Surgeon General's Office 1 . ■ V ■' T *' •■- ^V'h, .:J !r) ■'-')' ~»0Q.GQO'G1"'■'•" QX30T. t" ~'> • •'"> v$i ■ ■ :y* NEW-YORK: WILLIAM RADDE, 322 BROADWAY. 1848. Wl / c is indicated when vomiting is joined to a disposition to mucous evacua- tions. Wieum. 9th, is used when there is softness and fulness of the abdomen, frequent alvine evacuations of brown matter, mixed with mucus, and tensive sensation at the pit and in tin; region of the stomach. Pulsatilla 12th, is employed in irritable and delicate persons, if accompanied by 44 diseases of the shivering, frequent vomiting of mucus, and mucous evacuations. Antimonium crudum 9th, is used when we observe great weakness and extraordi- nary slowness of digestion. Ferrum and china are also employed with success, especially when the disease arises from the abuse of laxatives. Ipecacuanha 3d, is especially efficacious in almost all cases of obstruction, and may be administered in repeated doses. Many patients suffering under affections of the abdomen, experience pains in the sto- mach and liver, jaundice, abdominal obstruc- tions, haemorrhoidal tumors, etc. These affections are of frequent occurrence, especi- ally in persons from forty to fifty years of age, and of sedentary habits. In such cases, nux administered daily or every two days, is always found more useful than any otlier means ; though, at times, the symptoms have required other remedies, such as calcar., bryon., sulj)h., lycopod., sepia, graphit., silic, carb. veget., phosph. Case l._One of the patients, who was always obliged to remain in a sitting posi- tion, was reduced by the affection almost to despair. The chief symptoms were obstruc- tion of the liver, jaundice, hemorrlioids, ALIMENTARY canal. 45 constipation, flatus, puffing of the abdomen, severe pains on the right side of the chest, continuing for several hours and extending to the middle of the thorax and to the hips, impeding and frequently preventing respira- tion, ceasing for some time and again com- mencing more powerfully than before, both by night and day. During the spasmodic attacks, the pulse was beating one hundred and twenty times in a minute, the face be- came red and the head confused, terminating in oppressive headache. This condition had existed for four days, without any remedy affording relief. Aeon., nux, coloc, ars., curbo an. and vcget.< and phorph., performed a perfect cure in less than six weeks. Case 2.—A young man, who had been hypochondriacal for some years, and had become weak and emaciated, complained of haeinorrhoidal affections, frequent colic, con- stipation, wind, spasms of the abdomen and chest, with loss of sleep. He had become restless, timid, morose, and often very irrita- ble. A few doses of mix, phosphorus and nux again, combined with anacardium, re- moved the principal symptoms; the evacua- tions became regular, the appetite and diges- tion improved, the spasms ceased, the sys- tem gained strength, physically as well as morally. 5 46 DISEASES OF THE Case 3.—A female had been suffering for five years under almost daily darting pains on the right lower region of the abdo- men, which extended as far as the loins and back; there were hemorrhoids, frequent tenesmus, constipation, flatulence, swelling of the bowels, legs and feet, accompanied with pain, coldness of the hands and feet, character susceptible, morose and depressed. Three months exhibited a cure by the use of sulphur, nux, coloc, phosph., nux and phosph. again. ALIMENTARY CANAL. 47 CONSTIPATION. This is a very common disease. Its se- verity varies Math the causes which produce it. Sometimes it is an accessory of other affections, or the consequence, as already observed, of some organic change in the in- testines. The most common constipations, which continue during several days without being accompanied with any other accident, have generally for their cause the too scanty se- cretion of the liquids necessary in digestion, or a particular weakness of the intestines. They attack chiefly women and old men, and are occasioned by a sedentary life, a dry kind of nourishment, advanced pregnancy, the abuse of remedies, or a predisposition resulting from previous constipations. Constipation is always accompanied more or less with other affections of the abdomen ; the difficulty, however, of discovering them renders it necessary for the practitioner to undertake a careful examination of the pa- tient. Frequently we find the patient suffer- ing also from a sensation of fulness or op- 48 diseases of the pression at the stomach and epigastric region after eating, and that for several hours ; fre- quently also there exists a ravenous appetite followed by nausea, temporary heat in the face and a pressive pain in the head. In these cases high dilutions are preferable to low, because they speedily remove the dis- ease without producing accessory symptoms. The treatment is regulated according to the causes of the affection. Opium 6th, is very salutary in case of a simple constipation, which does not originate from an internal disposition or a malady of long duration, but from external circumstan- ces, particularly from those which have a de- bilitating influence upon the nervous system, and when that constipation, without being truly painful, presents the following symp- toms : desire to relieve the bowels, with sen- sation as if the intestines were obstructed, and there existed impossibility of evacuation, beating in the abdomen, pressure at the sto- mach, want of appetite, thirst, dryness of the mouth. Case.—For a patient, having a sallow com- plexion, loss of appetite, tendency to vomit, flatulence, pressure at the stomach, constipa- tion, dry cough, was prescribed tincture of nux vomica, one drop night and morning, advising him to increase the dose one drop' ALIMENTARY CANAL. 49 every day. An improvement was speedily manifest without any crisis. At the end of fifteen days, he had quite recovered ; the cough left him in a short time. Constipation constitutes very frequently a separate disease often produced by abuse of coffee. Out of many cases, one was very remark- able. During six days, no motion, giddiness, stupor, intoxicating heaviness in the head, especially in the morning, great heat and redness of the face, dryness of the mouth, acid and bitter taste, heartburn, nausea, especially in the morning, loss of appetite, flatulence, pressure at the stomach, swelling of the stomach after eating, shooting pain in the abdomen, tenesmus, pain in the rectum and loins, oppressive constrictive pain in the chest, sleep disturbed at night, great lassitude and drowsiness in the morning, restlessness, great general depression. A few doses of pure tincture of nux vomica removed these symptoms entirely. The following cases occurred lately in my own practice. Case 1.—An elderly, man had, for up- wards of twenty years, suffered from consti- pation, accompanied by severe headaches, to such an extent that he was compelled every few days to absent himself from business, 5^ 50 DISEASES of the having fulness in the stomach after eating, tongue dry and loaded, etc. He could exist only by taking, every second day, a dose of some aperient medicine, which relieved his head for the day only ; the pain returning as regularly as possible the following day. The stomach had become so weakened by repeat- ed purgatives, that it was unable to digest even the best food ; and they had produced a distressing disease of the lower intestines. He complained likewise of dull pain in the region of the liver, which was much increas- ed upon pressure. Sulphur, in five weeks, enabled the bowels to act daily, and the headache entirely subsided. Case 2.—An old naval officer was placed, in early life, on the West India stations, where he had yellow fever several times and with difficulty escaped with life, leaving on one occasion only eight or tenon board his vessel. These attacks produced disease of the liver, and consequently confirmed consti- pation, which had existed upwards of thirty years when I saw him. He informed me that, during that time, he had never obtained relief from the bowels without aperient medi- cines : taking them regularly every second day, they had become as necessary to his existence as food.- Accompanying this state of stomach and bowels, were most distressing ALIMENTARY canal. bi headaches, and great depression of the ner- vous system. Though introduced to me, he did not expect anything like permanent re- lief. Nevertheless, after continuing for two months the medicines I prescribed, the bow- els became regular and acted daily ; and, upon seeing him many months afterwards, he told me that, during that time, he had not taken or required one dose of aperient medi- cine. The remedies were nux. 30th, bryon. 30th. and verat. 12th, every second or third day in succession. Case 3.—A gentleman had long suffered from an eruptive disease covering great part of the body. At the same time he com- plained of dyspeptic symptoms, such as acid and bitter eructations, fulness of the stomach and bowels after eating, with pain in the region of the liver and consequent constipa- tion. I prescribed verat. for the skin dis- ease, to which it yielded. At the same time, the stomachic symptoms subsided, and the constipation gave way ; so that, at the end of two months, although he had not taken pur- gative medicines of any kind, as previously in the habit of doing, at least weekly, he as- sured me his health was in a much better state than for many years before. Case 4.—A medical man, who had lived 52 DISEASES OF THE * in the country where he was accustomed to horse exercise and active life, upon his set- tling in town, where he had now resided nearly twenty years, soon became affected with derangement of the digestive organs— such as nausea, giddiness, weight and pain in the head, loss of appetite, distention of the stomach after eating, with acid flatulence, loaded tongue, pain in the liver, general falling away, and palpitation of the heart to such an extent that in bed the clothes were often lifted up. This continued for several years, when the bowels became obstinately constipated, requiring purgatives, tonics, alkalines and alteratives continually. He informed me that a week never passed with- out medicine—seldom a day without either soda or a purgative. All these means were discontinued; and, by the use of calcarea carbonica, and subsequently carbo vegetabilis, the dyspeptic symptoms subsided, and the constipation was removed. Upwards of three years have elapsed with no return of the complaint. Case 5.—Colonel P. had resided many years in a warm climate, and during the greater part of that time, had labored under irregularity and derangement of the bowels, which terminated in confirmed constipation. Having lived freely, he had two or three ALIMENTARY CANAL. 53 attacks of inflammation of the liver, which produced induration and evident enlarge- ment. He had frequent fits of vomiting, with acid and bitter eructations, weight and fulness of the stomach and bowels, particu- larly after eating, restless nights, headache, tongue loaded, dryness and thirst, kidneys much affected, and was altogether much emaciated. Bryonia, vcratrum and opium were given in succession, when all the symp- toms gradually yielded ; and in from three to four months, the patient was convales- cent. Constipation in Women.—In this case, ex- ercise, especially in the open air, abstinence from coffee and heating drinks, and the use of fruit, are necessary, and assist the action of mix 8th, which is in most cases the requisite treatment. If this only improves the condi- tion without curing it entirely, we may ad- minister ignat. 6th, gl. 2, after which mix 10th, again. In some cases, bryony 6th, gl. 2, opium 2d, gl. 2, and vcratrum will answer. When the constipation is obstinate, it will be advisable to assist these remedies with lave- ments. If all these fail, we must then have recourse to plumb., alum., plalin., sepia, and especially the two last. Bryony is still more important in cases of lying-in women, when constipation arises 54 DISEASES OF THE very frequently from inflammatory irritation of the abdominal organs, to which this reme- dy is strikingly adapted. We may in the same manner treat the constipation which usually occurs in the first days after delivery, if it do not speedily dis- appear of itself. Case.—A lady, the wife of a professional man, had suffered from constipation for up- wards of twenty years, and during the last four or five years, had been obliged to take aperient medicine daily. In such a way, indeed, had purgatives been administered, both as to quantity and quality, that they had produced ulceration of the lower intestines, discharging blood, pus and mucus, in quan- tities that became alarming. She had long suffered from torpid, if not diseased, state of the liver, and great weakness both mental and bodily, etc. She was much reduced and fast hastening to the grave, when I was con- sulted. Six doses of nux and bryonia entirely removed the constipated state of bowels, and the general health rapidly improved. Occa- sional doses of nitric acid restored the ulcera- ted bowels to health, and the discharge gradu- ally ceased. Nearly five years have since passed with no return of the disease; and though not a single purgative has been since taken, the general health is better than at any previous period of life. ALIMENTARY CANAL. 55 Constipation in Children.—The first point necessary is to regulate the regimen of the child and the nurse. Care must also be taken that the child be not too much confined by its clothes. The constipation of new-born children has usually for its cause food which does not agree with their age, especially when they are not suckled, or when, besides the milk of their nurse, they receive more solid food. It may be prevented by adding to that milk, in cases when it is not sufficient, only very light substances, such as cow's milk mixed with water, pigeon or chicken soup, water gruel slightly boiled, etc. If the patient be in good health, a lave- ment of warm milk, water gruel, with or without castor oil, is frequently sufficient: should it fail, another lavement of honey water will be certain to produce the effect. If the mother is not accustomed to coffee, two or three spoonsful may be administered to the child. When these dietetic precautions are not sufficient, we must have recourse to interna, remedies. For this purpose, mix 10th is appropriate, especially when the mother has been accustomed to coffee, in which case it is a specific. Hut it is also efficacious in other cases, for instance, when coustipation is pro- 56 DISEASES OF THE duced by undigested food, or when the alvinc excretions are so hard that the child cannot void them without great straining, pain and blood. Next to this stands opium 2d, which is indicated when the peristaltic movement of the intestinal canal is, so to speak, destroyed, when there exists no inclination to obtain relief, and the abdomen gradually swells. Advantage has sometimes been derived from a higher dilution than that just mentioned. Next to these two remedies, bryon. 10th, 1 and 2, veratr. 10th, 1, are most effective. The first operates in a manner very similar to nux vomica, and frequently succeeds when the other has failed, and vice versa. With respect to veratrum, it is most efficient in cases where the rectum appears deprived of all action. When the disease is very obstinate, tinc- ture of sulphur, or lycopodium 30th, are very successful. Calc. carb., and zinc are equally valuable: the latter is one of the best reme- dies in constipation in children. Sulph. in the morning, and nux vom. at bed-time, are sovereign remedies against con- stipation. In very obstinate constipation, alumina and plumbum will be found very efficacious, the former given in the morning, the latter in the evening, especially when in- ALIMENTARY CANAL, 57 effectual efforts to evacuate are present; or if the faeces are hard, dry, broken, and evacua- ted with a great deal of straining.] COLIC. Colic is a pain, generally pinching, tearing, tensive, without any symptom of inflamma- tion, without fixity or continuity, rarely burning, which affects the interior of the ab- domen, especially the region of the umbili- cus, tends almost always from above down- wards, and has often for an accessory a -.swelling of the abdomen. The stomach be- ing exempt from suffering, or that being only accidental, if that viscus contains no impuri- ties, the patient scarcely ever vomits; and if that does occur, he ejects only the matters contained in the stomach, mixed with a little bile. There is sometimes accidental consti- pation, more frequently a little diarrhoea, rarely any fever. In children, after evacuation of urine, more considerable than ordinary, we often remark much agitation and impatience, con- tinual crying, sudden screams, contortions which disfigure the countenance during sleep, sleeplessness and cramps. They draw up 6 58 DISEASES OF THE I the limbs, bend them, and are incapable of lactation. The treatment of colic is regulated princi- pally by the causes which have produced it. In children, it is usually caused by cold, or by worms : in adults, by severe cold, by ex- cess in eating and drinking, but often also by a particular disposition to flatulence and to hemorrhoids. Chamomilla 12th, or pulsotilla 15th, cures colic produced by a cold, when it presents the following symptoms: violent, cutting, tearing pains in the bowels, causing agita- tion which allows the patient no rest, a sen- sation as if the abdomen were entirely empty, with continual commotion in the intestines, dark circles around the eyes, frequent collec- tion of saliva in the mouth, violent and tear- ing pain below the navel, pains in the loins, nausea, inclination to vomit, diarrhoea, eva- cuations green, watery, and mixed with mucus. Nux vomica 24th, for adults, 30th, for children, causes the prompt disappearance of a colic characterized as follows: constipa- tion, sensation of a heavy weight in the ab- domen, extraordinary heat, considerable ten- sion of the part, with anxious, short, and painful respiration, fulness of the abdomen and under the ribs, shooting, pinching, com- ALIMENTARY CANAL. 59 pressing pains, as if the intestines were press- ed, violent and confusing pain in the head, the abdomen painful to the touch, loss of consciousness, the extremities cold at the moment when the affection is most violent. Windy colics, which have their seat in the lower part of the abdomen, yield to the same remedy in cases in which the air, seeking a passage, produces pressure, as if by a sharp or cutting instrument, towards the bladder and rectum, a pressure which is acutely felt at every step, but which repose, the sitting or the lying position, cause quickly to disap- pear. Mercury 10th, for adults, 12th, for chil- dren, and cina, are successfully employed against colics caused by worms, the symp- toms of which are great inclination to vomit, collection of saliva in the mouth, twisting in the bowels, with sensation of hardness around the umbilicus, convulsive twitchings in the muscles of the abdomen, frequent hic- cough, disgust for food, continual desire to relieve the bowels, the abdomen hard and swollen, tensive and burning pain, eructa- tions, general weakness, diarrhoea, evacua- tion of mucus, with pains in the bowels, es- pecially towards midnight. The symptoms of colic produced by excess of nourishment or by unhealthy food, are: nausea, weight, with a feeling of extension 60 DISEASES OF THE and of painful tension in the abdomen, tear- ing, pinching, and cutting pain, increased by touch, white saliva foaming from the mouth, pains above the navel, diarrhoea, evacuations green, or of a citron color, with violent pain in the stomach, countenance pale, dark cir- cles round the eyes, slight convulsions of the limbs, bending of the body, pressive and ten- sive headache. Haifa cup of strong coffee would have the effect, in persons who do not make habitual use of that beverage, of eva- cuating the superabundant or unhealthy ali- ments contained in the stomach and intes- tines. When this means has produced the desired result, it should, after some hours, be followed by pulsatilla 18th. Pulsatilla 12th, is the best remedy against hemorrhoidal colics, of which the usual symp- toms are the following :—beating at the pit of the stomach, a painful feeling of constric- tion as if it were too full, borborygmi in the abdomen, the escape of flatulence prevented heat and swelling of the abdomen, general heat with swelling of the veins of the hands and forehead, insupportableness by the pa- tient of all vestments, greater suffering when in bed, movement procuring some relief, pains in the loins, an almost entire incapa- bility of dressing, pain in the abdomen as if a blow had been received, agitation,anxiety, sleeplessness. ALIMENTARY CANAL. 61 Colocynth 30th, is very efficacious against various kinds of colics, especially when they cannot be ascribed to a known cause. But it is more particularly indicated by pains in the abdomen, violent and continual, or ceas- ing only to re-appear with greater intensity, and leaving in the parts that have been af- fected a pain of tearing which produces at every step a sensation as if the intestines were freely suspended, which obliges the pa- tient to walk very slowly and with extreme caution, the pain experienced in the umbili- cal region sensible chiefly at a small point of small extent, recurring only at intervals of from five to ten minutes or even longer, com- mencing always by slight shootings from the ribs to the centre, which gradually aug- ment, becoming constrictive, pressing, tear- ing, dragging, and reach such a degree of violence that the patient utters loud cries, the anxiety and pain allowing him no rest, and compelling him to writhe with the agony. Colics, with which some women are at- tacked at the commencement of the catame- nia, usually disappear when it has occurred; but the affection may, in certain circum- stances, continue and become very distress- ing. Nux vom. 30th, is then often employed with success, especially when the disease is characterized by a twisting in the abdomen, 6* 62 DISEASES OF THE with some nausea, a poignant spasmodic paift in the pelvis chiefly about the ischium, which becomes remittent, pressive, or shoot- ing, with constriction in the region of the bladder. Coffee 3d, causes the disappearance of the following symptoms : pains in the abdomen, violent and spasmodic, which affect even the chest, bending of the body with convulsions of the limbs, grinding of the teeth, general cold, crampoid stiffening, loss of respiration, sighing, fulness of the abdomen, with pressure. Pulsatilla 18th, may be employed in the same circumstances when they are accompa- nied by violent and pressive pain of the ab- domen and loins, and by an evident shooting from the trunk to the thighs, which ceases when seated, and to which are joined a pain- ful pressure on the rectum, and pains in the back. Frequent colics may produce a disposition to be attacked by them from the slightest causes, and may even become the origin of organic changes. HEMORRHOIDS. This disease, which is very common, has for its cause an impediment to the circulation ALIMENTARY CANAL. 63 in the vessels of the abdomen, and has al- most always for its precursor a long series of affections of the digestive organs. It attacks chiefly men of middle age, and women after the suppression of the catamenia, and it is characterized by obstinate constipation, by congestions in the head and chest, vertigo, palpitation of the heart, pains in the back, tenesmus, itching in the perinaeum and in the rectum, excrescences about the anus, colics, etc. It re-appears at fixed or indefinite pe- riods, and has commonly for its result a more or less considerable excretion of mucus or blood. During pregnancy, we generally find some disorder in the alvine secretions, and haemor- rhoidal effusions. Two or three weeks after delivery, every motion is accompanied by lancinating pain in the rectum. In a short time, the evacuations occur every three or five days, the excretions being dry and hard. After long and inefficient efforts, no relief is obtained, or at most but of a small quantity of matter; the pain in the rectum reaches the greatest degree of suffering, with anxious perspiration of the face, and tendency to syn- cope ; with the evacuation a discharge either of pure blood, or sanguinolent mucus; after which the heat and shooting pains in the rec- tum remain for some time. The anus itself forms a round, hard, livid tumor. There are 64 DISEASES OF THE continual pains in the loins, extending to- wards the back, especially during move- ment. Hemorrhoids may be divided into two large classes, internal and external, and each of these classes may be subdivided into fluent and dry. The patient ought above all things to ob- serve a severe regimen, to take much exer- cise in the open air, to keep the feet warm, and to avoid coffee, wine, spirits, and mental excitement. In the first place, however, it will be well to point out the principal remedies most likely to be successful in the disease of which we treat. Most of the antipsoric remedies iaiay be beneficially used, amongst which we recognize arsenicvm, antimonium crudum, calcarea, graphites, mercurius, phosphorus, sulphur. These may be alternated with aconite, ar- nica, nux, pulsatilla, etc., used as intercurrent medicines. Arsenic.—In cases of large, burning, ulcer- ated external hemorrhoids. Antimony.—In fluent hemorrhoids, with excretion of black blood, and burning and pricking sensation. Calcarea.—Expulsion of hemorrhoids dur- ing evacuation, spasmodic contractions of the rectum. ALIMENTARY CANAL. 65 Graphites.—Painful hemorrhoids secreting a mucous liquid. Mercurius. — Inflammation accompanied with tearing pain around the margin of the anus, evacuations acrid and bloody, excoriat- ing the extremity of the rectum. Phosphorus. — Itching hemorrhoidal tu- mors, with small ulcers allowing the dis- charge of a great quantity of blood. Flow of mucus from the anus, which remains open. Sulphur.—Hemorrhoidal colics followed by discharge of blood, expulsion of haemor- rhoids, descent of the rectum. Aconitum.—Extensive hemorrhage from hemorrhoidal tumors; hemorrhoidal fever, violent inflammation of the tubercles, which are hard, bright and ready to burst. Arnica.—Hemorrhoidal tumors caused by external violence. Nux.—Constipation, pressure on the rec- tum, tenesmus before and after evacuations, discharge of blood-stained mucus; dry hae- morrhoids, painful during evacuation. Pulsatilla.—Excretion of yellowish mu- cus, hemorrhoidal tumors, with smarting and soreness. I would here direct attention to the fact that, with the exception of arnica, apsoric medicines cannot alone cure hemorrhoids produced by external violence, such as long riding, or wearing bandages which exercise constant pressure on the part. In all other 66 DISEASES OF THE cases, we should have recourse to antipsorics, alternately with apsorics, according to the indication. When, besides a disagreeable itching, he- morrhoidal excrescences occasion a continual and violent burning, accompanied by diar- rhoeal evacuations, we employ with success capsicum annuum 15th: arsenic, alb. 30th, possesses the property of dispelling this burning in the rectum and the neighboring parts. Case 1.—A female, aged twenty-two, mother of six children, of a venous-arterial constitution, had been for two years suffering from blind hemorrhoids, arising principally from a sedentary life, and the habitual use of very strong coffee. She one day found three tumors at the anus, as large as nuts, which produced great throbbing and burning pain, and prevented her sitting down. The pain extended half way up the rectum, accompa- nied with febrile symptoms, heaviness of the head, vertigo, loss of appetite and constipa- tion. An allopathist prescribed twenty leeches, hip-baths and emollient lavements. This treatment was continued for eighteen days, during which the patient had ninety leeches and thirty-six hip-balhs. Instead of the disease, however, being in any way alle- viated, the symptoms increased to an extra- ordinary degree, the patient suffering exces- ALIMENTARY CANAL. 67 sive pain, which no narcotic could relieve. The medical attendants declared that no re- source was left but to extirpate the tumors, which they asserted was necessary on ac- count of the formation of cancerous ulcers. This was the advice of many eminent prac- titioners who were called in consultation. The friends, being alarmed, determined to try the homoeopathic treatment. The following was her condition :— Ijoca I Affection.—The patient tossing about in bed, and complaining of burning, shoot- ing and throbbing pains in the anus and its vicinity, which she described,as similar to those that might be produced by a red-hot iron. Outside the anus and extending in- wards were three tumors as large as nuts, in- flamed, and having on (heir internal surfaces some excrescences of a very painful nature that bled at the slightest touch. The whole internal surface of the anus was ulcerated, and secreted an ichorous liquid. Sympathetic Affections.—Weight and pres- sure at the occiput; loss of appetite, tongue dry, chapped and hot; violent thirst, consti- pation ; ardor urinae, loss of sleep, skin dry and hot. and dread of death. Ars. 10th, 3, was prescribed, suspending all other remedies. This selection was determined by the shooting and burning pains, the ichorous dis- charge, and the moral symptoms. 68 DISEASES OF THE After the powder had been taken half an hour, the patient slept undisturbed for three hours, when she no longer suffered the vio- lent pains. A second dose of arsenic 10th, % was pre- scribed. The following day the patient ex- perienced only a slight sensibility at the anus when seated. She had a copious evacua* tion. The tumors had diminished during the night in size, redness and sensibility; the ichorous discharge from the anus had ceased, as well as the ardor urinae. The patient was now left three days with- out medicine, at the end of which time was administered, in consequence of the consti* pation and loss of appetite, nux 10, 3. From this time, there was a general improve- ment, and the patient was enabled to leave her bed. Sepia, nux vomica and sulphur had thus in a very short period entirely removed an affection that had been regarded as incu* rable. In suppression of hemorrhoidal flux, for several months ; continual vertigo, occasion- ally so severe as to prostrate the patient to a state of insensibility, dull pain in the head, as if intoxicated ; violent, pressive and stu* pifying headache; loss of memory ; alvine evacuations, infrequent and hard. A few doses of cole. carb. 5th, effected a cure. Sulphur 30th, effects the most perfect and the most durable cure when the disease pre- ALIMENTARY CANAL. 69 sentsthe following symptoms: continual de- sire to obtain evacuations even after diar- rhoeal or sanguinolent dejections, a darting pain of excoriation in the rectum and neigh- boring parts, with itching, burning, and hu- midity of the excrescences, which cause a constricting fulness in the rectum, and often even the descent of that viscus, violent and darting pains in the loins, and tension as if the skin and the muscles were short- ened. In hemorrhoids, especially termed blind, with constipation and shooting pains in the rectum, accompanied by various affections of a hemorrhoidal nature, or consequent on the suppression of sanguine congestions, or ha- bitual hemorrhages, congestion towards the head, continual pressive pain at the occiput, vertigo, flow of blood to the heart, great ex- citability of the whole vascular system, pul- sation throughout the body, with anxiety, oppression, disordered digestion and consti- pation, sulphur is successful. Case.—A man, aged thirty-two, of strong constitution, and arterio-venous tempera- ment, was attacked, after riding for a very considerable distance, and indulging much in heating liquors, by blind hemorrhoids, which at first only produced constipation, itching and throbbing at the anus. His me- 7 70 diseases of the dical attendant prescribed cold hip-baths, cold lavements and leeches. These danger- ous applications diminished the heat, itching, and throbbing, but had no effect on the he- morrhoidal tumors or the constipation. The bite of a leech produced an abscess, followed by anal fistula, which was operated upon by an eminent surgeon. But the wound would not heal; the hemorrhoids protruded at every evacuation; and the patient's state was worse than before; he was in the following state:— Local Affection.—The patient complained of heat, fulness, and throbbing at the part. The hemorrhoidal tumors protruded at every evacuation, discharging and causing heat. The incision made by the operator six weeks before was not yet closed. Tu- mors as large as nuts were apparent exter- nally when the patient sought evacuation, their internal surface was livid, and covered with excrescences. Sympathetic Affections.—Weight and ful- ness of the head, face red, covered with tu- mors, appetite good but soon satiated, fre- quent eructations, pressure and tension of the two hypochondria, impeding inspiration, scanty evacuations with copious expulsion of flatus, sleep restless, disturbed by dreams, depression, anger, discontent, peevishness, indifference towards his wife and children, ALIMENTARY CANAL. 71 of whom, however, in health, he was remark- ably fond, gloomy thoughts, propensity to commit suicide. Here there was clearly a well-developed case of hypochondria resulting from hyper- venosity of the abdomen. For this reason, in order to act effectually on the venous sys- tem, and render the organization accessible to treatment, sulph. 4th, gtt. 1, in a drachm of water, was administered. Never is it more necessary to begin by rousing the sus- ceptibility of the organization than in cases of exaltation of abdominal venosity, or what is called hypochondria. Every morning for eight days, the patient took one drop in a glass of water, without any evident effect, except that during the first four days, the wound occasioned by the operation was per- fectly healed. After eight days the moral state, the abundance of flatus, and the ten- sion of the hypochondria, induced the pre- scription of conium 10th, 3. Three hours afterwards, a considerable aggravation oc- curred. The moral symptoms especially were carried to such an extent, that a cup of coffee was administered. This antidote had very little effect, for the symptoms remained equally severe during two days. On the third day, however, there was an improve- ment ; the tensive pressure of the hypochon- dria, and especially the moral condition, were 72 DISEASES OF THE sensibly ameliorated. It became clear that the moral affection was closely connected in this patient with that of the abdomen; for in proportion as the pains in the hypochon- dria re-appeared, the disposition of the mind changed also. He was left for eight days under the operation ofconium, administering only a little milk and water each day, in order to satisfy his desire of taking some- thing. The conclusion of this period was follow- ed by constipation and loss of appetite, which led to the prescription of nux 10th, 3, but the nux vomica had no effect, although it was the first dilution. Recourse was then had to lachesis 10th, 2, which was more suc- cessful ; although it did not agree perfectly with the moral state, it accorded well with the primitive affection, its action being re- markably powerful upon the function of the venous system, or rather of the nervous sys- tem that influences it. Three doses were then administered, one every third day; an exhibition peculiar to lachesis, which re- quires to be repeated till the development of a manifest action, which we must be es- pecially careful not to disturb, even when it appears after the first dose. There is not in fact any medicine likely to do so much mis- chief as lachesis; it is one of the best poly- chrests we possess, but at the same time, ALIMENTARY CANAL. 73 one of the most dangerous when impro- perly applied, or repeated too frequently. In repeating a dose of lachesis, great atten- tion must be paid to the moral condition, the sleep, and the appetite ; if all be right in this respect, we may repeat the dose with confidence, although fresh symptoms have been exhibited. After these three doses of lachesis, nothing was administered for fifteen days, in order to leave sufficient time for their action to exhaust itself. It was then found that the symptoms for staphys. and natr. carb. were indicated, which was pre- scribed in dose 10th, 3. These remedies concluded the treatment, and the patient was perfectly cured after two months' application of the homoeopathic system, without recur- ring to a course of mineral water which his medical attendant had advised. Experience has proved that nux vomica 24th, is peculiarly efficacious against this dis- ease, especially when it is caused by the use of heating drinks, such as wine, spirits, strong beer, and coffee, by the influence of sedentary habits and of prolonged study, by the hardness of the faecal matter, worms, pregnancy, swelling of the abdominal vis- cera, organic injuries of the rectum and neighboring parts. When it has for symp- toms considerable excrescences which are the seat of burning and shooting pains, a 7* 74 DISEASES OF THE sense of strangling in the rectum, narrowness of that viscus, joined to dull and darting pains felt by shocks in the loins and hip- bones ; a pain as of cracking in the loins on the slightest movement, which causes the pa- tient to cry out, and does not permit him to remain erect or to walk except in a bent position, a flow of pure clear blood after alvine evacuations, or accompanied by de- sire of evacuation. Case.—Mr. S., aged thirty, of strong constitution and very corpulent, had for some years been afflicted with a hemorrhoidal af- fection, characterized by swelling and thick- ening of the hemorrhoidal veins, accompa- nied with constipation and strangury. The use of leeches applied to the part almost every month afforded the patient a tempo- rary relief, but the disease grew worse, and each time it became necessary to apply the leeches at shorter intervals. He exhibited the following symptoms: vertigo, confusion of ideas, throbbing pains in the temples as if nails were being driven in, face pale and puffed, contraction and slight convulsive movement of the eyelids, singing in the ears, tongue whitish, the patient having a sensa- tion as if it were contracted, thirst and desire for cooling drinks. In the morning, vomit- ing of slimy acid matter, mucus in the mouth ALIMENTARY CANAL. 75 Six hours after dinner, rejection of food taken, either wholly or partially, with sensa- tion of weight in the occiput, numbness of the right arm, especially of trie third and fourth fingers, (these symptoms disappeared when everything was thrown off the sto- mach,) indigestion, acid eructations, flatu- lence, constipation, continual desire to mic- turate, urine voided by drops, with sensation of heat at the prostate gland, occasionally bloody, palpitations of the heart or coeliac arteries after repose ; sensation of oppression at the chest, compelling the patient to take long inspirations, numbness in the shoulders, arms, and legs, starting and nightmare at the commencement of sleep ; lassitude and weak- ness, feeling of languor in the stomach, con- stant drowsiness, great want of prolonged sleep, yawning, sensation of cold, restless- ness, nervous depression. Nux vomica 30th, was prescribed, and a second dose three days afterwards, from which he received great benefit; afterwards, sulphur, graphites, silicea 30th, re-establish- ed his health, at the end of two months, and also removed the excessive obesity, resulting undoubtedly from a morbific cause. Case 2.—A female, aged twenty-eight, of arterio-lymphatic temperament, in whom, from the age of seventeen, menstruation had 76 DISEASES OF THE always been attended by violent abdominal spasms, and almost incessant vomiting of bile and mucus during the first days. These symptoms she attributed to a fall some time previous. She was in the following state :— Local Affection.—The patient complained of violent burning and throbbing pains, with fulness at the rectum, hemorrhoidal tumors appeared at each evacuation, no relief was obtained oftener than once in eight days, with much pain. Sympathetic Affections.—Pressive pain in the forehead and'occiput, coryza, loss of ap- petite, clammy taste in the mouth, leucor- rhcea a few days before and after the cata- menia, contusive pains in the limbs, excessive sensibility to external impressions, extreme excitability of the whole nervous system, tendency to anger and ill humor, sleep broken by alarming dreams. All these symptoms indicated nux, which was administered (10th, 3). The first dose speedily produced a good effect; the appetite improved, sleep became tranquil, and the leucorrhcea soon disappeared. It may be said that these phenomena would have occur- red of their own accord simply under the in- fluence of diet; but to meet this objection it must here be stated that the patient had fre- quently subjected herself to a much more se- vere regimen without obtaining any success- ALIMENTARY CANAL. 77 ful result. At the end of fifteen days, as there were still remains of headache, and the he- morrhoidal tumor occasionally protruded, sepia 10th, 3, was administered. Three weeks afterwards, in order to remove, the pimples from the face, and destroy the predo- minant venosity, was prescribed sulph. 8th, which produced the desired effect. In these cases a distinction is made between local and sympathetic affections, and this method will save students a vast deal of trouble in the examination of the patient and the selection of the remedy. In combining the primitive affection with the moral state, and guided by the combined appearance of the symptoms, selecting the best homoeopa- thic remedy, it is almost impossible to go wrong. There are cases in which we find no organ or system specially affected, and consequently we cannot distinguish between the local and sympathetic affection, though both are in existence. In such a case, a be- ginner should administer sulphur and bella- donna, alternately at suitable intervals, un- til the sufferings are relieved or the symptoms appear more marked, guided by which we can easily discover the proper remedy. Sul- phur may also be administered at intervals of two, four, six, or eight days, according to the susceptibility of the patient. The selec- tion of dilutions may be regulated in the 78 DISEASES OF THE same way. A susceptible patient is often acted upon as strongly by a very small dose as another, not easily affected, will be by the strongest. Peculiarity of constitution can alon^ decide the point, and hence so many opinions upon this important subject. In this matter all depends upon the extent of the patient's susceptibility, and this is the reason why hypochondriacs are frequently so long before they experience any effect. Case.—In the case of a young female, at the end of her sixth accouchement, after two attacks of intermittent fever, the inflamma- tion of the hemorrhoidal tumors extended between the ninth and the thirteenth day, gradually to the following extent: the ori- fice of the anus swollen in a round and thick bunch, divided by furrows into three unequal parts, one being the size of a small egg, the others of a nutmeg. The tumors were of a bluish-red, hard, hot, shining, and extremely painful when touched. The patient suffered extreme pain in the part, as if it were exco- riated, accompanied by violent pricking and shooting pains. The latter occurred from time to time in paroxysms, and produced in- voluntary exclamations. The patient was unable to sit, turned herself with difficulty, and always with increased pain. Muriatic acid 3d, gutta 2, cured her in ten days. ALIMENTARY canal. 79 Case.—A lad aged thirteen, who was in other respects in good health, had for several years been suffering incessantly from hemor- rhoids, in the cure of which all allopathic treatment had been found ineffectual. The affection was manifested by the following symptoms : infrequent evacuations, extreme- ly painful, every third or fourth day ; several tumors appearing at each motion with con- siderable loss of blood; in addition, they bled frequently through the day. Nux vomica and ignatia (several doses) produced regularity of evacuations, so that they occurred every day and completely free from pain. Nitric acid 15th, administered at short intervals during several weeks successively, stopped the flow of blood, the tumors gradually appeared less frequently and finally ceased altogether. The same success has been ob- tained by administering daily a tea-spoonful of ammon. carbonic. 10th, gl. 3, dissolved in six ounces of water. Before antipsorics were known, says Hart- mann, I always regarded bryony (4th and 6th,) as an invaluable remedy in cases of he- morrhoidal tumors, and even at the present time I by no means reject it, although nu- merous antipsorics are more efficacious in these affections. Its salutary influence is remarkably observable when the patient complains of burning pain in the lower part 80 DISEASES OF THE of the rectum, after evacuation, and when pain leaves him slowly. Its indication is still more certain when the patient suffers from fulness on the left side of the loins, and this fulness degenerates during movement into lancinating pressive pain, relieved only by rest, and announced by too great a flow of blood. A description of pain in the stomach, of frequent occurrence in persons suffering from hemorrhoids, after the apparition of tumors at the anus, may here be mentioned. It is also frequently met with in pregnant women, who during their pregnancy have been sub- ject to varicose veins of the legs, which after delivery cause considerable pain, and are often accompanied by headache, diminished by rest and increased by motion. Case.—A woman aged forty-eight, and the mother of several children, had been af- flicted since her last accouchement with he- morrhoidal tumors. These tumors bled seve- ral times in the year, with good effect. Sud- denly, however, moral causes occurred to ag- gravate the affection, which then presented the following condition. Itching and heat at the anus, shooting pains in the rectum ; frequent tenesmus, sen- sation of fulness in the abdomen ; six small tumors of different sizes, round and oval ALIMENTARY CANAL. 81 shape, of a bright red, extremely painful, in- ability to sit down, evacuations accompanied with much pain. Compresses steeped in decoction of camo- mile, were applied to the parts, and adminis- tered internally a small portion of the camo- mile extract. At the end of twenty-four hours all the symptoms were diminished, and on the fourth day all trace of disease had vanished. [If the patient be of a very plethoric ha- bit, the disease is not of long standing, the pains in the sacrum are slight, and the burn- ing and itching hardly perceptible, nux vom. will act beneficially. If the patient com- plain of itching and burning in the anus, pains in the sacrum, as if the latter were bro- ken, and finds it very difficult to lean for- ward, the bowels be sluggish, faeces hard, frequently as if burnt, and there are hemor- rhoidal excrescences, ars. is the remedy.] ENTERITIS, OR INFLAMMATION OF THE INTESTINAL CANAL. Aconite possesses virtues both powerful and prompt in salutary operation when em- ployed in inflammation of the intestines, bladder, lungs, etc. In enteritis the effica- 8 82 DISEASES OF THE ciousness and speedy operation of its cura- tive effects, seem to be developed in direct proportion to the intensity of the inflamma- tory symptoms, the violence and extent of the fever, the power and acuteness of the pains, tensive darting or shooting, for the more in- tense the symptoms are, the delirium, and respiration short and difficult, the fewer nerv- ous symptoms present themselves, aconite 10th becomes more energetic and indispen- sable. Case.—In the month of September, 1838, a young person aged fourteen, having taken cold after being much heated, had been seiz- ed with very severe enteritis. In spite of all the allopathic means which had been used, such as leeches, of which eighty-seven were applied during the first six days, fomenta- tions, emollient cataplasms, liniments with oil of henbane and tincture of opium, emol- lientand slightly-laxative lavements, bathing of the lower extremities, emulsions and calo- mel, finally joined with opium, the disease, instead of decreasing, increased daily up to the seventh, at which time the patient was all but dead. Aconite Sth, 3, was prescribed to be repeated every three hours during the night. The next morning, the eighth of the disease, the young patient was much better. For the first time since the commencement of ALIMENTARY CANAL. 83 the disease, she had slept for quarters and half-hours at a time during the night; the constant vomiting accompanying the taking of food, had ceased ; the pains in the lower part of the abdomen, which had been previ- ously incessant, had almost entirely depart- ed ; the abdomen was but little sensitive to the touch, less swollen and distended; the fever, previously incessant, was fast subsid- ing, and this complete change occurred with- out any crisis by perspiration. The patient again took a few doses of aconite during the day. The following morning she was per- fectly free from danger. This homoeopathic case astonished her friends not a little. Still I could not per- suade myself that it was attributable to the administering of aconite in such small doses. I rather thought it ought to be considered as a consequent effect of the antiphlogistic treat- ment previously adopted, although this hy- pothesis was weakened by the absence of any crisis, and a crisis of some kind will generally occur in inflammatory diseases of this nature. The entire recovery of the patient was long: she was very weak, and was unable to walk without assistance before the expiration of three weeks. During the fourth week, she exposed herself carelessly to cold air, and that brought on the same disease again. In- 84 DISEASES OF THE cessant pains in the umbilical region, increas- ed by the slightest pressure, painful eructa- tions, frequent vomiting of a yellowish-green matter, constipation, pulse small, quick and hard, general heat, thirst, continued agitation and anxiety, sufficiently announced a case of enteritis. The parents of the patient re- quested that recourse should be had to ho- moeopathy : aconite 8th, 3, was administered. A quarter of an hour had scarcely transpired before the patient fell into a quiet sleep that lasted more than three hours ; upon awaken- ing she felt herself relieved ; she no longer complained of any of the previous symptoms, but wished to leave her bed, which, however, she was not allowed to do till the following day. Affections of this kind when treated allo- pathically, continue generally from seven to nine days before there is any vast improve- ment. I was therefore not a little astonished at so prompt a cure by a single dose of aco- nite, without any exhibition internal or ex- ternal of allopathic remedies. A careful perusal of the annexed case will convince the reader that, in certain cases, nigella sativa has an incontestible advantage over aconite. A female, aged twenty-seven years, the mother of tjhree children, who had enjoyed uninterrupted good health with the exception ALIMENTARY CANAL. 85 of measles and scarlet fever when young, was attacked with violent enteritis, which during four days baffled copious bleedings, and the usual remedies. The state of the pa- tient was as follows : violent febrile action at night, head confused, diminution of sensibili- ty, tendency to ill-humor, indifference, great anxiety alternately with a sensation of heat and tension, inability to preserve an upright position, trembling, disordered vision, diffi- culty in moving the eyes, sensation of paraly- sis in the eyelids, violent buzzing in the ears, dryness of the nose, with sensation of cold, sinking of the features, face of a red color, lips pale and trembling, tongue red, dry and furred, with difficulty of moving it, speech muttering and unintelligible, as in cases of paralysis, rancid taste in the mouth, no se- cretion of saliva, loss of appetite, sensation of fulness, without any desire to vomit, pres- sure at the stomach with tensive pain, palpi- tation in the region of the stomach, contrac- tion of the abdomen, pressure at the anus, respiration slow, deep and noisy, gaping, moaning, deep and pressive pain in the chest, occasional cough, palpitations of the heart. swelling of the abdomen, tension and ex- treme sensibility of the part when touched. and violent darting pains when leaned upon, swelling in a direction toward the inguinal region, shooting with pricking pains, on the 8* 86 DISEASES OF THE slightest touch, decrease of urinary secretion, occasionally accompanied with heat, bor- borygmi in the hypogastrium, ulcerative pains, immobility of the legs, sensation of curvature in the loins, occasionally violent burning heat followed by cold, great agita- tion, loss of sleep, frequent sighing, moaning, indolence, with great irritability of the nerv- ous system. The symptoms of enteritis were clearly de- veloped, and the disease was so advanced that slight hopes remained of cure. Less re- liance was to be placed on aconite, than up- on those remedies adopted to oppose nervous symptoms. Neither nux vomica nor bryony appearing suitable, nigella 6th, gl. 1, was administered. At first, it did not appear to produce any favorable effect; at the end of one hour, all the symptoms were increased: delirium, with extreme heat at the back part of the head, continual jactitation, cries, respi- ration short and quick, unquenchable thirst with burning heat, violent pains in the abdo- men towards the loins, sharp cutting gnawing pains in the intestines, involuntary move- ments in bed, requiring the patient to be held down. At the end of two hours, these affections diminished, the head was relieved, accompanied by repose, tranquillity and ge- neral improvement. Towards evening, in- crease of symptoms, but in a slight degree ALIMENTARY CANAL. 87 and for a shorter period, soon succeeded by drowsiness and tolerably quiet sleep, disturb- ed only by agitating dreams, involuntary startings and inarticulate words. The patient passed a quiet night. The following morn- ing, with the exception of shooting and ten- sive pains in the abdomen, and excessive weakness, the patient was tolerably well, and complained only of dull pressive headache in the forehead, with rather sharp pains in the occiput, thirst, and dislike to food. A se- cond globule was administered, which pro- duced a very short aggravation of the symp- toms, especially of the headache, whilst the tensive and darling pain in the abdomen was succeeded by shooting pains. The febrile exacerbation of the evening was also less vio- lent; mix 10th, gl. 1, was administered. The next morning, the patient said she had slept well and soundly, and that she felt tolerably strong ; all the pains in the head had depart- ed, when she felt only a sensation of vacuity; there was no sensation of heat or cold, respi- ration free, ordinary tone of voice, very slight thirst, tongue moist, a little white at the edges, but no redness, natural taste, desire for food, sensation of emptiness in the sto- mach, occasional eructations without pain, plentiful evacuations, hard and of a dark co- lor, departure of pains and swelling of the ab- domen, only in sitting up in bed shooting 88 DISEASES OF THE pains with tension in the coecal region. On the sixth day, the patient was free from any irregularity excepting ordinarily, in the even- ing, a shooting and pressive headache at the back part of the head. Strength, however, soon returned under the influence of a gene- rous diet, the appetite was restored, the pa- tient had two evacuations daily, and slept well during the night. From this time, the cure was complete. Aeon, is no doubt the main remedy, but not always sufficient to extinguish al the symptoms, and requires the aid of Bell., in most cases. When obstinate constipation is present and Aeon, has not removed the burn- ing pains in the umbilical region, Bry. should be administered. DIARRHOEA. This is a prompt and repeated evacuation of humors secreted in a defective manner, and in too great abundance, with or without a mixture of faecal matter. It is often only a slight indisposition, without danger ; but it may also be accompanied by pains and fever, may degenerate into another malady, and may have very serious consequences if it is not suitably treated. Its most common cause ALIMENTARY CANAL. is cold, or intemperance in eating or drinking. Its accessory symptoms are the partial or total loss of appetite, cardialgia, swelling and tension of the abdomen, borborygmi, dryness and coldness of the skin, thirst, scanty secretion of the kidneys, depression, irregu- larity and intermittent arterial pulsations, cutting and tearing pain, frequently in one part, sometimes in another, with an inclina- tion to vomit, which disappears to return again at the end of a few minutes. Long and violent diarrhoeas cause burning in the rec- tum, tenesmus, great weakness, alterations in the features and even faintings. Dulcamara 24th, is an infallible remedy against aqueous diarrhoeas which arise from cold, and are not accompanied either with pains in the abdomen or any other accessory indisposition. To diarrhoea arising from cold must be op- posed china 12th, when the evacuations are of an acrid and clear liquid, without mixture of faecal matter, are preceded by violent colics, by spasmodic and pressive pains in the intestines, eructations, borborygmi, and by a sensation of weakness in the abdomen. Case.—A man aged eighty-one, in full possession of his intellectual faculties, though of a delicate constitution, generally healthy and of regular habits, was seized in the au- 90 DISEASES OF THE tumn of 1836, without any perceptible cause, with a serious disease; after a few days, during which the disease had continued to increase, I was called in to prescribe. For the last two days, and especially at night, a very copious diarrhoea, watery and mucous ; the patient voided what little food he took undigested; he had frequent vo- mitings of mucus, water and aliments, with sour and bitter taste; however small the quantity of liquids or solids, he instantly experienced painful pressure in the abdomen, and especially in the region of the stomach, with oppression at the chest, followed by eructations which gave some relief. No ap- petite, constant feeling of fulness, and an insurmountable antipathy to what he was previously most fond of. Sleep broken, ex- haustion amounting almost to syncope, pulse quick and rather hard; anxiety, restlessness and agitation. Nothing was so well suited to this indi- vidual ease of disease as bark. Everything indicated it, his physical as well as his moral condition. Bark in solution was consequently administered, at ten in the morning. The next day, the patient's condition was altered considerably for the better. No diar- rhoea, nor vomiting; the patient had enjoyed a good night's rest; his appetite was somewhat better; he speedily recovered his usual tone ALIMENTARY CANAL. 91 of body and mind ; and in a few days he was restored to as perfect health as was compati- ble with his age. A lady, advanced in years, had been for some weeks suffering severely from continu- ed diarrhoea. She had taken all possible domestic medicines, and even applied to several allopathic physicians. She was then very pale, thin and weak. She could eat but little, and almost instantly voided the food undigested; thirst extreme. Six doses of china 11th, one every three hours, having produced no effect, one drop of tinct. ratan- h'ue was administered night and morning. At the end of four days, the complaint had subsided; but the remedy was continued, since which time she has had no relapse. If the cold is caused by night air, and pro- duces a pinching at the pit of the stomach, borborygmi, a feeling of relaxation as if eva- cuation were about to take place, a cutting and tearing pain with pressure in the abdo- men, which is cold, nausea, shivering, sudden? and frequent desire to evacuate, at first without result, and afterwards with excre- tions, frequent, aqueous and green, with dis- position to fainting, it is desirable to admi- nister mercury 12th. If diarrhoea arises from errors of regimen, and manifests itself by loss of appetite, with a sensation of dryness, etc., of slight burning of 92 DISEASES OF THE the tongue without thirst, a bitter and saltish taste in the mouth, eructations foetid, hic- cough, nausea, and vomiting, fulness of the abdomen, colic, much flatulence, commotion of the intestines, urgent desire to relieve the bowels, inquietude, with frequent evacu- ations, pulsatilla 12th, is the best remedy. Chamomilla 12th, is employed successfully against diarrhoeas which arise from anger, accompanied by bitter taste in the mouth, eructations, a sensation of fulness at the pit of the stomach, pressive pain in the head, general weakness, frequent evacuations of green, aqueous, acrid and foetid matter. Pains in the abdomen violent, tearing, which leave no rest to the patient, and oblige him to twist himself, a sensation as if the ab- domen were entirely empty, with continual movement of the intestines, blue circles round the eyes, nausea, vomiting, evacuations watery, mucous and foetid, are symptoms requiring the employment of chamomilla 12th. Those which result from fear, anxiety, and generally from strong emotions, yield readily to opium 6 th. Case.—A man aged forty, previously in the enjoyment of good health, was seized suddenly during the night with violent colic and continued diarrhoea; next day, things ALIMENTARY CANAL. 93 remained in the same state ; and in the even- ing I was sent for. I found the patient in bed, very weak, his breath affected when speaking, and he complained of alternations of cold and heat. Evacuations occurred very frequently, preceded by pains in the abdo- men ; they were discharged with violence and were altogether aqueous; at the same time there was much flatus in the abdomen, with nausea and excessive thirst. Had cholera existed in the vicinity, the patient might have been thought to be slightly affected with it. From the general appearance of his face, it was evident that the abdominal nervous sys- tem was considerably affected. Half a grain of arsenic was pounded with two scruples of sugar, and divided into fifteen powders, one to be taken every hour as long as the exhaust- ing diarrhoea continued. At the same time a slight emulsion of almonds was prescribed as a beverage in very small draughts. From the moment he took the arsenic, he had only six diarrhoeal evacuations. He fell asleep, but not into a sound sleep, before midnight, and had no evacuation during the night. In the morning, he had slept well, and, though very weak, felt more easy; the skin was moist, and thirst less violent. The same remedy was continued, but more slowly, recommending him to discontinue it if the diarrhoea did not return ; and he continued to 9 84 DISEASES OF THE improve. With the exception of the weak- ness and anorexia, the patient recovered ra- pidly. A few doses of the sixth of a grain of mix vomica cured him completely. Diarrhaa in Women.—As this complaint frequently arises from cold, it is advisable to keep the stomach warm, in order to aid the action of dulcam. Sth, which is a specific in such cases. If the diarrhoea arises from the stomach being overcharged, or from fat food, prescribe pulsat. 6th, and sometimes anti- mon. cr. 10th, gl. 1. If it be accompanied by pains in the stomach, and the excretions be watery, it will be necessary to recur to chamomilla 4th, gl. 2. When there is tenesmus and frequent evacuations, small in quantity, mucous and bloody, it may almost always be removed by mere. sol. 4th, some- times also by sulph. 10th, which is remarka- bly useful in obstinate and habitual diar- rhoeas. In certain cases phosph. and petrol. deserve preference. If the complexion be very yellow and sallow, lycop. 10th may be successfully used. The following case proves the necessity of carefully observing the characteristic symp- toms of a disease before the application of the remedy. My own wife, says a homoeopathic practitioner, who was very subject to diar- rhoea arising from cold, complained in the morning of violent griping pains, tendency to ALIMENTARY CANAL. 95 vomiting and looseness. As I had frequently cured her in similar cases with dulcamara, I did not hesitate to administer it; but finding no improvement in her condition in the space of an hour, I administered vcratrum album without any more beneficial effect. Another hour elapsed, when by careful observation I found that the diarrhoea was accompanied by tenesmus. I then gave her mere, solub. Five minutes afterwards she fell asleep, and awoke in half an hour free from all pain and diarrhoea. The sleep convinced me that I had selected the proper remedy, as it is always consequent upon the administration of good specifics. Whenever the patient falls into a sleep or even a state of dozing immediately after tak- ing the remedy prescribed, we may safely prognosticate a cure; it does not, however, follow that sleep must necessarily precede the removal of disease. In dysenteric diarrhica, sharp shooting and griping pains in the abdomen; violent pain in the back and loins : pressure at the stomach after eating; eight or ten evacuations daily ; ejection of a small quantity of white mucus, followed by tenesmus ; constant but ineffectual attempts to evacuate ; alternations of cold and heat, the former especially; thirst, etc.: was removed by belladonna. The 96 DISEASES OF THE patient, a female, at other times quiet and good-tempered, was very irritable and con- tinually crying. In chronic diarrhoea with eruption of itch- ing pimples on the body, and leucorrhcea, emetic tart, was successful. Diarrhoea in Children.—An infant, thirteen weeks old, had been crying incessantly for days, suffering from green diarrhoea, some- times mucous, and at others watery. The family attendant administered an infusion of camomile and opium in fennel water from time to time, because the child refused all food and even fluids. For the last two or three days, he dozed with the eyes half open; the veins of the head were full of blood ; at times he awoke starting from his sleep, cried violently and exhibited extreme restlessness. The medical attendant finding him very weak, began to doubt if he would livethrough the night. After a few doses of coff. 3d, 1, belladonna 10th, 2, and one of nux vomica 10th, l, employed as an antidote to the opium, matters returned in three days to their primitive state. The diarrhoea, rest- lessness and griping, were speedily remov- ed by a single dose of senna 2d, 3. The child recovered its health ten days after- wards. Ipecacuanha is useful in serous diarrhoea ALIMENTARY CANAL. 97 in children, accompanied by vomiting of a green or white mucus, with griping pains in the abdomen. In those acute diarrhoeas in children de- scribed as relaxation of the stomach and the intestinal canal, the diarrhoea is established without any perceptible cause. Evacuations copious and more or less frequent, according to the intensity of the disease, consisting of aqueous mucous matter, sometimes greenish, and at others greyish, of foetid smell. At the same time, slight fever, heat in the palms of the hands and soles of the feet, incessant thirst, loss of appetite, rapid wasting of the body, constant agitation, moaning and weep- ing, paleness and dryness of the skin without turgescence, abdomen very sensitive, puffed, elastic, occasional vomiting, urine small in quantity and colorless, sleep comatose or light, eyes half closed. The patient remains in this state from three to five days. A few doses of calc. acet. gl. 1, suppressed the incessant and copious evacuations, and the child, which was previously almost a skeleton, soon became florid and ruddy. In another case, in addition to chalk, mere. sol. was administered with good effect. In the most acute form of this disease, especially when attended by violent pains in the abdomen, colocynthis is undoubtedly the first and best remedy. 9* 98 DISEASES OF THE In children towards the fourth month, those green diarrhoeas, attributed to acidity in the primes via; or to dentition, are often observed. The disease appears to depend upon some particular anomaly of the biliary secretion, the causes of which are unknown. The evacuations are more or less frequent, of a vegetable green, sometimes watery, at other times and more generally mucous, frothy, like the white of an eg^r, and occasionally mixed with sanguinolent mucus. The chil- dren cry very frequently, from griping pains, abdomen swollen, with loss of substance. In such cases, mercury has been found an inva- luable specific. Sometimes diarrhoeas occur in children of more advanced age, that suc- cessfully resist various modes of treatment for a long time. Suddenly aphthae appear, and in a few days mercury removes both the diarrhoea and the sores. Generally speaking, diarrhoea in children depends upon a sub- inflammatory state of the mucous intestinal membrane. Ferrum carbonicum is useful in diarrhoea, especially in children. When the disease has existed for some time, after eating or drinking there are speedy aqueous evacu- ations without pain or effort, containing al- most always a certain quantity of undigested food, accompanied with paleness of the face, loss of substance, hardness and swelling of ALIMENTARY CANAL. 99 the abdomen, without flatulence, sometimes voracious appetite, and at others total loss, thirst, etc. In chronic dysenteric diarrhoea in children accompanied with violent griping pains, great thirst, loss of substance and slow fever, ar- sen. alb. is very efficient. In cases of neglected diarrhoea in children during their first dentition, when they void a brown liquid five or six times every day, become extremely thin and yellow, and there is loss of appetite, with enlargement of the abdomen, ars. 10th, gl. 1, is frequently suc- cessful. In one case, a single dose was suffi- cient ; in other cases, the dose was repeated every three days ; but in no case more than four times. Dulcamara, is useful in diarrhoeas with which children are attacked during dentition, and to which are often joined fever and loss of appetite. [Diarrhoea caused by cold, when the stools are liquid, yellow, mucous, with colic and cutting pains about the navel, want of appetite, desire for drink, nausea, pallor, weakness and uneasiness, requires dulca- mara. If there is constant rumbling in the bowels, with a sensation as if the belly were empty, nausea, vomiting, mucous stools, uive pulsat.; if the stools smell like bad eggs, chain. 100 DISEASES OF THE Diarrhoea caused by irregularity of diet is accompanied by bad taste in the mouth, of- fensive breath, eructations and nausea, ful- ness in the region of the stomach, want of ap- petite. Here too puis, is indicated, especially if the irregularity of diet consisted in the par- taking of too much fat meat, fried food and rich pastry. Diarrhoea attributable to eating fruit will be stopped by bry. Against diar- rhoeas and vomiting from over-indulgence in fruit, verat. should be given after every stool; or ipec. Diarrhoea attended with very rapid pros- tration, watery stools, and colic pains, re- quires ars. Diarrhoea during dentition is to be cured by many remedies, amongst which sulph. and mere, are very prominent.] DYSENTERY. Mercury is the principal remedy in this disease, and has been found extremely effica- cious in two epidemics. The disease was mostly simple dysentery, commencing with shivering and cold, with alternations of heat, with pain in the abdomen with watery evacu- ations as in ordinary diarrhoea : but very soon the fever increased, with cold, heat, thirst, headache, and general depression, and the ALIMENTARY CANAL. 101 evacuations assumed a dysenteric character. In the midst of extreme pains, occurring at very short intervals, with violent tenesmus, pain and burning heat, there were evacu- ations of small quantities of blood and mucus. The tongue was more or less furred and dry, with loss of appetite and pains in the limbs. In many cases, especially in children, the discharges were accompanied with masses of dark-green mucus, which occurred more or less frequently every quarter of an hour, with tenesmus. Many patients required only one dose of mercury pule. 3d, gl. 1. Others re- quired several doses. The wonderfully prompt operation of sub- limate in autumnal dysentery in adults, has frequently been witnessed. A few doses of the sixth dilution were sufficient to stop the most violent attacks. In colics and diar- rhoeas, the proper homoeopathic remedies, such as colocynth, aloes, and rheum, have been no less successful. A man was suffering severely as follows:— The affection commenced with cold and heat, anxiety, diarrhoea, spasms in the abdomen, violent pain in the loins, tenesmus, and void- ing of a small quantity of blood. The reme- dies applied, antiphlogistics, did not diminish the disease ; on the contrary, the anxiety, tenesmus and thirst increased; every ten mi- nutes the patient vomited sanguineous mucus 102 DISEASES OF THE mixed with blood. On the third day, he took sublimate 16th, which in a few days entirely removed the symptoms. In dysentery in a child eighteen months old, who had previously suffered from humid tetter, the dysentery had baffled allopathic treatment. The child, which was previously strong and healthy, grew pale and thin at the end of three weeks, and ejected sanguineous mucus without particular suffering several times a day. A few doses of baryta effected its speedy removal. A female, aged twenty-three, of phlegmatic temperament, was seized, in consequence of eating unripe fruit and other errors in regi- men, with discharge of blood, to which she at first paid no attention. The skin was dry; there were sharp, shooting pains in the abdo- men ; thirst, bitter taste in the mouth, tenes- mus, bilious evacuations streaked with blood. A very small dose of tartar, emetic, removed it in three or four days. In the beginning of July, an epidemic dysentery broke out, consisting of three pe- riods. First Stage.—Attack: some were seized with giddiness, scarcely able to stand, heavi- ness of the head, griping pains in the abdo- men ; others with colic, nausea, pricking in various parts of the stomach. A patient complained of compression of the brain, and ALIMENTARY CANAL. 103 violent headache, especially about the fore- head, shooting pains and fulness of the orbits, especially when he held down his head.— Progress: after twelve or even twenty-four hours, painful tenesmus, useless attempts, or evacuation very small in quantity, of a frothy mucous matter, mixed at times with blood, during which the patient suffered severely from a feeling as if the intestines were com- pressed. Colic and pain in the abdomen, bending the patient almost double. Frothy evacuations of a yellowish color, similar to saffron. Desire to evacuate every five or ten minutes, accompanied by painful tenes- mus, pulse small and depressed, face sunk, weakness and trembling of the limbs, with anxiety. Second Stage.—Two or three days after the commencement of the disease, all the symptoms that affected the head and abdo- men grew worse, accompanied by a sensation of burning and pricking at the stomach, with vomiting, especially during evacuations. These were blackish and foetid; a few mo- ments afterwards, violent eructations, inces- sant hiccough, painful spasms and cramp of the abdomen, inclination to evacuate, some- times ineffectual, at others followed by a dis- charge of mucous matter and blood, frequent discharge of soft, puriform substances tinged with blood, described by the patient as if he 104 DISEASES OF THE had voided a mass of substances, attended with insupportable pain. Tongue dry and rough, thirst, desire for iced water, painful lassitude, general spasm, cramp in the calves of the legs, trembling and weakness amount- ing to paralysis of the legs, cold shivering of the back, sensible coldness of the hands and feet, and soon after, heat of the forehead and head; fever accompanied by dryness of the skin, depression and suffering as in approach- ing death. Loss of strength, the eyes sunken and surrounded by livid circles. Great fall- ing away, and occasionally death. • Third Period.—Evacuations of blackish, aqueous matter, eighty to one hundred daily ; loss of substance and emaciation, general coldness and colliquative sweats, delirium, insatiable thirst, strong desire for ice, burn- ing heat of the mouth and stomach (pyrosis), tongue dry, chapped and blackish,teeth black, breath cadaverous, face hippocratic, constant groaning, violent suspirations and hiccoughs. Afterwards tranquillity, cessation of several symptoms, apparent improvement in the condition of the patient; death. The remedies deemed advisable in accord- ance with the homoeopathic treatment were, in the first period, camomile of the tenth dilution, colocynth and corrosive sublimate of the thirteenth. Camomile taken in the form of globules (one or two every half-hour) ALIMENTARY CANAL. 105 always exercised a salutary but temporary influence during the first period of the dis- ease ; for which reason the patient was never left solely to its effects; but there were admi- nistered eight or twelve hours afterwards, two globules of colocynth, and the patient was left for twenty-four hours to its action. At the end of this time, there was a sensible improvement, and health was re-established at the end of a few days. In a case where two globules of colocynth were given imme- diately on the commencement of the disease, a complete cure was performed in twenty- four hours. In an epidemic, corrosive sub- limate was administered, but it was discon- tinued, no proof of its action having been witnessed. In the second stage colocynth was found again efficacious; beneficial effects were alse experienced from rhus toxicodendron and sul- phuric acid. Rhus of the thirteenth dilution produced successful results, especially when the disease began, from improper allopathic treatment, to degenerate into typhus fever. In the last stage arsenic of the thirteenth dilution appeared to be effective. Case I.—A laboring man, aged twenty, of a strong constitution, had been for two days suffering under heaviness of the head, and acute pain in the forehead. On the morning 10 106 DISEASES OF THE of July 30, he was seized with violent colic, and griping in the abdomen. His efforts were incessant, but ineffectual, to relieve the bowels, with tenesmus. In the evening, the following was the pathological state : vertigo similar to that produced by drinking, painful heaviness of the head, as if pressed in a vice, sudden shooting pains in the eyes, flatulence, violent colic as if the intestines were being cut, forcing the patient into a bending po- sition, useless efforts and tenesmus, evacu- ations of frothy matter mixed with blood and mucus, weakness of the legs, pulse slow and small, excessive thirst, paleness of the face, slight shivering, sensation of cold. Camomile of the tenth dilution repeated every three hours; colocynth the following morning. Finding that after six hours the morbid phe- nomena were relieved, fresh doses were ab- stained from. The following day, the patient was quite recovered and able to attend to his work. Case II.—A man, aged twenty-five, was seized, on the 23d of July, with vertigo and headache, accompanied with griping pains and copious evacuations. On the fifth day of the disease were observed the following phenomena: Suborbital cephalalgia, as if the head would split, acute pains in various parts of ALIMENTARY CANAL. 107 the abdomen, flatulence, tenesmus, nausea during evacuation, discharge of whitish frothy mucus every half-hour, mixed with streaks of blood, and accompanied by violent pains in the abdomen and sacrum, the patient feel- ing as if voiding his intestines. General weak- ness of all the limbs, sensation of paralysis, depression, eyes and face sunk, pulse small and slow. After employing colocynth, repeat- ed during the first two days, with rhus and sulphuric acid, the patient recovered on the eighth day. One of his sisters, his eldest brother, and two of his daughters were similarly attacked with dysentery, accompanied by fever. The two daughters were also suffering from worms : nevertheless these four persons were cured by the use of aconite, camomile, rhus and sulphuric acid : the case, however, of the elder brother exhibited an instance of the danger of bleeding and leeches in this epi- demic. Case III.—A little girl, aged eight years, of weak constitution, was seized with dysen- tery and exhibited the following symptoms. Pain over the right eyelid, violent colic in the epigastrium, evacuations with pain in the abdomen, sometimes of mucous blood-stained matter with ascarides, at others of bright clear blood. These evacuations were attend- 108 DISEASES OF THE ed with intolerable pain, thirst, general cold- ness, paleness, loss of substance, fever in the afternoon, ceasing towards evening. Subli- mate was administered, and two days after colocynth: no improvement; on the contrary, the patient was worse. Rhus was prescribed, and a cure was effected in the fourth day of the treatment, after three doses, being the fifteenth from the commencement of the attack. Case IV.—A young girl, aged sixteen, of rather strong constitution, was -first seized with dysentery. On the fourteenth day of the disease, after she had gone through all the stages, it appeared to have degenerated into hectic fever. The following were the phenomena observed. Dysenteric evacu- ations, constant ejection of liquid matter and food, thirst excessive, tongue dry. Dull pain in the loins, hiccough, cough accompanied with expulsion of bronchial mucus, remittent fever, pulse frequent and weak, slight shiver- ing at night, foetid, clammy perspiration in the morning; during the remainder of the day, skin dry and rough. Sensation of inter- nal heat, extreme thinness or rather emaci- ation. Pulsatilla repeated during three days. The sixth day arsenic and nitric acid alter- nately every six days. I had the satisfaction ALIMENTARY CANAL. 109 of finding that the young patient recovered completely in eighteen days. [Dysentery is divided into 1. while, when there are fever, cutting pains in the region of the stomach, frequent, forcible, painful de- sire to go to stool, and mucous evacuations; 2. red, when the evacuations are bloody ; 3. dry, when there is a constant desire to eva- cuate, but nothing passes. This latter is the worst form. The best remedies in the first are puis, and colchicum; in the second mere, corrosions and ipec. Violent colic- pains are generally present in both, and re- quire colocynth.] SPORADIC CHOLERA. A female was suffering under this disease ; continual vomiting, first of aliments, after- wards of a greenish liquid, with frequent diarrhoea, more and more liquid and color- less, violent cutting and shooting pains in the abdomen, cramp in the legs, suppression of the urinary secretion, rapid decrease of strength. Colocynth 6th, gt. 1, repeated every two or three hours, effected its speedy removal. Vcratrum also is successful in sporadic cholera. 10* 110 diseases of the A child, six months old, of weak constitu- tion, had been for three days suffering from vomiting and diarrhoea, and was extremely weakened. Six doses of vcratrum album 12th, were administered, one every two or three hours. Still no improvement in his condition. His body was cold as ice, and thirst insatiable. The case was critical. Cupr. metallic. 30th, Avas prescribed, and a tea-spoonful was administered every ten or fifteen minutes, till these symptoms disap peared. The child was saved, and in a few days completely recovered. ASIATIC CHOLERA. It will not be amiss, if I put before the eyes of my readers, the advice given by Hahnemann, for the treatmpnt of cholera. It is sufficiently simple, concise and easy of ap- plication, to be readily understood by every person. These instructions were given ex- actly as follows.—First, therefore, I refer +'• the precautions the medical man should takj for his own safety. Directly epidemic cholera breaks out, eve- ry medical man should procure the following solution. Put an ounce of camphor in twelve ounces of pure spirits of wine, and shake it ALIMENTARY CANAL. Ill till it is completely dissolved. Before enter- ing the patient's room, take two drops of this solution as a preservative, and repeat the same precaution on entering every patient's room to prevent infection from the mephitic air confined there. Before entering the room, it will be well to wait a few seconds in the ante chamber, a precaution rendered necessary by the fatigue the medical man suffers from his numerous avocations. If he visit his patient in a state of perspiration, he is much more likely to receive the contagion. Great attention also must be paid to diet, that is to say, he should never suffer either hunger or thirst, and never overload the stom- ach with food or liquid ; with respect to the choice of food, he should take only that which possesses undoubted nutritive qualities, with- out any exciting properties. But in this he must, like his patient, be guided by circum- stances, as it would not be discreet to discon- tinue, whilst the epidemic is raging, the use of wine, tea, coffee, or any other heating ar- ticle which he had been daily in the habit of using. It may be as well to add, that the medical man should be fully imbued with the importance of his functions at these difficult times, banish all fear from his mind, be pre- pared by reflection for all occurrences, and possess great presence of mind. Directly a patient is seized with cholera, 112 DISEASES OF THE administer one or two drops of the solution of camphor before mentioned, on sugar or in pure water. Repeat the dose every five mi- nutes ; whatever the intensity of the disease, the camphor should in all cases be adminis- tered during the first hour after the com- mencement of the attack. As long as the patient feels any benefit from the use of the camphor, it should be continued ; and if the disease yields to this application, no other will be necessary. When this, however, is not the case, we must be guided in our treat- ment by what the symptoms require. If there is vomiting, or only tendency that way, or if the vomitings are accompanied by ex- cruciating pain, agitation and icy coldness, the patient should take one or two globules of arsenic. If this produces a good effect without complete cure, the dose should be renewed every two or three hours, according to the strength of the patient. If the symptoms enumerated above are ac- companied by cramps, recourse must be had, not to arsenic, but to cuprum, of which two globules may be administered, and the dose repeated every two hours if necessary. The cholera, however, may assume another form, its characteristic symptom being fre- quently violent diarrhoea. In this case vcra- trum album must be given, and in this stage of the disease, ice may be beneficially used. ALIMENTARY CANAL. 113 Hahnemann expressly says, allow the pa- tient as much as he chooses. Sometimes a period occurs when the pa- tient falls into asphyxia. We must be care- ful, however, not to treat him as if dead, though he may appear to be so, much less consign him to the undertaker. We must administer a few drops of carbo vegetal) His in water, and at the same time rub the whole of the body with ice. But if the patient, when actually in as- phyxia, has not been previously treated ho- moeopathically, the whole external surface of the body must be rubbed with camphor, and a few drops in a glass of water be poured into his mouth, even if he is unable to swallow. Persons not suffering under acute cholera, and who, though not confined to their beds, are affected with cholerine, and experience alternately weakness, palpitation, anxiety, cramp in the calves of the legs, cold, uneasi- ness, sickness, diarrhoea, should take every day, or oftener if need be, one or two globules of phosphorus to preserve them from infec- tion. Persons who are quite free both from cholera and cholerine, will do well to submit to preservative treatment, for which purpose they should take every eight days a globule of vcratrum album, if diarrhoea be the chief characteristic of the disease, and a globule of 114 DISEASES OF THE cuprum, if the general symptoms are vomit- ing and cramp. CHOLERINE. During the second invasion of the cholera at Berlin, Rome, Marseilles, etc., an epidemic broke out which attacked young children chiefly, adults not however being exempt from it. Although this epidemic did not present all the symptoms, nor yet all the intensity of cholera, still the character of the disease was the same, and this will be evi- dent from the following cases. This resem- blance induced a recurrence to those reme- dies which had frequently been found effica- cious in cases of cholera, and the result was satisfactory. The diarrhoeal evacuations of the patients were whitish, liquid, and occasionally blood- stained, resembling the juice of meat, a cha- racteristic, with the exception perhaps of the blood, of most choleratic evacuations; they were frequently accompanied with tenesmus and colic ; the patients suffered from nausea and sickness; some exhibited a bluish dis- coloration round the eyes, nose and mouth. The limbs had lost a great portion of their natural heat. But of all these symptoms, the ALIMENTARY CANAL. 115 most singular was the considerable loss of substance, and that in a few days; the skin became flaccid, by the disappearance of the subjacent fat, and lost its elasticity, as in old men. Whatever the symptoms were, it is certain that in many respects they were simi- lar to those of cholera, and also very analo- gous to those of epidemic dysentery. The major part of the patients had been unsuc- cessfully treated in the usual manner. Case I.—A child, aged eleven months, of good constitution, and previously enjoying excellent health, had been for six days suf- fering under violent colics, with very copious diarrhoeal evacuations of a whitish color, very abundant, at times mixed with blood, extreme sleeplessness, face pale, eyes sunk, tongue dry and furred, sores on the sides of the nose, with obstruction of the nostrils, extreme thirst, loss of appetite, violent colic, with tenesmus causing the child to cry in- cessantly. The patient free from fever, the skin cold, extreme weakness and loss of substance, dis- pirited and exhausted. On the 2Sth of August, nux vomica, tenth dilution, was prescribed in four ounces of distilled water, three spoonsful every day The next morning, 29th, the patient had only three evacuations, more cohesive and free 116 DISEASES OF THE from blood. Again was administered a tea- spoonful of the mixture ; and on the follow- ing day, the child was able to sleep, and had recovered his playfulness and appetite. On the 1st of September, the patient was a second time seized with frequent blood- stained evacuations, accompanied with con- vulsions of the limbs and very violent tenes- mus, each evacuation preceded by cries and griping pains in the abdomen. On the second of September, prescribed veratrum, third dilution, in four ounces of distilled water, two spoonfuls to be taken during the day. On the third, the diarrhoea and colic were sensibly diminished, and on the fifth the patient was perfectly recovered. Case II.—A child, aged five months, in the enjoyment of general good health, and strong for her age, was seized with very co- pious diarrhoea towards the end of the month of August. For nine days, she had been treated in the usual way; opiates and gums were administered both by the mouth and in lavements. On the first of September, she was as follows: Face very pale, eyes sunk and wandering, pupils dilated, features distorted, tongue dry and white, thirst, loss of appetite, fre- quent vomitings, violent colic and copious evacuations, discharge of foecal matter al- ALIMENTARY CANAL. 117 most every minute, loss of substance, skin dry and hot. No sleep for several nights, difficulty of breathing. As an internal remedy, nux vomica was prescribed, tenth dilution, in four ounces of distilled water, a spoonful every hour. At the same time, were applied to the stomach flannels soaked in warm water. On the fol- lowing day the child was much better, and on the third of September entirely cured. WORMS. Most frequently attack women and chil- dren, are engendered by bad food, moist and unhealthy air, and by everything which fa- vors the collection of mucus in the intesti- nal canal. Their existence is often unknown, and on the other hand, we attribute to them many affections which arise from other causes. The kinds of worms most common are as- carides, lumbrici and taenia or tape-worm. The ascarides resemble the worms of cheese, but some of them attain nearly the length of the finger. They are particularly common in children, to whom they cause a disagreeable itching in the intestinal canal and of the nose, frequent and pressing desire 11 118 DISEASES OF THE to relieve the bowels, with some other symp- toms. The lumbrici have the form of earth- worms. They are white, have at the point of the head, a circle surrounded with a little wart, unite in different parts of the intestines, on the parietes of which they cause, by mov- ing and sucking, an irritation which produces pinching and pain, particularly in the region of the umbilicus. The usual signs of their presence are the following: nausea, much aqueous saliva or other liquid in the mouth, foetid breath, countenance puffed and pale, bluish or brownish arches below the eyes, dilatation of the pupils, sleep disturbed, ab- domen distended and tense. The tape-worm is flat, whitish, often very long, and composed of a great number of articulations. It is somewhat difficult to discover its existence. It sometimes occa- sions extraordinary sensations of pressure, of cold and of undulatory movement in the abdomen, acute pain, cramp, epileptic, and convulsive movements ; often none of these symptoms are observable. The only certain sign of its presence is the appearance of some portions which are naturally detached from its body, and are replaced by a new growth. The greater part of the means employed against these three kinds of worms have at most, for their result, the separation of a por- ALIMENTARY CANAL. 119 tion of them, without destroying the morbid principle which produces them. When the lumbrici or the ascarides live in the intestines in children without producing any serious effects, they do not require interference of art. But if we observe signs or a real altera- tion in health, it becomes necessary to oppose to each particular case the means which it requires. We can most frequently employ against ascarides, aconite, mix, mercury, ig- natia, valerian ; and against lumbrici, mix, china, belladonna, mercury. Stramonium 9th, will remove colics pro- duced by worms. Cicuta virosa 30th, is sa- lutary in fevers caused by worms and ac- companied by cramps with violent pains in the bowels.—Tincture of sulphur . 30th, causes the disappearance of the itching, which arises from the same cause.—Filix mas 11th, administered from time to time, always al- lays the irritation, which is sometimes pain- ful, produced by the tape-worm. [Cina is an excellent remedy when the sleep is uneasy, there are rolling of the eyes during sleep, bleeding at the nose, and vio- lent itching of the anus. If the bleeding at the nose returns frequently,/jmZ.v. is indicated. Bloated face, nausea, vomiting, morbid ap- petite, periodical colic pains, mucous diar- rhoea, intermitting pulse and convulsions, call for verat., sabadilla, and cicuta. If the com- 120 DISEASES, ETC. plaint is of long standing, antipsorics should be resorted to, such as calc. carb., natr. mur., kali carb., caust., petrol.] ON HOMOEOPATHIC DIET AND REGIMEN. BY P. CURIE, M. D., &c. &c. COMMON PRACTICE IN THIS RESPECT. In none of the medical schools which have preceded that of Hahnemann, have the rules for the adoption of regimen been fixed upon a sound and invariable basis. Each school has formed these rules upon its peculiar views of the nature of disease: and thus, while some prescribe an extremely low diet, others order, or permit the use of, the most nourishing aliments and stimulating wines. The object of the former is to subdue that irritation, which they consider to be the generating principle of the disease, by an almost total abstinence from food,—whilst the latter attempt to counteract, by stimu- lants, that debility which, in their opinion, is often the foundation of the malady. The examination of the doctrines and rules of each school, will demonstrate the existence of these contradictions and uncertainties; and I do not hesitate to affirm, that this will con- 11* 122 tinue until the homoeopathic law is adopted, which, by giving a fixed and sure basis to therapeutics, will, at the same time, destroy all uncertainty regarding regimen. Homoeopathic Rules of Diet and Regimen. The object to be attained by attention to regimen in the treatment of disease, is to place the patient in a condition the most favorable for the action of the remedy; and to accomplish this, the two following rules are considered essential. 1st. To prohibit the use of every descrip- tion of aliment which possesses medicinal properties, or which might destroy or modify the action of the medicines administered. 2d. To regulate the quantity of such ali- ments as are allowed to the patient, in order that the daily waste of the constitution may be supplied, without overcharging the diges- tive powers. The homoeopathic physician prohibits his patients from using spirituous liquors, spices, acids, strong tea and coffee, and aromatic substances. He also excludes from their regimen, every aliment which his experience informs him is of difficult digestion, and in general all fat meats and the flesh of animals which are too young ; as well as all fruits of bad quality, or which are not perfectly ripe. 123 He moreover recommends them not to reside in marshy districts, nor in dark and damp streets, in which there is no free circulation of air. For similar reasons, he advises them to avoid public meetings, and large parties, where the temperature of the air is either too elevated, or vitiated by the number of persons breathing it. The aliments to be preferred, are such as the patient digests with the greatest facility ; and, in this, experience alone can guide him. The physician can neither predicate those which will be agreeable to him, nor those to which he has a dislike. The patient is allow- ed to drink pure water, weak beer, or a very small quantity of wine mixed with water. Wine undiluted, as well as tea and coffee, are allowed only to patients who have been long accustomed to their use, and who would sutler from privation of them. The physi- cian must decide in what cases they ought to be entirely prohibited, or be only partially permitted ; but even when it is necessary to allow them, they ought to be taken in much smaller quantities, and much weaker than usual. It is also strongly recommended to the homoeopathic patient to avoid everything which is culculated to excite strong emotions, and all excesses either of labor or pleasure. Exercise is likewise a very important ele- ment in the homoeopathic regimen. It is 124 indispensable that, patients afflicted with a chronic disease, should not lead too sedentary a life. They ought to take exercise daily in the open air, to as great an extent as their strength will permit; and if they are unable to walk, they ought to be taken out in a car- riage, although this mode of exercise is less salutary than walking. If the patient is too ill to partake of either of these modes of ex- ercise, the air of his apartments ought to be frequently changed, and the greatest atten- tion paid to cleanliness therein. Hot baths are not permitted in homoeo- pathic treatment; but sponging with cold or slightly-tepid water is recommended in pre- ference. These, of brief Duration in Acute Diseases. The regimen here pointed out is more espe- cially adapted to the treatment of chronic diseases. But it is also suitable in acute complaints; although, in the latter, it is sub- ject to many particular modifications which cannot be detailed in a work like the present. I will only observe here, that rigorous atten- tion to diet in acute disorders, is rarely of long duration in homoeopathic practice. In no case is the patient restricted from taking food, except in cases where he has a positive disinclination to it; and whenever the desire 125 for food returns, he is allowed by degrees to indulge it. Besides, the duration of acute diseases being infinitely shorter by the ho- moeopathic mode of treatment than by that of the old school, the duration of dietetic restric- tions is also shorter, and consequently the inconveniences arising from long abstinence from food are avoided. Such Rules Accessory, not Curative. From the preceding observations, an opin- ion may be formed of the rationale of the homoeopathic regimen. It will be remarked that we consider it only as accessory, and not curative ; and that, consequently, there is a wide difference betwixt the homoeopathic school and that which has been called the expectant—that which looks to the efforts of nature for everything, and proclaims diet, water, and exercise, to be sovereign reme- dies. No doubt, diet, water and exercise, are excellent things. Unquestionably, for him who has too constantly remained within doors, it may be well to prescribe exercise. To another, who has gorged himself with the delicacies of the table, it may be proper to recommend moderation in eating, and to dic- tate such a diet as will give the alimentary system time to recover from the effects of 126 repletion. And, to him who has indulged in an excess of wine, it may be wise to prescribe water: to deprive him for a time of that in which he has indulged to excess, is easily understood, and it may alone be sufficient to re-establish the health, which the abuse of it had deranged. We should not have mentioned the expect- ant school at all—as it enjoys credit only with those who are absurdly credulous—had it not been that we have always been repre sented as ranging ourselves under its banner. Those who have seen the success of the ho- moeopathic treatment could not well deny it; but they have preferred attributing this suc- cess to the regimen, and not the principle, and to that curative virtue of homoeopathic doses which we proclaim. Their arguments appear to us to be quite unfounded. It is easily seen that our regimen is infinitely less severe than that which is commanded by cer- tain other medical schools ; for we always allow to our patients a quantity of substantial nourishment in accordance with their appe- tite and digestive powers. It is true that, even in this objection, our system of diet is, so far, well understood ; but its excellence is dependent on this, that it does not injure the constitution of the pa- tient, and more especially on its favoring the most simple and beneficent therapeutic 127 which has ever existed. But, on this pointy it has justly been asked,—if Homoeopathy has really performed so many wonderful cures by its dietetic prescriptions alone, are not the routine practitioners criminal if they continue to torment their patients with bleed- ings, leeches, cupping, setons, artificial ul- cers, hot irons, disgusting draughts, pills and other kinds of dangerous and repugnant me- dicines ? Assuredly, if the homoeopathic regimen contributes to the preservation of health, it has no more power than any other system in destroying disease. And those who advance the opinion, that it is the strict attention to diet, exacted by the homoeopathic physician which alone produces a cure, ought to feel the absurdity of supposing examples of such diseases as cholera, typhus, or bilious fever, being cured by such means ; and as regards chronic disorders, no one has effected their cure by a regulated diet alone. We know, on the contrary, that by adhering for a long time to a low diet, the organs of digestion are weakened, the susceptibilty of the nerv- ous system increased, and that thus new disorders may be produced. All this is so true, that it is only those of the routine phy- sicians who have very naturally lost confi- dence in their art, who have adopted this do- nothing practice. 128 The argument of our opponents is the less reasonable, even allowing it to be possible to cure by regimen alone ; for, in that case, of what use are the long and difficult studies of the medical practitioner ? and why does he devote his time to them if they lead to nothing better than to a simple diet? This would be placing a very low value upon the labors of those who have devoted their lives to the advancement of a science which they consider one of the most important: it would be placing that science itself in a low rank, and it would leave little hope to those who expect to derive from it some alleviation of their sufferings. Mbim •I,. ■ :'i l-.''".!'!-!.^! i.'.M.'l Lili'i'il,1 hl'llu!!;*! :!li:>:;l! :;rj!' !;iiliij iiilijiW'W, 'e;ji! i.rri'liti i