efcffifc NATIONAL LIBRARY OF MEDICINE NLM DDSSSHfifi 5 U.S. NATIONAL LIBRARY OF MEDICINE NLM005554885 IBRARY OF MEDICI'-E NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE 10 Aavaan tvnouvn 3nidi03w jo Aavaan tvnouvn 3nidiq3v; jo Aavaan tvnouvn IBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE JO AMVaaiT TVNOUVN 3NOIQ3W JO AavaaiT TVNOUVN SNOIQ3W jo Aavaan TVNOUVN IBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE a. jo xavaan tvnouvn snioiosw jo Aava8n tvnouvn snioiosw jo Aavaan tvnouvn ■o 5 S^H.?^ u /-^JV X 5 S^B.rU*. o ,-WaI/ X 5 RARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE jo Aavaan tvnouvn snoiosw jo Aavaan tvnouvn snoiosw jo Aavaan tvnouv Supposed Normal Position . THE TREATMENT OF Uterine Displacements INCLUDING PROLAPSUS, ANTEVERSION, RETROVERSION, ANTEFLEXION, AND RETROFLEXION. SECOND EDITION, ILLUSTRATED. CHICAGO : DUNCAN BROTHERS, 1884. IV p Copyrighted by DUNCAN BROTHEKS, 1884. PREFACE TO THE SECONDpDITION. That the little treatise on "Prolapsus Uteri" should ever demand a second edition, is quite unexpected but gratifying-. If it has promoted an increased re- liance on remedial agents for the treatment of uterine displacements, the authoris well repaid'and contented, trusting that this new edition will be found a still greater assistance in furthering true Hahnemannian principles. In its new form it includes all "Uterine Displacements." It has been rewritten, revised and new remedies have been added, furthermore it is sup- plied with a complete Repertory or Clinical Index of all symptoms more or less directly affiliated to dis- placements of any kind. But the space allotted did not permit at the same time all the concomitant symp- toms more specially related to other disorders, such as menstruation; amenorrhoea; leucorrhoea; ulceration; induration; haemorrhoids, etc. The repertory will point out the remedy, and the concomitants will be easily found in the pathogenesis of each remedy. The Authok. PREFACE TO THE FIRST EDITION. In obedience to the request of many physicians, my paper on "Prolapsus Uteri and its Homoeopathic Treatment," read before the Western Academy of Homoeopathy, appears in pamphlet form. The pro- mulgation of the true principles of our school, as taught by Hahnemann, has induced the writer to issue a sketch of treatment for a condition, hitherto considered to be almost unattainable by medicine alone. The prevailing idea has opened the door to all kinds of mongielism and quackery, and which has resulted in the greatest injury to the female. The mongrel may laugh and even think them not worth a trial; but the true physician will conscienciously try the indications here given, and the effect will be certain success. With the exception of Collinsonia, all the remedies have been given in the 200th potency, (usually Dun- ham's preparation,) and upwards. One dose has been given per day, until some improvement became per- ceptible, when medication was stopped, and the remedy given time to develope its curative action. In the majority of cases, one remedy, when properly selected, finished the cure. These symptoms have been collected from many sources, but for brevity's sake, the references are not mentioned. Wm. Eggert. CONTENTS. Page. Preface, .... 5 Introduction, .... 17 The most recent views on the Management of Uterine Displacements. Illustrated. Diagnosis of Uterine Displacement, . . 26 The Normal Position. Its Normal Position and Symptoms. Illustrated. Homoeopathic Therapeutics, ... 50 The Remedies and their Characteristic Indications for Uterine Displacements. Clinical Index, or Repertory, . . .95 Uterine Displacements, Symptoms and Concomit- ants, Anatomically arranged. Appendix. . . . , Hg Additional views and Experiences. Prolapsus and Remedies. Anteversion and Flexion. Illustrated. THE TREATMENT OF UTERINE DISPLACEMENTS. INTRODUCTION: Among the many diseases to which women are sub- ject, I consider Uterine Displacement to be the most prevailing, hence its large literature. It would be useless to recapitulate the pathology or etiology, for ] could add nothing that would be considered new or original; I shall therefore confine my few remarks to therapeutics only, hoping that some suggestions may be welcome to one or another. I know that my views on this subject are not accept- ed m to to by a majority of medical men, still I have the assurance that they coincide with, at least, those of quite a number of eminent practitioners and speci- alists. 18 UTERINE DISPLACEMENTS. Prolapsus Uteri, for example, is to my mind, noth- ing but the symptom of a diseased condition of the whole system, and the few exceptions 1 must grant, are attributable to traumatic causes. Effects are too frequently taken for causes, or disease itself. It is this diseased condition of the whole system, that weak- en and relax the uterine ligaments which in turn causes the deviation of the uterus from its natural position. Bearing in mind this fact, and the office of a Homoeopathic physician becomes evident and pointed. If he will diligently search in his Materia Medica, he will soon become acquainted with the armamentarium to combat the trouble satisfactorily to his patient, as well as to himself. I have during the last ten years discarded all exter- nal medication, as well as other appliances, with a few rare exceptions, to which I will briefly refer: In women who are so situated as to be able to enjoy rest and comfort, I use nothing externally except a hip or spinal bath, warm, cool or cold, according to circum- stances; or an abdominal compress, of likewise dif- ferent temperature, to be worn by night or during the day only. This has been all sufficient to me, and I can speak from a large experience. But, in the cases of working women, I have been obliged to resort to some additional means. After the reduction of the displace- INTRODUCTION. 19 Prolapsus.—Third Degree. 9999999 20 uterine displacmenets. Duncan's Natural Abdominal Support. introduction. 21 ment, I insert a cotton ball, corresponding in size to the vaginal or pelvic cavity, fastened on a string, to which I add in grave oases, and when the women is obliged to work hard, the perineal compress fastened by a bandage around the waist and between the limbs. The cotton ball is usually withdrawn for the night and reinserted in the morning. But even such appli- ances are only required for a short time, for the prop- perly indicated remedy will soon give permission to dispense with them. An external abdominal support, if light and elas- tic, often aflords great relief and aids the cure. That local appliances and medication affect apparent cures, 1 will not deny, for I remember too well the temporary relief I have often witnessed from the pes- sary, the uterine supporter, as well as from Glycerine, Hydrastis, Calendula, Arnica, and even the Argentum nitr. But I do assert, from my own experience as well as that of many others, that the disease is thus rarely ever cured; it is merely held in suspense or is sup- pressed, and in more or less time it will surely return either in the same or in another form, particularly so, if the prolapsus thus treated be complicated with leucorrhoea, ulceration or induration, and the patient will be worse than at first. The theory of metastasis is to us a living fact, in spite of all the sneers that have 22 uterine displacements. been heaped upon it. The cases where surgical ap- pliances are absolutely necessary, are very rare indeed; for a ruptured perineum, etc., is not of every day oc- currence. And why should my experience meet oppo- sition even in theory? In the majority of cases we find the displacement complicated with congestion, leucor- rhoea, abrasion or induration, and it is against these associated ailments usually, that external medication is enforced, particularly so, as many authorities wrong- fully assert that leucorrhcea,ulceration, etc., are the immediate cause of the displacement, an assertion with a very poor foundation indeed; experience has taught me quite the reverse, for I believe that leucorrhcea, ulcerations, etc., are oftener caused by the prolapsus, than is prolapsus by them. But let this be as it may; if we can heal with such entire satisfaction the most vicious diseases of the external skin without the use of topical applications (and the mucous membrane of the throat in diphtheiia,) it must seem strange to as- sert that the diseases of the mucous membranes of the uterus, or of the uterus itself, must be treated dif- ferently. It would be discarding analogy and logic at the same time. Treating then prolapsus uteri or other displacement Homoeopathically, we must seek a remedy that covers more or less the whole complex symptoms; it will de- introduction. 23 mand the strictest individualization, and reward our patient in a two-fold manner. It will most certainly benefit her, and do away with the speculum to a great extent. In reference to the speculum, Dr. Skinner says, " it has made more ulcerations than it ever cured; and it has discovered a thousand-fold more than ever ex- isted." Taking the stand-point I assume, it is common to hear it said, that cases cured by remedies alone were spontaneous cures, and had nothing to do with medical skill, and if I further assert, that our best and prompt- est successes, have been accomplished with high, and even the highest attenuations, then our opponents see at once nothing but moonshine; may they enjoy it; it shall never debar us from proclaiming the sunshine of truth. Spontaneous cures, or self-limited cases, such as apparently occur before or during menses, after exertion as riding, coughing, coitus, etc.,are not so very frequent; my observation has taught me re- peatedly, that we, in reality, under such circumstan- ces, deal rather with the aggravation, than with the origin of a dislocation. And supposing that the cir- cumstances just mentioned, were capable of produc- ing a prolapsus each time they occur, would it not be a formidable proof of the existence of a tendency to such disorder? And where is the remedy to be found to correct such tendency? Will a pessary or uterine 24 uterine displacements. supporter, an abdominal supporter or perineal pad prevent it? I say emphatically, no! Or, will you cor- rect it by external medication? I say again, never! You must have resort to internal remedies, and then alone will you succeed, providing you select properly. Individualization is the foundation of our treatment, and to further this end we are compelled to analyze the symptoms in each case before us; and here as else- where, experience is our best teacher. After having taken notice of all the symptoms, we naturally turn our attention first to those which affect the uterus and its appendages most directly. My first inquiry is with reference to the menstrual flow, and in a large majority of cases we will meet irregularities of every descrip- tion ; next 1 examine into the condition of the uterus and ovaries. Generally the symptoms aid us sufficient- ly for all diagnostical purposes. The character and location of pain, as well as the character of the vagi- nal or uterine discharges, speak to us in a plainer and more practical language than the speculum. Next to this I seek for symptoms reflex or otherwise, giving to the symptoms of the mind, to a great extent pre- ference, in cases where the selection of the remedy becomes difficult. In this connection I cannot withhold the strong en- dorsement of the foregoing views that appeared in the introduction. 25 following article read before the Massachusetts Sur- gical and Gynaecological Society by no less authority than Henry Minton, M. D., the distinguished editor of The Homoeopathic Journal of Obstetrics and Diseases of Women and Children: "At no period in the history of medicine has the gynaecological craze, in regard to uterine displace- ments reached a higher point than it now occupies. "Every pelvic pain, and many pains that are far from being pelvic, indeed every abnormal condition of the female sexual organs not easily accounted for are at once attributed to " falling of the womb," or to some variety of uterine displacement. " The importance of the subject is made manifest by its allotment for our consideration this evening-; this whole society is requested to give it their undivided attention, and each individual member is expected to throw all the light he may posses upon it. " The complaint has become quite popular, and it is talked about with as much familiarity and complacency as was at one time awarded to " biliousness," and the satisfaction it affords as an explanation of many ills is truly astonishing. The phrase is hackneyed and mean- ingless, still, like that other now popular term " mal- aria," is bandied about by physician and patient with an unction that passes for a complete and satisfactory 26 uterine displacements. explanation of the most abstruse and complicated cases. " The woman now who has the temerity to consult a specialist in regard to any of the numerous complaints to which her sex is liable, is almost certain, and with- out much ceremony, to be requested to assume the genu-pectoral position on a gynaecological table, while a visual and manual survey of her external and inter- nal genitalia is made. This examination must, of course, reveal something, and where no absolute in- fraction is found, displacement is sure to exist to, a greater or less extent. Displacement, or what passes for displacement, is certain to be found because the normal position of the uterus within the pelvis is never constant, but ever-changing. " I hold in great disfavor this readiness and haste in making local explorations. The unwarranted pre- sumption of many in the profession, that because a woman suffers from backache and pelvic distress, she must therefore have some local uterine disease, demand- ing a speculum examination should be frowned down by all right-thinking men. We thoroughly appre- ciate the necessity of a correct diagnosis, and would censure any man who failed to make all reasonable efforts to attain it; at the same time I am decidedly of the opinion that the treatment of sexual complaints introduction. 2? in young and unmarried women should be purely con- stitutional until such time as the necessity for local exploration is clearly and positively apparent. Never resorting to, or placing any reliance upon local treat- ment, the appearance of the parts-upon inspection affords us no therapeutic indications, and therefore is of but little practical interest. " The etiology and pathology of uterine displace- ments has received as much, if not more, attention than any other morbid condition of the female sexual organs. " Men of acknowledged ability in the profession have for ages past given it their close attention, and have written volumes upon the subject, endeavoring to elucidate and enforce their particular and often pecu- liar theories in regard to its cause, and detrimental effect upon the health of women; and still the most important point connected with the whole subject, "uterine therapeutics," has not advanced one whit. The same old mechanical methods of past ages are still depended upon. This stasis is the result of a misap- prehension of cause and effect. Believing that uterine displacement is a cause of suffering, the chief endeavor has been to devise some mechanical means for its relief, and under this delusion a system of "uterine mechan- ics" has grown up, which from its directness, simpli- 28 uterine displacements. Pelvic Hematocele, Causing Displacement. introduction. 29 city and plausibility has gained many adherents, while "uterine therapeutics" have been neglected. '' Believing, as I do, that uterine displacement is but a symptom of some constitutional defection, or simply attendant upon seme local abnormality, not a disease per se, I cannot refrain from entering my protest against the use of mechanical means of all kinds and descriptions, (of course I am not speaking of displace- ments from mechanical causes, as falls, shocks, etc.) I do not believe that uterine displacements of any kind or degree was ever cured, or even benefitted, by the use of a pessary. This, I fully realize, is a strong assertion, and is in direct opposition to the teachings of many intelligent and honorable men; nevertheless, I believe it to be true, and my belief is not founded upon theory alone, but upon a long and varied exper- ience. " It can be easily demonstrated that uterine displace- ment is not a disease and that it does not deserve the attention in treatment that is now so bountifully be- stowed upon it. It is a symptom only, and as such will subside when the cause which induced it has been removed. The causes of which it is but a symptom will, in the large majority of cases, be found to be chronic pelvic cellular inflammation, any inter-pelvic disorder which diminishes the supports of the uterus, BO uterine displacements. Retroversion from Distended Bladder.—First Degree. INTRODUCTION. 31 of a local neurosis, arising from an impaired or dis- ordered highly developed nervous system. " The uterus being a movable organ within the pelvis is subject to various changes of position. Its mobility is one of its most characteristic features. All its attachments when in a healty condition are such as to admit of the utmost freedom of motion within certain limits in all directions. With every motion of the body, even by ordinary respiration, and when cough- ing, singing, laughing, or when walking the position of the uterus is changed. When standing the uterus sinks downward, even in the virgin. With the finger the uterus can be lifted up and moved in all directions, and during coition the uterus is elevated to a consider- able extent without giving pain. By tight clothing the uterus is forced completely out of its place with- out a word of complaint from the subject, or the development of a morbid sign. We are all familiar with what ease and impunity the uterus can be drawn down close to the vulva for surgical interference. The uterus is constantly exposed to forces producing tem- porary displacements; for instance, the bladder in front when fully distended produces complete retro- version, which, though annoying, is seldom painful, and what annoyance there may be comes from the bladder and not from the uterus; behind, is the rec- 32 UTERINE DISPLACEMENTS. Anteversion from Distended Rectum.—First Degree. INTRODUCTION. 33 turn which when distended acts also as a displacing cause, operating from above and behind producing anteversion. From above we have the abdominal pressure which is constantly acting upon the uterus, and which is greatly increased by every straining effort which brings the abdominal muscles into action or a state of tension, while below the pelvic floor has a constant action in supporting the uterus against the pressure from above. " From these facts it will be seen that the uterus may be displaced in any direction, and the causes of such displacements are but natural conditions which are in constant operation. Thus we may have retroflexion, anteflexion, ascent, descent, prolapsus, or, in fact, any decided removal of the uterus from its normal position while the subject remains perfectly oblivious to the transition constantly in operation. " These displacements are transient and pass away when the conditions which produce them cease to operate; they are therefore purely physiological. It is only when the uterus becomes fixed and stationary, failing to return to its normal position from a continu- ance of the condition which displaced it, that treat- ment is called for. "What is the normal position of the uterus, is a question of vital importance to those physicians who 34 UTF.RIN E DISPLACEM ENTS. look upon the displacement as the cause of all the con- comitant symptoms with which it may be associated. '' It has never yet been revealed to man what the nor- mal position of the uterus is. The very means which we must adopt in studying its topography is sufficient to frustrate the end in view; the simple introduction of the finger into the vagina will often be sufficient to excite a movement of the uterus. What the anato- mist considers a uterus in a normal position, the gynae- cologist considers abnormal. It is impossible to estab- lish a point which can be accepted as the normal pos- ition in health. " Great pains have been taken by gynaecologist to demonstrate what they believe to be the exact angle which the " long axis of the uterus should make with the horizon, when a women is in the erect position," as a govering principle in the adjustment of pessaries. These efforts of late have been greatly stimulated by the prodigious efforts of the uterine mechanics. Men, with an assurance that to the more modest in the pro- fession seems astounding, will map out the exact pos- ition which the uterus should occupy, and every line of departure from this standard they are capable of determining with geometrical accuracy, and will in- dicate the exact mechanical contrivance that alone can rectify the displacement and cure the patient. This INTRODUCTION. 35 is a laudable ambition, and were it not for the absence of two important facts, would be worthy of emulation; namely, we have no evidence that uterine displacement ever causes local or constitutional disturbance of any kind : secondly, we have no evidence that replacement and retention of the uterus in its supposed normal position, affords any relief from the numerous discom- forts with which the displacement is associated. "As before stated, uterine displacement is not a dis- ease, but a symptom, the result of uterine and peri- uterine inflammation, or a local neurosis, arising from an impaired or disordered, highly developed nervous system. " Here, as elsewhere, the totality of the symptoms constitutes the disease, and the similimum is the remedy." i 36 UTERINE DISPLACEMENTS. DIAGNOSIS OF UTERINE DISPLACEMENTS. THE NORMAL POSITION. What constitutes a displacement of the uterus? As a matter of fact, it must be any deviation of the organ from its normal position. But what is the normal position? Upon this point I cannot do better than to quote from an article that appeared in the Medical Advance from the able pen of O. B. Moss, M. D., and read before the Kansas State Society, he says: " It may seem to you superfluous, or possibly pre- sumptuous, that I should raise such a question before a society composed of physicians; but to me the ques- tion seems pertinent, for I have never yet found a nor- mal uterus occupying the position indicated by illus- trations attached to the works of our most popular authors. And moreover, I have known physicians to devote themselves faithfully for months to the restor- ation of uteri which were normal as to position when they began, and abnormal as to their state and func- tion, if indeed not also abnormal in position, when they ceased their meddlesome treatment. Something must be wrong, or these errors would not occur; and I consider it more just to ascribe them to a misappre- DIAGNOSIS. 37 hension of the normal position of the organ than to willful, meddlesom surgery. Such cases improve, not when the indefatigable doctor has taught the uterus a better position than it already occupied, but only when the patient, too weak and discouraged to submit to further treatment, abandons medical advice altogether or seeks a more skillful diagnosis of her case. " In some of these cases there may exist slight devia- tions from a perfectly normal position, but so slight as to require no mechanical interference. The fact is, the organ is often diagnosed as being displaced for the simple reason that its normal place is not clearly apprehended. The student of Gray, Wilson, and other popular works containing diagrams of the female pel- vic organs, expects to find in the living subject that the vagina and uterus form a gentle curve, corresponding to the pelvic curve. But when, instead of this, he dis- covers that the vagina dips backward in a line a little above the sacro-coccygeal articulation, and that the uterus, lying parallel with the sacrum, is at a right angle to the vagina, resting on the bladder as a cush- ion, what must be his conclusion respecting the posi- tion of the uterus, with all the diagrams and teach- ings of popular authors fresh in his memory? Naturally he could reach but one conclusion, and that 38 UTERIN E DISPL AC EM E N TS. St pposed Normal Position. DIAGNOSIS. 39 is that the organ is displaced. His diagnosis is "par- tial prolapsus with anteversion." [See cut.] " It has been my good fortune on many occasions, in conjunction with other physicians, to examine women supposed to be suffering from uterine displacements of a more or less serious nature, and I blush for all to Normal Position.—Supposed 10 be First Degree of Prolapsus. say that we had no difficulty in confirming each others diagnosis. The uterus was often wrongfully accused and barbarously abused. Finding the long diameter of the uterus and vagina at right angles to each other, "prolapsus" is the verdict rendered against the unfor- tunate organ; and if, in consequence of an unusually 40 UTERINE MSPLAC1MENTS. small amount of cellular tissue intervening between the uterus and bladder, the former is found without difficulty riding upon the latter, "anteversion" is the inevitable though erroneous diagnosis. Then if ante- flexion co-exist with the conditions already described, the case is supposed to be seriously complicated, and the appliances employed for restoration of the organ are correspondingly more diabolical. " In the normally poised female body, a line passing from the vertex downward along the anterior border of the second lumbar vertebra, touching the inferior border of the pubic bone, and so on to the plantar arches, marks the center of gravity. Now this line falls anteriorly to the uterus, which lies back under the sacral arch, out of the way of the direct downward pressure of the abdominal contents. In short, the center of gravity of the abdominal organs is in front of the pelvic organs, and passes through the pubic bone. " Whatever constitutional dyscrasias, luxurious hab- its of life, physical conditions, or other circumstances, may operate as depressing influences upon the vital forces of the system, debilitate the woman, interfere correspondingly with the axes of the body and change the center of gravity of all the organs. Standing or sitting in such a vicious position as to throw the body DIAGNOSIS. 41 into a curve with the concave surface looking forward, throws the center of gravity backwards through the pelvic organs, and the superincumbent weight is turned towards the line of the pelvic axis. Debility is opposed to the erect posture in standing, and our modern luxurious furniture suggests, if it does not compel, the curve when sitting. Thus, displacements are the logical sequence of these causes, and emphasize the fact that uterine dislocations may generally be regarded as the effect rather than cause of ill health, and should be treated on the basis involved in this principle. ABNORMAL POSITIONS AND SYMPTOMS. "The general diagnosis of displacements of the uterus is not difficult from the subjective symptoms alone, while the specific form of displacement in any given case cannot "be positively known without objective investigation. " When women are suffering from uterine derange- ments of the form under discussion, or otherwise, it will be observed that they generally do not apply to a physician for assistance until the expression of their disease is a complication of painful troubles, known as "reflex" or "sympathetic;" as, for example, when 42 UTERINE DISPLACEMENTS. there is functional derangement of the heart or stomach, due to the sympathy of the nerve centers that guard these organs, with the nerve center of the organ primarily diseased. But perhaps the most common of all the reflex symptoms that attend uterine and ovar- ian disorders, is cephalalgia, while this is certainly the most difficult to control. " Following, now, as a natural sequence of sympath- etic irritation of organs distant in the body from the original disease, and owing in part, also, to the fact that grave displacements of the uterus may exist in the absence of any marked pelvic symptoms, our patients usually come to us complaining only of these reflex symptoms. But the observing, physician who has had some experience in the treatment of this class of diseases, is led to a careful investigation of each case, employing such means as are necessary to elicit a complete account of its origin and progress. However, many cases are met with in which the pelvic symptoms are among the most prominent, and thus all difficulty of speedily reaching a correct diagnosis is removed. "Among the most prominent subjective symptoms that indicate displacement of the uterus, are: Great weakness across the lumbar or sacral regions of the Bpine; irritation of the bladder, with frequent desire to urinate, which is attended with burning in the DIAGNOSIS. 43 urethra; sensation of weight or bearing down in the pelvis or drawing downward from the region of the ovaries; discomfort referred to the rectum, as from the pressure of a foreign body, irritating and produc- ing a desire for stool; evacuation of the bowels accom- panied by the feeling as if the faeces would bring the pelvic organs down with them, and followed by aching, numbness or bearing down in the pelvis. "But, although many of these symptoms may exist in any given case, with others of minor diagnostic impor- tance that I shall omit, yet further investigation, as I have already intimated, will be necessary—that of a digital examination per vaginam—before a complete or satisfactory diagnosis can be made. Each physician, then, must decide for himself what subjective symp- toms indicate the necessity for a tactile examination; and since I desire to treat specifically upon the replace- ment of the organ, I shall not stop to describe the exact nature of the case that may require mechanical treatment. Suffice it to say, however, that when the natural supports have become so much relaxed as to admit of any considerable permanent removal of the uterus from its normal position in the pelvis, other means besides medicine are likely to be required in effecting a cure. "Now with the case in hand, without the aid of the 44 UTERINTE DISPLACEMENTS. Ketroversion.—Second Degree. DIAGNOSIS. 45 uterine sound, so much in use by many physicians, I proceed with the replacement upon purely mechanical principles. "Let us suppose we have a case of retroversion on which we are to operate. With the patient lying on her back, and limbs well flexed upon the abdomen, I introduce two fingers of the right hand, if that be practicable, placing the left hand upon the abdomen next the skin, so that nothing shall interfere with my manipulations. Now, by the position of the mouth of the ulerus, pointing forwards, and the absence of the uterine body overlying the bladder, poised, tumor-like, in situ ; and further, by tracing with one finger along the posterior surface of the organ to the fundus, and finding the latter occupying a horizontal position in the pelvis, pointing backwards, resting beneath the sacral promontory, and pressing against the rectum— we readily recognize the physical characteristics of the case. "Our physical explorations carried thus far, with the index finger resting against the anterior surface of the cervix uteri, and the other finger against the posterior surface, we have formed a lever on the principle of the tongs, with which we can raise several pounds, and will often succeed without difficulty in raising the uterus to its proper position. But in case of failure, 46 UTERINE DISPLACEMENTS. Retroversion and Flexion. DIAGNOSIS. 47 we may place the patient on the right side, which will remove the weight of the intestines to a con siderable degree from the pelvic organs. Now, using the right hand as before, we attempt again what we just failed to accomplish ; but still finding the task difficult, owing to the impaction which the organ has sustained during the months or years of its displace- ment, we will find very material aid by seeking the sacral promontory with the left hand and pressirg deeply into the abdomen, so that the fingers will glide along the anterior surface of the sacrum to the fundus of the displaced organ. "It will be observed that we approach the fundus with two forces, the lines of approach forming a right angle; for if we are not able to raise the uterus by the leverage we have already secured with the two fingers of the right hand, the index finger may be allowed to rest on the anterior surface of the cervix uteri, while the other finger seeks the fundus, to operate more directly with the force brought to bear with the left hand. "But again, if we should not succeed in this last posi- tion, it will be well to place the patient on the left side, with the back to us, while another effort is made. And besides the manipulations over the abdomen, already described, it will often be of great assistance 48 UTERINE DISPLACEMENTS. to have the patient incline the body a little from the side on which she lies towards the face, while with the left hand under the hip, we elevate the body so the force of gravity will aid in returning the uterus to its normal position. The same principles hold good in other displacements, only of course the force should be applied according to the indications in each case; and among the great variety that exists, cases will seldom be found in which the practical results of this process will not most fully commend the theory advanced. However, where inflammatory processes have resulted in adhesions of the peritoneal covering of the uterus to that of the rectum, we will have a complication that will interfere with the success of our operations, in proportion to their extent and solidity. But the same complication would interfere with our efforts to replace the uterus with the sound also; while the injury done to the organ would necessarily correspond with the increased force such a condition would require. "I regard the use of the sound exceedingly objection- able, in the fact that it irritates the mucous membrane of the uterus; and in many cases where the mucous surface is already congested or inflamed, it must retard the recovery of the patient. But not only does the sound injure the uterus, for it may induce irritation of the ovaries and cellular tissue, and even cellulitis and DIAGNOSIS. 49 ovaritis. Indeed, my observation has been, not alone among my own patients where the sound had been used, but also among the patients of other-physicians, that when the most careful use was made of this Combined Uterine Elevator. instrument occasionally, the improvement that would naturally occur during the two or three weeks' absence of treatment, would be all or nearly all canceled at the next operation with the sound. "The sound has a diagnostic use, and for that I shall continue to employ it when necessity demands it; but rarely have I found it required for several years past in replacing a dislocated uterus, and I am fully con- vinced that its perversion in this form of disease has resulted in more injury than its most discriminate use can ever counterbalance." One of the best instruments for repositing the uterus is the Combined Uterine Elevator. 50 UTERINE DISPLACEMENTS. Homoeopathic Therapeutics, In selecting a remedy for a given case, consult both the Clinical Index under the appropriate heading, and the various remedies here given. In case of doubt, refer to the Materia Medica. After the selection is made, give the remedy plenty of time to act. The patient should report, or be seen at least once a week. ACONITUM NAPELLUS. Prolapsus usually of sudden occurrence with or without ha3inorrha>ge, with inflammation of the geni- tal organs. Heat, dry skin, anxiety with cold perspi- ration. Nervous excitability with great fear of death; bitter vomiting. ^ESCULUS HIPPOCASTANUM. Prolapsus or retroversion with inflammation of the cervix. Prolapsus with uterine pains running down- ward. Pain in the right hypogastric region. Throb- bing in the pelvic cavity and hypogastrium. Leucor- rhcea with constant backache. Pain especially in hip and sacrum; great lameness in the back, worse on walking. Occipital pains, light colored soft stools. Large, protruding, painful haemorrhoids. HOMOEOPATHIC THERAPEUTICS. 51 AGARICUS MUSCAEIUS. Prolapsus especially after cessation of menses. Pro- lapsus with profuse, dark leucorrhcea. Itching of the genitals and desire for an embrace. Swelling of the vagina. Aversion to work. Irresistible drowsiness in day time. ALETRIS FARINOSA. Prolapsus from muscular atony. Prolapsus with menses too profuse and too early. Metrorrhagia. Leucorrhcea. Habitual tendency to abortion. Want of appetite. Indigestion. Great debility. ALOE. Prolapsus with labor like pains extending down the legs. Labor like pains in loins and groins, worse when standing. Menses too profuse and too early, with diagging down into the rectum and fullness in the pelvis; too early and too long. Uterine haemor- rhage about the climaxis. Leucorrhcea of bloody mucus, preceded by colic. Fullness, heat and heavi- ness in the hypogastrium. Backache. Haemorrhoids protrude in bunches, and are relieved by cold water. Debility. For women of relaxed and phlegmatic habit. 52 UTERINE DISPLACEMENTS. ALUMINA. Prolapsus with bland, painless ulcers upon the os; stitches, throbbing, itching in the vagina. Leucor- rhcea corroding, profuse, running' down the heels, often only in day time, relieved by cold washes. Hysteria. Palpitation of the heart. Frequent mictu- rition; urine smarting, even corroding. Pain in sac- rum. Tremor. Symptoms worse every other day, or during dry weather, better in the open air or in wet weather. AMMONIUM MURIATICUM. Prolapsus with uterine pains extending from the right side of the pubes to the hip and small of back. Uterine pains extending from both os pubes to the small of back; cutting and stitches, with urging to urinate evenings; menses too profuse; too early and too profuse; too early; black; clotted; with pain in abdomen and back lasting all night; flow worse at night. Leucorrhcea like the white of an egg, or brown, slimy after making water. Continual leucor- rhcea. Leucorrhcea painless or preceded by pain around the navel. Distention of abdomen without accumulation of wind. Crumbling stools. Cannot walk erect, on account of pain as from a sprain in the groins. Discharge of blood at stool, during menses; coldness between the shoulders; backache, especially at night. Displacements with pain in the groins; they feel sore, as if swollen. HOMCEOPATHIC THERAPEUTICS. 53 ANGUSTURA. Prolapsus after rising in the morning, with quickly following stitches, relieved by cold washing. APIS. Prolapsus with pain in the right hypogastric or ovarian region. Hypertrophy of the uterus. Bearing down pain, with tenderness over the ovarian region. Affections of the ovaries, with stinging pain, worse from coition. Menses too profuse ; scanty; intervals of one day; irregular; bloody mucous; dark red. Menorrhagia or dysnienorrhoea from congestion of the ovaries. Amenorrhea with pain in the right hypo- gastric region. Pain in the right ovary, before and during menses. Leucorrhcea, acrid, profuse, green or yellowish. Urine t-canty and dark, often burning or smarting; exceptionally too profuse. (Edema of dif- ferent parts of the body. Swelling under the eyes. Drops}'. Thirstlessness with most every affection. Waxy paleness of the skin. ARGENTUM METALLICUM. Prolapsus with pain in the left ovary and small of back, extending to the front and downwards. Ulcers (scirrhus) of the uterus discharging purulent, ichor- ous, sometimes bloody water, with unbearable stench. Cervix spongy. Painful soreness in the whole abdo- men, worse when riding in a carriage. 54 UTERINE DISPLACEMENTS. ARGENTUM NITRICUM. Prolapsus with shooting pains through the abdomen and stomach. Pains like sticks or slivers in or about the uterus, excited whilst walking, riding, or at stool. Bleeding ulcers of the uterus, the haemorrhage being of short duration. Menses too profuse, too early and too long; scanty or irregular and clotted; too profuse with cutting in the small of back and groins. Leucor- rhcea bloody; corroding; yellow; profuse; mucous. Metrorrhagia at climaxis, or in young widows, or in those who have borne no children. She is always hurried. Moral and nervous disturbances appear in regular paroxysms. Vertigo in the morning with headache. Distention of abdomen and stomach. Back- ache, especially at night, with great weakness of the legs. Discharge of urine in drops. Great debility. For scrawny, feeble, dried up looking women. ARNICA. Prolapsus caused by concussion, leaving a sore, bruised feeling in the uterine region, which prevents her from walking erect. Prolapsus with ulcers with tendency to bleed. Menses too profuse and too often; blood bright red, mixed with clots. Bloody discharge between the menstrual periods. Metrorrhagia after coition. Excessive sensitiveness of mind. Very nerv- ous, cannot stand pain. Head hot, body cool. Putrid eructations. Nausea in the epigastrium. Urine with HOMCEOPATHIC THERAPEUTICS. 55 brick dust sediment. Tendency to small boils. For nervous and sanguine, plethoric women, with red face, lively expression, disposed to cerebral congestion. ASTERIAS RUBENS. Displacements with sensation of pressure in the hypogastrium, impeding locomotion. AURUM. Prolapsus from straining or lifting; worse during menses. Prolapsus of the uterus and vagina. Prolap- sus with induration and bruised, shooting or drawing pains. Chronic inflammation. (Aurum mur. Aurum mtir. natr.) Heat in the vagina. Menses delayed, especially the first; or too late and too scanty. Amenorrhoea with great melancholy. Leucorrhcea thick and white; or profuse, corroding, yellow. Her mind constantly turns toward suicide. Hysteria. Quarrelsome. Fine pimples on the face. Retention of urine and difficult stool, (Tarantula) worse during menses. Urination frequent with painful retention. Urine like buttermilk. Severe backache, worse dur- ing menses. Drawing pain at the pubes. Cold hands and feet. 5<) UTERINE DISPLACEMENTS. BELLADONNA. Prolapsus after parturition especially. Prolapsus at climaxis; parts congested, burning, stinging, ten- sion, bearing down; in the loins and sacrum drawing, cutting, pressing, cramp like pains; with nervous irritable women. Prolapsus with induration. Bear- ing down pains, as if everything would issue from the vulva, relieved by standing, especially felt in the morning. Spasmodic contraction of the uterus and terrible bearing down pain, worse in the morning. Transient stitches in the uterine region. Genital organs sensitive, can bear neither touch nor the least jar. Heat and dryness of the vagina. Affections of the right ovary. Drawing pains in the pelvic region. Menses too early and too profuse; blood bright red; retarded and too pale. Blood black; clotted; hot; offensive. Bloody discharges between the menstrual periods. Amenorrhoea with congestion to the head. Dysmenorrhcea, with rush of blood to the head, espec- ially in women of full habit, with pain in limbs and back. Leucorrhcea of white mucus; with or without colic. Hysterical headache. Takes cold easily, espec- ially when uncovering the head. Backache as if the back would break. Most of the pains come and go quickly. BENZOIC ACIDUM. Prolapsus with fetid urine. HOMOEOPATHIC THERAPEUTICS. 57 BROMIUM. Prolapsus, the uterus descends about two inches; membranous dysnienorrhoea. Wind from the vagina. Pain in left ovary CALCAREA CARBONTCUM. Prolapsus with sensation of pressure on the uterus. Bearing down, as if prolapsus would occur, and the internal organs would pass out, hence the difficulty in standing. Stinging in the os. Constant aching in the vagina. Burning in the cervical canal. Ulcers. Poly- pus. Accumulation of mucus between the labia and thighs; menses too early, too profuse, and too long; the least excitement causes a return; cold, damp feet; rush of blood to the head; swelling and pain of breasts before menses; too late, retarded. Membranous dys- menorrhea. Suppression of menses in women of full habit. Leucorrhcea like milk with itching and burn- ing; before menses; during micturition; profuse at times; worse after exercise; with great debility. Desponding mood. Faultfinding. Ill-humor. Hysteria. Stupefying, throbbing headache. Supra-orbital neu- ralgia. Headache with empty eructations. Icy cold- ness in and about the head. Head and upper part of the body sweats profusely at night. Vertigo on going up stairs. Trembling pulsation of the heart. Sour vomiting. Painful micturition. Backache. Heavi- ness of the limbs and great fatigue from walking. 58 UTERINE DISPLACEMENTS. Cold feet as if she had on damp stockings; shortness of breath. Bloated abdomen with emaciation and good appetite. Anasarca from working in the water. Great sensitiveness to cold air. Climaxis. Leuco- phlegmatic temperament. Old maids, or women who have had no children. CALCAREA PHOSPHORICUM. Prolapsus as well as other displacements worse dur- ing stool, micturition or menses. Displacements with rheumatic pains; worse in damp weather, or in changes from warm to cold. Prolapsus with aching in the uterus. Pain and pressure in the genitals. Throbbing, stinging, tickling, sore aching with draw- ing upwards in the symphysis and downward in the thighs. Menses too profuse. Menses every two weeks; black, clotted; too late; blood dark, or first brio-ht, then dark. Leucorrhcea after menses, like the white of an egg; it increases in the ratio that the menses decrease. Mental anxiety. Fault finding. Acne with red pimples full of pus. Dirty complexion. Weak sinking feeling in the abdomen. (Phosphoricum.) Flatulency. Burning in the epigastrium. Fistula in ano. Haemorrhoids oozing a watery fluid all the time. Every cold causes rheumatic pains. Young ladies who have been crossed in love. HOM02OPATHIC THERAPEUTICS. 59 CANTHARIDES. Prolapsus with swelling of the cervix; Itching in the vagina. Burning in vulva and pudendum. Inflam- mation of ovaries. Menses too early and too profuse; blood black; bloody mucus; retarded. Membranous dysnienorrhoea. Burning in the sides of the head, ascending from the neck, with soreness and giddiness; worse in the morning and afternoon; better when walking or lying down. Loss of appetite. Aversion to food. Thirst, with aversion to all fluids. Burning in the breast and in the stomach. Urinary difficulties; constant desire to urinate, passing only a few drops at a time; burning after micturition. CARBO ANIMALIS. Prolapsus with induration. Ulcers, scrofulous or malignant, witn foul discharge. Tearing transversely across the pubis, and then through the pudendum as far as the anus. Stitches in the groins; menses too early with terrible exhaustion, can hardly speak; too profuse, too early and too long; blood black; with lameness in the thighs, pressing pain in back and groins; chilliness; yawning. Leucorrhcea acrid, offen- sive, staining the linen yellow; watery; worse on walking or standing, with weak feeling in the stomach. Alternate cheerfulness and despondency. Excessively merry. Heaviness in the cerebellum. Pain in vertex 60 UTERINE DISPLACEMENTS. as if the skull were open. Copper colored complexion, many pimples on the face. Bitter taste, especially in the morning. Eructations tasting of food. Distress after a meal. Pain in the stomach. Delicate women with glandular affection. CAULOPHYLLUM. Anteversion with flexion and uterine contraction. Coitus painful; pains continue a long time after the attempt. CHAMOMILLA. Prolapsus with menses too early and too profuse; blood dark, clotted, sometimes offensive; suppressed from anger or checked perspiration. Profuse dis- charge of clotted blood, with severe labor like pain, and tearing in the legs. Discharge of blood between the menstrual periods. Griping and pinching in uterus followed by discharge of large clots. Mem- branous dysmenorrhea. Leucorrhcea, yellow, smart- ing, sometimes corroding. Acrid water from the vagina after a meal. Burning in the vagina as if excoriated. All ailments accompanied with an altered change of mind and disposition; when amiable in health, she is now uncivil, snappish, short spoken, irritable, and during the aggravation of pains, she almost becomes furious and wild. Semi-lateral, tear- HOMOEOPATHIC THERAPEUTICS. 61 ing headache; usually with one red cheek. Headache felt even during sleep. Twitching of the eyelids. Toothache, worse after warm drinks. Drawing from the small of the back forward. Crampy feeling in the calves at night. Frequent desire to urinate; passing large quantities of pale water. Pains are worse at night, and in the open air; better after sweating, on rising, and when walking. CHINA. Prolapsus, likely caused by sexual excess, loss of blood or other fluids. Prolapsus with painful indura- tion of the vagina. Ovarian affections. Menses too profuse and too early; black clots with spasms in chest and abdomen; or watery, pale, with clots. Menses too profuse, with sensation of great distention of the abdomen; after menses great weakness, trembling debility, with ringing in the ears and fainting; with spasmodic uterine contractions. Bloody menses with discharge of black coagula or purulent matter, Avith itching or contractions of the inner parts. Discharge of bloody serum alternating with pus. Leucorrhcea before menses, instead of menses with itching. Full of plans, especially nights. Sadness. Indifference and apathy. Slow train of ideas. Excessive anguish. Con- gestive headache. Heaviness in the head. Headache as if the head would burst. Periodical neuralgia; worse from touching the parts. Humming in the ears. 62 UTERINE DISPLACEMENTS. Complexion pale, gray or yellow. Bitter taste of everything she takes; or at the back part of the tongue. Eructations, especially after a meal; she feels full and tight. Flatulency. Diarrhoea. Scanty urine with brick dust sediment. Backache worse from the least motion. Cough with granular expectoration during the day or evening; not at night or in the morning. Night sweat morning and night. Sweat after the least exertion. Marked periodicity of symp- toms. CIMICIFUGA. Prolapsus from deficient innervations and muscular atony with pain in the hypogastric region. Retrover- sion. Prolapsus with pain in uterus. Great tender- ness of the uterus to pressure. Spasms of the broad ligaments. Sharp pains across the hypogastrium. Pain in loins and groins, worse from standing, with fullness and heaviness in the uterine region. Pain in the pelvis and lower part of abdomen, worse from motion. Bearing down pain in abdomen and small of back. Menses too early and too profuse; dark, coag- ulated; scanty; severe pain in abdomen, has to double up; retarded or suppressed from different causes. Rheumatic dysmenorrhoea. Leucorrhcea with sensa- tion of weight in uterus; without ulceration; in hysterical or rheumatic women. Great melancholy with sleeplessness. Frontal headache. Pain in and HOMCEOPATHIC THERAPEUTICS. 63 over the eyes, extending to the occiput. Pain in the eyeballs; violent aching in the small of back. Lum- bago. Spinal myalgia. Limbs feel heavy and torpid. Faintings. COLLINSONIA. Prolapsus with dysmenorrhcea. Amenorrhoea from congestion of uterus. Leucorrhcea. Pruritus. Haemor- rhoids. Chronic constipation. Chronic diarrhoea after parturition. CONIUM. Prolapsus with induration. Ulceration. Stinging in the cervix. Contractive, labor like pains, from both sides of the abdomen. Bearing clown pains as if pro- lapsus would occur, worse when standing or walking; before or during menses. Aching, burning soreness in hypogastrium. Induration of the mammae or other glauds. Sterility. Menses too early and too scanty; or too late and too scanty; with discharge of brownish colored blood; too profuse. Congestive dysmenor- rhcea, with shooting pain in left chest. Before men- ses. Breasts swollen hard, painful; bearing down with drawing in the legs. Amenorrhoea with hyster- ical symptoms; low spirited; flabby breasts and great exhaustion after the least exercise; crampy pains in the bowels. Leucorrhcea profuse; acrid and corrod- ing; thick, milk like, with labor like colic; preceded 64 UTERINE DISPLACEMENTS. by colic and lameness in back, and followed by debil- ity, hoarseness and cough with expectoration ; bloody mucous. Great depression of spirits. Hysteria from suppression or too great indulgence of the sexual instinct. Inclination to start. AVant of memory. Excitable. Darting pain through the forehead, from within outward. Vertigo when lying down, and espec- ially when turning over. Sick feeling in the morning. Cough, worse when lying down, or at night; espec- ially during pregnancy. Stitching in the small of the back, -with drawing pains in the lumbar vertebrae, especially when standing. Stiffness of the legs. Numb- ness and coldness of the feet. Chilliness in the morn- ing. Sensation of great debility in the morning when in bed. Sudden loss of strength while walking. DIRCA PALUSTRIS. Prolapsus with sensation as if the uterus were too low, and would come out at stool. ERIGERON. Prolapsus with metrorrhagia. HOMOEOPATHIC THERAPEUTICS. 65 FERRUM. Prolapsus with shooting pains in uterus. Painful coitus. Prolapsus of vagina. Pain in the right hypo- chondriac region. Menses too late, too profuse and too long. Watery or lumpy, preceded by labor like pains. Menses intermittent; ceased two or three days, and then returns; too profuse, like flooding, in deli- cate and weakly women, with red face. Before men- ses ; stinging headache; ringing in the ears; discharge of long pieces of mucus from the uterus. Amenorrhoea with chlorosis; congestive headache; fiery, red face; feels weary and tired all the time, with desire to lie down. Leucorrhcea, bland, milky; or with itching and soreness; acrid and corroding in the beginning; with pain in the os uteri when lying down, and dry- ness of the vagina. Hysterical symptoms after menses. Anasarca; bellows around the heart. Women whose faces become bright red easily, during pain or emotional excitement, when otherwise pale. FERRUM JODATUM. Retroversion withm pressure upon the rectum, that she can neither stand nor walk. Congestion of uterus; burning on pressure and weight over sacrum, drag- ging pains in loins, or pelvis and thighs (especially in anaemic girls) with imperfect circulation; cold hands and feet; nausea in the morning, brownish tongue on first rising, with sordes on teeth, bloated feeling and rumbling in abdomen. 66 UTERINE DISPLACEMENTS. GELSEMIUM. Anteflexion; the uterus feels as if squeezed by a hand. Cutting uterine pains running from the front backward and upward. GRAPHITES. Anteversion; the finger reaches the os with diffi- culty; vagina cold; pains worse while standing. HELONIAS. Prolapsus at climaxis, with great debility, and extreme mental depression. Prolapsus from atony, in women enervated by indolence and luxury. Prolap- sus with the os protruding even externally. Antever- sion, the finger passes with difficulty between the os and rectum. Ulceration of cervix or os; discharge constant, dark, offensive. Consciousness of a womb. Vaginal irritation. Ovarian pains. Soreness and heaviness in the hypogastrium. Uterine haemorrhage, often even from the least exertion, or lifting a weight. Menses too profuse and too often; in women already feeble from loss of blood; blood coagulated and offen- sive; scanty, with weakness, drowsiness and albumin- ous urine. Amenorrhoea. Leucorrhcea, profuse; with serum; with haemorrhage; with atony and anaemia; with stitching, swelling and inflammation of vulva; HOMOEOPATHIC THERAPEUTICS. 67 pruritus. Face sallow, having an expression of suffer- ing. Digestive disorders. Backache. Dragging and weakness in sacrum. HYDRASTIS. Prolapsus with ulceration of cervix, os and vagina. Leucorrhcea profuse, ropy, thick. Pruritus. Sympath- etic affection of the digestive organs. IGNATIA. Prolapsus with menses too early and too profuse; blood black, clotted, putrid; scanty, delayed. Amen- orrhoea. Crampy pains in uterus, with lancinations, worse from touching the parts. Labor like pains, fol- lowed by purulent, corroding leucorrhcea. Leucor- rhcea with excited sexual desire. Sighing. Brooding t© herself. Seeks to be alone. Full of grief. The slightest contradiction irritates her. Lovely disposi- tion. Headache as if a nail were driven from within out, through the sides of the head. Nervous headache. Aching in forehead and the root of the nose. Throb- bing headache. Empty feeling at the pit of stomach. Want of appetite. Aversion to milk, meat or warm food. Canine hunger. Throbbing in the abdomen. Prolapsus ani from even moderate pressure to stool. Painful contraction of the anus after stool. Haemor- rhoids prolapse with every stool, and are very painful. 68 UTERINE DISPLACEMENTS. Stitches from the anus up to the rectum. Frequent discharge of watery urine. Chlorosis with swelling of feet. Cold hands and feet. Numbness of feet and legs. Convulsive yawning. Hysterical convulsions. Most all her symptoms worse in the morning; from coffee; tobacco; noise; reading; sunlight; better when changing position, or lying on the painful side. Sanguine nervous temperament. IPECACUANHA. Prolapsus with uterine pains running downward. Menses too early and too profuse; blood bright red. Menses returns every two weeks. Great weakness after menses. Menorrhagia with constant nausea and vomiting. Peevish humor. Aching in the head. Lan- cinating in the forehead. Paleface. Blue rings around the eyes. Vomiting of ingesta. Distress in the umbul- ical region. KALI BICHROMATICUM. Prolapsus seemingly from hot weather. Menses too early, with vertigo, headache, nausea and feverishness. Membranous dysmenorrhcea. Leucorrhcea, yellow, ropy, can be drawn out in strings, stiffening the linen; with pain across the small of back, and dull heavy pain in epigastrium. Swelling ©f the labia. Soreness and rawness in vagina. Accumulation of HOMCEOPATHIC THERAPEUTICS. 69 t mucus about the genitals. Ill-humor. Low-spirited. Indifference. Aversion to all kinds of labor. Morning headache, usually with pain over one eye. Sudden attacks of vertigo. Shooting pains through the abdo- men. Stitches extending from the abdomen to the spine. Constipation. Obstinate suppression of urine. Red urine. Unrefreshing sleep ; awakes with a start at 2 a. m., with nausea and headache. Pain in the coccyx. For fat and light haired women in particular. KALI CARBONICUM. Prolapsus with menses too late and too scanty, and of a pungent odor; acrid, corroding the thighs; too early, too profuse and too long. Before menses; sexual desire, with the sensation of a thrill as during an embrace, especially on waking in the morning; sour eructations; shooting or crampy pains in abdo- men ; swelling of cheeks and gums. During menses; pain in the head, ears, teeth, back; coryza; heavy aching in the small of back and down the buttocks; griping colic with pressure in abdomen and groins; backache when walking; pain in the back as from a heavy weight; nettle rash; pudendum sore, burns and itches. After menses soreness in vagina during coi- tion ; pimples at the vulva. Amenorrhoea with anasarca or ascites; heart disease; tendency to con- sumption. Leucorrhcea acrid; corroding. Leucor- rhcea yellow, with backache; labor pains; itching in 70 UTERINE DISPLACEMENTS. pudendum; itching pain in and about the uterus; aversion to an embrace or the opposite; shooting pain all over the abdomen. Anguish and sadness. Vexed and irritable. Tendency to stool, especially when touched. Drowsiness in day time. Nightmare. Wakes at 3 a. m. Dullness in head. Headache when walking or riding. Pressure over the eyes. Burning in the eyes. Painful bloatedness of both groins. Cold hands and feet. Bloated face in the morning, especially be- tween the eyebrows and upper lip. Dryness and itch- ing of the skin. Aggravation at 3 a. m., after coition and menstruation. KREASOTUM. Prolapsus especially after menses. Prolapsus with induration. Ulceration. Uterus tender to touch. Menses too profuse, too early and too long; intermit- tent ; in the third month of pregnancy; succeeded by an aciid smelling, bloody ichor, with itching; pain during the flow, but much aggravated after it; of dark colored coagulated blood; or watery blood with colic. Metrorrhagia. Leucorrhcea corroding and putrid; staining linen yellow and stiffening it; bland or acrid, causing itching; milky after coccydynia; be- tween the menses, with great weakness, especially in the legs; intermittent, worse when standing or walk- ing; profuse, smelling like green com, with backache and flushes of heat in the face; of blood and mucus wThen rising in the morning. Stitches in vagina from HOMCEOPATIIIC THERAPEUTICS. 71 above downward like electric shocks; (Scirrhus). Swelling, heat and hardness of the labia. Painful coitus. Bearing down and weight in the pelvis. Burn- ing in the pelvis as if from live coals, with constant whining and moaning. All uterine complaints worse after menses. Ill-humor and low spirited, worse from music, causing her to weep. Weakness of memory. Lacerating headache. Humming and buzzing in the head, with even hardness of hearing. Livid complex- ion. Chilliness. Frequent desire to urinate. Herpes. Climaxis. LACHESIS. Prolapsus with climaxis; with flashes of heat, hot vertex. Congestion. Ulceration, syphilitic or other- wise, or with condylomata. Uterine region extremely tender to touch; can't bear her clothes resting upon it; she pulls her dress constantly away. Bearing down pains. Labor like pains, as if everything would issue from the vulva, followed b}^ a slight discharge of blood. Uterine region feels as if swollen. Chronic pains in the right groin or uterine region while stand. ing, extending to the genitals, or to the liver, umbili- cus, stomach and chest. Swelling and induration of the right ovarian region, worse from motion or emotion. Menses regular, but too scanty and too short; lumpy black or acrid blood; delayed or inter- mittent; reappeared during climaxis. Menstrual colic beginnino- in the left ovary. Menstrual pains cease as 72 UTERINE DISPLACEMENTS. soon as the flow begins. Amenorrhoea with pain in the stomach, chest and eructations at every menstrual time. Leucorrhcea profuse, smarting, staining the linen green and stiffening it; with redness and swell- ing of the external parts. Lowspirited. Feels unhappy on awaking in the morning. Weeping. Jealous. Proud. Suspicious. Irritability and peevishness. Wants to be alone. Headache after a cold, preceding coryza. From the sun. Throbbing in the whole head, most violent above the eyes. Sensitiveness of the left side of the head. Morning headache relieved by lying down; worse from pressure. Vertigo with tendency to faint. Epistaxis. Yellow complexion with redness of cheeks. Constipation; stool resembles sheep's dung. Alternate constipation and diarrheal. Con- striction in rectum. Stitches in rectum when sneez- ing, laughing or coughing. Haemorrhoids protrude after stool. Urine profuse and foaming. Bruised pain in the hips. Pain in coccyx when sitting down, as if sitting on something sharp. Chilliness at night and flashes of heat in daytime. All symptoms are worse after sleep, especially from sleep after dinner; they also commence on the left side generally. Lachesis is above all, applicable after Belladonna or Sepia have proven insufficient. L1LIUM. Prolapsus and flexion. Prolapsus, anteversion or retroversion with constipation. Prolapsus with severe HOMOEOPATHIC THERAPEUTICS. 73 bearing down pain as if everything would issue from the vulva; she is obliged to support the vulva with her hands, or to sit or lie down. Bearing down pain with pain in the left ovary and left mammae. Bearing down pressure as if she would pass a stool. Neuralgic pains in uterus, cannot bear the touch, not even the weight of her clothes, or the slightest jar. Pain extending from the chest to the uterus. Aching over the pubes with pains in the knees. Sexual desire increased. Intermittent sharp pains across the lower bowels. Burning from groin to groin with morning stool. Bloated feeling in the abdomen and uterus. Pruritus. Menses scanty, flowing only as long as she is moving about; dark, thick, smelling like the lochia ; on second day after the time to menstruate, with cut- ting in the bowels, and clammy limbs. After menses profuse, bright, yellow leucorrhcea, excoriating the external parts, even the perineum. Amenorrhoea with ovarian pains. Leucorrhoea profuse and corrod- ing; staining the linen brown; with bearing down pain, worse in the afternoon till midnight; better till the next afternoon, when all the symptoms of the previous day return. Lowspirited. Weeping. Appre- hensive. She feels nervous and irritable, and yet she feels jolly. Always in a hurry, with inability to per- form anything. Urgent desire to stool. Frequent desire to micturate, with burning in urethra. Urine bright colored; scanty; hot; red sediment. Pain in sacrum. 74 UTERINE DISPLACEMENTS. LYCOPODIUM. Prolapsus with dropsy of the uterus. Uterine pains running upward. Wind discharged from the vagina. Warmth and dryness of the vagina. Burning in the vagina, during or after coition. Cutting across the hypogastrium, from right to left. Diseases of the ovaries, beginning with the right. Menses too pro- fuse and too long; blood partly black, clotted, and partly bright red or serum, with labor pains, followed by fainting; too late and too long. Menses too scanty; too early; reappearing every six or eight days. Increased discharge of blood from the genitals during every passage of a hard or soft stool; sup- pressed from fright. Amenorrhoea. Leucorrhcea in starts; milky, or blood red; worse before a full moon; corroding, with sensation of pressure through the vagina when stooping. Always wakes up very cross. Lowspirited. Weeping; doubts about her salvation. Desires to be alone. Headache over the eyes, espec- ially after breakfast. Stitches in the temples. Swell- ing and sensitiveness at pit of stomach. Gripino- in the epigastrium. Satiety; after even a morsel of food has been taken. Hunger at night when awaking. In- carcerated flatulency. Rumbling in the bowels; espec- ially in left hypochondrium. Constipation. Severe backache every time she desires to urinate. Red sand, or brick dust sediment in the urine. Palpitation of the heart. Swelling of the soles of the feet. Pain in the soles of the feet. Unrefreshing sleep. Shivcrino-. Great debility. Chlorosis. Aggravation of symptoms from 4 to 8 p. m. HOMOEOPATHIC THERAPEUTICS. 75 MAGNESIA MURIATICUM. Displacements with great weakness of the limbs, especially the legs. Bearing down in the ovarian region. Uterine spasms extending to the thighs. Induration of the os. Menses too profuse, and too early or too late, with great pain in back when walk- ing, and in the thighs when sitting. Leucorrhcea after stool, or after uterine pains, followed by metrorrhagia. Hysteria. MERCUR1US. Prolapsus of the uterus and vagina, (Merc, sol.) feels better after coition. Prolapsus with induration. Ulcers at the os or cervix, deep, with ragged edges; superficial; syphilitic: with or without condylomata. Itching of the genitals, worse from contact of uriue, and relieved by cold washing. Deep, sore pain in pel- vis, dragging in the loins. Abdomen weak, as if it had to be held up, or it would drop down by walking. Pain and pulling downward above the genitals, with pulling pains in both thighs, as if the muscles and tendons were too short. Sterility or easy conception. Menses too profuse, with anxiety and colic. Scorbutic affections appear, or become aggravated during men- ses. Discharge of blood between the menstrual periods. Amenorrhoea with congestion to the head, and general vascular excitement at every menstrual • period. Leucorrhcea corroding, causing itching; or 76 UTERI.VE DISPLACEMENTS. purulent, containing lumps, and worse at night; bland; greenish; with sweetish odor; with pimples on the labia; with a sensation of coldness. Constant anxiety and apprehensiveness. Indifference. Peevish- ness. Suspicious. Congestion to the head, with feel- ing as if the head would fly to pieces. Headache at night. Pain in the breasts. Frequent desire to urin- ate; urine red or brown. Cold, clammy sweat on the legs every night. Swelling of hands and feet. All symptoms worse at night from the heat of the bed. MUREX PURPUREA. Prolapsus with uterine pains extending upwards from right side of uterus, crossing the body, to the left mammae. (Lilium from chest to uterus.) Pain in uterus as if cut by a sharp instrument. Bloody leu- corrhoea during stool. Leucorrhcea watery; green; thick; profuse before menses. Uterus feels dry, and as if constricted. Increased sexual excitement. Gone sensation at the stomach, worse about 11 a. m.,relieved by eating and lying down. NATRUM CARBONICUM. Prolapsus with bearing down pain in hypogastrium, as if everything would issue from the vulva. Indura- tion of the cervix, and ill-shaped os. Menses too early HOMOEOPATHIC THERAPEUTICS. 77 and too long; preceded by drawing in nape of neck and headache. During menses, tearing headache, dis- tended abdomen in the morning,relieved by diarrhoea; nervous, cannot bear music; worse in a thunder storm. Leucorrhcea thick, yellow, putrid, ceasing after urin- ating. NATRUM CHLORICUAI. Prolapsus with interscapular and vertebral neural- gia. Leucorrhcea. Great debility. NATRUM MURIATICUM. Prolapsus with swelling and hardness of the cervix. Ulceration. Bearing and pressing down pains as if prolapsus would occur, every morning, has to sit down to prevent it. Bearing down pains, as if every- thing would issue from the vulva, no matter if she is standing, sitting or lying. Sterility with too early and too profuse menses. Itching pimples on the pudenda, with falling off of the hair. Aching in the lumbar region, relieved when lying on the back. Cut- ting in the urethra after micturition. Uterine cramps with burning and cutting in the groins. Dryness of vagina and painful coition. Menses too profuse and too early. Menses too scanty, too late and too short. Before menses; great anxiety and sadness; qualmish- ness with sweetish taste rising into the mouth, in the 78 UTERINE DISPLACEMENTS. morning especially; expectoration of bloody saliva; headache; heavy eyes; palpitation. During menses; extreme sadness; violent headache on awaking in the morning; colic. After menses; headache; leucor- rhcea; itching of vulva. Amenorrhoea with excessive redness at each menstrual period. Leucorrhcea pro- fuse, white, transparent; acrid, greenish; when awak- ing in the morning after colic; transparent; causes itching; with yellow complexion; lasting only a few hours; with headache; colic and mucus diarrhoea; with severe bearing down pains. Irritable and cross after coition. Awakens every morning with violent headache. Great appetite; longing for salt, or for bitter food or drink. Constipation. Fissure of the anus with flow of blood. Involuntary urination when coughing or laughing. Weak voice and exhaustion from talking. Palpitation when lying on the left side. Pulsation in the small of the back. Pain in the small of the back when rising. Backache relieved by lying on something hard. Languor and heaviness of the arms. Burning of the feet when walking. Cold feet. Sleepi- ness in day time, and sleeplessness at night. Sleep dis- turbed. Dreams of robbers. Chlorosis. Debility, worse mornings in bed. Especially applicable to those cases that have been subject to topical application of Nitrate of Silver, when high attenuations will be found pre- ferable. HOMOEOPATHIC THERAPEUTICS. 79 NITRIC ACIDUM. Prolapsus with bearing down pain as if prolapsus would occur; with backache, and pain through the hips and thighs. Ulcers on the os like aphthae. Syphi- litic mercurial ulcers. Excrescences on the cervix. Condylomata. Stitches in vagina when walking in open air. Itching of the vulva. Pruritus worse from taking cold. Falling oft' of the hair from the genitals. Uterine haemorrhage from over exertion. Menses too profuse and too early. Menses to scanty, too early, irregular, like muddy water; dark, thick blood, with eructations, and cramp like pains, as if the bowels would burst. Leucorrhcea greenish water or mucus; flesh colored; brown; acrid; ropy; fetid. Irritability. Great redness. Indifference. Tired of life. Joyless. Yellow face, especially around the eyes, with red cheeks. Pimples or black pores on the face and fore- head. Bitter taste. Longing for fat, herring, chalk, earth. Aversion to bread and meat. Constant nausea with heat in the throat. Food causes acidity. Pain in the region of the liver. Abdomen swollen, with pain down the thighs. Flatulency. Feels so weak that she looses breath and speech. Inclination to diarrhoea. Cutting pains in the anus after stool, lasting for hours. Fissures at the anus. Stitching and burning in rec- tum. Haemorrhoids. Urine with strong fetid odor. Hard knots in the mammae. Debility with heaviness and trembling of the limbs, especially mornings. Antidote to diseases of mercurial origin. Symptoms worse in the evening and at night; many are relieved from eructation und carriage riding. 80 UTERINE DISPLACEMENTS. NUX MOSCHATA. Displacements with too profuse menses especially anteversion. Labor like pains. Flatulent distention of the uterus. Enormous distention of bowels after each meal. Pain and pressure in back outward. Sen- sation of a lump in the left lower abdomen; antever- sion. Prolapsus of uterus and vagina, with dryness of mouth, tongue and throat, especially when sleeping. Sterility. Hysteria; globus hystericus. Pain and vomiting from pessaries. Menses too early; too late ; irregular, thick and dark; with bearing down; pull- ing and drawing in limbs; waterbrash; stitches in lower abdomen, worse while sitting; pain in the liver; pain in the back as if a piece of wood was lying cross- wise and being pressed out; tension in hypogastrium; great drowsiness; mouth dry; fainting; hysterical symptoms. Suppression of menses from exposure to wet, with pain in abdomen. Leucorrhcea instead of menses. Changable disposition. Absent mindedness. Great tendency to laugh, worse in the open air. Heav- iness in the head. Sudden heaviness from walkino- against the wind. Cough when getting warm in bed. Enlargement of liver and spleen. Fainting with pal- pitation, followed by sleep. Symptoms worse from cold, wet or windy weather; when riding in a car- riage ; better from warmth; warm weather. Adapted to women with dry skin, who do not perspire easily. HOMOEOPATHIC THERAPEUTICS. 81 NUX VOMICA. Prolapsus after miscarriage; after parturition; after straining or lifting, or from reaching high. Prolapsus of long standing, with dry cough and sense of con- striction around the hypochondria. Prolapsus with great urging to stool or to urinate. Ulceration of the os. Condylomata. Congestion and bearing down pain. Severe backache. Backache, cannot turn over in bed. Uterine pains running from the uterus to the neck of the bladder and abdomen. Pain bearing down early in the morning when in bed, or during a walk. Soreness across the pubes. Sensation of contraction in the bowels. Pain in the hypogastrium; (left.) Pains toward the sacrum, with ineffectual urging to stool. Periodical pains in the bowels, setting in after a meal. Crampy, stitching pain in pelvis. Uterine spasms, with colic and discharge of coagula. Swelling within the vagina. Burning, heaviness, stitching in uterus. Hardness and swelling of the os. Itching eruption on vulva. Varices on the labia. Micturition frequent, little at a time, with burning. Prolapsus of the uterus and vagina. Menses too profuse, too early and too long; too early, too scanty and too short; with colic; discharge of dark, thick,clotted blood; reappear after having seemed to cease; irregular. Menorrhagia at climaxis. Leucorrhcea fetid staining the linen yellow. Restlessness. Excitability. Cross. Headache in occi- put. Headache in forehead, as if the eyes were forced out. Headache in vertex as if a nail were driven into 82 UTERINE DISPLACEMENTS. it. Stitches and jerking through the body. Indiges- tion from high living. Constipation of large, difficult stools. Drawing in the thighs. Sleeplessness after 3 a. m., she feels unrefreshed in the morning. Debility, she wants to sit or lie down all the time. OPIUM. Prolapsus from fright. Softness of the uterus. Menses too profuse with violent colic, has to bend over, and urging to stool. Amenorrhoea from fright, with great drowsiness Chronic constipation with hard, black balls. Eclampsia. OVI TOSTA. Chronic prolapsus with profuse and long lasting haemorrhage. Profuse leucorrhcea of a white, yellow, green or sanies character. The characteristic symp- tom of broken-back is always prominent. Especially adapted to chronic cases, even where cancer is sus- pected. PALLADIUM. Prolapsus with right ovarian pains. Heaviness and pressure deep in the pelvis; relieved by lying on the left side. All motions are painful. Weeping mood. HOMOEOPATHIC THERAPEUTICS. 83 PETROLEUM. Prolapsus in patients reduced from chronic diar- rhoea, the latter occurring during the day only; great debility. Menses too profuse and too early; too late and too scanty; with intense itching. Before menses throbbing in the head. During menses, singing and roaring in the ears; heat in the palms of hands and soles of feet; tearing in the thighs; spots on the legs painful to touch; weakness. Leucorrhcea like albu- men ; profuse; every day; with lascivious dreams at night. Irritable disposition and inclination to scold. Lowspirited. Weeping. Pulsation in the cerebellum. Involuntary micturition. Haemorrhoids. Fetid sweat in the axillae. Soreness and moisture on the genitals. Herpes on perinaeum. PHOSPHORUS. Prolapsus with weak, sinking feeling in the abdo- men. Uterine pains running upward. Stitches from the vagina into the pelvis. Sterility from excessive voluptuouness, or with too profuse and too late men- ses. Leucorrhcea instead of menses; corroding, caus- ing blisters. Debility. Emaciation. Fainting. PICRIC ACIDUM. For the excessive tired feeling attending some case of prolapsus. 84 UTERINE DISPLACEMENTS. PLATINA. Prolapsus with induration. Ulceration. Bearing down, as if prolapsus would occur; especially during menses. Ovarian irritation, especially when with stitches in the forehead. Pain, sensitiveness and con- tinual pressure in the region of mons veneris and the genital organs. Pruritus with anxiety and palpita- tion. Vulva sensitive to coition. Increased sexual desire. Frequent sensation as if the menses would appear. Menses too early, too profuse, and too long or too short; blood dark, partly clotted, partly fluid; too profuse and too late; blood thick, like tar; with low spiritedness ; colic; twitching with screams; pull- ing in the groins; headache; desire for stool. Amen- orrhoea; sudden suppression of menses, with extreme anguish, and fear of dying. Leucorrhcea like the white of an egg, only in day time; after urination or after rising from a seat, with pressing down in the groins, or in the pudendum. Excessive pride and haughty disposition. Fear of death with trembling of the limbs. Low spirited. Absent minded. Hysteria. Headache as if a tape were drawn around the head. Terrible pressing headache. Twitching of the eyelids. Burning heat in the face with great thirst, especially towards evening. Sensation of coldness and creeping of the whole right side of the face. Pale face. Want of appetite. Constipation while traveling. Red urine with white clouds. Weakness of the nape of neck. Backache. Most ailments worse during rest, better during motion. HOMOEOPATHIC THERAPEUTICS. 85 PODOPHYLLUM. Prolapsus of uterus, or of uterus and vagina from over lifting or straining. Prolapsus of uterus and rec- tum, with exhausting but natural morning stool. Pro- lapsus after parturition, especially with great pain in sacrum. Prolapsus with induration. Ulcers. Hyper- trophy. Pain in left ovarian region. Lumbar backacha after working. Bearing down sensation as if the geni- tals would protrude during stool. Menorrhagia from straining. Amenorrhoea in young women, with bear- ing down in the hypogastric and sacral regions, with pain from motion, better when lying down. Leucor- rhcea of thick, transparent mucus. Flatulency infre- quent. Rumbling and pain in the transverse colon. Pain and soreness in the liver, relieved by rubbing the parts. Constipation. Muco-gelatinous stools. PULSATILLA. Prolapsus with pressure in abdomen and back as from a stone. Worse on lying down and from heat, better in the fresh air. Crampy constriction in vagina. Bearing down every morning. Pain in uterus from touch, and during coition. Menses too late, too scanty, too short; intermittent; blood thick, clotted, or thin, watery; or changable; worse during day while walk- ing; suppressed alter getting the feet wet; from chlorosis; from nervous debility with throbbing head- 86 UTERINE DISPLACEMENTS. ache; with pressure in stomach; pain in uterus; dysuria; pressure on the bladder, frequent and copious micturition, without strangury; ophthalmia; morn- ing nausea. Metrorrhagia changable; stops and flows at climaxis, or after the abuse of Quinine and Iron. Disposition mild, bashful, yielding. Inclination to weep. Low spirited, gloomy, silent. Great anguish. Fear of death. Confusion in head. Lacerating pain in one side of the head, ears and teeth. Headache as if from overloading the stomach, or eating fat food. Vertigo. Dimness of vision. Exceeding bad taste in mouth every morning, and dry tongue without thirst. Nothing tastes good. Indigestion. Ineffectual urging to stool. Limbs tired, go to sleep. Chilliness and pale- ness of face. All symptoms worse in the evening; while lying on the left or painful side; or in a warm room. For women good natured, phlegmatic, blond hair. RHUS TOXICODENDRON. Prolapsus after parturition; straining or lifting. Prolapsus in rheumatic persons, whose pains compel her to shift about in order to get relief; she feels worse in damp weather, or before a storm. Uterine complaints resulting from exposure to cold damp weather; from getting wet, particularly while pres- piring. Labor like pains and pressure in abdomen while standing. Soreness in vagina, hindering em- brace. Menses too profuse, too early, too long; acrid, HOMOEOPATHIC THERAPEUTICS. 87 causing biting in vulva; light colored; with coagula and labor pains. Amenorrhoea from getting wet; with milk in the breasts. Low spirited. Tired of life. Fear of death. Ill humor. Absent minded. Weeping, especially in the evening. Desire to be left alone. Bruised pain in small of back. Backache relieved by lying upon something hard. Fain in the ankles. Walking, first with difficulty, but as she proceeds, she walks better and better. Feels worse after a long walk. SECALE•CORXUTUM. Prolapsus after parturition. Prolapsus; the os almost protrudes; uterus hot and painful; dilatation of the os so as to admit the middle finger, with great desire to urinate; labor pains relieved by wet band- ages or pressure upon the abdomen; this lasted three days; she did not miscarry, though the os remained open during this period; afterwards the uterus grad- ually ascended, the pains diminished, and after five or six days the os contracted. Prolapsus with ulcera- tion; thin, bloody discharge; gangrenous or painless; it feels as though it had been burned; indolent ulcers, discolored and rapidly spreading. Bearing down pain. Menses too profuse and too long, with tearing, cutting colic; cold extremities; cold sweat; great weakness and small pulse; with violent spasms; blood thin and black; or black and clotted; or brown, fetid fluid. Atonic haemorrhages during climaxis. For thin and scrawny women. 88 UERINE DISPLACEMENTS. SEPIA. Prolapsus of the uterus and vagina from relaxation of uterine and vaginal supports, relieved by lying down, worse from standing, sitting or any exercises, with bearing down pains, goneness at pit of stomach, pain and burning in small of back. Prolapsus with congestion. Flexion. Procidentia. Ulceration. Super- ficial ulcers on the os. Chronic metritis. Cervicitis. Induration. Pain in hypogastrium. Stitches mostly in the neck of the uterus, extending to the umbilicus and pit of stomach. Tenderness of the genital organs. Coition painful. Bearing clown pain as if prolapsus would occur, she must lie down and cross her limbs to prevent it. Uterine pains running from the groins outward and backward. Uterine pains running up- ward to the umbulicus, loins, stomach and chest. Violent stitches in vagina upward. Swelling and eruption of vulva. Great irritability of the bladder; leucorrhcea, hot flashes of heat. Sediment of urine adhering to the vessel, and difficult to remove. Emptiness at pit of stomach, especially about noon, relieved by eating or lying down. Menses too early and too profuse; too late and too scanty. Amenor- rhoea. Metrorrhagia at climaxis or during pregnancy. Leucorrhcea of yellow or greenish water; like pus; bad odor and much itching in vulva. Retroversion with pressure upon the rectum as if from a lump or ball, not relieved by stool. Oppression of breathing. Yellow saddle across the bridge of the nose. Chilli- HOMOEOPATHIC THERAPEUTICS. *9 ness; aversion to open air. For women with dark hair; especially during pregnancy, child bed or while nursing. SILICEA. Prolapsus with myelitis or spinal irritation. Ulcers at the os or cervix, with sensation of coldness in them. Increased sexual desire with spinal affections. Very little sexual desire. Nausea during or after coition. Bearing down pressing in the vagina, parts tender to touch. Serous cysts in the vagina. Itching in puden- dum. Menses too early and too scanty; too profuse and too late; irregular, every two or three months; acrid, fetid; between the regular periods. Metror- rhagia or amenorrhcea from suppressed foot sweat. Leucorrhcea, profuse, corroding; milky, preceded by cutting around the navel. Constipation. Offensive foot sweat. Icy cold body. Painful haemorrhoids. Hysteria. Debility. STANNUM. Prolapsus of uterus with bearing down pain. Pro- lapsus of vagina, worse during stool; feels so weak, she must drop clown suddenly, but can get up readily. Menses too early and too profuse, preceded by melan- choly and pains in the malar bone, which continue during menses. Leucorrhcea with debility; yellow, 90 UTERINE DISPLACEMENTS. white, transparent mucus. Neuralgic pains; pain begins lightly and increases gradually to its highest point, from which it gradually declines. Great weak- ness in larynx and chest; they give out when talking, singing or reading; all of which will cause great exhaustion, and she has to avoid them. STRAMONIUM. Prolapsus with pain in the left hypogastric region Menses too profuse. Whining and sobbing after menses. SULPHUR. Prolapsus from reaching high. Prolapsus worse from standing. Prolapsus with pain in the hypogas- trium; (right.) Bearing down in pelvis, towards the genitals. Menses too late and too short; suppressed; blood thick, dark, corroding the thighs, sour smelling. Before menses headache; cough in the evening; epis- taxis. During menses epistaxis, rush of blood to the head, weak faint spells. Leucorrhcea of yellow mucus; corroding, preceded by pain in the abdomen. Weak feeling in the hypogastrium and genital organs. Burn- ing in the vagina, she is scarcely able to keep still, especially so when sitting. Sore feeling in vagina, during coition. Itching of vulva, with pimples all around, and burning in the vagina. Uterine pains HOMOEOPATHIC THERAPEUTICS. 91 running from the groins to the back. Sterility with too early and too profuse menses. Weak, famt and hungry from 11 to 12 a. m., must have something to eat. Heat at the vertex. Terrible sick headache weakens her very much. Rush of blood to the head. Epistaxis. Heavy, deep sleep, which exhausts her. Light sleep awakens frequently, which in turn weakens her. Walks stooped from debility. Burning in the soles of the feet. Symptoms worse at night, during rest, and when standing a while; the heat of the bed especially aggravates nocturnal pains. For scrofulous persons; and those who are lean, and walk stooping. TARANTULA. Prolapsus; anteversion; or retroversion, with re- tention of urine and difficult stool. Mterine neural- gia with great redness and despair. Pruritus. Metror- rhagia. Great weight and burning in hypogastrium, with upward pressure. Continual leucorrhcea. THUYA. Prolapsus with ovarian affections; (left.) Ulcers on the os, flat, like aphthae. Excrescences of the uterus, bleeding easily, and very offensive. Violent pain in the left iliac region, when walking or riding; she must lie down, to get relief; the same occurs during menses, and extends into the left groin. Sensitiveness of the 92 UTERINE DISPLACEMENTS. vagina, preventing coition. Pain and cramps in vulva and perinaeum, when rising from a seat. Moist con- dylomata. Inflammation of left ovary, worse during menses. Menses too early and too profuse, preceded by profuse sweat. Leucorrhcea, mucous. Excrescences around the meatus urinarius, with constant desire to urinate. Foaming urine. Disinclined to talk, espec- ially in the morning. Wants to be alone. Hurried with ill-humor. Talks hastily. Irritable. Music causes weeping and trembling of feet. TRILLIUM. Prolapsus with chronic engorgement of the cervix. Prolapsus from over exertion, too long walking or riding. Menses too profuse, and worse from the least movement. USTILAGO. Prolapsus with menorrhagia. Cervix tumefied, bleeds when touched. Bearing down pain as if pro- lapsus would occur. Constant aching, referred to the mouth of the womb. Burning in the ovaries. Pain in the ovaries; worse in the left, shooting down the legs. Menses too scanty, with ovarian irritation; too profuse and too early; blood clotted. Membranous dysmenorrhcea. Metrorrhagia during climaxis; more or less constant oozing of dark blood, with small HOMOEOPATHIC THERAPEUTICS. 93 coagula. Between the menstrual periods, constant suffering under the left breast, at the margin of the ribs. Sinking, weak sensation at the stomach. VERATRUM ALBUM. Prolapsus of uterus with dysmenorrhcea; or pro- lapsed and strangulated vagina, with vomiting, diar- rhoea, exhaustion, and cold sweat. Menses too pro- fuse and too early; suppressed, with despair of salva- tion and blood spitting. Amenorrhoea with nervous headache, leaden face, nausea, vomiting and diarrhoea. Pains and tenderness of the hypogastrium. Great debility. ZINCUM. Prolapsus with violent intermittent pain with ulcers upon the os; bloody, acrid discharge; uterus and ulcers almost destitute of feeling. Increased sexual desire, especially at night, tempting to mastur- bation. Burning pain in the left ovary, partially relieved by pressure, but subsiding entirely during menses. Pruritus. Varices on the genitals and legs; with fid- gety feet. Menses too profuse and too early; lumps of coagula passing away only when walking; flow most profuse at night. Dysmenorrhcea with heavy limbs; violent drawing, twisting around the knees; oppression of stomach, has to loosen her dress; chilli- 94 UTERLNE DISPLACEMENTS. ness. Amenorrhoea with red and pale face alternately. Leucorrhcea of bloody mucus, with itching of vulva, after menses; preceded by cutting colic; thick mucus, three days before and after menses. Low spirited at noon, and lively in the evening, or vice versa. Head- ache from drinking even small quantities of wine. Headache relieved during menses. Aversion to food. Pressing pain in the abdomen. She is never well, except during menses. REPERTORY OR CLINICAL INDEX. 95 REPERTORY OR CLINICAL INDEX. It may facilitate the selection of the remedy if the local con- dition and the three most prominent symptoms serve as guides. These may point to the remedy. The therapeutics should now be consulted, aDd if necessary, the materia medica appealed to for final decision. Some physicians instead of taking one or more characteristic symptoms as their guide, write down all the symptoms of the case and then divide them up to corres- pond with the heads in this repertory. In that way the selec- tion is very easy. The therapeutics and materia medica may be appealed to before a final decision is reached. Which ever method is resorted to the case should be frequently reviewed. UTERINE DISPLACEMENTS. Anteversion. Calc. phos., Cauloph., Graph., Helon., Lilium, Nux m., Sepia, Tarantula. Retroversion. iEscul. hipp., Calc. phos., Cimicifuga, Ferr. jod., Lilium, Sepia, Tarantula. Flexion. Cauloph., Helon., Lilium, Sepia. Anteflexion. Gels. Prolapsus more or less with all the remedies given in this treatise. Prolapsus after cessation of menses. Agaric, m., Kreasot. Prolapsus after parturition. Bell., Nux v., Podoph., Rhus tox. Prolapsus with prolapsus of vagina. Aurum, Ferr., Merc, Nux m., Nux v., Sepia, Stan. 96 UTERINE DISPLACEMENTS. Prolapsus with prolapsus recti. Podoph. Prolapsus from muscular atony. Alet. far., Cimicifuga, Helon. MIND AND DISPOSITION. Absent mindedness. Nux m., Plat., Rhus tox. Alternate cheerfulness and despondency. Carbo. an., Nux m. Altered state of mind, when amicable in health, she is now cross, snappish, uncivil, and during aggravation of pain, ehe becomes almost furious and wild. Cham. Anxiety and anguish. Aeon., Calc. phos., Chin,, Kali c, Merc, Puis. Apprehension. Lilium, Merc. Aversion to work. Agaric, in., Kali bich. Brooding over herself. Ignat. Desire to be alone. Ignat., Lach., Lye, Rhus tox. Disinclined to talk, especially in the morning. Thuya. Doubts about her salvation. Lye Excitable. Aeon., Conium, Nux v. Fault finding. Calc. c, Calc. phos. Fear of death. Aeon., Plat., Puis., Rhus tox. Full of plans, especially at night. Chin. Hurried in all her actions. Argt. nitr., Lilium. Hurried, hasty in her talking. Thuya. Hysteria. Calc. e, Cimicifuera, Ferr., (after menses,) Ignat., Magn. m.,*Nux m., Plat., Silic Hysteria from suppression of, or great indulgence in the sexual instinct. Conium. Ill-humor. Calc c, Kali bich., Kali c, Kreasot., Lach., Nux v., Petrol., Rhus tox. Ill-humor and cross always on awaking. Lye Indifference and apathy. Chin., Kali bich., Merc, Nitr. ac. Irritability. Nitr. ac, Petrol., Thuya. Irritability and nervousness, and yet she feels jolly. Lilium. Irritability from the slightest contradiction. Ignat. Jealousy. Lach. Joyless. Nitr. ac. Laughing, great tendency to, worse in open air. Nux m. Lovely disposition. Ignat., Puis. REPERTORY OR CLINICAL INDEX. Low spirited, melancholic. Calc c, Chin., Conium, Helon., Ignat., Kali bich., Kali c, Kreasot. (Worse from musici it makes her weep.) Lach., Lilium, Nitr. ac, Petrol., Plat., Puis., Rhus tox. Low spirited and unhappy when awaking in the morning. Lach. Low spirited at noon, lively in the evening; or vice versa. Zinc Low spirited with sleeplessness. Cimicifuga. Merry, excessively. Carbo an. Moral or neivous disturbances appear in regular paroxysms. Argt. nit. Mild, bashful, yielding disposition. Puis. • Nervousness. Lilium. Nervousness, can't bear music; worse in thunder storm. Natr. c Nervousness, can't stand pain. Arnica. Nervousness, inclination to start. Conium, Kali c. (especially when touched.) Peevish. Ipec, Lach., Merc. Pride. Lach., Plat. Quarrelsome. Aurum. Restlessness. Aeon. Nux v. Sen sitiveness, excessive. Arnic a. Sighing, full of grief. Ignat. Slow train of ideas. China. Suicidal inclination. Aurum. Suspicious. Lach., Merc. Talks hasty. Thuya. Tired of life. Nitr. ac, Rhus tox. Want of memory. Conium, Kreasot. Weeping. Lach., Lilium, Lye, fallad., Petrol., Puis., Rhus tox., Thuya, (from music.) HEAD. Burning in the sides of the head, ascending from the neck, worse in the morning and afternoon. Canth. Confusion. Puis. 98 UTERINE DISPLACEMENTS. Congestion. Arnica, China, Mere, Sulph. Dullness. Kali c. Heat of head when body is cool. Arnica. Heat at the vertex. Sulph. Heaviness. China, Nux m. Heaviness in cerebellum. Carbo an. Humming and buzzing in head, with even hardness of hearing. Kreasot. Pain in the head; headache. Pain aching. Ipee Pain after a cold, preceding coryza. Lach. Pain as if a nail were driven from within out, through the sides of the head. Ignat. Pain as if a tape were drawn around the head. Plat. Pain as if from overloading the stomach, or eating fat food. Puis. Pain as if the head would burst and fly to pieces; congestive. China, Merc. Pain at night. Mere Pain felt even during sleep. Cham. Pain from drinking even a small quantity of wine. Zinc. Pain from the sun. Lach. Pain frontal, and root of nose. Ignat. Pain frontal, as if the eyes were forced out. Nux v. Pain frontal, darting from within outward. Conium. Pain frontal, lancinating. Ipee Pain frontal, over one eye; pressure. Kali c. Pain frontal, over the eyes; after breakfast. Lye Pain frontal, over the eyes, extending to the occiput. Cimici- fuga. Pain frontal, over the eyes throbbing; violent. Lach. Pain frontal, stitches. Plat. Pain frontal, supra-orbital neuralgia. Calc. c. Pain half sided; also in ears and teeth. Puis. Pain half sided; usually with one cheek red. Cham. Pain hysterical. Bell. Pain in cerebellum ; throbbing. Petrol. Pain occiput. iEscul. hipp., Nux v. RPEERTORY OR CLINICAL INDEX. 99 Pain in the morning, relieved by lying down; worse from pressure. Lach. Pain in the morning; usually with pain over one eye. Kali bich. Pain in the morning, when awaking. Natr. m. Pain in the morning, with vertigo. Argt. nitr. Pain in the temples ; stitches. Lye Pain in vertex. Carbo an. Pain in vertex ; as if a nail were driven into it. Nux v. Pain lacerating. Kreasot. Pain nervous. Ignat. Pain neuralgic, periodical, worse from touch. China. Pain pressing, terrible. Plat. Pain relieved during menses. Zinc. Pain sick headache, that weakens her very much. Sulph. Pain throbbing. Calc. e, Ignatia., Lach. Pain when walking or riding. Kali c Pain with empty eructations. Calc. e Perspiration of head and upper part of body; profusely at night. Calc c. Sensation of left side of bead. Lach. Vertigo in the morning, with headache. Argt. nitr. Vertigo on going up stairs. Calc. c. Vertigo, sudden attacks of. Kali bich. Vertigo when lying down; especially when turning over in bed. Conium. Vertigo with tendency to faint. Lach., Puis. EYES. Burning in the eyes. Kali c. Dimness of vision. Puis. Pain in the eyeballs. Swelling of the upper lids. Kali c. Swelling under the eyes. Apis. Twitching of the lids. Cham., Plat. EARS. Humming. China. 100 UTERINE DISPLACEMENTS. NOSE. Epistaxis. Lach., Sulph. FACE. Acne with red pimples full of pus. Calc. phos. Bloated in the morning, especially between eyebrows and upper lid. Kali c. Blue rings around the eyes. Chin. Ipee Burning heat with great thirst; especially towards evening. Plat. Complexion copper colored. Carbo an. Complexion livid. Kreasot. Complexion pale, Ipee, Plat., Puis. Complexion pale, gray or yellow. Chin. Complexion sallow, with expression of great suffering. Helon. Complexion yellow, with redness of cheeks. Lach., Nitr. ac. Sensation of coldness and creeping of the whole right side. Plat. Yellow saddle across the bridge of nose. Sepia. MOUTH. TEETH. TASTE. Dryness of tongue and throat,especially when sleeping. Nux m. Toothache worse after warm drinks. Cham. Taste bad every morning, excessive dry tongue without thirst. Puis. Taste bitter. Carbo an., Nitr. ac. Taste bitter at back part of tongue. Chin. Taste bitter of everything she takes. Chin. Nothing tastes good. Puis. APPETITE. Aversion to food. Canth., Zinc. Aversion to food, especially bread or meat. Nitr. ac. Aversion to food, especially milk or meat. Ignat. Canine hunger. Ignat. Hunger at night when awaking. Lye Longing for fat, chalk and earth. Nitr. ac. Longing for salt, or for bitter food or drink. Natr. m. REPERTORY OR CLINICAL INDEX. 101 Satiety, after taking even a small quantity of food. Lye Thirst with aversion to all fluids. Canth. Thirstlessness with most every affection. Apis. AVant of thirst. Aletr. far., Canth., Ignat., Plat. STOMACH. Acidity from food. Nitr. ac. Burning in epigastrium. Calc. phos. Burning in epigastrium and breasts. Canth. Distress after a meal. Empty, gone feeling at pit of stomach. Ignat., Ustilago. Empty, gone feeling at pit of stomach at about 11 A. M. Murex purp., Sulph. Empty, gone feeling at pit of stomach, especially at noon. Sepia. Eructations after a meal especially ; feels full. Chin. Eructations putrid. Arnica. Eructations tasting of food. Carbo an. Griping. Lye Indigestion. Aletr. far., Helon., Hydrast., Puis. Indigestion from high living. Nux v. Nausea during or after coition. Silie Nausea in epigastrium. Arnica. Nausea in the morning. Conium, Ferr. jod. Nausea with heat in throat. Nitr. ac. Pain. Carb. an. Swelling and sensitiveness at the pit of stomach. Lye Vomiting and pain from pessaries. Nux m. Vomiting bitter. Aeon. Vomiting of ingesta. Ipee Vomiting sour. Calc. e ABDOMEN. Bloated after each meal; enormous. Nux m. Bloated wind of stomach. Argt. nitr. Bloated with emaciation and good appetite. Calc c. Bloated with pain down the thighs. Nitr. ac. 102 UTERINE DISPLACEMENTS. Bloated without accumulation of wind. Amm. m. Bloated feeling in abdomen and uterus. Lilium. Bloated feeling with rumbling. Ferr. jod. Contraction and sensation of. Nux v. Distress in the umbilical region. Ipee Enlargement of liver and spleen. Nux m. Incarcerated flatulency. Lye Pain, aching in lumbar region, relieved by lying on the back. Natr. m. Pain periodical, setting in after a meal. Nux v. Pain in region of liver. Nitr. ac. Pain in region of liver relieved from rubbing the parts. Podoph. Pain in left iliac region violent, when walking or riding ; she must lie down. Thuya. Pain pressure in abdomen and back, as from a stone. Puis. Pain, soreness, worse when riding. Argt. m. Pain shooting. Kali bich. Pain shooting in abdomen and stomach. Argt. nit. Pain stitches, extending to the spine. Kali bich. Rumbling, especially in left hypochondrium. Lye Rumbling, especially in transverse colon. Podoph. Throbbing. Ignat. Weak, sinking feeling. Calc. c, Phos. Weak, sinking feeling as though she had to keep it up, or it would drop when walking. Merc HYPOGASTRIC REGION. Feels swollen. Lach. Fullness, heaviness, with heat. Aloe. Fullness, heaviness, with pain in groins and loins, worse from standing. Cimicifuga. Pain from standing. Cimicifuga, Verat. alb. Pain, aching, burning, soreness. Conium. Pain above the pubes,- with pain in the knees. Lilium. Pain and pulling down above the genitals, with pulling pain in both thighs, as if muscles and tendons were too short. Merc. REPERTORY OR CLINICAL INDEX. 103 Pain at pubes. Aurum * Pain bearing down or labor like. See uterus. Pain cutting across, from left to right. Lach. Pain cutting across, from right to left. Lye Pain intermittent. Zinc. Pain intermittent across the abdomen sharp. Lilium. Pain left. Lach., Nux v., Stram. Pain right. Amm. m., iEscul. hipp., Apis, Ferr., Sulph. Pain sharp; pains across the abdomen. Ciaiicif uga. Pain, soreness across the pubes. Nux v. Pain, soreness across and heaviness. Helon. Pain stitches, transient. Bell. Pressure in abdomen and weight great, with upward pressure. Tarantula. Pressure in abdomen hindering locomotion. Aster, rub. Pressure in mons veneris and genital organs; continual. Plat. Sensation of a lump in the left lower abdomen ; anteversion. Nux m. Sensitiveness in abdomen, great aversion to touch. Bell., Lach., Lilium, Verat. alb. Throbbing in abdomen and pelvis. ^Escul. hipp. Weak feeling in genital organs. Sulph. PELVIC REGION. Bearing down and weight. Kreasot. Burning as if from live coals. Kreasot. Heaviness and pressure; deep in pelvic region relieved by lying on left side. Pallad. Pain in pelvic region. Bell. Pain crampy, stitching. Nux v. Pain worse from motion. Cimicifuga. GROINS. (SEE OVARIES.) Bloatedness of both groins painful. Kali c. Pain, burning from groin to groin, with morning stool. Lilium. Pain in groins and loins; with fullness in hypogastrium, worse when standing. Cimicifuga. 104 UTERINE DISPLACEMENTS. Pain in groins hindering erect walking. Amm, m. Pain and stitches. Carbo an. STOOL. Bloody, during menses. Amm. m. Constipation. Kali bich., Lach., Lilium, Lye, Natrum m., Nux v., Opi., Podoph., Silic Constipation alternating with diarrhoea. Lach. Constipation chronic. Collinson. Constipation while traveling. Plat. Diarrhoea. Chin. Diarrhoea chronic, after parturition. Collinson. Diarrhoea, inclination to. Nitr. ac. Flatulency. Calc phos., Chin., Nitr. ac, Podoph. Difficult. Aurum. Light colored, soft. ^Escul. hipp. Muco-gelatinous. Podoph. Retention of stool and urine. Tarantula. Urgent desire. Lilium. Urgent desire for stool and micturition. Nux v. Urging, stool ineffectual. Puis. URINARY ORGANS. Difficulties of different kind. Alumina, Amm. m., Apis, Argt. nitr., Aurum, Benz. ac, Calc. e, Canth., Cham., Chin., Ignat., Kali bich., Kreasot., Lach., Lilium, Lye, Merc, Natr. m., Nux m., Nux v., Petrol., Tarantula. Excresences around the meatus urinarius, with constant desire to urinate. Thuya. Urine albuminous. Helon. Urine foaming. Thuya. Urine like buttermilk. Aurum. Urine red, with white clouds. Plat. Urine with brick dust sediment. Arnica, Chin., Lye Urine with red sediment. Lilium. Urine with sediment adhering to the vessel, and difficult to remove. Sepia. Urine with strong, fetid odor. Nitr. ac. REPERTORY OR CLINICAL INDEX. 105 ANUS AND RECTUM. Constriction in rectum. Lach. Cutting pain in anus after stool. Nitr. ac. Fissures. Nitr. ac. Fissures with bleeding. Natr. m. Fistula in ano. Calc. phos. Haemorrhoids. iEscul. hipp., Aloe, Calc. phos., Collinson., Ignat., Lach., Nitr. ac, Petrol., Silie Painful contraction of anus after stool. Ignat. Pressure as from a lump in rectum, not relieved by stool; retroversion. Sepia. Prolapsus ani from even moderate pressure to^tool. Ignat. Prolapsus ani with exhausting, but natural morning stool. Podoph. Stitches from the anus to the rectum. Ignat. Stitches in rectum when sneezing, coughing or laughing. Lach. Stitching and burning in rectum. Nitr. ac. SEXUAL ORGANS IN GENERAL. Accumulation of mucus. Kali bich. Accumulation between the labia and thighs. Calc. c Inflammation. Aeon. Pain across the pubes. extending through the pudendum as far as the anus. Carb. an. Pain and pressure. Calc. phos. Pressure in sexual organs and mons veneris, continual, Plat. Soreness and moisture. Petrol. Tenderness. Sepia. Tenderness, can neither bear the touch,nor the least jar. Bell. Weak feeling in sexual organs and hypogastric region. Sulph. Vulva. Burning in vulva and pudendum. Canth. Condylomata. Lach., Mere, Nitr. ac, Nux v., Thuya. Inflammation. Helon. Itching. Silie Itching with falling off of the hair. Natr. m. Nitr. ac. 106 UTERINE DISPLACEMENTS. Itching worse from contact of urine, relieved by cold washing. Merc. Pain and cramps in vulva and peringeum when rising from a seat. Thuya. Pruritus. Canth., Collinson., Helon., Lilium., Nitr. ac (from taking cold,) Nux v., Sepia, Sulph., Tarantula, Zinc. Pruritus with anxiety and palpitation. Plat. Sensitiveness to coition. Plat. Swelling of the labia. Kali bich., Sepia. Swelling of the labia, heat, hardness. Kreasot. Varices. Nux v., Zinc. Vagina. Coldness. Graph. Cysts. Silie, Zinc. Dryness and heat. Bell. Dryness and warmth. Lye Dryness with painful coition. Natr. m. . Heat. Aurum. Heat and dryness. Bell. Induration. Chin. Itching. Canth. Pain in vagina, aching. Calc. c Pain bearing down, parts tender to touch. Silie Pain burning. Bell., Cham. Pain burning during and after coition. Lye Pain burning, she can scarcely keep still, especially when sit- ting. Sulph. Pain, crampy contraction. Puis. Pain, irritation. Helon. Pain, soreness and rawness. Kali bich. Pain, soreness hindering coition. Rhus tox. Pain, stitches from above downward. Kreasot. Pain, stitches from below upward. Sepia. Pain, stitches running into the pelvis. Phos. Pain, stitches when walking in the open air. Nitr. ac. Swelling. Agaric, m., Nux v. Ulceration. Hydrast. Wind from the vagina. Brom. REPERTORY OR CLINICAL INDEX. 107 Uterus. Abortus; habitual tendency to. Aletr. far. Amenorrhoea. (See menses suppressed.) Cervix, inflammation of uterus. ^Escul. hipp., Aurum, Sepia. Cervix spongy. Argt. m. Cervix swollen. Canth. Cervix swollen hard. Natr. m. Cervix tumefied, bleeds easily when touched. Ustilago. Conception easy. Merc. Congestion. Bell., Ferr. jod., Lach., Nux v., Sepia. Consciousness of a womb. Helon. Distention of womb flatulent. Nux m. Dropsy. Lye Dry feeling as if constricted. Murex purp. Excrescences. (See condylomata under vulva.) Mere, Nitr. ac. Thuya. Haemorrhage, Metrorrhagia. Aeon., Aletr. far., Apis, Erigeron, Kreasot., Tarantula. Haemorrhage after coition, or between the menstrual periods. Arnica. Haemorrhage between the menstrual periods. Bell., Cham., Merc Haemorrhage during climaxis. Aloe., Argt. nit, Puis., Secal. cor., Sepia, Ustilago. HaBmorrhagia, from over-exertion. Nitr. ac. Haemorrhage from the least exertion. Helon. Hypertrophy. Apis, Podoph. Induration. Aurum, Bell., Carb. an., Conium, Kreasot., Magn. m., Merc, Natr. e, Natr. m., Plat., Podoph., Sepia. Inflammation. (See Cervix, Congestion.) Leucorrhcea. (For characteristics and concomitants see the pathogenesis of each remedy.) Leucorrhcea instead of menses. Chin., Conium, Nux m., Phos., Silie, Zinc Menses. (For characteristics and concomitants see the patho- genesis of each remedy.) Menses too profuse. Aurum. m., Apis, Argt. nit., Chin., Con- 108 UTERINE DISPLACEMENTS. ium, Ferr., Ipee, Merc, Nux m.,Nux v., Opii., Podoph., Stram., Ustilago. Menses too profuse, too early. Aletr. far., Aloe., Amm. m., Arnica, Bell., Canth., Cham., Chin., Cimicifuga, Helon., Ignat., Ipee, Magn., Natr. m.,Nitr. ac, Petrol., Sepia, Stan., Thuya, Ustilago, Vera.t. alb., Zinc Menses too profuse, too early, and too long. Argt. nitr., Calc. e, Carbo an., Kali e, Kreasot., Nux v., Plat., Rhus tox. Menses too profuse, too early and too short. Plat. Menses too profuse and too late. Phos., Plat., Silie Menses too profuse, too late and too long. Ferr. Menses too profuse and too long. Lye, Secal. cor. Menses too scanty. Apis, Argt. nitr., Cimicifuga, Helon., Lilium, Ustilago. Menses too scanty and too early. Conium, Lye, Nitr. ac, Silie Menses too scanty, too early, and too short. Nux v. Menses too scanty and too late. Aurum, Conium, Kali e Petrol., Silie Menses too scanty, too late and too short. Natr. m., Puis. Menses too scanty and too short. Lach. Menses too early. Amm. m., Calc. phos., (every two weeks,) Carbo an., Ipee, (every two weeks,) Kali bich., Nux m., Silie Menses too early, too long. Aloe., Natr. e Menses too late. Aurum, Bell., Calc. e, Calc phos., Canth., Cimicifuga, Lach., Magn. m., Nux m. Menses too late, too long. Lye Menses too late, too short. Sulph. Menses intermittent. Apis, Ferr., Kreasot., Lach., Puis. Menses irregular. Argt. nitr., Nitr. ac, Nnx m., Nux v., Silie Menses increased discharge of blood during a hard or soft stool. Lye Menses returns after having seemed to cease. Nux v. Menses returns during climaxis. Lach. Menses returns from the least excitement. Calc. e Menses returns third month of pregnancy. Kreasot. Menses suppressed. (For characteristics and concomitants see the pathogenesis of each remedy.) Amenorrhoea. Apis, REPERTORY OR CLINICAL INDEX. 109 Aurum, Bell., Calc. e, Cimicifuga, Collinson., Ferr., Helon, Ignat., Lilium, Lye, Mere, Nux m., Opi., Plat., Podoph., Puis., Sepia, Sulph., Verat. alb., Zinc. Membranous dysmenorrhcea. Brom., Canth., Cham., Kali bich., Ustilago. Pain in uterus. Cimicifuga. Pain aching. Calc. phos. Pain constant, referred to the os. Ustilago. Pain as if the uterus was squeezed by a hand. Gels. Pain bearing down ; labor like. Bell., Nux m., Nux v., Secal. cor., Stram., Sulph. Pain bearing down as if prolapsus would occur. Bell., Natr. c, Plat. Ustilago. Pain bearing down as if prolapsus would occur during stool. Podoph. Pain bearing down as if prolapsus would occur, has to sit down to prevent it. Natr. m. Pain bearing down as if prolapsus would occur followed by slight discharge of blood. Lach. Pain bearing down as if prolapsus would occur, has to support vulva with her hands. Lilium. Pain bearing down as if prolapsus would occur, has to cross her limbs to prevent it. Sepia. Pain bearing down as if prolapsus would occur, no matter if she is standing, sitting or lying. Natr. m. Pain bearing down as if prolapsus would occur when standing or walking; before and during menses. Conium. Pain bearing down as if prolapsus would occur with backache, and pain through the hips and thighs. Nitr. ac. Pain bearing down, as if would have a stool. Lilium. Pain bearing down, can hardly stand up. Calc. c. Pain bearing down, every morning. Puis. Pain bearing down, extending down the legs. Aloe. Pain bearing down, followed by leucorrhcea. Ignat. Pain bearing down, from both sides of abdomen; contractive. Conium. Pain bearing down in abdomen and small of back. Cimicifuga. Pain bearing down in groins and loins, worse when standing. Aloe. 110 UTERINE DISPLACEMENTS. Pain bearing down in morning, when in bed; or during a walk. Nux v. Pain bearing down relieved by standing. Bell. Pain bearing down while standing. Rhus tox. Pain bearing down with pain in left ovary, and left mammae. Lilium. Pain bearing down with tenderness over the ovarian region. Apis. Pain bearing down, worse in the morning; violent, with spas- modic contractions of uterus. Bell. Pain burning in the cervical canal. Calc. c. Pain burning, stinging. Bell. Pain burning, stitching, heaviness. Nux v. Pain coming from the chest. Lilium. Pain crampy, with burning and cutting in groins. Natr. m. Pain crampy, with lancinations, worse from touching the parts. Ignat. Pain cutting as if from a sharp instrument. Murex purp. Pain from touch, or during coition. Puis. Pain like sticks or slivers in uterus, when walking, riding, or at stool. Argt. nitr. Pain neuralgic, can't bear the least touci to the abdomen. Lilium. Pain neuralgic, with great sadness and dispair. Tarantula. Pain pressure, sensation of. Calc. c. Pain relieved after coition. Merc. Pain running downward. iEscul. hipp., Ipee, Lach. Pain running downward from chest to uterus. Lilium. Pain running from both os pubes to the small of back. Amm. m. Pain running from front backward and upward. Gels. Pain running from groins outward and backward. Sepia. Pain running from groins to the back. Sulph. Pain running from right hide of pubes to the hip and small of back. Amm. m. Pain running from uterus to neck of bladder and abdomen. Nux v. Pains running upward from right side of uterus, crossing the body to the left mammae. Murex purp. REPERTORY OR CLINICAL INDEX. Ill Pain running upward in the symphysis, and downward in the thighs. Calc. phos. Pain running upward to liver; umbilicus; stomach; chest. Lach., Lye, Phos., Sepia. Pain shooting. Ferr. Pain spasms, extending to the thighs. Magn. m. Pain spasms of the broad ligaments. Cimicifuga. Pain spasms with colic, and discharge of coagula. Nux v. Pain stinging in os or cervix. Calc. e, Conium. Pain stitches in the morning; when rising. Angustura. Pain worse while standing. Aloe., Graph., Sulph. Polypus. Calc c. Sensation as if menses would appear ; frequent. Plat. Softness of. Opi. Sterility. Conium, Mere, Natr. m., Nux'm., Phos., Sulph. Tenderness of uterus to pressure. Cimicifuga, Kreasot. Ulceration of different kinds. (For characteristics see the pathogenesis of the remedies given.) Alumina, Argt. m., Argt. nitr., Arnica, Calc. e, Carb. an., Conium, Helon., Hydrast., Kreasot., Lach., Merc, Natr. m., Nitr. ac. Nux v., Plat., Podoph., Secal. cor., Sepia, Silie, Thuya, Zinc Uterine complaints from exposure to cold, damp weather; from getting wet, especially when perspiring. Rhus tox. Uterine complaints worse after menses. Kreasot. Ovaries. Ovarian Region. Affection of ovaries. Chin., Plat. Affections beginning with the left. Lach. Affections beginning with the right. Lye Affections of left. Brom., Lach., Thuya. Affections of right. Bell., Lach. * Affections with stinging pain. Apis. Inflammation. Canth. Pain. Helon. Pain bearing down. Magn. m. Pain burning. Ustilago. Pain left. Podoph., Zinc. 112 UTERINE DISPLACEMENTS. Pain left and small of back, extending to the front and down- ward Argt. m. Pain right. Apis, Pallad. Pain worse in left, shooting down the legs. Ustilago. Mammae. Hard knots in the mammae. Nitr. ac Induration. Conium. Pain. Merc. Sexual Desire. Decreased, and very little. Silie Increased. Agaric, m.,Canth., Lilium, Kreasot.,Murex purp., Nux v., Plat., Silie, Sulph., Zinc. Coitus. Painful. Argt. nitr., Bell., Cauloph., Chin., Ferr., Ignat., Kali c, Kreasot., Lye, Mere, Natr. m., Nux m., Nux v., Puis., Rhus tox., Sepia, Sulph., Thuya. Nausea during and after. Silie LARYNX. Weakness in larynx and chest great, they give out when talk- ing, singing or reading. Stan. Weak voice, and exhaustion from talking. Stan. CHEST. Cough dry, with sense of constriction around the hypochon- dria. Nux v. Cough when getting warm in bed. Nux m. Cough with granular expectoration, during the day or evening only. Chin. Cough worse when lying down; at night. Conium, Puis. Pain burning larynx and stomach. Canth. Pain extending from the larynx to the uterus. Lilium. Pain under left breast, on the margin of ribs, constant; between the menstrual periods. Ustilago. Shortness of breath. Calc. c, Sepia. REPERTORY OR CLINICAL INDEX. 113 HEART. Palpitation. Alumina, Lye Palpitation when lying on left side. Natr. m. Trembling pulsation. Calc. c. NECK AND BACK. Coldness between the shoulders. Amm. m. Inter-capsular and vertebral neuralgia. Natr. chlor. Pain in sacrum. Alumina, Lilium, Podoph. Pain in sacrum and hips. ^Escul. hipp. Pain in sacrum and loins. Bell. Pain in sacrum and loins; pelvis ; thighs. Ferr. jod. Paiu in sacrum, dragging and weakness. Helon. Pain in small of back. Backache. Aloe., Aurum, Calc e, Cimicifuga, Helon., Plat. Pain in small of back after washing ; lumbar. Podoph. Pain in small of back and outward pressure. Nux m. Pain in small of back as if back would break. Bell. Pain in small of back at night especially. Argt. nitr. Pain in small of back bruised. Rhus tox. Pain in small of back, cannot turn over in bed. Nux v. Paiu in small of back drawing forward. Cham. Pain in small of back every time she desires to urinate. Lye Paiu in small of back relieved by lying on something hard. Natr. ni. Rhus tox. Pain in small of back, stitching, with drawing in lumbar ver- tebrae, especially when standing. Conium. Pain in small of back when rising. Natr. m. Pain towards the sacrum with ineffectual urging to stool. Nux v. Pressure in back and abdomen, as from a stone. Puis. Pulsation in small of back. Natr. m. Spinal irritation ; myelitis. Silie Spinal myalgia. Cimicifuga. Coccyx, pain in. Kali bich. Coccyx, pain in, bruised feeling when sitting down. Lach. Weakness of nape of neck. Plat. 114 UTERINE DISPLACEMENTS. EXTREMITIES. Burning in the soles of feet. Sulph. Burning of feet when walking. Natr. m. Cold feet. Natr. m. Cold feet and hands. Aurum, Ferr. jod., Ignat., Kali c. Cold feet as if from damp stockings. Calc. c. Cold feet with numbness. Conium. Heaviness and great fatigue when walking. Calc. c. Heaviness and languor of arms. Natr. m. Heaviness and torpid feeling of arms. Cimicifuga. Numbness of feet and legs. Ignat. Pain in calves at night; cramps. Cham. Pain in ankles. Rhus tox. Pain in hips, bruised feeling. Lach. Pain in soles of feet. Lye Pain in the thighs ; drawing. Nux v. Stiffness of legs. Conium. Sweat of feet; offensive. Silie Sweat on the legs at night; cold, clammy. Merc. Swelling of feet and hands. Mere Swelling of feet with chlorosis. Ignat. Swelling of soles of feet. Lye Tired, go to sleep. Puis. Varices, with fidgety of feet. Zinc. Weakness great, especially of the legs. Magn. m. SLEEP. Disturbed; dreams of robbers. Natr. m. Drowsiness in daytime. Agaric, m., Kali c. Drowsiness in daytime, sleeplessness at night. Natr. m. Heavy, dead, exhausting her. Sulph. Light; awakens often ; exhausting her. Sulph. Nightmare. Kali c. Unrefreshing. Lye Unrefreshing, sleeplessness after 3 a. m., Nux v. Unrefreshing, wakes with a stool at 2 a.m., with nausea and headache. Kali bich. Wakes at 3 a. m. Kali c. REPERTORY OR CLINICAL INDEX. 115 FEVER. Chilliness. Kreasot., Lye Chilliness and paleness of face. Puis. Chilliness, aversion to open air. Sepia. Chilliness at night, and flashes of heat in day time. Lach. Chilliness in the morning. Conium. Coldness. Ferr. jod., Silie Heat and dryness of skin. Aeon. Night sweat. Chin. Sweat after the least exertion. Chin. Sweat in axillae; fetid. Petrol. SKIN. Anasarca. Ferr. Dryness and itching. Kali c. Dryness, hardly ever perspires. Nux m. Herpes. Kreasot. Herpes on perinaeum. Petrol. (Edema. Apis. Tendency to small boils. Arnica. Waxy, pale. Apis. GENERALITIES. Aggravation of symptoms after a long walk. Rhus tox. Aggravation after sleep; especially after a siesta. Lach. Aggravation after 3 A. m. Kali c Aggravation at night. Cham., Nitr. ac. Aggravation at night and from the heat of the bed. Merc, Sulph. Aggravation every other day. Alumina, Chin. Aggravation from coffee; tobacco; noise; reading; sunlight. Ignat. Aggravation from coition and menses. Kali c Aggravation from cold, wet or windy weather; Nux m. Aggravation from,dry weather. Alumina. Aggravation from 4 to 3 P. P. Lye Aggravation from heat. Puis. 116 UTERINE DISPLACEMEMTS. Aggravation from riding in a carriage. Nux m. Aggravation from standing. Aloe., Sulph. Aggravation in open air. Cham. Aggravation in the evening. Nitr. ac, Puis. Aggravation in the morning. Ignat,, Nux v. Aggravation when at rest. Plat. Puis., Sulph. Aggravation while lying on the left side. Puis. Aggravation while lying on the painful side. Puis. Amelioration of symptoms, after sweating. Cham. Amelioration during menses. Zinc. Amelioration in open air. Alumina, Puis. Amelioration in wet weather. Alumina. Amelioration from changing position. Ignat. Amelioration from eructation. Nitr. ac. Amelioration from lying on the painful side. Ignat. Amelioration from motion. Plat. Amelioration from riding in a carriage. Nitr. ac. Amelioration from warmth ; warm weather. Nux m. Amelioration on rising. Cham. Amelioration when walking. Cham. All motions are painful. Pallad. Chlorosis. Aletr. far., Amm. e, Calc. e, Conium, Ferr., Helon., Ignat., Ipee, Lye, Natr. m., Phos., Puis., Silie Debility. Aletr. far., Aloe., Argt. nitr., Helon., Lye, Petrol., Phos., Silie, Verat. alb. Debility after talking, singing, reading ; has to avoid it. Stan. Debility, drops down suddenly, but can get up rapidly. Stan. Debility in the morning, when in bed. Conium, Natr. m. Debility, she wants to sit or lie down all the time. Nux v. Debility, sudden loss of strength while walking. Conium. Debility that she looses breath and speech. Natr. m.,Nitr. ac Debility, walks stooped. Sulph. Debility, with heaviness and trembling of limbs; especially evenings. Nitr. ac. Emaciation. Phos. Fainting. Cimicifuga, Phos. Fainting with palpitation, followed by sleep. Nux m. REPERTORY OR CLINICAL INDEX. 117 Jerking and stitches through the body. Nux v. Pains begin lightly, increase gradually to its highest point, from which it gradually declines. Stan. Pains come and go quickly. Bell. Rheumatic pains. Cimicifuga. Rheumatic pains, has to shift about, to get relief. Rhus tox. Rheumatic pains worse in damp weather, or in changes from warm to cold. Calc. phos. Takes cold easily ; especially when exposing the head. Bell. Takes cold easily; very sensative to cold air. Calc c Tired feeling, excessive. Picric acid. Tremor. Alumina. Walking first with difficulty, but as she proceeds, she walks better and better. Rhus tox. Yawning, convulsive. Ignat. 118 UTERINE DISPLACEMENTS. APPENDIX [The following articles read before the Massachusett's Sur- gical and Gynaecological Society,convey, perhaps, the most ad- vanced views on uterine displacements. We have consented to their appearance in this work, so that, perhaps more physi- cians may be benefitted. The author is not to be held respon- sible for any views herein contained that may conflict with the general tenor of the body of the work. He is of the strong opinion that finally remedies will be the dernier ressort, in the majority of cases.] PROLAPSUS UTERI AND ITS THERAPEUTIC TREATMENT. In the therapeutic treatment of prolapsus uteri we must be guided almost entirely by clinical experience, if we look only at that one symptom ; but if we take the totality of the symp- toms, which is ever necessary in the treatment of all diseases, we have a wider range. The healthy, unimpregnated uterus generally weighs about a certain amount, and if the surrounding parts are in a healthy condition, it is kept in a normal position. If the uterus becomes impregnated and is quite heavy, if the attachments are quite healthy and the patient is well, there is no prolapsus. I have known a case where the uterus contained a foetus that weighed eighteen pounds, besides a large placenta, without any prolapsus. On the other hand, I have known a case where the uterus APPENDIX. 119 would weigh but an ounce or two more than normal, and it was constantly out of place. Now, what does this teach us? That the cause of prolapsus does not lie in the uterus itself, nor is it produced by the weight alone, neither does it lie in the appendages alone, for no well woman ever had prolapsus uteri. In treating this disease, which is only one symptom of a diseased system, we must connect with it all the abnormal symptoms to be found. We shall find that the prolapsus was not the first symptom that indicated a departure from health. And to cure the prolapsus we must restore the system to a healthy condition. Replace the uterus as often as you please, but it will not remain in position. Still, a system may be badly diseased without any prolapsus. In most diseases, and for most symptoms, we administer remedies and expect them to remove the symptoms, whatever they may be ; but in cases of prolapsus, many of us resort to the use of pessaries or other means of support. The great trouble is we have too little faith in the power of nature to restore to health, or medicines to aid in the restoration. If we treat and cure a case having for one of its symptoms prolapsus uteri, and it is done by the internal administration of remedies only, we are just as apt to use pes- saries in the next case. We would very rarely, if ever, think of using pessaries in case of prolapsus of the rectum, then why for prolapsus of the womb ? It is because the diseases are so dissimilar, or because in the latter case it is a little more convenient? For one, I have always felt that in this disease the remedy must be pretty strong, that is, a low attenuation, while in leucorrhcea, a dis- ease so nearly connected, I have been much more successful with attenuated remedies; still I can see no reason why they should not be treated similarly. I have seen a case of leucor- rhcea of sfeveral years standing, with tormenting pruritus 120 UTERINE DISPLACEMENTS. vulvae, cured in one week with Sulphur, very high. I have seen a case of prolapsus uteri, so bad the os protruded exter- nally, cured in two weeks by the administration of Helonias tincture, a few drops in one-half a glass of water, nothing else being done or given, and the patient kept about her work- that of a cook. I have seen a patient eight months pregnant, the uterus and contents so prolapsed the patient could not. walk, and nearly wild with pruritus vulvae, completely cured in six hours by the administration of Collinsonia 3d. She said everything seemed to go back to its place, and the relief was so sudden and great she fainted completely away. Nowl cannot tell why I gave different attenuations in these cases, only that experience has seemed to prove to me that in some cases and some remedies act better in different attenuation. Why does it take more to help nature cure a disease than it takes to pro- duce a disease with nature trying to ward it off ? Two cases in illustration : A lady was about to visit friends in a distant city, when she received a letter that there was a case of mild varioloid in the house, and not to come. The letter was opened by a daughter who was seven months pregnant. In a little more than two weeks the lady who opened the letter was con- fined, and the child was covered from head to feet with as handsome small-pox pustules as I ever saw. A youne lady in the western part of this state sickened and died of diphtheria. Some of the beautiful flowers at the funeral were placed in a letter and sent to a lady friend in Japan. In two weeks after receiving the letter the young lady sickened and died of diph- theria, although there was none of the disease about there No one can, by any kuown method, calculate how much of dis- ease was sent in either case, yet in the last case it was suffi- cient to destroy the life of a healthy young person. Must we be able to calculate by figures, chemistry, or the microscope how much it will take to remove diseases before we are willing; to perish? APPENDIX. 121 In this, I do not mean to advocate the high attenuations, but do claim and believe that all curable diseases can be cured by medicine,, and that in very small doses, when aided by nature. It is not necessary for me to designate what remedies will cure prolapsus uteri. I do not believe we have a remedy in our Materia Medica but what will cure a case of prolapsus^ provided it covered all of the symptoms present, and there were a plenty of symptoms to be found. If I should report fifty cases all cured, by remedies given, they would not cure a single case unless they were indicated. I very seldom make an ocular or digital examination in treating uterine diseases, and I know that I have had young ladies to treat because they were not obliged to undergo such unpleasantness. I acknowledge that after I have cured a case, I do not always know what I have cured, and on the other hand, those who make frequent examinations seldom treat a case without local applications—so they have really learned nothing of the thera- peutic value of medicines. The most modest young lady is not afraid to apply for treatment when suffering from diarrhoea, but hesitates to apply for aid when suffering from leucorrhcea, and by hesitating, it becomes worse, and assumes a chronic form before anything is done for it. If we knew what reme- dies could do, and would use them we could avoid much suffer- ing both mentally and bodily. I have said it was unnecessary to report cases and the remedies given, but I referred to cases where our well known remedies were given. You know the indications for those as well or better than I, but I wish to again refer to Ovi tosta. It acts nicely in all old chronic cases of leucorrhcea, and one case was cured where I know there was prolapsus uteri. One important symptom of the remedy is back ache, and that is usually found in prolapsus uteri. I am not aware that any good proving of the remedy has yet been made. A. M. Cushing. 122 UTERINE DISPLACEMENTS. THE MECHANICAL TREATMENT OF UTERINE ANTE-DISPLACEMENTS. Ante-displacements of the uterus are divided into two classes, to wit, anteversion and anteflexion. I will very briefly call your attention to what I consider to be the rational method of treating such cases, i. e., by mechanical means. First, we will consider anteversion of the uterus. Having determined by the proper methods of diagnosis that we have an anteverted uterus to deal with, we must adopt those meas- AJNiiiVifiuSlUM.—SKCUiMl) 1/ugkek. ures having for their object the maintenance of the uterus in a normal position. Before applying a suitable pessary we must be sure that no pelvic peritonitis or peri-uterine cellulitis exists, or that the fundus of the uterus is not bound down by adhesions to the posterior wall of the bladder. If peritonitis or cellulitis exist in the slightest degree, it must be removed APPENDIX. 123 by proper treatment, which does not come within the scope of this paper to consider. If an anteverted uterus is adherent to the bladder by inflam- matory product, we should elevate the fundus as much as possible without injury, and tamponade the vagina. This can but be done by placing the patient in Sim's position, and with the vagina fully exposed by the aid of Sim's speculum, carry a tampon of cotton, made aseptic by a saturated solution of Boracic acid and Glycerine, into the anterior fornix of the Anteversion.—Third Degree. vagina. At the same time we should bring the cervix forward and keep it thus by placing tampons in the posterior cul-de-sac. These tampons can be allowed to remain from three to five days, when they should be removed and fresh ones renewed. The fundus uteri should be elevated more and more at each treatment, until the adhesions are removed. During the latter part of the treatment by tampons, we should add to the aseptic solution, for saturating the tampons, Tannic acid in the pro- 124 UTERINE DISPLACEMENTS. portion of a dram to the ounce by measure. This will give tone to the vaginal walls, and render them more tolerant to the presence of a pessary. In choosing a pessary for an anteverted uterus, we must bear in mind that the office of a pessary is to elevate the fundus and bring the cervix forward. The pessary, which I have found in practice to be the most efficacious in these cases, is Fowler's. The originator of this pessary designed it for cases of retroversion, but I find it equally as good in anteversion. These pessaries are numbered one to four respectively. Before sending a patient away, after insert- ing a pessary, we should satisfy ourselves that it is a perfect fit; they should cause no pain or uneasiness; should not be too wide, to unnecessarily distend the vagina, or too long, to protrude from the vulva. We should instruct our patients how to remove them, and direct them to do so as soon as pain or soreness is produced. The question is often asked, how long a time should a pes- sary be worn before it is dispensed with? In answering this question, I will state, until the uterine supports are able to maintain it in its normal position. We should occasionally, say every two or three months, remove the pessary, and resort to the use of the tampons again for a few days ; then let the patient go without any support, and closely watch her for two weeks or more, when, if the uterus does not depart from its normal position, we may dismiss her; otherwise, if there is any tendency for the uterus to become anteverted, we should introduce the pessary. It may be necessary, in inveterate cases, to use a mechanical support for one or more years. We should, however, never allow a patient to wear any form of pessary longer than three months at a time. It is a good rule to follow, to alway request a patient to call after wearing a pessary two months to have it removed, when you can judge APPENDIX. 125 whether it should be worn longer or not. A patient, while wearing a pessary, should daily use a vaginal injection of tepid water and Boracic acid for the purpose of cleanliness. ANTEFLEXION OF THE UTERUS. In treating anteflexion of the uterus, we must adopt those measures having for their object the restoration of the uterus Anteflexion with Ovaritis and Sinus. to its normal shape and position. This form of uterine dis- placement is more trying, attended with more frequent draw- backs, and taxes the patience and skill of the gynaecologist more than all other forms of uterine displacements put together. Yet, notwithstanding all these discouragements, if we can secure the utmost confidence of our patients, we shall be able to perform a radical cure in a few cases, and greatly relieve the large majority. The mechanical means I usually 126 UTERINE DISPLACEMENTS. adopt in treating cases of anteflexion are tampons, rapid dila- tation of the cervical canal, and pessaries. We must first ascertain whether the anteflexed uterus is movable or bound down by adhesions. If the latter condition is found to exist, we must adopt those measures recommended under the head of anteversion complicated with adhesions. If the uterus is movable and no contra-indications, such as pelvic peritonitis or peri-uterine cellulitis, exists, we may proceed to rapidly dilate the cervical canal by means of steel dilators and tamponade the vagina as recommended while speaking of anteversion. This should be repeated every five to eight days until the uterus is restored to its normal shape, when a suitable pessary should be chosen to maintain it in its normal position. The object to be fulfilled by a pessary is to elevate the fundus, and at the same time carry the cervix backward, thus strengthen- ing the uterus. I find that a Fowler or Thomas cup pessary fulfills the desired purpose better than any other I have yet tried. It will be necessary to wear a pessary in cases of ante- flexion a much longer time than in cases of anteversion. H. K. Bennett. EXPERIENCE WITH REMEDIES FOR PROLAPSUS. The therapeutic individuality, and clinical observations, of a few drugs, possessing great value in prolapsus of the womb, complete or incomplete, is the subject of this paper. In its preparation, I have not only considered my own exper- ience, but have carefully examined the comparative observa- tions of several authors, in connection with the toxicological effect of certain drugs upon the female organs of generation. I will say here, that if this paper does not instruct or interest the members of this society, it has not been prepared without profit to myself. APPENDIX. 127 This subject touching upon the female organs of generation, in the pathological changes, organic, functional, and curative treatment, both medicinal and mechanical, has become vast in importance. Agaricus is indicated when prolapsus uteri follows the ces- sation of the menses, and is almost unbearable; with tearing pains running from the pelvic region to the back, and an inexpressible desire for an embrace. Antimon. crudum is the remedy when there is a pressing or crowding sensation in the womb, with a feeling as if some- thing was ready to escape. Aurum /oL—When the uterus is prolapsed and indurated with a bruise, shooting and drawing sensations, having a sen- sation of weight in the abdomen, alternate fretting and cheerful- ness, very sensitive to pain and cold, desires death, without dread or fear of it. Aletris farinosa is a valuable remedy in uterine atony, in sterility, or tendency to miscarry. Also in great debility, loss of strength, pale and scanty menses are conditions indicating its need. It must not be lost sight of in the descent of the uterus in consequence of relaxed ligaments, or the ligaments having lost their tonicity ; to be of value, the patient must be thin in flesh, of spare habit, or what is called a Phosphorus patient with a cough. To rely upon its value in preventing abortion, it must be given in the early stage of pregnancy. Its affinity is for the female generative organs, and should not be overlooked in treating chlorotic girls. The mental symp- toms are fitfulness and peevishness. Aurum metallicum is indicated in prolapsus uteri involving induration of the uterus more or less, especially when the mental tendency is suicidal, or disgust for life, dejected, melancholy, unhappy, desires solitude, imaginations vivid with 128 UTERINE DISPLACEMENTS. evil apprehensions, fearful, peevish, excited if contradicted, thinks she is unfit to live, longs for death. Thus when Aurum is called for, the mental symptoms are among the most prom- inent, and when this state of mind is manifest, always look for prolapsus or a hardened womb. Asofoztida has a delightful curative effect, when the female generative organs are sensitive to the touch, and the sexual desire very strong, with cutting and tearing pains, with offen- sive leucorrhcea, peevish, hysterical, and dissatisfied with her best friends, apprehensive of some dreadful calamity, with the feeling of a bolus in the throat. Belladonna has its symptoms occurring in the morning, with a sensation as if the contents of the abdomen and pelvic cavity would escape through the vulva; also having a burning uneasy sensation with great weight through the whole uterine region, menses are apt to be premature and profuse, the moral condi- tion is ferocious, raging, biting, striking, tearing, fighting, restless, has a desire to escape and run away, headache, vertigo, aggravated by noise,, by motion, by contradiction. The head symptoms are most aggravated and alarming, with eyes swollen, sparkling, inflamed, and aversion to light as well as sound, her manners are foolish, and expressions silly and immodest. Caulophyllum is a remedy of great value; its sphere of action is at present understood to play more especially upon the tis- sues of the uterus than any other part of the organism. The rheumatic, or neuralgic pains in the head, joints of the body, shifting in character, together with the train of dyspeptic symptoms, are dependent more or less upon some form of uterine disturbance. When Caul, is indicated by the above symptoms, we shall generally find the patient complaining of APPENDIX. 129 a fullness and uneasiness in the pelvic cavity, with contrac- tions that intermit, instead of being persistent, as in the case of Ergot. It has its value, marked in quality, after confine- ments, with spasmodic pain in dysmenorrhcea, and threatened miscarriages. The aborigines used it to prevent prolonged and painful labor. Cimicifuga racemosa is another remedy, having a good repute among the Indians and early practitioners of our country, known by the name of "squaw root;" while its range of action is through the brain, spinal cord and nervous system, its pathological action extends to the muscular system between the joints, and especially to the muscular fibre of the uterus. The mental symptoms are not marked, except the patient feels that she is either going to die, or be crazy. There is more or less hysteria with pains shooting from right to left in the uterus, extending into the back; while the sensation is down- ward pressure, the pains shoots upward. It is a polychrest remedy for many diseases of the womb. A therapeutic knowl- edge of Cimicifuga will give us a valuable remedy in an atonic condition of the uterus, or a perverted function. Agitation of the mind and pain will remind us of this drug, every where and every time. Ignatia is the twin sister to Cimicifuga. Her specific action also is the nervous system—spinal cord. It is the great rem- edy in affections growing out of a disturbed or diseased uterus, such as hysteria, chorea, epilepsy, dyspepsia, constipation,etc., etc. When indicated iu consequence of uterine prolapsus, we are told by the patient that the pains are violent and cramp like, resembling labor pains, relieved only by a strong pres- sure, or taking the recumbent posture. The menses are too soon and too profuse—the flow very dark and offensive, coagu- 130 UTERINE DISPLACEMENTS. lated, followed by purulent, corrosive leucorrhcea,easily excited to tears, desires to be alone by herself, coffee always aggra- vates her pain and makes her morose. Calcarea carb. is a constitutional remedy, not so localized as many others. It is of great value when we find the menses coming on every two or three weeks, abiding several days, and followed with a milky leucorrhcea, especially with a scrofulous diathesis. Food does not assimilate, the abdomen is large, appetite ravenous, or precarious. She usually has a desire for boiled eggs, and is easily excited. There is often a sting- ing pain in the neck of the womb, with a heavy ache in the vagina, itching and soreness in the vulva. The symptoms are worse in the morning and in the open air, also at the full moon. She has an aversion to the use of cold water. This symptom is marked in a certain class of children and consumptives. Helonin has its place among the uterine remedies, although akin to many others in its therapeutic action. Its sphere of action is through the cerebro-spinal nervous system, reaching thereby the generative female organs and kidneys of both sexes. Hence when our patients complain of constitutional debility, anaemia, torpidity, etc., in the uterus and kidneys, think of Helonin. There is not only a sensation of bearing down, or displacement of the uterus and vagina, but there is a loss of muscular tonicity; the womb is flabby or relaxed, with . dysmenorrhcea, metrorrhagia, leucorrhcea and pruritus, etc., etc. This drug is among the restorative medicines. It belongs to the group in which is found Ferrum, Nux vomica and a host of others, and has a very important place in nephritic as well as uterine ailments. Kali carb. in its primary sense acts upon the mucous mem- brane of the lungs and genito-urinary organs; the skin, etc APPENDIX. 131 The walls of the vagina and uterus are extremely sensitive, with great dryness, a sensation of soreness, burning and itch- ing in the pudendum. An aversion to an embrace, although her sexual desire is easily excited. The pain in the back, is like that produced by pressing in from both sides, and with her changes, the pain is of a colic nature, occurring in the early part of the morning, three or four o'clock. There is a sense of emptiness, as if the whole body was hollow, this symp- tom is peculiar to Kali c. A pathoguomonic symptom, stitch- ing pain in the joints, etc., with pulsation in every artery of the body. Lacliesis.—This remedy is indicated in uterine derangement, occurring at the time of menopause more than at any other age of life. In displacements of the womb, the abdomen is sensitive to the least pressure; not even the weight of the clothing can be borne without pain. There is more or less burning in the vagina, irritation and swelling of the vulva; thoughts are lascivious, and sexual desire greatly augmented. The pains run downward from the loins into the thighs at short intervals, especially during the menses, which are scanty. The pains are characteristic by being more upon the left, than on the right side. There is also a sensation of something iu the throat, which abides in spite of swallowing or hawking. One of the most marked symptoms, calling attention to this rem- edy, in uterine disturbances, is a feeling of a ball in the blad- der, or abdomen, or in both. Lilium tig.—Is indicated for congestive and inflammatory conditions of the uterus. This is a remedy not to be lost sight of in nymphomania and pressing down pains, with a sensation of great weight as if the whole contents of the bowels would escape through the vagina; relieved only by pressing the 132 UTERINE DISPLACEMENTS. hand against the vulva; and what is very characteristic of Lilium tig. is as though the whole internal parts were being pulled downward from the breasts and umbilical region, emerging through the vagina. The mind is depressed and there is a dread of impending evil, feels in a hurry and utterly incompetent to perform her imperative duties, is apprehensive and suspicious, very timid and inclined to weep at seeming difficulties. Mercury.—Is a medicine that affects the entire organism, not only decomposing the blood but giving rise to constitutional as well as local diseases; among others, the genito-urinary organs are not exempt, producing prolapsus of the uterus and vagina with intense itching and smarting, excoriation of the genitals; having a sensation as if something were pulling downward, producting pain in the thighs; the symptoms are all worse in the night. There is an inexpressible feeling of an internal and insupportable weakness; a feeling of the need of an abdominal supporter, or something to help support the organs of the abdomen. Mercurius has proved in my hands a valuable remedy with threatened miscarriage, after the eighth month of utero-gestation, with a sense of a support needed. Nat rum mur.—Acts on the blood, lymphatics and glandular system ; its characteristic pain in the uterus is of a stitching nature, accompanied with a soreness of the vagina, leucor- rhcea, yellowish, pain in the back and smarting or burning , pain in the urethra after micturition, On rising in the morn- ing, there is a disposition to sit down to relieve the downward pressure. The pressure of the prolapsed uterus is toward the vulva starting from both sides of the abdomen, has a dread of exercise, and a sense of physical weakness, emaciation, chilli- ness, intermittent headache. The eyes suffer from the sudden APPENDIX. 133 coming and going of sparks, or a transient flash of light (like electricity) before them. Loss of smell and taste, with exces- sive coryza, acidity and sour eructation. All these accompany a Natrum mur. prolapsed uterus. Nux moschata.—When indicated we have not only a prolap- sus of the womb but of the vagina, globus hystericus, mental listlessness, pains running from the uterus upward, particu- larly from the right side towards the umbilicus. The menses are irregular in time and quantity and quality. Nux vomica.—This drug is indicated when the menses are too soon and last too long. Foetid leucorrhcea, yellowish in character. Women who faint easy and are irritable and scold- ing in their nature, or despondent; dullness in comprehension and weakness of memory, who have been irregular in their habits of eating, and have been drugging all their lives, and have been the rounds with doctors, and now desire to try Homoeopathic treatment. Look out for this class of patients, and if you treat them, take the job for a year and cure it in a month, then you will get a good advertisement. I'lotinum.—Is indicated when there is a very great sensitive- ness of the parts, which is said to be painful to bear; the pressure is towards the mens veneris, with the desire for an embrace, voluptuous. Menses to frequent and profuse. The flow is dark and clotted ; with more or less trembling and pal- pitation. The patient has great illusions, every body about her is inferior to herself, she is haughty, proud and looks down upon her associates (if she has any) with contempt. She dreads death and thinks it is near, everything seems small beside herself. These sort of patients are apt to lose their virtue before they get married, unless they have the benefit of Platina, which is a nymphomania remedy. 134 UTERINE DISPLACEMENTS. Sepia— It would be hard to tell a gynaecologist anything about this drug, which seems to overshadow all others—unless it is Lil. tig. In female diseases the symptoms indicating the use of this remedy are very prevalent in prolapsus uteri. The congestion of the os, and burning, shooting, stitching pain in neck of the uterus, and a sensation as if the entire contents of the pelvic cavity would be expelled, unless prevented by cross- ing the limbs. While the feeling is, as if the uterus would drop from the vagina, the pain is upward, and the breathing is oppressed. The disposition is irritable, easily offended, inclined to be indifferent to matters and friends about her. She is apathetic and moody, pain in left side of head with pressure and heaviness in the abdomen. Tarantula.—It is said that the effect of a bite from this spider is more severe and terrible than by any other poisonous insect. It is indicated when the dyscrasia is brought on from some bad habit, or indulgences, as from abuses of various sorts, intemperance, etc. It is said to have cured some severe cases of St. Vitus Dance, and chronic disorders, spasmodic, or hysteric in character. Allen speaks of it as a valuable uterfne remedy under the head of "aching," "bruised sensation," "derangement as if connected with the bladder," "distention," "induration," "prolapsus when walking, pushing the intes- tines," "sensitiveness" "swelling of the uterus," etc., etc., appearing to affect the nerves of motion in a manner different from any known remedy. There are very many more remedies for prolapsus, which have not been alluded to in this paper, possessing great value. Such as Alumina, when there is prolapsus uteri, with a sense of constriction of the pelvic organs, with a drawing pain in the right ilium and gnawing pain in the sacrum, shooting up APPENDIX. 135 into the small of the back, burning pain, easily prostrated, cannot endure much exercise, stools scanty, peristaltic motion deficient. Excessively faint and tired, unable to stand—with a transparent leucorrhcea, ruiAing down to the feet when walking, which is a pathognomonic symptom. There is a great dryness and a sensation of a brier or lump in the trachea, creating a tendency to clear the throat, but ineffectual. A loes is a valuable remedy in this disease, when it is con- nected with the diseases of the rectum. Conium.—With induration, ulceration and profuse leucor- rhcea. Animal carbon, Kali brom, have their many virtues. Podophyllin and Phosphoric acid, with many others of noted wealth for diseases and debility of the uterus and adjacent surroundings cannot be referred to at this time. A word or two with regard to local treatment, or supports. The means used may be called " legion," many of which have done more harm than good. Pessaries have flooded the world, and we all know, have in a few instances only proved worthy of praise. Mops are better. They are soft and pliable, and can be medicated, and easily adjusted and removed at will by the patient as directed. Lunar caustic, Iodine, Nitric acid, Potassa, etc., etc., may be in demand occasionally, but few and far between. The last item that is suggested to the gynaecologist is "the sponge," although no new remedy, nor thought altogether pre- ferable to cotton balls or mops. The grand thing is to select the local expedient as a vehicle, whether it is cotton or sponge. It is for the physician to carefully study his therapeutic remedy; which, in my opinion, from experience, properly chosen, will do the work in three-fourths of the cases calling for uterine treatment. 136 UTERINE DISPLACEMENTS. The local remedies are not multiplied, nor difficult to apply with the soft cotton. Among the local remedies are Calendula, Hydrastis, Belladonna, Carbolic acid, Sanguinaria, Thuja, Saf- foline, etc., which I think is preferable to Glycerine. Goodell in his Lessons on Gynaecology, an estimable work for the study on this subject, ignores pessaries unless made of soft metal, as light as possible, and pliable as the case demands, so that when applied there is perfect adjustment and ease. To Dr. II. F. Campbell, of Georgia, are we indebted for the "pneumatic self replacement of the uterus,'''' as he calls it. He describes the posture as follows: " Let the patient loosen all strings and fastenings of her dress and corsets, and place her- self on the bed on her kness, bending the body forward till the head and thorax are brought down to the same plane as that on which her knees are resting; namely, the surface of the bed. The face turned to one side, resting on the two hands while the elbows are spread out widely from the sides. The knees are to be from five to ten inches apart and the thighs perpen- dicular to the bed. This is called the "knee-breast posture." "If the patient, while in the tripod attitude, refrains from strain- ing and breaths naturally, there will be established a reversal of gravity which relieves the uterus from its own weight and from the superincumbent viscera," and the prolapsing womb returned to its normal relation. O. S. Sanders. A CATALOGUE OF BOOKS PUBLISHED BY DUNCAN BROTHERS. The books in the following list are of special interest, consid- ering, as they do, nearly all the diseases of humanity and their Homoeopathic treatment. These works may be obtained of any bookseller, or will be sent by mail, on receipt of the printed prices, postpaid, to any address in the United States, Canada, Europe, the Orient, or the Isles of the Sea. No risks are as- sumed, either on money or books. Descriptive Catalogues furnished free on application. Duncan Bros. 133 and 135 Wabash Ave., Chicago. A Hand-Book on the Diseases of the Heart, and their Homoeopathic Treatment. By W. P. Armstrong, M. D., formerly Lecturer on Diseases of the Heart; Member of the American Institute of Homoeopathy, etc. One volume, 240 pages. Cloth bound, $1.50. The heart is one of the vital organs. It is the great hydraulic engine of the body. When it fails all the machinery stops. A knowlege of its disorders, and the ability to cure its curable diseases should be possessed by every physician. To be able to diagnosticate correctly every case of heart disease or supposed heart disease, is what this work teaches. It is written in a plain, practical manner, and is especially clear just where help is needed. A Treatise on Ovarian Therapeutics. By W. Eggert, M. D. The object of this work is to show the power of Homoeopathic remedies in curing ovarian diseases, tumors, etc. Price 25c. • 2 Catalogue of Books A Guide to Post Mortem Examinations. By A. R. Thomas, M. D., Professor of Anatomy in Hahnemann Medical Col- lege, of Philadelphia. In one handsome volume of 337 pages. Cloth $2.00. This is a work that should be in the possession of every student and every practitioner. The directions for opening each grand division of the body tire clear and thorough, and could have been written only by one who had been there himself. Chapters IV. and V. are alone worth the price of the book.— Am. Horn. Observer. We are glad to know that Prof. Thomas has consented to place in the hands of the profession so valuable an aid in post mortem examinations. Not only do we learn how to perform the operation skilfully but the mor- did anatomy of the part is plainly set forth. This work should be placed in the hands of oar students, aud made a part of the curriculum of our Bchools. It is well systematized, compact and beautifully printed.—Med. Advance. A New Similia. First Principles of Homoeopathic Thera- peutics. By A. W. Woodward, M. D., Professor of Mate- ria Medica and Therapeutics, Chicago Homoeopathic Medical College. This is a unique presentation of the study of remedies and their therapeutic application. The selection is based upon the similar order of succession of symptoms—a new similia. Physicians read this brochure with profit. Price, 25 cents. A Treatise on the Decline of Manhood. By A. E. Small, M. D., President of Hahnemann Medical College. In one volume. Cloth, $1. Sexual Neurosis would have been a good title for this book, for it deals with innervating troubles, such as spermatorrhoea and masturbation in both sexes, and sexual weaknesses ; but the author has chosen the caption used by the quack to frighten and bleed his victims. This little book gives to the profes- sion and the poor sufferers some practical suggestions and advice. It is essentially a treatise on the various causes that induce the premature decline of manhood and the most judi- cious means of removing them and curing their effects. The Published by Duncan Brothers. 3 wise, fatherly counsels of the venerable author especially adapts it to be put into the hands of erring and despondent young men. The work abounds in practical hints for the medical adviser. A Treatise on Diphtheria. By A. McNiel, M. D. Member of the American Institute of Homoeopathy, etc. A neat compact volume of 145 pages. Cloth, $1.00. This is a prize essay and a valuable reference book. "The latest and best work published on the subject from a Homoeo- pathic standpoint."—The Homoeopathic Courier. Abridged Therapeutics : Founded ut>on Histology and Cel- lular Pathology. New Treatment of Disease by the Inor- ganic Tissue Cell-Salts, the Natural Constituents of the Human Body. With an Appendix, "Special Indications for the Application of the Inorganic Tissue-Formers." By Dr. W. H. Schussler. Authorized Translation. Cloth, neatly bound, $1.00. Surgical Principles and Minor Surgery. By J. G. Gilchrist, M. D., Formerly Lecturer on Surgery, Medical Depart- ment, Michigan University. One volume of 205 pages. Cloth $1.25. This work is adopted as a text-book on Minor Surgery in the leading medical colleges. It is written in a plain unassuming style, so that he who reads may understand.—North Am. Journal of Horn. Dr. Gilchrist seems to possess a rare union of surgical dexterity and medical skill, aDd hence we have all the greater pleasure in commending this excellent work as a sound Minor Surgery.—Homoeopathic World. The present volume is a very excellent work, and leaves out many top- ics usually discussed in books on minor surgery, confining itself to band- aging, dressing, splints, catheterism, etc. Everything is concise and practical. Dr. Gilchrist is a very pleasant writer, and has a knack of putting things very neatly.—New Eng. Med. Gazette. This work is intended as an aid to students and as a complete and con- venient resource to the busy practitioner who has but occasional need for surgical knowledge. The application of splints and bandages is well illustrated by means of white linear drawings on a black ground. We commend the book as eminently useful.—Hah. Monthly. 4 Catalogue of Books The Nurse, or Hints on the Care of the Sick. By C. T. Harris, M. D. This work should be understood by every beginner in practice as well as by every nurse. Price, 65 cents. If every physician would insist upon the nurse in his employment mak- ing herself thoroughly acquainted with this little book, it would be a help.—Organon. "It will not hurt a physician even to glance over the pages devoted to mothers and nurses, and this little treatise ought to become one of the tracts domiciled in every household.—North Am. Journal, of Homeopathy. Such a work is very muc^ needed. It is simply and early written, giving hints on all the points, which a nurse ought to know. We cordially reco- mend this little work to the attention of mothers and sisters, who will find it a valuable vade mecum.—Monthly Homoeopathic Rev., London. The Ophthalmoscope; Its Theory and Practical Uses. By C. H. Vilas, M. A., M. D., Professor of Diseases of the Eye and Ear in the Hahnemann Medical College, and Clinical Professor of Eye and Ear Diseases in the Hahne- mann Hospital. Just issued. Cloth, $1.00. This practical treatise rills a most important field. We take pleasure in commending this manual on the Principles and Practice of Ophthalmoscopy. The work is a very good one, and will be a great aid to the beginner in studying the subject.—Physicians' and Surge- ons' Investigator. The treatise now before us is calculated to do just what it indicates; it tells us what the Ophthalmoscope is, how to use it, and what use to make of it. It is a most interesting work, written by one who is master of the subject under discussion, and who has the ability to make himself well understood; the volume is profusely illustrated, printed on good paper, and should have rapid sale. We can heartily recommend it—Med. Counselor. How to See with the Microscope. By J. Edwards Smith, M. D., Professor of Histology and Microscopy. In one elegant volume of 410 pages. Cloth, $2.00. This work is an invaluable one, and is up to date on this most important department. The hints he gives are really useful —more than that, they are highly instructive. Every word proves the great experience of the writer, and the pleasant agreeable style of his language makes the book a fascinat- ing lecture. And that is just a point which deserves great praise, for we acknowledge never to haye read a book so full of teaching, written in such an amiable style, such as this one; certainly not in the line of books on microscopy.— North American Journal of Homoeopathy. Published by Duncan Brothers. 5 An Illustrated Repertory of Pains in Chest, Sides and Back; their direction and character confirmed by clinical cases, By R. R. Gregg, M. D. In one octavo volume. Third edi- tion. Cloth, $1.00. Gregg's "Illustrated Repertory" is an old and valued friend, and in many a disputed case the arrow's point divided our choice of the remedy.—N. A. Journal of Horn. The idea of helping our sadly overladen memories with the aid of picto- rial symptomatology is very laudable .... This book teaches us one very useful lesson, which our careful author has evidently learned well, viz., the very great importance of noting the directions of pains.—Homoeo- pathic World. A Treatise on Typhoid Fever and its Homoeopathic Treat- ment. By M. Panelli, M. D. Translated by G. E. Ship- man, M. D., with copious additions including a chapter on symptomatic indications for remedies by C. Hering, M. D. One volume of 300 pages. Cloth bound. $2.00. Typhoid fever is an insiduous and treacherous disease, and even the oldest and most experienced physician is often glad of practical suggestions as to varieties, complications and management. This work, including the observations of both European and American writers, is at once a most systematic and practical treatise, and without a peer in medical literature. Spectacles, and How to Choose Them. By C. H. Vilas, M. O., Professor of Diseases of the Eye and Ear, Hahne- mann Medical College. One neat illustrated volume. 172 pages. Bound in Cloth, $1.00. It tells everything which an intelligent layman or even an ordinary practitioner need know about the anomalies of vision and their correction. It would, we should think, be especially valuable to opticians in towns where no oculist is resident; and if we know of any such, we could hardly do them a greater servicp. than by bringing it to their knowledge.—British Journal of Homoeopathy. A very interesting and instructive book, not only for the general practi- tioner, for whom it is especially designed, but also for laymen, technical- ties and obscure terms being avoided. Its aim is to prevent the too common haphazard and often injurious custom of choosing one's owa spectacles, or trusting to unprincipled or ignorant venders. The dollar for it will be well spent.—New England Medical Gazette. 6 Catalogue of Books Helps to Hear. By James A. Campbell, M. D., Professor of Diseases of the Eye and Ear, Homoeopathic Medical Col- lege of Missouri. A neat volume in cloth. Price, 75c. This work will prove a godsend to many a poor soul shut away from the voice of humanity. The whole list of instru- ments designed to help the hearing are carefully reviewed. Diseases of the Pancreas. By Professors A. R. Thomas, J. C. Morgan, A. Korndcerfer, and E. A. Farrington, Hahn- emann Medical College of Philadelphia. Cloth bound, 50 cents. Just out. This is a compact treatise on the Diseases of the Pan- creas and their Homoeopathic Therapeutics by a quartet of able men. Every physician not thoroughly informed on pan- creatic diseases should get a copy at once. Diseases of the Brain and Nervous System. By J. Martine Kershaw, M. D., Professor of Brain, Spinal and Nervous Diseases in the Homoeopathic Medical College of Missouri. Eight parts. Price per part, 50 cts. Parts I and II of this valuable work are now ready. Each part is complete in itself. Part I treats of Facial Neuralgia; Cervico-brachial Neuralgia; Dorso-intercostal Neuralgia; Angina pectoris; Gastralgia; Mastodynia ; Neuralgia of the Ovary, Uterus, Testicle, Urethra, Bladder, Kidney and Dia- phragm. Part II treats Spiral Irritation; Chorea; Labio-laryn- geal Paralysis; Facial Paralysis , Writer's Spasm. A Hand-Book of Homoeopathic Practice. By George M. Ockford, M. D., Member of the American In- stitute of Homoeopathy, etc. Just out. Price, free by mail, $2.50. This wort has already been accorded a hearty welcome by the Profession. It is excellent I have recommended it to our students.—H. F. Biggar, Cleveland Hospital Medical College. Dr. Ockford has given in his hand-book as good a condensation of treat- ment as any one can give.—Homoeopathic Physician. Published by Duncan Brothers. 1 Text-Book of Materia Medica. Characteristic, analytical and comparative. By A. C. Cowperthwaite, M. D., Ph. D., Pro- fessor of Materia Medica and Diseases of Women in the Homoeopathic Department of the State University of Iowa. Second edition revised and enlarged, making an elegant compact volume of 676 pages. Cloth, $4.50; half morocco, $5.50. Junt out. This work gives, (1), a concise "general analysis" of the physiological action of the remedies, (2), then their "Character- istic symptoms," (the more distinctive ones standing out in italics), (3), the remedies have many of their symptoms com- pared with other remedies, showing the relative value of each remedy, and (4), the practical value of each remedy is given in the "therapeutic range." These features make it a valuable elementary text-book, and very convenient for reference for the student or general practitioner. The fact that a second edition of any work should be called for within the time which has elapsed since the issue of the first edition of the book under consideration, is sufficient evidence that it has met an appreciative demand. The text has been thoroughly revised, and a number of addi- tional remedies incorporated. We can justly say that it is multum in par- vol—The Homoeopathic Times. In less thai: six hundred pages, Prof. Cowperthwaite gives a clear, but necessarily brief synopsis of the characteristic symptoms of nearly three hundred drugs. Some remedies, not in the first edition, ha-* been added; others, thoroughly revised, and many new "comparisons" added. These comparisons are a new and special feature of Prof. Cowperthwaite's book.—The Homoeopathic Physician. A Hand-Book of Diet in Disease. By C. Gatchell. M. D. Formerly Professor of Practice, Homoeopathic Depart- ment, Michigan University. Clinical Lecturer in Cook County Hospital. Second edition now ready. One com- pact volume. Cloth, $1.00. "This work is plain, practical and valuable. It is really a guide on diet, and one the profession will find reliable and correct."— U. S. Medical Investigator. I consider your work on " Diet in Disease" to be*'the most practical, and therefore the most useful work on the subject with which I am acquaint- ed. No physician should be without it; every mother should have it. It is in use in many of the households in which I practice.—C. C. Olmstkad, M. D.. President of the Wisconsin State Homoeopathic Medical Society. 8 Catalogue of Books Surgical Therapeutics. Surgical Diseases and their Homoeo- pathic Treatment. By J. G. Gilchrist, M. D., Formerly Lecturer on Surgery, Homoeopathic Department, Michigan University. Third ediiion. Nmv ready. One large volume of 464 pages. Cloth $4.00. I look upon it, in its new edition, as an extremely valuable book, and exceedingly useful, not only to the Surgeon, but the general practitioner, as well. I have read and consulted it in my practice, with much pleasure and profit.—Chas. M. Thomas, Prof, of Surgery in Hah. Medical College. "This is the third edition of the first work on Surgical Therapeutics in our school, entirely rewritten and brought down to date, enriched by the clinical and therapeutical researches of a hard student. . . . The chap- ters on 'Tumors,' 'Diseases of the Nerves,' and especially that on the 'Genito-Urinary Diseases' are exhaustive in their remedial indications, and invaluable to the practitioner removed from easy access to surgical consultation."—Medical Advance. Obstetric Therapeutics. By S. Leavitt, M. D., Clinical Pro- fessor of Obstetrics, Hahnemann Hospital, Chicago. A convenient hand-book elegantly bound. Cloth, $1.00. This is a neat little book, giving the clinical and pathogenetic indications for remedies in Obstetrics and a repertory of remedies as applied to Ob- stetrics. The arrangement is simple aud the symptoms are presented without the customary needless repetitions with which our literature it burdened. We heartily commend it to the profession as a reliable, trusty and convenient guide. It is a practical little book, and deserves a larire and rapid sale, which we doubt not it will obtain.—Horn. Jour, of Obstetrics. Text-Book on Diseases of Infants and Children, and their Homoeopathic Treatment. By T. C. Duncan, M. D., Clinical Professor of the Diseases of Children, Chicago Homoeopathic Medical College. The third revised edition is now ready. Lomplet- in one volume of over 1,000 pages. Cloth $6.00'; leather $7.00. This work,—exhaustive, plain and practical,—takes up O*** diseases of children in a very systematic manner. "*"?& ue< velopement of the child is first considered in "is congenital malformations and .diseases. The disor^jgrs attending birth and their management are next fully given. Then all the diseases of the whole alimentary tract are treated with all the fullness and precision their importance demands. Next, the Published by Duncan BrotJiers. 9 diseases of the glandular system are considered. The diseases of the child's throat, bronchi, lungs, heart, brain, skin, kidneys, etc, are very fully treated. The general diseases follow—not omitting worms. The volume closes with a full analysis of acid and alkaline children. This third edition has been carefully revised and brought up to date, making it the most complete treatise on the diseases of children, in one volume, and a credit to Homoeopathy. The author has made such a concise compilation that his work may be adopted as a text-book of our School, and we trust that no Homoeopathic physician will allow himself to be without it.—Homoeopathic Times. Each subject is treated exhaustively and compiled from the very best and latest literature on the subjects. Much time and labor has been expended in gathering and arranging the material for publication. The therapeutic indications are fully ana admirably given having been taken from all Homoeopathic sources, native and foreign.—Hahnemann Monthly. Duncan's Text-book fills a long-neglected want. It is the only Homoeo- pathic book on diseases of children written on a scientific basis. We feel glad that Duncan gives such prominence to physiological therapeutics, a branch too much neglected in many otherwise fair text-bcoks. How and when to feed a child is at least of equal importance as to heal it, when from sheer ignorance it is made sick. As old a physician as I am, I thank Dr. Duncan for this instruction.— N. A. Journal of Homoeopathy. Medical and Surgical Diseases of¥om°n, and their Hom- oeopathic Treatment. By R. Ludlam, M. D., Professor of Medical and Surgical Diseases of Women, Hahnemann Medical College and Hospital, Chicago, .bifth edition. He- written and systematically arranged. Enlarged to 1029 octavo pages. Cloth $6 00; leather $7.00. "Dr. Ludlam's book includes a wide range of subjects : The functional diseases of menstruation ; of pregnancy, hysteria, etc., as well as the or- ganic diseases of the ovaries, uterus, etc. The work is well and profusely liiustrated ; its descriptions are brief and good, etc."—The Homosopathic Physician. This is no mere reprint with added matter, buta completo recasting and developement of the whole work, While the clinical form is (with ad- vantage) preserved, the lectures are so arranged and multiplied that they present a systematic picture of ovario-uterine pathology and therapeu- tics. It is thoroughly scientific, thoroughly practical; it is the teaching of El man who has seen and done *w°* of which he speaks, and knows how to 10 Catalogue of Books speak about it with clearness and elegance. It affords delightful reading and instructive reference.—British Journal of Homoeopathy. It is perhaps needless to remark that this edition, which practically amounts to a new book, is incomparably the best treatiseongencecology ever published. Although this branch of medicine, having been cultivated with great assiduity, has made wonderful progress within a few years. Dr. Ludlam has not only kept fully posted in the discoveries of others, but has also himself introduced many valuable improvements. That this work should pass through five editions in ten years attests its popularity. The last contains almost four hundred more pages than the fourth, and sixty lectures instead of thirty-two. We are greatly pleased at the change irutbe arrangement of the lectures, which now follow each other syste- matically, instead of discussing certain subjects just in the order in which patients happened to come into the clinic. In short, there is no book en the subject that can more profitably be put into the hands of the Homoeo- pathic student [or physician than this. If you can afford but one book, buy this.—New England Medical Gazette. Feeding and Management of Infants and Children, and the Homoeopathic Treatment 01 their Diseases. 12 mo. pp. 426. Neatly bound in cloth, $2.00; half morocco, $2.75. This popular elementary work by Dr. T. C. Duncan, is essen- ftally a treatise on the Hygiene of Children. It is a valuable book for beginners, and also for physicians to supply their patrons. Evidently Dr. Duncan is a fine baby kenner, an eminent authority on paedology and a man of no mean merit.—Homoeopathic World. We recommend this work especially to students and young physicians for the chapters on food and management which they will find better treated than in any other small work on this subject, indicative of the words with which the author heads his introduction : "An ounce of pre- vention is worth a pound of cure."—American Homoeopath. Diet Rules for Children of Different Ages. These are plain, practical directions, designed for general circulation, and are abstracts from a paper read before the Illinois Homoeopathic Medical Association, by Dr. T. C. Dun- can, and from a public address given by him in Hershey Music Hall to a large audience of mothers of Chicago. Those who have examined these rules speak highly of them. Price 1 cent each, or ten cents per dozen copies. Published by Duncan Brothers. 11 Practical Guide to Homoeopathy for Family and Private Use. By Drs. Pulte, Laurie, Hempel, Ruddock, Burt, Verde, and others. Paper, 25 cts ; cloth, 50c The demand for a compact and yet plain guide for the use of Homoeopathic remedies has produced this work that has had a very large sale. It is just the guide for the beginner. The Law of Cure. By T. M. Triplett, M. D. This is a stirring pamphlet that awakes and arouses enthusi- asm of Homoeopathy. Per hundred, $2,00; 200 with card printed upon them, $4.00. The Progress of Medicine as Influenced by Homoeopathy. By A. J. Clark, M. D. This is a new tract that is destined to have a large run. Price, per 100 copies $1.00; if 200 is taken and card printed on back, $2.00; 500 copies, with card, $4.00. How to Feed Children to Prevent Sickness. Bound in paper, 10 cts.; cloth 25 cts. This is the substance of an address, by T. C. Duncan, M. D., delivered to a company of mothers. It bears chiefly on the avoidable causes of sickness among children. Sun Stroke and its Homoeopathic Treatment. By C. B. Knerr, M. D. Price, 15 cents. This brochure treats a grave emergency in a plain, practical manner; coming from an associate of Father Hering, it bears the mark of scientific exactness and reliability. The Prevention of Congenital Malformations, Defects and Diseases. By J. C. Burnett, M. D., editor Homoeopathic World Price, 25 cents. This little treatise suggest the possibility of a great work. If congenital malformations can be prevented it will prove a great blessing. Every mother as well as every puysician should read this book. 12 Catalogue of Books. Analysis of Acute and Chronic Diseases and their Supposed Causes. By C. P. Jennings, S. T. D. Price 15 cents. The basis for acute and chronic diseases is well established in this phamphlet and the therapuetic procedure for both well marked. How to be Plump ; or, Talks on Physiological Feeding. By T. C. Duncan M. D., editor of The United Stales Medical Investigator, etc. Neatly bound in cloth 25 cents. This novel work is practical, and should be read by all. Teething and Croup. By W. V. Drury, M. D., M. R .1. A., formerly Physician to the Children's Department, London Homoeopathic Hospital. One neat little volume. Price 25 cents. This little work is full of practical suggestions as to the man- agement of children suffering from teething disorders and that much dreaded disease croup. The notes from the American editor adds to its usefulness. Skin Diseases and their Homoeopathic Treatment. By John R. Kippax, M. D., LL. B., Professor of principles and Prac- tice of Medicine and Medical Jurisprudence in the Chicago Homoeopathic Medical College; late Clinical Lecturer and visiting Physician to Cook County Hospital; Member of the American Institute of Homoeopathy; Member of the Col- lege of Physicians and Surgeons, Ontario; Author of Lec- tures on Fevers, etc., etc. Third Edition just out. Price, $2.00. What is said of this valuable work : The Hahnemann Monthly says : "Dr. Kippax has given us in this book excellent material briefly disposed and well described. The Homoeopathic indications are excellent." TheHomocepathic Physician says : " To the busy practitioner, as well as to the student who desires to quickly gather a hint as to the diagnosis or treatment of any skin affection Dr. Kippax's Hand Book will be of service." The Physicians and Surgeons Investigator says: "No matter whether a doctor is a Homce path, or any other, he will do well to read this work. He can obtain an understanding of the diseases of the skin more thoroughly from this book than from almost any other. We congratulate the author and publishers on pruducing such an interesting work." The American Homoeopath says : " The book will be found a useful guide in the study of skin affe.tions and their treatment. We have been in the habit of c< mmending it to students, and find the; new edition still more useful as a Hand Bwok." Published by Duncan Brothers. 13 The North American Journal of Homoeopathy says : "That the second edition is a great improvement on the first one, even a superficial glance will show; and the therapeutics of each disease are given more thoroughly. Alphabetically the diseases are mentioned an easy plan, as it passes over the difficulty of dividing them scientifically. (Ho» that word is abused), but authorities differ, and who shall be the judge ?" Having thoroughly examined the "Hand-book of Skin Diseases," it gives me pleasure to accord it my hearty approbation. Its chief value is its conciseness, while in every detail it fulfills perfectly its offlc as a valuable treatise for study and reference by both students and practitioners, being a neat, systematic, reliable, compact and comprehensive work upon diseases of the skin. I shall take satisfaction in recommending this book to the classes attending my lectures upon the skin, as well as to the profession generally. Phil. b. Ascularius, M. D., Lecturer on Skin Diseases in the New York Homoeopathic College. In these days (f massive books it is refreshing to read a brochure which condenses the pith of a large work into a small compass. Such is Dr. Kippax's "Hand-book of Skin Diseases." To these advantages to the busy pratitioner and student are added in this book excellent type and paper, and plenty of inter-space to prevent the wearying of the eyes. The class'fication of sUn diseases is concise arid very useful. This is a difficult task well performed. Part II, contains ihe description and treat- ment of skin affections arranged in alphabetical order. The definitions are printed in small caps, which brings them prominently before the eye and helps in their comprehension. Part III, comprises a chart of charac- teristics, with diagnostic, therapeutic, dietetic and hygienic hints. The remaining thr e parts include a glossary, metric tables, and bibliogra- phy of works consulted by the author. In regard to treatment, the work its quie complete for a hand-book.—Hahnemannan Monthly. Diseases of the Rectum. Their Homoeopathic and Surgical Treatment. By M. Avers,M.D. Price,75 cents, now ready. Thanks for Ayers' Diseases of the Rectum. It is a good little work. S. Lilienthal. Dr. Mortimer Ayers' modest little monograph on Diseases of the Rectum is just such a work as thousands of physicians need, and we hope it may find many purchasers.—American Homoeopath. This is a neat work on a subject, that we feel, should be more thoroughly understood, by the general practitioner. It is the practical ideas of a practical man, we should judge, and fills a much needed want.—The Regu- ar Practitioner. ]hisb ok will prove a useful practical work to thf physician and sur- geon, for rectal and anal complaints are not asepfily diagnosed or treated to admit of our ignoring the ripe experience of our able colleague.—The Homoeopathic World. 14 Catalogue of Books. The information presented is practical, and the illustrations of the dif ferent diseases treated, by reports of cases, it is a strong indorsement of the value of tbe remedies employed, it is astepfarward in the right direc- tion.—TTie St. Louis Periscope. A good book written in plain style and no attempt made to mystify the plain reading by scientific hypothesis. The Homoeopathic treatment is reliable, perhaps too much condensed, but the cry for condensation is now fashionable. So much surgery as Ayers teaches every physician should be able to p< rform, and that is another recommendation.—The North American Journal of Homoeopathy. We are pleased to find in this work much of importance. It is truly a valuable addition to our growing literature and every one who reads or rather studies it, with care, will feel in common with us a sincere gratitude towards the author. There is no doubt that ju&t this sort of book is wanted by thousands of practitioners, and they cannot better supply their want or better show their appreciation of the book than by obta ning a copy.— Medical Advance. The author has condensed the subject on which he treats as much as possible and yet be comprehensive. He illustrates his subjects by cases in his own practice. The first chapter is on Hygiene of the Rectum ; then Ulcers, followed by Fissures; Pruritus ; Prolapsus ; Hemorrhoids; external and internal; Abscesses ; Fistulas and the Surgical and Homoeo- pathic treatment. We have many inquiries for such a work, and here it is. Send for it, practice by it and you will save much suffering.— The P and S. Investigator. Surgical Emergencies and Accidents. By J. G. Gilchrist M. D., Professor of Surgical Pathology and Therapeutics, in the State University of Iowa; Formerly Lecturer on Surgery in the Homoeopathic Medical College of the Uni- versity of Michigan; Member of the College of Physic- ians and Surgeons of Michigan; Author of Surgical Principles and Minor Surgery; also, Surgical Diseases and their Homoeopathic Therapeutics. Price, neatly bound in Cloth, $4.50. Just out. It gives us great pleasure to call the attention of the profes- sion to this valuable book, which is designed to aid where aid is often most needed. Few are always ready for surgical emergencies. A work that deals with the various emergen- cies, as well as their possible and probable complications giving the experiences and views of noted surgeons' will often prove a friend in need. DUNCAN BROTHERS, 133 and 135 Wabash Avenue, CHICAGO. " The Foremost Medical Journal." The UNITED STATES MEDICAL INVESTIGATOR A Semi-Monthly Magazine of the Medical Sciences. Edited by T. C. Duncan, M. D. $3.00 Per Annum for Two Large Octavo Volumes. This consolidated journal continues with 'he most flattering prospects. The circulation being now over 60,000 copies per year. The remarkable offer of TWO VOLUMES a year filled with timely and practical medical articles, items, hints, etc.. and the small price for TWENTY-FOUR NUMBERS post-free, is one of the marvels of medical journalism, and is highly appre- ciated by the profession. A FEW TESTIMONIALS. The Investigator grows better and better.—B. L. Hittchinson. It is a live work, and I am more than pleased with it.—Geo. W. Stearns. Can't do without The United States Medical Investigator.—Lowell, H. Smith. The more I read the Investigator the better I like it. I cannot do without it—F. M. Clakk. Please renew my subscription for The Investigator. No other will take its plate.—C. C. Wakefield. I connot do without The United States Medical Investigator. It is a journal to keep one informed.—R.C. Marshall. " I have been a subscriber for ten years to The Investigator, and ex- pect to be the rest of my natural life."—J. Ferris. The December number of The Investigator was a splendid produc- tion, and is a good misssionarv among the "heathen" Allopaths—give them an occasional dose.—C. B. Currier. " I took a six month's trip with you and now renew for a full year for the following reasons : 1. Everything in it is practical. 2. It is an avenue through which the common practitioner can give vent to his thoughts and experiences. 3. It is Homoeopathic to the back bone and never ceases to wave the banner of similia similibus curentur."—C. E. Walker. Two large volumes a year, commencing January ani July. Over 1,20(> pages of solid, practical medical facts—for the small amount of only $3.00. Send for sample copy. Try it four months: only $1.00. DUNCAN BROTHERS, CHICAGO. '*> o x^^v 5 ^^\~s 5 >• and Welfare. Public » Heollh Service * Belhesdo, Md 5 U S Deportment of ^ Heollh. Education, » and Welfare. Public 0 Health Service * Oils * &i/ s jnd Welfare, Public *> Health Service °? Bethesda, Md *> U S Department of ^ Health, Education. Jo and Welfore, Public O and WeHore. Pul = /^'?W = • > > sdo. Md » US. Department of 5: Heollh. Education. *> ond Welfare. Public ^ HeolthServ.ee r \wt?cvffl z \«tH^tv > ° < ^tehul ^ < z iJOdSQ5ri pw opsaittag 3Di«js$ iti|oaH :>'iq"d's,°llaM Pu° uoiiojnpg 'u,i|Dau Z > * V)^K - ST/ s :sda, Md. *> US Department of °? Health. Education, *> ond Welfare, Public ^ Health Service o qp ti\/ 7 x/^y so z Dda0 9n PW 'opsa^tag 331^35 u,t|D3H '!iqnd '3'°)I3M Pu° uoi|03np3 u,i|OaH 0 x^/^\ 5 p?\y >- da, Md » U S Department of " Health, Education, *> and Welfare, Public ^ Heollh Service 0 "Vn /7\. - y'v^,-©^ ° 0 NLM005554885