DIAEKHOEA, DYSENTEKY, DIAREHCEA OF CHILDREN, INDIGESTION, REMOEEHOIDS, ETC., ETC., THEIR TREATMENT ON HOMCEOPATHIC PRINCIPLES. BY / WILLIAM YALLANCEY"DEUEY, M.D., M.E.1.A., FOEMEHLT LECTURER OF MATERIA MEDICA AND THERAPEUTICS IN THE SCHOOL OF MEDICINE, PARK STREET, DUBLIN J FELLOW OF THE BRITISH HOJKEOPATHIC SOCIETY, ETC., ETC. SECOND EDITION\vi { Jb' ' ¦' LONDON: HEADLAND & CO., 15, PRINCES STREET, HANOVER SQUARE, W. 1866. ; r .; A pamphlet on Cholera, published in 1854, Eout of print, it became necessary to prenew edition, in doing this the original has been considerably enlarged, while rs on Diarrhoea, Indigestion, &c. &c, een added, the whole constituting a new It is written for the use of junior prac titioners in homoeopathy, and missionaries.* Emigrants also may derive help from it when out of reach of efficient medical aid. The action of each medicine is given in group ings, according to the symptoms met with in disease, while for greater security short reper tories are added. It is thought that the plan adopted will get over the difficulty so often complained of, and make the choice of a remedy easier and more certain. * The missionaries of the Church of the United Brethren, or Moravians — a most devoted body of men — are frequently called on to treat disease in the discharge of their labours, and that often under circumstances of peculiar difficulty. Should this little book prove of use to any among them who have adopted homoeopathy, it will not have been written in vain. iv Some observations on children are introduced, that it is hoped may be of use, the attention of the Author, from his position at the London Homoeopathic Hospital, being much directed to the study and treatment of their diseases. The practice of ordering medicines alternately is avoided, as, besides being unnecessary, it adds considerably to the difficulty of knowing which is the best remedy, and which is the one that may be doing good. I Bearing in mind the unsettled state of many estions in the homoeopathic body, the book equally adapted for those who use high or v dilutions, while those who do not agree as the size of the dose can regulate it according their own views. The author's mode of ictice is sufficiently distinct for those who Dose to adopt it. Allopathic as well as homoeopathic authors have been consulted, and. are occasionally re- 86, Hakley Street, Cavendish Square, W. Illovving list contains the names of the most tly used medicines ; those referred to in the c in capitals, while 48 of the most useful, for t case, are distinguished thus *. ¦lumbers give the pages where the medicines tioned. *Aconitum, 55, 142, 166. Agnus Castus. Agaricus Muscarius. Alumina, 109. Emonium Carbonicum, 142, 143. moniurn Muriaticum. Ktimonidm Ckudum, 20, 25, 26, 43, 142, 143, 181. riMONiUM Tartakicum, 96. Argentum Nitricum. * Arnica Montana, 164. *Arsenicum, 19, 20, 22, 23, 25, 39, 58, 60, 84, 92, 144, 166, ASAFCETIDA 181. Aurum Foliatum. *Baryta Carbonica, 142, 144. *Belladonna, 29, 38, 86, 142, 145. vis a. Bromine. *Bbyonia Alba, 20, 26, 110, 130, 146, 190, 191. A 2 vi *Calcarea Carbonica, 21, 26, 27, 28, 41, 129, 146) 166, 179, Calcarea Caustica. KALCAREA PIIOSPHORICA, 181 alendula, 177, 181. Camphor, 56, 83, 86, 89. Cannabis. *Cantharis, 28, 59. lapsicum, 23, 59, 166, 171. arbo Animalis, 167, 201. *Carbo Vegetabilis, 60, 85, 94, 142, 147, 166, 171, 201. Causticum, 167, 171, 181, 185. *Chamomilla, 21, 25, 38, 142, 147, 168. Ihina Officinalis, 19, 21, 22, 23, 25, 26, 29, 60, 61, 142 148, 169. Btsa, 27, 41. ematis. tccuLus, 25, 142, 148. FFEA. CoLCHICUM, 60. *Colocynthis, 24, 56, 84, 149, 168, 179 *Conium, 142, 149, 201. Biprum Metallicum, 86, 93. gitalis. Drosera Kotundifolia. txcAMARA, 20, 22, 25, 29. patorium, 60. Ephorbium. phrasia. ix Mas. vii E?hites, 149, 168, 185, 190, 192. amelis, 164. Helleborus Niger. *Hkpar SuLrauίis, 150, 182, 183. Hydkastis Canadensis, 113, 186, 202. *Hyosctamus Nigek, 19, 29. *Ignatia Amara, 142, 150, 168, 187, 190, 192, 200, 202 lODIDM, 28. *Ipecacuanha, 20, 23, 26, 40, 58, 85, 93, 151, 168, Jatropha Curcas, 95. Kali Bichromicum. *Kali Carbonicum, 151, 169. Kali Hydriodicum. Kalmia Latifolia. Kreosotum. *Lachesis, 110, 142, 151, 202. Ledum Falustre. Lobelia Inflata. *Lycopodium, 110, 133, 142, 152, 169. Magnesia Carbonicum. Magnesia Muriatica. Mercdrius Corrosivus, 43, 57. *Mekcueius Solubilis, 20, 23, 24, 26, 40, 43, 57, 85, 129, 152, 190, 192. Mezereum. Moscnua, 142, 153. Muriatic Acid, 169, 171. Natrum Caubonicum, 154. Natrum Muriaticum. *Nitric Acid, 169, 171, 187. Nux Mosciiata, 142, 154. *Nux Vomica, 23, 24, 57, 110. 142, IG9, 172, 187. 190, 192, *Phosphokus, 22, 26, 156, 182, 188. Boric Acid, 19, 26, 61, 95, 142, 156, 170, 171. cca Decandra. *Platina, 111. Plumbum, 112, 200. *Podophyllum Peltatum, 21, 22, 42, 112, 190, 193. *Pulsatilla, 24, 29, 43, 59, 85, 133, 142, 156, 170, 171 •Rhbom, 20, 24, 29, 40. Rhus Eadicans. Eoxicodendkon, 23, 61, 157. a. *Sabina, 157. Sambucus. Sanguinaeia Canadensis, 181, 182, 202 Sarsaparilla, 188. *Secale Cornutum, 26, 94. Selenium. *Sepia, 29, 157, 188, 190, 193, *Secale, 29, 30. *Silicea, 61, 158, 182, 202. Spigelia. ?StAPHYSAGRIA, 61, 142, 159, 179. •Sulphur, 19, 21, 25, 26, 27, 28, 42, 61, 112, 142, 159, 170, 171, 183, 190, 193. Sulphuric Acid. « Terebinthma. Thuja. Viola Tricolor. *Veratrum, 20, 24, 25, 43, 61, 85, 86, 91, 160. Vekatuum Vieide, 171. Zinc. For the sake of uniformity, those new to homoeopathy are recommended to use the 12th centesimal dilution. For tropical countries, the medicines should where practicable be obtained in the form of tincture. Spirits of Camphor. — It is recommended that this be prepared by dissolving in spirits of wine (60 over proof) one half its weight of Camphor. According to information received from Headland and Co., a saturated solution contains its own weight of Camphor, while the old homoeopathic Spirit of Camphor contains one-sixth part of Camphor. Those who on Dr. Rubini's authority (see page 78) prefer to use the strength recommended by him, can regulate the strength of their dose according to the number of drops they give, while any that have the weaker preparation can in like manner regulate the size of their dose. Should any unpleasant effect remain after the Camphor, a little strong coffee will help to anti- X EXTERNAL REMEDIES.* KJ external application, the medicines may be d as lotions or in the form of cerates. Ehose to -which reference is made are Aenica, ENDULA, HAMAMELIS, HYDRASTJS CaNADENSIS, guinaeia Canadensis, and Veeatrum Viride. K^hese medicines, as well as the Tincture of Camr, should be kept separate from the diluted licines. Irhey should not be used too long, and should once be discontinued on the appearance of any Vicinal symptom. In such a case, when they are lmed, they should only be used at half or one¦d of the strength previously employed. II r hen used in the form of injection, as recomded at page 202, care should be taken either to them less frequently or not at all, if they pro! irritation or induce medicinal action. Some may prefer using them in the first instance in a much more diluted form ; and this is recommended to those not very familiar with the use of these remedies ; the great object being, to obtain all the good possible, without producing fresh symptoms. * See Homoeopathic Guide in the Treatment of Accidents and Use of External Bmedto, by William V. Dkbky, M.D. xi TABLE OF CONTENTS. PAGE 3om— with Bloody do. . . 22 — with Scalding do. . . 23 — with Griping and Colic Pain 24 — from Errors of Diet . . 25 — in Hot Weather 26 — Chronic 26 — with Worms 26 — Scrofulous 28 — of Child-bed 29 — with other Illness .... 29 — of Children 31 Eepertory for Diarrhoea . . 44 — for Evacuations 49 Dysentery 52 — Treatment of 54 Repertory for Dysentery 63 Cholera 68 — Nature of Epidemics . . 74 — Symptoms of Cholera.. 74 — Statistics 76 — Results of treatment by Camphor 78 — Allopathic approaches to 78 — Treatment and General Management 79 — Premonitory Diarrhoea 83 — Prophylactic Treatment 85 — Treatment of Cholera . . 87 PACE Constipation 103 — Symptoms that sometimes follow 105 — Causes of 106 — Treatment 107 Indigestion 114 — Symptoms of 120 — Ulcer of Stomach 126 — Causes of 127 — Cases 129 Flatulence 133 — Symptoms 134 — Causes of 135 Treatment of Indigestion, Dose 141 Indigestion, Flatulence, &c. — Principal Medicines of use in 142 — Medicines with some of their chief uses 142 xii PAOE Haemorrhoids 161 — Symptoms of 161 — Hajmorrhoidal Colic . . 163 — Causes 164 — Treatment 165 — Chief Remedies 171 — Surgical Treatment . . 171 Polypus of the Rectum .. 178 Fistula in Anus, &c 180 Ahscess 183 Fissure and Ulcer 184 — Treatment 185 Prolapse of the Rectum .. 190 — Treatment 190 — Surgical Treatment . • 194 Stricture of Rectum 196 — Cancer 198 — Treatment 198 — Choice of a Medicine . . 200 Repertory 204 AND THE MODE OF ADMINISTERING THEM. Medicines used in Homoeopathic practice are kept by the Chemists in the form of Tinctures, Pilules, Globules, and Triturations or Powders. Substances that can be prepared as Tinctures are kept in all strengths, from " the mother," or strongest tincture, up to what are known as the high dilutions, 30, 200, &c. Insoluble substances are kept in the form of powder or trituration up to the fifth centesimal dilution, after which, as experience shows, they are capable of imparting their virtues by solution or otherwise to alcohol ; above this strength they are kept in the form of tinctures, and can then be used for preparing pilules and globules. These are prepared in the same manner, by saturating them with the tinciof whatever strength may be required. As have to be moistened throughout with the re, the globules have the advantage of being b more easily and more thoroughly penetrated, me pilules on the other hand are more easily counted, and are less liable to be lost, and have the advantage of size, which has great attractions to recent converts from allopathy, who have not learned that the great secret of homoeopathic success is the choice of the right medicine, the want of which cannot be compensated for by the size of the dose. I The dilutions are prepared, in the case of insoluble ags, by triturating one grain of the medicine with lety-nine grains of sugar of milk, or for the deci-1 scale, one grain to nine. Medicines that can obtained in the form of tinctures are diluted by ling two drops of the mother tincture to ninetyle drops of alcohol, or such other solvent that it takes up the active property of the drug. The ther dilutions are prepared by keeping to the ac proportions. I The third dilution of insoluble substances is someles ashed for at the chemist's in the form of tincture, ule, or globules. If such be supplied, the chances '¦ they are utterly worthless, as they should only be •d in thefo r im of trituration, belovo the sixth centesimal I Without going into the question of the efficacy of uted medicines, whieL subjact is fully discussed other treatises en homoaopathy, it is sufficient to y that their power has been fully demonstrated, 2 rnds of times, during a period extending over century. We get a clue to the action of these small quantities by supposing that the trituration, or succussion (in the case of tinctures) that the drugs undergo in the making of the dilutions developes some power similar to electricity, which gives a force to the medicine that but feebly exists in its crude state. Then, again, the medicines being given on the principle of like curing like, the smallest particle is directly antagonistic to the disease ; and as we cannot say how small a particle of miasma may develope a fever, we cannot say how small a quantity of a medicine strictly homoeopathic to it may antidote it. Let the explanation be what it may, the facts are established, and the law of small doses was not arrived at by guess work, but resulted from the pure experimental induction of the master mind of Hahnemann.* (has been asserted that the high dilutions act sr in chronic disease, the low dilutions in acute, -tever truth there may be about the action of higher in chronic disease, there is no sound ority for the statement about the superior effiof the lower ; on the contrary, those who have Borne further remarks on this subject will be found in troductiou to my book on External Remedies. B 2 3 tested the high dilutions in acute disease (which many who use the low dilutions have not) are fully convinced of their power. So in regard to globules. Some prefer tinctures ; but it should never be forgotten that homoeopathy was raised to its high position by men who used globules for many years, and whose success certainly has not been sui'passed by any men of the present day. It may be regretted that Hahnemann did not confine himself to the use of tinctures and powders, as less prejudice would have arisen ; but having used them, we cannot now deny their efficacy. Many medical men of high standing use the low dilutions, and meet with a large amount of success. If these potencies are as efficacious, they possess the advantage of being more easily prepared, and there is less difficulty in believing in their action. Whether this controversy will ever be settled it is hard to say, but it is much to be regretted that so much party feeling has been allowed to grow up. The only way to arrive at truth is for the men of each school, laying aside prejudice, to watch the practice of the other, and to test both methods in their own practice. Till the question is more nearly adjusted, each medical man must decide these points for himself, and choose the tincture, pilule, globule or strength, that he can best cure disease with. 4 Administration of the Medicines. To prepare the medicines for use. If Tinctures are employed, one drop ; If Pilules, five ; E lobules, nine may be dissolved in nine spoonsful of cold water, and well mixed by loured backwards and forwards from one to another about thirty times. ¦ssert-spoonful may be given to an adult for a t tea-spoonful to a child. ¦ glass in which the medicine is, should be vered with white unscented paper. ¦ould be kept in a cool place, where there is eh sunlight, and away from all spices or ¦spoon should not be allowed to stand in the c ; and if two medicines are used, each should 3eparate spoon. ¦Ups, tumblers or spoons should be well before being used for any fresh medicine.* Triturations are given dry on the tongue, f and for * Medicine cups marked one and two, and of two sizes, are kept by all homoeopathic chemists. They have covers, and will bear boiling water without breaking, which tumblers rarely will. t By some medical men they are administered immediately 5 i ip • -ii ill the sake of convenience, pilules or globules are at times given the same way. In cases where the power of swallowing is lost, it is a great advantage to be able to give medicines in this way. In apoplexy and similar cases, the tincture may be held close to the nose, to allow of its being inhaled ; or some pilules or globules, dissolved in a small quantity of water, to which spirit of wine is added, may then be inhaled. There is but little doubt that medicine administered in this way acts well, and in urgent cases may be used, as well as putting the medicine dry on the tongue. One pilule or three globules may be given for a dose. ¦ occasionally asked what books I recommend study and practice of homoeopathy. ¦following list supplies the names of those onsider most generally useful. ¦temann's Organon. For information as to t principles of homoeopathy, and what he Hull's Jahr. 2 vols. Biann's Acute and Chronic Diseases. 4 vols. t's Manual. For domestic use, Hering's or Kelly's Hand-book. * Hahnemann's Materia Medica and Chronic Diseases 6 7 DIET, CLOTHING, VENTILATION, &o. Phas been written on this subject, and long fawn up of what may be eaten and what — lists that are laughed at by the healthy, times very carefully studied by the hyiriac. Homoeopathy is not a system of :s, nor is it a " Hunger Cure." Common sense points out pretty plainly what may be eaten as wholesome, and what left untouched ; and though people often very unwisely transgress in these matters, a list of rich, articles of food will more likely remind the person fond of good living of what he would like than lead him to avoid it. Besides the old saying is very true, "What is one man's meat is another man's poison." Some eat pork with impunity, others cannot touch it. Few would think of interdicting roast leg of mutton, and yet there are stomachs that will be upset by touching a particle of the brown, or even of the gravy off the dish. Each medical man, when "consulted, will point Ewhat suggests itself to his mind for the indiual case before him. Many homoeopaths content themselves with forbidding rich or highly-seasoned food ; coffee, as being medicinal, and strong tea ; fixing the amount of stimulant that may be required or not exceeded ; or, in the case of severe illness, pointing out the food that will be best borne by the stomach, or furnish the largest amount of nutriment. When cholera or epidemic diarrhoea prevails, a little more caution may be required. Thus pork in hot weather, shell-fish out of season, sour wines or ale, unripe fruit, uncooked vegetables, tainted meat or game, all fish, fruit or vegetables not quite fresh should not be used at all; while certain fruits, such as melons, stone fruit and raw apples, cyder, iced drinks, malt liquor, made dishes or rich fish should be used with great moderation. I Among things that may very safely be forbidden, mts should not be omitted ; they injure the neriis system, and induce hysteria; as at present sd they cause much annoyance. Those ladie9 lo like them should recollect that others dislike 3m, especially when forced upon them in omnises, churches, or letters. The person in health who wishes to preserve it, should allow himself a fair variety of wholesome 8 not too fast, and at regular and not too long intervals. While advocating temperance in all things, it cannot be too strongly impressed on the minds of all, that a sufficient supply of good wholesome food, including vegetables, will often prevent the accession of disease or modify its progress ; a fact to be remembered not merely in reference to self, but in dealing with our poor population in workhouses, and with children in schools. The physician will often gain much help by attention to other points besides the administration of medicine. It would occupy too much space to do more than briefly allude to one or two of these. Clothing, exercise, cleanliness, and ventilation of houses are subjects that may often require looking to. In our changeable climate, it is often necessary to caution patients against wearing too light clothing. The fine days in the spring and fall of the year are succeeded by cool evenings and nights, so that it is better for those who are out at uncertain hours to suffer some little inconvenience by being prepared for all temperatures, even if a little too warm during the day, than to be exposed without a sufficient supply of clothing when it is cold. Hence one of the advantages of woollen garments, if changed sufficiently 9 often for the sake of cleanliness, and not worn in bed which is not cleanly, and is hurtful. Exercise is also necessary to the preservation of health, and when of a proper kind, may do much to preserve or restore health. Thus a man suffering from inactive liver, will often get rid of the inconvenience by the use of horse exercise. Cleanliness is as important to health as it is to comfort, and the neglect of it, either personal, or of our dwelling-houses, or the neighbourhood adjoining, is so apt to bring disease, that it is the duty of the physician to point out any thing that attracts his notice. Under this head the ventilation of houses is included, and provides for the free admission of fresh air, and the prevention of the escape of foul air indoors from defective drains or untrapped sewers. The use of certain articles of food will be found to assist much under certain circumstances ; thus habitual constipation will often be conquered by the use of brown bread, oatmeal porridge or stirabout. Mutton suet boiled in milk will be of use where there is emaciation, and it does not disagree.* In * Cod-liver oil, a teaspoonful or dessert-spoonful twice a day, taken in a little warm milk or orange wine, may be of use to strumous subjects, when not taking any medicine regularly. If it interferes with the appetite or causes nausea, it should be lessened in quantity or discontinued. 10 advanced stages of debilitating diseases, turtle soup will be found a valuable auxiliary. So also where there is much exhaustion and depression, champagne will exhilirate the patient, and often rouse him to take food and exercise that may enable him to throw off the feeling of illness that at times creeps on, without, for some time at least, any distinct disease being apparent. These are, however, expensive remedies, but the ingenuity of the physician will often provide substitutes that may prove extremely valuable, and go a great way towards the B should be brought as needed into the sick 1 removed when not required. The sight of en prevent its being relished, and its remaine air of a bedroom will not improve it. C3f-tea is an excellent assistant to the doctor ; two or three teaspoon sful, added to the other of an enfeebled infant twice or three times , will often make a wondrous change in its tion. ¦ose severe illnesses where nothing but beef be taken, it will help to sustain life ; aided be, by port wine or brandy till the disease ad other food can be assimilated. * * Beef-tea is best made as originally directed by Liebig. 11 I Diet for Persons Suffering from Diarrhcea. the first appearance of diarrhoea, it is desir-3 that some restriction be placed on the food en, as it is often aggravated where this is not ;nded to. Where there is nausea or vomiting, ill pieces of ice may be placed on the tongue. is is very grateful, and allays the sickness. Beefmay be given from time to time in small quants till other food can be borne. > Where the bowels act when food is partaken of, should be used in very small quantities, so as to ow it to be taken into the system without having > bowels disturbed. I Plain boiled rice ; rice pudding ; rice water ; arwroot; boiled milk ; chicken broth made without ice, and thickened with rice ; boiled chicken ; beefi; broth made from lean mutton, and thickened th rice ; lean mutton boiled, furnish a diet roll >m which to select according to the state of the tient. Port wine and water, or brandy and water, ly be given where stimulants are needed. stand in its own weight of cold water (a pound to a pint) for six minutes ; place on the fire till it boils ; then let it simmer for fifteen or twenty minutes ; strain, and add a little salt. In this way excellent beef-tea is quickly prepared, no small part of its merit when an exhausted patient is waiting for Rest. — There are few diseases that are more benefited by quiet than diarrhoea. Movement is very apt to bring on an action of the bowels. The remaining quiet, and resisting the desire to evacuate the bowels when the actions are frequent, will be a great advantage. In cholera, where the sickness does not prevent it, rice water should be drunk freely ; even cold water will prove very grateful. Strong broth and brandy and water may be given, to help to sustain the strength ; but the power of assimilation being more or less suspended, fluids will chiefly prove of use by replacing the great drain caused by the liiiuid evacuations. 13 14 DIARRHCEA. Diarrhoea, " a flowing through" is the term applied to liquid evacuations from the bowels. It may arise idiopathically, that is as a primary disease, or as a symptom of an already existing one, as happens in consumption, typhoid fever, &c. It occurs at all seasons of the year, but is most prevalent in the autumn, being partly attributable to fruit, but perhaps even more so to the change of temperature, from the great heat of the day to the cool of the evening ; also in some measure to the influence of the great heat, and atmospheric causes produced by the increased temperature and stillness of the air ; possibly also to the effects of bad drainage and the impure state of our rivers or springs at that season. Diarrhoea is also more prevalent when cholera is threatening, being a sort of advanced guard of the more dreaded enemy. It may run either into cholera or dysentery. J.i i i "WaA nn Ipr thp hpads of Diarrhoea of irritation; Congestive or inflammatory diarrhoea; and lientery or diarrhoea with undigested food. The first form — Diarrhoea of Irritation, is produced by the food taken, either being in excess or containing something that produces irritation. ¦estive Diarrhoea arises from causes such 3, that induce an increased flow of blood to ous membrane of the intestines. EIRHCEA CONTAINING UNDIGESTED FOOD OCCUrS there is loss of digestive power. So manyre concerned in the assimilation of food, that ure of one, in the due discharge of its funcoon shows itself by the evacuations not being re called healthy. Besides such causes, undigested stools may arise from irritation or congestion, or may show itself in the course of other diseases ; in children especially in connection with teething or mesenteric disease. It may also show itself where there is deficient vital power following prolonged illness. Kes these divisions, diarrhoea may be said to 3 Or CHRONIC. Brnay be painless, or accompanied by griping colic pains ; flatulent rumbling ; straining, ng, or flatulence with stools ; nausea or vomitchills ; fainting ; vertigo ; or perspiration. Diarrhoea is said to be feculent in proportion to 15 I" 11 c increased consistency of the evacuation ; thus it ay be of the consistency of gruel, or very thick, c stools being partially formed. The stools, when ry thin, are called watery. In cholera, there is c peculiar appearance of rice water. The stools may contain curdled or undigested matter ; in children, they assume the peculiar chopped egg appearance. They may be bilious, frothy, slimy, flocculent, mucous, bloody, membranous, some of these being characteristic of dysentery. They may be whitish, greenish, yellow, brownish, or black. I The smell varies, thus they may be sour, pecurly offensive or putrid. Children especially are bject to sour evacuations. I From the combination of two or more of these /tures, diarrhoea may assume a variety of forms. it as the homoeopath selects his medicine from 3 similarity of its action to the group of sympas in the case before him, he has a rule to guide q that becomes the surer in proportion to the :uracy with which he makes his comparison ; ice every symptom has its value, some of course re than others. The greater his experience in treatment of disease and his knowledge of it, i greater the facility with which he chooses his 16 separate headings, pointing out the medicine most likely to be of use ; so that by looking for the principal symptoms, the medicine may be selected with greater certainty than if I were to give all the symptoms, and say that such and such a medicine may be of use. I find that it is a very common complaint, that the uncertainty of choosing from groups of symptoms leads to a frequent change of medicine, which is very bad practice. Still, where I can give one or two symptoms, often found together, I shall do so, as it may assist without confusing as a full group might do. After choosing a medicine, a further reference to the symptoms in the Repertory may make the choice as accurate as our present knowledge admits of. It cannot be impressed too strongly on the minds of all practitioners, that a knowledge of disease, and then the careful study of the Materia Medica and the Repertory based upon it, is the key to all sound practice. Once a medicine is selected, it should be persevered with steadily for some time, or till a change of symptoms calls for a fresh selection. A serious mistake is often committed in changing to a fresh medicine because a dose or two does not give marked relief. Kioea may set in suddenly with considerable or may follow after some previous indisposiger arising in proportion to the amount of >n produced by the continued drain on the c 17 system, and may be further increased by the presence of pain. I Chronic diarrhoea, when the actions are not imerous, may in some cases continue a long time thout endangering life ; but if it can be checked, should never be allowed to continue, as it may oduce unhealthy changes in the intestines, and ly gradually undermine the strength, besides aiding more readily the inroads of other diseases a weakened constitution. Besides this, chronic irrhcea should be looked on with suspicion, lest it but a symptom of some important disease. CHOICE OF A MEDICINE, AND ITS ADMINISTRATION IN DIARRHCEA. See Repertory at the end of article Diarrhoea. I The medicine is to be selected in accordance with Lat has been said at page 17, and is to be mixed as ected at page 5 ; that is, if tincture, one drop ; if ibules, nine ; if pilules, five, in nine dessert >onsful of cold water, and well mixed. A dessert )onful to an adult, and a teaspoonful to a child, If a teaspoonful to a young infant, may be given 3ry one, two, or three hours, and after each action the bowels, till relief is obtained ; then at longer ervals. In chronic diarrhoea, a dose twice or ree times a day may be sufficient. 18 Wenham Lake ice, in small pieces, on the tongue from time to time, if there is vomiting. Best, as mentioned at page 13, is of great importance. Forms op Diarrhoea usually met with, and Medicine most Frequently Needed. Painless Diarrhoea. — A patient may be attacked with a desire to evacuate the bowels, followed by a loose feculent stool ; after a time, another loose action takes place, followed by others, which may become quite watery. If no cause can be traced as likely to have brought on the attack, and there be no peculiar symptom or characteristic about the stool, Arsenicum may be given. If there is much debility following the attack, China may be given. In a protracted attack of painless diarrhoea, Ferrum may be used. In chronic painless diarrhoea, Phosphoric Acid For involuntary painless diarrhoea, occurring in childbed, Hyoscyamus. Where these remedies fail to give relief, Sulphur should be used ; but if other symptoms, which are usually present, show themselves, they should be compared with the above, or for a larger list of medicines having this symptom of painless diarrhoea, the Repertory may be consulted. c 2 19 Chill. — Simple Diarrhoea from this cause should be treated, in the first instance, with Dulcamara. Where colic and pains in the hones are present, Mercurius. t)iarrhcea, arising from cold, alternating with stipation and spasm of the stomach, Bryonia. With Vomiting. — Ipecacuanha. For nausea, vomiting with or without diarrhoea, griping and fermented stools. A dose of this or the other medicines every half-hour or hour, and after vomiting, till relieved. lAntimonium Crudum. Nausea, violent vomiting, guish, foul tongue and disordered stomach. IVeratrum. Prostration, coldness, violent diaroea and vomiting. lArsenicum. Great thirst, anguish, fainting, vomity and diarrhoea. Case. — Last November, a gentleman awoke from sleep soon after midnight, suffering from nausea. After a short time he vomited whatever food was on his stomach ; this afterwards changed to bilious vomiting. There was pain in the stomach, as if a blow had been received there. He had one dose of Ipecacuanha, but in consequence of the wretched feeling of sickness, sudden faintness followed by copious watery actions of the bowels, I gave Arsenicum, using the 12th dilution, which was most 20 with this medicine, the symptoms soon abate< though the faintness returned more than once From the rapidity with which this came on imme diately preceding a copious watery stool, it appeare< as if there was a rapid pouring out of the water part of the blood into the intestines, similar to wha may take place in cholera. The fears of an outbrea of cholera had not subsided at this time. Sourish Evacuations. — Very common in the diarrhoea of children ; if present with the peculiar chopped egg appearance, Chamomilla. For simple sourish stools, with or without griping, Rheum. If with straining, Mercurius. Where the attack is prolonged in children, in scrofulous or consumptive patients, Calcarea Carbonica. Where any of the foregoing remedies fail to give relief, Sulphur. Whitish Evacuations. — When occurring without any other prominent symptom, or when chronic, Calcarea. If there is much colic or straining, Mercurius. If with pain after food, flatulence or debility, China. With children teething, at first Chamomilla ; but if persistent, Calcarea. 21 White mucous diarrhoea, Dulcamara. Undigested Stools. When passed without pain, Ferrum. If coming on at night, or after eating or drinking, China. If accompanied by vomiting, much prostration from copious action during teething, or with dysenteric symptoms, involuntary or after food, Arsenicum. Occurring in elderly persons, Phosphorus In children, with prolapse of bowel, or whitish slimy stool, Podophyllum. Bloody Stools. When blood is passed by stool, it must be determined whether the case is one of bloody diarrhoea, bleeding piles, or dysentery. If there is soft feculent matter mixed with each evacuation, the case may be regarded as one of diarrhoea, though it must not be overlooked that haemorrhoids and diarrhoea may exist together ; but in that case the previous existence of haemorrhoids and the character of pain would help to point out the nature of the case. In like manner the character of the pain and evacuations would distinguish the case from one of dysentery. Many of the medicines required for dysentery will be found useful here ; so that if the symptoms are accurately 22 For bloody evacuations, chiefly consisting of bright red blood, Ipecacuanha every ten or twenty minutes till amendment takes place. Evacuations bloody, with burning, vomiting, ex cessive. colic forcing out of the rectum, Arsenicum This medicine will also be found very useful fo bloody diarrhoea occurring in measles, small-po PRhus Toxicodendron will also be found serviceable rheumatic and typhoid fever, when the stools are mixed with blood, or are red and yellow, and mixed with jelly like mucus. rercurius for bloody mucous stools, with straincolic and desire to evacuate bowels, with scanty action. Capsicum. (See the action of this medicine, Scalding Stools, and article Haemorrhoids.) Pi, every two or three hours, for the debility a loss of blood by stool. O Scalding Stools. Arsenicum. Burning acrid stool. INux Vomica. Frequent small stools, causing a ling of smarting or burning. Eapsicum. Smarting, stinging pain in anus during rhoea. Km. Green, slimy, acrid stools corroding burning of anus and soreness with diardren 23 with these symptoms. Pulsatilla. Loose and acrid stool from errors of diet. Diarehcea with Flatulence. (See Flatulence.) Gkiping and Colic pain. IColocynth. Griping pain about navel, relieved by tion; griping like cutting squeezing, worse on >ving, relieved by bending forward ; feeling as if ueezed between stones ; colic with emission of tulence, griping worse after meals. Veratrum. Grumbling and pinching in abdomen ; flatulent colic ; nightly colic. It is an excellent medicine for the crampy pains in stomach and abdomen. Different cases that occurred in the autumn of 1865, where the diarrhoea was slight but the crampy pains severe, were relieved by this medicine. Mercurius. Griping pain ; colic which is only relieved by lying down ; cutting, writhing pain with talmy feeling; stabbing pain; pinching with chilliss and shuddering ; all the better indicated if th small actions and straining. 1 Rheum. Cutting pain with distension of abdomen d sour pap-like evacuations. INux Vomica. Griping pain followed by small tiding actions. I Pulsatilla. Colic relieved by rest, aggravated by >vement; flatulent colic with loose acrid stools, ging as if diarrhoea would set in. D D 24 (rsenicum. Excessive pains at night; after eating rinking ; wandering pains in abdomen ; pains anguish, restlessness and despair; lacerating, modic pains ; writhing sensation. ¦ omilla. Hot diarrhceic stools, with cutting drawing pain in abdomen, especially during ¦, or if produced by anger. Eur. Frequent pappy stools with cutting in 1 ; tenesmus, followed by expulsion of hot iulence, or brownish diarrhoea with pinching. Dulcamara. Diarrhoea with colic after cold ; pinching in abdomen ; oppressive colic with rumbling preceding and succeeding stool. Fainting. ¦ icum. Fainting fits ; palpitation and tre weakness. Cocculus. After stool tenesmus and fainting Dulcamara. Slimy diarrhoea with faintness. Veratrnm. Extreme weakness during stool. DIARRHffiA FROM ERRORS OF DIET. Arsenicum. When caused by eating fruit. Ktilla. When attended by flatulence, nausea position to vomit, vomiting of food ; if after rich food. Colocynth. If with griping pain. Ammonium Crudum. Disordered stomach, loaded 25 Ipecacuanha. Where there is much vomiting. I Diarrhoea in hot weather. See Diarrhoea from hiU. lAntimonium Crudum. Weariness, languor and (ordered stomach with diarrhoea in hot weather. Headache and feverish symptoms, and irrhoea from exposure to heat. Chronic Diarrhoea. IThe symptoms present in each case must point fc the treatment in accordance with the foregoing ections and with the repertory ; but the medicines st likely to be of use are Calcarea Carbonica, ma, Phosphorus, Phosphoric Acid; Sulphur and 'ah where there is great exhaustion and prostraa of the vital powers. Diarrhoea with worms. I Among the most prominent symptoms caused by >rms are picking of the nose ; itching in the recn; blueness below the eyes ; frequency of passing ter ; irregular appetite ; starting and moaning ring sleep ; grinding of teeth ; spasms or convulns, and distended abdomen. In addition to these nptoms, mucous or bloody diarrhcea is occasionally ssent. Mercurius is one of the best medicines in the treatment of worms, and one that I have found more generally useful than Tina 1" 1 " 26 versally recommended. The reason that this latter is found to fail may be owing to its being given simply because worms are present : when properly indicated by the symptoms, it is a valuable remedy. Mercurius may be given where there are white pappy involuntary stools, moaning restless nights, convulsions, and disposition to weep. Cina is also of use where there are pappy o bilious stools or white involuntary diarrhoea ; vora cious appetite ; vomiting and diarrhoea after drink ing; vomiting up of worms; constant pressure i the stomach in the night ; tossing about and lamen tations ; disposition to pick the nose ; paleness o face; delirium; convulsions, and twitchings of limbs It has helped me very much in whooping coug with children who had what I may call the worm constitution, being also otherwise indicated. ¦ rea Carbonica, Sulphur, and other medicines of use where indicated by the symptoms. iugh it is of the utmost importance that the of the disease should be known, if even for g else but to know the symptoms to look for :pect, it cannot be too often inculcated that is no worse practioe than treating a disease on account of a name. The existing sympurnish the only key to safe practice. The following case bears on the point. A little 27 28 suffering severely from painful urination, with constant and urgent desire to pass water. I asked the question if the child suffered from worms. The mother had never seen any, and was not aware that she did. I gave Cantharis 30, to get the urinary symptoms relieved, which object was attained ; but in addition, a very large quantity of small threadworms were voided. Scrofulous Djarrhcea, or more properly the diarrhoea of scrofulous persons, must be treated according to the character of the diarrhoea ; but Calcarea Carbonica and Sulphur are medicines that may be of use to the constitutional state. lodium (lodine) is also a medicine that is of much use in scrofula. It is of use for irregular stool alternate constipation and diarrhoea ; long and ex hausting diarrhoea; violent diarrhoea with colic copious discharge of a watery, foamish whitish mv cus, with pinching around umbilicus ; discharges o thick mucus, or purulent, part of the feces being retained, like dysentery ; discharges of bloody fetid mucus ; itching and burning in anus. Choleraic Diarrhcea. (See Premonitory Diarrhoea of Cholera.) DIARKHGEA OF CHILDBED, ¦ not of very frequent occurrence, nor differmuch from ordinary attacks of diarrhoea as ire any very extended notice, as the rules laid down are equally applicable, may in iwo cases require some special medicine. Kelladonna. Where congestion of the womb, with sing pain; or erysipelatous redness of the breast, itening abscess, is accompanied by diarrhoea. ¦ tilla. Where, in addition to diarrhoea, the r secretion of milk is suppressed, or where phlegmasia alba dolens. Bmara. Where there has been a chill that ight on diarrhoea. ¦m. For colic and cutting pain ; urging and etid stools. Sepia. Offensive mucous diarrhoea; acrid or offensive leucorrhoeal or lochial discharges ¦3. Watery mucous diarrhoea ; involuntary a, with great prostration ; especially if there se or prolonged bloody lochial discharge. China. For the debility following such attacks. Hyoscyamus. Involuntary diarrhoea, painless. DIARRHCEA WITH OTHER ILLNESS. In the course of other diseases diarrhoea is apt to set in, and from the great exhaustion consequent 29 Thus in small-pox, measles, scarlet fever, it may appear. In typhoid fever it is a leading symptom. In consumption it is very apt to alternate with night sweats, and so exhaust the strength. Under homoeopathic treatment the consumptive patient gains considerably, for the administration of Sulphuric Acid to check the perspiration and of Acetate of Lead to check the diarrhoea, or other medicines given for the same objects in allopathic practice, often fail to benefit the patient ; for though one symptom may be relieved, it is only too frequently to be followed by aggravation of the other. I The medicines most likely to be serviceable are senicum, Calcarea Carbonica, China, Hyoscyamus, ircurius, Pulsatilla, Phosphoric Acid, Rhus, Veram, and Sulphur. The rules for their selecq in no way differ from those already laid down : 3 medicine may require a separate notice. Secale. This medicine is exceedingly valuable in colliquative diarrhoea, either voluntary or involuntary, and when attended with great exhaustion or collapse. Its action in producing petechire, and spots of ecchymosis and gangrene, point to its use in fever, purpura, and senile gangrene. 30 31 DIARRHOEA OF CHILDREN. Geneeal Management of Children, &c. (the period of childhood is rarely passed without ac attacks of diarrhoea, a few words on the cause 1 treatment of such attacks, as well as on the nagement of children generally, seems necessary. IVLy experience at the London Homoeopathic Hosil, where I see a large number of children, as 1 as those I see in private practice, enables me to iorse the opinion so often expressed, that many the complaints of children, diarrhoea especially, aggravated, if not altogether induced, by misnagement in the matter of food ; and apparently y slight causes, suffice to disarrange a child's A child that is wet-nursed by its mother, or a woman hired for the purpose, is affected by emotions of the nurse, such as grief or anger. Her diet also will produce a marked influence for good or evil. If from bad health or poverty a sufficient supply of nourishment is not furnished to the nurse to supply the wear and tear to her own frame, as well as the dditional dram on it, the child will soon suffer. ut so on the other hand the child will be injured >y the overfeeding of the nurse, especially if she jets very fat on the increased diet which many take hen suckling. A good nurse may get a little ;outer, if thin after the termination of pregnancy. .er face should have a healthy look; she ought not ;o suffer from backache or feeling of exhaustion uring or after suckling. Vegetables, when first taken, are very apt to disrrange the stomach of the child ; but as they help ;o keep the nurse in good health, and when of a >roper kind improve the milk, it is desirable that le child should be gradually accustomed to the ilk secreted on a mixed diet. By attending to the uantity and quality of the vegetables, and occasionly discontinuing them for a day or two, most lildren can be brought to take the milk without uffering. Malt liquor is often partaken of in much larger uantities by persons nursing than is at all necesary. This ought to be avoided. The quantity of imulant taken should be regulated very much by le quantity used at other times. A slight increase ill usually be sufficient, as a little extra food, such s a good drink of milk and gruel at night ; barley ater and milk, if thirsty ; meat or egg for breakfast, if not usually taken, will help to supply the materials 32 and malt liquor in excess, which is so often insisted on by hired nurses, unaccustomed to any approach to such kind of living in their own homes, onty tends to derange their own health, and as a consequence injure the child. Where any drain such as menstruation, especially if abundant, or leucorrheal discharges exist, the nursing should be very carefully watched, and immediately lessened or discontinued on the slightest appearance of the child suffering. An abundant supply of milk which some delicate women have, is no proof that it is of good quality. A child partaking of such watery, unhealthy milk is very apt to suffer from cerebral mischief, convulsions, &c, which may terminate fatally on a first attack. I have different times seen such milk act like a poison, and have only by insisting on the immediate weaning of the child seen its life saved. I am satisfied that many children are lost from this cause, without any suspicion arising as to what really produced the mischief. The subject is far too little looked into by medical men. As some mothers, from the delicacy of their own health, are unable to nurse their children, they are compelled either to get a wet nurse or bring their children up by hand. In this choice of evils the medical attendant is usually appealed to, that his D 33 opinion may decide the point. This being the case, his mind should be made up beforehand, so that there may be no doubt as to what he is to recommend. My own experience teaches me that if directions are properly carried out, there ought to be no difficulty in bringing up the majority of children by hand. In the case of some few delicate children, where there is a deficiency of animal heat, and where there is general debility, vitality being at a low ebb, a wet nurse may be almost indispensable ; but with these exceptions it is not necessary, though, where a perfectly unexceptionable nurse can be obtained, no doubt nature's provision of woman's milk for the nourishment of the young infant cannot be improved The pernicious system of selecting wet nurses from amongst women whose lapses from virtue place them in a position to obtain these situations, is often t tended with evils that are but little foreseen by c mother, who is satisfied with a good-looking and apparently healthy nurse.* * It is no disinclination to help these unhappy creatures that makes me speak thus. On the contrary, I am most thankful for every judicious effort that is made to prevent their error, to restore them, and preserve them from falling lower in the path of degradation and sin. But when we are aware of the fearful immorality that exists in our land, and when we read the appalling accounts of the infanticide that 34 vvnere J. am reluctantly oDiigea. to act vise tn&t a wet nurse be procured, I recommend that a healthy married Irishwoman be obtained ; if possible, one who may have lost her own child, but who is not fretting. These women are in the habit of taking wet nurse's situations, which married Englishwomen as a rule are not, and from the warm-hearted feelings of their race make attached nurses. |)ne of the earliest causes that children brought by hand suffer from is sour food ; in hot weather, ecially, much diarrhoea arises from this cause, careless nurse neglecting to keep the feeding- J.e clean, may through her neglect induce a sharp ick, and if the source of the mischief is not ?cted, a prolonged one. Two bottles should be provided, one being always kept scalded and ready for immediate use, to replace the other. The old-fashioned bottle with a hole for is the reproach of our nation, and is sufficient to call down God's righteous indignation upon us, we should allow them to rear their own offspring, help them in every way to do so, but certainly offer no premium to them for having fallen ; though in many cases our pity may be largely called out for them, while our indignation is reserved for the greater sinner who has betrayed them. Of the manner in which disease may be propagated by nurses, Dr. Hughes Bennett gives a striking illustration in his Practice of Medicine, page 977, Fourth Edition. D 2 35 places about it for sour particles to lodge. The teats I An infant's food should at first consist of milk d water, — three-fourths milk, one-fourth water, lis may be given every two hours. When the ild grows older and stronger, and a larger quantity i be borne, the length of the intervals between 3 times of feeding may be increased. When a ange of food is called for, some thin arrowroot, or ird's farinaceous food, or well baked flour, baked some hours in a baker's oven, may be added to 3 milk, and given twice a day. This food should t be of a thicker consistence than cream. I When milk or food is vomited, the quantity given one time should be diminished, even if it has to given a little oftener. I When a child suffers from constipation, barley ter may be mixed with an equal quantity of milk, ; must be discontinued if the bowels become ixed. Parents often get unnecessarily anxious en a child suffers from constipation. It rarely es any trouble beyond inconvenience, and may relieved by treatment. My experience leads me think that children who suffer from constipai are far healthier than those subject to attacks liarrhoea. When a child is delicate, the food not appearing 36 to nourish (in some cases owing to the inferior quality of the milk), two or three teaspoonsful of strong beef-tea (prepared in small quantities at a time, as directed page 11) may be added, twice or three times a day; the quantity being cautiously increased, if desirable. It should, however, be recollected that a small quantity will go a great way with a child, if the other elements of nourishing food are good and in sufficient quantity. i3esides the medicines the directions for the use which have been already given, some require arate notice, with special reference to the diar;a of children. Eo facilitate the selection of theViost appropriate icine, the most prominent symptoms of each are n in italics.* llf the child objects to taking the medicine, disliking sold, or resisting perhaps from an unpleasant recollection iuseous doses, a little powdered white sugar at the edge le spoon will sometimes help to get over the difficulty, a young infant, half a teaspoonful will be sufficient for ise. Where the child's dislike cannot be overcome, or re it is desirable to avoid giving the cold medicine, the ules may be given dry on the tongue; but the handling medicines should be avoided as much as possible, on unt of the perspiration of the hand. The habit some nurses have of wetting the finger to take up the globules is very objectionable. 37 I Dose. — A dose may be given from one to four hours, needed, and after each action. Chamomilla. Especially during teething; painful elling of gums and toothache. This medicine will >c found useful where there are restless nights ; oaning; crying out; excessive drowsiness orheaviess; fretfulness ; starting; convulsions; feverish leat ; flushing of one cheek; sour, mixed greenish atery or whitish mucous stools, sometimes with omiting of food or colic; stools like mixed eggs; ungested stools; hot diarrhceic stools, smelling like tten eggs ; nightly diarrhoea with colic ; corrosive ools; painful or involuntary urination; flatidence; lirst ; rash and sore places on skin. I Belladonna will also he found of use during an tack of the diarrhoea of teething, as well as at any ne that head symptoms, such as convulsions, be esent. It will likewise be of use, if the general mptoms correspond, for diarrhoea occurring with arlet fever, and other complaints. It will meet any of those attacks of children arising from teethg or convulsions, especially where Chamomilla ,s not given all the relief that might be expected I The indications for its use are alternate paleness d flushing of cheeks; redness of face, coldness of it; abdominal pain; suppression of urine, or passing involuntarily ; drowsiness or stupor ; sleeping with 38 the eyes half open ; wandering ; restless tossing about ; waking up screaming ; distortion of eyes ; dilated pupils ; trembling of limbs ; rigidity of limbs ; convulsions. I Che forms of diarrhoea in which it is of use alone, >etter still if in conjunction with any of the above iptoms, are pappy, mucous, slimy, sourish or mish stools; diarrhoeic stool followed by urging ; esmus ; shuddering during stool ; flatulent colic ; oluntary discharge of faeces from paralysis of the incter ani. Efhere there is diarrhoea, a dose may be given y two or three hours ; but if symptoms of conions are present, it may be given every fifteen minutes, or at longer intervals, according to the r urgency. Ijn an attack of convulsions, cold water may be hed on the forehead, and the child put into a ¦m bath. Belladonna may be given dry on the gue if the child cannot swallow ; and should the ick be unusually prolonged, Camphor may be >wed to be smelt; but this should not be resorted hurriedly, as it may interfere with the action of le other medicine that may be on the whole better ted to the general state. Brsenicum. Where the evacuations are copious, ry, or involuntary, or where there is great proson, or where the actions are chiefly at night, or 39 follow the taking of food or drink. It is also of use for putrid, greenish, brownish, blackish, or dysenteric stools, for undigested stools, or where they produce much scalding. Excessive vomiting. Distention of stomach, worse after vomiting or diarrhoeic stool ; distention of abdomen ; great pain in stomach and abdomen ; sunken features, cold sweat in face ; aphtha in mouth ; great thirst. Diarrhoea produced by fruit or improper food Diarrhoea during teething. Ipecacuanha will be found of use where there is simple vomiting and diarrhcea. Also in the colic of children, where there is uneasiness, screaming and tossing about ; the stools are grass green, lemon yellow colour, or fermented. It may be given every one or two hours, and after each action, or after vomiting. Rheum is an excellent medicine for sour stools, with or without griping ; frequent urging to stool With loose pappy actions; increased urging on moving about ; sensation as if too much had been eaten ; colic is relieved after the action. Mercurius. Picking of nose, worms, loss of appetite, or offensive breath occurring with diarrhoea, are indications for this medicine. It is also of use for sour smelling, chopped egg looking stools; whitish, yellowish, pappy, or bloody, 40 For greenish diarrhoea with violent pinching and cuttiug ; soreness of anus ; bilious frothy stools ; tenesmus; scanty stools, desire for stool ivithout action; chilliness or shuddering before or during stool. Diarrhoea from a chill. Kain in liver ; cutting abdominal pain ; aphtha wss of month ; ulcers. Fina. Moaning in sleep, worms and diarrhoea, page 37. lOalcarea Carbonica is an invaluable medicine for ofulous or ill-nourished children ; for protracted thing or defective growth ; for chronic diarrhoea ; worms, especially after Mercurius, if that has ed to complete a cure ; for enlargement of abdon, and glandular swellings. It is of use for scanty, knotty, watery or pappy clay-like evacuations ; whitish stools with pain in liver ; frothy, sourish or involuntary stools. I)ase. — The following case for which Calcarea i selected with advantage, is merely inserted to w the symptoms for which that medicine was sen. i! was last year consulted about Master E. G., 9, suffering from darting pain at the lower ier of the liver. The pain, which had continued ut a fortnight, got worse of an afternoon, and i accompanied by flushing. 41 diarrhoeic stools in the day ; bad appetite. Calc. Carb. 7 / 30 globules, V 9 th every four hours. Podophyllum is of use for chronic diarrhoea that is worse of a morning; where there is extreme weakness and cutting pain in the intestines after stool ; for diarrhoea that is worse after eating or drinking ; the character of the evacuation may be yellow, dark green, white slimy, hot, watery or frothy mucus ; also frequent chalk-like offensive stools, with excessive thirst, in children; undigested stools; chronic diarrhoea, with prolapsus ani. It is of use for the diarrhoea of children, which is painful and attended with screaming and grinding of teeth in children. This medicine corresponds with some of the actions of Arsenicum and Chamomilla, and though perhaps of less value than those medicines, yet where the chalk-like stools and prolapse are present it is well worth a trial. Further experience may assign it a higher place. Sulphur, though a valuable medicine for constipation, is none the less so for diarrhoea, when properly indicated. It will be found especially valuable where other medicines have been given without producing the desired result, and where the diarrhoea is protracted. It may be given where there is bloody, brown, or green mucous stools, attended with moaning or crying ; frothy diarrhoea ; emission of hot, fetid flatulence ; scalding stools; white, slimy stool; 42 Mercurius or Mercurius Corrosivus has failed to give relief. Also for frequent pappy stool with cutting in abdomen. I Graphites. May be of use in cases of emaciation ; icous diarrhoea, whitish or reddish ; ascarides or nbrici ; distended abdomen with diarrhcea. It is 're likely to be needed in chronic cases. Kintimonium Crudum. For diarrhcea occurring in ; weather; with loaded tongue and disordered mach ; with vomiting. Dose same as Ipecacuanha. IPulsatilla. For diarrhcea from improper food ; ir regurgitation of food or sour vomiting; vomiting bile or food ; colic as if diarrhoea would come on ; ulence and rumbling; soft liquid stool; diarrhoea of isles ; watery diarrhoea ; mucous, slimy or bloody ,cuations ; loose acrid stool in the morning ; diar>.a with cutting in abdomen. Veratrum. Coldness ; crampy pains in stomach ; frequent and violent diarrhcea ; extreme weakness during stool; shuddering; rumbling of flatulence and colic ; vomiting and diarrhcea ; choleraic diarrhoea. 43 44 EEPERTORY FOR DIAERHCEA. touGH the directions previously given may be ficient guide to enable a medicine to be selected the treatment of most cases of diarrhoea, yet le will arise where a choice may lie between two or three medicines, or where greater certainty may be called for. To provide for such cases, a short Repertory of the principal medicines used for diarrhoea and its symptoms is added. In compiling it, besides Jahr, &c, I have availed myself of Bryant's excellent Manual, a book I can safely recommend ; indeed, if some fresh matter were added to it in a new edition, I know no Repertory that would surpass it.* In working with the Repertory, the medicine that takes in the greatest number of symptoms and those of most importance is the one that ought to be given. KBdnninghausen, Jahr and Possart, and Hempel have produced excellent books, that are valuable helps for king with at home. Bryant's, besides its other merits, is very portable ; B6nninghausen's (so called) Pocket-book is a goodly- sized octavo The medicines are distinguished according to their value: Small capitals for the most important; italics for those that rank next ; and small type for those that have the symptom, but about which, so far as our present experience goes, less is known, — though, if the medicine is otherwise carefully selected, it may be found to act as well as a better known remedy. Ehe medicines previously mentioned are disuishecl thus *. DIAERHCEA (medicines most frequently required in). Aeon. *ant-c. apis. am. *Ans. *bell. *Bey. *Calc. camph. canth. *caps. *Caeb-v. *Cham. *Chin. *cina. cocc. *coloc. con. cupr. *dulc. * graph, hell. hep. *hyos. ign. *iod. *Ipec. kal. lack. lye. magn. *Merc. mez. mur-ac. nitr-ac. n-mos. *nux-v. *phos. *phos-ac. *Podoph. *Puls. *Rheum. *rhus. sabad. sabin. sang. *secale. *Sep. sil. spig. staph. stram. *Sulph. sulph-ac. tart. *Vekat. Diarrhoea (with abdominal pain.) See with Colic. Diaerhcea (caused by acids) : Ant-c. Bry. lach. Nux-v. Staph. r^TERNATiNG WITH Constipation : ant. ars. hry. iod. lach. Nux-v. phos. rhus. ruta. sabad. Ancjer (after) : Cham. Coloc. nux-v. staph. Anguish anxiety (with) : ant. apis. ars. camph. jat. lach. mere, verat. tLDBED (of): ant. Hell. *chin. *dulc. *hyos. *Puls, rheum. *Secale. *Sepia. 45 DIAKKHCEA : ferrum. *graph. ign. *ipec. *MfflίO. n-mos. phos *Podoph, *Puls. *Kheum. *Sulph. *Vekat. Chill ok cold (from a) : ars. bell. Bry. camph. cham. Dulc. ipec. Mekc. n-mos. nux-v. op. puls. sulph. verat. Chilliness (with) : Mekc. Puls. spig. Sulph. Chronic : *ars. *Calc. chin. dulc. *ferr. Graph, hep. ipec. Jcreos. lach. magn. mur-ae. nitr-ac. phos. *Phos-ac. Sep. siL Sulph. verat. Cold drinks (from) : Ars. bry. carb-v. dulc. n-mos. puls. Colic (with) : aeon. am-c. ant. *Ars. bar-c. bry. camph. canth. caps. *Cham. *chin. colch. *Coloc. con. *dulc. hell. hep. Ipec. lach. magn. *Merc. Merc-c. mez. mosch. natr. natr-m. *nux-v. phos. *Puls. *Rheum. rhus. sil. spig. staph. stram. * sulph. *Verat. Colliquative (a term usually applied to any copious evacuation — as diarrhoea, or perspiration —such as may appear in the course of any other disease) : ant-tart. Ars. bry. Chin. con. ipec. jat. kreos. nitr-ac. n-mos. nux-v. phos. phos-ac. sec. Verat. Consumption (in): ars. calc. Chin. Ferrum. Phos. phos-ac. puls. sec. Cries (with) in Children : carb-v. Cham. Ipec. Podoph. senn. sulph. Damp weather (in) : dulc. lach. mere, n-mos. rhus. Dentitiok (during) : ars. calc. Cham. ferr. ipec. magn. Merc. sec. sulph. Distention of abdomen (with) : apis. ars. cham. colch. ferr. ipec. magn. Merc sec. sulph. Drinking (after) : Ars. cm. ferr. podoph. See Cold 46 DIAEKH(EA : Eating (after) : Aks. Chin. Coloc. Feee. Lach. podoph verat. Eructations (with) : ant. cham. con. dulc. mere. puls. Evening (in the) : caus. kal. lach. mere. Exanthems, eruptive fevers (after) : Ars. chin. mere. phos-ac. Pdls. sulph. Excoriation in anus (with) : ars. cham. ferr. lach. Merc. puls. verat. Faintness (with) : *Arsen. calc. coce. *dulc. *verat. Feeble person (in) : ars. calc. Chin. ferr. phos. Phos-ac sec. verat. Flatulence (with emission of) : see Flatulence : ant apis, carb-an. carbo-v. Chin. cocc. colch. coloc. dulc. ign. lach. magn. phos. Sep. staph. sulph. sulph-ac. verat. Fright (from) : ign. ipec. Op. plat. puls. Fruits (from eating) : ars. chin, coloc. lach. puls. Gkiep (after) : ign. Phos-ac. staph. Griping (with) : see Colic : apis. *Arsen. *Cham. *chin. *Coloc. dulc. Ipec. Merc, nux-v. Puls. Rheum, sulph. Verat. Headache (with) : podoph. Joy (from) : coff. op. puls. Lying-in women. See Of Childbed. Meal. See Eating. Milk (from partaking of) : bry. Lye. Sep. Sulph. Morning (in the) : am-c. ant. bry. podoph. verat. Nausea (with) : aeon. ant. am. ars. bell. dulc. hell. ipec. lach. mere. phos. puls. rhus. verat. Night (at) : ant. ars. bry. caps. caus. cham. chin. cm. dulc. ign. ipec. lach. mere, mosch. pub. rhus. sulph. 47 DIAKRIICEA : Old people (in) : ant. ars. bry. chin. Pnos. plws-ac sec. Pain in loins (with) : nux-vom. - in limbs (with) : rhus. in small back (with) : nux-v. Puls, in abdomen (with). See Colic. in stomach (with) : bell. bry. Painless : am. *Ars. bell. bry. calc. carb-v. cham, *ohm, cm. cocc. con. dulc. *Ferr. graph, hell, *Hyos. ign. ipec. lye. magn. mere, mur-ac. op. Phos, *Phos-ac. plat. puls. rhus. sabin. sec. spig. Stkam, sulph. Verat. Perspiration (with) : aeon. jat. mere Prolapsus of the rectum (with) : ars. calc. dulc. graph ign. lack. mere. Podopii. ruta. Sepia, sulph. Pregnant women (of) : ant. dulc. hyos. phos. puls rheum, sulph. verat. Eumbling in abdomen (with) : am. ars. ant. bry. cham, chin, colch. Coloc. hep. ign. magn. nit-ac. phos. sec strain. Verat. Scrofulous persons (in) : ars. bar-c. *Calc. chin, dulc, *iod, lye. Sep. Sil. *sulph. Siiiverino (with) : bar-c. dig. mere. puls. sulph. Shuddering (with) : bell. mere. puls. rheum, verat. Tenesmus (with) : aeon. ant. alum. Ars. bell, coloc. hep ipec. lach. Merc. Merc-c. nitr-ac. Nux-v. op. phos. rhus. sen. Sep. Sulph. — Evacuation (after) : caps. — Evacuation (before) : mere. See Dysentery. Thirst (with) : ars. cham. dulc. ferr. podoph. 48 Violent : ant-t. arg-nit. Aks. cupr *Verat. Vomiting (with) : *Ant. ant-t. *Ars. cupr. dulc. *Ipec. Jat. lach. phos. stram. *Verat. Weakness (with) : Ant-tart. *Ars. Jat. iod. mez. bell. cham. coloc. puls. rheum, sec. apis. bry. chin. ipec. kal. lach. mere, plios. Sec. stram. *Verat. Worms (with) : *calc-c. *c!na. *graph. magn. *mere. n-mos. plat. *sulph. DIARRHOEA, with Evacuations Acrid, Burning, Scalding: ant. Ars. cham. chin. dulc. ferr. ign. kal. lach. Merc. natr-m. nux-v. puls. staph. sulph. verat. Bilious : ars. Cham. chin. cm. dulc. ipec. Merc. Merc-c. nux-v. phytol. podoph. puls. tart, verat. Blackish : aeon. am. Ars. brom. bry. camph. chin. coloc. hep. ipec. kreos. mere, nux-v. op. phos. sulph-ac. verat. Bloody : aeon. ant. apis. am. Ars. bry. calc. canth. caps, carh-v. colch. coloc. con. cupr. dros. dulc. graph, hep. ign. iod. ipec. kreos. lach. magn-m. Merc. Merc-c. nitr. nitr-ac. n-mos. nux-v. petr. phos. plumb. puls. rhus. sabad. sil. sulph. sulph-ac. tart, verat. Bloody Mucus: am. ars. canth. caps, carb-v. chin, colch. coloc. dros. dulc. graph, hep. ign. iod. ipec. lach. Merc. Merc-c 1 . nitr-ac. nux-v. puls. rhus. sabad. Sep. sil. sulph. Brownish: arg. am. Ars. bry. canth. chin. dulc. kreos merc-c. rheum, sabad. Sep. sil. sulph. verat. Cadaverous (smelling) : am. carb-v. kreos. sil. stram. Changeable (one evacuation differing from another) : puls. Dysenteric : Ars. bell, canth. caps, carb-v. colch. coloc. dig. hep. iod. ipec. Tcreos. Merc. Merc-c. nitr_-ji£~~ —— ¦ nux-v. plumb, rhus. rhus-r. staph. sulph. taxt'.'yf,'^ ¦snted (as if) : Ipeo. sabad. Compare : Frothy, ulent : aeon. ars. calc. campk. cupr. dulc. ipec. jat. phos. ph-ac. rhus. sec. verat. Frothy : calc. canth. chin, coloc. iod. magn. mere op. podoph. rhus. ruta. sulph. sulpli-ac. Gelatinous (jelly-like) : apis, colch. hell. rhus. Sep. Greenish : arg-nit. Ars. calc. canth. Cham. chin, coloc dulc. hep. Ipec. magn. Merc. Merc-c. nitr-ac. nux-v Pnos. ph-ac. podoph. Puls. rheum, sec. Sep. stann Grayish : aeon. ars. hell. cede, carb-v. chin, colch. Dig hep. ign. ipec. lach. mere, nux-v. phos. Ph-ac. rhus sec. sulph. verat. Involuntary: ant-t. am. Ars. Bell. bry. calc. carb-v. chin. tin. colch. dig. hell. hyos. lach. mur-ac. op. Phos. Ph-ac. puls. rhus. sec. staph. sulph. Verat. — Night (at) : am. ars. bry. chin. lach. mere, mosch. puls. rhus. sulph. verat. — Sleeping (when) : am. mosch. puls. rhus. Motley (mixed up) substances : Cham. mere, n-mos. puls. rhus. sec. sulph. sulph-ac. Mucous : alum. am-c. ant. am. ars. bar-c. bell. bor. brom. calc. canth. Caps, carb-an. carb-v. caus. Cham. chin, colch. coloc. con. dig. dros. dulc. ferr. graph. hell. hep. hyos. ign. iod. ipec. kal. hreos. lach. led. lye. magn. Merc, merc-c. natr-m. nitr-ac. n-mos Nux-v. petr. phos. ph-ac. podoph. Puls. rheum, rhus. ruta. sabad. sabin. sec. sen. Sep. sil. spig. squill. stann. staph. Sulph. sulph-ac. verat. PApry : apis, ant-c. bell, carb-v. chin. cm. cocc. con. col. Merc, nitr-ac. op. phos. plat. Eheum. sil. 50 Purulent : am. bell. calc. canth. chin. cocc. con. iod. kal. lye. Merc, nux-v. petr. puls. Sep. Sil. sulph. Putrid : aloe. ars. bry. Carb-v. cham. Chin. cocc. coloc graph. Merc, nitr-ac. n-mos. nux-v. sec. Sep. straw. sulph. sulph-ac. Scanty : aeon. ars. hell, calad. caps, coloc. mere, merc-c Nux-v. Sour : aloe. am. calc. Cham, coloc. dulc. graph, hep magn. mere. petr. phos. Rheum, sep. sulph. Stinking, offensive: aeon. ars. bry. calc. carb-an. carb-v cham. chin. cocc. dulc. graph, ipec. lach. mere nitr-ac. nux-v. ph-ac. plumb, puls. rhod. Sep. sil staph. stram. sulph. sulph-ac. verat. Undigested (lientery) : ant. am. ars. bry. calc. Chin col. con. Ferr. graph, kreos. nitr-ac. n-mos. Phos ph-ac. Podoph. rheum, rhus. sang. sec. sil. sulph sulph-ac. Watery : aeon. aloe. ant. apis. arg. ars. bell. boy. brom calc. canth. carb-an. carb-v. Cham. Chin. dig. dulc ferr. hyos. ipec. jat. kreos. lach. mere, mur-ac. Nux-v petr. phos. ph-ac. podoph. Puls. rheum, rhus. sec. spiff staph. sulph. sulph-ac. tart, verat. Whitish : aeon. am. ars. asar. bell. calc. carb-v. cham chin, colch. dig. dulc. hep. ign. ipec. lach. mere nux-v. podoph. phos. ph-ac. rims. sec. sulph. verat. Yellowish : apis. Ars. bell. calc. Cham. Chin, cocc coloc. dulc. ipec. Merc. Merc-c. petr. phos. ph-ac plumb, podoph. puls. rhus-r. sec. tart. terb. verat. Consult also, article Flahdence and Repertory. 51 52 DYSENTERY. This disease is usually ushered in by diarrhoea though it may be preceded by constipation. It i described as a specific febrile disease, accompaniec by tormina or griping, followed by straining an scanty stools, consisting chiefly of blood and mucus with but little feculent matter. At a later perio the evacuations become larger, containing bile, puru lent discharge, and shreds of membrane ; the odou is very offensive. Scybala, as they are called, o hard lumps of feeces are sometimes passed. Serous reddish brown, offensive, putrid discharges, in larg tantities, may come on as the disease advances. iere is feverish heat, quickened pulse, dry skin, ¦red tongue, thirst, sleepless restless nights, high coloured and scanty urine. The abatement of these symptoms indicates a return to health ; the increase of them, with hiccough and vomiting, sharpened features, rapid and failing pulse, or in protracted cases steadily increasing emaciation, point to a fatal termination. The mischief that produces these symptoms seems Ibe in a great measure localised in the colon or ge intestine, commencing about the ccecum. The itary glands are affected ; the mucous membrane congested and swollen ; there are dark red or rple patches; the membrane shreds off or sloughs, ge pieces coming away by stool. The rectum and ¦t of the small intestine, as "well as the serous mbrane of the abdominal viscera, are implicated ; I if recovery takes place, the large intestine is to be left thickened, lessened in capacity, and weakened. Isolated cases of dysentery occur from time 1 time in this country, but less frequently than for merly ; in its epidemic form, it is not seen now a it used to be. But in China, India and Africa it i very fatal in its ravages. It is very prevalent i marshy, aguish districts. It has at times attackec armies with great severity. Our troops sufferec much in the Crimea and at Walcheren. It \va prevalent in Ireland in the terrible famine years The absence of vegetable diet, living chiefly on sal food, or insufficiency of food, will produce it. Atten tion to these points has greatly diminished the out breaks of dysentery, which has done as much o more to destroy armies as a bloody battle field. In our Navy, the improved quality and quantity of food has nearly put a stop to scurvy and dysentery. 53 Eit may, however, be protracted, and, chronic, continue for weeks, months, or In addition to the causes of dysentery already named, unripe fruit, or anything that produces irritation in the bowels, as well as the chills of autumn, may bring on an attack. The imperfectly cooked Indian meal no doubt helped to produce it in Ireland, after the failure of the potatoes. TEEATMENT. (From the nature of the disease, the effect of treat-3nt will very much depend on the cause that has oused the mischief. If from chill, or one or two meals of unwholesome or improper food, it may be lested in an early stage, when it might with :ater propriety be termed dysenteric diarrhoea, en when it has got fairly established, there is re hope of the medicines telling quickly, than en it arises from some cause long in operai, as from partaking of salted and insufficient 1, or from exposure to marsh miasma, where the Where any exciting cause is known to be in operation, the sooner it is removed the better. Good food, a dry situation, and warm clothing, may arrest an attack, or prevent it when threatening. 54 The diet must be regulated by what has been said at page 12. If the disease is chronic, it will be found that some articles, such as game, can be taken, while other meat cannot. Each case must be dealt with according to the manner in which food is found to agree, always recollecting that the strength of the patient should be well sustained by the most nourishing food that can be borne, and given sufficiently often to prevent any approach to exhaustion. Liebig's essence of meat promises much in these cases, if all said of it is true, or even partly true. Dr. Plassall has recently bx-ought out some new preparation. As there is every likelihood of their coming into very general use, they will most probably be produced at less cost and be more easily procured than at present. In some cases soup cannot be borne unless in the smallest quantity. Milk and farinaceous foods must then be trusted to. Frequency of Dose. — A dose of the medicine selected may be given every half hour, or one, two, or three hours, and after each action as the urgency of the case seems to call for. Aconite. This medicine may be given every one, two, or three hours, in cases where there are febrile symptoms, chills, heat, and thirst ; burning, pinching and griping, or spasmodic pressure at intervals in umbilical region ; scanty urine with burning and 55 tenesmus at neck of bladder ; frequent scanty and loose stools with tenesmus. So long as amendment goes on, the Aconite may be continued ; but if the symptoms alter, the stools becoming more dysenteric in their character, another medicine may be called for. The Aconite may, however, still be useful at night ; a dose every half hour for four or five doses, to procure sleep and allay the fever. Colocynth. Whether this medicine may be re quired before Aconite, after it or at a later perioc depends on the symptoms ; and the same observa tion applies to all medicines, as it is impossible 1 say how a disease will set in, or what effect a mcd cine may have on the disease ; thus in the cholerai diarrhoea of 1854, many of the cases that I treatei with Camphor yielded so far that the tendency t cholera disappeared, but were superseded by dysenteric attack. The symptoms calling for Colocynth, which i often required early, are — griping in the abdomen especially about umbilicus, like a cutting or squeez ing, worse on moving, relieved by bending forward griping worse after meals ; bruised feeling, or as i bowels were squeezed ; rumbling and emission o flatulence ; distention of abdomen ; cutting pains. Diarrhoea with tenesmus ; pappy stools preceded by burning and ar'mina 1 1 A t 1 56 burning at anus ; itching, burning, and rawness of anus, with oozing of mucus after an evacuation. Red tongue, edges of tongue sore ; eructations ; vomiting. Nux Vomica will be found of use where there is distcntion of abdomen after a meal ; cramp-like pains and nausea ; ineffectual urging to stool with anxiety ; frequent small, corroding, mucous stools ; feeling as if lower portion of bowel were contracted ; hard and softish evacuations, scybala. Mercurius Solubilis. Is an invaluable medicine in dysentery and dysenteric diarrhoea. It is indicated by cutting pain in bowels ; colic ; pinching in abdomen ; chilliness and shuddering ; restlessness and anguish ; constant desire for stool with tenesmus; much forcing with small stools ; chilliness between stools. Discharges of bloody mucus ; loose faeces lined with mucus and blood ; green slimy acrid stools ; black tenacious pitch like stools. Ptyalism and soreness of mouth ; ulcers in mouth ; tenacious saliva ; bleeding gums ; coated tongue. Mercurius Corroslvus, Humphreys, an American Homoeopathic writer on Dysentery, says that this medicine is employed indifferently with Mercurius Solubilis by many practitioners, but thinks that it is more applicable for a more severe type. In this 57 to remember, that however closely one medicine ¦proach another in its action, the preference always be given to the one that most closely hes the disease. The symptoms pointing to its use are violent pains in bowels, oesophagus and abdomen ; bloated abdomen very painful to touch ; lacerating pains, continued colic, griping and burning in abdomen. Evacuations of faeces mixed with mucus and dark coagulated blood ; frequent discharges of bloody mucus ; intolerable painful urging and tenesmus. Suppression of urine ; dysuria ; emaciation ; trembling of limbs ; spasms ; hectic fever ; ulcers in mouth. A steady persistence with this medicine will prove of immense value in many of those old cases of dysentery of persons invalided from hot climates, E there are muco-purulent discharges showing onsiderable ulceration of intestines exists, every one, two, or three hours, and after each ; in chronic cases, three or four times a Ipecacuanha. For bloody stools, especially if there is a free discharge of bright red blood ; in which case a dose may be given every ten or fifteen K. Also where there is vomiting or much cramps and evening exacerbation. 58 of abdominal pain after food ; pains with great prostration and despair of recovery. Gi-eenish black, brownish, putrid, shreddy, bloody burning stools ; excessive vomiting ; sunken face, pale and death coloured ; thirst ; Hiccough ; retention of urine ; cold sweats. Cantharis. Though it meets very well the burning, pinching, and colic pains ; urging and bloody stools, will be found especially serviceable in those cases where the urinary organs are engaged ; where there is pain in the kidneys, suppression of urine, or frequent desire to urinate with scanty emission or bloody urine ; also severe burning pain in It may also be used with advantage where the stools consist of white mucus like scrapings from the bow r els, streaked with blood. Capsicum. Colic and cutting about umbilicus ; mucous stools streaked with blood ; tenesmus ; nightly diarrhoea with burning ; stools are followed by thirst, and drinking by shuddering ; haemorrhage from the anus, connected with piles ; feeling of bursting or distention in abdomen. Pulsatilla will be found useful in those cases where mucous stools are passed ; chilliness during stool ; in some old cases where the dysentery has been somewhat subdued, but where these mucous . i . . , „ i ? . p , , 59 men ; greenish bilious diarrhoea at night preceded by rumbling ; nausea and coated tongue. Colchicum. For autumnal dysentery ; for colic pains ; flatulent distention ; scanty stool with urging and straining ; frequent evacuations of jelly like mucus relieving the colic ; bloody stools mingled with a skinny substance ; discharges of white mucus with violent tenesmus ; burning and prolapse of bowel. Carlo Vegetabilis may be used when there are excessively putrid stools ; much flatulence ; collapse ; cold sweat on face and limbs ; pinched face ; and small pulse. China. This medicine has been recommended where the disease has any thing of an intermittent type, or appears to owe its origin to marsh miasma. Under similar circumstances Arsenicum may be of use, as well as a medicine that has been found very serviceable in the ague of the West Indies and elsewhere — Eupatorium.* * The action of Eupatorium in dysentery is not sufficiently marked to justify a special notice, but as this book may fall into the hands of missionaries in the West Indies, who are in the habit of using this medicine for ague, it is well to notice that where there is purging with smarting, or tenesmus with small stools, if the type of the fever should also correspond in any case, they will have the best possible 60 China will be found serviceable after any great is of blood ; also where there are putrid stools ; ody stools, with stitches in anus ; blackish, bilious, whitish or pappy stools. China may be very serviceable in certain stages of chronic dysentery, where there is pain in stomach and weight after food, or much debility. Phosphoric Acid will be of use in chronic cases ; where there is debility ; white gray diarrhoea ; slimy, |;ery, or undigested stool ; tenesmus ; crampy n and emission of flatulence ; emaciation and guor ; mental oppression. IRhus Toxicodendron is of use where there is esmus, with nausea and lacerating in intestines ody, mucous, jelly like stools ; involuntary stool This medicine is much employed in fevers of various kinds, especially those cases where the lips are dry, brown, or black, and parched ; the tongue dry or parched, red or brown ; where there is evening fever with diarrhoea. Being suitable for these Imptoms, makes it a valuable medicine in dysentery a typhoid type. Staphysagria may be given for a few doses in cases where there is much mental irritability and fretfulness. I have found this, in different forms of illness, an invaluable intercurrent remedy where there has been much mental worry. 61 Veratrum will be of use where there is greenish, watery, flocculent diarrhoea ; violent bloody diarrhcea; chilliness and shuddering with the frequent stools ; great prostration and coldness. Silicea may be given where there is exhausting nightly diarrhoea ; hectic fever, and night sweats ; tipy stools with fragments of mucous membrane, owed by smarting of anus ; bloody or mucous stools ; chilliness ; griping pain in stomach ; cutting colic in abdomen. These symptoms point to the Sue of this medicine when the disease has been ablished some time, and when ulceration exists. Sulphur will be of use in chronic cases ; also where there are lumpy stools with mucus ; insufficient stool ; pressing on rectum and bladder ; tenesmus ; pappy or frothy stools ; scalding stools ; sour or fetid stools ; white slimy stools ; bloody stools ; discharges of reddish mucus, with fever and want of appetite ; colic with distention ; colic after food ; pinching and cutting in abdomen ; enlargement and hardness of liver; jaundice. Cases of dysentery, where other medicines have been given and failed, will be often much benefited by Sulphur where the indications point to its use. Besides the foregoing remedies, many more may be used, but as far as possible the leading indications of the best medicines are given ; in a few cases the Repertory may help to point out others. 62 REPERTORY EOR DYSENTERY.* MEDICINES MOST FREQUENTLY NEEDED IN DYSENTERY. Small capitals, italics, or small type, show the corresponding value. Those previously noticed are distinguished thus *. DYSENTERY. *Aeon. am. *ars. bry. bell. *cantli. *caps. *carb-v. cham. *china. * colch. *Coloc. dulc. *eupat. hepar. hyos. *ipcc. kreos. lach. *Merc. *Merc-c. merc-iod. nitr-ac. n-mos. *Nux-v. *phos-ac. *rhus. Sep. *sil. *staph. * sulph. *verat. Abdomen, pain as if bruised: camph. carb-v. cham. Coloc. nux-v. plumb, puls. staph. strain, sulph. verat. Abdomen, burning pain in : Aks. bell. cantJi. caps. carb-v. colch. Lach. mere. phos. rhus. sec. Sep. verat. Abdomen, distention of : aeon. Aks. bell, canth. caps, cham. China, cocc. colch. Coloc. hyos. ipec. lach. hjc. mere, merc-c. nitr-ac. nux-v. rhus. Sep. sulph. verat. Abdomen, distention of, during the stool : lycop. — pains in the, before: caps, carb-veg. coloc. Merc. nitr-ac. puls. rheum, staph. sulph. verat. r pains in the, during : ant. Ars. bry. carb-veg. ign. Merc, nux-v. rheum, spig. Sulpii. verat. * This repertory for Dysentery is based on the repertories of R H 1 & Dysentery : Abdomen, with painful sensibility of : Aeon. ars. bell canth. carb-v. ehavi. Coloc. hyos. lach. Meec. nitr-ac Nux-v. puls. sulph. verat. r spasmodic pain in: ars. bell. bry. lach. nux-v. rhus. sulph. Anus, burning in the, during stool : lach. mere. puls. ITCHING IN THE, DURING : HiefC. Sll. Sulph. THROBBING IN THE, AFTER : lach. RETRACTION OF THE, DURING : thuja, RETRACTION OF THE, AFTER : igll. r pains in the, before : carb-an. carb-v. lach. phos. sep sulph. Anus — Paralysis of sphincter: bell, coloc. hyos. lach rhus. Bitter taste in the mouth: aeon. ars. Bry. Cham chin, coloc. ipec. Merc, merc-c. nux-v. nitr-ac. puls rhus. verat. Chilliness before stool: dig. Merc. mez. phos. — during: nit-ac. mere. Puls. sil. sulph. verat. Colic, during stool: ars. coloc Colic, in dysentery: aeon. ars. bell. bry. caps, cham colch. Coloc. dulc. ipec. lach. lye. Merc, merc-c. Nux-v, puls. rhus. sulph. Cuttings in the Anus, with stool : calc. canth. carb-v ipec. nitr-ac. phos. staph. abdomen, before stool : ars. caps, carb-v. dulc Merc, nitr-ac. puls. rhus. staph. sulph. — during stool: ars. carb-v. chain, dulc. lach. mere, merc-c. nux-v. rheum, sulph. verat. — after stool: carb-v. canth. puls. rheum, staph 64 fvAcuATiONS, acrid, corrosive : Acs. cham. China, Merc. nux-v. Pols, sulph. verat. r Bilious : ars. Cham. chin. dulc. ipec. Merc. Merccor. nux-v. Puls. verat. r Blackish : aeon. am. Acs. bry. chin, coloc. ipec, lach. mere, nux-v. verat. — Bloody: aeon. am. ars. bell. bry. Canth. caps. carb-v. china, colch. coloc. dulc. Ipec. lach. Merc. Merc-c. nitr-ac. Nux-v. Puls. rhus. Sulph. verat. r Bloody Mucous: Acs. craps- carb-v. ipec. Merc. Merc-c. nitr-ac. nux-v. petr. puls. rhus. Sulph. r- Blood-streaked : canth. calc. carb-an. mere. phos. puls. r Brownish : am. Ars. "bry. canth. China, dulc. mere. merc-c. Sulph. Verat. — Burning: ars. lach. mere. — Changeable in colour : Puls. — Eggs, like beaten : cham. puls. — Fermented: ipec. t Frothy : canth. chin, coloc. mere. rhus. sulph. Flocculent : ars. Ipec. Verat. tDark green : Ars. Merc. Grass green : ipec. — Greenish : ars. bell. Cham. dale. ipec. Merc, merc-c-puls. sulph. verat. rGrey : ipec. Merc. Phos-ac. rheum. Gelatinous : Calc. colch. rhus. Sep. — Involuntary: am. Ars. Bell. bry. carb-v. Chin. Hyos. lach. mere, mur-ac. op. phos. puls. Rhus. sulph. verat. t Involuntary, during sleep : am. puls. Rhus Membranous : canth. colch. sil. f 65 fvACUATioNS, motley, mixed up substances : cham. Merc. puls. rhus. sulph. — Mucous or slimy : am. ars. bell. Caps, canth. carb-v. Cham. chin, colch. Coloc. dulc. hep. hyos. ipec. lach. Merc, merc-c. nitr-ac. nux-v. plios. Puls. rhus. staph. Sulph. verat. Purulent : bell, canth. chin. Merc, nux-v. petrol, puls. Sil. sulph. Putrid : Ars. bry. Carb-v. cham. China, coloc. mere, merc-c. nitr-ac. nux-v. sulph. — Sour : calc. cham. mere. petr. phos. Rheum, sep. Sulph — Undigested : ars. Iry. China, ipec. mere, nitr-ac. nux-v, phos. phos-ac. sulph. verat. r. Watery: aeon. Ars. calc. cham. China. Ipec. nux-v, petrol, phos. phos-ac. Puls. rhus. sec. sulph. verat. t Whitish : aeon. Ars. Calc. cham. China, colch. Merc ux-v. phos. Puls. rhus. Sulph. verat. Yellow: ars. canth. Chin, coloc. dulc. Ipec. mere, rhus Heat and Thirst, with : aeon. Ars. bell. bry. cham. chin, dulc. hyos. Merc, merc-c. mur-ac. nux-v. rhus. sulph verat. Eausea, with, before stool : aeon. Sep. staph. - during : coloc. ipec, mere, nitr-ac. sil. sulph. - after : aeon, caust. nitr-ac. Rectum, pains in the, before stool: bell, carb-v. lach nux-v. puls. rhus. Sep. — during: ars. canth. carb-v. coloc. ipec. mere, nitr-ac, nux-v. pids. ruia. staph. sulph. after : ars. carb-v. china, lach. nitr-ac. nux-v. puls, staph. sulph. Rectum, prolapsus of, with stool : ars. calc. canth. dulc 66 Stitches in anus: aeon. ars. carb-an. carb-v. chin. ign. mere, natr-mur. nux-v. phos. sej>. sil. sulph. Eimus : aeon. am. Ars. bell. calc. canth. Caps, colch. eb. hep. ipec. lack. lye. Merc. Merc-c. nilr-ac. :-v. op. phos. Eheum. rhus. ruta. Sep. sil. Sulph. Urination, painful : aeon. ars. camph. Canth. caps, colch. Dulc. Lach. mere, n-mos. Nux-v. phos. phos-ac. puls. rhus. staph. Sulph. Sep. verat. — suppressed : aeon. am. ars. bell, camph. Canth. caps, carb-v. colch. coloc. con. dulc. graph, lach. lye. Nux-v. Op. plumb, puls. rhus. sulph. Vomiting, in connection with stool : ars. bell. dig. dulc. ipec. lach. phos. rheum, stram. tart. 67 C 8 CHOLERA. History. — A disease under this name has been described by several old writers, and coming towards more modern times, by Sydenham, who describes it as a disease occurring in the month of August. He speaks of 1676 as the hottest year that was recollected, and adds : "As the summer came to a close, the cholera morbus raged epidemically, and being promoted both by the unusual heat of the weather, it brought with it worse symptoms in the way of cramps and spasms than I had ever seen. Not only, as is generally the case, was the abdomen afflicted with horrible cramps, but the arms and legs, indeed the muscles in general were afflicted also, so much that the patient would at times leap out of bed and try to ease the pain by stretching his body in every direction." Elsewhere he says : " Violent vomiting, accompanied by the dejection of depraved humours ; difficulty in passing them ; vehement pain ; inflation and distention of the bowels ; heartburn ; thirst ; quick, frequent, small, and unequal pulse ; heat and anxiety ; nausea ; sweat ; cramps of the legs and arms ; faintings and coldness of the extremities, constitutes the true cholera, and it kills within twenty-four hours." In consequence of the bilious discharges, the word has been supposed to be derived from x o^' bile and piw to flow ; or it may be from ¦xpXac, an intestine, and piu> to flow. Thus bowel flux. This last derivation would adapt it better to what we now know as cholera, where there may be no bilious discharge. This English or autumnal cholera, though at times very fatal, did not, so far as our knowledge extends, assume any thing like the proportions of the disease that we now know as Asiatic cholera, though it is extremely probable that this latter may on former occasions have swept over Europe. Without, however, indulging in conjecture on this point, or speculating on our imperfect knowledge of past epidemics, it is sufficient for our purpose, that in the summer of 1817, an outbreak of epidemic cholera took place at Jessore, eighty-six miles from Calcutta, that at once assumed such a formidable character, and spread in such a remarkable manner, as to become a question whether it was not a new disease. Having spread in different years over a great part of India, abating and re-appearing with increased severity, threatening Europe, attacking 69 of October, 1831. The first case recorded by Drs. Haselwood and Mordey, who in 1839 published a very excellent account of the disease as witnessed by them, was that of a man named Sprout, who was attacked October 23rd and died October 26th. His son, attacked the evening of the 37th, died on the 31st. No contagion could be traced in the first case ; the man, who was attended by Mr. Holmes, laboured under diarrhoea for some days previous to the attack. Prior to this, isolated cases had occurred as early as the month of August, which were very probably the first droppings of the storm ; but it was not till the end of October that the disease was fairly recognised as existing in the country. In 1832 it spread over the United Kingdom. Of the amount of mortality it has been found impossible to obtain an accurate estimate, as the returns were not properly made, the number of cases being for various reasons suppressed.* * The Clerk of the Board of Guardians at Yarmouth says : " There were, I helieve, a great many more cases here than were known. I returned all cases that were sent to me to the Board of Health, but I believe not one in ten was returned; the feeling of most parties being that if they were published just at the season for watering places, the town would suffer, as visitors would be afraid to come to Yarmouth." 70 In London, it was reported that there were 14,144 cases and 6,729 deaths. In England and Wales, in 1832-33, the attacks are stated to have been 71,006 and the deaths 16,437. With the exception of one or two slight appearances, there was no serious outbreak till 1848-49. Having appeared at Hull in 1848 much as it did at Sunderland in 1831, it broke out with great severity in 1849, in which year the returns for England and Wales showed 53,293 deaths from cholera. In 1854 England again suffered from an outbreak, which, though very severe in some localities, was less generally fatal than in 1849, the deaths amounting to 20,097. In reference to these attacks, Dr. Aitken, in his excellent work on the Practice of Medicine, having alluded to the hot summer of 1831, and the unusual stillness and closeness of the atmosphere of November, December, and January, goes on to state : " According to the delicate and accurate observations of Mr. Glaisher, the meteorological phenomena of the three visitations appear to have been remarkably similar (excepting as to the temperature), and especially as to the misty condition of the atmosphere, which was thin in high places and dense in low ; the absence of motion in the air ; remarkably high reading of the barometer; and a total absence of 71 Black Sea fleet, give similar accounts ot these meteorological phenomena which attended the outbreaks of cholera in their experience. Such meteorological conditions have a marked tendency to favour the chemical decomposition of organic substances, and to render the season defective in those atmospheric changes, which, by decomposing and dispersing into space the products of decomposition, renew the purity of the air." A very remarkable circumstance in connection with the origin of cholera has just come under our notice (May, 1806). The steamer England, conveying German emigrants from this country to America, arrived at her destination, having lost a large number of her passengers from a severe outbreak of cholera, which appeared while the ship was at sea. This was set down to the habits of the Germans and their partaking freely of saver-kraut, though whether this last is a supposition or a fact it is impossible to say. But intelligence has reached us that the steamer Virginia has arrived at New York, having had 38 deaths from cholera on the passage. The disease broke out in the same latitude as on board the steamer England. The cabin passengers were not attacked. It is a question, did the disease arise from any want of cleanliness or from atmospheric causes ? or did a certain condition of the 72 ill /• i i i favourable to the development ol cholera, produce it ? If this last is the case, we need not look to the East for the commencement of this disease, as our own neglect at home may merely require some at present unknown agency to call this deadly disease into operation. I Since the above was written, the cholera has ken out on board another steamer, the Helvetia ; this instance, not in the same latitude as the .ers, but when at sea, after leaving Liverpool and ore her arrival at Queenstown. The vessel had put back to Liverpool, and the disease has un>pily spread ; thus adding another proof of its imunicability to persons coming in contact with ers suffering from it, if they are in a state of ,Ith that will be affected by it. Our experience of fever ought by this time to have taught us that the crowding together of emigrants or others, particularly when epidemics are threatening, is calculated to produce disease, as even with a desire that everything should be cleanly and orderly, it is impossible to secure that it be so ; and once sickness commences, the confusion and terror that is produced adds in no small degree to the mischief. If our laws do not admit of interference with the action of those principally concerned in these matters, the sooner they are altered to allow 73 Nature of Epidemics. — Careful observers of fever have clearly shown that it is improper to classify all cases of continued fever under that heading, and have very accurately pointed out the difference between typhus and typhoid fever. So that in time it may be more easily shown than we see at present, the difference, if any, between English and Asiatic cholera. From the fact that it is often a disputed point whether a severe case of autumnal cholera is or is not Asiatic cholera, there must be a very striking similarity. Taking this into consideration, and reasoning from what we see in other diseases, it is very probable that they are identical, but that from some atmospheric cause the ordinary disease assumes a peculiarly malignant type — as typhoid symptoms are engrafted at a later period on other diseases. * Dr. Billing regards cholera as a febrile disease frequently proving fatal in the first or cold stage. Whatever its real nature is, there is no doubt that the system appears to be suffering from the effect of some very deadly poison. Symptoms of Cholera. — In English cholera, * The difficulty of at once determining what is the real character of any epidemic disease has been demonstrated in the case of the rinderpest, by the attempts that have been 74 there is, as we have seen, bilious vomiting and purging, and if the disease is severe, cramps and collapse. The Asiatic, or, as it is usually called from its greater severity, " The Cholera," is generally preceded by some premonitory diarrhoea. Where this exists, much may be done in the way of treatment to ward off the more formidable disease ; but in some cases there is no such warning. Dr. Quin, describing the attack he suffered from at Tischnowitz, in Moravia, whither he had gone in the true spirit of an enthusiast to study and treat the disease, says : " I fell to the ground insensible, (no premonitory diarrhoea)." If diarrhcea exists, it is usually painless. There is usually languor and discomfort of the stomach ; sudden vomiting and purging come on, often in the night. The purging is profuse, the stools having the appearance of ricewater, and may be free from odour. There are pains down the thighs ; severe abdominal pain ; cramps or spasms of the muscles, chiefly those of the abdomen or legs ; there is great exhaustion or fainting ; hurried and anxious breathing ; suppression of urine ; great thirst ; collapse sets in very rapidly ; coldness and blueness of the skin ; cold breath ; cold tongue ; the power of generating animal heat is all but extinguished ; sunken pinched face ; blueness round eyes ; loss of lustre of eye ; shrivelled 75 feeble pulse, generally rapid ; the skin loses its sensibility ; there is great restlessness ; death may take place in a few hours ; recovery may be rapid following a comfortable sleep, or secondary fever of a typhoid character may follow, from which recovery may take place, or from which the patient may sink. An Indian physician, speaking of cholera, says that every thing is poured out and nothing taken in, owing to the loss of absorbing power. This deadness of the stomach is a remarkable circumstance, and has its bearing on the treatment. The quantity of Carbonic Acid given off by the lungs is greatly diminished. As might be expected, the serum of the blood being drained off, the remainder is thick and dark. The liver and spleen have usually been found gorged with blood ; the right side of heart and pulmonary arteries filled with blood ; the left side and aorta empty. Statistics. — It may be proper here to insert the results of homoeopathic as compared with allopathic treatment. From the returns of the treatment at Tischnowitz, there were — Cases of Cholera. Cured. Died. Allopathically treated... 331 ... 229 ... 102 Homoeopathically ... 278 ... 251 ... 27 With Camphor alone... 71 ... 60 ... 11 76 Dr. Joslm, an American writer, states that Drs. lte and Ehrmann used the one drop doses of mphor with almost universal success early in the ease. In more advanced cases, they employed noeopathic attenuations of Arsenicum, Carbo getabilis, Cuprum, Secale, Veratrum, &c. They had cases of cholera 1,116 Deaths only , 35 Per centage of deaths 31/..3 1 /.. In 1854, when the cholera raged with great violence in the neighbourhood of Golden Square, where the Homoeopathic Hospital then stood, the return from that hospital to the general Board of Health showed a mortality of only 16 - 4 per cent. Dr. Mac Loughlin, the Government Medical Inspector, bore the most honourable testimonj' to the success of the homoeopathic treatment ; but the Board, with a professional zeal that reflects but little credit on their love of truth, suppressed the return, which was afterwards obtained by order of Parliament. Dr. Rutherfurd Russell, in a recent lecture on cholera, in giving some statistics, quotes from the Hon. Dr. Goding, of Barbadoes, as to the per centage of deaths, " that while allopathy ranges from 70 per cent, its maximum to 28 per cent, its minimum, homoeopathy ranges from 23 per cent. 77 Results op Treatment by Camphor. — Dr. Rubini of Naples, has informed us that treating all his cases with Camphor only, he met with the greatest success, (certainly unequalled by any other treatment). His cases were seen at once, as they occurred in a public institution, so that they immediately came under observation — an incalculable advantage. He gave five drops of a saturated solution of Camphor every fifteen minutes. As Dr. Quin, who had a very large per centage of recoveries, treated some of his cases with Camphor only, but did not meet with the same marked success, it is necessary to look for the somewhat different results in the fact already stated, that Dr. Rubini's cases were treated from the very commencement. Bearing on this subject, it is well to place on record what Hahnemann wrote in 1831 :—": — " It is members of a family alone that can most certainly and mutually cure each other with Camphor sjririt, because they are able instantaneously to aid those taken ill." Allopathic approaches to Homceopathy. — Dr. Johnson, in a recent publication, claims great credit for the treatment of cholera by evacuants, showing that greater success was met from this method than other allopathic measures. It is a pity he cannot see that this is the very point we are contending for, and that to homceopathy he is inand 78 set him speculating as to the probable cause ; by carrying his researches a little further and reducing his dose (the propriety of which course he has got an inkling of), he might obtain results far superior to any he has yet dreamed of. This is not new : Dr. Billing long ago saw practically that this mode of treatment was in the right direction, but he failed in the legitimate conclusion, as many others have done. TREATMENT & GENERAL MANAGEMENT. As prevention is better than cure, it is desirable to ascertain, if possible, the predisposing causes, that by guarding against them, a threatened attack may be prevented or mitigated. As the most fatal outbreaks of cholera usually take place in neighbourhoods where sanitary regula" tions are overlooked, the warning thus given should not be neglected. All drains, cesspools, water closets, sinks, &c. should be immediately inspected, and all defects remedied ; all decaying animal or vegetable matter, or stagnant water, should at once be got rid of. The foul air produced by any of these causes is a fertile source of disease. House pails should be kept out of doors, and every effort be made to get 79 cleaned out often. The servants should be specially warned against taking the covers off the drain pipes at the sinks, for the purpose, nominally, of letting the water run more freely, — in reality, to save themselves the trouble of gathering up the washings off the plates and saucepans, and which refuse is apt to stop the drains, or if kept swept up into corners, to cause unpleasant smells. Chloride of Lime and different disinfectant fluids have been largely used to counteract some of these evil influences, and more recently Carbolic Acid has been strongly recommended for the same purpose. There is no doubt it overpowers other odours, and from its power of destroying parasitic growths, may exercise some influence over the sporules of disease, if such germs exist, or are in such a form as to be reached by chemical agency. It may be used as follows : — Carbolic Acid, one tablespoonful ; Acetic Acid, or vinegar, three tablespoonsful ; of this mixture add a teaspoonful to half a pint of water, and sprinkle it freely about the rooms and passages ; also put a little into the bed-pans, commodes and chamber vessels. (Dr. Bayes' Plain Directions on Cholera.) I would add, ivhen removed out of the room. This precaution is necessary, as it is impossible to say how far the presence of chlorine, carbolic acid, vinegar, &c. may interfere with the action of our medicines, if used in the patient's room. 80 the feculent discharges may serve to propagate the disease, and that in this way soldiers using the same privy are exposed to danger from this source.* The free use of the Carbolic Acid may lessen this. |[t has been found that the drainage of sewers, .veyards, &c, into wells, also foul surface drainage, } caused some very fatal outbreaks of disease. I se saw the inmates of a large boarding-house suffer erely from diarrhoea, caused, by the drainage of a vy communicating with the well-water used for liking. In the outbreak of cholera in 1854, the 3 Dr. Snow showed how cholera was propagated tin India, soldiers encamping on old grounds, the scene jrmer outbreaks of the disease, have suffered, possibly lg to some infected material on the ground ; though it t not be overlooked that the cause of the first outbreak, drainage, &c, might still have been in operation. Some years ago, I recollect being told by the late Dr. Gregory, physician to the London Small- Pox Hospital, that he had been consulted as to whether the opening of a graveyard in Kent, where persons who had died twenty years before of small-pox had been buried, could have given rise to a fresh outbreak of the disease. He thought not ; but 1 could not agree with him. When the old Small-Pox Hospital was pulled down to make way for the Great Northern Railway station, the materials were sold, after which there was an outbreak of small-pox in London. To say the least of it, this looked like cause and effect. G 81 by drinking impure water, the pump in the Golden Square district having, without doubt, caused much of the terrible fatality of the disease in that neigh- Kurhood. The town pumps of London drawing eir supply from surface drainage, give forth water loaded with impurities; so towns draining into rivers contaminate the water. Farm yards often poison wells. All these sources of evil require immediate looking to and correction. The free admission, of fresh air into houses, by the opening of doors or windows, endeavouring to secure ventilation without exposing the inmates to unnecessary draughts, is most desirable. Strict attention t)uld be paid to personal cleanliness. The clothes m should afford sufficient warmth without overheating. When warm and perspiring, great care should be taken to avoid being chilled, either by the use of cold drinks, the throwing off of clothes, or exposure to cold air. Much of the autumnal diarrhoea is brought on by being heated during the day, fthen, without any change of clothes, encounterthe cool and often cold air of evening. The question is often asked, What can homoeopathy do in such a disease, — so severe, and so rapid in its progress ? The statistics given at page 76 show that this mode of treatment has been the means of saving many lives that, according to all human calculation would have succumbed under 82 by checking the premonitory diarrhoea many cases may be prevented running into regular cholera. PREMONITORY DIARRHOEA Treatment of. Though not a necessary forerunner of cholera, diarrhoea is so often a premonitory symptom, that in cholera times every case should be at once treated. As some persons may object to take homoeopathic medicines, and as homoeopathic patients may want to know what is to be done when first attacked, if out of reach of aid, it is well that there is a remedy that may be safely used, and that does not interfere with the prejudices of those who object to small doses. This medicine is Camphor, already alluded to. So valuable a medicine is it, that if trusted to alone, many lives would be saved. It must, however, be given by itself, as the numerous ingredients of an allopathic prescription are enough to destroy the virtues of any medicine ; and owing to this cause, the powerful auxiliary, possessed in this invaulable agent has been overlooked. Two drops may be given every five or ten minutes, accoi'ding to the severity of the symptoms, till eight or ten doses have been taken ; if doing well, then at lengthening intervals. Dr. Rubini gives five drops of the saturated solution every fifteen minutes. g 2 83 ii i? tit i, ™ Where there is vomiting, small pieces of Wenhamlake ice the size of a marble may be allowed to dissolve on the tongue ; this will often allay the vomiting, and allow the Camphor to be better borne. The Camphor may be given in a little sugar-water or on a lump of sugar. Where it is desirable to give a smaller quantity ta young child, three drops may be put in six spoonsful of sugar-water, and a spoonful given a dose. To an older child a stronger dose can given in this way, care being taken to stir the medicine well before it is administered. Camphor may be used in any stage of cholera ; though where other medicines are better indicated, t where the Camphor after a fair trial for a reasone time, say for about two hours, has not prelted the disease getting worse, some other medic may be given. (See pages 89 and 90.) The diarrhoea may be treated according to the symptoms present ; but to expedite reference, a brief summary of the most frequently needed medicines and their symptoms may be here given. Arsenicum. For copious watery evacuations, with great prostration ; painless or involuntary stools ; excessive vomiting. Colocynth. Diarrhoea with griping pain about umbilicus, relieved by an evacuation, or by stooping 84 ¦hit • i i -1 ¦ • j . • • ¦ • Mercunus. Bilious purging ; cutting pam, straining and tenesmus ; scanty stools, often bloody mucus. R Ipecacuanha. Vomiting is the chief symptom ; arrhcea may be present with it. Small pieces of ice may be put on the tongue, and the medicine given every half hour, and after each time of vomiting. Pulsatilla. Diarrhoea from disordered stomach. IVeratrum. Flatulent rumbling, crampy pain in mach, greenish, watery, brownish blackish diarea; coldness ; crampy pain in stomach, with or hout large actions. Ilarbo Vegetabilis. In 1854 I saw several cases of )ecies of flatulent colic, with hut slight action of bowels. There was bloated feeling in abdomen ; ention from flatulence ; eructations ; rumbling ; iety ; uncomfortable feeling in bowels, and unain sort of pains. These symptoms usually ded to Carbo V. 30, a dose every one, two or ;e hours, according to the severity of the pain. X Phosphoric Acid. Whitish, watery diarrhoea; blues about eyes, flatulence, and weakness. PROPHYLACTIC TREATMENT. To prevent an attack of cholera, Veratrum, Cv- 85 It has been stated that workers in copper enjoy an immunity from the disease. Acting, I suppose, on this hint, my friend Dr. Bayes of Bath has brought out a flannel bandage containing a thin plate of copper, that may be worn in cholera times. The warmth from the flannel cannot but be beneficial, and the very probable value of the copper as a prophylactic agent may make it a useful auxiliary. Without attaching too much importance to these measures, as their value has yet to be more fully proved, it is enough to say that no harm, and possibly much good may result from adopting them. During the prevalence of the epidemic a dose of Veratrum may be taken every morning ; or Cuprum may be taken in the same way. I would give the preference to Veratrum ; unless in the epidemic prevailing, spasms should be one of the earliest symptoms, hitherto Veratrum would have been best. Those who are weak homoeopaths had better take two drops of Camphor on a lump of sugar, night and morning. The great benefit that has followed the use of vaccination as a preventive of small-pox, though not as successful as its advocates desire, is sufficiently so to lead to its all but universal adoption. In like manner, Belladonna is so useful in warding off scarlet fever, that a few failures should not lead to 86 try it. If it does not in every case prevent, it may lln former years, when in allopathic practice, I d the opportunity of giving Belladonna in somelat tangible doses, as a preventive of scarlet fever, ice adopting homoeopathy, I have had opporlities of testing this remedy in small doses. My oerience of both methods enables me to bear ong testimony in its favour. {With, these facts before us, we may hope that a lilar success will attend the prophylactic treatnt of cholera : the least that can be said is that s worth a trial. TREATMENT OF CHOLERA Irhe patient should be allowed to drink freely of 3-water ; if preferred, water with ice in it may be en. Small particles of Wenham-lake ice (as mdy stated, page 84) placed on the tongue, will p to allay vomiting, and allow the medicine to be lined on the stomach. In some few cases (of ich I saw one in 1854) cold drinks renew the sms ; in the case to which I allude, warm riceer had to be taken slowly. If food is taken, it should consist of chicken broth, broth made from lean mutton, or beef-tea; rice may be boiled in this, and salt added. The patient will 87 while there is tendency to vomiting, there is not much hope of its being retained. The patient must remain in bed : a bed-pan should be used, as getting into the upright position frequently renews many of the symptoms or induces fainting. The room should be kept well ventilated, and of a comfortable temperature. The amount of bed covering must be regulated according to the patient's feelings ; for though coldness is a marked symptom, weight of bed clothes may cause discomfort without inducing warmth. Rubbing the patient, applying hot fomentations, hot flannels and hot jars may be resorted to. Recently, Dr. J. Chapman of London has recommended the use of ice in bags to the side of the spine. There may be some value in what he proposes, but as yet we want to learn more of the practical value of these suggestions, and whether as auxiliary appliances they may be of any use. To look for a universal remedy for cholera in any such means, is only calculated to bring the remedy into disrepute, and thus cause us to lose some little good that we might obtain from it. It has also been proposed to apply ice to the epigastrium. But if every remedy that has been proposed were to be enumerated, a goodly sized volume might be filled, and in the end our doubts as to the 88 son, speaking of the recent outbreak of lSbo, in Cairo, says that all the various plans (including Chlorodyne and Opium, which he specially mentions) had their advocates, and all failed. I Passing on, then, to remedies that have had a r trial, and the application of which are based on fixed principle, I shall name the medicines, as arly as I can, in the order in which they are of ue, and are likely to be needed, beginning with 3 that I have already different times mentioned. I Camphor. There is no medicine that has been ire generally used by homoeopaths and allopaths m this one ; by the former in the shape of a ong alcoholic tincture : in their hands it has red many lives. Allopaths have unfortunately r en it in combination with other drugs, so that ij have lost the advantage they might otherwise ye obtained. In 1849 it was rather a favourite nbination to give Calomel, Cayenne pepper, and mphor, mixed up with some conserve in the form a pill. In this shape, administered to a stomach ere the power of absorption was deadened, it was It will be found useful where a patient comes under treatment after taking allopathic medicine. Opium is often given to check choleraic diarrhoea ; Camphor comes in very well after it, antidoting the medicine and actin<* curativelv on the diarrhoea It 89 may be given where there is a threat of cholera, if there is any doubt as to the choice of a medicine. It is specially called for where there is coldness ; cold sweat ; blue, cold or shrivelled skin ; spasms or trembling ; great anguish ; burning in the oesophagus and stomach, and painfulness of the pit of the stomach to the touch. Mode of administering it. — Where these symptoms are present, Camphor may be given, two drops every five minutes ; or if it is not desirable to disturb the patient too often, five drops every ten or twelve minutes. A lump of sugar or a little sugar water is the best vehicle for the medicine ;* to a child it may be given in smaller doses, see page 84. As reaction takes place, the medicine may be given at longer intervals ; or if improvement does not take place after an hour or a little longer, another medicine may be chosen. Stage of disease for its administration. — Some medical men will prefer beginning with a different medicine, and giving Camphor in the stage of collapse. It is a question of confidence in our remedies; but from the strong evidence brought forward by Dr. Quin, confirmed by the experience at * Dr. Rubini uses a saturated solution; but without knowing the strength of the spirit, we cannot compare his ? ¦, k ourg 90 the London Homoeopathic Hospital in 1854, as well as elsewhere, and supported now by the powerful testimony of Dr. Kubini, should we be visited by another epidemic of cholera, many practitioners will be disposed to commence treating their cases with this medicine, and under the circumstances will have good grounds for doing so. Unquestionably if there I any doubt in the choice of another medicine, the mphor should be the first given, as the evidence its favour holds out every encouragement to hope the best results. Should it fail, another medic must be chosen ; but its use should not be •ndoned too hurriedly. It will often happen that animal heat is restored after six or eight doses, ugh in some cases many more doses must be given before there will be much visible amendment. t-"he Camphor and spoons that have been used uld be removed from the room when no longer needed. Veratrum. Of the ordinary homoeopathic medi(lB there is none enjoys a higher reputation than atrum in the treatment of choleraic diarrhoea, or era. It has been very largely used, and has n and again proved a sheet anchor. Case. — A patient asked me for some medicine in case of an attack of cholera. I gave her some Veratrum 30. It happened that her sister was attacked 91 purging and fainting, out of which she was roused by the accession of cramps. These symptoms kept returning again and again in the same order. The Veratrum was mixed and given in rapid doses. I was not sent for till morning, but when I saw her, I considered the disease to have been got under control. The only troublesome symptom I had to contend with was complete suppression of urine, lasting many hours, which caused considerable stupor, but yielded within an hour after taking Opium 30, the urine being passed freely. In addition to what has been said before (page 85), the symptoms for which Veratrum is specially serviceable are, violent and excessive vomiting, the vomiting being frequently preceded by shuddering ; frequent and violent evacuations ; in some cases violent abdominal pain and rumbling; the face is pale or bluish ; the cheeks sunk,, the 'nose pointed ; extreme prostration ; general coldness; there may be trembling and disposition to faint ; cold sweat ; feeble, almost imperceptible pulse ; great thirst ; spasms ; cramps, especially in the calves of the legs. A dose may be given every ten, fifteen, or thirty minutes, as needed. Arsenicum. This medicine is chiefly useful where the disease is ushered in by sudden and violent vomiting and purging ; rapid loss of strength and 92 burning pain in throat or bowels, or colic pain ; oppression at chest ; hoarse cries ; sunken countenance ; pale death-coloured face ; sunken eyes, with blue margins and pointed nose ; spasmodic pains ; cramps ; oppressive anxiety and excessive anguish at pit of stomach ; lamentations and moaning ; I A dose every ten, fifteen, or thirty minutes, as eded. I Ipecacuanha. When the attack commences ivith viting, this medicine may give great relief, and der the disease more manageable by other medics. In addition to its use for empty or violent liting, it will be of use for flatulent colic with fre!iit diarrhoeic stools ; griping, grasping pain in ¦omen, relieved by rest, aggravated by movement ; nented stools ; frequent liquid diarrhoea, with Jmishness in abdomen. But in the advanced jes of the disease it is seldom so suitable as the A dose every ten, fifteen, or thirty minutes, as needed, giving a dose after vomiting. E'uprum seems most suitable in those cases where ms or convulsions are the most urgent symps. There are violent spasms in the abdomen, upper limbs, and legs, often piercing cries with them ; pale 93 about; excessive weakness ; coldness ; hurried athing. I A dose every ten, fifteen, or thirty minutes, as eded. I Case. — In 1854, I saw a lady early in the day, om I left doing well. During the afternoon, siring the bell of a neighbouring church tolling, 3 got alarmed and suddenly relapsed. On my •ival, I found her suffering from incessant and vioit cramps. A steady perseverance with Cuprum , in rapidly repeated doses, was attended with nplete success. The case is interesting, as the ise of the relapse was so evident. lOarbo Vegetabilis. (See page 85.) When the vomit; and purging have abated, but cold sweat and >pocratic countenance mark an advanced stage of lapse, and the patient is lying cold, blue, and Iseless, this medicine may be given every five Qutes, and continued till reaction sets in, if there any change for the better. If after a few doses ;re is no sign of any amendment, Camphor may again given every five minutes ; but the prospect saving such a case by any means must be slight. iSecale. Though this medicine has not been used much as some others in cholera, still its indicans are so important, that they ought not to be srlooked, as in any future epidemic it may be md of use. It is indicated by sunken face; violent 94 colic, also convulsive ; coldness in back and abdomen ; bilious vomiting ; involuntary diarrhoea ; cholera-like paroxysm ; sudden striking change of features, with deep sunken eyeballs, surrounded ¦with blue margins ; constant nausea and vomiting after taking the least food ; frequent diarrhoea with watery, slimy evacuations ; hoarse hollow voice ; sup- Ission of urine ; cramp in the calves ; scarcely ceptible pulse ; unquenchable thirst ; spasms and vulsions of limbs. Ii dose every ten, fifteen, or thirty minutes, as ded. i^hosphoric Acid is more likely to be of use in the rhoea preceding or following cholera than in the ase itself. It is suitable for blue margins md the eyes ; sunken eyes ; nausea ; coldness in stomach ; pinching or cramping pain in abdomen ; paroxysmal cutting pain, rumbling and flatulence ; frequent desire for stool ; white, grey, slimy, watery diarrhoea. A dose every ten, fifteen, or thirty minutes, as needed. Jatropha Curcas has been used in America, and finds a prominent place amongst Dr. Josliu's mcdi- Vs. It appears to be of use for watery vomiting diarrhoea, accompanied by anguish and coldness of the body ; viscid sweat ; violent cramp pains in lower limbs ; violent vomiting and purging, with commedicines. 95 I Other medicines — Antimonium Tartaricum, &c. ly be of use, but our experience of their value is t sufficient to make us pass over well tried remedies on the chance of benefiting by them. By Eerting their action I would only add to my list medicines, without being able to say much for The after treatment of cholera may require Aconite for the removal of inflammations ; Belladonna for head symptoms and retention of urine ; Cantharis for scanty painful urination ; Opium for more complete suppression or for stupor ; Veratrum or Phosphoric Acid for remaining diarrhoea, giving the preference to Phosphoric Acid for light-coloured slimy stools : it, as well as China, will be found of use for the debility remaining after the great drain there has been on the vital fluids. In India, the recovery is often more rapid thau in this country. But with proper nourishing food, especially good beef-tea and broths, liquid nourishment being needed, and with proper homoeopathic medicines to control secondary fever, or any of the above symptoms as they arise, convalescence ought 96 97 REPERTORY FOR CHOLERA. Introductory. — As the symptoms of Cholera are usually well marked, and its course less liable to variations than some other diseases, I have endeavoured in describing the treatment to make the directions as clear as possible, so that there may be less need for reference to a repertory, which is not desirable where promptness of action is required. However valuable such compilations may be, they can never dispense with the necessity for a fair average amount of knowledge of the Materia Medica, as the physician should always be prepared to prescribe off-hand in case of emergency, reserving his repertory for complicated cases that afford time for study. The young practitioner will find this difficult at first, but practice and careful study will overcome many difficulties. P blowing repertory is restricted in the num medics and of symptoms, those only of mos ice being retained. In this I have departec 3 latitude I allowed myself in the othe es : in the case of Cholera brevity being Whereas in the others all additiona earing on the subject is of use. H Joslin, in his Reportory, the arrangement of which I chiefly follow, gives many more medicines than are needed, and some of which have but little bearing on Cholera ; he also rather under estimates the value of some of the medicines ; otherwise, his groupings of symptoms are very useful. A few medicines useful for the premonitory or secondary stages are included, but they are not distinguished as the more useful medicines. CHOLERA (medicines for the treatment of, and its various stages). Aeon. *Aks. bell. bry. *Camph. *Carb-v. cham. chin. *coloc. *Cupk. Hpec. *jat. nnx-v. op. *phos. *phos-ac. *sec. *tart. *Verat. * To distinguish medicines previously referred to. Cholera Symptoms : Abdomen. See Diarrhoea, with pain in. Anguish or anxiety : aeon. Ars. bell. bry. Campii. Carb-v. cham. Cupr. ign. ipec. nux-v. Phos. phos-ac. sec. tart, verat. Apathy: ars. bell. cham. chin. phos. plios-ac. staph. verat. Blueness op skin : aeon. ars. bell. bry. Camph. Carb-v. Cupr. dig. op. phos. phos-ac. Sec. Verat. Bluish colour of face : aeon. ars. bell. bry. Camfii. cham. Cupr. dig. ipec. op. phos. staph. tart. Verat. Breath (cold) : ars. Carb-v. camph. verat, Burning in stomach : Ars. bell. bry. camph. canth Carb-v. cham. jat. mere, nux-v. Phos. phos-ac. Sec, verat 98 Bs: aeon. ars. bell. bry. Camph. canth. Caeb-v. chin. cupr. ipec. mere, nux-v. op. Phos. phos-ac. tart. Veeat. Be : Acs. Camph. Caeb-v. hydrocy-ac. Veeat. EN, WITHOUT VOMITING OB DIAEBHCEA : CAMPH. Caeb-v. hydrocy-ac. Veeat. Consteiction of chest (spasmodic) : camph. Cupe. ipec. nux-v. op. phos. phos-ac. verat. P: ars. bell. Camph. carb-v. cham. Cupe. ipec. phos-ac. sec. Veeat. fand coldness eaely in attack, without much diaeeh(ea : Camph. — WITH LITTLE OE NO DIAEBHCEA OE VOMITING : arS. Camph. Cupe. ipec. sec. verat. — at night : ars. camph. Cupe. ipec. sec. K'omach : bell. bry. carb-v. cham. Cupe. nux-v. sec. Veeat. — in aems : Phos-ac. Sec. Ret : Camph. carb-v. nux-v. phos-ac. sec jgees : Phos-ac. — in hands: bell, coloc. phos-ac. sec. — in legs : ars. bry. carb-v. Camph. coloc. Cupb. Jat. nux-v. phos. phos-ac. sec. tart. Veeat. — in thighs : Camph. ipec. phos-ac. verat. BETUEN AT NIGHT : CUpr. SECALE. Diaebhcea. See article Diarrhoea, and Eepertory, if necessary. ¦3IPAL MEDICINES FOB CHOLEBAIC : AeS. Camph. coloc. dulc. ipec. mere, nux-v. phos. phos-ac. rheum, secale. Veeat. ¦i pain in abdomen: Acs. carb-v. cham. coloc. mere, merc-c. nux-v. phos. staph. tart. Veeat. H 2 99 Choleea Symptoms: Diakkhcea, painless : Ars. bell. bry. carb-v. cham. chin, ferr. hyos. op. Phos. Phos-ac. puls. sec. Verat. — with kausea : ars. ipec. mere. Phos. — and vomiting: Ars. cupr. jat. Ipec. phos. sec. tart Verat. — with aching ok pressuke at stomach : camph. cham Cupr. mere. phos. phos-ac. sec. tart. Verat. — with prostration : Aks. bry. chin. mere. Phos rheum. Secale. Vekat. — with liquid stools : ars. carb-v. chin. jat. Phos Phos-ac. Sec. Verat. WITH LIQUID STOOLS AND RUMBLING : OTS. jat. nUX Phos. Phos-ac. puls. sec. tart. Verat. — For colour of stools, see Eepertory for Diarrhoea. — with rice-water stools (flocculent) : ars. Camph cupr. ipec. jat. Phos. Phos-ac. sec. verat. Eyes sunk: Ars. camph. Cupr. Phos. Phos-ac. Sec. Verat. Face. See Bluish Colour of. - choleraic : Ars. camph. Carb-v. Cupr. ipec. Phos phos-ac. Sec. Verat. — bluish colour about eyes : Ars. cham. chin. Curί. ipec. mere, nux-v. phos. Phos-ac. Sec. staph. Verat. Movement (aggravation by): aeon. ars. bell. bry. camph. canth. carb-v. cupr. dig. ipec. mere, nux-v. phos. phos-ac. sec. tart, verat. Nausea, with pain at stomach: aeon. ars. bell, camph. cham. cupr. mere, nux-v. phos. tart. Verat. Pain. Diarrhoea with Pain, &c. Perspiration, cold : aeon. Ars. bell. bry. Camph. canth. Carb-v. cham. chin. cupr. ipec. mere, nux-v. op. phos. vhos-ac. rheum, sec. tart. Vekat. 100 REPERTORY FOR CHOLERA. 101 Cholera Symptoms : Perspiration, clammy : Ars. camph. jat. mere, nux-v. phos. phos-ac. sec. Verat. — cold, with bluish skin : Ars. camph. carb-v. Cupr. ipec. Sec. Verat. Pulse feeble and small : Ars. Camph. Carb-v. chin, dig. nux-v. Phos. Phos-ac. puls. Sec. Verat. FEEBLE AND FREQUENT : UTS. CaRB-V. lach. nUX-V. — feeble and slow: Camph. dig. mere. puls. Verat. — SCARCELY PERCEPTIBLE, WITH RICE-WATER STOOLS: aCOn. ars. bry. camph. phos-ac. sec. ¦ verat. Respiration laborious, with cold and blue skin : Ars. camph. carb-v. cupr. ipec. sec. verat. Rumblings in bowels : aeon. ars. bell. bry. canth. carb-v. cupr jat. mere, nux-v. Phos. Phos-ac. puls. sec. tart. Verat. Stomach. See Burning in ; Cramps in ; Diarrhoea with aching; Nausea with pain; and Vomiting with pain in. Thirst : aeon. Ars. bry. camph. carb-v. cham. cupr. ipec. mere, nux-v. phos. phos-ac. sec. Verat. Tongue, coldness of : ars. bell, camph. carb-v. sec. Verat. — and of breath : ars. carb-v. camph. Verat. Urine, retention of : camph. canth. op. verat. — with desire to urinate, at stage of reaction : Canth. — scanty or suppressed : ars. camph. carb-v. cupr. ipec. sec, verat. — scanty ok suppressed, in the consecutive fever : Bell. carb-v. op. Rhus. stram. Voice, hoarse and faint : ars. bell. bry. camph. cham. chin. Carb-v. Cupr. mere, nux-v. phos. phos-ac. sec. Cholera Symptoms: Vomiting, conditions of. Vomiting : aeon. Aks. bry. camph. cupr. Ipec. jat. mere, nux-v. phos. puls. sec. Veeat. t after drinking: Ars. bry. nux-v. puls. Verat. WATERY LIKE THE STOOLS, WITH PIECES OF MUCUS: Ars. bell, camph. cupr. jat. sec. ipec. Verat. — with pain in stomach : ars. bry. camph. cupr. ipec. phos. tart. Verat. — WITH DIARRHCEA : CIVS. CUpT. jat. IPEC. pTIOS. SCC. Verat. Weakness, sudden : ars. carb-v. cupr. ipec. nux-v. Phos. phos-ac. sec. Verat. From the above symptoms, it would appear that the chief medicines as to value might stand in somewhat of this order :—: — Verat., Camph. Arsenicum, Cuprum. Carbo-veg., Phos., Secale. Jatropha, Ipec., Phos-acid, Coloc. 102 103 CONSTIPATION. DIFFICULT, SCANTY, OR SUPPRESSED ACTION OF THE BOWELS. There are few things more dreaded by many Englishmen than constipation. It is associated in their minds with apoplexy, stoppages, and a number of unknown but much dreaded evils. At one time this fear was almost national. The blue pill followed by black draught is in less demand ; but other aperients are still by many deemed a necessity, notwithstanding what homoeopaths have done to show the folly and mischief of the practice, and aided as they now are by some of the leading teachers of the allopathic school. "It has been supposed," says Professor Bennett, of Edinburgh, " that a good alvine evacuation once a day is necessary to the healthy state of the body, and that an individual who only has such an evacuation once in two days, and sometimes in three, is constipated. This idea has led to the habitual use of purgatives, and is the principal cause of the enormous number of aperient pills annually sold with government stamps in this country. The fact is, that many persons naturally . i ,• | T • x three days, and retain their health quite well." Dr. Haber§n (an allopathic writer of considerable eminence) s, page 456 in his work on Diseases of the Abdomen : " Temporary relief is afforded by powerful purgatives, but the delicate mucous membrane of the intestinal tract is weakened, a sort of chronic catarrh is induced, and the very condition sought to be removed is aggravated tenfold." The period that may elapse without an action o the bowels, and yet no danger to life ensue, is muc longer than at first sight would appear possible. . have never seen more than sixteen days. Some tim ago there appeared in the Lancet an account of boy who passed three months without an action. Dr. Habershon, page 452, relates the following : " A case is recorded by Mr. Staniland [Medical Kzette, p. 246, 1832-33,) of a patient, set. 73, who I habitual constipation, so that, during the last j years of her life, the bowels were only acted upon once in every two months ; after being confined for four months and eight days, they were very freely acted upon ; seven months then elapsed without any pain or evacuation. Some weeks before death she had a fall, which produced very severe pain in the region of the ccecum, and led to local inflammation, gangrene, and foecal extravasation into the peritoneum. The intestines were found enormously distended with fseces, the transverse colon 104 Pi diameter, and the sigmoid flexure le rectum six inches." He records child aged six, where there was no four months, and recovery took I Though these cases show that people often alarm emselves very unnecessarily about confined bowels, must not be lost sight of that constipation arising >m stricture, tumours, or carcinoma, is attended th danger, and gives rise to very great distress ; t these cases hardly come under the head of conpation, confined bowels being then a symptom of other disease. I The annoyance caused by the absence of one stool lay often leads to the pernicious practice of taking 3rient medicine, instead of seeking to attain that ect by healthful means that will not have the 3ct of giving momentary relief at the expense of reased mischief. I Symptoms that Sometimes Follow Constipation. Constipation may induce vertigo ; headache ; noises head ; loss of sleep ; discomfort from flatulence ; pitation ; depression of mind ; neuralgic pains from ssure on the nerves ; haemorrhoids and varicose Ehen any of these symptoms exist, they must be 3d along with the constipation. If in doing ;he homoeopathic law is adhered to, much more 105 permanent and satisfactory results will be obtained than by any attempt to treat isolated symptoms. Causes of Constipation. — By ascertaining the cause, much may be done to remedy the evil. It may arise from want of tone in the intestinal canal and deficiency of muscular contraction required for the expulsion of the faeces. From irregular habits in not attending to th wants of nature in relieving the bowels at regula times, or when a want to do so is felt, young ladies a boarding schools often lay the foundation of habitua constipation, piles and other inconveniences, by bein unable to leave their classes unless in regular rota tion. If the rules for health and discipline interfere it would be well that the latter should be made t give way. Inactivity of the liver causing deficiency of bile insufficient mucous and other secretions may als induce constipation. So, also, loss of power in th muscular coat of the intestine renders it unabl to perform its functions, and the mischief is furthe increased by the over-distention. Painful evacuation of bowels from haemorrhoids or other causes may also lead to it. Cicatrization and thickening of the mucous membrane after dysentery, by producing obstruction to the passage of the faeces, cause an accumulation. As already observed, constipation thus induced is a 106 symptom resulting from some other disease ; but be the cause what it may, the inconvenience caused is the same, and requires treatment. I Constipation arising in the course of any other ease, as inflammation, &c, will usually subside the more active disease is subdued. It is well bear this in mind, for patients often give much όble, and cause themselves no small amount of siety, from their desire to get this one symptom ieved, and not unfrequently at a time that it uld be far better let alone. Dr. Habershon, who goes very fully into this subject, says that the character of the food may lead to its becoming impacted in the large intestine. He points out the fact that hardened faeces may be retained in the colon (especially the lower part) and rectum, even though there be periodical action even of a fluid kind, as fluid may pass laterally while the hardened scybala are retained. He also says that drinking excessively of cold water induces an enfeebled relaxed condition of the mucous membrane of the alimentary canal. Habitual drinkers of icewater, now so much the practice in some houses, may suffer from this cause. Treatment. — By attention to diet much may be done to lessen constipation. The use of brown 107 porridge for breakfast are often sufficient. Some- Kes the addition of a little bran to the porridge or about, which should be made of coarse oatmeal, help to stimulate the action of the bowels. Some persons take a drink of cold water before breakfast, which answers very well. Others again, by selecting the same hour every day to try and secure an action, establish a habit that, if not interfered with, conduces much to their comfort. - When these various methods fail, besides taking some one of the remedies suitable for constipation, if it is desirable to secure an immediate action, it can be best done by using an enema. Where the twels have been confined for a few days, so that it probable the faeces are hardened, I am in the habit of ordering the injection of three table spoonsful of leet oil, allowing this to be retained for some time, often happens that nothing further is needed ; but t be insufficient, it may be followed by some other ection for which the oil will have prepared the y, by rendering the passage of the hardened mass Fold water is often sufficient, about half a pint at ne, retaining it for some time, and repeating it every second or third day till it can be dispensed with. Persons suffering from piles should use some other injection. A pint of warm water where a free action is desirable, or half a pint if only a slight 108 stimulant is needed, may be used ; but if one more stimulating is needed, a pint of gruel, two table spoonsful of sweet oil, and a table spoonful of common salt is an old-fashioned and efficacious mixture. lln cases where there is great difficulty in getting 3 bowels to act, some soap dissolved in warm ,ter will rarely fail in procuring an evacuation ; m the irritation produced some pain may follow 3 use of this, but it is only of temporary duration. I When children suffer much from constipation, "a lall piece of soap, narrowed off at one end, pushed ;o the passage and worked about a little, rarely Is to procure an action. iWith adults, a tallow candle, used in the same y, will at times be sufficient if there is any reason 1 not wishing to use an enema ; it is less irritating m soap, and if there are piles, from its soft Ming nature, it is not likely to cause much pain. |[n homoeopathic practice, many medicines will ieve constipation if it occur as one of a group of aptoms ; but if it stand alone, or be the leading optom with which to contend, the choice of a ledy may then be limited to a few medicines, ese, and the special circumstances calling for ir use, are sufficient to give here. Alumina may be given where there is hard and difficult stool with pain in rectum ; bearing down, 109 of the rectum ; tenesmus following pressure in abdomen ; cutting in orifice of rectum, with some blood. A dose once or three times a day. Bryonia is of use where the stools are large, hard, and tough, with protrusion of the rectum. Also for chronic constipation. It is a useful medicine in the constipation of children. A dose twice or three times a day. Lachesis. Chronic constipation ; unsuccessful urging to stool ; hard stool, consisting of small hard balls ; alternate constipation and diarrhcea ; distention of abdomen and flatulent eructations. A dose three times a day or oftener. Lycopodium. Constipation with flatulence ; small and difficult stool, with sensation of much remaining ; fulness and distention of abdomen, especially after a meal ; cold feet ; pain in liver, also after a meal ; heartburn and eructations. I consider this a very useful medicine for children where flatulence and constipation are combined. A dose every two or three hours till relieved. Nux Vomica. Urging to stool with constipation. In these cases, by relieving the straining, the action of this medicine may be rapid ; but for ordinary cases of constipation, a speedy action should not be looked for, though if it be steadily persevered with, 110 liove constipation. It is specially useful for conation in connection with other complaints, or habitual constipation ; it may be given when stipation follows over eating or indigestion ; persons suffering from hernia, apoplexy, sea, vertigo, jaundice during pregnancy ; to je accustomed to drink, smokers, coffee drinkers, persons of sedentary habits. A dose once a day, or three times a day, as needed. I Opium is of use in chronic constipation, especially ;r other medicines have failed to give relief; it ms to rouse the dormant energies in chronic con)ation, as it does the vital energies generally in rte disease where they do not respond to the ion of medicines. Constipation appearing as a aptom in the course of other diseases is well met Opium. Convulsions, drowsiness, loss of con>usness, retention of urine, further indicate its . It is useful in the chronic constipation of A single dose may be given, or it may be repeate< every hour or three times a day, according to the nature of the attack and the object for which it is Platina. Constipation of hysterical females, or where the menses are too profuse or are attended with pain. It has also been recommended for constipation 111 following lead poisoning, or the result of travelling. A dose three times a day, or oftener if required, for painful or profuse menstruation. Plumbum. Alternate diarrhoea and constipation ; scanty, hard, black, brown, lumpy stools ; tenesmus. This is a useful medicine in chronic cases of constipation. A dose may be given every night for ten or twelve days, or till the constipation is relieved. Where the constipation occurs with colic, the medicine may be given every half hour or hour while the pain lasts, hot fomentations being used at the same time. In constipation connected with paralysis, Plumbum is a valuable medicine. Podophyllum has lately been much used in allo pathic practice as a purgative. It is a very valu able homoeopathic remedy of established reputation though some have recently brought it forward as somewhat new remedy. It is of use for constipation with flatulence ; for women suffering from prolapse of the uterus ; for chronic prolapse of the anus ; for whitish stools ; chronic hepatitis and costiveness. A dose three or four times a day. Sulphur is of use for intermittent stool ; hard knotty stool ; difficult, painful, or like sheep's dung ; pain during stool as if rectum would be torn, with piles ; constipation with dyspeptic symptoms ; also 112 procure relief. The well-known action of Sulphur, in altering the course of a disease where other remedies havq failed, makes it like Opium, a remedy of much value, hut having a wider and more extended range of action, and affecting many forms of disease. |[t may be given in a single dose as an intermete remedy, an interval of hours or days being >wed to elapse before another medicine is given, ording to the urgency of the symptoms or effect of the first dose ; or where it is depended alone, it may be given once a day or three times lay, watching its action, and not continuing it Iydrastis Canadensis is used by some homceopaths low dilution, as a remedy for simple constipa- If it should prove to be really homoeopathic is state, it will be a valuable acquisition. r other symptoms consult Repertory at the end book. i 113 114 INDIGESTION. Indigestion. — Dyspepsia, from dvg signifying difficulty, and 7rE7rrw to digest ; difficult digestion. "The stomach and its difficulties" has formed a theme on which many writers have enlarged, and there are but few who have not at one time or other had some practical experience of what indigestion is. Ei we consider the whole process of digestion many organs and wondrous structures em in the assimilation of food, we can easil md how the inactivity or irregular perform any one part may derange the whole. First, good teeth are required to chew and mas ticate the food, which, in the process, becomes we] mixed up with the mucus from the mouth, am saliva, the flow of which from the parotid and other glands, is promoted by the action of the jaw, an< though it is poured out and partly does its work in cases where food is swallowed hurriedly, it is not the same thing as solid food passing into the stomach, after being well bruised up and brought in contact sugar. The secretion from the tonsils and other glands facilitates the passage of food to the stomach, the contractions and muscular actions of which cause the slow and gentle rolling over and over of the food which becomes mixed with and acted on by the gastric juice, which, as well as slimy mucus, is secreted by the stomach, and is poured out rapidly under the stimulus of food. The action of the nervous system has been demonstrated by experiments on animals ; thus, division of the pneumogastric nerves causes the collection o: food in the oesophagus, and Bernard has shown that irritation of the pneumogastric promotes the flow oi gastric juice, while irritation of the sympathetic checks it. The practitioner must not lose sight o: these facts, and jump to the conclusion that because the stomach or abdomen is the part chiefly complained of, that the mischief has its origin there. It is of importance also to bear in mind that if more food is taken than the system requires, the supply of gastric juice is insufficient for the excess, and the food remains undigested. Friends of the patient are always anxious to keep the strength up, and by pressing food on an unwilling stomach often add to the distress of the sufferer and increase the debility, as, in many cases of illness, the power of digestion is very much diminished or suspended. i 2 115 Ewe say, not unfrequently takes the matter a bands, and causes the ejection of the and offending matter by vomiting or re- The great secret of success is to give in illness the amount of food that can be borne and of the most nourishing kind, avoiding the error of those who, equally mistaken in their views, endeavour to starve out disease, and attempt, by this method and by promoting copious perspiration, to reduce the strength, and at times succeed in doing so as surely as if done by the lancet. The gastric juice, by means of its active ingredients, hydrochloric acid, pepsin, &c, acts on the food, converting the albuminoids into peptone, which is taken up by the gastric veins, and being circulated through the liver and porta probably causes a flow of bile ; other parts of the food are differently acted on, fat being melted ; sugar and gelatine absorbed ; milk is curdled, its casein being converted into peptone ; and some parts of food are not acted on while in the stomach. The amount of time that certain kinds of food require to be assimilated should be taken into account, also the kind of food that is most completely aested, so that there may be less superfluous matto get rid of, which often causes difficulty. It is greatly to be regretted that the system of high 116 feeding of cattle, killing them at too early an age, and interfering with the natural habits of animals, by keeping them fastened up instead of letting them wander about to seek their food, should be so much practised at the present day. Such complete interference with the natural order of things, in this and similar cases, cannot but be hurtful. There is a balance in all these things that should be preserved, and where this is neglected, sooner or later the penalty must be paid. The flesh of wild animals containing less fat is much more easily digested, and is far more wholesome than that of a prize ox. When the stomach has done its share of work in the digestion of food, the resulting thick fluid, called chyme, mixed with indigestible matter passes on to the duodenum, when it comes in contact with the bile and pancreatic juice. r glance here at the functions of the liver and of bile, as bearing on our subject, may not be of place. The action of the bile appears to be to check decomposition lessening the foetor of the faeces, — it may neutralize acidity in a slight degree, — stimulate the intestines to action, and promote the absorption of fat, which is more easily taken up in parts wetted by bile, this last being its most important use, so that the action of the liver and its ducts in duly seto 117 aid in the absorption of so essential an element as fat, is at once apparent. Hence congestion of the liver, obstruction of the duct from gall stone, or other causes, will explain the cause of loss of flesh, and the white or offensive stools, jaundice, and other ailments to which bile, retained in the system, gives rise. Besides its other uses, it is one of the vehicles for withdrawing matter from the blood no longer needed, and which, if left, would cause much disturbance ; thus headaches, vertigo, &c, arise from this cause. In like manner bile, when secreted but passing up into the stomach, will check digestion. Eich food requiring a free secretion of bile may cause bilious vomiting and diarrhoea. Bernard has shown that there is another action of the liver, the formation of sugar, which it is unnecessary to discuss here, further than to remark that the healthy action of the gland is as much needed for this as for any other purpose. The injurious effect of hot climates is well known, giving rise to liver complaints, cerebral disease, dysentery, &c. Persons returning from the east often bring home with them a diseased liver that gives rise to dyspepsia and other ailments. The pancreatic juice mixing with the fatty matter of the food forms an emulsion which is more readily absorbed, it is also believed to act on starch convertof 118 fatty or oily looking stools, where the process of forming an emulsion for absorption is interfered with. As the food passes along the intestinal canal it is further acted on by the secretions from the variou glands, and digested matters that can be taken v are absorbed by the lacteals and blood vessels, a pearing in the lacteals in the form of Chyle, a whitis opaque fluid, owing its colour to fatty matter. Th chyme from having been of a creamy character be comes thicker and darker, and by the time the lowe end of the small intestine is reached, most of the digestible matter has disappeared and the refuse that goes to form the faeces remains. Various gases, carbonic acid, hydrogen, carburetted, and sulphuretted hydrogen, are evolved. The amount of these les rise to more or less flatulent distention, proving pain or discomfort if the quantity is large, if accumulated at any one part from whence they cannot escape. A peculiar movement, peristaltic or vermicular as it is called, of the intestines secures the passage of the food along the canal. When this is disturbed or inlased it may give rise to pain, and if the serous ering is inflamed, the suffering may be very The absorption of fluid goes on along the large 119 course through the colon, pass into the rectum, and t p the distention or irritation they cause, produce c desire for an action of the bowels, the accomplishment of which is aided by the thick mucus secreted by the rectum. This short account of the process of digestion is tfficient to show how necessary it is that each part ould be in a healthy state for the performance of its functions, and we also see how other diseases may influence digestion, or how indigestion may complicate them. Symptoms of Indigestion. — One of the earliest symptoms to which attention is called is furnished by the appetite. I The loss of it, anorexia, accompanied probably looking ill, attracts the attention of friends, en before any complaint is made of indisposin. In some cases there is foul, or red, or dry, or glazed tongue, worse before food has been taken, much thirst. Depraved appetite, desiring strange or unnatural things is at times met with, especially in pregnant women ; thus, a woman may have a fancy to eat chalk, plaster out of the wall, &c, in other cases the appetite is only fanciful, though the stomach is, to use a lawyer's expression, " made a party to the suit," in such cases the cause may 120 Flatulence and eructations, which may taste bitter, sour, or have the taste of the food in the stomach, or be tasteless, may be either inodorous or fetid, at times excessively so. (See Flatulence, page 133). Offensive breath, which may be sour, or having a flavour of bad eggs may proceed from indigestion ; but it must not be forgotten that bad breath may depend upon decayed teeth, or an unhealthy secretion from the tonsils, or the bronchial glands. The foul state of the tongue will be in some measure an index to the stomach being at fault, and what will remedy the other symptoms complained of will usually rectify this. When the tonsils or bronchial glands are at fault, the malady is more deeply seated and is not so amenable to treatment. It unfortunately happens that in these cases friends are much more conscious of what is wrong than the individuals themselves, and as it is rather a deli cate subject to speak to a person about, it is often allowed to continue without any effort being made to relieve it. Even if advice is sought, the patient hearing that in all likelihood a long course of treat ment may be necessary, is unwilling to enter on it. Regurgitation of Food is present in many cases, and occurs at any period of digestion ; it, perhaps, comes on most frequently when the powers of the stomach are in a measure exhausted, and is also 121 been partaken of, the stomach digests up to a certain point and then seems to weary of its task, sooner than if there was a greater variety. A moderate mixture of wholesome food is, I think, better than a single article when persons suffer from indigestion, for the reason I have just stated, and also that a greater power of selection furnishes more of the elements required for nutrition.* Stews, especially when they contain carrot or turnips, are apt to disagree and give rise to unpleasant risings. Many other articles of food might be mentioned, but it is sufficient to allude to fat, this being melted will float on the fluid in the stomach, and in some cases will allow but little respite till it is ejected. When this is done if it is spit into the fire a blaze will shoot up the chimney, endangering it if there is any accumulation of soot. Few persons who have not witnessed this, can credit how large a flame of fire may be produced. Besides the risings of food there * This furnishes no excuse for the epicure, who will pay the penalty of his folly. A sufficiency of what is plain and wholesome and a little varied is desirable, excess or daintiness is pernicious. The precept " let your moderation be known unto all men," has equal force here, and should be pressed home by the physician when he meets with patients who depart from this rule. 122 times intensely acid setting the teeth on edge, the sensation in the stomach being that of a hot burning pain (fer chaud of the French). This combination of pain, heat, and acid risings, is known as pyrosis or waterbrash,* sometimes in England it is called the blackivater. The pain in the stomach is called Gastrodynia, or Cardialgia.\ There is also poured out in some cases from the mouth to the stomach a thick adhesive mucus, which, hanging about the glottis, may produce cough. It is associated in some cases with elongated uvula, or with an cedematous state of it. I have long considered disordered stomach a common source of this worrying com- * Before the potato famine waterbrash, and heartburn and flatulence were very common complaints in Ireland, am led to the consu mption of many gallons of Infusion of Gen tian or Quassia, in dispensary practice. Better prices foi work and produce, and better food have, it is to be hoped altered this. f Pyrosis, Ilt/pwur ; but has an influenza cold, running from c, pain over eyes, slight cough with a little iping, a feeling, of dust in throat. Mercurius, one pilule* of the 12th, to be * The pilules I use are much smaller than the ordinary ones. I usually keep them soaking in tincture. X 129 taken four times a day, if soreness is felt sufficiently to need it. Bryonia 7/30, in nine dessert spoonsful ; a spoonful every four hours. After this recovery was sufficiently advanced not to require further treatment. The following case is given for the sake of its Case.— lB66, May 25. Esq., set. 7 Has suffered for the last 50 years from dyspepsi When a young man had the misfortune to fall int the hands of a doctor who, being a great advocat for calomel, gave it pretty freely to his patients, an< to this gentleman in his turn. The dyspepsia date from this as its probable cause. Has always suffered from acidity, with occasional acid risings, flatulence, and distention, but this last symptom has not troubled kirn much of late. There is a red sediment in the urine ; when this is the case there is amendment in other respects. Eighteen months ago, after worry and anxiety, began to suffer from sleepless nights. For this he has taken Nux Vomica, the effect has been to procure sleep if not suffering at the time from acidity, but when this is present to any extent, without 130 regurgitation of acid fluid. I Took brandy and water at his meals for many ars ; obtained relief by discontinuing it. For a ac found sherry suit very well, but it lost its ect. Scotch ale and port wine in their turn ited for a time, but bitter ale did not answer. I Rich food disagrees and prevents sleep. Indigesi food, such as the brown part of roast mutton will 3p him awake. I Suffers now from leant of sleep, apparently caused acidity; burning in throat, slight tendency to tie¦ssion, yawning, and when this is present it is an lication that sleep will be broken ; writing, or overrk knocks him up. He finds that a stimulant 3S him good. Urine is now clear and pale ; bowels lfined, this he attributes to the port wine which is at present taking. I las tried various allopathic remedies. Also went a water cure establishment, where he had some iceopathic treatment, with a certain amount of efit. About four years ago when this gentleman suffering from considerable distention and disibrt after food, I advised him to take China eh he did, and for a period of two years conied to obtain relief from it, taking it instead of ordinary dose of blue pill. The recollection of brings him to me on the present occasion. k 2 131 Ammonium Carbonicum, a pilule of 12, three times a day; but if suffering much from acidity, every one or two hours till relieved. I This being an instructive case, I give it (though c result is not yet known), as it illustrates much of lat has been already said about the symptoms. tThe following case reported by me in a paper "on at is termed fulness of blood to the head, &c.,"* es a different set of symptoms to the last. I Case. — Mr. J. C. aged about 35 (judging from > appearance), consulted me in April, 1855. He nplained of extreme weakness ; tremulous sensan, as if ready to fall ; hand shakes when drawls ; loss of appetite ; has a dislike to food, it proces nausea ; the desire to vomit has been relieved the expulsion of flatulence ; had a pain under ;h ears, feels some still after pressure ; a sort of >oting pain under left ear. Consulted an allopath the previous week, who gave him some powerful aperient medicine that aggravated his symptoms. Buffered at times from frontal headache ; much st, but that is less ; vertigo on rising from a * British Journal of Homoeopathy} Vol. 19, 1861 , pngf 132 seat, felt it on coming into the air this morning ; feels faint; and a great disinclination to -work. Pulse weak and quick; tongue foul, white and yellow ; much mucus from throat ; stools dark coloured ; suffered last year from eczema. I at first gave him China 30, without any marked benefit ; then Puls. 5/30 1/14, three times a day for two days. April 17. The report is, bowels rather inactive coated tongue ; dry mouth ; vertigo while walking or on turning quickly, felt for the moment ; tremblin continues ; fulness of stomach ; rather less flatulence pain in stomach, increased by stooping or pressure less nausea and headache ; feels on the whole bettei Lycopodium 5/30 1/14 three times a day. April 20th. Feels very much better ; tongue a little foul and whitish, but much cleaner ; slight unpleasant taste ill mouth ; better appetite ; nausea, headache, and vertigo gone ; less flatulence : less mucus from throat ; bowels regular. In two days to repeat the Lycopodium. No more medicine was needed, the patient being cured. Flatulence. — At first it may seem unnecessary, after what has been said in connection with indigestion, to give a separate notice of what is after all 133 well known, and which, in any disease, may be but one of many symptoms of equal importance. But when we recollect that, in many cases, little besides flatulence and the pain it gives rise to is complained of, and that when it is removed our patient is cured, a little guidance in the selection of the medicines best suited for its relief may not be out of place. Symptoms, &c. — Flatulence presents itself to our notice in numberless ways, and in connection with tiny diseases. We have it with rumbling and a riety of pains in the abdomen ; moving about or incarcerated ; with constipation or with diarrhoea ; tth vomiting ; with eructations ; with regurgitation food. Expelled by empty vomiting, or passed by 3 bowels ; associated with headache, vertigo, de- of spirits ; accompanying many diseases and complicating them very much ; serving as an index to «c state of the patient in fevers, &c, by the amount distention of the abdomen or tympanitis ; imitating diseases by the symptoms it produces ; often leading to the belief that there is some local congestion or inflammation, and from the distention of some one part of the abdominal parieties, causing a doubt in some cases as to whether a tumour may not be present, the rapid disappearance of such a phantom tumour being rather perplexing to the medical attendant, if he has expressed an opinion in 134 I our of the reality of some abnormal growth. Insd, so far has an error of diagnosis been made, ,t I believe cases have occurred where tapping ! been resorted to, to relieve a dropsy that did not st. And lastly, the well known complications of ;ulence and hysteria produce a variety qf sympis that are by no means agreeable either to ient or doctor. Causes of Flatulence. — The various changes lit are always going on from the moment of our stence, are liable to disarray from many causes, 1 once a little is out of order, despite the natural dency to recovery, it is hard to say how far the jchief may go, or how long it may continue. The :t source of mischief may continue in operation, a disease may run a given course, during which r one symptom may be persistent. li. deficiency of nerve force, as well as debility n any other cause, may give rise to imperfect estion, and derangement of the action of the nentary canal. Feeble heart, inactive liver, geneor local disease, may in the one case insufficiently , or in the other disturb the natural functions. Ed partaken of may produce the mischief, the vital and chemical changes continperation, giving rise to solution, absorpsntation, and decomposition, will naturally 135 produce some, and with any interference, a large amount of flatulence. TREATMENT OF INDIGESTION, &c. It is a safe rule in the treatment of all disease to remove the exciting cause as early as possible. This does not necessarily produce a cure, for the mischief that has sprung up has perhaps taken a firm hold, that cannot be shaken off in a moment ; but by the removal of the cause, the patient is placed in as favourable a position as the circumstances admit of, and the action of our remedies is not interfered with by the continued feeding of the disease. The points chiefly to be attended to are regulation of diet as to quantity and quality, the intervals between meals, and the time to be allowed for its being partaken of leisurely. In some cases it is very necessary to be strict with patients, as many of them resist rules, and when a little better, return to their old habits. It is far better for the physician to decline attendance, than to allow his plans to be frustrated, so that he loses in credit, while the patient remains uncured. So much has been said about diet in connection with the causes of indigestion, &c, and also in the introductory remarks, page 7, that it is perhaps sufficient to say that the diet of the dyspeptic patient 136 must be regulated according to the requirements of each case. To enumerate all the articles of food that have been known to disagree would be simply to include all kinds of food. I have known rice, arrowroot, and such simple things, produce the most intense acidity : bread at times does it. In such a case, a change to home-made or some other kind of bread may be tried. The gluten bread may be of use, but the elements of nutrition wanting in it must be supplied through some other medium. Even cold water is complained of at times by patients as causing discomfort in the stomach. If I do lay down anything like a rule in my own practice, it is simply to forbid spices and rich food, and in some cases potatoes, and then to interfere as little as possible, until, by watching my patient a little, I can find out what is manifestly hurtful. Patients are always anxious to know what they may drink. What has just been said about food applies equally here, one can take what another cannot touch. Coffee is usually forbidden to patients under homoeopathic treatment ; it is a question how far this is necessary, unless in susceptible cases where it might interfere with the action of the medicine, or where it is known to be hurtful. I have, certainly, seen it taken without interfering in the least with the treatment. 137 it is imperative to interdict tea altogether ; this happens in exceptional cases, where nervous subjects have injured themselves by taking strong tea, which acts so powerfully on the brain. Milk, or cocoa in some of its various forms, may be substituted. Stimulants are valuable if used in moderation, but in excess are a curse. The doctor must remember his responsibility, and, as far as lies in his power, warn against abuse. No rule can be laid down, but it will often happen that when malt liquor or wine * cannot be touched, a very small * Wine, if obtained in its natural state, would no doubt suit many ; but the process of mixing — a large quantity of Inferior1 nferior with a small quantity of good wine, which the Spaniards understand in the preparation of their Amontillado, the brandying for the British palate either at home or abroad, and the further process of remixing a lot of second class wine with some questionable East Indian, that takes place in this country— produces an article very different from what came originally from the grape. We have lately had some instruction about the manufacture of sherry in Germany, in the preparation of which potato spirit plays an important part. No wonder John Bull suffers so much from dyspepsia. Manzanilla sherry will be found an excellent wine for many stomachs. A friend of mine gets a much cheaper, but good wine, having also a slightly bitter flavour, direct from Spain ; if such a wine were easily procurable, I know 138 quantity, from one to four dessert spoonsful, of good brandy in a glass of water may be taken with advantage. Where much acidity is present, the relief obtained by soda or other alkalis is only temporary, and the cure is as far off as ever. Sipping cold water may give relief for the moment, but free regurgitation when it takes place is the most natural way of getting rid of it ; also of any food that lies heavy on the stomach ; brisk walking for a short time will encourage it. good Marsala, which is a much less costly wine and very superior to inferior sherry, will suit many. Clarets, Burgundy, and good Rhine wines, will suit some stomachs. I cannot speak from experience as to the real value of Hungarian or Austrian wines. Port is a favourite wine in recovery after illness, and when good is an excellent wine, but those who take port wine regularly, lose the advantage that is gained by the invalid, and not unfrequently suffer from gout, &c. Champagne, Moselle, or sparkling Hock, are very good wines for the sickness and lassitude of pregnancy, and also where there is depression of the nervous system. A fortnight or three weeks continuance is better than taking them for a longer period. There is an excellent wine of this class, though not strictly a champagne wine, possessing many qualities to recommend it, St. Peray, the produce of vineyards in Ardeche, the property of my friend M. Giraud Faure, oh- 139 Kere nausea is felt, a drink of warm water at settles the stomach, or promotes regurgitation liting. Where flatulence gives rise to abdominal pain, warm fomentations, or where practicable, as in the case of children, a warm bath will be found to give considerable relief in most cases. Warm, dry heat is good, but unequal to moist heat. I Loosening the clothes is often sufficient to give a jat amount of ease, as their weight, or even a lit string, will in some cases cause distress. LAn enema of some warm water or gruel, by re)ving an obstacle to the passage of flatulence, may ?e much temporary relief. As many of the medicmes are of use for the same symptoms, it is the tate of the patient in other respects, as well as any sculiarity of the case immediately in hand, that ust decide us in our choice. E'.n some chronic cases of dyspepsia the cold water . covered with oil silk and a piece of dry sheeting r all, worn for some time, gives help. K[n others a more regular course of water treatnt, or movement cure occupying the mind, and ducing an alterative action, is of service ; so also change of scene, travelling, horse exercise, or change of occupation, are of great value in their way, but are only auxiliaries, being secondary to a course of regular homoeopathic treatment. 140 Choice of a Medicine. — It is of course impossible to say that this or that remedy is the best, where only the name is dealt with, but by taking a group of the symptoms usually attending it, a nearer R;h to the right medicine is attained ; so that ome simple derangement or a more complitate of disease produces indigestion or flatui familiarity with such groups of symptoms en give much assistance. In the following list of medicines those most likely to be of use are enumerated, and, as a little assistance, some of the principal diseases in which they are of use are given, so that when abdominal symptoms are present in any such cases the selection can at times be made without further reference ; when such is necessary, the repertory at the end of the book may furnish the information sought; if more is needed, Jahr, Bonninghausen, or Bryant's works must be looked to. Dose. — Where the object is to procure immediate Rm pain or some urgent symptom, the medir be given every thirty minutes, or at longer >r intervals as needed, till relief is obtained. Where a more permanent effect is sought, a dose once, to four times, a day. I generally order the medicine to be taken half an hour before meals. 141 The medicines most likely to be of use, occur, in point of value, in somewhat of the following order. In Indigestion, Nux Vomica, China, Pulsatilla, Lycopodium, Conium, Ammonium-Carbonicum, Baryta Carbonica, Chamomilla, Sulphur, &c. In Flatulence, Cocculus, Carbo Vegetabilis, Conium, Nux Vomica, Chamomilla, Pulsatilla, China, Lachesis, Belladonna, Sulphur, &o. In Nervous Depression, Ignatia, Staphysagria, Phosphoric Acid, Nux Moschata, Moschus, &c. In Vomiting, Ipecacuanha, Antimonium Crudum, Nux Vomica, &c. Aconite. — Is of use in fever or inflammatory attacks; eruptive fevers ; croup ; fulness of blood to head ; delirium ; retention of urine or scanty urination ; diarrhoea ; jaundice. Pain ; nausea ; vomiting ; scanty urination ; diarrhoea ; sleeplessness ; attacks of pain and restlessness ; attacks of fainting ; palpitation ; shiverings and chilliness ; or burning heat ; anxiety, and fear : vertigo on movement ; dilated pupils ; &c. If with any of these colic pain, rumbling and fermentation and feeling of fulness from flatulence, thirst, bitter taste in mouth and loss of appetite, vomiting, nausea, rising of sweetish water in mouth, pressure as from a load in stomach, hiccough, are present, this medirinp may hp mvpn 142 Ammonium Carbonicum. — Glandular swellings ; lassitude and weariness, as if from overwork ; eruption on upper part of body, like scarlet fever ; chilliness; alternote heat and chilliness ; chilliness or feverish heat of an evening ; headache, pressure or bursting feeling in head ; sore throat, swelling in throat, difficult sivallowing; acrid discharge from nose. I This medicine has been much used by homoeopaths low forms of scarletina. It is of use for sourish d metallic taste in mouth ; eructations; sour eructans and heartburn ; thirst and loss of appetite ; alruishness after dinner ; uneasiness, with pres:e on stomach and forehead ; vomiting of blood ; nfulness of stomach when pressed on; oppression; tention, weight, and pain in abdomen ; rumbling griping with flatulence ; constipation or diarrhoea ; colic before and after stool ; discharge of blood ; vertigo; sleeplessness; kept awake by burning in stomach; yawning; nausea at night, and pressure on stomach; turbid urine, white sandy urine, and reddish urine after dinner. (Compare with cases, page 130.) Antimonium Crudum. — Disordered stomach ; violent vomiting ; diarrhoea ; exhaustion in hot weather ; itch ing, vesicular and other spots on skin ; loathing, nan sea, and eructations in fevers ; vertigo ; headache after bathing. Slimy stools ; spasmodic pains ; rumbling and inof 143 appetite ; coated tongue ; flatulence, discharge of slimy stool with flatulence; frequent desire to urinate. Apis. — A useful medicine in dropsies ; erysipelous, ovarian tumours, d'C. Weight and heaviness in head ; pressure ; sensation of rush of blood ; vertigo ; &c. ; will be found of service for sensation of fulness and bloating in abdomen ; eructations, tasting like yolk of egg ; nausea and vomiting ; bilious vomiting, pressing in hypogastriurn ; sore feeling in bowels ; urination frequent and high coloured ; flatulence with stool. Arsenicum. — Violent vomiting and diarrhea; dysentery; cholera; inflammation; dropsies; gangrene; typhoid fever, intermittent fever ; asthma ; jaundice ; epilepsy ; convulsions ; marasmus ; d'C. Painful distention of abdomen, worse after vomiting and diarrhoea ; sour, bitter eructations ; cutting, rumbling, and diarrhoeic stools. Baryta Carbonica. — Scrofulous affections; glandular swellings ; complaints of old people or children ; apoplexy ; in suppuration of tonsils, no better remedy, especially when given early. Also useful in the early stage of diphtheria when characterised by swelling, hut before much deposit has taken place — when this occurs, it may be followed by Hepar ; chronic tonsillitis ; loose cough with accumulation of mucus, &c. 144 stomach ; pain on pressure, soreness in stomach ; painful writhing sensation in stomach while eating, as if the food had to force its way over sore places ; painful distention of abdomen; urging with loose stool ; pain in loins ; frequent emission of urine ; yellow sediment. I Belladonna. — Congestions and inflammation ofhea lungs, or abdominal viscera; nausea, vomiting — an< undigested food ; moaning, and waking up of children % screams; convulsions; sleeping with eyes half open mtion of urine ; epilepsy ; gout ; double vision irium ; hallucinations ; excitement ; glandula ilings ; sore throat ; scarlet fever ; for which it is also prophylactic, see page 86. i flatulent colic ; spasmodic, half-suppressed eruc ons; distention of abdomen around ribs; protru i of colon, like a pad§ ; pressure in the abdomen eh is drawn in (when lying down) ; constriction ibdomen around umbilicus, as if a ball woult a; pinching colic, rumbling; soreness to touch. § Case. — I had a very interesting case a few years ago, where this swelling up of the colon was my indication for Belladonna. An old lady, upwards of seventy, who had spent some years in the West Indies, was attacked with most violent abdominal pain ; there was excessive vomiting, like coffee 145 . ?-1 1 ' • 1 ,1 1 1 J .1.1. grounds; which she said exactly resembled the black vomit. The attack was most severe, and the pain excruciating ; this peculiar symptom, rising up of part of the integuments like a pad, was present. In different attacks in which I saw her, the symptoms were the same, and the relief following Belladonna 30 most marked and speedy. Other medicines, apparently well selected, except their not having this symptom, failed to give relief. Bismuth. — Which is such a useful remedy in allopathic practice, for pain after food, seems to owe its virtue to its homoeopathic action. I have used it homoeopathically in similar cases, but have formed a preference for other remedies. Bryonia. — A valuable medicine in gout, rheumatism; swelling of joints; inflammations; pleurisy, pneumonia, dc. Fevers, cerebral congestion, dc. Will be found of use for flatulence in conjunction with these, producing colic pains, rumbling and moving about in abdomen. Nausea of a morning, vomiting, regurgitation and eructations, bitter taste after food, distention after a meal, constipation, drowsiness and inclination to sleep after dinner. Hot red, brown, or scanty urine. Calcarea. — Is an excellent medicine for scrofulous diseases of children ; ascarides ; constipation ; hard undigested stool ; polypus ; profuse and too frequent mendren, 146 with feeble and imperfect development ; phthisis ; mesenteric disease ; affections of liver ; gall stones ; whitish stools, chronic diarrhcea. It will be found of use for distention of abdomei after eating or drinking ; tightness and pain in hypochondria ; colic ; rumbling and incarceration o flatulence ; sour or bitter eructations ; frequent uri nation ; fetid dark brown urine, with a white sedi ment. Carbo Vegetabilis. — Bronchial affections; whooping cough : phthisis ; glandular swellings. Dark red urine as if mixed with blood ; reddish turbid urine ; leucor rhcea ; collapse ; offensive discharges ; indigestion , hcemorrhoids, Sc. This is one of our best medicines for flatulence It may be given where there is fulness and distention, or palpitation after a meal ; flatulent colic empty eructations, heartburn, sour eructations emission of flatulence ; crampy pain ; pressure in stomach. Qhamomilla. — A most valuable medicine during the dentition of children ; irritability and fretfulness flushing, especially of one cheek ; startings and crying diarrhoea ; jaundice ; metrorrhagia ; pressive spasmodic uterine pains ; also for severe pains ; bronchial at tacks, dc. It may be given for flatulent abdominal pains : l 2 147 oppression in stomach ; weight after a meal ; griping spasmodic pain ; pinching ; fermentation ; empty or sour eructations ; aggravation of pain by eructations ; bloatedness in epigastrium ; incarcerated flatulence ; spasms ; oppression of breathing ; restlessness and tossing about at night ; yellow flocculent sediment in urine. China. — Useful in intermittent and other fevers; after debilitating losses ; indigestion, giving rise to feeling of fulness of blood in head ; affections of liver and spleen ; dropsies ; metrorrhagia ; urine with brickdust sediment ; whitish stools, dc. It will be found very useful where pain and weight is felt at stomach (or chest, as patients usually say) after a meal ; incarcerated flatulence ; colic, griping, spasmodic pain ; fermentation ; eructations sour, tasting of food ; diarrhoea; emission of fetid flatulence ; cough after meals : dark spots before eyes. Cocculus. — Apoplexy and paralysis ; epilepsy ; diarrhea, with fainting ; oppression of chest ; palpitation ; suppression of menses, with oppressive abdominal spasms ; flatulence ; anguish and oppression of breathing ; leucorrhcca ; dimsightedness ; black spots before eyes, dc. A very good medicine, where other symptoms are absent; for flatulent distention and colic; putrid eructations and diarrhoea, with emission of fetid 148 K3 ; cloudiness of head, increased by eating ing ; vertigo ; noise in ears. For simple distention with pain ; it is one of our best ¦ynth. — Disease of hip joint ; neuralgic pains ; us illnesses the symptoms are aggravated by ; dysentery; and various forms of diarrhcea. ¦»f our best medicines for colic and griping am worse on moving ; relieved by bending ; distention ; rumbling ; emission of flatud eructations. Rn. — Paralysis ; scirrhus ; coughs ; diabetes ; diseases of the ovaries ; glandular swellings ry of glands ; dropsies ; apoplexy ; dullness, or lacerating feeling in head, Sc. luable medicine for distention after food ; 5 ; emission of flatulence, and cutting pain len ; eructations, sour, tasting of food. For atulent distention after food, this medicine our best. ¦dies. — Is a useful medicine in some forms of disease ; emaciation ; s%ippression of menses ; and leucorrhcea ; sensitiveness to cold air ; nof chest ; haemorrhoids, worms, Sc. Waterbrash ; fulness and hardness of abdomen, with incarcerated flatulence ; gripings ; distended abdomen, with diarrhcea ; knotty stool ; and various 149 ache during and after a meal ; headache of a morning ; roaring in ears ; sour smell from urine ; turbid urine with reddish sediment. Hepar Sulphuris. — A valuable medicine, both in acute and chronic disease ; coughs, with hoarseness ; croup ; diphtheria ; suppurations ; affections of scalp and skin. It may come in well in certain cases of Indigestion, where the symptoms do not yield to the ordinary remedies. It is suitable for eructations ; waterbrash and burning in throat ; nausea and coldness ; vomiting of mucus ; regurgitation ; fulness, palpitation, and oppression after a meal; griping, pinching, and lacerating in abdomen ; incarceration of flatulence, and rumbling ; stitches in region of liver ; obscuration of sight when reading ; yellow, or brown-red urine; greasy pellicle on urine; burning during emission of urine. Ignatia. — Hysteria ; grief ; headaches, beating, cramp-like, or with feeling as if something were pressed into brain ; worms. Increased secretion of saliva ; constant mucus in mouth when walking ; taste in mouth as of a deranged stomach ; sour taste of saliva ; want of appetite ; gulping up of a bitter fluid ; empty vomiting ; distention of abdomen after a meal ; hiccough after eating or drinking ; nausea ; canine hunger ; spasmodic pains in stomach and abdomen * -flatulent 150 colic ; rumbling in bowels ; inspiration is impeded as from a load ; palpitation at night and after dinner. Ipecacuanha. — Hemorrhages ; tetanic spasms ; rattling cough ; suffocative cough ; asthma ; contraction of chest and panting breathing ; vomiting, and diarrlma. Aversion to food ; qualmishness ; nausea and vomiting ; nausea with empty eructations and accumulation of a quantity of saliva ; griping and flatulent colic ; bloody urine ; turbid urine, with brick-dust sediment. Kali Carbonicum. — Stitching pains in chest ; phthisis; cough, from elongated uvula ; intermission in beats of heart. Restless sleep, startings ; acidity at night ; sour eructations after a meal ; drowsiness during a meal ; nausea and feeling of faintness ; heartburn ; sour burning from stomach; spasmodic and cutting pains in stomach ; burning in region of liver ; distention of abdomen ; incarcerated flatulence ; excessive emission of flatulence ; spots and gauze before eyes. Lachesis. — A medicine especially valuable at the change of life in women ; constipation, with small, lumpy stool ; dimness of sight ; mistiness ; vertigo ; convulsions; apoplexy ; paralysis ; ulcerated sore throat; tightness of breathing and asthma ; laryngeal phthisis ; coughs ; pneumonia ; erysipelas ; palpitation ; noise in ears <&c 151 This is a medicine that I often use where a vomiting up of wind is complained of; it is of use for distention of abdomen, with pain, and chronic constipation ; frequent urination ; foaming or yellow urine. Lycopodium. — 7s used with advantage in epilepsy ; emaciation ; phthisis ; coughs with salt or purulent expectoration ; oppression of chest; palpitation; pneumonia; dropsies; glandular swellings; chronic hepatitis; aching and tension in region oj 'liver ; itching eruption about anus ; worms. »Of use for distention of abdomen, with weight and ness ; pressure and griping ; tension in hypogastrium. I find it a useful medicine in constipation and flatulence of children. I have used it also with great benefit where there has been a reddish sediment in urine. As a good deal of controversy has been excited about an indication for the use of this medicine, to which Dr. Wilson first directed attention, " a working in and out of the alse nasi," or as it has been also called "fan-like movement of the ala 3 nasi," I can add, from personal observation, my testimony to much that has been said in its favour. Where the other symptoms correspond, and this symptom is present, I believe we have a remedy of the utmost value. 152 It is of use for chilliness and fever ; aching in hones; rheumatic pains, characterised by perspirations that do not afford relief ; sore throat; ulcers; itch-like eruptions ; glandular swellings and suppurations ; various forms of ophthalmia ; aphtha, ; diarrhoea ; dysentery ; jaundice ; affections of bladder and kidneys ; desire to urinate without the ability to do so ; catarrh, with cough and coryza; soreness of nose; toothache; worms, It may be given for constant risings of air from stomach, bitter eructations ; regurgitations ; offensive breath ; nausea and shuddering ; bilious vomiting ; burning and ulcerative pain in stomach ; weight and pressure of food in stomach ; colic, from chill ; distention of abdomen ; pain in region of liver ; undigested stools ; foul tongue ; offensive breath ; ulcers in mouth ; turbid urine ; white filaments in urine ; sour, scanty, fiery red urine ; dark red urine, as if bloody ; desire to urinate, without emission ; burning and cutting in urethra. I us. — Nervous paroxysms ; hysteria ; fainting, by headache ; convulsions ; tetanic spasms ; S ; restlessness ; anxiety ; palpitation ; conof chest, and shortness of breath. Bitter taste in mouth ; eructations ; nausea ; oppression and soreness in stomach ; tightness and hypochondria ; bursting feeling in abdomen ; grasping above umbilicus, arresting breathing ; pinching in 153 abdomen ; scanty and thick urine, like yeast ; retention of stool ; urging in abdomen ; diarrhoea. Natrum Carbonicum. — Vertigo ; rough, dry, scraping, and acrid sensation in throat ; sour taste in mouth ; coated tongue ; thirst ; diarrhoea after drinking milk ; eructations ; sour, bitter rising of sweet water ; waterbrash ; inclination to vomit ; heat in face ; retching and hawking up of mucus, and finally vomiting of frothy tasteless mucus ; pressure as from a stone in stomach ; contraction around stomach ; pinching colic and distention of abdomen ; incarcerated flatulence ; lumpy stool, &c. Nux Moschata. — Useful for rheumatic affections in damp weather ; oppression of chest, imitating pneumonia in hysterical subjects ; also for oppression of chest ; hcemoptysis ; palpitation of heart and fainting ; Colliquative diarrhea, dc. It may also be given for eructations ; distention from flatulence, preventing sleep at night ; cutting in epigastrium ; pressure in stomach, with burning risings; flatulence during childbed. I can speak from some experience of this medicine as to its value. I have derived much benefit from it in chest affections. Nux Vomica. — One of our most generally useful medicines, so much so that many persons, new to Vir»mror>r>otViT7 nr»rmiro a nnfirio an tli'a m rlipinP 154 that they are slow in according to others. It is particularly useful for nausea and vomiting ; constipation ; hernia; inflammations; dysentery; indigestion; gout ; epilepsy ; convulsions ; delirium tremens ; tetanus ; apoplexy and paralysis ; jaundice ; fainting ; catarrh ; ulcers in mouth, die. It may be given for sensitiveness of the stomach to pressure ; hiccough ; regurgitations ; sour eructations ; Pressure in stomach ; cramp-like, griping pains ; pressure, as from incarcerated flatulence, under ribs ; distention of abdomen after a meal and after drinking ; flatulent colic after stool ; urging to stool in constipation or diarrhoea ; foul tongue ; vertigo ; headache from taking wine or coffee, or from excessive -mental labour ; headache, with nausea and vomiting ; black spots before eyes ; drowsiness in day time, or after a meal ; empty retching ; vomiting of sour smelling mucus ; waterbrash ; nausea and vomiting of pregnancy ; painful an& ineffectual urging to urinate ; burning in .jiir'athra, urging to urinate, with brick-dust sediment. Opium. — Convulsions ; apoplexy ; paralysis ; delirium tremens ; epilepsy ; tetanus ; droivsiness ; coma ; wdkefulness ; sleeping with eyes open; stertorous breathing ; delirium ; congestion of blood to head ; vertigo ; ailments of old people ; insensibility of nervous system, and inhere there is not a "response to the action of tnedicine; 155 suppressed or retention of urine ; deficiency of contractile poiver of bladder ; constipation, <&c. Painful distention of stomach and abdomen ; tympanitis ; incarcerated hernia, with vomiting of foeces ; hard stool, preceded by pinching pain in abdomen and flatulence. Phosphorus. — Scrofulous affections ; phthisis ; fiatulous abscesses; rheumatic pains; bone pains; psoria- II chronic and typhoid diarrhoea ; tightness in chest ; arseness ; soreness in chest, with saltish bloody expectoration; hectic fever ; pneumonia; cholera, dc. Frequent eructations, sour after a meal and sour regurgitations ; pressure in stomach after a meal ; oppressive fulness in abdomen ; griping ; incarceratn of flatulence, with coldness of body and heat face ; rumbling, as if diarrhoea would set in, or inful after eating, or with emission of flatulence. Phosphoric Acid. — Debility ; nervous weakness ; depression of spirits ; emaciation ; night sweats ; hypochondriachal affections ; bone pains ; palpitation, also on starting from sleep ; diarrhoea ; cholera, Sc. f Pressure in epigastrium ; pinching, crampy pains abdomen ; rumbling ; emission of flatulence after acids. Pulsatilla. — Disordered stomach after rich food; Kdering pains of rheumatism and gout; palpitation; tings ; puerperal disease ; phlegmasia alba ; sup- 156 Ilochia ; after-pains ; false pains of labour ; r suppressed menstruation; varicose veins; sivellfeet; semilateral headache ; measles ; night 'ough with thick, offensive, or bloody expectorayspncea, dc. Eructations ; sour, bitter, tasting of food ; hiccough ; rumbling, with purging and griping ; flatulence, with hysteria ; colic pain in abdomen after stool, as if from flatulence ; headache after overloading stomach ; foul tongue ; offensive breath ; vertigo ; colourless watery urine, with brick-dust sediment, or with blood ; tenesmus of bladder. ¦ Toxicodendron. — An excellent medicine in erysipelas ; rheumatism, pains worse in damp and at night in bed ; nettlerash ; paralysis ; and bruises ; fevers ; restless sleep, tossing Pressure in stomach as if swollen ; painful abdominal distention with colic. These symptoms with the character of stools, red and yellow jelly-like stools, with blood ; pinching preceding action ; nightly diarrhoea, and colic, and involuntary stools ; make this a valuable medicine in typhoid fever. Sabina. — Of use in gout; profuse menstruation; miscarriage. Diarrhoea, with emission of flatulence. Sepia. — A valuable medicine in diseases of women, 157 fia ; back-ache; menses too early, too scanty ; itching pudendum, of use at the critical age ; glandular swellings ; scirrhus indurations ; bursting or contractive tidache ; vertigo ; turbid, fetid urine ; urine with ck-dust sediment ; smarting in urethra, pressing donnt desire to urinate ; disturbed sleep ; palpitation ; cough with tightness, salt, bloody expectoration ; pneumonia ; night sweats ; jjhthisis. I Headache with nausea ; soreness of tongue ; avern to food ; sour, bitter taste, or salt taste in >uth ; much thirst ; heat and palpitation during [estion ; acidity after a meal ; eructations, bitter, ir ; waterbrash ; nausea ; nausea and vomiting of ;gnancy ; nausea and vomiting. I Pains in stomach after eating ; pain on pressure ; assure in stomach as from a stone ; burning in pit stomach ; cramp in stomach and abdomen ; beatl, stitching, or sore pain in liver ; stitches ; isms ; colic ; burning or cutting pain in abdomen ; tulence ; weight in abdomen ; distention ; diarrhoea er milk ; various forms of diarrhoea. Silicea. — Phthisis ; hectic fever ; night sweats ; abscess ; painful ulcers ; old suppurating sores ; fistulous sores; glandular swellings; scrofula; rachitis; bone pains ; urine with reddish or yellow sediment, dc. Headache with eructations ; eructations, loud, sour, bitter ; waterbrash, with shuddering ; pain in 158 ¦bdomen in children ; fetid flatulence ; rumutting, burning pains. Staphysagria. — This medicine, as already mentioned (page 61), will be found very valuable for ailments aggravated by mental worry; pains in bones; soreness of gums ; pain from decayed teeth ; painful and swollen Feeling of hunger, even after food ; scraping eructations ; hiccough ; nausea ; pressure in stomach ; rumbling and cutting in abdomen ; cutting in bowels after a meal ; diarrhoea, and flatulence. Sulphur. — In the course of many diseases, when the properly-chosen homoeopathic medicine does not act well, a few doses of sulphur may effect a salutary change. It is specially used in constipation ; hcemorrhoids ; sourish diarrhoea ; tenesmus ; scrofulous affections ; emaciation ; curvature of bones ; glandular swellings ; abscess ; inflammatory diseases ; pleurisy ; hepatitis, dc; jaundice; gout and rheumatism; dropsy; leucorrhcea ; fetid urine; blood with urine; frequent There are few chronic diseases where this medicine may not be called for, and in some acute ones its action is most marked. It is of use for eructations, sour or bitter ; waterbrash ; various kinds of vomiting ; indigestion after various kinds of food ; headache after a meal ; acidity and regur- 159 Itulency, relieved by sitting bent ; distention strium, with oppression of breathing before >t and after a meal ; rumbling in the hypoy; flatulence, smelling like rotten eggs ; •I, followed by emission of hot, fetid flatulence. Veratrum. — This medicine, already spoken of as one of our most useful in cholera and diarrhcca, will be found of much use in cutting colic ; flatulent colic ; emission of flatulence ; rumbling ; scanty emission of flatulence, with pinching pain ; distention of abdomen ; unperceived discharge of loose faeces, with flatulence ; and, in some cases, of constipation. More medicines are here enumerated than was intended, but the difficulty has been to select without HAEMORRHOIDS OR PILES. Theee are few complaints more common than piles ; they however vary considerably in the amount of inconvenience they cause, some individuals being scarcely conscious of their existence, while others are at times great sufferers. Symptoms. — From the situation in which these painful tumours occur, chiefly within the anus, they are extremely liable to be protruded, and so cause much pain till they are returned. At times, from their vascular nature, they bleed very freely, especially after stool, inducing much weakness ; and if this should be of long continuance, the drain on the system produces an anaemic state that is very hurtful. They chiefly consist of enlarged veins, with thickened cellular or mucous tissue in a state of hypertrophy or of congestion. They may occur singly or in clusters, and vary in size from a pea to a large nut. They are red, bluish, or brownish, the colour showing the amount °f inflammation or vascularity present. When ex- M Fal, they are partly covered with skin. They very uncommon in children. I They give rise to many symptoms, such as itching, rious kinds of pain, burning, smarting, throbbing, olapse, weight, pressure, straining, ineffectual orts to relieve the bowels, pain in back, irritation bladder, and in women, of the womb. In some ses, ease can only be obtained in the recumbent sture, as the attempt to sit causes much distress. Besides haemorrhage, there is often a mucous dischai-ge. At times the only symptom may be a peculiar dull pain occurring most commonly in the night, severe enough to cause a feeling of faintness, and lasting for half an hour or an hour. Dr. Marshall Hall, in his work on Diseases of the Nervous System, describes this peculiar pain, and says that relief may be obtained by evacuating the bowels ; the smallest piece of faecal matter by pressure against an haemorrhoidal tumour is sufficient to produce this pain, which disappears after an action. The effort of straining will sometimes give relief ; passing a bougie or administering an enema generally gives immediate relief. In some cases the pain produced by piles is very great, amounting to severe colic. In other cases the severe pain is confined to the tumour, which may be much inflamed, or be strangulated. It 162 163 HAEMORRHOIDS OR PILES. throbbing, or there may be excessive smarting and burning, continuing for a long time after the bowels have acted. A discharge of blood may lessen the suffering caused by the swollen piles. The suppression of an habitual hsemorrhoidal discharge has been looked upon as a cause of other mischief in the system. It is possible that it may be so, as it is a great mistake to look upon piles as a merely local disorder ; but with ordinary care, the tsician need be under no apprehension. He never go astray in stopping the haemorrhage, treating any fresh symptoms as they may c. (See Note, page .174.) ILemorrhoidal Colic. — Medical men at times meet with cases of very severe colic pain, that is usually found to extend from the upper part of the abdomen down into the left groin, or the pain may appear to extend upwards. The bowels are often, though not always, constipated in these cases. On close inquiry, it will be found that the patient has suffered from piles, that there has been a dread of evacuating the bowels, leading to an almost unconscious resistance to doing so. The same state of things will arise from a painful fissure or ulcer in the bowel. The constipation and retention of flatulence increase m 2 very much the colic pain, so that much relief usually follows an action of the bowels. The Causes of Piles. — The causes that produce them most frequently are constipation, purgative medicines, pregnancy, disease of liver, and want of exercise. Food and spices that irritate the rectum are probable causes of piles, and those who have a tendency to dilated or varicose veins may be supposed to be peculiarly liable to them. Treatment of Haemorrhoids. — When haemorrhoids are swollen and painful, a warm poultice may be used. The good produced by it being often very great, the acute pain subsiding, and the patient being much tranquillized. Sometimes cold applications give relief. When there is soreness and smarting, five drops of tincture of Arnica, rubbed up with a dessert spoonful of fresh lard, makes a useful ointment, and is very successful in removing the feeling of excoriation. Barbadoes tar is said to act very beneficially, but whether it has a homoeopathic action or not is undetermined. The gall ointment of allopathic practice probably 164 owes its efficacy entirely to its astringent pro- The combination of this ointment with opium, which I have often used in former days when practising as an allopath, reduces the piles and relieves pain, but it is a question how far the suppression of piles in this way may not produce other mischief, hence, in homoeopathic treatment, we seek to remove or relieve them by directly curative agency ; and those who have tried both methods are quite satisfied with homoeopathy. Colic pain occurring with haemorrhoids is generally much alleviated by an action of the bowels ; this is best secured by an enema of three table spoonsful of sweet oil, followed by a larger one of gruel or warm water, if the oil alone does not secure an evacuation. Warm fomentations or a warm hip bath may be used at the same time. Children suffering from pain in the lower part of the bowels may resist an action of the bowels, and so produce colic pain, which is often in them, as it is also in adults, aggravated by urging without proper action. When the piles are protruded with an action of the bowels, they should be washed with warm water, and gently pressed back. Pressure. — Pressure with an ivory, boxwood, or other form of pad, kept up by a bandage, or the 165 An egg-shaped bougie attached by a neck to a pad, the whole of ivory, and secured in its place by bandage, is used to procure external and internal pressure. The medicines must be given in accordance with the existing symptoms. ¦> Aconite may be given if there is feverish restlessness ; also where there are stitching pains ; pressure ; bleeding ; colic pains ; back ache. A dose every one or two hours till relieved. Arsenicum, if diarrhoea is present ; bloody stools ; burning or stitching pains ; debility. A dose after each action, repeating in one, two, or three hours as needed. Calcarea is recommended when there is suppression of an habitual discharge, or if there is frequent bleeding. A dose every three or four hours. Capsicum. Burning pain ; itching ; smarting, stinging pain in anus during stool ; haemorrhage. I have used this medicine more frequently when there has been bleeding than for any other symptom. A dose every half hour or hour while needed. Carbo Yegetabilis. This medicine I have chiefly used for bluish swollen protruding piles; pain or soreness in rectum after stool ; mucous discharge. For these symptoms this is an excellent medicine. It will be found of use for burning in anus with emission of 166 turn ; pressure on rectum or on bladder, with abdominal colic pains coming on at intervals ; discharge of blood ; pressing or crampy colic after stool ; itching of anus, increased by scratching and followed by burning. A dose may be given three or four times a day, or while pain is severe, every twenty minutes or half hour, or at longer intervals. Carbo Animalis. Shooting pains ; in cases of old not very painful tumours, a continued course of this medicine may be of use in reducing it. A dose twice or three times a day. Pressure, as mentioned page 165, might be used at the same time. Causticum. This medicine is suitable for stool attended with soreness, smarting, or burning in anus ; also for itching of anus ; oozing of moisture from rectum; large painful piles; pustule near anus discharging pus and blood ; pain in perinaeum ; fissure about anus; fistula. A dose every two, three, or This medicine has hardly been used as much in these complaints as it appears to deserve, owing possibly to some prejudice against the preparation (which is not at all sustained by its use in disease). It is certainly worthy of a trial after Carbo Vegetabilis and Muriatic Acid, to which it is somewhat allied in action, or before those medicines if fitting 167 Chamomilla may be given for urging to stool with diarrhoea ; tearing pains in back at night ; inflamed piles, with ulcerated places and fissures about anus ; severe colic or flatulence. A dose every one to four hours, or every half hour, if needed. China should be given where the urgent symptoms have been controlled, but where debility remains after haemorrhage. Colocynth. Hsemorrhoidal colic; discharge of blood ; contraction of rectum during stool ; burning ; pressure alternately on bladder and rectum. fraphites. Itching, swelling soreness of anus ; ing cracks between varices ; discharge of blood prolapse of rectum. Hamamelis. This medicine has been used in allopathic practice for the treatment of haemorrhages. As a popular remedy for piles, it has been very largely used in the United States under the name of " Pond's extract." Hering of Philadelphia, and others, have used it in painful and bleeding haemorrhoids. For such cases it is suitable ; also for chronic cases it may be used as a local application, in the form of a cerate or lotion. Ipecacuanha may be given every ten or twenty mtes if there is profuse haemorrhage. It is also icated by stinging, cutting and burning pain at margin of anus. Ignatia is a valuable medicine for nervous or 168 hysterical subjects ; also where there is itching of anus, prolapse of rectum and bloody stools ; constrictive pain or smarting. A dose every two or three hours. Lycopodium. Distention and protrusion of the varices ; aching with pressure on the rectum, with cramp pain in the abdomen ; cutting in the rectum and bladder ; stitches in the rectum ; itching painful eruption of anus ; tension in anus ; hard stool and flatulence. A dose one, two, or four hours. Kali Carbonicum. This medicine is of use in some of the same cases as Carbo Vegetabilis. It is of use for itching of anus ; ulcerated pimples at anus ; burning and pinching ; swollen painful piles, apt to protrude when making water ; discharge from rectum of blood or mucus. A dose every two or three hours. Muriatic Acid. There is no medicine that I have found more useful where there is burning pain than this. It is also very valuable where there are swollen blue haemorrhoids painful to contact ; also where there is hcemorrhage at stool ; itching of anus. A dose every two or three hours ; if to relieve severe pain, every fifteen or twenty minutes. Nitric Acid. Pressure ; burning ; swelling soreness and pinching with discharge of blood during stool. See page 187. 169 where constipation is present ; also where there is nausea ; vomiting ; flatulent colic ; abdominal spasms or tenderness ; colic, especially if occurring with a suppression of an habitual haemorrhoidal discharge of blood ; burning and smarting in piles, with swelling ; ineffectual urging to stool ; contraction of rectum hindering the expulsion of stool. A dose may be given every one or two hours, or once or twice a day, as needed. Phosphoric Acid. Protrusion of piles ; debility following haemorrhage ;, painful bleeding during action; nervous weakness and depression of spirits. A dose three times a day. Pulsatilla. Especially in cases of nervous women, or where scanty menstruation is also present. It will be of use where there is flatulent detention and pain ; colicky pain ; soreness or itching of anus ; protrusion of haemorrhoids ; blind haemorrhoids, or with discharge of blood. Sulphur. A very valuable medicine in chronic cases of constipation with piles ; for hard and difficult or lumpy stools, mixed with mucus ; tenesmus and burning pain in anus ; unsuccessful desire for stool ; pressure on rectum, as if it would protrude with pressing on bladder ; prolapse of rectum ; stitches or shooting pain in rectum ; protrusion of piles ; haemorrhage or suppression of the customary 170 colic. A dose every one or two hours in acute cases ; in chronic, once a day ; or in more urgent cases, three times a day. Veratrum Viride holds out a promise of being a useful medicine in cases of swollen bluish red piles with neuralgic pain : it may prove a useful external application. As yet we do not know enough of it to speak authoritatively. From the above medicines, at first sight it may not appear easy to make a selection ; but if individual symptoms are looked for, the choice will not be so difficult. In order of value, I estimate the principal ones thus :—: — Muriatic Acid, Carbo Vegetabilis. Sulphur, Nux Vomica, Puls., Caps., Caust. Phosphoric Acid, Nitric Acid, &c, &c. Also consult repertory at the end of the book. Suegical Treatment. — Though interference of this kind is not much likely to be needed in homceopathic practice, yet in a very obstinate case, or where time is of importance to a patient, the question arises, as to what is best to be done, so as speedily and safely to get rid of the cause of trouble. A reference to surgical authorities might be sufficient, but a short outline of the treatment pursued 171 Eore valuable, as it shows at a glance what our ;e is in such cases. The methods that present themselves to our notice Xi : — nitric acid ; the ligature ; excision ; and the mp. I The first (introduced by the late Dr. Houston, of iblin), Druitt, (in his admirable work, " The Sur- Dns' Vade Mecum,") speaks of as a safe, speedy, d effectual remedy in the proper case. " It is adapted for destroying a diseased surface — (solid tumours — but any patch of tender, tumid, . bleeding surface of mucous membrane which is source of irritation and haemorrhage. The ration is performed as follows : — The bowels having been just previously cleared, the patient must be told to protrude the piles ; and if he cannot do it easily, he should sit over a vessel of warm water, or have an enema of warm water. The diseased surface is to be wiped with lint ; and a portion of it, the size of sixpence, to be deliberately dabbed with a smooth wooden stick dipped into the con- Itrated acid. When this has taken effect, any erfluous acid is to be mopped up ; lard is to be lied copiously, in order to prevent the caustic being too widely diffused, and the parts are then to be returned within the sphincter. The patient should go to bed, and the bowels be kept quiet, if necessary, by opium — for forty-eight hours ; and 172 when the slough caused by the acid separates, the surface generally cicatrizes speedily, and leaves the part braced up and contracted. It is difficult to exaggerate the benefits of this plan of treatment. It seldom causes pain or any ill consequences."* "When the parts cannot be protruded, the acid may be applied through the speculum, &c." Much * I have detailed this method of treatment, which, however, some might object to resort to, on account of having to give opium. As, however, this drug is not administered otherwise than, as chloroform might be, to facilitate the success of the operation, by causing temporary constipation, each practitioner must elect for himself whether to resort t it or not. In this particular case it might possibly be dispensed with ; but a question arises out of it which ought not to be passed over. I have myself a strong objection to resort to any medicines not strictly homoeopathic ; but cases may arise, where, to aid a surgical operation, or to relieve unbearable pain, such as arises in the progress of an incurable disease, the welfare of my patient must be my first consideration ; and however reluctant to abandon curative for palliative measures, I thankfully avail myself of those means that have been mercifully placed within my reach. On this point I wish to express myself decidedly, for being an advocate of pure homoeopathy, so admirably taught by Hahnemann, I have no wish to depart from it unless duty to my patient demands it ; but as a physician, I refuse to be fettered by any rules that interfere with my liberty of action, and prevent me doing the best I can to cure or alleviate disease. 173 has been said of the danger of the ligature, to obviate which Mr. Henry Smith has lately endeavoured to bring the clamp into greater prominence by publishing a work on the subject. We have, however, the testimony of Mr. Lane, surgeon to St. Mark's Hospital, that having used the ligature 427 times, in the immense majority the progress towards recovery had been singularly uniform, having rarely met with any untoward symptom, or had healing much delayed ; that he had only met with two untoward cases, where death took place from tetanus, both patients being attacked the same day when the disease was epidemic in London ; that he had never seen pyaemia erysipelas or diffuse inflammation follow the operation. He says that his colleague, Mr. Gowlland, has met with very similar results, including even two cases of tetanus that occurred about the same time as Mr. Lane's. The existence of organic disease in any impoi'tant organ, as lungs * or kidneys, has usually been considered a reason for hesitation in removing piles. * This connection between piles, fistula, and affections of the lungs, is very remarkable. A patient who has suffered from bronchitis, great prostration, &c. through the winter, and who is also subject to piles, says in a letter, " It appears to me that my asthma is worse when they (his haemorrhoids he is speaking of) discharge less freely." 174 For the purpose of removal, the piles are protruded, or are seized and drawn out with a forceps, and then tightly tied round the base with a fine piece of hempen twine. Where the tumour is large, it should be tied with a double ligature, a needle being passed through the base, so that each half may be tied separately. The piles should be slightly punctured before the ligature is tightened. Superfluous folds of membrane should be treated in the same way, and should be tied in small portions, that they may quickly slough off. The ends of the thread should be cut off before the parts are returned into the rectum. The operation should be performed under chloroform, to relieve pain and relax the sphincter. The patient should remain in bed, and avoid action of the bowels for forty-eight hours. Druitt, to whom I am indebted for these steps in the operation, says, " Pain is to be relieved by an opiate, and if it persist, the ligatures should be examined to see if they remain as tight as possible ; and if not, they should be re-applied. External piles may be removed by excision — loose folds of skin may be cut off, and the edges brought together by suture. To remove internal piles by excision is dangerous, as fatal haemorrhage might take place ; but with certain precautions, it can be done ; the pile being protruded, and transfixed 175 is to be cut off; the exposed surface may be allowed to return after twelve hours ; bleeding may be controlled by cold, or by the use of Calendula lotion. Should this fail, astringents and caustics are still within our reach. In cases where it is of importance to control haemorrhage, but where there is no vessel that we can tie, some of the old barbarous methods of our ancestors, such as the actual cautery, or styptics, must be had resort to ; but in Calendula, homoeopaths have a remedy that will help them out of some of their difficulties. The late Mr. Cusack, of Dublin, Mr. Henry Smith, and others, have adopted various methods having the same end in view. The piles are grasped in the blades of a forceps, and are then cut off, the raw surface being touched with nitric acid or with an iron at a black heat. Mr. Cu sack's plan, I believe, was to grasp the piles firmly with a strong forceps, and then burn them off with a red-hot iron. Mr. Henry Lee, surgeon to St. George's Hospital, one of the most recent writers on this subject, recommends that haemorrhoids which are composed of a soft vascular substance, and which readily bleed, should be treated with nitric acid applications. While those that are composed of thickened mucous membrane, infiltrated with lymph, should be seized 176 man objects to the ligature. Where so much is to be said in favour of each method, it is clear that the question is still unsettled. If it is decided in any case not to use the ligature, the rules laid down by Mr. Lee may be useful as a guide, whether to employ nitric acid or excision — bearing in mind, also, that the size of the tumour must not be overlooked, as already mentioned (page 175). ¦ these operations, Calendula lotion should be to the sore surface. * 177 POLYPUS OF THE KECTUM. Polypoid growths are sometimes associated with fissure. They are usually accompanied with haemorrhage ; and as there is often much soreness or tenderness, especially if fissure is present, the patient tries to avoid allowing the howels to act, which is apt to produce severe colic pains. Elren suffer from polypus, and as they very o from piles or fissure, the nature of the producing colic pain, constipation, and hage, may be suspected. It may happen, f, that the rupture of the pedicle, in thus rid of the mischief, prevents the disease In adults, the bodies are firmer. Treatment. — As we are still without sufficient provings of medicine to make our treatment of polypus as clear as that of some other diseases, we can only suggest a general outline of what may help us till we can speak with greater authority. Thus, where the symptoms resemble those produced by In the case of a child that recently came under my notice, where there were grounds for supposing that a polypus might be the cause of trouble, much relief was obtained by using colocynth, and clearing out the bowels, by the administration of sweet oil as an enema, following it by a warm water enema when relief of the bowels did not follow within two or three hours. Where no other medicine is specially indicated, Calcarea taken twice a day for some days, and repeated from time to time, may be of service. Staphysagria is also a medicine that may be used for the same purpose. It may be employed if Calcarea has failed, or before it if there is much mental The surgical treatment of these cases is to apply a ligature round the pedicle. If there is a fissure, an incision must be made through it at the same R Excision is not safe, as it may require the on of a heated iron to control the hsernorid even that may not be done without condifficulty. See Kepertory. 179 FISTULA IN ANO. This troublesome affection is usually the result of an abscess close to the rectum. The muscular action of the parts adjoining it, and the passage of focal matter, prevent its healing. There may be an internal opening in the bowel and also one externally, this being a complete fistula, or there may be only an external or an internal opening. Sic surgical treatment by dividing skin, sphincter bowel with a probe-pointed bistoury, and so g open the canal, will be found fully described rgical works. The Medical Treatment consists in the use of such homoeopathic remedies as are best indicated by the existing state of matters ; and in such a case, where allopathy is powerless, or has to resort to the knife at once as the only successful remedy, homoeopathy has an immense advantage, for besides the hope of dispensing with the operation in some, its success will be facilitated in those cases where it Where the parts are much inflamed, poulticing should be employed. Where there are granulations or raised edges about the opening, sanguinaria lotion may be used ; or, if there is purulent discharge, calendula lotion — being made to pass up the fistulous track by a syringe. The Calendula may be used after an operation. The bowels should be kept open by enemas. Eitimonium Crudum. Is recommended for fistuulcers. It may be used for pain in rectum tg stool ; feeling of soreness as if an ulcer were open ; protrusion of rectum ; itching, burning excoriation of anus. A dose every three to six s, as needed. ¦ tida may be given where the parts are very , the discharge thin and offensive. A dose given three or four times a day. ¦ea carbonica, where there is redness, swellhardness round the fistulous parts. A dose les a day. Calcarea phosphorica has been strongly recommended* in the case of fistulous abscess, before the fistula is confirmed. A dose three times a day. E\cum. — Spasm of rectum ; pain in perinaeum, near rectum discharging blood and pus, ysical depression, and especially in cases 181 11 T 1 . 1 1 where the parts disposed to heal open up again, Causticum lotion may be used in these cases, and the medicine given three times a day. Hepar Sulphuris. — For abscess near the rectum ; burning, throbbing pain at night ; corrosive pain ; and where the parts bleed readily when touched ; discharge of sour-smelling pus. A dose three or four times a day. Petroleum. — Difficult stools, with sore pain in anus ; pressure ; tenesmus ; burning pain in the region of anus ; fistula. Phosphorus. — An exceedingly valuable medicine, especially in scrofulous cases. Useful for lymphatic abscesses, full of fistulous ulcers, with callous edges ; fetid, badly-coloured pus ; and hectic fever. A dose three or four times a day. Sanguinaria Canadensis. — This medicine may be used in old cases, also where there are hardened edges and an ichorous discharge. Also, where there are granulations, it may be given three times a day, the Sanguinaria lotion being applied to the fistula at the same time. Silicea. — Old cases ; painful, accompanied by hectic fever, showing but little disposition to heal, especially where other medicines have been given without benefit. Hill and Hunt say where there is sanious, or yellowish-white discharge; fistula 182 A dose once or twice a day. Sutyhur. — Old cases ; bleed easily ; edges raised and swollen ; granulations ; eruptions ; stinging and lacerating pain ; stitches in rectum. A dose once or twice a day. It is of importance to bear in mind that there is often a connection between chest complaints and fistula, so that, in selecting a medicine, other symptoms besides those connected with it have to be taken into account. The fear that exists as to the drying up of a long-standing discharge need have but little weight in homoeopathic practice, as where such a result is obtained it follows on purely curative treatment. Abscess in the neighbourhood of the rectum Bbc treated with hepar sulphuns once it is to be forming, and should be opened early, more places than one if necessary, so as to i free evacuation of the contents. 183 FISSURE AND ULCER. Eesides haemorrhoids and fistula the anus is often seat of very painful fissures and ulcers, or there be much irritation ; this latter is also caused n eruption or moist discharge, and gives rise to distressing itching. The pain, especially of ire, is out of all proportion to its size ; it usually vvs an action of the bowels, and may continue three or four hours. In consequence of this, the desire to evacuate the bowels is resisted; constipa- Xl follows ; and the mischief becomes much agvated. Case. — Some time since I attended a lady in her confinement ; all went on well for some time, till she began to complain of pain about rectum and constipation ; an enema failed to give relief, owing, I believe, to the nurse not administering it properly. As there was desire to evacuate the bowels, but no action and much pain, it became necessary to ascertain the cause of this. An inch inside the anus I found an elevaseat of pain ; the bowels were loaded. A properly administered enema procured a copious action of the bowels, and the administration of nitric acid 30 relieved the discomfort and removed the pain. ¦edges of a fissure become hardened, and there a discharge. ¦read of the pain attending an action made st the desire to evacuate the bowels, promuch the same state already described, Treatment, licum may be of use where there is a feeling riation, soreness to the touch ; burning, i sometimes relieved after the discharge of otty stool ; burning pain of piles ; diarrhoea, every two to four hours. Calcarea. — Spasm of rectum ; itching ; burning ; stinging or shooting pain ; feeling of excoriation ; fistulous ulcers, with redness and swelling ; tendency to formation of ulcers, and difficulty in getting them to heal. A dose every two to four hours ; if spasm, every hour. E'icum. — Soreness and oozing of moisture c rectum ; burning ; stitches during stool ; hoids ; fistula. A dose every two to four 185 rectum and anus ; haemorrhoids ; painful burning ; cracks (rhagades) between the varices ; prolapse. A dose from two to four hours. Hydrastis Canadensis. — Has been recommended in constipation, also in cases of dysentery where the faeces are passed, in the form of hard balls covered over with yellowish tough mucus ; and in cases of ulceration of rectum following dysentery. It appears likely to be a very useful medicine applied locally in cases of ulcer, or fissure of the anus ; it has been used in piles, and is strongly recommended in cases of excoriation of anus occurring in children or adults. Unfortunately, this valuable medicine has been rather under a cloud from the injudicious manner in which it has been introduced into practice as a remedy for cancer. But the information we are gradually collecting, will, it is to be hoped, raise it from that position. Dr. Bradshaw says it is of use in chronic sluggish ulcers and hard glandular swellings, &0., others recommend it in constipation. Dr. Hale collects a good deal of information about it in his New Remedies. There is also an interesting paper by Dr. Bayes, of Bath, read before the British Homoeopathic Society and published in the third volume of the Annals, in which he endeavours to show that the chief value of Hydrastis in cancer is 186 diate neighbourhood are affected. His own experience, corroborated by that of Mr. Pope, of York, shows that the pain of cancer may be aggravated by not using a sufficiently diluted lotion. It may also produce an erysipelatous attack. Where used for fissure or ulcer it may be given internally three or four times a day, and be applied to the affected part in the form of lotion or ointment. Ignatia. — Spasmodic tension in the rectum ; sharp painful pressure in the rectum after stool ; sore pain ; tenesmus ; prolapse of rectum ; haemorrhoids. A dose from two to four hours. Nitric Acid. — This medicine is found in practice to act well in some affections of the rectum. The symptoms it appears to meet best are — stitching, cutting, and pressing in the rectum and anus during stool ; exhaustion, excessive irritation, anxiety, and general uneasiness after stool ; burning and pinching in the rectum ; long pressing when going to stool ; soreness and smarting in anus ; haemorrhoids. A dose two to four hours. Nuoc Vomica. — Burning and smarting ; ineffectual urging ; violent aching in the rectum, arresting the breathing, about midnight ; painful spasmodic stricture in anus; constipation; contraction and narrowing of the rectum, hindering the expulsion of stool ; itching, smarting, and sore pain. A dose v. 187 Phosphorus. Burning and scraping after stool, with a desire to urinate ; lacerating in the rectum ; mucous discharge ; of use in scrofulous subjects. A dose one to four hours. Sarsaparilla. Violent urging ; contraction ; ulcer at the anus, covered with a black blister. A dose one to four hours. Sepia. — Tenesmus ; soreness or cutting, with swelling of anus ; smarting after stool ; discharge of mucus ; prolapse ; and haemorrhoids. Cleanliness. In addition to these internal remedies, besides washing with tepid or cold water, whichever is most comfortable, for the sake of cleanliness, where a fissure exists if attended with much soreness, it may be washed with Hydrastis or Arnica lotion three or four times a day ; or an ointment made of five drops of Tincture, rubbed up with a dessert spoonful of lard, may be used.* Where there is much discharge, Calendula lotion may be used. The bowels should be kept free by enemas, but the pipe of the syringe must be introduced very carefully, as it may produce much pain. After an * A cerate made with mutton suet and oil; for the sake of obtaining it fresh and free from salt, -which is often introduced 188 FISSURE AND ULCER. 189 ¦of the bowels, it is well to wash out the nth some thin arrowroot and water. Surgical Tbeatment. — Where all other methods fail, the fissure or ulcer should be divided with a probe-pointed straight bistoury ; guided by the finger, the incision should divide the mucous membrane, and in severe cases surgeons recommend part of the sphincter to be divided. Some lint or cotton should be laid into the wound to allow the parts to heal by PROLAPSE OF THE EECTUM. This complaint is by no means uncommon, } T oung children as well as adults suffering from it. The bowel turns over on itself and comes down. Where there is no external appearance, but when a portion of the bowel is grasped by another portion, there may be much pain and a feeling of weight. In other cases, a large piece of the bowel come's down and protrudes externally. Constipation or piles may produce this. Teeatment. The principal homoeopathic remedies are, Bryonia, Graphites, Ignatia, Mercurius, Nux Vomica, Podophyllum, Sejria, and Suljihur. In selecting one or other of these remedies, something more is desirable, if possible, than the one symptom of coming down of the bowel. The existence of piles, of constipation, of diarrhoea, tenesmus, pain, &c. must be taken into consideration, and once a remedy is carefully selected, it should be steadily persevered with In chronic cases, a dose of the selected remedy may be given night and morning for three or four weeks. Then a rest of a week or ten days may intervene, when the medicine may be again given as before. In continuing the use of a medicine for some time, it is necessary to watch its effect, that no aggravation is produced, or that no fresh symptoms are developed ; on the appearance of any such, it is as well to rest for two or three days, or longer if necessary. This practice may be .opposed to the opinion of some, but as these points are decided by testing and experience, I can say that, having administered medicines in this way to many patients, and in a great variety of diseases, I have rarely (though it has sometimes happened) had occasion to suspend a medicine.* Bryonia. This medicine will be found of use in those cases of constipation where the stools are * I have recently seen two cases of aggravation ; in one of them, Sulphur appears to have produced swelling and soreness of the end of the nose ; in the other case, Hepar has induced headaches. In this latter the cure has pro- Emost satisfactorily since the medicine has been susnow about four weeks. The medicines have been the 30th dilution. 191 large and tough, being passed with difficulty and attended with protrusion of the rectum. In a recent case, the medicine may be given three or four times a day. Graphites. See page 168. Ignatia. Frequent unsuccessful desire for stool, with colic ; tenesmus and tendency to protrusion of the rectum ; inactivity of the rectum ; spasmodic tension of rectum ; sharp painful pressure after stool ; itching ; soreness ; haemorrhoids. This medicine may be used in those cases alluded to where the bowel begins to come down, but appears to be grasped by another portion. See page 190. A dose every one to four hours. Mercurius. This medicine is specially of use where dysenteric stools are present ; discharge of blood ; soreness and protrusion of anus. See page 57. A dose every one to four hours, and after each action of the bowels. Nux Vomica will be found of use where constipation is present ; where there is ineffectual urging to stool ; pressure on the anus ; tenesmus ; large hard faeces, or small stools with urging and tenesmus ; pressing in rectum previous to stool ; discharge of blood, with sensation as if the rectum were contracted or constricted ; hsemorrhoidal tumours. It will be found of use in the same class of cases as Ignatia. A dose from one to four hours. 192 likely to become a favourite in allopathic as well as in homoeopathic practice, though in the hands of the old school a large part of its range of action will most likely be lost from ignorance of the valuable agent they have got hold of, and also from not being able to discriminate the cases to which it is applicable. I have used this medicine in affections of women, as well as in the diseases of children for some years, and consider it one of considerable VfLILIG It will be found a useful medicine for prolapse when attended with diarrhoea, occurring in children also in chronic cases. From the provings of the medicine, it would seem to be specially suitable in those cases where the prolapse occurs most frequentlj in the morning. Chalk-coloured offensive stools, with irritation from teething, are a further indication for its use with children. In chronic cases, a dose may be given night and morning. Where diarrhoea is present, every two or three hours and after each action. fepia may be given where there is smarting of rectum after stool ; prolapse of the rectum ; protrusion ; itching or bleeding of haemorrhoids. A dose night and morning, or every four hours. Sulphur will be found of use in chronic constipa- o 193 tion with lumpy stools ; where there is pressure on the rectum as if it would protrude, and pressing on the bladder ; stitches in the rectum, especially of an evening ; prolapse with the hard stool. {This medicine may be of use in constipation and o in diarrhoea (page 25) ; it is also applicable to ronic cases. A dose night and morning ; more quently if diarrhoea is present. Surgical Treatment. — Besides these remedies, tain other measures may be adopted, either for replacement of the protruded bowel, or if remedies fail for its relief by operation. When the bowel protrudes, it should be washe< gently, and then pressed back, by the hand, or by a oiled finger passed upwards. Where there is muc telling and pain, fomentations should be use( 'ore the reduction is attempted. If there is muc tress, Chloroform may be required. I With children, it is recommended to pass a piec adhesive sticking plaster across the buttocks, s to draw them together and so retain the bowel i place. Adults may at times be obliged to res et or, in some cases, to retain the bowel in it cc by a pad or bandage. Where it is thought desirable to adopt further measures, some folds of the mucous membrane of the bowels may be pinched up and tied with ligature, 194 "or ligatures niay be passed by needles through several folds of skin just at the margin of the anus, which are then to be tied up tightly ; or a small patch of relaxed mucous membrane may be desti'oyed by the acid." The extirpation of piles will usually cure prolapse if they occur together. (Druitt.) See Repertory. 195 STRICTUKE OF THE RECTUM. When there is great difficulty in expelling the faeces, even though they are soft, and when they are passed either flattened, grooved, or in thin long pieces, and when this is habitual, there is good ground for believing that some obstruction exists. Where the faeces are flattened, there may be some tumour ; where grooved, it may arise from some enlargement of the prostate gland ; but where the fasces are moulded small, stricture of the rectum may be the cause. One form of this is spasmodic, in which case the appearances will vary according as the spasm is or is not giving trouble at the moment. In the other cases, where there is permanent narrowing of the passage, the faeces, where at all solid, will be small. In these cases the distress is very great where the disease is of long standing and the passage small ; the bowels are emptied with great difficulty, accumulation of incarcerated flatulence in the intestines. Case. — A case of this kind, that I saw not very long ago, gives a good idea of a severe and aggravated form of the complaint. Several years ago, the patient suffered from a frequent desire to evacuate the bowels, but had only one regular action in the day. This continued, and in about two years afterwards she suffered almost daily from attacks of painless diarrhoea ; the following year there was alternate constipation and diarrhoea, with contraction of the intestine ; the faeces were tinged with blood, and large quantities of mucus passed. A year later, spasms attacked the rectum, and appeared to extend up the abdomen ; there was great straining, and the patient resorted to opium to obtain relief. The mischief gradually increased till six or seven years had elapsed from its first appearance. Division of the sphincter gave instant relief to the daily distress in the bowel, but when evacuation became necessary every eight days, difficulty still existed, the pain after it remained great, though, to a certain extent, decreased. A gradual increase of contraction, neuralgia, spasm, and abscess, with great misery from the accumulation of gas and faecal matter in the intestines, the passage of the bowel 197 ence 01 two or three strictures, is the continued history of this distressing case, which was borne with wonderful fortitude and resignation. An occasional operation on the sphincter gave some temporary relief ; but the strictures could not be relieved by any means used by surgeons of much experience who made this subject a specialty. When I first saw this patient thirteen or fourteen years had elapsed from the first appearance of mischief. I was anxious, if possible, to have an artificial opening made, but difficulties rendering the operation unusually hazardous were in the way. IJanceb. — Some judgment is necessary to know ether the hardened ring of the stricture is canous or not; as, in this last case, even extra tion is required in the use of bougies. The uliar hardness of the strictured part, the existence laemorrhage, and the burning, shooting pain, will 1 to the belief that cancer is present. Tbeatment. Happily the cases met with in practice have not all reached the stage of the one just related before they come under observation. Where seen early, much may be done by the use of cold water enemas and elastic bougies, but great care is requisite in 198 the bowel. The daily use of the bougie, retaining it for ten or fifteen minutes, may produce a marked improvement, the continued pressure promoting absorption. K[n the rectum there are three valves, on which i faeces rest ; when lying close together in an pty bowel they may cause some difficulty in passing a bougie. The recollection of this should make the surgeon more cautious in his practice and diagnosis. Stricture, though liable to occur elsewhere, is most common about three or four inches up the bowel. When obstruction occurs high up in the intestine, percussion, and the appearance of fulness presented to the eye, will assist in forming an opinion as to where it is situated. It may be proper here to mention that, in extreme cases, the sigmoid flexure of the colon in the left iliac region, or the coecum, on the right side may be opened, or, with far less risk, the operation known as Amussats may be performed : this consists iv making an opening in the left loin into the distended bowel, and forming an artificial anus. In cases of Cancer, when the use of very soft bougies have failed to procure relief, and when the passage is all but closed, Amussats operation may do much to alleviate suffering and prolong life. When the disease is low down in the rectum, attempts have been made to remove it by excission ; 199 but such a procedure is full of risk. Many years ago, I saw a portion of the rectum removed, in an hospital in Paris, I think by M. Velpeau, but death followed in forty-eight hours. Choice of a Medicine. iThe presence of piles makes some difference in c selection of a medicine. For simple spasmodic •icture, ignatia, nux vomica, opium, plumbum, or Iphur, should be looked to. See Constipation, lln permanent stricture, besides the mechanical >ans already spoken of, and subject to the restricns that prudence demands, the remedies used ist be selected according to the general symptoms, our knowledge of medicines that act specifically in icture is necessarily very limited, so that it is Scult to give much preference. The character of j pain, the existence of discharge of any kind, istipation, flatulence, &c, should be taken into :ount in the selection of a remedy. Calcarea Carbonica may be used for violent pressure in rectum ; spasm of the rectum, accompanied with pinching, stinging, and anguish; shooting pain between the evacuations ; burning ; and soreness. In spasmodic stricture this medicine may be given every one or two hours, or even oftener if the pain 200 ture three times a day ; more frequently if the object is to relieve pain. Carbo Animalis is recommended as a medicine of some value in indurations of the intestines. The symptoms for which it might be useful are : pain in the small of the back during stool, with inflation of the abdomen, extending as high as the chest ; stool followed by a desire for urinating ; burning in the rectum ; painful contraction in rectum ; stitching and soreness in rectum ; oozing from rectum. Carbo Vegetabilis. — Sensation as if stool would come on, with burning of anus and emission of flatulence ; constipation ; violent urging, with tingling in the rectum, and pressure on the bladder, resembling a hsemorrhoidal colic coming on at intervals ; discharge of mucus or blood ; tenesmus ; stitching pains ; discharge of acrid corrosive humour from the rectum ; soreness ; much the same class of cases as carbo animalis. In some cases of tumours I have given these medicines in succession, with benefit, and would recommend the same practice here. Conium. — Constipation, or diarrhoeic stools ; tenesmus ; burning at rectum during stool ; chilliness during stool ; palpitation after stool ; tremulous weakness after every stool, passing off in open air ; pressing in the direction of anus and the small of the back in frequent paroxysms ; frequent stitches 201 in the anus between the stools ; burning and heat at the rectum and anus ; flatulent distention. This medicine may be of use in cancer. Ilgnatia. — Spasmodic tension of the rectum ; irp, painful pressure after stool ; unsuccessful dee for stool, with colic ; hysterical tendency. ILachesis. — Constipation ; lumpy stools ; pressure anus ; pains in rectum before stool ; burning ring or after stool; constriction and lacerating anus. IYm# Vomica. — Constipation ; frequent urging, h anxiety ; colic pains in abdomen ; discharge of od, with feeling of constriction ; painful spasdie stricture of anus ; contraction and narrowing ;he rectum, hindering the expulsion of stool. Sanguinaria. — Ineffectual pressure to stool, then vomiting ; diarrhceic stools, with great flatulence. This medicine I should think worth a trial in cases where no other medicine is specially called for. Ten drops in a little cold water may be injected twice a day, so as to come in contact with the Hydrastis may possibly prove to be a useful local remedy in these cases. A preference should be given to it if there is a suspicion of cancer. About three drops in a little cold water may be injected, and, if possible, retained for a few minutes. 202 203 STRICTURE OF THE RECTUM. ¦r stool; discharge of bloody mucus ; jerking, ull sticking pain in rectum ; cutting in the tension in anus ; burning in anus. Is medicines may be given twice or three day, or more frequently, to relieve urgent is. Besides using Sanguinaria as an in- Calendula may be used in the same prowhere there is purulent discharge. See Repertory. L SHORT REPERTORY FOR STIPATION, FLATULENCE, INDIGESTION, COLIC, HAEMORRHOIDS, &o. &o. Abridged and altered from Bryant & Bonninghausen Abdomen, anguish in : ant-c. §ant-t. apis. §Ars. bar-c. bell, gcalc. §camph. Caeb-v. §Cham. gcoff. coloc gcupr. hep. gipec. %lye. mez. Merc, mosch. natr-m. gnux-v. plat. §Phosph. gphos-ac. plumb, puls. rhtis. §sec. Sep. §stram. sulph. sulph-ac. gthuja. §Verat. Those thus § marked take in also Anguish in Stomach. rBDOMEN: See Cramp-like pains in, Distension of, Fermentation in, &c. &c. Acidity op stomach : am-c. ars. bell. bry. calc. carb-an. Carb-v. caus. cham. chin,, con. ferr. graph. Jcal. lach. Lye. magn. mere, mur-ac. natr. natr-m. nitr-ac. n-mos. Nux-v. petr. Phos. phos-ac. plumb, puls. rheum. Sep. sil. stann. Sulph. sulph-ac. tart. zinc. Anus and Rectum. Abscess in the Anus: Aeon, bell calc. hep. lye. mere. puls. sil. sulph. Burning in the Anus : am-c. alum. ant. Ars. bar-c. bry. calc. caps, carb-an. cocc. colch. graph, iod. Jcal lach. mur-ac. natr. nitr-ac. nux-v. op. puls. Sep. staph. sulph. Burning in the Rectum : am-c. ars. calc. canth. carb-an. con. jat. kal. mur-ac. natr. natr-m. nitr-ac. nux-v. petr. phos. puls. Sep. sulph. sulph-ac. tart. Congestion of blood in the Anus : lach. Sep. suljrfi-ac. ¦ction in the Anus: lach. mez. natr-m. nux-v. huj. Kion of the Anus : camph. natr-m. nux-v. plumb. uj. ¦ chaps, fissures in the Anus: alum. am. calc. Graph, hep. Iyc. mere. petr. rhus. sulph. ¦ro, tickling, in the Anus: chin, colch. croc. ign. nux-v. plat rhus. spig. zinc. ¦am (in the) : calc. nux-v. rhus. sabad. Sep. spig. ¦. tart. Compare: Itching. If op Blood, during, and at a time different, from f evacuation: am-c. ant. calc. chin-s. coloc. ign. lye. mere, merc-c. mur-ac. natr-m. nux-v. phos. mis. sabin. stram. zinc. Compare : Haemorrhoids. Emission op Mucus, at a time different from that of evacuation: alum. ant. ars. chin, colch. graph, lach. mere. merc-c. mur-ac. nux-v. phos. plat. puls. sabin. stram. zinc. Compare : Hsemorrhoids. Eruptions in the Anus : calc. kal. lye. natr-m. petr. — Burning: calc. — Herpetic: natr-m. petr. — Itching: lye. — Ulcerated : kal. nit-ac. ¦moN in the Anus : am-c. ars. bar-c. calc. carb-an. kal. mere, natr-m. nitr-ac. sulph. Fistula in Rectum : aloe. Calc. carb-an. cans. con. hep. lye. puls. Sil. sulph. Inertia, atony, of the Rectum: Alum. anac. camph. chin. 205 Itching in the Anus: Aeon. Alum. Am-c. anac. ant, bar-c. calc. Carb-v. Caus. colch. graph, ign. Kal. Lye. mere, mur-ac. Nite-ac. nux-v. phos. ph-ac. plat. rhus. Sep. sil. spig. spong. sulph. thuj. zinc. Oozing at the Anus : bar-c. carb-an. carb-v. nitr-ac. — Perineum (at the) : carb-an. carb-v. — Rectum (from the) : anac. carb-v. Sep. Pin the Anus, and Rectum (indefinite) : aeon. caus. nux-v. plumb, sulph. t Burning. See Burning in the Anus, and Rectum. Constrictive, or contractive : ign. mang. nux-v. plumb. thuj. Rectum (in the) : calc. hreos. nux-v. sep - Excoriation (as from): ars. caus. graph, hep. ign. nux-v. puls. spong. verat. zinc. Rectum (in the) : am-m. ars. lye. nux-v. puls. Compare : Excoriation ; and Pains, Smarting. t Incisive, cutting: caus. chin-s. leal. natr. staph. — Rectum (in the) : caus. lye. magn. natr. Shooting: ars. Carb-an. carb-v. chin. con. ign. kal. lye. magn. mere, nux-v. phos. Sep. sil. spong. sulph. zinc. Rectum (in the) : carb-an. chin. ign. leal. magn. I natr-m. nux-v. phos. plat. ruta. Sep. sil. sulph. tart. Smarting: ant. dulc. mur-ac. ph-ac. puls. verat. — Rectum (in the): ign. mur-ac. natr-m. ph-ac. puls. Spasmodic, in the Anus, and Rectum : calc colch. hreos. lye. phos. nux-v. — Tearing (sharp drawing) : colch. kal. natr-m. ph-ac. Rectum (in the) : kal. natr-m. ph-ac. ruta. sabad. Paralysis of the Anus : aeon. bell, coloc. hyos. phos. 206 Polypus (chief remedies for) : aw. bell. Calc. con. graph hep. mere, nitr-ac. Phos. phos-ac. sang. sil. Stafh, sulph. thuj. Prolapse : ant. ars. calc. colch. graph. Ign. loch. lye. Merc, mur-ac. Nux-v. Podoph. ruta. Sep. Sulph. Spasms in the Anus, and Rectum : bell, colch. ¦c in the Anus and Rectum: ars. calc. coloc. ign. mang. mere. mez. nux-v. op. plumb, sep. sil. sulph. thuj. Swelling of the Anus : graph, nux-v. sulph. Throbbing in the Anus : grat. lach. natr-m. rhod. Appetite, Depraved — Malacia, from a Greek word signifying softness. Pica (a magpie) — applied to the longings of pregnant women. Xi (desire for) : ant-c. ant-t. am. ars. bry. carb-an. chin. con. dig. hep. ign. Jcal. kreos. lach. magn. puls. sabin. sec. Sep. squill, stram. sulph. Verat. ;r things (longing for) : dig. natr-m. — lime, chalk (longing for) : nitr-ac. nux-v, ¦ salt things (desire for) : calc. carb-v. caust. con. nitr-ac. phos. verat. ¦or brandy (desire for) : aeon. ars. boy. bry. calc. hep. lach. mosch. mur-ac. nux-v. Op. puls. Sep. staph. sulph. sulph-ac. ¦ther longings, see Bb'nninghausen's Repertory. vomit : * Ars, chin. ipec. Nux-v. petr. phos plumb, sec. Verat. * See case of vomiting similar to "black vomit," 207 Cancer in stomach: ars. bar-c. con. lye. nux-v. phos, verat. sulph. Consult also particular symptoms. Cholera. See Repertory for, page 98. Colic : aeon. am-c. ars. Bell. calc. caus. Cham, chin, cocc. coff. Coloc. hyos. ign. ipec. lye. mere, mosch. Nux-v. phos. podoph. Plumb. Puls. rhus. rhus-r, sang. sec. sulph. tart, verat. r flatulent : ant. am, aur. bell. Cakb-v. Cham. Chin cocc. coloc. con. graph, hyos. ign. Lye. n-mos. Nux-v. plumb. Puls. staph. Verat. r- h^morrhoidal : carb-v. coloc. hyos. lach. nux-v, puls. sulph. — hysterical : Bell. caus. cham. Cocc. coff. con. Ign, ipec. Magn-m. mosch. Nux-v. plat, stram. verat. — menstrual : Am-c. bell. calc. carb-v. Cham. Cocc, coff. con. graph, hyos. ign. nux-v. plat. Puls. sabin, sec. sulph. zinc. L miserere (vomiting of excrements) : aeon. bell. bry. ux-v. Op. Plumb, thuj. — painters' : alum. bell. bry. Nux-v. Op. Plumb, thuj. — worms (from) : aeon. Cm. ferr. ign. mere, n-mos. natr-m. ruta. Sabad. sil. Spig. sulph. Constipation : aeon. alum. am-c. ant. ars. bar-c. bell. Bry. calc. canth. carb-v. caus. chin. cm. Coco, colch. con. dulc. ferr. graph, hep. hyos. iod. leal, kreos. lach. Led. Lye. magn. mere. mez. natr-m. nitr-ac. Nux-v. Op. petr. phos. phos-ac. plat. Plumb, podoph. puls. rhus. rhus-r. sabad. sabin. Sep. Sil. Staph. stram. Sulph. sulph-ac. verat. zinc. t chronic : Alum. am-c. Bry. Calc. cans. con. graph. al. lach. led. Lye. Nux-v. Plumb, sep. Sulph. Cramps in legs or feet : alum. am-c. anac. ant-t. ars. 208 §iod. jat. lach. lye. magn. mere. natr. nitr-ac. . petr. rhus. rhus-r. Sec. Sep. sil. staph. stram. ¦like pains in abdomen: am-c. Bell. calc. cham, cocc. coif. Coloc. con. ferr. Hep. Hyos. ign. iod, magn. mere. mez. mosch. Muk-ac. nitr-ac v. plat, plumb, podqph. rhus. sabin, sulph. Em stomach: ant. bell. bry. calc. carb-an. Cakb-v. , cham. Cocc. coff. Con. cupr. graph, hyos. ign. lach. lye. mere, nitr-ac. nux-m. Nux-v. Phos. b. sec. Sep. statin, sulph. thuj. verat. Diarkhcea. See Kepertory for, page 45. Distention of abdomen : Aeon. alum. am-c. ant. apis. am. Ars. bar-c. Bell. bry. calc. canth. caps, carb-an. Carb-v. caus. Cham. Chin. Cocc. colch. Coloc. con. cupr. dig. dulc. Graph, hep. hyos. ign. iod. ipec. kal. hreos. lach. Ltc. magn. Magn-m. Merc, merc-c. mez. mosch. Mur-ac. nitr-ac. n-mos. nux-v. op. phos. phos-ac. plat, plumb, puts, rheum, rhus. sabin. sang. sec. Sep. Sil. spig. stann. stram. sulph. verat. Bon of stomach: ars. bis. calc. caps, carb-an. coff. dulc. hell. iod. kal-bich. magn. natr. op. plat. petr. puls. sulph-ac. Dysentery. See Repertory for, page 63. ¦sa, oppressed respiration (after a meal) : ars. carbham. chin. lach. mere, n-mos. nux-v. phos. puls. . zinc. Imzzing and humming in : aeon. am-c. am, aur. . bry. calc. Caus. cocc. con. droa. dulc. Graph. hyos. iod. kal. lach. led. lye. magn. mere, mosch. m. nitr-ac. Nux-v. petr. phos. plat. Puls. rhus. Sep. sil. spig. Sulph. thuj. verat. v 209 Enteeitis (inflammation of the bowels) : Aeon, ant-c ant-t. ars. bell. bry. canth. cham. chin, colcli. coloc hyos. ipec. lach. Merc. mez. nitr-ac. nux-v. op. phos, plumb, puls. rlius. sec. sulph. Eructations : aeon. alum. ant. ant-t. apis. Am. arg-nit, ars. bar-c. Bell. Bry. calc. camph. cann. carb-an carb-v. caust. cham. chin. cm. Cocc. Con. dros. dulc, ferr. graph, hep. ign. iod. ipec. hal. lach. lye. magn Merc. mez. mosch. mur-ac. natr. natr-m. nitr-ac, nux-v. petr. Phos. phos-ac. plat, plumb. Puls. Rhus. Ehus-r. sabad. sabin. Sep. sil. spig. stann. staph, Sulph. sulph-ao. thuja. Verat. zinc. — abortive : aeon. am-c. bell. Carb-an. caus. cocc. con graph, hyos. kal. Phos. puls. rhus. sulph. zinc. — bitter : am-c. am. ars. bell. Bry. calc. carb-v. chin, dros. ferr. lye. Merc, mur-ac. Nux-v. Puls. Sep. sulph-ac. verat. ¦ burning : bell, canth. hep. iod. lach. lye. phos-ac podoph. sulph. — drinking (after) : ars. mez. rhus. f- eating (after) : ars. bry. calc. camph. carb-v. chin. con. ferr. lach. mere, natr-m. nitr-ac. nux-v. petr. phos. puls. Sep. sil. sulph. thuj. verat. zinc. — noisy : con. petr. plat. ¦ painful : carb-an. caus. cham. con. natr. nux-v. phos. rhus. Sep. r putrid (smelling or tasting) : am. bell. cocc. mere nux-v. phos-ac. thuj. — sour : alum. am-c. ars. bar-c. bry. calc. carb-v. caus. cham. chin. dig. ferr. graph, kal. lach. lye. magn. mere, natr-m. nitr-ac. nux-v. petr. phos. phos-ac. podoph. puls. Sep. sil. spig. sulph. sulph-ac. verat. 210 Ej V A\jU A.I. HJrISj ol OOLo UAaD ¦ clCjUll. xi I j U M.» Ct77t~C» dill* tir.ll ars. aur. bar-c. bell. Bky. calc. canth. carb-an carb-v. caus. chin. cm. cocc. con. graph, hep. ign. iod kal. lach. led. lye. magn. Magn-m. mere, mur-ac natr. natr-m. nitr-ac. Nux-v. Op. petr. phos. phos-ac Plumb, rhus. ruta. sabad. sabin. Sep. sil. spig. stann staph. Sulph. sulph-ae. thuj. verat. — knotty: alum. am-c. bar-c. bell, carb-an. caus. chin graph, iod. kal. lach. led. Magn-m. Merc. natr. nux-v. Op. petr. plat. Plumb, ruta. Sep. sil. stann. Sulph. sulph-ac. thuja. — whitish : aeon. am. ars. aur. bell. Calc. carb-v. caus. cham. chin. cm. cocc. colch. Dig. dros. dulc. liep. ign. lach. Merc, n-mos. nux-v. op. phos. phos-ac. plumb, puls. rheum, rhus. rhus-r. sec. spig. spong. sulph. sulph-ac. verat. Eyes, confusion of sight : alum. am-c. anac. ant-t. bar-c. bell. bry. calc. cann. caus. cham. chin. con. dros. dulc. graph, hep. hyos. ign. lach. Lye. mere. Natb-m. nitr-ac. phos. plumb, puls. sil. staph. stram. sulph. Kcts appear double : am-c. aur. Bell. con. dig . , lye. Natr-m. nitr-ac. puls. sec. stram. sulph. spots, dark, before eyes : aeon. aur. bar-c. bell. calc. cann. caus. chin. cocc. con. dulc. kal. lye. magn. mere, natr-m. nitr-ac. phos. rhus. ruta. sec. Sep. sil. stram. sulph. thuja. Fainting : Aeon. ant-t. am. ars. bell. bry. calc. camph. cann. canth. carb-v. Cham. Chin. cm. cocc. coff. coloc. Con. cupr. Dig. ferr. graph, hep. hyos. ign. ipec. kal. kreos. lach. led. lye. mere. Mosch. n-mos. Nux-v. op. phos. plumb, puls. rhus. sec. Sep. sil. spig. staph. stram. sulph. Verat. P 2 211 Fainting aftee a meal : nux-v. phos-ac. sulph-ac. Feet, coldness op : aeon. alum. am-c. anac, ant-t. ars Kcalc. carb-an. caus. cocc. colch. con. dig. dros ph. kal. kreos. lacJi. lye. mere. mez. mur-ac. nalr, Natk-m. nitr-ac. petr. Phos. plat. samb. Sep. Sil, stann. sulph. sulph-ac. verat. zinc. Fermentation in . abdomen (sensation of) : aeon, am carb-an. coff. con. hep. mur-ac. rhus. stram. — in stomach : anac. graph, plat. Fistula. See under head of Anus. r.ATULENCE in abdomen: aeon. am-c. ant. am. ant-t. ars. bell. calc. canth caps, carb-an. Cakb-v. caus. cham. Chin. cocc. colch. coloc. con. dig. ferr. graph, hep. ign. ipec. kal. lach. Lye. magn. nitr-ac. n-mos. nux-v. phos. phos-ac. podoph. plumb, puls. rheum, rhus. Sep. sil. staph. sulph. verat. [incarcerated: calc. canth. carb-an. Cakb-v. caus. Cham. Chin, cocc. con. graph, hep. iod. kal. lye. Natr. Natr-m. Nitr-ac. Nux-v. phos. plat. Plumb. Puls. rheum, rhus. Sep. sil. spig. stann. Sulph. verat. — emission of: aeon. am. aur. bell. bry. calc. canth. caps, carb-v. caus. cham. chin. cocc. con. dig. ferr. graph, hep. hyos. ign. leal. led. lye. magn. magn-m. natr. natr-m. nitr-ac. n-mos. phos. phos-ac. plumb, puls. rhus. staph. stram. sulph. sulph-ac. thuja, verat. zinc. — burning : aeon, chain, magn-m. nux-v. phos. plumb. puls. staph. zinc. — putkid smelling : am. Ars. aur. boy. bry. Carb-v. cham. chin. cocc. dulc. graph, hep. ipec. mere. natr. nitr-ac. nux-v. puls. ruta. sec. Sep. staph. sulph. 212 Flatulence, smelling like rotten eggs : am. coff. ¦ smelling : am. bell. ealc. cham. dulc. graph, mere. natr. rheum, sep. sulph. Food :: — acids (sufferings from) : Ant-c. Ars. bell. caus. dros. ferr. lack, natr-m. nux-v. phos-ac. Sep. staph. — eggs (from) : colch. ferr. puls. r meats (from): aeon. ant. ars. Carb-v. colch. dros. ipec. natr-m. nitr-ac. Puls. Sep. thuj. — fruits (from) : Aus. Bry. carb-v. Chin. lye. magn-m . mere. natr. Puls. rheum, sep. verat. — ices (from) : ars. Carb-v. natr-m. n-mos. pids. ¦ (from) : alum. Ars. bry. Calc. carb-v. cham. Con. ign. kal. lach. lye. natr. natr-m. Nitr-ac. . phos. puls. Sep. sil. spong. Sulph. — pastry (from) : ant. ars. Carb-v. ipec. Puls ¦ (from fat) : ant. ars. Carb-v. ipec natr-m. Sep. — salt food (from) : ars. calc. carb-v. dros. lye. nux-v. I confusion in : aeon. asa. Bell. bry. calc. camph. caps, carb-v. caus. cham. cocc. con. graph, hyos. kal. mere, mosch. natr-m. Nux-v. Op. phos-ac. puls. rims, rhus-r. Sep. spig. thuj. ¦ESTION, OR CONGESTIVE HEADACHE: ACON. am-C. apis. Am. bar-c. Bell. Bry. coff. ferr. hyos. Merc. Nux-v. Op. puls. sulph. ¦sss in head : Aeon. am-C. apis. Bell. Bry. carb-v. chin. mez. mere. petr. rhus. Ehus-r. sulph. ¦ giddiness : Aeon. bell. calc. camph. lach. mosck. 213 Head, headache with nausea : aeon. alum. am-c. bry, calc. carb-v. caps. chin. Coco, coloc. Ipec. Jcal. lach mosch. natr-m. nitr-ac. nux-v. puls. rhus-r. sang. Sep, - heat in : aeon. am-c. ant-t. apis. am. aur. bell. bry. calc. camph. canth. carb-an. carb-v. caus. chin, hell, liyos. magn-m. mere. mez. natr. nitr-ac. n-mos. phos, plumb, sep. sil. stram. sulph. Heartburn (pyrosis, waterbrash) : alum. am-c. bell, Calc. canth. caps, carb-an. carb-v. caus. chin. Con, dros. graph, hep. ign. iod. kal. lach. lob. Lye. magn. mere, natr-m. nitr-ac. n-mos. Nux-v. petr. phos, pocloph. puls. sdbad. Sep. sil. sulph. sulph-ac. verat. zinc. — meal (after a) : Am-c. calc. chin. Con. iod. Lye. mere, natr-m. Nux-v. Sep. Sil. Sulph. Haemorrhoids (piles): aeon. alum. am-c. anac. ant. apis. ars. bar-c. bell. calc. canth. caps, carb-an. Carb-v. caus. cham. chin, coloc. cupr. ferr. Graph, hep. ign. Kal. Lach. led. lye. magn. mere. Mur-ac. natr-m. nitr-ac. Nux-v. petr. phos. ph-ac. podoph. Puls. rhus. sabin. Sep. sil. stann. staph. stram. Sulph. sulph-ac. thuj. verat. zinc. See Anus and Eectum ; also Prolapse of Rectum. — anus (in the) : am-c. anac. ant. ars. bar-c. carb-v. caps. caus. coloc. Graph. Kal. lye. Mur-ac. natr-m. nitr-ac. nux-v. phos. Puls. Sep. sulph. sulph-ac. verat. — bleeding : aeon. am-c. ant. ars. bell. calc. Caps. carb-v. cham. ferr. ign. ipec. Kal. lach. Mur-ac. nitr-ac. nux-v. phos. Ph-ac. puls. Sep. sulph. DEBILITY FOLLOWING BLEEDING : Calc. CHIN. Ph-AC. — bluish and swollen : carb-v. mur-ac. 214 Kiids, burning : ant. Ars. calc. caps, carb-an. cliam. lach. lye. mur-ac. nux-v. staph. snlph. — chronic : calc. caus. carl-v. graph, lach. lye. nitr-ac petr. Nux-v. Sulph. colic (connected with). See Colic. — cracks, and fissures (with) : ant. caus. cham Bus discharge (with) : ant. caps, carb-v. colch, . ign. kal. lach. inur-ac. nitr-ac. nux-v. puls. sulph-ac. ¦ful : Ars. carb-v. caus. coloc. graph, lye. mur ix-v. phos. Ph-ac. ¦s in the loins (with) : aeon, bell. caps, carb-v . hep. nux-v. sulph. — protruding: Caus. hep. lye. phos. Ph-ac. Puls. Sep, Bum (in the): ars. Calc. caus. coloc. hep. lye . Phos. ph-ac. Sep. sulph. ¦>ting pains (with) : Ars. bar-c. ign. leal, lach, ac. natr-m. nux-v. puls. sulph. ¦llen : calc. caus. caps. Carb-v. coloc. Mur-ac, ic. puls. sulph. SUPPRESSION OF H-EMORRHOIDAL FLUX : Calc. GAlfo-V. nux-v. puls. Sulph. ulcerated : cham. hep. nitr-ac. sil. ¦ca (in the): aeon. ant. ars. calc. carb-v. colch Nux-v. Puls. sulph. 1i : aeon. bell. bry. carb-an. cocc. colch. cupr. graph. Hyos. Ign. lye. magn-m. mere, natr Nux-v. op. phos. plumb, puls. ruta. samb. sil stram. sulph. sulph-ac. verat. zinc. 215 aeon. Ant. am. ars. bry. Carb-v. Chin. con. coff. hep, Ipec. Nux-v. Puls. phos. Sulph. Nausea : aeon. alum. am-c. anac. ant-c. ant-t. am. Ars. aur. bar-c. bell. bis. boy. camph. cann. caps, carb-an. carb-v. Caus. chain, chin. cm. cocc. colch. con. croc, cupr. Dig dros. dulc. graph, hell. hep. hyos. ign. Ipec. jat. kal. kal-bich. kreos. Lach. led. Lob. lye. magn. magn-m. mere. mez. mosch. mur-ac. Natr. natr-m. nitr-ac. Nux-v. petr. phos. phos-ac. plat, plumb, podoph. Puls. rheum, rims, rhus-r. sabad. samb. sang. sec. Sep. sil. spig. spong. squill, stann. staph. Sulph. sulph-ac. thuj. verat. zinc. See Vomiting. 'alpitation: Aeon. ant. ant-t. ars. asa. aur. bar-c. Bell. boy. brom. bry. calc. camph. carb-v. caus. cham. Chin. cocc. coff. colch. con. cupr. dig. ferr. graph, hep. hyos. ign. lod. Jcal. halm. lach. Lye. magn. magn-m. Merc. mez. mosch. mur-ac. natr. Natk-m. nitr-ac. n-mos. nux-v. op. petr. Phos. phos-ac. plat, plumb. Puls. rhus. rhus-r. ruta. sabad. sabin. sec. Sep. sil. Spig. spong. staph. sulph. sulph-ac. thuj. Verat. zinc. Ks, aching, in abdomen : apis, bar-c. camph. carb-v. us. cham. chin. cocc. cupr. dulc. hyos. ign. iod. lye. ;rc. mez. nitr-ac. op. ruta. Sep. sil. tart. — indefinite, in abdomen : alum. ant. ant-t. ars. bry. calc. canth. caus. colch. coloc. con. graph. Ign. iod. lach. magn. mez. natr. plat, plumb, podoph. rhus. Rhus-r. sang. Sep. sil. sulph. Erom a bruise in abdomen : am-c. carb-v. calc. chin. cocc. Coloc. con. cupr. hep. ign. led. lye. o. natr. Nux-v. op. puls. ruta. rhus. sabin. Sep. — in abdomen, burning: aeon. am-c. caps. caus. cham. 216 Pains in abdomen, cutting : aeon. alum. am. Ars. bell bry. calc. camph. canth. carb-an. carb-v. cans, cham chin. cm. Coloc. Con. cupr. dig. dros. graph, hep hyos. ign. ipec. kal. kreos. Lach. lye. magn. mere mur-ac. natr. natr-m. Nitk-ac. n-mos. nux-v. op. petr phos. phos-ac. plumb, puls. rheum, rhus. sabad. sabin sec. Sep. ail. spig. staph. sulph. sulph-ac. tart, verat. zinc. IN ABDOMEN, GRIPING, GRASPING : am-C. apis. BELL. calc. caus. chin. Coloc. hep. ipec. lye. magn. puls. rhus-r. stann. staph. sulph. sulph-ac. zinc. IN STOMACH, INDEFINITE, VIOLENT, OR ACHING : aCOn alum. am-c. ant. arg-nit. Ars. bar-c. bell. bry. calc. camph. caps, canth. carb-v. caus. cocc. colch. coloc. con. cupr. dig. dulc. ferr. graph, hep. hyos. ign. iod. lach. lye. magn. mere, natr-m. nux-v. petr. Phos. plumb, puls. rhus. Ehus-r. Sep. sil. stann. staph. stram. sulph. tart, verat. zinc. ¦ also Cramp-like Pains ; Cramps in Stomach ; ; Soreness, &c. ¦mtis : Aeon. ant-t. ars. Bell. Bry. canth. cham. coloc. hyos. mere. Nux-v. op. phos. puls. rhus. I. verat. B(flow of water like mucus from stomach) after a calc. natr-m. sil. sulph. Pressure in abdomen : alum, arg-nit. aur. bell. bis. bry. calc. carb-v. Caus. chin. coff. colch. coloc. con. ign. iod. leal. lye. magn. magn-m. mez. natr. natr-m. nitr-ac. nux-v. op. plat, plumb, rhus. Sep. sil. spig. stann. staph. sidph. thuj. verat. zinc. ¦ in stomach : alum. am-c. ant. am. Ars. aur. bar-c. bell. Bis. Bry. calc. canth. Carb-an. caus. Cham. chin. coff. coloc. con. Cupr. Dulc. Ferr. graph. Hep. iod. ipec. kal. Lach. Lye. mez. mosch. mur-ac. Natk-m. 217 plumb, puls. rhus. sabin. sen. Sep. sil. spig. Stann sulph. sulph-ac. tab. tart. zinc. Pressuee in stomach, after a meal: alum. am-c. arg-nit Ars. Bell. Bis. bry. calc. carb-an. cham. Chin, cocc, Feer. hep. iod. lack. led. lye. Merc. mez. nux-v. op. Phos. plat. puls. rhus. Sep. sulph. tart, thuj. Eeguegitation : am-c. am. ars. bell. Bey. calc. cann. carb-an. Carb-v. chin. con. dig. ferr. graph, hep. ign. ipec. Lach. lye. mere. Natr-m. Nux-v. Phos. plumb. podoph. puls. Sep. Sulph. sulph-ac. Bumbling in abdomen: aeon. am-c. anac. ant. apis. am. ars. osa. bell. bry. calc. canth. caps, carb-an. carb-v. caus. Coloc. con. dig. graph, hep. ign. iod. lach. lye. magn. magn-m. natr. natr-m. nitr-ac. n-mos. nux-v. Phos. phos-ac. plat. puls. sabad. Sep. sil. spig. stann. sulph. sulph-ac. tart, verat. zinc. riN stomach : am. carb-an. magn. phos. phos-ac. plat. Sep. spig. tart. Soreness, tenderness of abdomen : aeon. apis. ars. Bell. canth. carb-v. cham. coloc. cupr. hep. hyos. ipec. lach. Merc. Nux-v. plumb, puls. rheum, stann. Sulph. — of stomach : Ars. bar-c. bry. calc. camph. canth. colch. coloc. mere. natr. nux-v. Phos. puls. rhus-r. sec. Sep. sulph. sulph-ac. tart, verat. rOF abdomen on pressure : f apis. bell, carb-an. mere nux-v. sabad. f Though the provings give this symptom with but a small number of drugs, there is no doubt that its existence may be inferred from the presence of various forms of abdominal pain. 218 Rss op abdomen to touch : bell, carb v. cJiam. cupr. hyos. ign. mere. Nux-v. plumb, puts. Sulph. tart. — op stomach to peessuke : alum. am-c. ant. ars. bar-c. bry. lach. magn. natr-m. Nux-v. puls. rhus-r. Sep. sil. sulph. — of stomach to touch : alum. Ars. bry. calc. camph. canth. colch. coloc. ign. kal. lach. lye. Merc. natr. natr-m. Nux-v. petr. Phos. spig. stann. sulph. sulph-ac. Vertigo : Aeon. anac. ant-c. apis. am. ars. aur. Bell. boy. bry. Calc. camph. cann. carb-an. caus. cham. chin. cm. cocc. con. cupr. dros. ferr. hep. hyos. ign ipec. lach. lye. mere, mosch. natr-m. n-mos. Nux-v. op. petr. Phos. phos-ac. Puls. Ehus. Khus-r. sang. sec. Sep. sil. spig. stram. sidph. thuj. verat. zinc. tFEOM gastric derangement: aeon, ant-c. ars. bell, cham. lye. mere. Nux-v. petr. Puls. rhus. sil. sulph. — after a meal : cham. kal. Lach. Nux-v. petr. Puls. rhus. sulph. Vomiting: aeon. am-c. ant-c. ant-t. apis. am. Ars. bell. bis. Bry. calc. camph. cann. canth. cham. chin. cm. cocc. colch. coloc. con. Cupr. dig. dros. dulc. enp. ferr. graph, hep. hyos. iod. Ipec. jat. lach. lye. mere. natr-m. nitr-ac. n-mos. Nux-v. op. petr. phos. plumb. 219 INDEX. In addition to which, for further action of medicines, consult Repertories, pages 45, 63, 98 and 204, as well as List of Medicines and References, page v. PAGE Abdomen, distention of, 40, 56, 125, 134 See medicines for Dysentery, Indigestion and Flatulence ; also Repertories. Abdominal pain, 23, 24, 25, 55, 58, 125 Also see Colic, Dysentery, Haemorrhoids and Repertories. Abdominal pain in Cholera 75 Abscess near Rectum, 181, 182, 183 Absorption, power of, lost in Cholera 76 Acidity 139 Administration of Medicines 5 Ague, Eupatorium used in treatment of, in West Indies 60 Aitken's, Dr., practice of medicine referred to .... 71 Albumenoids 116 Allopathic dosing injurious 127 Allopathic leanings to Homoeopathy in treatment of Cholera 78 — treatment, failure in Cho- Amussat's operation 199 Aneurism, throbbing in Indigestion mistaken for . . 124 Annals of British Homoeopathic Society and Hospital 186 Anorexia 120 Anus, artificial 199 — burning in, 28, 57, 59, 163, 165 See also Scalding Stools 23 — Fissure of 184 — Fistula in 180 Appetite, depraved 120 Asthma and Piles, connexion between 174 Anxiety a cause of Indigestion 128 TAGE Barbadoes Tar said to be of use in Piles 164 Bayes, Dr., bandage for Cholera, containing copper plate . , 86 — on Disinfectants in Cholera 80 — onHydrastis 186 Beef Tea 11,37,87, 96 Bennett, Professor Hughes, on Constipation.., 103 Bernard, experiment on pneuinogastric 115 — on formation of sugar in liver 118 Bile 116 — use of 117 Billing, Dr., on Cholera, 74, 79 Black Vomit 145 Blood, loss of. See Diarrhoea, Dysentery and Haemorrhage. Bone Pains and Diarrhoea 20 Bonninghausen's Repertory Books recommended ...... 6 Borborygmus 124 Bougie, caution as to use of in Stricture of Rectum . . 199 — in treatment of Haemorrhoids 165 — use of, to relieve haemorrhoidal pain 162 Breath, offensive 121 Bryant's Manual, 6, 44, 63, 204 Camphor, antidote for .... ix — in Cholera 83 — Spirits of, strength recommended ix Cancer, Hydrastis, use of in 186 — in Kectum 198, 199 Carbolic Acid as a disinfectant 80 Carbonic Acid given off from lungs in diminished quantity in Cholera .... 76 Cardialgia 123 Case of Cholera 91 — Cholera, relapse from fright, cramps 94 Cases of Choleraic Diarrhoea, relieved by Camphor, but followed by dysenteric symptoms . . 66 — Crampy pain relieved by Veratrum in 1865 24 Case of Diarrhoea with faintness 20 — Diarrhoea with lightcoloured sourish evacuations 41 Cases of Flatulent Colic, during Choleraic period of 1854, successfully treated by Carbo Veg. . . 85 Case of Indigestion with Headache and Nervous 221 PAGE Case of Indigestion with Grasping Pain in Liver, and Flatulence 129 — Indigestion with great Acidity 130 — Sore Spot in Rectum, with Constipation 184 — Stricture of Rectum .... 197 — Swelling of Colon, vomiting like Black Vomit . . 145 — Worms with Urinary symptoms 27 Casein from Milk 116 Cautery, Actual 176, 179 Cerate 188 Champagne, St. Peray, &c. 139 Chapman's treatment of Cholera by Ice Bags to Spine 88 Cheeks, flushing of 38 Childbed, Diarrhoea of 29 Children, Diarrhoea of .... 31 — effect of pain in Rectum 165 — Indigestion in 126 — Management of 31 — Piles rare in 178 — Polypus of Rectum in. . 178 — Prolapse of Bowel in . . 194 — suffer from sour evacuations 16 Chill 54,55 — danger of when heated 82 PAGE Chloride of Lime, how far useful as a disinfectant . . 80 Chloroform 194 Choice of a Medicine and its administration 20 Cholera 68 — Allopathic treatment of, 78,89 — Asiatic 74 — Camphor in ix, 78 — Carbonic Acid given off from lungs in diminished quantity 76 — cases 91, 94 — causes of 106 — Diarrhoea not always a premonitory symptom . . 75 — English 74 — epidemics of 74 — Hon. Dr. Goding of Barbadoes on Statistics of . . 77 — Joslin on 77 — MacLoughlin, Dr., his testimony in favour of Homoeopathy in 77 — management of 79 — PremonitoryDiarrhcea of 83 — prophylactic treatment of 85 — Quin, Dr., attacked by 75 — recovery from, more rapid in India than in 222 PAGE Cholera Rubini, Dr., of Naples, his treatment of, ix, 78, 83, 91 — Statistics 76 — symptoms of 74 — - treatment of 78, 87 — after treatment 96 Chyle 119 Chyme 117 Cicatrization and thickening of mucous membrane a cause of constipation. . 106 Clamp in treatment of Piles 176 Cleanliness 10, 188 Clothing 9,54 Clothes, weight of, produces distress 140 Cocoa 138 Cod-liver Oil 10 Coffee ix, 137 Cold drinks may renew spasms in Cholera 87 Coldness of skin in Cholera 75 Cold water enemas in Constipation 108 Cold water enemas objectionable in Piles .... 108 Collapse. See Weakness. Collapse in Cholera 75 Colic, 23, 24, 25, 38, 39, 62, 165 See Abdominal Pain, also Repertories, and medicines given under head of Indigestion. — flatulent . . 85 PAGE and Flatulence, and Repertories. Colic, hsemorrhoidal . . 163, 165 Colon, case of distention of 145 — thickening and diminution in size of, after dysentery 53 — retention of faeces in . . 107 Constipation 103 — a cause of Prolapse of Rectum 190 — alternating with Diarrhoea 28, 111 — cases of, without action, of some months' duration 104 — causes of 105 — diet in 107 — Homoeopathic medicines in 109 — in children 110 — in children less hurtful than Diarrhoea 36 — injections in 108 — symptoms that sometimes follow 103 — treatment of 107 — with haemorrhoids .... 164 — with Fissure, &c 184 — with Stricture of Rectum 196 Consumption, Diarrhoea in 21 Convulsions Ill — in children 39 Cough from secretion of 223 PAGE Cracks, rhagades about anus — Fissure 184 Cramps 58, 75, 86, 125 See medicines for Cholera, and Eepertory. — in Cholera,case of, treated by Cuprum Metallicum .. 94 Debility 19 Diarrhoea 14 — acute 15 — administration of medicine in 18 — alternating with Constipation 28, 111 — bloody 22 — cases of 20, 41 — causes of 14 — chill, from a 20 — chronic 15, 18, 26 — colliquative 30 — congestive 15 — of Cholera often painless 75 — feculent 15 — from errors in diet .... 25 — in hot weather 26 — inflammatory 15 — of childbed 29 — of children 31 — outbreak of, in boardinghouse, from using water contaminated by drainage from privy 81 PAGE Diarrhoea premonitory of Cholera 75, 83 — premonitory of Dysentery 14 — rest in, desirable 13 — scrofulous 28 — sudden 17 — symptoms of 15 — temperature, changes of, inducing 14 — treatment of 38 — with Colic 24 — with Flatulence. See medicines for Indigestion and Flatulence 142 — with Griping 24 — with other illness 29 — with Prolapse of Bowel 22 — with Scalding Stools . . 23 — with Sourish Evacuations 21 — with Teething 38 — with Undigested Food, 15, 22 — with Whitish Evacuations 21 — with Worms 26 Diet 12 See Food. Dilution of medicines .... 2 Division of sphincter in Fistula 180 — partial, in Fissure, &c. 189 Dose, size of 13 Drains dangerous * y 224 Druitt's Surgery quoted, 172, 175, 195 Dysentery 22, 52, 106 — chronic 54 — discharges from bowels in 52 — following use of Camphor in 1854, slight cases 56 — hot climates produce . . 118 — occurs in aguish and marshy districts 53 — Prolapse of Bowel in . . 52 — seat of mischief in .... 53 Symptoms of 52 reatment of 54 pepsia 114 Emaciation, mutton suet boiled in milk, of use in some cases of 10 Enemas 108, 162, 179 — in Stricture 202 — caution as to the use of x England, outbreak of Cholera on board of ship . . 72 English Cholera 74 Epidemics, nature of 74 Eructations 121 Evacuations : — acrid 23, 38, 57 — bilious 16, 60, 61 — black 16,57,58, 61 — bloody .. 22, 23, 28,52, 56, 57, 58, 59, 62 See Haemorrhoids. Evacuations : — brownish 59 — chalk-coloured .... 42, 193 — chopped- egg appearance, 16, 21, 38 — clay-coloured 41 — dysenteric 40, 192 See Dysentery. — feculent 19, 22 — fermented 20 — flatulent 21, 25 For Flatulence with Stools, consult medicines under subject Indigestion. — flocculent 16, 62 — frothy 16, 62 — greyish 61 — green 16, 23, 39, 59 — hard 57, 107, 109, 110 — inodorous 75 — involuntary 29, 39, 61 — jelly-like 23, 60 — knotty, lumpy.. 62, 109, 110, 112 — membranous.. 52, 59, 60, 62 — mucous . . 28, 38, 52, 57, 58, 59, 62 — offensive 21,29, 52 — pappy 39, 40, 41, 43, 56, 61, 62 — purulent 58 — putrid. . 16, 40, 52, 59, 60, 61 — scalding, corroding, 23, 24, 57 — scyballous 52, 57, 107 — serous 52 '¦i 225 Evacuations : — slimy 57, 62 — sourish 16, 21 — watery, 19, 21, 28, 29, 38, 39 — like rice-water 75 — whitish.. 16, 21, 28, 38, 59, 60, 61, 62 — undigested, 22, 25, 38, 40, 61 — violent 92 — yellow 16,25 Exercise 10, 140 External remedies, and caution as to their vise .... x Eye, appearance and loss of lustre of, in Cholera .... 75 Eyes, distorted, &c 39 Face, choleraic 75 — sunken features, &C...40, 60 Fainting in Cholera 75 — with Diarrhoea 25 Faintness in case of Diarrhoea 20 Fat food liable to disagree.. 122 Fecal matter causing hsemorrhoidal pain 162 Kng bottles 35 entation in stomach . . 135 Fissure and Ulcer of Rectum and Anus 163 — case of severe pain from sore place in rectum. . . . 184 Fissure, surgical treatment Fissure, treatment of .... 185 Fistula 180 — medical and surgical treatment 180 Flatulence 133 — causes of 135 — distention of abdomen from 134 — distention from, may be mistaken for dropsy .... 135 — gases, principal ones that cause 119 — incarcerated 134 —of children. See medicines for Diarrhoea of Children 38 — pain and Colic from .... 140 — symptoms connected with 134 — treatment of 140, 142 And medicines given for Indigestion. Fomentations 88, 140 Food. See Diet 7, 12 Also Indigestion and Flatulence 135 — articles of, to be taken or avoided 8 — causing Indigestion, 115, 127 — causing Flatulence .... 135 — for infants and children, — improper, a cause of Dysentery 54 — in ulceration of stomach 126 — mixture of, in moderation, desirable 122 226 PAGE Food producing Diarrhoea 15 — quantity and quality of, to preserve health 9 — should not be kept in sickroom 11 — stimulates flow of gastric juice 115 Gall ointment used in Allopathic practice in Piles .. 165 Gastric juice, action of, 115, 116 Gastritis 124 Gastrodynia 123 Glands, solitary, affected in Dysentery 53 Globules long and successfully used in homoeopathic practice 4 Gluten bread 137 Gowlland, Mr., his treatment of Piles by ligature 174 Gregory, late Dr., on spread of Small-pox 81 Griping and Colic pain . . 24 Habershon, Dr., on Constipation 104, 107 Hsematemesis 126 Haemorrhage .... 59, 161, 175, 176, 179 Haemorrhoids 161 — causes of 164 — cautery, actual, in .... 176 — clamp, use of 174, 176 — Colic, with 163, 165 PAGE Haemorrhoids, excision of. . 175 — haemorrhage from . . 59, 161 — ligature in 174, 175 — Nitric Acid, application of, in 172, 176 — pressure in 165 — strangulated 162 — surgical treatment of . . 170 — treatment of 164 Hahnemann, his teaching of Homoeopathy 173 Hall, Dr. M., on painful hsemorrhoidal tumours .. 162 Hallucinations from Indigestion 125 Hartman's Acute and Chronic Diseases 6 Haslewood and Mordey on Cholera in Sunderland in 1831 70 Hassall, Dr., new preparation from meat 55 Heartburn 123, 128 See Indigestion, and Repertory. Heart, feeble 135 Heat, absence of, in Cholera 75 — Diarrhoea arising from 26 Hectic Fever 62 Helvetia, Cholera on board of steamer 73 Herring on Hamamelis .. 168 Bering's Domestic recommended 6 227 PAGE Holmes, Mr., attendant on first recorded case of Cholera in England 70 Homoeopathic medicines . . 1 Homoeopathy in Cholera . . 82 Hot climates, injurious effect of 118 Humphreys on Dysentery 57 — his Eepertory 03 Hunger cure, Homoeopathy is not a 7 Hypochondriasis 125 Hysteria 8, 124, 134 Ice bags, Dr. J. Chapman's treatment of Cholera by, to spine 88 Ice to relieve vomiting. . 12, 87 Ice water, habitual use of, hurtful 107 India, Cholera in 69 — Dysentery in 53 — recovery from Cholera more rapid in, than in England 96 Indigestion 114 — cases of 129 — causes of 127 — Flatulence and 133 — chief medicines of use — medicines likely to be needed, with their most frequent uses 142 — symptoms of 134 — treatment of 136 PAOE Inhalation of medicine, when power of swallowing is lost 6 Injections. See Enemas. Insoluble medicines asked for at Chemists', in an improper form 2 Ireland, effects of Famine Fever in 53 Jaundice G2, 111, 118 Jessore, appearance of Cholera at, in 1817 69 Joslin, Dr., his Eepertory chiefly followed 1)8 — on Cholera 77 — on Jatropha Curcas .... 95 Lacteals Ill) Lane on ligature in Haemorrhoids 173 Lee, Mr. Henry, surgical treatment of Piles 176 Leucorrhcea during suckling 33 Liebig's essence of meat . . 55 Lientary, Diarrhoea with undigested food 15 Ligature in Piles .... 174, 175 Literary men subject to Dyspepsia 128 Liver, congestion of 118 — enlargement of 62 — flow of bile from, stimulated by Peptone 116 — found gorged with blood, in Cholera 76 — inactivity of, a cause of Constipation 106 228 Liver, inactivity of, a cause of Flatulence 135 — pain in 41, 110, 118 MacLoughlin, Dr., testimony in favour of Homoeopathic treatment of Cholera 77 Malt liquor too freely partaken of by nurses .... 32 Manzanilla Sherry recommended 138 Materia Medica, knowledge of, required 97 Meat, Liebig and Hassall's preparations from 55 Medicines v — administration of 5 to children 37 — action of. See Reper— in Indigestion, with some of their principal uses . . 142 — perseverance in use of selected medicine advised 17 Menstruation hurtful during suckling 33 Mental emotions a cause of Indigestion 128 Mesenteric disease 15 Milk for children 36 — in Dysentery 55 — in Indigestion 126 —of unhealthy mothers Milk, suppression of, with Diarrhoea 29 Mind, depression of, from Constipation 105 from Indigestion. . . . 125 — irritability of, relieved by Staphysagria 61 Moderation in all things . . 122 Nausea 58, 124, 140 See Repertories. Opium antidoted by Camphor 89 Organic disease, suspicion of, in Chronic Diarrhoea 18 Pancreatic juice 117, 118 Paralysis, Constipation in .. 112 — of sphincter ani 39 Paterson on failure of proposed cures for Cholera in Egypt 88 Pepsin, action on food .... 116 Peptone 116 Peristaltic (clasping, compressing) movement of bowels 119 Petechise 30 Phlegmasia alba 29 Piles. See Haemorrhoids. Pilules, administration of. . 5 — note on size of 129 Pneumogastric nerves, effect of division of 115 229 FAQS Polypus of Kectum, spontaneous cure, and treatment of 178 Porridge as food in Constipation 109 Port wine 139 Pope, Mr., on Hydrastis . . 187 Pond's Extract of Hamamelis 168 Pork 8, 25 Potato a cause of Waterbrash 123 Pregnancy, dyspeptic symptoms in 128 Pressure in treatment of Haemorrhoids 165 Prophylactic treatment . . 85 Prolapse of Eectum .... 60, 190 — causes of 190 — surgical treatment of . . 194 — treatment of 190 Ptyalism 51 Pumps a source of danger in Cholera 82 Purgative medicine, abuse of 103 Pyrosis 123 Quin, Dr., attacked by Choler — nature of attack . . 75 — his treatment of Cholera 78 — statistics of his cases .. 76 Eegurgitation 101 See Repertory. Repertory for Diarrhoea . . 44 — for Dysentery ........ 63 — for Constipation, Indigestion, Haemorrhoids, &c, &c 204 — remarks on 17,97 Eespiration, hurried 75 Rest, advantages of 13 Rhagades 186 Rubini, Dr., his treatment of Cholera by Camphor, ix, 83, 91 Sarcina Ventriculi 125 Sauer-kraut 72 Scarlet Fever, prophylactic virtues of Belladonna . . 86 Scents, when objectionable 8 Schools, improper rules in Ladies' 106 Scrofula 28 Scrofulous Diarrhoea .... 28 Scurvy lessened in Navy by improvement in diet .... 53 Scybala 52, 51, 107 Sedentary habits a cause of Indigestion 128 Skin, blueness and coldness of, in Cholera 75 Small doses, law of, fully established 3 Small-pox, outbreaks of, in London and Kent 81 — vaccination in 86 230 PAGE Spasms 75 Spices objectionable 137 Statistics 76 Stimulants 12, 13, 138 Stomach, Diarrhoea with disordered 20 — pains in Indigestion . . 124 — weight in 61, 125 — see Repertories. Stools. See Evacuations, and Repertories. Stricture of Rectum 196 — case of 197 — connected with Cancer . . 198 — treatment of 199 Sugar formed in liver .... 118 Sydenham on Cholera Morbus 68 Sympathetic nerve, effect of irritation of 115 Tar in Haemorrhoids, said to be of use 164 Teeth, grinding of 26 — good, required for mastication H4 Teething, Diarrhoea during 21 Temperature, changes of, induce Diarrhoea 16 Tenesmus 56 See Repertories for Diarrhoea and Dysentery. Thirst in Cholera 75 Tinctures 1> 5 PAGE Tischnowitz in Moravia, Cholera treated there by Dr. Quin 75 Tongue in Cholera 75 — in Dysentery .... 52, 57, 61 — in Indigestion 120 Tonsils, secretion from .. 115 Tonsils and bronchial glands, unhealthy secretion from, a cause of bad health 112 Tormina . , 52 Triturations 1,5 Tumour, hsemorrhoidal .. 161 — phantom 134 Tympanitis 134 Typhoid Diarrhoea.. 23, 30, 61 Ulcers in Mouth 57 Ulcer in Stomach 126 — in Eectum 184 Urine, high coloured and scanty, in Dysentery 52, 55, 59 — retention of, in Cholera, relieved by Opium .... 92 — retention of, scanty or suppressed 38, 52, 55, 58, 59, 75, 111 — suppression of, in Cholera 75 Urination, painful 28, 38, 56, 59 Urinary symptoms in a case of worms 27 231 PAGE Uterus, pains in, connected with Haemorrhoids .... 162 Uvula, elongation of 123 Vaccination 80 Vegetables, see Diet. Vegetables useful for nurses 33 Vegetables, want of, a cause of dysentery 53 Ventilation 10 Vermicular action of bowels 119 Vertigo 125 Virginia — Cholera on board of ship 72 Vomiting, flatulent 134 — ice of use in 12, 87 — in Cholera 75 — in Dysentery 52, 59 — up of worms 27 — with Diarrhoea . . 20, 25, 40 — with indigestion . . 124, 128 PAD Walcheren, sufferings of British Army from Dysentery at 53 Waterbrash 123 Water Cure 140 Water, impure, a supposed cause of Cholera 82 Water, impurity of, causing outbreak of Diarrhoea in a boarding house 8 Weakness, debility, prostration 39, 115 Wet-nurses, impropriety of employing unmarried women as 34 — Irish women preferred as 35 — observations on 31 Whooping Cough, Cina of use in 27 Wine, note on 138 — Champagne, Claret, &c. 139 — Manzanilla Sherry .... 138 ' — St. Peray, a sparkling wine, recommended .... 13i Worms 26, 41 232 PUBLISHED BY HEADLAND AND CO., No. 15, PEINCES STKEET, HANOVER SQUAEE, LO2iTI3O3sr, "W. 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