture, beautifully tinged with violet. It has a peculiar odor, somewhat resembling that of new honey, and a faint peculiar, not unpleasant taste. Dose, from ten drops to a fluid drachm." This is probably the manner in which our Homceopathic Mother Tincture is prepared, as it resembles the above very nearly. Owing to the fact that the tincture is sometimes very uncertain in its action, some writers assert that the active principle of the plant must bo volatile. Dr. T. C. Miller, who is good authority, says : "The best prep- aration, in my opinion, is the tincture, kept in a black bottle, or a bottle cov- ered with black paper, to insure it against the action of light. In summer it should be kept in a cool cellar. With these precautions it will retain its strength." This statement is substantiated by others, that light and heat injure the tincture. This should be a hint to Homoeopathic phys- icians and Pharmaceutists who wish to use or sell a reliable preparation of this medicine, for it would be a lamentable error to give attenuated doses of an inert tincture. The best Homoeopathic preparation of Gelseminum I have ever used, was from the Pharmacy of Dr. E. A. Lodge, of Detroit. He is scrupulous- ly careful to keep a fresh article on hand. His preparations of Gelseminin are quite reliable. Halsey & King of Chicago, and Wm. Raddeof New York and Phila- delphia, undoubtedly aim to keep only reliable articles. But I cannot refrain from urging our Pharmaceutists to sell only those preparations of this drug which they can conscientiously recommend. I propose as a reliable test, that all Homceopathic Physicians and Pharmaceutists should, before administering or selling any prepara- tion of Gelseminum, either test its effects upon themselves or upon some animal. There is so little danger attending its trial in sufficient closes to cause prominent pathogenetic symptoms, and the absolute certainty that, if a good article, it icill manifest its effects, unless some idiosyncracy of the prover militate against it, that there is no ex- cuse for selling or using an uncertain or unreliable article. Let the Hornceopathist bear in mind two important facts : 1st, that the dried root is, if not absolutely inert, very nearly so. 2d, that light and heat injure the tincture, and very probably all the powdered prepa- rations. 2. 10 A MONOGRAPH UPON GELSEMINUM. Authorities. I have drawn freely from the writers of the various schools of medicine, giving their opinions, theoretical and therapeutical deductions, leaving it to the discriminating physician to draw his own conclusions of the real value of their assertions or suggestions; and to apply to them the infallible test of pathological or pathogenetic provings; or its uses in disease. I wish my own opinions, and clinical remarks, to he judged by the same standard, but in a spirit of candor and honest intention. I here record my obligations and sincere thanks to the following ph}rsicians for valuable contributions, manuscripts, pamphlets, &c.:— HOMEOPATHIC. Dr. J. S. Douglas, of Milwaukie, Wis. Dr. R. Ludlam, " Chicago, Ills. Dr. J. C. Morgan, " Lebanon, " Dr. F. L. Vincent, " Campaign, La. Dr. W. H. Holcomb, " Waterproof, " Dr. M. E. Lazarus, " Columbus, Ga. Dr. D. W. Rodgers, " Quincv, Mich. Dr. H. M. White, " Cold water. " Drs. Williams, Murch and Smith, (students and provers.) ECLECTIC, &c. Dr. T. C. Miller, East Tennessee, Dr. C. N. Cleveland, Cincinnati, 0. Mr. P. D. Hill, Mr. H, A. Tilden, New Lebanon, N. Y. Mr. B. Keith. New York City, Dr. John King, Cincinnati, 0, Dr. Grover Coe, New York. TOX1COLOGICAL EFFECTS. There are but few cases of fatal poisoning recorded of Gelsemin- um ; and it is to be regretted that no post-mortem examination was made. We do not therefore know what pathological changes it pro- duces in the human body. Case 1, This is said by King to be the first known case of poisoning by Gelseminum ; and that by it, the plant was first brought into notice. " A planter on the Mississippi, while laboring under a severe attack of bilious fever, which resisted all the usual remedies, sent a servant into his garden to procure a certain medicinal root and prepare an infusion of it for him to drink. The servant by mistake collected another root, (the Yellow Jessamine,) and gave an infusion of it to his master who, shortly after swallowing some of it, was seized with the following— Symptoms. Complete loss of muscular power, was unable to move a limb. or even to raise his eyelids, although he could hear, and was cognizant of cir- cumstances transpiring around him. His friends, greatly alarmed, collected around him watching the result with much anxiety, and expecting every min- ute to see him breathe his last. After some hours he gradually recovered him- self, and was astonished to find that his fever had left him." (King's Disp.) Remarks. In this case no treatment was reported to have been giv- en, yet the man recovered perfectly, besides being rid of an obstinate fever. No one can compare the above symptoms with those of Cata- lepsy, without remarking the striking resemblance. It ought to prove a specific for that malady. TOXICOLOGICAL EFFECTS. 11 Case 2. Several deck hands of a steamer on the Mississippi river, tapped a barrel of Tincture Gelseminum which they supposed to be whiskey. All who drank of it were more or less affected. But of three men who had partaken freely, having swallowed about a pint each, two died. I have the complete details of the above cases from Mr. Hill who was present. The symptoms were about the same as in Case 1. The other was saved by the employment of Quinine and Capsicum in large doses, aided by external stimulation. It is deeply to be regretted by the profession that the men thus poisoned were not examined. Such examination by competent path- ologists would have cleared up forever the mystery of the action of this wonderful drug. Case 8. A lady aged 21, suffering from Typhoid Pneumonia, took 10 drops of Tincture Gelseminum ; in an hour 11 more ; and in two hours after 12 drops. Shortly afterwards appeared the following— Symptoms. She could not see any one in the room, although persons stood close by the bed. Her eyes were wide open; pupils dilated, pulse regular and full, skin natural and healthy in color, feet and hands cold. She seemed to know all that was going on ; described her symptoms; said she felt faint; felt as though her blood had ceased circulating and that her head felt very light. Treatment. She was given a teaspoontul of Aromatic spirits of Ammonia in water, and repeated in fifteen minutes. At the expiration of half au hour she said she felt perfectly well, complained of no pain whatever; the fever was subdued, nnd in four days she was able to rise from her bed. (Dr. Lun- gren, of Franklin, N. C.J Case 4. Dr. B----, a practising physician in one of the upper counties of Georgia, while suffering from a severe nervous toothache, took what he guess- ed was about 30 drops of the Tincture. Symptoms. In ten minutes he said, " I cannot see you." His eyes were wide open, pupil dilated ; pulse 80 or 90. He attempted to walk, and stag- gered like one intoxicated. (He was immediately given a dose of Ipecac, as an emetic). In a few moments there was partial paralysis of the glottis, tongue and eyelids. He became very sick and vomited but little (from the Ipecac). He wrote with a pencil on paper, for he could not speak, " I am very sick: wish to vomit but cannot." In a few moments he vomited, but tho discharge passed through the nostrils. His hands and feet became icy cold, pulse regular 80 or 90. Treatment. Warm bricks were applied to his feet, his hands and ankle. were chafed ; strong Aqua ammonia was placed to his nose and upon his chest. In an hour he was able to speak. The next day he complained of being very faint; took aromatic spirits of Ammonia, and the next day rode home, a dis- tance of twenty-three miles. It is needless to say the toothache left him. [lb.] Case 5. A convict in the N. II. State prison swallowed one-and-a-half ounces of the fluid extract, with intent to poison himself. The effect was, great prostration, nausea and vomiting, dilated pupils, inability to speak or move, coldness of the surface, feeble pulse, &c. The effects passed off, with proper antidotes, in about 24 hours. (Dr. Pattee, in Tilden's Journal.) Remark. In this case we observe nausea and vomiting, which is a rare effect of the drug. ANTIDOTES. Unless the person is seen immediately after the drug is taken Em- etics, it is said, are not safe or advisable, on account of the additional prostration they may cause. In fact, none but the most stimulating 12 A MONOGRAPH UPON GELSEMINUM. emetic substances would have any effect upon a stomach paralyzed by a large dose of Gelseminum. Probably the best emetic remedy is mustard, a teaspoonful of the ground seed in half a cup of warm water. Ammonia is a valuable antidote to the prostrating effects of the drug, as also are Quinine, Capsicum, and Brandy. With these Dr. F. D. Hill saved several persons from death, while others, treated with emetics and purgatives, died. Dr. King states that a piece of Turks Island salt (common coarse salt) about the size of a pea, chewed and swallowed, will produce a restoration in five or ten minutes in many instances. A spoonful of salt and water may be given, if the patient is too weak or insensible to chew it. Electro-Magnetism is a powerful antidote to its paralyzing influence. In bad cases it should be perseveringly used. A strong preparation of Xanthoxylum (Prickly Ash) would prove a reliable stimulant antidote. The Homoeopathic antidotes against the primary symptoms of pros- tration, &c, are Aconite, Veratrum viride, Veratrum album, Ar- senicum album, Secale, Chloroform, Carbo vegetabilis and China. Against its specific effects upon the head and eyes, Opium, Bella- donna, Stramonium, Hyoscyamus, Agaricus and Spigelia are indicat»- ed in small quantities. The proper antidotes to its secondary symptoms, convulsive, spinal, &c, are Nux vomica, Ignatia, iEsculus glabra, Cuprum, Agaricus, and iEthusa. The warm bath, mustard to the extremities, aud cool applications to the head and spine would be valuable palliative means. EFFECTS UPOK DOGS- The animal experimented upon was a small spaniel, apparently in good health. I am much indebted to my pupils, Drs. C. A. Williams and L. F, Smith for their careful record of the symptoms, &c, in the case. At 9 A. M. gave % dram of- Tilden's Fluid Extract. No symptoms appear- ing at the expiration of 30 minutes, gave a similar quantity. In about 15 minutes noticed a slight twitching of the eyelids ; some dilatation of the pu- pils, increased action of the heart, 120 per minute. A few minutes more and the muscles of the face, head and neck were affected with twitching; the heart heat with irregular force, now hard and full, then very weak. The dog be- came giddy and staggered; there was drowsiness or closure of the lids,—prob- ably a kind of paralysis of the lids,—with occasional starting as if frightened. In this state of stupor he remained about 80 minutes. At 10:30 \% drams was given. In less than five minutes spasmodic contractions of nearly all the muscles of the body took place. The limbs were drawn spasmodically against the body ; the head drawn forcibly to one side. The left side seemed most affected. There was also labored breathing, like the inspirations in asthma; trembling of the whole body, especially the limbs, great dilatation of the pupils obliterating the iris ; heart's beat 140., Then came clonic opisthotonus. All this time the eyes were closed and the animal seemed drowsy and stupid ; tongue appeared of a bright red, with purple tint. These symptoms gradually ceased until 12 o'clock, when 12 drams more were administered. This was immediately followed by great tremor of the whole body. He walked backward for some distance, staggering from side to side. In about 15 minutes he sank into a stupid condition, with nodding and inabil- T0XIC0L0G1CAL EFFECTS. 13 ity of opening the eyes. For the next 15 minutes this state was continued with occasional jactitation of the muscles. At 12:30 One dram was given, followed by a renewal of the spasms. The whole body and limbs became severely convulsed; complete blindness with greatly dilated pupils ; tongue a dark purple and hanging from the mouth. At this time, (about 30 minutes after the 4th dose,) the pupils contracted very much [!] with continual loss of sight; then nausea and efforts to vomit, for the first time. Heart's action 120 ; respirations 90 per minute! After a few moments he became quiet, when 30 drops were given. In about five minutes the muscles of the thorax seemed entirely paralyzed, or else the lungs became partially paralyzed ; respiration seemed only carried on by violent efforts of the abdominal muscles. The heart's action was very rapid, weak and flutter- ing, and could not be counted. He tried to walk, but the posterior extremi- ties were dragged—paralyzed. Involuntary urination. He fell down in a minute or two, and there was entire paralysis of the whole voluntary muscu- lar system. He lay completely motionless; a leg lifted fell dead and heavy. Respiration very slow and labored ; long, sighing inspirations. In this paral- yzed state he remained about 20 minutes, when, at 1:30, another dose of 30 drops was given,followed by gasping for breath—seemed to be dying, but the heart's action was so rapid it could not be counted. For the next half hour the respiration was alternately gasping and stertorous, then it became natur- al, but the blindness and paralysis continued about an hour. At 4 o'clock the animal seemed lively and well! This experiment presents several peculiarities worthy of notice— 1st. The reruarkably rapid action of the drug. In some instances prominent effects were noticed a minute or two after the medicine had been taken into the stomach. I have frequently noticed this peculiarity of Gelseminum, in the human subject. One case in particular; in which I gave 5 drops of the Fluid Extract to a young woman laboring under an attack of pneumonia. In less than two minutes she exclaimed—"How queer I feel—how dark it seems." The pupils were somewhat dilated, and there was partial blindness. But few other drugs act with equal rapidity. 2nd. The temperature of the body was at no time below the natural point! This fact somewhat surprised ine. I had expected to see coldness of the ex- tremities, as in the human subject under similar circumstances, Perhaps the poison was not carried far enough to cause the necessary prostration. 3d. The constantly excited state of the heart. I requested my pupils to carefully note the rate and other peculiarities of the heart's action, but they as- sert that at no time was it below the normal standard. In all our provings, and in all the records of its effects on man, we have found a decided decrease of the action of the organ of circulation. From what cause proceeded the greatly increased action of that organ in this case I cannot fully determine. Whether the quantity administered, or whether the difference in the physio- logical system of the canine species, was the cause of this unexpected action, I leave for future experiments to determine. May it not be that owing to the large doses given, the primary effects could not appear ? We know that in the case of Quinine, a large dose will induce collapse without any primary stimulation. All the other symptoms exhibited by this animal, are confirma- tory of the provings and collected symptoms caused by this medicine in man. We here have an array of spasmodic and paralytic symptoms truly interest- ing. A drug capable of arousing into action the voluntary nerves in such a manner, cannot fail to prove, when once its true sphere of action is understood, one of the mi.st valuable remedies which we possess But it will need years of careful investigation, such as has been bestowed upon Aconite, in order to render its properties perfectly understood. In the second experiment made on the same animal, two days after the first, about eight drams, in all, were administered. One diara every hour was given. During the first seven hours the symptoms were very similar to those obtained on the first trial; they need not therefore be repeated here. But the last hour 14 A MONOGRAPH UPON GELSEMINUM. of the animal's life was accompanied by symptoms worthy of especial notice. All the symptoms of general muscular prostration, and paralysis of the vol- untary motor nerves had obtained. The condition then changed, and from a state of partial insensibility, the dog became for a moment very furious, and seemed to regain, during that brief time, all its strength. It ran across the room ; leaped upon the lounge ; over a chair ; ran howling under a table, and glared out at us with bloodshot and protruded eyes. This period of transient excitement as suddenly subsided, and he became convulsed, with heavy, stertorous breathing, dull and expressionless eyes, with some rigidity of the limbs. The beating of the heart was very feeble and slow, scarcely perceptible. The respirations became more and more stertorous, final- ly rapid and short, and the animal died without any struggle or convulsion. So prominent were the apoplectic symptoms that I predicted that we should find a lesion of some blood vessels, and extravasation, in some portion of the brain. The post mortem proved the correctness of my diagnosis, as the pa- thological appearances hereafter given, will show. The peculiar symptoms manifested by this animal just before death, arewell worth the careful study of the physiologist. How can we account for the sudden change from partial paralysis and muscular prostration, to unnatural strength and fury ? Did the sudden and furious congestion of blood to the brain so excite its vital actions that it sent down a tremendous influence to the spinal cord, sufficient to arouse it from its condition of paralytic torpor? It reminded me of what I have often witnessed in those pernicious conges- tive typhoid fevers of the West, in which the patient, after lying for days in a state of great prostration and insensibility, becomes suddenly aroused and fu- riously maniacal, for a few minutes or hours, and then sinks into a comatose state from which he never arouses. Should I meet again with such a case, I should test the value of Gelsemin- um, for if any remedy is capable of removing such morbid condition, it is this. PATHOLOGICAL APPEARANCES. Besides Dr. Miller and myself I cannot ascertain that any physician has no- ted the pathological appearances caused by Gelseminum, and those appear- ances have only been noticed in animals. Although several authenticated cases are on record of this drug proving fatal to man, no post mortem has, in such cases been had, to my knowledge. But the appearances found in ani- mals are valuable, and may lead us to important and reliable conclusions. Dr. Miller says : " In cases where death was not caused immediately, the principal manifestation was a suspension of the function Of the nerves and a derangement of the circulation. In those cases where death occurred speedily it changed the medullary structure of the brain, and destroyed the vitality of the blood in the vessels and in the lungs. Its action on the blood was to pro- duce a manifest derangement of its structure." ( College Journal Vol. 4, No. 3. ) " On dissection of animals killed by large doses of Gelseminum, I observed a constant hyperemia of the lungs and brain ; the right part of the heart and large vessels, being distended -with blood, and considerable congestion of the capillaries in the mucous coat of the intestines. The muscular fibres of the heart were dark, red, and soft. The blood within the ventricles was fluid The substance of, and membrane covering the spinal marrow, were filled with blood," " The pathological appearances caused by Gelseminum correspond with those caused by apoplexy and asphyxia, i. e., extravasations from the vessels of the brain and its membranes, and in the heart and lun^s." " The application of the Tincture to wounds in the legs of fro^s caused tet- anic spasms. (College Journal, ibid.) The appearances noted by Dr. Miller very nearly accord with those noticed by me in case of the Spaniel, before mentioned. GENERAL EFFECTS. 15 I found the brain in a high state of hyperemia. Three large drops of dark colored blood were found effused under the arachnoid membrane. Taking this fact in connection with the last symptoms of the dog, and we have a complete picture of the sub-arachnoid form of apoplexy as described by Pruss. I did not notice any changes in the medullary structure of the brain, but the substance and membranes of the spinal cord were con- gested. The lungs were in a state of active hyperemia, and much heavier than natural. The right side of the heart was filled with dark coagulated blood. In the left side of the heart some thin watery blood was found. The substance of the heart presented no unnatural appearances, except a slight unnatural redness. * Not having a suitable microscope I could not carry the examina- tion as far as I wished to do. Other important changes might have, by its use, been discovered. The pathological appearances above mentioned give us very valu- able indications for the use of this remedy in disease. It tells in un- mistakable language of the importance of noting the morbid changes caused by fatal drugs. Wo know now that Gelseminum causes a true apoplexy, and that the external symptoms were a real index of the lesions going on within the brain. The fact of its causing congestion of the spinal cord and its mem- branes, is worth all the theoretical deductions in the world, when not based upon actual observation of such pathological changes. THERAPEUTICAL DEDUCTIONS. In a general manner we can conclude that Gelseminum will prove most useful:— 1st. In many abnormal conditions of the nerves of motion, and of those organs which are supplied most freely by those nerves. It is Homceopathic to all debilitated conditions of the voluntary nervous systerr., also to those conditions of perverted nervous action, such as trembling jactitations, twitching of single muscles, choreas, spasms, (clonic) painful cramps, and contractions of various muscles, &c. 2d. To congestive conditions of the various organs of the body, es- pecially the head. Congestions of the lungs and uterus are more read- ily controlled by Veratrum viride, Tartar emetic and Aconite. 3d. To those remote and secondary affections of the organs of di- gestion ; to secondary affections of the liver, spleen, kidneys and gener- ative organs, all of which must have been preceded by some malady of the nervous centres. GENERAL EFFECTS, on the nervous System—Nerves of sensation. Gelseminum does not exert the decided and specific effect upon the nerves of sensation that we witness from the effects of Aconite. It 16 A MONOGRAPH UPON GELSEMINUM, causes none of the numbness, tingling, prickling aud crawling sensations which mark the action of that poison. The pains which may be caused by Gelseminum are not, in my opinion, caused by a primary affection of the nerves of sensation, but depend upon a certain morbid condition of the nerves of motion. Such pains are caused by cramp, like contractions of muscles and tendons, constricting certain nerves or blood-vessels, or they may arise as in case of Aconite from irritation of the ganglionic nerves, about the blood- vessels—many are probably congestive in their nature, like the pains in the head and eyes. In pure Neuralgia, this remedy can be of but little service; although it may be very useful in removing many con- sensual symptoms, such as excessive nervous irritations, drawing and twitching of the musclep of the affected parts &c. Dr. Douglas, how- ever, declares that—" A majority of all cases of Neuralgia will be promptly relieved by Gelseminum but it sometimes requires to be given in pretty large doses, repeated every half hour till the pain is relieved." Nerves of motion. Gelseminum like Nux vomica, Angustura, iEsculus, Ignatia and Strychnia, does primarily affect the nerves of motion, but in an opposite manner. It depresses and paralyzes these nerves, while they excite, and irritate. But while the action of Gelseminum differs from that of Strychnia in this respect; in another it affords a remarkable resemblance. Both cause hypersemiaof the spi- nal marrow, which may increase to actual engorgement or extravasa- tion. This condition is not brought about as soon by Gelseminum as by Nux vomica, but the condition when obtained has very nearly the same results. But while the active congestion of the spinal marrow caused by Nux vomica, is accompanied by an exalted and tense state of the motor nerves, even to tetanic spasm; the passive congestion of Gelseminum is accompanied by a paralytic or debilitated state of those nerves, or a condition exactly opposite to tetanus. Gelseminum may cause death by prostrating and exhausting pri- marily the energies and vital power of the nerves of voluntary and involuntary motion. While Strychnia, Nux vomica, &c., would pro- duce death from the same cause, but the fatal prostration would be secondary; the exhaustion being preceded and caused by the primary irritation aud spasmodic action of those nerves. Gelseminum may also cause death by congestion and apoplexy of the brain and spinal marrow. Nux, Ignatia and Strychnia may also cause death by producing such a congested condition of the spinal cord and its membranes as to lead to final hemorrhage into those important tissues. CLINICAL REMARKS. The primary Homoeopath;city of Gelseminum to paralysis from loss of motion will be dis^as^ed in other places. Its use in very many forms of Convulsions may here be alluded to. The other schools of medicine, viewing this drug as a powerful anti-spasmodic, would see it indicated in nearly all forms of convul- GENERAL EFFECTS. 17 sion. It has been used in both clonic and tonic spasms in Epilepsv, Chorea, Hysteria, &c. I gave it in one case of severe Hysterical Epilepsy—a young girl after suppressed menses had attacks every evening, lasting an hour or two, during which time so severe was the spasm of the glottis that asphyxia seemed really impending. The attacks had been every day for two weeks. Five drops of the tincture were given at three and again at six o'clock P. M. At seven, the usual hour, no spasms ap- peared, and did not return until the next menstrual period, when the remedy had no effect, and Asafoedita, in oue grain doses, every four hours was resorted to, which brought on the menses and cured the spasms. I have treated many cases of Hysteria from various causes with this medicine, and I know of none, more generally useful. Eclectic writers claim to have cured cases of Chorea with Gelse- minum. In the three cases, treated by me, one recovered, one was benefitted, and one, a case of years continuance, seemed to be aggra- vated. In Tetanus, it would seem to be one of the most powerful Anti- pathic remedies, yet I cannot find a single recorded case, treated with this remedy. After testing the medicines Homoeopathic to the dis- ease, like Nux Vomica, Ignatia, Aconite, &c., I should resort to the Gelseminum with a good deal of confidence. We know that it pro- duces its peculiar prostrating effects, even to an extreme degree, without causing any local lesion. Now it often happens that no ma- terial traces of disease can be discovered either in the brain and spi- nal marrow of persons dead of Tetanus. Dr. Gerhard declares that of the twelve cases he examined no lesion whatever could be detected. Some of the secondary symptoms of Gelseminum strongly resemble this disease. A trial of this agent is to be hoped for in this formid- able malady. In Hydrophobia also, no appearances have been found which could account for the fatality of the disease. In this terrible malady, Gelseminum ought to be found useful if not curative. In material dosos it telaxes all the muscles, calms the fury of nervous excitement, relaxes the glottis, and prevents spasms. Why should it not be val- uable in Hydrophobia? The spasms in this disease are brief and clonic, similar to the secondary ones of Gelseminum. The circula- tion is much disturbed (excited). The dog killed with it could not drink while under its influence. Were I to become hydrophobic. I should take Gelseminum and "await the end." Since writino- the last page, several of my colleagues have reported to me cures of spasmodic croup in children, made with Gelseminum' used according to my suggestion. I have no doubt but it will prove an invaluable remedy in that malady, named by Wood—" Infantile spasm of the Glottis.11 It is known in medical works under the name of Laryngismus Stridulous, Asthma of Millar, &c. The essential 3. 18 A MONOGRAPH UPON GELSEMINUM. nature of the disease is a general morbid excitability of the nervous system, directed especially to the muscles of the glottis, which con- tract spasmodically. It has been said to arise from irritation or inflamation of the cer- vical portion of the spinal marrow, (that portion most irritated by Gelseminum) the presence of worms in the intestines, &c. From whatever cause it may arise, the Gelseminum if not a cura- tive remedy, properly—will be a valuable palliative, used in drop doses of the first dilution or mother tincture, frequently repeated; it must procure relief in the majority of cases, while during the inter- mediate time, it should be alternated with Belladonna or Hyoscya- mus, Arsenicum, or Moschus. MUSCULAR SYSTEM. The most prominent of all the effects of Gelseminum is to induce a profound and intense prostration of the whole muscular system. Its effects are first manifested on the voluntary muscles, afterwards on the involuntary. No remedy so suddenly and surely destroys the tone of muscular structure, but it acts not by causing any disintegra- tion or disorganization, but by impairing the vitality of those nerves which supply it with life. This property of Gelseminum can be made subservient to the physician in many ways. In cases of obstinate tonic couvulsions and cramplike rigidity, full doses, sufficient to bring the muscular system under its pathogenetic action, will promptly remove such morbid conditions. There is no danger in this method of administering the remedy, for one of the pe- culiarities of its action is that there is no permanent injury done to the tonicity of muscular structure, urftess its use is long persisted in, and wantonly abused. In this respect it a^ts wonderfully like chlo- roform. Like Chloroform, it will be found very useful to the Surgeon, when in cases of dislocation or fracture, reduction is rendered difficult or impossible by a rigidity of the muscles of the part. In such cases the system may be brought under its influence very readily. It does not however give that insensibility to pain, which is the prominent effect of chloroform. It is freely used by some obstetricians in cases of rigidity of the os- uteri, or external parts. King advises it in all such cases as being much superiar to Lobelia, as well as pleasanter, as it does not nause- ate nor cause that sense of deathly prostration so peculiar to that drug. I have used it successfully in such cases, as well as for those severe spasmodic pains which sometimes come on in labor. In such instan- ces it must be given in appreciable doses, of five, ten or fifteen drops, repeated if required; a slight dimness of sight is a good indication that the remedy is acting. ^ GELSEMINUM SEMPERVIRENS. (Yellow Jessamine.) FEVERS. 19 VASCULAR SYSTEM™HeartandArteries. Pulse frequent, soft, weak,—so feeble as to be sometimes impercep- tible. Fluttering pulse. Pulse full 120. Pulse slow and full, or slow and soft. Sensation as though the blood had ceased to circulate. (Various Observers.) (See Note.) * Heart's action slow and feeble. The beats of the heart cannot be felt. In case of the dog, the action of the heart was very rapid, but feeble, so fast that the pulsations could scarcely be counted. (Hale.) The action of the heart and arteries much depressed with cold hands and feet, chills, and pain in the head. (Douglas). Pathological appearances. In Dogs : The right side of the heart and large vessels were distended with blood. The muscular fibres of the heart were dark red, and soft. The blood within the ventricles was fluid. (Dr. Miller) The right side of the heart was filled with dark coagulated blood. In the left side a quantity of thin watery blood. An unnatural red- ness of the substance of the heart. The great bloodvessels were filled with black coagulated blood. (Hale). CLINICAL REMARKS. In diseases of the heart, particularly in those iu which the chief in- dication is to diminish the action of that organ, Gelseminum will be found a valuable remedy. In some forms of functional derange- ment it will often effect a cure. In material doses it will alleviate those case3 of excessive action of the heart from plethora, congestion, neuralgic or rheumatic irritation, or hysteric palpitation. Like Aconite, and Veratrum Viride, Gelseminum is not Homoeo- pathic, or curative in any organic affections of tbe heart, but like the above named remedies and Digitalis, it is a very valuable auxiliary in the treatment of those maladies. It is an excellent palliative iu those troublesome symptoms which affect the head and eyes, during the progress of heart disease. The sensation of fulness, heaviness, giddiness, throbbing, jerking, &c, the dimness of sight and other amaurotic symptoms are admirably met by small doses of Gelseminum or its alkaloid. FEVER. Within a few minutes, sometimes within two or three, a marked " Xotk Its action on the pulse is well illustrated by the observations of Drs. White and 1'orcb of Charleston S. C. In tbe treatment of Yellow Fever they found that the Gelseminum appeared to influence the volume of the pulse before its ireqtiency. The following shows its effect upon the pulse in disease: Mean frequency of pulse. When first given, Twelve hours after, Adult Males. Beats per minute. 112.4 55.4 Adult Females. Beats per minute. 101.3 54 H Children. Beats per minute. 122 2 70.9 20 A MONOGRAPH UPON GELSEMINUM. depression of pulse, which becomes 10,15 or 20 beats less in the1 minute, if quiet, but greatly disturbed by movement. Chilliness, especially along the back, pressive pain in the head, most generally of the temples, sometimes in the occiput, at others over the head. The chilliness is soon followed by a glow of heat and prickling of the skin, and quickly succeeded by perspiration which is sometimes profuse and disposed to be persistent, continuing from twelve to twenty-four hours. As soon as the reaction takes place after the chill the pulse rises as much above the normal standard as it was before depressed below it. With these symptoms is a puffy, swollen look, and feeling of fulness of the eyelids, slimy and disagree- able or bitter taste in the mouth, languid feeling in the back and limbs and sleepiness. (Douglas.) Febrile chilliness, cold extremities, especially the feet, heat of head and face with headache. Pulse uniformly depressed and rendered less frequent with chilliness, cold feet, heat and pain of the head.— (HidVs Jahr.) (This statement regarding the pulse is erroneous. I have found that In both men and animals, it often increased the rate and frequency of the pulse. Sometimes even the volume of the pulse seemed increased, but generally it is diminished. An explanation of this phenomenon will be found in the par- agraph " Head.") Derangement of circulation as shown in the fluctuations of the pulse from 70 to 120. Chilliness with vertigo, headache and coated tongue, cold extremities, inclination to "hug the fire," with chills following each other in rapid succession from sacrum to base of occi- put. (Dr. F. L. Vincent.) Dr. M. E. Lazarus, a well known painstaking prover, could not get any such prominent symptoms as recorded by Dr. Douglas. He however experienced a languor, with inclination to stretch, some slight chilliness, with feeble flashes of heat. He suggests that per- haps Dr. Douglas is very susceptible to the action of Gelseminum. My impression would be the same, as I have given it to healthy per- sons, in all manner of dos^s, yet never heard any one mention such decisive symptoms as those of Dr. Douglas. Still it is undoubtedly primarily Homceopathic to the pathological conditions upon which all real chills depend, and secondarily Homoeopathic to febrile con- ditions or the reaction which follows those conditions. In this respect it is somewhat similar to Aconite, and others of the same group. But it is only a general, not a particular resemblance. (There is one form of rigors, or "nervous chills, as they are sometimes called, in which, with shivering and chattering of the teeth, there is no sen- sation of chilliness. It is an irritated condition of the nerves of motion, and is seen in hysterical subjects, or appears during a fright or other mental emotion in he lthy persons. It is often seen during parturition, and is said to attend relaxation of Sphincter muscles. Now Gelseminum causes just such rigors by establishing similar conditions as the above, and a small dose of the tincture will control readily such morbid manifestations.) FEVERS; 21 In Simple Fever, without functional disturbance, Dr. Douglas de- clares it to be specific, given at the onset of any fever of simple un- complicated character, it will undoubtedly arrest it very promptly. It seems peculiarly adapted to the fevers of children and sensitive fe- males, while Aconite and Veratrum Viride are more applicable to adults, of robust and rigid constitutions. In the so-called Irritative Fever, it will be found a valuable rem- edy. It is more capable of meeting the majority of the symptoms of that malady than any remedy which I have used. It corresponds with the excessive nervous irritation, the tendency to irregular con- vulsive action ; the periods of wakeful debility; and the accessions of feverish stupor. In cases however, complicated with hepatic, or gastric difficulties it will have to be aided by Mercurius, Podophyl- lum, Ipecacuanha and Tartarus emeticus. Should the lungs be im- implicated it might answer alone, but Phosphorus, Bryonia or An- iimonium crudum will be of service. If the bowels are affected, Pulsatilla, Mercurius or Chamomilla may have to be given; al- though some of the provings seem to indicate that Gelseminum affects the intestinal functions. Wood, with doubtful propriety, classes Infantile Remittent, as well as Worm Fever, with Irritative Fevers. There may be some general affinity, as Gelseminum has proved use- ful in each. Since 1 have treated infantile remittents with this rem- edy, I have conducted them safely through their course with better satisfaction than before. Dr. R. Ludlam, in his article on the " Therapeutics of Infantile Remittent Fever," in the N. Am. Journal of Homoeopathy, says:— " Excepting the Aconite, there is certainly no remedy with which the pro- fession is at present familiar, which promises so much as the Gelseminum, in the treatment of this variety of the remittents of infancy and childhood." "From personal observation (and these hints have their origin in this source only) we should be inclined to recommend Gelseminum in those re- mittents which are primarily characterized by excessive irritability and ere- thism, either of the general or special nervous systems. There is perhaps no single means which, under ihe various circumstances which accompany and give good evidence of the aforesaid pathological condition, promises so much as this. We have sometimes failed with Aconite, with Chamomilla, and with Belladonna, to allay the excessive restlessness and disquiet occasioned by what the old nurses style an " inward fever" iu a little juvenile, and at other times have succeeded at once in its relief by a few doses of Gelseminum." ( I [Hale] have found the Scutellaria, or Cypripedium, in drop doses of the Mother Tincture, to succeed in calming the nervous irri- tability of children, and even adults, when all other remedies had failed. A trial of these " nervines," so called, or their active prin- ciples, will give satisfaction in all cases of nervous erethism.) " This remedy appears also to be well adapted to the relief of those attacks of this fever which border closely upon intermittens, examples of which might readily be mistaken for a masked fever of that peculiar type. In such cases, as well as those which toward their cl se, degen- eiate into ague, in one or another of its protean forms, we may pre- 22 A MONOGRAPH UPON GELSEMINUM. scribe a low attenuation of the G-elseminum with the confident hope of success. In our hands, indeed it has proved almost a specific for those remittents, the diagnosis of which, from a more definitely paroxysmal form of fever was not readily made out. We have also cured several well marked intermittents with it, but its sphere of usefulness would appear to lie somewhere along the boundary between these and the purely idiopathic remittents of which we have been speaking." The real value of Gelseminum in Intermittents, is not yet to a cer- tainty ascertained. Some Homoeopathic Physicians, among them Hol- combe, Ludlani and Douglas, assert that it will cure agues. Holcombe with characteristic boldness, gives us the following odd prescription for a Homceopathic one: For intermittents with cerebral symptoms, with hyperesthesia predominating— Recipe—Sulphate of Quinine, 10 grains, Gelsemin, 1 grain, Divide into five parts. Begin six hours before the expected paroxysm, and give one part every hour. " Indications for use. When the paroxysm has been marked by violent pains, referable to the cerebro-spinal, rather than the ganglionic system, and by correspondingly intense burning fever, great nervous restlessness, sensi- tiveness to light and sound, mental agitation or anxiety, delirium, sleepless- ness, curious sensations of falling, swimming from giddiness, partial blind- ness or deafness, especially applicable to nervous, excitable subjects, and to mild fresh cases, without prominent gastric or hepatic symptoms, in short, before any visceral complication has been engrafted on the nervous phenom- enon." (This last clause, I (Hale) regard as well indicating the sphere of action of Gelseminum in agues, but in the ' indications' proper, Holcombe has mixed up the primary with the secondary symptoms of the drug, which rarely appear together. The dose however that he advises is very nearly of the proper quanti- ty. Of the quinine, I think he prescribes altogether too much. In very similar cases, I have succeeded admirably with one-fifth or one-tenth grain doses of Quinine, alternated with one-tenth or one-twentieth grain of Gelsemin, or two or three drops of the mother tincture. Holcombe's prescription would undoubtedly arrest the paroxysms promptly, but it would be apt to give rise to visceral complications, which smaller doses would avoid, and at the same time be equally as efficacious.) Dr. Ludlam writes me— " Perhaps in the whole range of its clinical virtues there is no more satis- factory and really valuable use which can be made of the Gelseminum than in the treatment of those intermittents which might properly be styled post-iyhoid. It is to this expecial form of imtermittents, which succeeding upon an adynamic condition of system, are characterized by a want of d\s- tinctness in their several stages, and which are of a masked type and in- tractable in nature, that the Gelseminum has in our experience seemed to be particularly applicable. We have remarked the evident tendency in patients suffering with enteric fever, and who had but recently removed to the city [Chicago] from miasmatic districts, to sequela? of this order. Scarcely any FEVERS. 23 such patient has escaped this characteristic convalesence, and in none of those cases in which we have ordered this remedy have we failed to witness the best results from its employment, while in years past, such cases were es- pecially perplexing and tedious, we are free to express our pleasure in and appreciation of a means so entirely successful. These patients were all from the Southern States." John C. Morgan, M. D., author of a short proving in the April number of Sliipmari's Journal of Materia Medica, writes as follows : " It seems worthy to be called a specific for fresh cases of Intermittents, and will modify even old cases, changing double to single tertian. My dose is one-fourth drop in a teaspoonful of water, usually. I send a few clinical cases. (a) " W. S., a swarthy soldier of large frame, on going into camp, May 11, had no blanket, slept on straw under leaky sheds—the night being cold awoke early in the morning with a severe chill, but little shaking, fever en- sued. Took at a dose ten drops common Tincture Gelseminum. Fever augmented with slight delirium. Took five drops—some aggravation. Du- ring the afternoon and evening took fractional drop doses. No fever at night. The next day took one-fourth drop every two hours. He had no other par- oxysm." Remarks. This may not have been an attack of Intermittent. Such ehills followed by fever, are often the result of exposure, or getting wet. Still, had it not been for the Gelseminum, it might have resulted in some form of protracted fever. (Hale.) (b) A soldier of sanguine temperament had Diarrhoea and rheumatic pains with symptoms of Intermittent. Took for several days one-fourth drop Tincture Gelseminum, and was cured. Intermittent Fever. Case I. " Iu one case I had used all the usual anti-periodics, as Cornine Salicine, Quinine, £c, without success. Even after producing the'constitu- tional effects of Quinine, the chills would return, sometimes every day for awhile, then every other day. Thus the case continued for several weeks, until I despaired of success with the other anti-periodics, so I determined to try the Tincture of Gelseminum. Accordingly I left an ounce of the tincture of the fresh root, directing it to be given in doses of thirty drops every two or three hours until the eyes were affected, then the medicine was to be sus- pended until that passed off, then again resumed as before, and so on until the fever was broken. I saw the patient just as the chill was gone off and commenced the Tincture of Gelseminum immediately. The fever did not rise very high, nor continue long, nor did the chill ever return. The patient recovered from the time he commenced the medicine and was soon up at his usual avocation. Now what still more astonished me was, that the medicine never affected his eyes in the least, yet it suspended the chills immediately. I had frequently combined the Tincture of Gelseminum with the other anti- periodics before and met with very prompt success, yet I attributed it to the other articles, but this time I determined to try the Gelseminum alone,— [Sensible !—Hale.'] (Dr. Goss, Eclectic Medical Journal.) Case II, Nov. 4.—Intermittent Fever (tertian type). Has been affected six months, has pain in the head and pains over the body when he has no chill tongue not much coated, other symptoms common to the disease. Treatment.—Alkaline bath once a day. Recipe—Tincture Gelseminum, one-half dram three times a day. Nov. 17. Discharged cured.—(Newton's Clinical Reports.) The above are the only two published cases of Intermittents cured by the medicine alone. Very many cases are reported of pretended cures by Gelseminum, but as it was always given so mixed with Qui- 24 A MONOGRAPH UPON GELSEMINUM. nine, Hydrastin or other drugs, that no reliance can be placed upon the reports. Dr. H >lcombe write* me thit the Gelseminum was the basis of sev- eral celebrated Patent Medicines, noted at the South for the cure of re- mittent and intermittent fevers, that it certainly was the principal in- gredient in "Speed's Tonic," which at one time was popularly consid- ered an unrivalled febrifuge, but failing to cure those ca^es attended with organic complications it fell into disfavor, although it is still used by many people in the South. " From large doses I have seen blindness, partial deafness, singular torpor, stupidity of feeling, inability to open the eyelids, and nervous prostration, such symptoms as would follow a state of nervous excitement or hyperses- thesia. In small doses I have found it valuable in the opposite conditions. I class it with Aconite, Belladonna, anil Chamomilla. I have used it in the summer months for weeks at a time as I would Aconite. I believe in addi- tion to its febrifuge power, it has a specific anti-periodic influence. Dr. Douglas praises the Gelseminum, in drop doses, very highly in simple uncomplicated Intel mittents, when indicated by the symptoms, and speaks of having met with much success in its use. Dr. Ludlam has cured several well marked cases cf Intermittent Fever with the low dilutions Several of my colleagues report cases of ague, suc- cessfully treated with Gelseminum. I have used it frequently in Intermittents, and have succeeded in some servere cases in curing the disease, after it had been arrested with Quinine, but showed an obstinate tendency to return. These cases were reported in full in the August number of the North American Journal of Homoeopathy for 1861. It can be used both during the apyrexia, and iu the paroxysm. In larger doses during the former state, than during the latter. It will be found to control the painful nervous sensations which arise during the fever, better than Aconite, if indicated. An Eclectic Physician, engaged in a large practice in the State of Ohio, informed me that except in severe congestive cases, he relied altogether upon Gelseminum to break up the paroxysms of Fever and Ague. He stated, however, that he always gave a sufficient quantity to cause almost complete- blindness during the apyrexia, I can hardly doubt the veracity of my in- formant, but I suggested to him that he might break the patient, as well as, the ague. He had no fears of that result however. I am not aware that any Homceopathist has advised or used Gelsem- iuum in Typhoid or Enteric Fever. But its pathogenesis and phys- iological action has many points of resemblance to that form of Typhoid designated as Nervous Fever, i. e., when there is no intestinal lesion or any particular local complication. It is specifically indicated in those cases in which the patient, from some great excitement, or over-exertion, suddenly sinks into a low typhoid state, with great prostration of all the vital forces, and when he experiences strange sensations in the head, with morbid condition of the motor nerves, manifested by local paralysis, or continued jactitation of certain muscles. Women are more subject to this variety than men. With the former we have many hysteric symp- toms, such as nervous dysphagia, even hysteric spasms, sleeplessness^ aberration of sight, &c. GENERAL EFFECTS. 25 Gdsemiiium 3hould here be cautiously given in drop doses, or pel- lets cf the 2nd or 3d, and alternated with perhaps Ignatia, Scutel- laria, or Baptisia. In true enteric fever, I .should not place much reliance on Gelsem- inum. There are other remedies which pathologically correspond, and are consequently more specific. Among these are Baptisia, Rhus toxicodendron, Phosphoric Acid, Arsenicum, Terebinthina, and Muriatic Acid. In Yellow Fever, Gelseminum has not been used by the Homoeo- pathic school, I believe. Drs. Holcombe or Davis, make no mention of it in their reports to our Homoeopathic Journals. They relied up- on Aconitum, Belladonna, Arsenicum, Lachesis and Argentum Nitricum. The Eclectic and Allopathic schools have used it to some extent, but the only published report I can find relating to it, is a pamphlet, by Drs. White and Ford, of Charleston, S. C. The report was en- titled the " Bradycote [whatever that may mean] treatment of Yel- low Fever by Gelseminum Sempervirens." They prepared a tinc- ture from the fresh root as follows : Recipe—Radix Gelsemini four ounces, Alcohol (95 per cent.) and Aqua communis, each 8 ounces. To adults they gave of this 20 to 30 drops; to children, from 5 to 20: every hour for the first four hours; then at longer intervals, and with doses half as large. The manner in which it affected the pulse is shown by a table under caption of " Vascular system." Total num- ber treated with Gelseminum 24; all of ivhich recovered. Of these, fifteen were males and nine females. Adults 12, children 12, whites 22, blacks 2. Of tho whole number treated two vomited black vomit, five passed black vomit downward. In three cases hemor- rhage occurred from the tongue, gums or nasal passages. One woman was in the sixth month of pregnancy, and did not abort. Average Duration of Treatment. Adult Males. Day*. Adult Females. Days. Children. Days. 7.4 9.3 | 8.5 No marked prostration was caused by this remedy. The pulse be- ing, however, much less quickly reduced than by Veratrum Viride. In few cases was the heart's action fully lowered in less than twelve hours, and it was well controlled throughout the rest of the disease, in the majority of cases. The concurrent treatment was the same as with Veratrum. Mercurialization was complete in ten cases, incom- plete in fourteen cases. In a few instances a marked redness of the tongue was observed, a condition that was not distinctly noticed du- ring the administration of Veratrum. [This symptom has been often noticed in my provings. Hale]. The Gelseminum appeared to produce a general calming influence even during the early period of its administration, but was not found to possess any marked narcotic 4. 26 A MONOGRAPH UPON GELSEMINUM. propei ties. It seemed to promote the action of the kidneys, and du- ring its use only, in several cases, an erythema of the skin was no- ticed. This drug appeared to influence the volume of the pulse, be- fore it affected its frequency, and in most cases for the rest of the disease to control boih conditions in an equal manner. Emesis was not observed to ensue upon the administration of this medicine; the gastric irritability peculiar to the disease beiug moreover to all ap- pearances favorably influenced. There were treated by Veratrum viride 117 cases, of which 15 died. Of six treated by the ordinary method [without Veratrum or Gelseminum] three died. In Scarlet Fever, the Gelseminum bids fair to rank with Bella- donna. Besides being indicated in the peculiar intense fever, with nervous erethism, its well known action on the Skin will render it of value in impelling the eruption toward the surface. It causes a peculiar erythema, which has some resemblance to the eruption in Scarlatina as well as some forms of Purpura. Its analagous relation to both Belladonna and Aconite, strongly commends it to our favor, and if we are to judge its curative powers from its pathological effects, it will be found efficient, alone, where the former remedies are indicated. Dr. H. W. White, of Coldwater, Mich., speaks verv highly of its effects in Scarlatina. He asserts that it will-control the pulse, calm the nervous erethism, determine the eruption toward the surface, re- lieve pain, and lessen the cerebral congestion, in a manner superior to Belladonna or Aconite. Cases which seemed quite formidable at their commencement, soon assumed a milder character, and termin- ated safely. He considers it effectual, alone, to control the majority of cases. Should the disease assume a malignant character, Dr. White alternates it with Ammonium Carbonicum, Carbo-Vegetab- xlis, Muriatic Acid, or Arsenicum. Its use should be suspended, if symptoms of prostration set in. In Measles, the Gelseminum appears to be specifically indicated during the forming and "inflammatory stage [the eruptive]. Among its pathogenetic symptoms we find prominent catarrhal conditions, as "chilliness, watery discharge from the nose, hoarseness wilh feeling of soreness of the throat and in the chest, cough, &c." Among its effects upon the skin we find " a papulous eruption very much, the color of measles, which it closely resembles, but the papulas are more distant and distinct. It appears most frequently upon the face." Relying upon these fragmentary, yet prominent indications, I have treated several cases of Rubeola ve noticed would go far to substantiate such a belief. Let it be borne in mind that anything which has a severe depressing influ- ence upon the nervous and vascular systems may cause miscarriage. Thus, profuse bleedings, a chill, debility from acute disease, grief, fright or other depressing emotions, will in some constitutions tend to such an accident. Now the effects of this drug on the female organism, is very similar to the above, and may therefore under similar circumstances bring on the same results. Its general action on the uterus will be considered further on. In the vomiting and gastrodynia of pregnant females, when of a spasmodic character, Gelseminum may prove beneficial. Some writer has called attention to the similarity between this vomiting and sea- sickness. It is a curious fact that the remedies found beneficial in the one, are those most useful in the other. Thus nux vomioa, cocculus and chloroform are the remedies for sea-sickness, and I have found equally reliable in the severe vomitings of pregnancy. As Gelseminum bears a remarkable resemblance to the last men- tioned agent, I would advise its use in single drop doses, in cases where the usual medicines had failed to give relief, and where there was present considerable nervous debile irritability. GENITAL ORGANS. 47 The troublesome cramps of pregnancy, although generally amenable to the usual Veratrum album, Colocynth and Nux vomica may be controlled as readily by the use of Caulophyllin, Viburnin and Gel- semin. King in his " Obstetrics" speaks of using it in hour-glass contrac- tions, and inversion of the uterus, in order to aid manual operations, but doubts its safety under all circumstances. In these cases it would be expected to have many of the effects of Chloroform, especially relaxation. He also strongly advises its use in puerpural convulsions. In the treatment of the form of puerpural convulsions depending on Uraemia, I should place much reliance on the remedial powers of Gel- seminum. It will be found of much service in moderating the vio- lence of the fits as well as to run off by its diuretic effects, some of the urea and carbonate of ammonia upon which the primary morbid con- dition depends. Of the use of Gelseminum in rigid os uteri, Dr. Kino says: " It has within the last few years, been recommended to overcome this dif- ficulty, and I have administered it in a considerable number ot cases with benefit. It possesses an advantage over Lobelia in not causing nausea and vomiting, but as a general rule its influence is not so readily experienced as with that drug, and when once effected is of a more permanent character." [Donotjgive so much then, Doctor. J Prof. Cleveland, Dr. L. E. Miller, and many other writers eminent in the Eclectic and Allopathic schools speak very highly of the use of Gelseminivm in difficult labor from rigidity of the os or vagina. They consider it much more efficient, and its administration attended with less suffering and danger than Chloroform, Belladonna, Lobelia or artificial dilatation. I am not aware that it has yet been recommended in Homoeopathic practice, but I do not hesitate to declare it superior to any remedy usually recommended in our school. It may be applied locally to the os, in the form of the glycerole of Gelseminum; one to [two drams should be rubbed into the rigid os, with the finger. Croserio advises the administration of a few pellets of the 30th [!] of Belladonna. Jahr says, u If the neck should remain closed, and a hard rim should be felt all around the orifice, three globules of Belladonna dry upon the tongue will bring about the regular evolution of the progress of labor," or "if the dilatation of the vagina proceed too slowly, or be too painful, a few doses of Coffea, Secale, Pulsatilla or Nux vomica, will remedy this trouble." This latter prescription is much more scientific than the former for Coffea, Secale, Pulsatilla and Nux vomica undoubtedly cause rigidity of the vagina and os uteri, as a primary effect. But there is not a par- ticle of proof that Belladonna does. On the contrary, the well-known and invariable primary effect of Belladonna is to cause paralysis or relaxation of all the sphincter muscles. Gelseminum has many points of resemblance to Belladonna, but none more similar than its effect on the sphincter and circular muscles, 48 A MONOGRAPH UPON GELSEMINUM. all of which are primarily relaxed and even paralyzed. It dilates the pupil, paralyzes the glottis, relaxes the sphincter of the bladder and rectum, and those muscles of the os uteri and vagina, upon which their contractile power depends. While, then, it has a similar action to the Belladonna, it can be used with greater safety, for its effects are generally transient, and may be controlled, if excessive, by such a general remedy as common salt, or specific, such as Secale or Caulophyllum. The large doses of Gelseminum advised by Eclectics, are not neces- sary. From two to five drops of the tincture, or even first dilution, if good, will, in most cases, be found sufficient. There is one other argument for the use of Gelseminum in some difficult labors, which, if made reliable by the test of observation and experience will bring the medicine into deservedly high repute. I al- lude to the statement made by several prominent writers, but particu- larly Coe, whom I quote as follows: " Some division of opinion exists in relation to the true action of this remedy upon the uterus. We have had considerable experience in the treatment of female disorders, and have used the preparations of Gelseminum quite exten- sively. For Ave years past we have employed it as & parturifacient, and with better satisfaction than any other remedy. We use it for the purpose of relieving cramps, or other spasmodic difficulties, vertigo, nervous irritability, wakefulness, and other symptoms accompanying gestation. It seems to pre- pare the system for the parturient effort, and labor is completed in an un- usually short period of time. When administered in small doses, it gently stimulates uterine contraction, but when given in large doses it will arrest the progress of labor, with much certainty." The same writer seeks to account for this and other peculiarities of its action as follows: " Gelseminum is one of those medicines which are peculiarly governed in their action, by the quantity administered. Thus in small doses it acts as a gentle stimulant and tonic to the nervous system, giving vigor and harmony of action; while in large doses it proves a powerful relaxant, completely pros-' trating the muscular system, and by overstimulating the brain and nerves, produces irregular and disturbed nervous action." This sentence undoubtedly embodies the real sphere of action of this wonderful remedy, as well as the true rationale of its curative powers in disease. The explanation is worthy the staunchest disciple of Hah- nemann, for it indicates as strongly as words can, that it cures according to the law of Similia, i. e., it cures in small doses, that ivhich it causes in large. Air Passages.—Paroxysms of hoarseness with dryness of the throat; voice seems weak. [Douglas]. Sneezing followed by tingling and fulness in the nose, sneezing,with dull headache. Tingling in nose. (J. C. Morgan.) Paralysis of the glottis, with difficulty of swallowing; ineffectual efforts to articulate; voice thick, as if the tongue was too large; cough from tickling and dry roughness of the fauces; burning in the larynx THORACIC ORGANS. 4'J and down in the chest, under the sternum; a sensation of soreness in the chest when coughing. [Hale] Pathology. Mucous membrane of the larynx and bronchia red and congested. Clinical Remarks. Dr. Douglas considers it almost a specific in ordinary catarrhal fever with the usual symptoms of sneezing, watery coryza, soreness of the throat, and cough with rawness in the chest. During the winter of 1860-61 I treated a great many cases of se- vere influenza, then epidemic, in which the symptoms much resembled the above,'only more intense, often nearly approaching to acute bron- chitis. Gelseminum was the principal remedy relied upon. It seem- ed to act very favorably in cutting short, or modifying the disease. Only a few cases needed Phosphorus or Mercurius iodatus in alterna- tion. In Acute Bronchitis it will doubtless be found as useful as Aconite or Tartar emetic. In Croup, I have had no experience with it, except in one case of Spasmodic, in which a few doses seemed to arrest it. In Aphonia, from catarrhal paralysis it is fully indicated, in small doses. Thoracic Organs.—Stitching sensation in the region of the heart. Constrictive pain around the lower part of the chest. [Douglas.] Offensive breath; slow breathing and slow pulse, (primary) followed by rapid breathing, and quick, weak pulse (secondary). Sudden sensa- tion of suffocation, as in hysteria. Respiration almost imperceptible. Sighing respiration. (In men). [Hale.] Breathing unnaturally slow. Heavy and labored respirations. In- spirations, were of a sighing, catching character. Slow breathing with rapid pulse (primary). Respiration hurried and seemingly painful. Inspirations long with croupy sound. Expirations sudden and forcible. Sterterousbreathing, like one in apoplexy,—with coma and convulsions, followed by rapid breathing, collapse and death, (secondary), (See cases of poisoning in dogs). Pathology.—No post mortem examinations have ever been made on per- sons killed by Gelseminum, but the following pathological appearances have been observed by Dr. T. C. Miller, and myself, in animals poisoned by the medicine: Active Hyperaemia of the lungs; Lungs highly congested, heavy, sinking in water, but evidently not inflamed. Lungs bluish at the base, crepitating but little, and filled with venous blood. Clinical Remarks.—But few painful symptoms of the che*t have been observed by the provers of Gelseminum. This I presume can be accounted for on the supposition which the pathological appearances seem to uphold, that it does not cause inflammation, or any disturb- ance of the nerves of sensation of the thoracic organs. In this respect 7. 50 A MONOGRAPH UPON GELSEMINUM. it ranks with Aconite and Veratrum viride. It undoubtedly first attacks the nerves which control the respiratory movements, acting primarily as a sedative, causing more or less paralysis; and secondarily, irritating the same respiratory nerves into irregular and spasmodic action, with concomitant hyperemia. The venous congestion, I imagine to be the result of an inability of the veins to return the blood to the heart, from paralysis. The secondary symptoms shown by the dogs, were evidently of a spasmodic character, as regards the respiratory efforts, whilethe pri- mary respiratory symptoms, were as evidently the result of a sedative influence on the nerves. The therapeutic sphere of Gelseminum in thoracic affections may be briefly summed up. It is primarily indicated in paralysis or debility of the lungs, of a nervous origin ; and in passive congestion. It is secondarily indicated in all affections of the lungs and pleu- ra, which are marked by erethism, or vascular irritation; or when congestion is to be feared, or is already present; also in all spasmodic affections of the lungs and diaphragm, such as convulsive hiccough, certain forms of asthma, spasms of the air passages, convulsive coughs, &c. In real Pneumonia and Pleurisy, it is not truly homoeopathic, but may be used with benefit. The remarks of Dr. Marcy, relative to the action of Aconite on the lungs, are perfectly applicable—it appears to me—to Gelseminum. " It is highly probable, as we have already observed, that many of the pulmonary symptoms, produced by Aconite, are due to its specific action up- on the brain, rather than any direct impressions on the lungs. Normal res- piration and circulation can only be sustained by an unimpaired condition of the brain. Even when the impression upon this organ is slight, we observe an immediate change in the action of the heart and lungs. The inhalation of Chlorofo:m or Ether, for example, which exercises a specific influence upon the brain, causes an almost immediate acceleration of respiration and circulation—the pulse often rising to 140, and the respirations to 26 or more, in the minute." I have called attention already to the similarity of Gelseminum to Chloroform. It is probable that as soon as the Gelseminum produces a decided impression upon the brain, the symptoms of pulmonary sedation cease, because counteracted by the cerebral influences, and we have acceler- ation of the respiration and circulation. Let it be borne in mind too, that in some spinal diseases, various spasmodic affections of the lungs set in. The influence of Gelsemi- num on the spinal cord may induce similar symptoms. Dr. Douglas says:— " In the first stage of the disease (Pneumonia) as in most other inflammatory diseases, Gelseminum is capable of breaking up the disease in the first twenty- UPPER EXTREMITIES. 51 four hours by producing free perspiration. Repeat it as occasion requires till the fever and pain abate. Gelseminum is more prompt and effectual than Aconite and Bryonia if given at an early stage." Backt—Pain in the back as in the cold stage of ague, (in many cases). (Dr. Douglas.) Chilliness and chills running up the back from the loins to the nape of the neck. (Dr. 'F. L. Vincent.) _ Rheumatic pains in the left side of the neck. Contractive sensa- tions in the right side of the neck. A settled, dull, dragging head- ache, mainly in the occiput, mastoid, and upper cervical region, ex- tending to the shoulders, relieved when sitting, and by reclining the head and shoulders on a high pillow ; aching in the left anterior°part of the trapezius muscle. Thirst, languor, and aching in the sacro- iliac and lumbar regions, and the lower part of the left thigh, as when a fever is commencing. (Dr. J. C. Morgan.) Clinical Remarks.—It is homoeopathic and curative,—as I have often verified—in many of those aches and pains in the back, shoul- ders, neck and occiput, which so often precede or follow attacks of ague, or nervous fevers ;—also when these or similar pains are of a neuralgic nature, arising from some form of spinal irritation; or come on as the result of a cold, having somewhat of a rheumatic character. I predict that it will prove to be homoeopathic to many of those anomalous cases of spinal irritation, or chronic myelitis, which resist the usual remedies, Nux Vomica, Ignatia, Belladonna, Agaricus, Ma- crotin or Aconite. In paralytic conditions of the lumbar or sacral muscles, it is espe- cially indicated. The dog killed by Gelseminum, showed decided symptoms of opis- thotonos. The muscles of the neck and dorsal region were at times spasmodically contracted, throwing the muzzle of the animal nearly perpendicular. It may, therefore be found curative iu this form of convulsion. Upper Extremities. Coldness of the wrists and hands. (Dr. Douglas.) Itching about the elbows and fore arms. Some heat and dryness of the hands. Hands, especially the palms, feel hot and dry. Drawing-aching about the left elbow. (Dr. Morgan.) From large doses, the arms become powerless, with loss of volunta- ry motion; sensation remains intact. In doors the fore legs were not paralyzed until some time after the hinder limbs. In attempting to walk—dragging the posterior extrem- ities—the fore legs tottered as if weak, and finally gave way; then clonic contractions seized them. It would seem to be homoeopathic to paralysis of the arms, with 52 A MONOGRAPH UPON GELSEMINUM. loss of motion, but not sensation, (the reverse is true of Aconite), also when the paralyzed arms are affected with cramps and contractions. It may be found useful in some forms of rheumatism of the arms induced by a cold, and not inflammatory, attended with loss of mo- tion. Lower Extremities. Coldness of the extremities, especially the feet, often severe; feet feel as if in cold water, aguish feeling, with pain in the legs; pain in ppplitial spaces. (Dr. Douglas.) Aching in the left rectus femoris muscle, and drawing in the right calf; transient crampy pain in the inner part of the thigh when walk- ing ; rheumatic pain in the right knee and left side of the neck, the latter when lying down, the former when walking. While walking, a feeling in the knee joint as if the relation of the bones were de- ranged and did not fit, as in partial luxation; pains in the left thigh and knee; sudden catch or twist in the inside of the patella. (Dr. J. C. Morgan.) Paralytic symptoms made themselves manifest throughout the en- tire muscular system—first experienced in the knee and then in the inferior tibial region, increased unto falling. Loss of voluntary mo- tion in the lower extremities. Fatigue of the lower limbs after slight exercise. Soreness in the gastrocnemii muscles as if they had been beaten. (Dr. F. L. Vincent.) The paralysis caused by Gelseminum is first manifested in the lower limbs, which become weak and then powerless, but with no loss of sen- sation, at least not until the near approach of death. The dogs dragged their posterior extremities for some time before general paralysis took place. While paralyzed, the limbs were af- flicted with clonic spasms. It seems to be homceopathic to rheumatic pains iu the legs, ac- companied by crampy sensations, and weakness of the knees. Skin. The Gelseminum produces a very marked eruption in most of the cases. It appears on the face most frequently, but sometimes also upon the back, between the shoulders. It is papulous, very much the color of measles, which it closely resembles, but the papu- lae are more distant and distinct. Though very conspicuous, they are attended with little or no sensation—the patient being unaware of any eruption until he happens to see himself. Persons have frequent- ly been asked what was the matter, or if they had the measles, when they were not aware of the eruption. It generally appears the sec- ond or third day of the proving, and continues one or two weeks more. (Drs. Douglas and Snelling^s Provings.) An eruption of vesico-pustules—painless, but having no other an- alogy with measles, appeared during my proving on the inside of my thighs. (Dr. M. E. Lazarus). SLEEP. 53 Intense buttransient itching of small points on the face, at the edge of the hair, and on the scalp, pimple, quite sore, having the areo- la embracing the diameter of a pea, red and inflamed, (such an erup- tion not experienced at any other time.) The pimple appeared on the forehead and neck, sore to the touch, and seemed like small cuta- neous indurations, or minute furunculi. They finally disappeared without suppuration. (Dr. J. C. Morgan.) During its use—in yellow fever—a constant erythema of the skin was noticed, and a redness of the tongue; neither appearing during the administration of Veratrum viride. (Drs. White and Ford— Allopathic.) Clinical Remarks.—Its action on the skin is at once specific and peculiar. Taking into consideration its catarrhal symptoms, and we may consider it indicated in measles, as well as some other painless non-suppurating eruptions. Its use in erysipelas and exanthematous fever, has already been al- luded to. Dr. Coe writes : " We have found the tincture an excellent remedy, for poisoning by the Rhus toxicodendron and Rhus radicans. Dilute the tincture with from four to eight parts of water and apply as directed for erysipelas, keeping the parts constantly moistened with it. If there be any febrile excitement present, administer the tincture internally at the same time. * * * We have experienced the value of this remedy in our own person and can recommend it as reliable. Other practitioners have used it with success. * * Many forms of skin diseases [what ?] may be benefitted and cured by the internal and external application of the tincture." Sleep. Disposition to sleep; a sort of stupor; cannot keep the eyes open; is obliged to lie down and sleep. Drowsiness and long sound sleep are very general symptoms. (Douglas.) Drowsiness with dimness of vision; a kind of drunken stupor. Heaviness of the eyes as after night watching. (F. L. Vincent.) At first it seemed to cause drowsiness, afterwards aggravated the habitual sleeplessness. (M. E.Lazarus.) Unusually sound morning sleep, with difficult, weary waking (after taking 25 drops the day and evening previous.) Languor and drow- siness when trying to study,—slept an hour in the afternoon, and on being roused felt unwilling at first to move,—-eyes transiently blood- shot. (J. C. Morgan.) It cannot be considered a narcotic ranking with opium. Still it has some narcotic traits, in common with Aconite, Chloroform, Alco- hol, or Hyoscyamus. Unless taken in large quantities, it rarely indu- ces sleep by its direct effects, but it may give sleep by removing ner- vous erethism. It more resembles the so called nervines, Scutella- ria, Cypripedium, &c. The dogs, poisoned with Gelseminum, seemed sleepy, and " nodded" while under its effects. But actual deep sleep did not appear until 54 A MONOGRAPH UPON GELSEMINUM. the last moments, and then in the form of Coma, with heavy, sterto- rous breathing. (Apoplectic Coma.) We have the following opinions of writers of other schools: Professor Tully considers it a narcotic, and places it in a group with Spigelia. " It must be borne in mind that Gelseminum is narcotic. Some division of opinion exists as to whether the Gelseminum has a narcotic property. We should think that a very slight experience would be sufficient 10 decide this question. When the patient is brought fully under its constitutional influ- ence, the symptoms are so marked that we cannot conceive how the remedy should be deemed otherwise. On attempting to move about, the patient appears as if intoxicated; the muscles refuso to obey the mandates of the will, while the head is dizzy and the senses confused. In some respects the symptoms much resemble those produced by Stramonium, and in like man- ner pass off as soon as the remedy is discontinued; at other times the patient appears as if under the influence of Alcohol, and evinces a decided disinclin- ation to motion, and tendency to sleep, from which he awakes invigorated and refreshed." (Dr. Coe.) Whether it is a narcotic, is not yet satisfactorily established. (Dr .King.) Clinical Remarks . That Gelseminum is homoeopathic to Coma, from congestion of the brain, or apoplectic effusion, we have the proof of actual observation on animals. It is in those comatose states caused by cerebral congestions that we shall find it a valuable remedy. I have called attention to its usefulness in the stupor attending the fevers of children. [Infantile remittents.] It will be equally useful in the stupor of typhus cerebralis, or any form of typhoid, when Coma is a prominent symptom, and the other symptoms correspond. It may also be beneficial in the low delirium of typhoid fever. When used for the above, the low dilutions are advised. In that peculiar stupor, or drowsiness, felt by students and persons of sedentary habits, especially in hot weather, and not caused by he- patic torpor, this remedy in small doses, continued for many days, is as capable of affording relief as any drug I have ever used. When depending on hepatic derangements, it is removed by Podophyllum, Leptandria, or Nux Vomica. In Delirium tremens, or morbid wakefulness of drunkards, large doses, (5 or 10 drops) of the tincture, repeated as often as necessary, will be found as useful as opium, in some cases, and more efficient in others. No remedy so happily controls the sleeplessness and agitation of teething children, students, persons laboring under mental excite- ment, or hysteric females. The first dilution will usually suffice. GENERAL SYMPTOMS. Weakness and trembling throughout the entire system; listless and languid; great lassitude ; feeling of lightness in ihe body; fear of falling; easily fatigued; general feeling of illness as in fever, so prostrated that he can neither move hand nor foot; no power over any GENERAL SYMPTOMS AND ANALOGUES. 55 muscle; strange, indescribable feeling throughout the entire system. Clinical Remarks. The only symptom in the above which we need to notice in this place is the one in italics. It very frequently appears in persons suffering from spinal exhaustion, particularly when caused by onanism. This fact I have observed in several cases. A very few other remedies in our Materia Medica have this symptom. The general symptoms of Gelseminum can be arranged in a more practical manner—in such a way as to give a clear idea of the gener- al sphere of action ; its primary and secondary effects, and as a guide to the selection of the dose. ^ In the following parallel columns will be found as clear an exposi- tion of its general eftects, as the state of our present knowledge of the remedy permits us to possess, as well as its analogues in the va- rious conditions which it is capable of producing : Primary Symptoms, AND PATHOLOGICAL STATES Caused by Gelsemincm, and in which should be used the dilutions from the 1st upward. General Muscular prostration, with weakness or paralysis of the nerves of motion. (Chloroform, Alcohol, Lobe- lia, Aconite, Nux vomica,