:**Aii * M. RAPP, ©©©[KIBQKllDH 25 MARKET ST., PO'KEEPSIE. Blank Books, Portfolios, &c,made order.— Music, Magazines, &c, bound neatly and promptly. NATIONAL LIBRARY OF MEDICINE Bethesda, Maryland Gift of The National Center for Homeopathy cry ' V.'GOVr.l'RY. U.IK ' * : ,.JOt f Issued as an appendix to the North American journal of homoeopathy, 1859-1861. Not finished; covers Acacia through Asclepias tuberosa; concludes mid-word ("expec-") on p. 768. THE ELEMENTS NEW MATERIA MEDICA THERAPEUTICS. Based upon an entirely New Collection of Drug-Provings and Clinical Experience. E. MAECY, M.D., J. O. PETEES, M.D. A OTTO FULLGEAFF, M.D. 11 c* ^ INTRODUCTION. In presenting to the profession the commencement of a new work on Materia Medica, the editors are actuated by a desire to accomplish the responsible task in such a manner as to save the practitioner much time and study in the selection of appropriate medicines for different groups of symptoms, and of placing before him such only as are specific and reliable. Taking into consideration the limited knowledge we possess with regard to many drugs, we are aware of the difficulties to be encountered, and the immense research and labor it will require to carry out properly the duty we have undertaken. But with the aid of the Great Healer, and by dint of the industry and energy with which the good cause shall inspire us, the ideas we have conceived with regard to this important subject shall be fully carried out. The usual classification of the different organs of the body adopted by our School will be retained ; but in the selection of drug-symptoms, such only will be received as are positive and unquestionable. In making this selection we shall require First, that every symptom shall have been experienced by several dif- ferent provers. Second, that the pathological changes induced by the drug shall corres- pond with its pathogenetic phenomena, and be recorded directly under each organ. Third, that the drug shall have repeatedly cured morbid symptoms, simi lar to those recorded in its pathogenesis. It will be our object to place before the reader the actual genius of each medicine, and to expose not only drug-phenomena which have been felt and seen, but those which are often latent and unappreciated. We shall en- deavor to trace all phenomena to their causes, and thus to reach those hidden springs which so often induce discord and disease throughout the entire organism. It is only through pathology and physiology that this desirable end can be attained. To prove this position we cite two examples. It is well known that an inflammation or irritation of a certain portion of the cerebellum, will give rise to erections of the penis. It is also true that a mere local irritation of the erector muscles, and of the contiguous parts will also cause erections precisely similar in all respects to the first. Now Opium and Cannabis-indica induce erections by exercising their specific 4 Introduction. action upon the tubercula quadrigemina and the neighboring parts of the brain, while Cantharides produces erections by its specific influence over the parts connected with the erective muscles. In the first instance cited, Opium or Cannabis would be homoeopathic, while in the other instance Cantharides is the true specific. If we examine the pathogenesis of Arsenicum and Colchicum we shall observe that both produce dropsical swellings in various parts of the body. In both instances the visible and appreciable symptoms are the same, and if we are unable to trace out the genius of these remedies beyond this point, it would be a matter of indifference which should be prescribed to arrest the dropsical effusion. But pathology teaches us that Arsenicum causes dropsy by impairing the integrity of the spinal marrow, and the ganglionic and capillary nerves, while Colchicum produces the same symptoms in virtue of its specific in- fluence over the kidneys and bowels. Now let us suppose a case of Bright's disease. The patient presents himself with oedema of the legs, and an occasional puffiness of the face, but with no other pains, no other visible symptoms. An analysis of his urine, however, gives us albumen, and we diagnose granulated kidney as the cause of the cedematous condition. In this instance pathology alone can reveal the hidden and deep-seated action of those drugs, and thus enable us to select the one which is actually homoeopathic to the disease. These distinctions are important; but without the aid of pathology and physiology we could have no certain appreciation of them. Under each separate organ will also be recorded clinical facts from all sources, for the purpose of illustrating practically the curative sphere of each remedy. In making up this portion of our work, we shall draw upon the experience of reputable physicians in all parts of the world. By this course the practitioner obtains at a glance the therapeutic sphere of each medicine, and is able to compare critically all its pathegenetic, pathological, physiological and curative relations. Each number of the Journal will contain from fifty to one hundred pages of the work in the form of an appendix, and the matter will be paged in- dependently, so that at the expiration of each year it can be bound into a handsome octavo volume of about 300 pages. With these few explanatory observations we enter upon our arduous work. NEW MATERIA MEDICA. ACACIA. GUM ARABIC. AUTHORITIES. Waring's Therapeutics (44). Dierbach's Mat. Med. (16). Pe- reira's Mat. Med. (13). Peters (11). Clinical Remarks.—In coughs much relief is often experienced from allowing a piece of gum-arabic to dissolve slowly in the mouth. It is particularly useful in allaying the irritation of the throat which excites cough in Phthisis (44). I have found it as useful and curative in consumption as cod liver oil, and far more agreeable, but it must be taken in large quantities ; at least from two to four ounces per day, and followed up for months; the warm solution of one ounce of gum to half a pint of water, is the best preparation. (11). In Ardor urina?, and Calculous affections the mucilage proves of great service. Prof. Graham also thinks that the Gum may be employed as an article of diet for diabetic patients, without risk of increasing the sugar discharged in the urine. (44). Its use as a palliation in acute and chronic gastritis and colitis, and diarrhoea is well known. In Hemorrhage, the local application of finely powdered gum is often effectual in arresting the flow of blood especially from leech bites; severe epistaxis has been successfully treated by finely powdered gum blown into the nostril. (44.) In uterine haemorrhage a somewhat similar procedure may be used; or a strong mucilage in- jected ; or cloths or lint saturated with it introduced into the vagina.(11.) In Barns and Scalds.—Mr. Rhind of Edinburgh advises applying a thick solution of Gum-Arabic over the burnt surface. He states that it relieves the pain almost instantly, and that under its use the healing process appears to be hastened. He adds that repeated trials for several years and strict observation confirm him as to the value of the treatment. (44). In Sore Nipples.—Erasmus Wilson speaks of the mucilage of Acacia as a useful application. He directs it to be pencilled on the tender part immediately after nursing, and the nipple to be protected with a shield. He also speaks favorably of the application of a powder composed of equal parts of Gum-Arabic, and Borax. (44). But by far the most useful application is the Tincture of Benzoin, applied with a camel's hair brush. It need not be washed off again before nurs- ing. (11). 6 New Materia Ifedica. [Aug. 3 ACIDUM ACETICUM. ACETIC ACID. AUTHORITIES. Orfila (2.) Pereira El. of Mat. Med. Vol. 1. P. 351. (3.) Parrot. (40.) Beyer. (41.) Ottinger. (42.) Klusemann. (43.) Wiring's Thera- peutics. (44.) Vogt's Materia Medica (20.) Marcy (10.) Peters (11.) PHENOMENA. Intellect,—Confusion of ideas ; disinclination to exert the mind; slight and transient delirium ; diminished intellectual power. (2.) Clinical Remarks.—It has proved curative in mania with cerebral excitement; delirium caused by opium ; delirium of typhus ; alternate stupor and delirium of typhus. Disposition.—Irritability of temper; nervous and excitable mood.(2.) Ilead.—Giddiness ; dull pains in the forehead and vertex ; shooting pains through the temples ; heaviness of the head with sense of in- toxication ; indications of vascular excitement in the brain ; distention of the temporal blood vessels, with increased heat of the head. (2.) Clinical Remarks.—It has proved curative of haemorrhage of the nose, arising from determination of blood to the head—(used locally as well as internally); headaches from abuse of stimulants, tobacco, coffee and opium; affections of the brain dependent on nervous con- gestion. (3.) Scalp,—Clinical Remarks.—In Tinea capitis, the local application of the strong acid is recommended by Wigan. The first application is with the acid, diluted with three times its weight of water. On being applied, a number of spots previously looking healthy, become red patches; then, with a piece of sponge tied to the end of a stick, each spot is to be saturated thoroughly with the strong acid for three or four minutes. A single application is sufficient in the majority of cases. A crust grows up with the hair, which may be removed as soon as a pair of fine scissors can be introduced beneath it. Eras- mus Wilson speaks favorably of a similar mode of treatment repeated once a week. Eye,—Clinical Remarks.—Particles of Lime in the eye are effectu- ally dissolved and the pain eased, by bathing the eye into diluted vinegar. (11.) Face.—Face pale and waxen; eyes sunken and surrounded by a dark circle. (44.) Throat.—Clinical Remarks.—The sore-throat of scarlet fever is much benefitted by the application of the steam of warm vinegar ; in quinsy, and almost every form of ulcerated or relaxed sore-throat much relief is obtained by inhaling the vapor of hot vinegar and water. 1855.] Acidum Aceticum. 'i Appetite and Taste.—Diminished appetite; tongue pale and flabby; adipsia; vomiting soon after eating. (41.) Stomach.—When taken daily in its diluted form, and in large doses, it produces great uneasiness, cramps and colic, and gradually destroys so effectually the texture of the stomach, and its digestive functions, as to cause emaciation of the body. (20.) Clinical Remarks.—Dr. Tracy's (of Ohio) experience with the vegetable acids as correctives of acidity of the stomach has been considerable; he has prescribed them in a large number of cases, and nearly all with decided benefit. Dr. Tracy himself was subject to repeated and severe attacks of Conjunctivitis, accompanied with acidity of the stomach, which he had attempted to correct by the early and free use of soda, but in vain. He had for months abstained from the use of acids, but was finally induced to take a glass of lemonade, with great alleviation. The remedy was again and again repeated, and the threatened ophthalmic attacks effectually prevented. Dr. Tracy has found vegetable acids uniformly and entirely successful in removing the disposition to attacks of acidity of stomach in persons subject to them; and his impression is that in all such cases they can be relied upon with more confidence than any other remedies. In cases of acidity from pregnancy he has found the sub-acid fruit of great service, while those that were tart could not be borne, and mine- ral acids were decidedly injurious, while the whole range of alkalies and absorbents were of little or no avail. Braithwaite says this may seem a very unscientific (but very homoeopathic) mode of procedure, still facts seem to corroborate the value of the practice in some cases. Dr. Chapman of Philadelphia experienced relief from the same re- medy. The late Professor Wiston had for a long time ineffectually endeavored to relieve an opulent merchant of acidity of the stomach, who was very speedily cured by drinking of sour beer. Dr. Chapman had a most distressing case, which proved utterly intractable during nearly a whole winter, to the regular alkaline remedies, which was cured promptly during the summer, by the patient subsisting on the sour pie-cherry. Nor is this the only instance in which Dr. Chapman has heard of cures ascribed to tart and perhaps unripe fruit of several kinds, and one especially from Professor Hodges, to sour or unripe apples ; he also attended a case with Dr. J. Rhea Barton, which yielded immediately to wheaten mush and vinegar, largely and eagerly consumed. Abdomen.—Griping pain in the bowels ; diarrhoea; tympanitis, with difficulty of breathing (from large doses) rumbling in the abdomen.(42.) Clinical Remarks.—Dr. Parrot has treated successfully, diarrhoea accompanying typhus fever with diluted vinegar; also diarrhoea with pain in the gastric region, rumbling, and delirium; also, constipation with tympanitic abdomen and stupor; also griping pains in the ab- domen of several years' standing, with difficulty of breathing, sleep- s New Materia Medica. [Aug., lessness, vomiting after every meal, impaired sight, and irritable mood; also six cases of ascites following intermittent and scarlet fevers, (cured in three to four weeks by drachm doses). (40.) Stool.—Watery diarrhoea; diarrhoea, with colic pains, and tender- ness of the abdomen to the touch ; bloody discharges from the bowels. (42.) Clinical Remarks. — In a paper read before the Epidemiological Society of London, Dr. J. H. Tucker begins by alluding to the remarkable, but well established fact, that in 1849, the cider dis- tricts of Herefordshire, Somersetshire, and part of Devonshire were to a great extent, exempt from the ravages of Cholera, while the disease was raging around. Upon farther inquiry it was ascertained that this exemption was confined a good deal to those individuals who drank cider as a common beverage, and that those who partook of malt liquor occasionally suffered. He also remarks that in some parts of France and Normandy, more particularly where cider is the common beverage, cholera is seldom known to exist. Tucker also expresses the opinion that other vegetable acids will be found of service, such as lemon juice, (but lemonade often causes griping and diarrhoea,) orange juice, and sour wines made from grapes. As it would be quite impossible to supply the world with a sufficient quan- tity of pure cider, he suggests that Vinegar might be found a useful substitute in case of another outbreak of Cholera. He (hen proceeds to show that acid drinks were not only preventive, but remedial in epidemic disorders of the bowels. Cases are related, in which not only were persons exempt from attacks of cholera raging around them, who drank freely of cider, but a case of severe cholera is also related, which yielded to the diluted juice of sour apples. He also refers to some established facts connected with the spread of epidemic dysen- tery in the army, showing the efficacy of vegetable acids in that disease. Urine.—Urine increased in quantity, and of a lighter color. (3.) Utcr'JS.—Clinical Remarks.—In uterine haemorrhages the applica- tion of cold vinegar and water to the pubes is not only agreeable but tends considerably to arrest the discharge of blood. (11.) larynx. Trachea, and Chest.—Irritation of the windpipe and chest • dry cough attended with oppressed respiration, succeeded by a moist cough with fever increased difficulty of breathing, emaciation, nieht sweats, cedema of the feet and legs, diarrhoea and death ; Klusemann reports three cases of hemoptysis caused by the use of Acetic-acid in from one to four weeks. (43.) Clinical Remarks.—Vinegar, much diluted with water, has often checked night sweats, bronchial haemorrhages, and diarrhoea from hectic fever Kopperstaotter, Oettinger and others have cued L^ ™»l££$:%fithe use of vinegar in drachm doses "£ 1855.] Acidum Aceticum. 9 In phthisis the value of the external application of diluted vinegar to the chest and upper part of the body, in allaying the profuse per- spirations, is well known; it is a measure attended with salutary effects, and is of great comfort to the patient. The mixture employed by Sir C. Scudamore for this purpose, is composed of one pint of vinegar, one of cologne water, and two of water. Alcohol or spirits and water is often more useful than vinegar. Dr. Roberts strongly advocates both the internal and external use of vinegar for checking the hectic and night sweats, restraining haemoptysis and producing costiveness. As a preventive of phthisis Dr. Graves speaks favorably of washing the chest with vinegar and water, beginning with it tepid, and reducing the temperature gradually until it can be used cold. In haemoptysis the internal and external use of vinegar was highly esteemed by the ancients ; Caelius Aurelianus, Avicenna and Rhases are among its chief advocates. In Asthenia and Angina-pectoris it is of great importance to diminish the susceptibility of the patient to cold; one of the most effectual means of effecting this is to bathe the chest with vinegar and water. It is a measure fraught with benefit also to those who are liable to continual catarrhal attacks. (11.) Breasts.— Clinical Remarks.—To milk or mammary abcesses, the application of warm vinegar is stated by Dr. Dewees to be so success- ful in the early stage of the disease, that we need not in general look for any other remedy. It is he states, particularly useful, when the breasts are greatly and painfully distended with milk ; it should be perseveringly employed for twenty-four hours. This testimony in favor of it is very strong. Upper-Extremities.—Diminished muscular power of the arms and hands; paralytic sensation in the wrists and hands; coldness and prickling in the hands. (2.) Lower-Extremities.—CEdemateous swelling of the feet and legs ; impaired muscular power of the legs; diminished sensibility of the feet; coldness of the feet. (41.) Fever.—Hectic fever, with emaciation, cough, night sweats, diar- rhoea, dispnoea, and dropsical swelling of the feet and legs ; typhus fever, with violent delirium, diarrhoea, pain in the abdomen, rumbling in the gastric region; also typhus with stupor, tympanitic abdomen, and obstinate constipation. (2.) (44.) Clinical Remarks.—Diluted Acetic-acid has been employed as a remedy in abdominal typhus for centuries. Numerous cures are reported by this agent; but in these instances, it is probable that the credit rightfully belongs to the vis medicatrix natures. As a cooling beverage, to allay thirst, diminish heat, and dilute the irritating secretions of the digestive canal, it is doubtless a remedy of some value. (10.) Skin.—Skin pale and waxen ; general anasarca j diminished sensi- 10 New Materia Medica. [Aug., bility of the surface of the body; temperature of the skin below the natural standard. (2.) Clinical Remarks.—As an external application vinegar has been used with success to allay the intense itching and burning of eczema. Oettinger cured several cases of chronic eruptive disease, resembling lichen, by the internal and external use of this remedy. The refrige- rant influence of diluted vinegar on the surface is undoubted ; it not only diminishes heat, but allays pain. (10.) In Scarlatina, dilute Acetic-acid internally, has been strongly re- commended by Dr. Isaac Brown. He considers that is it more efficacious than any other treatment, and that is tends to prevent the occurrence of dropsy. Dr. Webster relates four cases, in which it appeared to him conclusive that sponging the body of the patient prevented the spread of the disease beyond the original patient. In Psoriasis, Dr. Cummin states that his trials with strong Acetic- acid have been highly satisfactory ; the diseased cuticle separating in flakes, and a new surface being exposed, of a much more healthy character. The application of the acid is hot and painful, especially when there are excoriations and fissures ; but these should be protected by Glycerine, or Simple-cerate. The acid requires, in most cases, to be repeated two or three times. In obstinate cases of lepra much benefit has been derived from the use of baths acidulated with Acetic- acid. (11.) Navus Maternus.—Dr. Behrend of Berlin advises in the case of the small fiat naevi, the application of strong Acetic-acid ; under this treatment the blood is made to coagulate in its vessels, the naevus becomes hard and yellow, and is thrown off in the form of a parchment- like layer. In obstinate cases the Muriate Tincture of Iron, or a slight application of strong Nitric-acid may be used. Warts and Moles may be removed effectually by the application of the strong acid. The warts should be first carefully pared down, and the acid should then be applied with a camel's hair brush. Large moles may be touched lightly with strong Nitric-acid, a wet rag may be applied at once to prevent the acid from burning too deep, and subse- quently the mole may be touched every day or two with Acetic-acid. I have found this mode of treatment very successful. (11.) Cancer.—Acetic-acid is the only known agent which dissolves the true cancer cells ; it may be used freely internally and externally-. Burns and Scalds.—Cleghorn of Edinburgh recommends the im- mediate application of vinegar to the burnt surface, to be continued until the pain abates, and when this returned the application was re- peated. In Purpura, whether attended by fever, or of a torpid character, Erasmus Wilson advises sponging the body with tepid vinegar and water. In Hospital Gangrene, when of a mild character, Delpech speaks highly of the topical application of Acetic-acid and Vinegar The ulcerations having been previously cleansed, are to be washed with 1855.] Acidum Benzoicum. 11 strong vinegar, and then covered with charpie wet with the same liquid. If this fails caustics must be used. Vinegar in Itch.—Professor Le Coeur of Caen, recommends for the cure of Itch, forcible frictions of the parts affected, with a hard sponge, soaked in good vinegar, thrice daily so as so penetrate the skin and rupture the vesicles. He has tried this treatment with the most com- plete success in ten cases, the average length of the treatment being less than five days. He thinks this treatment preferable to all others on account of its speedy action, its inexpensive nature, its freedom from all unpleasant odors, and its easy application. He suggests that similar results might be obtained by frictions with the mineral acids diluted with water. General Symptoms.—Febrile symptoms accompanying typhus hectic fever; dropsical affections arising from loss of blood, diarrhoea or functional derangements ; haemorrhages from the nose, lungs, and stomach ; local eruptions, of an itching and burning character ; deter- mination of blood to the head, with delirium, convulsive movements, and severe pains in the head. Only one fatal case of poisoning by the internal use of Acetic-acid is recorded. In this case, the patient (a girl) "appeared to be in- toxicated, suffered acute pain, and was violently convulsed."( Orfila). No post-mortem examination was made. ACIDUM BENZOICUM. BENZOIC ACID. AUTHORITIES. Jeanes' American provings. (30.) Waring's Therapeutics. (44.) Peters. (11.) North-American Journal of Homoeopathy, Vol. 3. (7.) Dierbach's Mat. Med. (6.) Sleep.—The experimentor awakened after midnight with violent pulsations of the heart and temporal arteries (pulse 110 in a minute) without external heat; and could not fall asleep again. In the morn- ing his tongue was covered with a white mucous coat and he had nausea, and total loss of appetite. In the afternoon at four o'clock all the symptoms had vanished. He awoke every morning about two o'clock, with strong internal heat, and a hard, bounding, but not quickened pulse; he had to lie awake upon his back, because the pulsations of the temporal arteries caused a puffing sound in his ears, and prevented him from going to sleep again (for eight weeks). (30.) Head.—Confusion of the head with drowsiness. Pressure in the temples, in the region of constructiveness. Pressure on the whole of the upper part of the head and spinal co- 12 New Materia Medic a. [Aug., lumn, as if these were pressed together by an elastic body, so that he bent himself involuntarily, and stretched forwards. This sensation without being painful, is productive of extraordinary anxiety (occur- ring two days in succession whilst sitting.) Itching on the scalp. (30.) Eyes.—Itching in the angles of the eyes. (30.) Nose.—Sensation of irritation in the left nostril, such as precedes sneezing, yet without being obliged to sneeze. Slight transitory hoarseness and repeated sneezing, in the morning, with a pleasant excitement and freedom of the head, which, together with its more rapid disappearance, sufficed to distinguish it from the ordinary symptoms of taking cold. (30.) Ears.—Itching in the left ear. Shooting pain in the right ear, intermitting. (30.) Teeth.—Slight cutting pain in the teeth. Darting pain in carious molars in both jaws. (30.) Clinical Remarks.-~Cot\on, well moistened with Tinct.-Benzoin is a capital application to aching and carious teeth. (11.) Mouth.—Soreness of the back part of the tongue, felt most while swallowing. Sensation of soreness and rawness at the root of the tongue, and on the palate. Extensive ulcerations of the tongue with deeply chapped, or fungoid surfaces. An ulcerated tumor in the left side of the mouth upon the soft commissure of the jaws behind the last molar-teeth. (30.) Clinical Remarks.—Benzoin must prove as useful in ulcerations of the mouth, as it does in many more external ulcerations. (11.) Throat.—Heat in the oesophagus, as from acid eructation. (30.) Clinical Remarks.—In two cases, in females, both for a long time subject to violent Angina, in neither of whom the allopathic treatment had ever succeeded in preventing suppuration, though early and ener- getically applied, and where, in the case of the daughter, homoeopathic treatment with Belladonna and other apparently indicated remedies had twice failed to prevent suppuration, although it diminished the suffering much more than any previous treatment, Benzoic-acid in alternation with Belladonna and Digitalis would speedily subdue the attacks, and finally seemed to effect such an alteration of the system that the tendency to this form of disease appeared to be almost ex- tinguished. (30.) Stomach.—Singultus. Sensation of heat throughout the abdomen. Pain in the left side of the abdomen immediately below the short ribs. (30.) Clinical Remarks.—In Pyrosis, the late Dr. Baillie was in the habit of employing the compound tincture; and generally found it effi- cacious ; Dr. Symonds also bears testimony to the value of this treatment. (44.) Bowels.—Bowels freely open with extraordinary pressure to stool; 1855.] Acidum Benzoicum. 13 foetid, watery, white stools, very copious and exhausting in infants, the urine being of very deep red color. (30.) Clinical Remarks.—In cases of diarrhoea in infants, where the stools are very copious, watery, very light colored and foetid, and where the urine is of an uncommonly deep red color, and its urinous odor remarkably strong, I have found Benzoic-acid produce very great improvement. (30.) In constipation apparently depending upon stricture of the colon, Drs. Hastings and Streeten state that the compound tincture of Ben- zoin will keep up the peristaltic action, without irritating the bowels; as there is a mechanical obstacle to overcome, comparatively large doses are required, but twenty drops, 3 times a day, will generally keep the bowels active and regular. (44.) Urine.—Irritability of the bladder; too frequent desire to evacuate the bladder, the urine being normal in appearance. Urine at first only increased in quantity, not in frequency, but in a few days urination became exceedingly frequent, with strong pressing; urine of an aro- matic odor, and saline taste ; the odor being long retained and most marked in the forenoon; urine highly colored, sometimes of the color of brandy, the urinous odor being exceedingly strong; urine of the above character, of a specific gravity greater than that of healthy urine when passed into the same vessel, assumed and retained its place below the healthy urine without mixing with it; and though of a very deep red color, it deposited no sediment; hot scalding urine of a deep red color and strong odor, causing so much suffering in its passage, that the patient made water but once a day. (30.) Clinical Remarks.—Dr. Jeanes of Philadelphia says : I have found the Benzoic-acid of great utility in a number of cases where the urine was of a deep red color, sometimes even as dark as brandy, and its urinous odor peculiarly strong. This highly colored and strongly scented urine occurs most frequently in syphilitic cases; where the external symptoms have been either wholly or partially suppressed by improper treatment; also in some cases after infection, but before the establishment of chancre or syphilitic gonorrhoea; and sometimes ac- companies these disorders. It is often so strongly marked as to attract the attention of the patient sufficiently to induce him to remark it to the physician. (30.) Case: A gentleman, aged 37, had the following symptoms: whitish deposit in the urine, forming a hard grey crust, very difficult to re- move, of offensive and strongly ammoniacal odor; specific gravity 1023; without albumen; the patient's appetite was good, tongue clean, and he slept well; but was pale, complaining of general lassi- tude and languor, and a sense of weakness across the loins; his bowels were generally confined. By the use of Benzoic-acid he was completely restored. (30.) Dr. Williamson of Philadelphia reports a case of Nephritic Colic in a man subject to it. The Urine was extremely high colored and 14 New Materia Medica. [Aug., strongly scented ; the Benzoic-acid afforded great relief in a paroxysm which occurred two years ago, since which time he has not had his usual returns of the complaint. (30.) In irritable states of the bladder, Dr. Prout derived much benefit from the Tinct.-Benzoin. It should be given, he observes, in small doses largely diluted, and persevered in for a long time. Dr. Soden of Bath relates four cases successfully treated with it. Dr. Garrod found that he could produce a very acid state of the urine with Ben- zoic-acid, enabling the urine to hold in solution a large amount of phosphatic salts. He used it in a case of paraplegia where the urine was highly alkaline, and deposited a large amount of phosphates ; under the use of Benzoic-acid, four times a day, the phosphatic de- posits soon became lessened, and in a few days entirely ceased, and did not return when the medicine was omitted. (44.) In incontinence of urine in children, Dr. Delcom relates two cases successfully treated with Benzoic-acid, when many other remedies had failed. (44.) Drs. Metcalf, Chapman and Fraene have used it with great benefit. (N. A. Journ. Horn. Vol. 3., p. 334.) Sexual Organs—A thrilling almost painful sensation on the left side of the glans-penis, extending into the urethra, so severe as to occasion starting, ending in a sensation of tickling and itching. Itching in the sulcus behind the corona glandis. Smarting of the fraenum praeputii. (30.) Clinical Remarks.—In Pruritus Scroti.—Erasmus Wilson states that pencilling the parts with the tincture will be found useful. (44.) larynx.—Sneezing, with slight hoarseness, without accompanying catarrhal symptoms. Troublesome, and almost constant, dry hacking cough. (30.) The powder of Benzoin introduced into the nose, readily causes sneezing ; the vapors of Benzoic-acid cause violent coughing. Ac- cording to Schreiber, if taken internally in large doses, it causes a long-continued scratching sensation in the throat, increased warmth of the body, quickness of the pulse, followed by profuse sweat, at- tended with dulness of the head and copious expectoration. Benzoic- acid will then also be found in the urine. (11.) Clinical Remarks.—-It is supposed to act specifically upon the mu- cous membranes, especially the pharyngeal, laryngeal and bronchial • the vapor sometimes causes great irritation of the air-passages ; still it is recommended by Dr. Cheyne in strumous laryngitis, and by Trousseau and Pidoux in chronic laryngitis and chronic catarrhs; they advise the air of the patient's apartments to be impregnated with the vapor of Benzoin, the drug being thrown upon burning coals, or it may be inhaled from a common inhaler, the Balsam or Acid being placed in boiling water. (44.) 5 It is regarded as a powerful expectorant in chronic chest affections, coughs asthma, suffocative catarrh, spasms of the chest, especially when these occur m connection wiih amenorrhcea and chlorosis (11 ) 1855.] Acidum Benzoicum. 15 Chest.—Pain about the third rib, and on the right side, midway between the sternum and the side. Pain in the right side of the back, about midway between the tenth vertebrae dorsalis and the side. Pain in the left side, about the sixth rib, increased by deep inspi- ration, and by bending the body to either side. Deep penetrating stitch in the posterior part of the left side, about the sixth rib. (30.) Clinical Remarks.—In a case where inflammatory rheumatism and violent asthma, both of long-standing and frequent recurrence, co- existed, and for which I gave the Benzoic-acid the patient remarked a great amelioration of his asthmatic paroxysms. This is worthy of mention, inasmuch as one of the benzoated tinctures of opium was for- merly termed Elixir-asthmaticum, and it may be that further obser- vations will prove the Benzoic-acid to be a remedy for some peculiar forms of asthmatic disorder. (30.) Breasts.—In sore and cracked nipples, the local application of Tinct. Benzoin is the most useful remedy, of all recommended for this pur- pose ; it forms a thin coating, like gutta-percha, which is not removed by the infant in nursing, and which need not be washed off before nursing. (11.) Back.—Dull pain in the back in the region of the kidneys. (30.) Extremities.—Nicking and cracking of the joints, both of the superior and inferior extremities, during motion; Pain in the joints of the fingers of the right hand. The pain leaves the right hand and appears in the left arm, then extends downward into the elbow, and leaving this situation, next appears in the region of the heart. The pain having left these parts, appears in the thigh and ankle. Pain in the right tendo-achilles, and in the region of the heart at the same time. The pain is incessantly and suddenly changing its location, but its most constant seat is in the region of the heart. After leaving the right, the pain appears in the left tendo-achilles. Aching pain in the hip, then in the left thigh, next in the knees, then in the toes. Sharp pain in the left ankle, during the time it supports the weight of the body while walking. Upon supporting a slight part of the weight of the body on the left foot, severe pain in the tendo-achilles close to the os-calcis. Pain in the gastrocnemii. Pain in the toes. Pain in the large joints of the great toes, with slight tumefaction and redness. Stitch passing upwards, through the right great toe, followed by a burning, which changes gradually again to a stitch, appearing afterwards in the left great toe, from which it vanishes with a thrilling sensation (in the morning).—Whilst lying down (8th day): itching on various parts of the extremities, yielding rather an agreeable feeling on being scratched, but leaving a burning. Feeling of coldness of the knees, as if they were blown upon by a cold wind. Frequent pulse. (30.) 16 New Materia Medica. [Aug., Clinical Remarks.—In many cases of rheumatism and of painful joints, with arthritic concretions, arthritic irritation of the great toe-joints attended with swelling and redness of the skin, urine highly colored and of strong ammoniacal odor, I have employed Benzoic-acid with much benefit. (Jeanes.) [30.] It seems to be one of the most homoeopathic remedies for wandering rheumatism, and rheumatic affections of the heart. In Gout, Benzoic-acid has been advised by Drs. Ure and Prout, to prevent the disposition of, and to remove when formed, the masses of Urate of Soda, which so commonly occur about the joints of gouty subjects. (44.) According to Lehmann, Benzoic-acid sometimes occurs in animal fluids, and its conversion in the animal body has already thrown much light on the metamorphosis of the tissues. Benzoic-acid stands in near chemical relation to Toluylic-acid, Copaivic-acid, and Cinnamic-acid. Benzoic-acid also bears some relation to Hydrocyanic-acid, for when heated with Potassium it yields Cyanide of Potassium. In fact, the oil of bitter almonds is regarded as a combination of Benzoyl with hydrogen; and Benzoin may be formed by the action of caustic alkalies on oil of bitter almonds, containing Hydrocyanic-acid. Again Nitro- benzide is a yellow fluid with a sweetish taste and cinnamon-like odor. Benzoic-acid has been found in the urine of the Herbivora and Carnivora, and it very often occurs in the place of Hippuric-acid. Again, when the urine of horses has stood for some time in the stable and begun to be ammonical it never contains Hippuric-acid, but only Benzoic-acid. In like manner we often meet with onlyBenzoic-acid in human urine, and if some portions of it have long been exposed to the air, they undergo such a change that only Benzoic-acid is found in the whole urine. Hence it appears to be a fact, as Liebig assumed, that a ferment is formed in the urine by means of which the Hippuric-acid is converted into Benzoic-acid; for if we mix a specimen of urine, whether from man or from the horse, with another specimen containing Hippuric-acid, on separating the acids from the mixture, we almost constantly obtain Benzoic-acid alone, the ferment of the urine contain- ing Benzoic-acid probably acting on the Hippuric-acid of the fresh urine. Moreover Benzoic-acid when conveyed into the organism is invariably converted into Hippuric-acid, as observed by Woehler Kel- ler, Ure, and others. The ingestion of Benzoic-acid causes an extremely disagreeable irritation in the throat, and subsequently a very profuse diaphoresis • it is also one of the very few acids which produce a marked augmentation of the acidity of the urine. Acidum Fluoricum. 17 ACIDUM FLUOKICUM. FLUORIC ACID. This acid plays an important part in the animal economy. Brugnatelli believed that he had discovered the existence of this acid in the gastric juice of birds, and Treviranus also believed that, when the contents of the intestinal canal of fowls were digested in porcelain vessels, the glazing was attacked on account of the presence of Hydro-fluoric-acid. Again, the Fluoride of Calicum is so integral a part of the enamel of the teeth, that we must ascribe to its presence (at least in part) the polish and extraordinary hardness of that substance. The presence of Fluoride of Calcium has also been determined with certainty in the bones of almost all animals. Berzelius found 2. 1$ of Fluoride of Calcium in the Dentine, and 3. 2-fr in the enamel of a man's teeth. The presence of fluorine in blood and milk has been clearly demonstrated by Dr. George Wilson. In regard to the origin of the Fluoride of Calcium, Lehmann says we cannot doubt that it is easily conveyed into the animal system with the food; we need only remember that many mineral waters contain traces of fluorides, and that plants take up a little Fluoride of Calcium from micaceous soils. Fluoride of Calcium was detected by Berzelius in the Carlsbad water, and has been found in other mineral waters. Fluoric-acid is a solvent for some elementary principles which resist the action even of Nitro-hydro-chloric-acid; thus it solves Silica in particular, also Silica and Silicic-acid. It is especially useful as a solvent of Silex in the animal economy, for small quantities of Silica are found in the blood, in the white of egg, in bile, in urine, and in the solid excrements, and occasionally in certain morbid concretions; it has also been shown by numerous experiments that Silica forms an integral constituent of hair and feathers, and hence it is evident that a perfect solvent for it is required in order that it may be readily con- veyed through the most minute capillaries to its appropriate destination. Fluoric-acid is an admirable solvent; its vapor is more pungent than Chlorine, or any of the irritating gases. Of all substances it is the most destructive to animal matter; it produces the strongest caustic effects; when applied to the skin it causes violent pain, the parts around become white and painful, forming a dense pustule filled with matter; even a very small and hardly visible quantity will produce the same effects, though only after the lapse of several hours. The smallest quantity applied to the hand excites violent itching, and pustules filled with matter are soon formed, according to Liebig; m fact the acid unites itself to the skin to such a degree, that it cannot be washed on even by means of carbonate of soda, although the pain may be mitigated. The solution of ^th of a grain, and even that of r\th does not produce either pain or redness; ith of a grain, however, produces some pain, 12 18 New Materia Medica. redness and heat, the epidermis falling off in scales after the lapse of a few days. In consequence of its solvent action upon flint, Fluoric-acid acts energetically upon glass; the transparency of the glass is instantly destroyed, and heat is evolved. As Fluoric-acid is sometimes developed in excess in the stomach, we may hazard the conjecture that it sometimes gives rise to intense suffering and may even be the cause of the well known perforating ulcer of the stomach; an excess of the acid will also cause rapid caries of the teeth; and may even cause felons, &c, &c. In order to give a better idea of its action in its concentrated state, we append the following case, from Frank's Magazine. Franz Pschick assistant in the Chemical Institute of Dr. Jacquin made some experiments with it publicly, December 23d, on which occasion he accidentally exposed his hand to the fumes of Acid.- *lounc for about one minute. An hour after the occurrence, while engaged in cleaning some instruments in warm water, he experienced a very troublesome prickling in the extremities of the fingers—and shortly after such violent pain, as obliged him to stop short from his work; soon after this he felt a chilly sensation in his left arm gradually extending all through his body; in the evening when he was seized with a violent fever and chill, he mistrusted the real cause of his suffering: the pam now became intolerable, and the integument of the hand very much swollen. On the morning of December 24th all the fin- gers of"the: left^handbut especially the thumb, were very much inflamed and discolored, with very great stiffness of the first and second pha- anges; and severe pain extending to the axilla. He then put his hand in albumen, drank water with some nitrate of potash, and applied a somewha0/ "t P T* * ^ ^ ^ °f which e™d hls Edition somewhat. Towards evening, however, the pain and swelling in- thrnight?^1115 re-aWlied Poultices-but could not sleep during an?n.h!?etf ^ thG extfmiti1es of the ^gers had become all white and he thumb covered with large blisters, attended with severe pulsating pain in the same; on opening one blister after another a thick, brown, and very offensive-smelling liquid exuded from the same tor^JLar"-In the course °f four weeks *■ £% Mental Condition.-Discontentment and excessive ill-humor were felt by Henng, Campos and others, followed by indifference and forgetiulness, and finally succeeded by perfect LPn,m!It a commonly gay disposition of the mind 7 * co*tentment and un- Chntcal Remarks.-Taking advantage of these effects upon the moral state, Henng gave it to an invalid old ladv who nnarrpllTl , i. with nurses, relatives, and the whole house • twoCs^Z^ '5 soon rendered the old lady patient and ^^£Z3%. Bead.-WhUst sitting,) a dull pressure and compression in the Acidum Fluoricurru 19 occiput, particularly towards the right, with the continual internal sensation of numbness in the left forearm, and severe pricking, whilst stretching it. (Hering.) Nausea and vertigo. Painful and sudden determination of blood to the forehead. (Hering.) Dullness of the head in the morning; towards the right, with numbness or burning in the forehead, after- wards felt in the jaws. (Hering, &c.) Dull heaviness of the head, forehead. Pressing pains in the fore- head. (Williamson, Husmann, &c.) Sharp shooting pain through the head. (Campos.) [30.] He felt as if struck with apoplexy, with rush of blood to the head, and partial loss of consciousness, so that he could not recollect where he was. The second dilution caused increased flow of saliva, pain in the head, and sensation as if the head was too heavy, and would drop from one side to the other. The first dilution caused a dull heaviness and pain in the whole head. Rush of blood from the nape of the neck through the centre of the head towards the forehead. Severe pressing pain in the left, or in both temples, followed by pain in the left shoulder; sharp darting pains, much worse than a prolonged electrical shock, or compression of the ulnar nerve, shoot- ing and painful indulation in the brain, occurring so quickly as to excite a very disagreeable idea of impending danger. Rush of blood to the head,'with heat in the forehead, increasing to frontal headache. Pain over the right eyebrow, followed by pain in the toes ; pain on the right side of the head, followed by pain under the right shoulder-blade. Clinical Remarks.—This remedy promises to prove a rival to Glonoine, against rush of blood to the head, apoplectic attacks ; it also seems homeeopathic to rheumatic and neuralgic headaches, especially of the wandering kind; and to some forms of sick headache. (11.) Scalp.—Itching of the head, and falling off of the hair. Clinical Remarks.—Williamson who had been becoming more and more bald for years, found after two months' use and action of Fluoric- acid that a new growth of hair was commencing, and he is now much less bald than before. The Fluoric-acid, and Fluoride of Calcium may prove a natural stimulant to the hair, at least it will render a sufficient quantity of Silicia soluble to supply the want of a full growth of hair. A weak solution might be applied locally to the scalp. (11.) Eyes.—Drawing pain around the eyes. Elevated red blotches and scaly eruption over the brows. (Williamson.) Frequent attacks of burning, itching on the eyelids and inner canthus of the eyes, inducing one to rub and scratch. (Hering, Husmann, &c.) Increased lachrymation. (Esrey.) The sight clearer. (Campos.) ; Bright, red sparklings, cross each other in all possible directions, like lightning, on closing the eyes in the evening. (Hering, Hus- mann.) [30.1 • • i Clinical Remarks.—It has removed muscae volitantes; it is homceo- 20 New Materia Mediea. pathic to photopsia and lachrymation ; also to Tinea-ciliaris; and probably to scrofulous ophthalmia. It has proved useful in fistula lachrymalis, attended with pain in the eye, extending very far down into the upper jaw ; and into the nostril, followed by soreness and painful sensibility of the bones of the upper jaw and nose. (11.) flose.—Sore feeling in the nose; appearance of pimples; fluent coryza, with sneezing. Pains about the bones of the nose, extending into and behind the eye and down into the malar bones. Clinical Remarks.—A very large pimple with inflamed base on the top of the nose, was cured in two days by Acid.-fluoric. 15th. (Jeanes.) A chronic inflammation of the nose with pain, redness, some swelling and heat,disappeared within three days; after the formation of a small pustule, with a smooth surface, on a painful red circle. (Hering.) [30.] Ears,—Stitches and pressing pain in the ears, followed by pains in the heels. (Freitag, Husman.) Increased sensitiveness of hearing in the morning. (Hering.) [30.] Clinical Remarks.—It may prove homoeopathic to some forms of rheumatic ear-ache, especially in rheumatic irritation of the fibrous tissues about the ear. (8.) Face and Jaws.—Heat and perspiration in the face. (Hering.) Itching on the right side of the face. (Geist, Husmann.) Deep pain in the bones around the eyes. (Hering.) Painful sensibility in the jaws, spasmodic contraction; drawing and gnawing pain in the inferior maxillary-bones ; burning pain on the outside. *(Hering, Neidhard.) [30.] Clinical Remarks.—This remedy seems to act specifically upon the periosteum of the bones of the face ; in this respect its action is some- what similar to that of Mezereum. (H.) Teeth.—Teeth feel warm; the warmth was felt in the teeth, and not in the gums; drawing, digging toothache. (Smith. Husman. Neidhard.) Sensation of roughness, as if broken, in the lower incisor teeth. Tongue feels painful on touching it. (Hering.) (30.) Clinical Remarks.—A fistula near the right eye-tooth, of several years' duration, gradually disappeared while taking the remedy ; Fluoric-acid seems to exert a specific action upon the fibrous tissues and periosteum about the jaws and teeth. (11.) Mouth.—Warm, burning sensation, as if from a sore on the inner side of the lips. Taste.—A solution of £ gr. caused in the mouth a violent pain, as from hot water, the teeth becoming very painful. Nausea.—One drop of the ,^th produced a bluntness of the teeth, a sensation of sticking, contraction and tension, after which the in- terior cuticle of the mouth became whitish and peeled off.__Twenty drops of the ^th, taken in water, excited frequent sour eructations, sensation of heat and disagreeable flat taste in the mouth. (Kreiner.) Acidum Fluoricum. 21 The taste is quite intolerable, like ink. (Thenard. Hering.) Acid, saltish, sweetish taste, with a greasy feeling. (Pehrson. Gosewisch. Jeanes. Hering.) Eructations, acid, sour, and bitter, with pyrosis, passage of flatulence, and choking.—Nausea. (Neidhard. Campos.) Sickness of stomach, with desire to vomit, vertigo and headache. (Esrey. Smith. Neidhard. Hering.) He vomits several times with difficulty, a clear, viscid fluid, con- taining coagulated white pieces. The whole day he felt nausea, eructations and lassitude. (After thirty of & solution about two grs. Kreiner.) Increase of saliva. Clinical Remarks.—It may prove curative against waterbrash, sore- ness of the stomach, gastralgia, &c. (11.) Palate and Fauces.—Prickling, and a smarting feeling on the tongue and palate. Tenderness and irritability in the larynx; feeling of sore- ness when coughing. (Jeanes.) Heat and dryness in the mouth and fauces. (Husman. Williamson.) Violent burning in the fauces and a sensation of constriction; rum- bling in the bowels, pressure in the stomach and burning eructations, choking for two hours. (Ten drops of A solution.) (Kreiner.) Sore throat, with difficult deglutition, hawking up of much phlegm, mixed with some blood. (Hering.) (30.) Clinical Remarks.—It seems homoeopathic to the chronic pharyn- gitis which is to commonly and erroneously termed bronchitis; also to pharyno-laryngitis ; and to chronic pharyngitis, when it arises from gastric disease ; also to ulceration of the throat and larynx. (11.) Stomach.—Pressure in the stomach and burning. Uncomfortable feeling. (Williamson.) Heat in the stomach before meals, which disappears afterwards, then heaviness in the stomach, and after some hours again heat; a^ravated during exercise. (Gosewisch.) (30.) Clinical Remarks.-We have already alluded to its applicability against dyspepsia, acidity of the stomach, water-brash, and flatulence; it is particularly useful when there is considerable tenderness of the stomach to pressure, with suspicion of ulceration of the stomach when attended with vomiting of small quantities of blood-streaked acrid mucus. (H-) Abdomen—Pain in the left side of the abdomen in the region of the spleen ; above the hip, hindering respiration. (Geist) Rumbling in the bowels, with erratic pains ; acute shooting pain in the bowels, as if caused by wind. (Smith.) (*"■) , Clinical Remarks.-It seems to exert a specific action^ upon he spleen, as Geist, Pehrson, and Freitag all felt pains about the region of spleen, and one experimenter, who had had a pain in the region of the spleen, for six days, found it to cease quickly, and it did not return again. (11.) 22 New Materia Medica. Facets.—Inclination to diarrhoea, two free passages the first day. Awaking after midnight with a large quantity of viscid, tasteless saliva in the mouth, attended with a burning pinching pain in the sto- mach, and with a sensation of distention from flatulency ; after the passage of some wind, the pain is increased, followed by a copious pappy evacuation of the bowels, after which the pain seemed to con- centrate itself in the region of the navel, and is followed by a second passage ; in the morning he had a third passage. (Pehrson.) Copious pappy evacuations ; watery stools, with pain around the navel. (Pehrson.) Frequent discharges of inodorous flatus. (Campos.) Small, excessively offensive discharges of wind. (Hering.) (30.) Anus.—Violent itching within and around the anus, violent itching ; returning frequently. (30.) Clinical Remarks.—It has proved somewhat useful against pro- lapsus ani; against irritation and constriction of the sphincter-ani; and against piles. (11.) Groins, Bladder and Urine.—Pain in the region of the bladder. (Hering.) Free and frequent discharge of light colored urine, of sufficiently large, but not increased quantity. (Campos, Hering, Williamson.) Pungent and strong odor of the urine. (Williamson, Hering.) [30.] Offensive and pimple-colored urine. Genital Organs.—Sexual passion much increased, with erections at night, during sleep; (Gosewisch, Campos.) Occasionally stitches and drawing through the left testicle, in the abdominal ring and spermatic cord. (Neidhard.) [30.] Menses eight days too soon and more copious, thick and coagulated. Clinical Remarks.—This remedy seems to exert almost as specific an action upon the genital organs as Phosphorus and Platina; it has aroused the sexual organs even in quite elderly persons. Chest.—Increased irritability of the larynx, with soreness of the cartilage. Soreness in the chest, oppression, pressing sticking pain in the chest. (E. Smith, Neidhard, Geist, Williamson.) [30.] Clinical Remarks.—It seems homoeopathic to many attacks of chronic but painful laryngitis, attended with soreness of the chest. (11.) Breast.—Itching on the nipple and around it, in the evening; the nipple next morning is much larger, more red, and the areola darker. A thin brownish crust is formed on the areola. (Hering.) [30.] It may prove useful to soreness of the nipples, and inflammation and suppuration of the breasts. (11.) Respiration.—Oppression in the chest, difficulty of breathine (Bute, Hering.) [30.] 6' Clinical.—In two cases of incurable hydrothorax, Fluoric-acid 3d gave much relief. (Jeanes.) [30.] Acidum Fluoricum. 23 Heart.—Uneasiness about the heart, painful jerking in the heart; continual soreness about the region of the heart. Clinical Remarks.—It may prove useful against some rheumatic affections of the heart, especially of the fibrous tissues, such as the valves, and chordae tendiniae. (11.) Neck.—Drawing pain in the right side of the neck. (Freitag, Williamson.) Now and then warm flushes like a warm breath proceeding from the nape of the neck towards the occiput. Stiffness and soreness of the nape of the neck. Back.—Pain in the back and shoulder; itching of the back. (Williamson, Hering.) [30.] Great heat in the back extending to the loins; the remedy is very homoeopathic to aching pains in the os-sacrum. Upper Extremities.—Rheumatic pain deep in the bones of the arms; wandering pains; tingling sensation, soreness, aching pain, and numbness of the arms, bones of the arms and fingers. (Hering, Freitag, Jeanes, Neidhard, Williamson.) [30.] Heat in the palm of the hands. (Husmann, Hering.) [30.] Numbness and lameness of the arms; heaviness and numbness of the arms; falling asleep of the forearms and hands; numb pains, lameness and powerless sensation in the hands; the hands are swollen and warm, and uncommonly red, appearing as if marbled. Clinical.—It removed a chronic perspiration in the palms of the hands, which persisted even during cold, dry weather ; although the back of the hand was dry, still, his palms were constantly so moist that every one who shook hands with him observed it, it disappeared on the fourth day after taking Ac-fluoric. (Geist.) [30.] lower Extremities.—Acute stitches on the right hip bone, spreading themselves over the glutei muscles. (Geist.) Pain in the right ischiatic nerve. Laming, pressing, burning, wandering pain in various parts of the lower extremities. (Williamson, Jeanes, Hering.) Soreness and pain on motion, in the left hip, particularly felt when getting out of the bed, worse in the morning. (Williamson.) Pain in the knee and ankle joints. (Neidhard, Smith, Williamson.) Heat and crawling sensation of the sole of the right foot. (William- son.) [30.] . Clinical Remarks.—It is particularly serviceable against those rheumatic and neuralgic pains of the extremities, which are very apt to fly to the head, or heart. Skin.—Burning pains on small spots of the skin, in different parts of the body. (Hering, Geist.) Itching in various places of the body, mostly on the posterior parts. (Hering.) • , i Violent pricking itching of the skin and small pimples here and there. (Hering.) u New Materia Medica. Several small light carmine red, elevated, round blood vesicles, resembling little flesh warts; they are very soft and compressible, and by a strong and steady pressure the blood disappears, but im- mediately returns again. They are very perceptible as light red en- largements of the capillaries raising up the cuticle. (Hering.) [30.] Clinical.—Numerous varicose veins of twenty years' standing on the left leg of an old man, were diminished one-half, after repeated doses of Fluor.-acid. (12th, Neidhard.) Heat.—Increased heat of the body. (Hering.) General feeling of heat, heaviness and lameness of the whole body. (Neidhard.) [30.] Clinical Remarks.—The moderate use of this remedy is supposed to render one more capable of bearing the summer heat, and to prevent liability to sun stroke. Perspiration.—Profuse, sour, offensive perspiration in the afternoon. (Williamson.) For several evenings an unusual profuse and glutinous perspiration, with itching. (Hering.) (30.) Sleep.—Sleeplessness. (Campos.) Day and night without his usual sleep; he feels as if he had already slept. Drowsiness in the forenoon. (Hering, Campos, Pehrson.) Sudden sleepiness in the evening. Profound sleep until late in the morning. (Hering.) Vivid dreams. (Hering, Husman, Pehrson.) (30.) Clinical Remarks.—It promises to prove useful against sleepless- ness from fulness of the head, or from the activity of the brain, with frequent awaking and vivid dreams. General Symptoms.—Jerking pains in different parts of the body (Hering, Neidhard, Campos.) Increased ability to exercise his muscles without fatigue. (Campos,) regardless of the most excessive heat of summer, or cold in winter. Hands, fingers, toes, feet, jaws, lips, eyebrows and eyelids, muscles of the face, &c. are all in motion, as in Chorea. ACIDUM GALLICUM. GALLIC ACID. Authorities.—Waring's Therapeutics. (44.) Wood and Bache. (7 ) The astringency of Nut-galls depends upon the presence of Tannic- and Galhc-acids ; of the former they contain 26, of the latter 6 per- cent. Gallic-acid in its properties is very similar to those of Tannin but it is much weaker; still in all cases of haemorrhage in which the bleeding vessels must be reached through the route of the circulation it is believed to be more efficient even than Tannic-acid, as its chemical affinities do not offer the same impediments to its absorption as those of Acidum Gallicum. 25 the latter acid. It is said to be the active ingredient in Ruspini's styptic. Mr. C. Wetherill, believing that Gallic-acid differs from the Tannic wholly in containing more water; conceived the idea of pre- paring the former from the latter by the fixation of water; this he effected through the agency of Sulphuric-acid; having mixed thirteen drachms of Tannic-acid with twenty-two fluid-ounces of Sulphuric- acid and four times that bulk of water, he heated the mixture to the boiling point, and then allowed it to stand; in a few days an abundant precipitate of wliite Gallic-acid took place amounting to 87. 4. per- cent, of the Tannic-acid. The experience with it is principally clinical and palliative. Nose.—Clinical Remarks.—In epistaxis, it is a useful application ; dossils of lint impregnated with it may be applied to the nostrils ; or a solution of it in warm water may be snuffed up the nostrils, and the throat gargled with it. (11.) Stomach and Bowels.—It does not so frequently produce constipa- tion as Tannic-acid. Clinical Remarks.—In Dyspepsia arising from a relaxed condition of the gastric mucous membrane, Dr. Sampson derived great benefit from Gallic-acid. In Hamatemesis and bleeding from-the bowels, or from any other part with which Tannic-acid can be brought in direct contact, it will be found more useful than Gallic-acid ; but when the haemorrhage proceeds from the spleen or liver, then Gallic-acid will prove most efficient. Dr. Bayles says: In Pyrosis the most marked benefit will follow the use of this remedy; it not only checks the secretion with a certainty and rapidity he has never seen to follow the ad- ministration of any other remedy, but it gives general tone to the stomach, increases the appetite, and even removes constipation in many cases. (44.) Kidneys.—In Haematuria, Dr. Garrod has used Gallic-acid with the greatest advantage, and is inclined to look upon it as the best styptic we possess. Dose, three grains, three or four times a day. Albuminuria.—Sampson relates four cases in which the albuminous character of the urine was changed to a healthy standard by Gallic- acid. Dose. Ten grains thrice daily, or dTtener; he considers that smaller quantities would have proved insufficient. (11.) In many cases of chronic nephritis, one grain doses of the first tritu- ration of Gallic-acid repeated every three or four hours, has effected prompt cures. It removes pains arising from sub-acute inflammation of the kidneys more speedily than any remedy we have ever employed We have witnessed its efficiency also, as a curative agent in several calculous affections of the kidneys. A number of excellent cures of nephritic maladies, are reported by Dr. Redmond Coxe, jr of Phila- delphia, who employed the remedy at the first trituration. (10.) 26 New Materia Medica. Genital Organs.—In Menorrhagia it has been found eminently useful; severe cases successfully treated by it are recorded by Ste- venson, Simpson and others; they continued its use during the inter- vals, as well as at the period of the discharge. In Leucorrhaea, Drs. Ballard and Garrod state, no remedy which they have employed will bear comparison with Gallic-acid, either for the rapidity with which the cure is effected, or in the permanency of the result. They used it internally, and by vaginal injection. In Gonorrhoea, Sampson says it will change a thick and yellow dis- charge in four days to the smallest quantity of colorless gleet. Chest.—The excessive expectorations of phthisis and bronchitis are much lessened by Gallic-acid. In the profuse perspiration of phthisis it has been used successfully : Ballard and Garrod state, that although, like all other medicines, Gallic- acid sometimes fails in arresting these discharges, yet they have more reason to be satisfied with it than with any other remedy which they had formerly been in the habit of using. During the past two years we have been in the habit of prescribing this acid in advanced phthisis with copious expectoration of purulent matter, profuse night-sweats, diarrhoea, and other hectic symptoms, and for the most part with favorable results. In the case of a young lady, who had a cavity in the left lung, with copious expectoration of pus, night-sweats, frequent haemorrhages from the lungs and bowels, evening-fever, and pulse 130 to the minute, the prolonged use of Gallic-acid of the first trituration, dried up the cavity, stopped the expectoration, the sweats, the haemorrhages, and the fever, and enabled the patient to regain her flesh and strength. Eight months have now elapsed since the cessation of these serious symptoms, and the lady experiences no difficulty except great short- ness of breath upon the slightest exertion. Her flesh, strength and general appearance are the same as when she enjoyed perfect health; but the sound of the left lung on percussion is dull. (10.) ACIDUM IIYDROCYANICUM. PRUSSIC-ACID. This acid may be readily procured from many vegetables, as from bitter almonds, apple-pits, the kernels of peaches, apricots, cherries, plums, and damsons ; also from the flowers of the peach, cherry- laurel and wild-cherry; from the bark of the latter, and from the root of the mountain-ash ; it has also been obtained from the ergot of rye. It is rarely or ever found in animals ; but Cyanogen has been de- tected in combination with iron, in the urine, menstrual fluid and sweat; and with Sulphur and Potassium in the saliva; the greenish- blue discharge of some ulcers probably depends upon the presence of Prussiate of Iron, at least Pereira once detected it. During the Acid Hydrocyanicum. 27 decomposition of animal matters, Cyanogen is frequently generated, as when blood and Carbonate of Potash are calcined in an iron pot. Also, when cheese is exposed to the action of water and the sun, it disengages Ammonia, and if heated in this state with Alcohol, it yields traces of Hydrocyanic-acid. Taylor says that the organs of per- sons who have died from natural causes have occasionally been found to exhale an odor of Prussic-acid, as he once perceived. It is probable that in many weakly, nervous and dyspeptic patients, Hydrocyanic-acid is found in the system, causing great, sinking feeling at the pit of the stomach, debility, nervousness and cramps. Poisoning by Prussic-acid is so commonly the result of an attempt at suicide, or of unpardonable negligence in allopathic physicians, that we ought to be well acquainted with its characteristic symptoms. When a large dose has been taken, as from half to one ounce of the diluted acid, insensibility commences in one or two minutes, attended with convulsive respiration at long intervals, the patient ap- pearing dead in the mean time. Case 1.—An English surgeon in large practice took seven drachms of dilute Prussic-acid ; he was quite insensible in two minutes, and survived about four or five minutes ; he lay on the floor senseless ; there were no convulsions of the limbs or trunk, but a faint flickering motion was observed about the muscles of the lips ; respiration seemed to cease for some seconds, then it was performed in fits and the act of expiration was remarkably deep and lasted for a long time. In another case, besides the above symptoms there was coldness of the hands and feet, and no pulse was to be felt; convulsions of the limbs and trunk are sometimes observed ; the finger nails have been found of a livid color, and the hands firmly clenched. Case 2.—From forty grains of the Prussic-acid a man was ob- served immediately to stagger a few steps, and then to sink down without a groan, apparently lifeless ; the pulse was gone, and the breathing for some time imperceptible ; but after a short interval he made so forcible an expiration that the ribs seemed drawn almost to the spine; the legs and arms then became cold, the eyes prominent, glistening and quite insensible ; after one or two more convulsive ex- pirations, he died in about five minutes. (Taylor.) Case 3.—From two drachms of medicinal-acid ; in about two minutes, extreme bitterness in the mouth, great confusion of the head, headache, and loud ringing in the ears; he walked a few steps, leaned forward on a table, became insensible; his thighs became rigid and were drawn up to the abdomen, when he fell backwards; in this state he remained three or four minutes during which time he was violently convulsed; from the use of Ammonia, sensibility soon returned, and vomiting with great relief supervened, and in half hour he was quite well, with the exception of pain and feeling of distension in the head ; during the convulsions, the arms were also rigid and on drawing them to one side, they forcibly reverted to their former 28 New Materia Medica. position ; the eyes were shut, teeth clenched, and muscles of the face violently convulsed. Case 4.—A man had taken for two months, on account of a chronic catarrh, ten drops of Ittner's-acid, without experiencing the slightest toxicological effect; at length he was found in bed, one morning with headache, blindness, dilated insensible pupils, feeble irregular pulse, occasional suspension of breathing and rapidly increasing insensibi- lity; in no long time spasms commenced in the toes, and gradually effected the rest of the body, till at length violent fits of general tetanus were formed, lasting from six to ten minutes, and alternating in the intervals with coma; subsequently the spasms were con- fined to the jaws and eyes, and delirium succeeded ; at four, P. M. he was tolerably sensible, but the delirium returned at night ; at ten, A. M. next day, he recovered his sight, and on the subsequent morn- ing he had no complaint, but. headache and pain in the eyes. Antidotes. Ammonia, cold affusion, and electricity. John Murray of London was so convinced of the efficacy of Ammonia as an anti- dote that he expressed himself ready to swallow a dose of the acid large enough to prove fatal, provided a skillful person were beside him to administer the antidote. Dupuy, Orfila and Christison agree to this, provided the Ammonia also be inhaled. AUTHORITIES. 1. Hahnemann. Mat. Med. Pur.—2. Orfila. Traite de Tox.— 3. Pereira, Mat. Med. and Ther.— 27. Baumgartner. Salzb. Med. Zeitung, 1829. Vol. 1. p. 377.-4. Frank's Magazine. (8.) Taylor's Med. Jurisprudence. (9.) Christon (12.) British Journ. of Horn. PHENOMENA. Intellect.—Inability to think; dullness of the senses ; vertigo ; illusion of the senses. 1. Violent delirium ; gay delirium, with desire to sing and dance, and acceleration of the circulation. (27.) Sleepi- ness; giddiness. 2. Indisposition to exert the mind; confusion of ideas. 4. Sudden loss of consciousness and of sensation. (2.) Clinical Remarks.—It is one of the most homoeopathic remedies to sudden coma; from opium the coma comes on gradually, rarely under the lapse of fifteen minutes ; while from Prussic-acid it is instanta- neous—even from doses too small to prove fatal, coma is seldom de- layed beyond two minutes. (11.) Affections and Disposition.—Despondency. (1.) Gloomy disposition ■ irritable mood, which disappears in the open air; fretful, peevish, and ill-humored; gay, laughing and singing mood, as if intoxicated.' (4.) Great agitation and excitement. (2.) Clinical Remarks.—Lonsdale thinks that hypochondriasis, orginating in derangement of the stomach, or kept up by a morbid state of the cbylopectic viscera may be advantageously treated by this remedy • it certainly seems homoeopathic to it, especially when attended with pyrosis. (44.) Acidum Uydrocyanicum. 29 Head.—Oppressive pain in the forehead, or in the left side of the occiput; tension in the frontal region ; pricking in different parts of the head. (1.) Feeling of tightness in the head; tightness in the forehead ; heaviness and pressure in the forehead ; tightness of the right side of the head, with pressure in the occiput and forehead; pressure in both temples extending to the orbits; lancinating and boring pain in the forehead and orbits. (4.) Very-severe tearing pains, sometimes at the bottom of the orbits, sometimes in the temples, and sometimes at the occiput; pain in the frontal region. (27). Pain and feeling of distention of the head. (3.) Head confused ; feeling of tightness around the head. (2.) Clinical Remarks.—It is one of the most homoeopathic remedies to passive venous congestion of the brain; to congestive apoplexy ; to dropsy of the brain, consequent upon excessive congestion, &c. The peculiar intermittent respiration caused by Prussic-acid is highly characteristic of dropsy of the brain, and also of softening of the brain. Chapman and Montagh suggest as one of the remedies for the apo- plectic condition, that is found towards the end of some cases of Asiatic cholera. (11.) Pathology.—In men: Brain dotted with blue points, and congested with blood; the ventricles of the brain turgid with blood.—Dura-mater covered with a thick, dark, bloody layer.—A quantity of thick, dark- blue blood in the brain.—(1.) Two ounces of dark red serum under the dura-mater.—Cerebral veins distended with thin uncongealed blood. —Brain softer than natural.—Bluish spots in the brain.— Lateral ventricle distended with serum. —Choroid plexus, dark, bluish red.— Cerebellum greyer than natural.—Tentorium cerebelli filled with very dark-blood.—Vessels of the dura-mater, pia-maler, basis cranii, choroid plexus, and substantia corticalis much distended with blood. (4.) Eyes.—Obscuration of sight; pressure over the inner canthus of the right eye; heaviness of the eyes, and a feeling as if they were immov- able ; lancinating and boring pain in the orbits; photophobia; protruded, glassy eyes, with dilated pupils. (4.) Obscured vision; pupils usually dilated but sometimes contracted. (3.) Pupils very much dilated and but slightly sensible to light; eye-balls prominent, very hard, and tender to the touch; the veins of the eye-lids very much dilated, and varicose; eye-balls convulsed, first being drawn towards the right, and then upwards; pupils contracted; eyes prominent, fixed and insensible to light. (27.) Pupils fixed and dilated. (2.) Pathology.—A very peculiar glistening and staring expression of the eyes, so as to render it difficult to believe that the person is really dead. Clinical Remarks.—The vapor of Prussic-acid has been applied to the eyes in cataract, and opacities of the cornea, with some success it is said; still the vapor applied to the healthy eye will cause dimness of the cornea. (11.) 30 New Materia Medica. Ears.—Pressure in both ears, with buzzing. (1.) Nose.—Wings of the nose bluish. (1.) Convulsive twitchings of the wings of the nose. (2.) Clinical Remarks.—A weak solution has been applied successfully to Acne about the face and nose. (11.) Pace.—Lock-jaw. (1.) Violent convulsions of the face, which is dotted with lead-colored spots; trismus. (27.) Face convulsed, and swollen; distortion of the mouth. Pathology.—Lead-colored spots sometimes observed on the face after death. (27.) Mouth, Pharynx.—Increased secretion of saliva ; tongue coated ; pain in the palate; spasm in the oesophagus ; inflammation of the pharynx and oesophagus. (1.) Difficulty of swallowing drinks, as if from paralysis. (27.) Irritation at the root of the tongue, changing to a scraping sensation; feeling of constriction in the tongue. (4.) Very bitter taste in the mouth ; irritation of the throat. (3.) Trismus; distortion of the mouth; tongue and throat red and inflamed; sore throat, rendering it difficult to swallow drinks. (2.) Pathology.—Violet color of the larynx, trachea, and oesophagus, down to the stomach.—Redness of the mucous membrane of the throat and oesophagus. (2.) Clinical Remarks.—It is quite homoeopathic to salivation and ul- ceration of the mouth ; probably also to chronic pharyngitis ; (8.) and to paralysis of the pharynx and oesophagus, with great inability to swallow. (11.) Stomach, Gastric Symptoms.—Inflammation of the stomach; loss of appetite. (1.) Oft-repeated vomiting; sensitiveness of the epi- gastric region; complete loss of appetite. (27.) Loss of appetite, which was afterwards increased ; feeling of warmth in the stomach; flat taste; aversion to food, although very hungry; heartburn; feel- ing of heaviness and pressure in the stomach. (4.) Frequent nausea; vomiting. (3.) Pain and fullness in the epigastric region. (2.) Pathology.—Veins of the stomach much injected.—Mucous mem- brane of the stomach of a reddish brown color.—Dryness of the mucous membrane of the stomach near the pylorus, but moist and easily separated from the middle coat in other parts.—(4.) Clinical Remarks.—We have in several instances successfully employed the 12th dilution of Prussic-acid in cardialgia. It has long been used in this malady by the other school, and with success for the the most part, although empyrically. Pereira has often seen it cure promptly severe forms of English cholera, attended with violet vomit- ing and purging, after opium had failed. (10.) The immediate and permanent relief sometimes obtained in gastro- dynia from Prussic-acid is very extraordinary; cases which have lasted for months and seemed to arise from some organic disease, may sometimes be cured in a few hours. It is also peculiar that in all [Acidum Eydrocyanicum. 31 cases we obtain either perfect success, or meet with complete failure, it is said never to cause partial relief. It not only allays pain m the stomach, but relieves vomiting, and that frequently when all other remedies fail. It is supposed to be most useful: 1st, In cases, in which pain at the stomach is the leading symptom ; 2d, When gastrodynia is attended with water-brash ; 3d, When excessive irritability of the stomach produces vomiting; 4th, In those disorders of the stomach which in their symptoms resemble affections of the heart. It is more homoeopathic to venous congestion of the stomach than to inflammation; also more homoeopathic to cramps of the stomach than to neuralgia, or atony. It is supposed not only to possess a remarkable power in allaying morbid irritability of the stomach, but also to induce a slower and more healthy secretion of gastric juice. Still Pereira says some of its effects are those of an irritant: such as the acrid impression made by the vapor on the nose and mouth; the salivation; the vomiting and purging ; and the redness of the stomach. (11.) Abdomen.—Occasional rumbling of the bowels, followed by a sense of heat throughout the abdomen; colic pains in the abdomen ; pain in the region of the right kidney. (4.) Tympanitic distention of the abdomen. (2.) . Pathology.—Villous coat of the duodenum, reddish brown, triable, and easily detached.—Villous coat of intestinal canal covered with a reddish mucus.—Injection of the veins of the intestinal mucous membrane. (4.) Clinical Remarks.—It is one of the most homoeopathic remedies to venous plethora of all the the abdominal organs, especially to venous congestion of the stomach, liver, spleen, and whole portal circulation. (11 ) Pereira found it curative against a most excruciating pain in the bowels, commencing daily at 2, P.M., and ceasing only at night, lasting for two months, and ^apparently caused by fever and ague; one dose effected a cure. Stool.—Involuntary discharges from the bowels. (4.) Involuntary Stools in bed. (27.) Colic and diarrhoea. (28.) Clinical Remarks.—-In Asiatic or malignant cholera it has occasion- ally appeared to be successful; it is the most homoeopathic remedy m the stage of collapse. Pereira has found it useful in checlking he diarrhoea of phthisical subjects when Log-wood, Chalk, and Opium had failed. Liver and Spleen.-A large quantity of dark violet-colored blood in the liver and spleen; liver and spleen brittle Joerg noticed in the mesentery of a frog, poisoned with Prussic-acid, that the circulation first in the veins became slower, then that in the arteries; finally the mesenteric arteries became paler and almost empty, while the veins became fuller, and the blood darker and almost violet-colored. In two 32 New Materia Medica. cases, Mertzdorf noticed that the bile and gall-bladder had a blue tint. Spleen gorged, soft and pultaceous. Urinary Organs.—Retention of urine. (1.) Increased flow of urine, with a slight burning in the urethra; involuntary discharges of urine. (4.) Pathology.—A large quantity of dark, violet-colored blood in the kidneys, much softened, and then veins gorged with black blood. Genital Organs.—Nocturnal pollutions. (27.) Pathology.—Scrotum blue and deprived of epidermis here and there ; penis in a state of semi-erection, with indications of seminal or prostatic discharge. (1.) Clinical Remarks—In gonorrhoea, injections containing Prussic-acid have been employed with benefit; Schlegel has also tried the cherry laurel water with the same result. The writer has cured one case of intermittent neuralgia of the left ovary with the 6th dilution, repeated every two hours during the intermissions, after many other of the usual remedies had failed. The paroxysms had been of daily occurrence for more than four weeks, and were entirely cured after two days. (10.) Larynx and Chest.—Inflammation of the larynx; feeling as if the larynx was swollen; tightness of the chest; asthma; acute sticking pains in the chest. (1.) Respiration difficult and rattling; dyspnoea, accompanied by very marked rale; cough, with a slight expectoration of a lightish yellow opaque mucus. Three days after the dose, the patient experienced all the symptoms of an intense pulmonary catarrh. Troublesome paroxysms of cough; catarrhal symptoms increased by the use of cold drinks; cough and dyspnoea worse on lying down in the evening. (2.) Scraping in the larynx and trachea; increased secretion of mucus easily thrown off by coughing; tightness across the chest; stitches in the chest on taking a deep inspiration; dryness in the mouth and larynx; dry cough; lancinating pains in both sides of the thorax, with difficult respiration ; palpitation of the heart, with fleeting stitches in the cardiac region ; scraping and tickling in the throat; lancinating pain on the rigrft side under the false ribs; respi- rations and pulsations of the heart rapid. (4.) Respiration feeble intermittent; respiratory murmur scarcely perceptible by auscultation; respiration sometimes very strong and sometimes intermittent; painful and accelerated respiration. (27.) Clinical Remarks.—Dr. Rosenberg recommends Ac.-hydroc. in true and sthenic cases of pneumonia; pneumonia in phthisical persons; in sub-inflammatory, so-called florid phthisis; in violent inflammation's of the lungs after venesection, in the stage of grey hepatization, with stinking purulent expectoration; also in pneumonia chronic,' with pleuritis and emphysema of the lungs; in pneumonia notha, in young very irritable persons, with phthisical disposition, attended with cough Acidum Hydrocyanic-urn. -3 dryness in larynx, scratching in the trachea, deep groaning respiration, oppression of the chest, and stitches of pain from deep inspiration. Ac.-hydroc. and its analogous remedies deprive, according to the provings of Magendie (Lecons sur le phenom. physiques de la vie, vol. IV.) the blood of the power to coagulate, and change it to a tar- like mass or raspberry-juice fluid, producing extravasation in the lungs, or obstruction in the capillary vessels ; whence arise symptoms of obstruction, and paralysis of the circulation, such as is manifest in cholera, typhus, &c, characterized by terrible anxiety, great op- pression of the chest, slow, weak, anxious and rattling respiration ; convulsive drawing together of the trachea; gelatinous, blood- streaked expectoration ; weak, imperceptible pulse, rolling of the eyes ; enlarged, insensible pupils; blue, cold skin ; absence of all pain.— [Miiller.—Horn. Vierteljahrsschrift, Vol. 2. p. 111.) A woman, about 25 years old, had been sick for sixteen days with- out medical aid ; the whole right lung, except a small place under the clavicle, was apparently in the stage of grey hepatization ; the expec- toration so fetid that it infected the whole room; there was rapid failure of strength. Ac.-hydroc. was given in small, and often-re- peated doses, (viz., ^ gr. Amygdalin) and in three days her life was out of danger. (Dr. Liedbeck—Hom. Vierteljahrsschrift.) 2. Band. Pathology.—A quantity of blood in the trachea.—Larynx, trachea, and lungs of a violet color, and filled with violet colored blood.— Lungs heavier, firmer, denser than natural, reddish, dotted with black points, and filled internally with a blue black blood of an oily con- sistence.—Lungs not entirely collapsed; rather hepatized; general distention of the veins of the lungs with black blood. Clinical Remarks.—The effects upon the respiratory and circulatory- organs, are owing to the influence of the acid over those parts of the nervous system from which the respiratory organs and heart derive their power. As a remedy, therefore, it is especially appropriate in spasmodic affections of the respiratory apparatus, like asthmr., hooping-cough, and other coughs dependant upon a morbid condition of the nerves supplying these organs. We have found the 12th dilution of great service in phthisis, where the cough has been very troublesome, with thick purulent expectoration, and the patient has become quite emaciated, weak, and nervous from hectic. We have seen its good effects also in asthma and hooping cough, after other remedies had been prescribed without any material benefit. The acid cured in two weeks, in the hands of Frank, phthisis pituitosa with the following symptoms, violent cough, with copious purulent expectoration, pressure in the region of the heart, wandering pains about the thorax, head- ache, furred tongue, high fever, dry skin, sleeplessness. The same physician has cured with it many severe cases of tussis hectica, and asthma spasticum. The specific action of this remedy on the chest is exceedingly well marked; the breathing is very apt to become labored and oppressed, 13 34 New Materia Medica. and the chest heavy and full, even before the stomach suffers, and in most cases the immediate cause of death is obstruction of respiration. It is most homoeopathic to venous congestion of the lungs. It is the best remedy against the Epilepsia thoracica of Schoenlein; in this affection the patient becomes oppressed towards evening, or is awaken- ed from sleep by the feeling of great constriction and oppression of the chest, so that he breathes violently and pantingly, but without sharp pain ; this feeling of constriction commences at the ensiform process, and spreads itself from thence over the chest, often attended with the feeling of an ascending aura; the attacks last from fifteen minutes to half an hour, and are followed by a spasmodic cough, which expels but little mucus ; or the aura arises to the head and the patient becomes dizzy. Finally convulsions set in. (11.) Dr. Chapman suggests it as homoeopathic to pulmonary apoplexy. In the last stages of cholera when diarrhoea has ceased and the vomiting has decreased, when there is anguish with pressure on the chest, and the patient becomes cold, with gradual extinction of the pulse, Prussic-acid deserves a trial. Superior Extremities.—Coldness of the extremities. (2.) Trembling of the right hand ; convulsions of the extremities. (27.) Clinical Remarks.—It is one of the most homoeopathic remedies to epilepsy. It is indicated against the sudden loss of consciousness, and violent convulsions, with venous congestion of internal organs, and blueness of the surface which attend this disease. (11.) Inferior Extremities.—Coldness of the extremities; convulsions of the extremities; trembling of the extremities. (27.) Skin.—Slight heat of skin on the second day, becoming hot and dry on the third day; face slightly swollen. (2.) Prickling of the skin. (4.) Clinical Remarks.—Frank cured in two weeks one case of herpetic eruption of two years' standing on the mons veneris, in a lady fifty years old, by the external use of the following lotion :—Acid.-Hydro- cyan. 3jss. and alcohol fiv. Steep.—Irresistible and constant drowsiness, or sleeplessness. (1.) Deep and prolonged sleep ; yawning; inclination to sleep; inability to sleep; sense of great fatigue, without being able to sleep soundly. (4.) Sleepless and agitated during the night. (27.) Clinical Remarks.—In obstinate cases sleeplessness consequent upon morbid excitement of the nervous system, or upon intense mental excitement, this drug is a remedy of marked power. Fever.—Pulse small and almost imperceptible in the left wrist; in- creased fullness of pulse on the second day; catarrhal fever on the third day, with hot and dry skin, cough, great oppression and difficulty of breathing, face red and swollen, aggravation of the symptoms by using cold drinks; evening fever, with heaviness and pain in the head, Acidum Hydrocyanicum. 35 sore throat so as to be unable to swallow drinks, inability to sleep, short fatiguing cough. (2.) Creeping sensations; creeping chills of short duration ; great heat; great tendency to perspire ; pulse variable. (4.) Pulsations of the heart and arteries, sometimes accelerated, sometimes slower than natural, and sometimes intermittent, but always feeble; heat, thirst, anorexia, sleeplessness, great lassitude, and pulse 100 per minute; gay delirium, with accelerated pulse ; paroxysms of coldness and trembling with pain in tlie head, sleeplessness, painful respiration, rapid and very small pulse. (27.) Vascular system sometimes affected very much, at other times not at all. Some patients only feel warmth in the epigastrium; in others this warmth arises to the face, in the form of flushes, attended with dizziness, and heaviness of the head; in others the feeling of warmth became general, and was attended with palpitation of the heart. Clinical Remarks.—Hydrocyanic-acid was formerly regarded as a remedy of peculiar efficacy in inflammatory fevers; but the more recent researches of Hahnemann, Orfila, Christison and others, have demonstrated that it possesses no control over affections of a purely inflammatory character. In hectic fevers, and in feverish conditions accompanying catarrh, asthma, hooping cough, &c, it is a valuable remedy in virtue of its specific action upon the nerves of the parts involved. It is much more homoeopathic to venous-congestions and inflammations than to arterial. Heart and Arteries.—The arteries and left cavities of the heart empty ; the veins and right cavities distended with fluid blood. In some cases death is c'aused by stoppage of the heart's action, although in experiments upon rabbits the heart has still been found beating on opening the chest. The venous system is usually gorged with blood, the blood in many cases being fluid, dark, or bluish black, or viscid or oily. Dr. Meyer found on putting a ligature around the large vessels close to the heart that Prussic-acid produced no effect. It only acts when taken into the circulation and then paralyzes the heart. Clinical Remarks.—In hypertrophy of the heart, Hope advises Prussic-acid as a palliative, in doses of two or three drops, two or three times daily; it requires to be steadily persevered in. In nervous palpitations, or those arising from debility it has been found useful. In angina pectoris it has been successfully employed by Brugnatello, Granville and others. Dr. Schlessier relates a very severe case, which, after resisting all other remedies, yielded imme- diately to Prussic-acid. Dr. Chapman, of Londdn, suggests it as a liomoeopathic remedy for angina pectoris, and refers to the many deaths reported in the newspapers, said to have been from spasm of the heart, without any organic lesion being found after death: Dr. Arnold, Lord (ieorge Bentwick, Horace Twiss and others died thus. (11.) Blood.—The blood is every where fluid, so that two pounds have ilowed from an incision in the scalp, and twelve ounces from that of •■u? dura-mater; it has had a glimmering bluish appearance as if 36 New Materia Medica. Prussian-blue or Cochineal had been mixed with it. It was perfectly fluid every where in the bodies of the seven epileptics poisoned with it at Paris. Only in rare instances has the blood coagulated after flowing from the body, or been found coagulated in the heart. The state of the blood reminds one of that after a person has been struck with lightning. It seems merely to depotentize the blood and render it venous, not to cause any dyscrasia in it. Hence it probably will not prove curative in dyscrasias, such as tubercle, cancer, &c. It may be homoeopathic to the blood disorder in cholera, as the blood then is often found to be of the color and consistence of treacle. (11.) Nervous System.—Pereira thinks that the parts most specifically affected by this acid are the brain and true spinal system. The pain in the head, insensibility and coma are evidences of the cerebral affection; while the tetanic convulsions depend upon a disorder of the true spinal system. Whatever may be the precise pathological condition of the brain and spinal cord it is probably identical with that which occurs during an epileptic paroxysm. Dr. Meyer of Tubingen instituted a number of experiments with Prussic-acid to ascertain if possible, with absolute certainty its exact mode of action. He proved that it paralyzes the extremities of the nerves it comes in con- tact with, i. e. deprives the part of sensation and motion, thereby causing passive congestion, and exudation from paralysis of the ca- pillaries. General Symptoms.—Catalepsy. (1.) Towards evening a feeling of exhaustion, especially in the lower extremities j dynamized motive power ; great exhaustion, with yawning and great inclination to sleep, contrary to his usual custom ; on being aroused from sleep, great con- fusion of the head, and inability to keep awake ; desire to sleep late in the morning; lassitude and exhaustion of the whole body; soon after taking an over-dose, falling senseless to the ground ; violent vertigo and chilliness, trembling of the limbs, vomiting ; difficult re- spiration ; intoxication with signs of fainting; paralysis; convulsions ; icy coldness of the extremities; trunk stiff and bent backwards ; symptoms better in the open air. (4.) AC1DTJI MURIATICUM. MURIATIC ACID. TOXICOLOGICAL EFFECTS. Very little is known concerning the action of this acid as a poison; but one case is reported by Orfila, and of 527 cases of poisoning there was not one in which this acid was used. The grosser symptoms do not vary from those of the other mineral acids. There is the same sensation of burning heat from the throat to the epigastrium, with vomiting of a highly acid liquid of a dark green Acidum Muriaticum. 37 color, mixed with mucus and altered blood; the tongue becomes swollen and dry; there is much thirst and great difficulty in swallow- ing ; and the chief seat of the paiu may be in the throat and fauces ; the pulse has been observed to be small, frequent and irregular; the skin cold and clammy; the intellectual faculties generally remain clear until death. (11.) Pathological Appearances.—The fauces, larynx and oesophagus highly inflamed, the mucous membrane lying in detached masses, or actually sloughing away; in one case the mucous membrane was thickened. The coat of the stomach so much corroded in many places that only the peritonial tunic is left, and in attempting to raise the organ, the parietes gave way. The contents of the stomach are sometimes yellowish, at others of a dark green color; the gall bladder has been found of a grass-green color from the well known action of this acid on the bile. The lining membrane of the stomach has been found of a black color, presenting a charred appearance ; the blackening extending through the duodenum in it whole length, especially on the valvulae conniventies; the intervals being stained of a greenish-yellow color from the action of this acid on the bile. When death does not take place for several days, the stomach is highly inflamed, and for the most part in a state of sloughing; large shreds of membrane may be hanging down, especially about the pylorus. Remarks.—It is evident that this and otheT mineral acids are the most homoeopathic remedies for the most intense ulcerative-, sloughing-, and phagadenic-inflammation ; in malignant typhus and scarlet fevers : bad forms of syphilis ; gangrenous stomatitis; putrid sore-throat; can- crum-oris ; gangrenous ulceration of the genital organs, &c. Antidotes.—Same as for the other mineral acids. (11.) authorities. 1. Hahnemann, Mat. Med. Pur. 2. Orfila, Traite de Tox. 3. Pe- reira, Mat. Med. and Ther. (45.) Dr. Serres. Orfila. Traite de Tox. p. 196. v. 1. (10.) Marcy. (11.) Peters. Taylor's Med. Juris- prudence. Christison. Waring's Therapeutics. phenomena. Scnsorium.—Vertigo in the open air, and unsteady gait. (1.) Gid- diness ; intoxication; stupor. (3.) Clinical Remarks.—In Frank's Magazine we find several cures re- ported by this acid, of convulsions preceded by buzzing in the ears and vertigo. The convulsions were severe, and after having lasted for several hours, were arrested by a few drops of the diluted acid. (10.) Mind and Disposition.—Out of humor ; irritability ;_most irritable in the evening. (1.) 38 New Materia Medica. Clinical Remarks.—It is recommended against melancholy and great sadness, when arising from or attended with great acidity of the stomach, bilious derangement, dyspepsia, &c. (11.) Head.—Tearing pain in the right parietal bone ; tensive pain in the right temple ; boring pain in the vertex ; feeling as if the brain were loose ; burning feeling in the head. (1.) Pathology.—Blood vessels of the brain very much injected, and the ventricles distended; the arachnoid thickened and opaque; the pia-mater very much injected : a large quantity of serum between the convolutions of the brain. (45.) Clinical Remarks.—The 1st dilution of Muriatic-acid has often proved curative in our hands in the headaches which so often accom- pany chronic hepatitis. Also in the dull and stupifying headaches which occur in the progress of typhoid and scarlet fevers, it has not unfrequently displayed excellent curative effects. (10.)—This remedy is infinitely more serviceable in headaches, inflammation of the arachnoid, and dropsy of the brain than Nitric-acid, which is used much more frequently by many physicians. (11.) Scalp.—Pustules on the forehead and temples; pimples on the fore- head, rapidly forming a scurf. (1.) Clinical Remarks.—Frank reports one case of Herpes furfur, ex- tending over the scalp and face, cured in five weeks by the acid, after Sulphur, Mercurius, Dulcamara, &c, had failed. In our own practice, two cases of porrigo of the forehead, attended with intense burning itching, and running rapidly into the scaly desquamation, were cured in six weeks by the alternate use of Muriatic and Sulphuric-acids, at the 3d dilution. Both of these patients had been for many years sufferers from gout and liver derangements ; a complication with which porrigo and eczema are almost invariably accompanied. (10.) Mack recommends it against humid, suppurating and scurfy eruptions ; against pimples on the forehead, finally running together into a scurf; but we have found Nitric-acid more useful. (11.) Eyes.—Itching in the eyes; slight inflammation of the eyes; burning in the eyes on washing them; one-half of every object appears to be cut off from the other half in a perpendicular line ; twinkling before the eyes. (1.) Eyes red, and sparkling. (2.) Pathology.—Injection of the vessels of the conjunctiva. (2.) Clinical Remarks.—High dilutions of the acid have been success- fully employed by us in chronic inflammations of the edges of the lids, remaining after scrofulous ophthalmia. It has likewise proved curative in eczema of the lids, eye-brows, and forehead. (10.) Ears.—Hardness of hearing; hearing morbidly acute, (secondary effect); frequent tingling, humming and whizzing in the ear; ears •ensitive to noise; tearing in the left ear; itching pimples upon both ears: heat and dryness in the ears ; ulcerative pain in the left ear, aggravated by boring with the finger. (1.) Acidum Muriaticum. 39 Clinical Remarks.—The writer has occasionally prescribed Muria- tic-acid in effections of the ears accompanying malignant scarlatina. It has proved most efficient in gatherings in the ears; attended with hardness of hearing, tenderness of the external ear to the touch, severe ulcerative pains, ringing, and slight sero-purulent, acrid discharges from the ears. We have seen good effects from this acid in the deaf- ness, and ringing in the ears accompanying typhoid fevers. In these instances, other symptoms have corresponded. In two instances, herpetic eruptions about the ears, have disappeared under the prolonged use of the 30th dilution. (10.) A weak dilution may oc- casionally be dropped into the ears ; Nitric-acid seems to act more specifically upon the eyes ; Mur.-acid. upon the ears. Nose.—Frequent sneezing; Coryza; frequent bleeding of the nose; stinging pains in the nostrils; violent itching of the tip of the nose ; obstruction of the nose ; acrid or corrosive discharge from the nose, or obstruction of the nose with dryness. (1.) Clinical Remarks.—In malignant scarlet fever with acrid and cor- rosive discharge from the nose, fetid breath, disposition to bleed from the nose, obstruction in the nose, soreness and blisters around the nose and mouth, redness of the eyes, gatherings in the ears, faint, darkish eruption, mixed with petechia?, ulcers in the throat ash-colored or bluish, the drug under consideration is a remedy of the highest im- portance. We can recall to mind a number of cures of the above group of symptoms with this medicine. In these cases, where the vitality has become very much depressed, we have been in the habit of using the first dilution, each dose in a table-spoonful of water. (10.) It has been recommended against bleeding from the nose ; great dry- ness, obstruction and thick scabs in the nose ; ulceration, fissures and scurfiness of the nostrils. (11.) Face.—Pimples on the face ; pimples around the lips ; vesicles around the mouth; burning of the lips; rough borders of the lips, with dry, cracked skin. (1.) Animated expression of the face; bluish color of the lips. (2.) Clinical Remarks.—Van Swieten has employed the diluted acid with benefit, as an external application in cancrum-oris. We have frequently used water acidulated with it, as a lotion to allay the intolerable itching and burning of porrigo, eczema, and lichen. Used in this manner, it never repels the eruption, or gives rise to any unpleasant secondary effects. It is particularly appropriate when the remedy is being administered internally for the same malady. He commends its internal use in obstinate eczema attacking the face, and in herpetic eruptions appearing in the whiskers and around the ears. In these cases we are accustomed to prescribe the higher dilutions. (10.) It is useful against acne and other pimples and pustules upon the face ; freckles ; and ulceration and scurfiness of the upper lip. (11.) Mouth.—Slight inflammation of the gums ; swelling of the gums ; 40 New Materia Medica. scorbutic gums; tearing pain in the right upper teeth; copious saliva in the mouth. (1.) Tongue very red and dry; lips darkish. (2.) Pathology.—Tongue brown, thickened, hard and dry; lips dark- ish; ulcerated spots on the mucous membrane of the mouth. (2.) Clinical Remarks.—Properly diluted this acid forms an excellent application for ulcers in the mouth arising from abuse of Mercury or from disordered stomach. It is a valuable internal remedy in ulcers of the mouth occurring as symptoms of scarlet and typhoid fevers, provided other phenomena are homoeopathic. We have already alluded to its use in cancrum-oris by Van Swieten. In scorbutic affections of the gums it has been used with advantage, both internally and locally. (10.) It is recommended against inflammation and swelling of the gums; scurvy of the gums; salivation; but more especially against diph- theritis of the mouth and fauces. It is indicated in all typhoid and malignant fevers, when the tongue becomes dry, brown and parched. (11.) Pharynx.—Rawness and smarting of the fauces. (1.) Redness of the throat; ulceration of the throat (10.) Pathology.—Pharynx and oesophagus of a purple red color, and excoriated in two or three places. (2.) Clinical Remarks.—This is one of our most valuable medicines in the greyish or purple and fetid ulcers of the throat occurring in malignant scarlatina. Above we have detailed the other symptoms which correspond with the drug pathogenesis. We have cured with it a few cases of troublesome ulcerations, of long-standing, appearing in individuals of impaired constitutions, and in persons of a scrofulous dyscrasia. In several cases of this description we have likewise failed of affording any relief. (10.) It is one of the most homoeo- pathic remedies to that croupous inflammation of the pharynx which is apt to descend into the larynx and trachea causing true croup ; or to travel down the oesophagus to the stomach. (11.) Taste, Appetite and Gastric Symptoms.—Bitter taste; acrid and putrid taste ; aversion to meat; hiccough before and after eating ; frequent eructations.. (1.) Hiccough; efforts to vomit; vomiting of yellowish fluids. (2.) Clinical Remarks.—In some forms of dyspepsia, Muriatic-acid holds a high rank as a curative agent. Pereira notices two facts connected with it, which give it a marked interest as a dyspeptic remedy: viz., its power when mixed with mucus, as a solvent or di- gester of various articles of food, and the fact of its being a constituent of healthy gastric juice. Our own experience has been confined to cases of indigestion in connection with scrofulous and other chronic ulcerations of the mucous membrane of the mouth, pharynx and oeso- phagus. In these instances we have now and then used a dilution of the acid with decided advantage. (10.) A very interesting cure of convulsive eructations is reported in Frank's Magazine. A man 60 years of age, subject to rheumatic and catarrhal complaints, took cold and was affected as follows: violent and tasteless eructations, lasting Acidum 2Iuriaticum. 41 sometimes for twelve hours, constant flow and spitting of saliva, violent thirst, without heat, impaired appetite, constipation, pressing pain in the chest, worse in the left side, sensation of coldness in the abdomen, rumbling in the bowels preceding the eructations, nausea, great weakness, faintness, cold feet, wandering pains in the head, knees, feet, &c. Every movement of the chest or body brought on an attack. After having taken a great variety of allopathic medicines, for a period of several months, without relief, this patient was promptly cured with a few doses of diluted Muriatic-acid. (10.) In some forms of dyspepsia Muriatic-acid will have to be assisted or alternated with Lactic-acid; this acid has been incontestibly proven to be an important ingredient of the healthy gastric juice—it is a color- less, syrupy liquid having a very sour taste; it coagulates albumen, and dissolves a large quantity of freshly precipitated phosphate of lime, properties which render it of great importance to the animal economy. It has been proposed by Magendie as a remedy in certain forms of dyspepsia, and for the removal of phosphatic deposits in the urine. (11.) Ilypocliondria.—Burning tension in the right hypochondrium ; stitch- es in the left hypochondrium, when stooping; stitches in the left side, under the ribs. Pathology.—Congested appearance of the liver; green tint of that portion of the gall-bladder in contact with the stomach. (2.) Clinical Remarks.—Muriatic-acid has long been employed, in tropi- cal climates, especially in chronic hepatitis. It is usually prescribed both internally, and as a constituent of the Nitro-murialic-acid bath. We have been in the habit of using this remedy internally and ex- ternally in obstinate cases of this description, and for the most part with satisfactory results. Stomach.—Empty feeling in the stomach and oesophagus ; pressure in the stomach ; feeling of repletion in the stomach ; heat and burning in the stomach. (1.) Violent pains in the epigastric region ; heat and burning in the stomach. (2.) Sensation of warmth in the stomach. (3.) Pathology.—Stomach thickened and inflamed on its external sur- face ; on its internal surface, the mucous membrane may be detached in layers, with the greatest facility, throughout its whole extent, and presenting in its cul-de-sac, gangrenous patches. (2.) In another case the stomach appeared to be charred, and the gall-bladder pre- sented a green tint at the part where it was in contact with the stomach. (3.) Clinical Remarks.—Chronic gastritis, with heat and burning in the stomach, frequent nausea, vomiting of solid food soon after ingestion, great thirst, sense of fullness in the stomach, or empty and constrictive feeling in the stomach, has often been removed by this remedy. The nausea and vomiting of pregnancy has often been either much relieved or entirely cured by this remedy. (10.) It is an important remedy in some of the most severe and hopeless diseases of the stomach (see page 37.) 42 New Materia Medica. Abdomen.—Colicky pinching in the abdomen ; colic early in the morning in bed ; violent cutting, with pinching in the abdomen, when standing or walking, going off when silting; distention of the abdomen ; feeling of repletion in the abdomen after a moderate meal; rumbling in the abdomen; pinching in the abdominal muscles; empty feeling in the abdomen. (1.) Pathology.—Thickening of the duodenum; jejunum perforated by a worm, which had found its way into the cavity of the abdomen. (2.) Charred appearance of the duodenum; green tint of that portion of the gall-bladder in contact with the stomach, (from the action of acid on the bile?). (3.) Clinical Remarks.—In flatulent distention of the stomach, with rumbling and colic pains,—especially on standing upright or walking, we have sometimes witnessed good effects from the 12th dilution of the acid. (10.) Stool.—Stool in small pieces, with straining; inactivity of the rec- tum ; hard, difficult stool, alternating with soft-stools; diarrhoea with burning at the anus ; itching of the anus and rectum ; swelling of the varices of the rectum, with burning sore pain; blood with the stool; itching in the perineum. (1.) Relaxed state of the bowels. (3.) Clinical Remarks.—Against several varieties of bowel complaint, Muriatic-acid is a remedy of decided value. With it we have cured several obstinate cases of chronic diarrhoea, attended with tenesmus, colic pains before stool, burning at the anus, stools occasionally bloody, prolapsus of the rectum after stool. It has also cured several cases of diarrhoea, with soft clay-colored stools, alternating with hard and difficult stools. It is likewise a favorite and efficient medicine in certain forms of diarrhoea accompanying typhoid and scarlet fevers. Our own experience points most strongly to the following indications in these fevers, scanty, loose, and bloody stools, with rumbling in the abdomen, colic pains before and during the discharges, tenesmus, burning at the anus, chilliness and prostration after each stool. (10.) It is quite as useful as Nitric-acid against prolapsus-ani, and blind and flowing piles, with burning soreness. Urinary Organs.—Frequent desire to urinate, with small emission, and tenesmus of the bladder afterwards ; frequent desire to urinate with profuse discharge ; profuse and pale-yellow urine ; slow emission of urine. (1.) Clinical Remarks.—The old school prescribe Muriatic-acid to coun- teract phosphatic deposits in the urine. It is homoeopathic in slight cases of chronic hepatitis, when the urine is pretty copious and tinged with bile. In one case of vesical tenesmus with frequent desire to urinate, accompanying a case of bilious diarrhoea, Muriatic-acid at the 2d dilution effected a prompt cure. (10.) In some cases of Oxalic- acid diathesis, Prout prefers Muriatic-acid to any other remedy ; also in the Cystic-oxide diathesis; Bulman cured a case of phosphatic calculus by injecting into the bladder, two drops of Muriatic-acid to Acidum Muriaticum. 43 four ounces of water, always taking care to wash out the bladder previously with warm water. It has cured ischuria ; frequent desire to urinate with profuse discharge of urine; diabetes; weakness and paralysis of the bladder. (11.) Genital Organs.—Itching of the scrotum ; leucorrhcea. Clinical Remarks.—Heare prescribed the acid at the 12th dilution in several cases of itching eruptions upon the scrotum and inside of the thighs. It has proved serviceable in one case of lichen, and in one case of porrigo. We have also administered it in cases of leucorrhcea, but with much less satisfactory results than we are accustomed to witness from the use of the Nitric-acid. (10.) Zeller of Vienna first used it in syphilis: Pearson found that it would radically cure the disease, but ascribed the benefit derived from it to its salutary action upon the stomach and constitution, and also to its agency on the ulcers of the throat and tongue as a local application. Rust of Vienna cured several hundred cases, without the aid of a single grain of Mercury; but he failed in every case in which a full diet was allowed; low diet is essential, and large doses, viz., one drachm per day in two pints of Barley-water. (11.) Larynx.—Hoarseness; loose cough with mucous expectoration morning and evening. (1.) Clinical Remarks.—Frank advises the acid in some forms of tussis convulsiva. He thinks it appropriate when the paroxysms of cough, terminate in vomiting, and throwing up of large masses of a whitish matter, looking like bread dissolved in water or milk—probably decom- posed gastric juice. He has also found it curative in cases unattended by vomiting, but where every attack was so violent as to threaten suffoeation, and reduce the patient almost to a condition of tetanus (10.) It has been advised against oedema glottitis ; chronic hoarseness, with soreness of the chest. (11.) CllCSt.—Oppression across the chest; deep breathing; sticking pain in the chest; boring stitch in the intercostal muscles of the right side ; stitches in the region of the heart; sticking pain in the chest during motion or inspiration; violent beating of the heart. (1.) Pathology.—Muriatic-acid does not exercise any specific action over the lungs; but has a general specific action upon the mucous membranes. In virtue of this action it is prescribed in certain affec- tions of the mucous membrane of the air passages. Clinical Remarks.—In the last stages of chronic bronchitis and catarrhal consumption, when hectic symptoms are marked and there are copious expectorations, irritating spasmodic cough, diarrhoea and profuse night sweats, this acid is often prescribed with benefit. (10.) Back.—Violent stitches in the left side of the back ; stitches in the scapula ; aching pain in the small of the back, when standing or sit- ting. (1.) 44 New Materia McJica. Clinical Remarks —This medicine will do good in the aching pains in the back, arising from diarrhoeas and prolapsus-ani. (10.) Superior Extremities—Drawing in the left upper arm; frequent drawing tension in the elbow-joint; itching and burning blotches on the fore-arms and elbows; itching eruption upon the hands; cramp- like tearing pain in the upper arm. Clinical Remarks.—In psoriasis between the fingers, eczema of the hands and fore-arms, and in itching blotches covering the arms we have prescribed the acid with advantage. (10.) Inferior Extremities.—Sticking with pressure in the muscles of the left thigh, only when sitting ; weakness of the thighs and wandering gait; itching herpetic spots on the inside of the thighs ; swelling of the knees; frequent tearing in both tibiae; coldness of the feet; itching stitches in the feet, worse when at rest; swelling and redness of the toes ; throbbing pain in the toes. (1.) Clinical Remarks.—We have cured one case of violent porrigo upon the inside of the thighs with the 12th dilution of this acid. (10.) Sleep.—Difficulty of falling asleep ; drowsy in the afternoon ; fre- quent waking at night; waking every morning at four, and inability to fall asleep again; nausea and distention of the abdomen, early in the morning when in bed; sleeplessness in the early part of the night; anxious dreams. (1.) A slight degree of stupor. (3.) Clinical Remarks.—Drowsiness arising from bilious derangement, is often relieved by the acid. Good effects have also followed its use in three cases of drowsiness occurring as symptoms of Bright's disease of the kidneys. In these last instances, the relief was only temporary. Fever.—Chilliness ; chilliness with thirst, dry mouth and burning face; heat of the body with inclination to uncover; night sweats; feverish shuddering. (1.) Pulse frequent and full, face animated eyes red and sparkling, severe headache, violent delirium, skin hot asd dry, tongue red, lips bluish, hiccoughs, nausea and vomiting. (2.) Clinical Remarks.—We esteem this drug a valuable remedy in certain stages of typhoid and scarlet fevers. The following symptoms which not unfrequently occur during the progress of typhoid fevers, point to its use: great prostration, occasional or constant delirium, rapid pulse, red and dry tongue, or dark and dry tongue, dull, con- fused pain in the head, stitching pains in the side, disposition to settle down in bed, slavering, digging with the head into the pillow, de- pression of the lower jaw, looseness of the bowels. In malignant scarlatina, the following group of symptoms indicate the employment of Muriatic-acid ; purple color of the cheeks, bluish lips, lips dark, dry and cracked, tongue red and moist, or dark and dry, pulse very rapid, lethargic state, with delirium, eyes red and suffused, great prostration, diarrhoea, irregular, faint eruption, becoming dark red, and mixed with petechiae, dark or greyish ulcerations of the throat, Acidum Muriaticum. 45 foetid breath, acrid and fetid discharge from the nostrils, soreness and blisters around the nose and lips, coldness of the extremities, occasion- al shuddering hiccough. (10.) This remedy is applicable in hectic fever with frequent shudderings during the day, and profuse night sweats in the morning in bed. While experiencing the chilly sen- sations the patient has great heat and burning in the cheeks, rapid pulse, dryness of the mouth, and thirst. (10.) Huss of Stockholm found it highly serviceable in typhus"fever, particularly in cases attended with cerebral symptoms (see head); its employment was not contra-indicated by the state of the tongue or stomach; it was useful whether the tongue was loaded or not, red and fissured, moist, or parched; it was also given whether the ab- domen was painful or not, tense or flaccid, and both when there was constipation or diarrhoea. If the doses were too large it always aggravated bronchial or pulmonary congestion. (11.) In the continued fevers of children, West found it useful in the ad- vanced stages, after the second week, when the vital powers were much depressed ; if he had used it earlier, he would have been still more successful. (11.) Skin.—Stinging itching in various parts of the body, relieved by scratching; stitches in the skin at different parts; ulcers on the skin; titillating, prickling itching of the skin, relieved only temporarily by friction. (1.) Skin burning and dry ; or cold "and clammy. (2.) Pathology.—The only morbid appearances which have been ob- served upon the skin in cases of poisoning, are, a bluish tinge of some portions of the surface, cedematous state of the feet and ankles. Manu- facturers of the article have been occasionally afflicted with pain- ful ulcers of the skin, in consequence of inhaling the vapors arising from the acid during the process of manufacture. (10.) Clinical Remarks.—Itching'eruptions of the skin have sometimes been cured by this drug. It is in these cases of eruptive disease in which a marked alkaline condition is found, that the remedy has been found most beneficial. It has been used in the old school as an ex- ternal application to sloughing phagedena, and in a diluted form, as a lotion to cancrum-oris. (10.) General Symptoms.—Lassitude; vacillating gait, owing to weakness of the thighs ; drowsiness ; pains in the periosteum of every bone. (1.) Asthenic conditions; putrid, typhoid, and malignant forms of disease; hectic symptoms, with profuse loss of fluids by sweat and diarrhoea. (10.) 40 New Materia Medica. ACIDUM NITEICUM. nitric acid. toxicological effects. From the strong acid, the symptoms come on immediately, and the swallowing of the acid is attended by the most intense burning pain in the fauces and oesophagus, extending to the stomach; there are gaseous eructations from the chemical action of the acid; swelling of the abdomen, violent vomiting oT liquid or solid matters, mixed with altered blood and shreds of mucus, having a strong acid reaction. The abdomen is generally exquisitely tender. The mucous membrane of the mouth is commonly soft and white, after a time becoming yellow, or of a brown color ; the teeth are also white, and the enamel is par- tially destroyed. There is great difficulty of speaking, as well as of swallowing; the power of swallowing is sometimes entirely lost. On opening the mouth, the tongue may be found swollen and of a citron color ; the tonsils are also swollen and enlarged. The difficulty of breathing is sometimes so great as to render tracheotomy indis- pensable, especially in young subjects. As the case proceeds, the pulse becomes small, frequent and irregular; the surface of the body extremely cold, and there are frequent rigors. The deglutition of the smallest quantity of liquid increases the severity of the pain, and gives rise to a feeling of laceration or corrosion. There is obstinate con- stipation. Death takes place in from eighteen to twenty-four hours, Kiid is sometimes preceded by a kind of stupor easily removed; the intellectual faculties commonly remain clear to the last. (11.) Should the patient survive the first effect of the poison, the mucous membrane of the fauces and oesophagus is discharged either in ir- regular masses, or a complete cylinder of the oesophagial lining may come away. There is great irritability of the stomach, vomiting, and destruction of the powers of digestion; the patient becomes slowly emaciated, and dies from starvation or exhaustion. Death may also be caused by inflammation and oedema of the larynx, with consequent suffocation. (11.) chronic poisoning. Case 1.—A man aged 34, swallowed a wineglassful of Nitric- acid, but the greater portion was immediately rejected by vomiting. An attack of acute gastritis followed, from which he apparently re- covered ; but about a month afterwards he had severe pain throughout the oesophagus to the epigastrium, and vomiting after taking food. He gradually sank and died in three months. Pathological Anatomy.—The pylorus was found so diminished in size, that its diameter did not exceed a line or two ; and the duodonum was equally contracted for about one and a half inch from its com- mencement. The mucous membrane was softened and red in patches; Acidum Nitricum. 47 and there were several cicatrices of ulcers. The subjacent tissues were in a scirrhous state. (Taylor's Medical Jurisprudence.) Case 2.—A man aged 52, drank two ounces of dilute Nitric-acid, followed immediately by violent pain and burning in the mouth, throat and oesophagus ; then he vomited up the larger portion of the acid. On the next day the pains in the mouth and throat had increased; the inner surface of the mouth, throat and tongue were covered with white, easily-detached, and partly detached shreds of mucous- and false membrane. The palate and tonsils were swollen and painful; swallowing was very difficult, and liquids only could be got down. Respiration was much oppressed. The stomach was somewhat painful to the touch; the muscles of the abdomen very much contracted. The pulse small and tranquil; brain undisturbed; stool and urine natural. During the following few days he had attacks of violent pain in the stomach; but in the course of eight days his mouth and throat had improved so much that he could take a little food; still he became weaker, his appearance was worse, and he became emaciated ; for two days before the final catastrophe he vomited his food several times and discharged some blood with his stools. On the fifteenth day, increased pain in the stomach sat in, with frequent attacks of nausea and anxiety, followed by violent vomiting of black and fluid blood, and of a broad membrane one foot in diameter; this membra- nous mass was putrid, black in patches, perforated in several places, and contained fibrous and large vascular ramifications. Soon after the vomiting he had stools containing a large quantity of black, offen- sive and putrid blood. After these evacuations the patient became miserable and weak, his pulse small and frequent, with increased pain in the stomach. In four days more he again vomited and purged black and offensive blood; he exhaled a most putrid odor; his limbs became cold; pulse small and very frequent; eyes dull, sight ex- tinguished ; still he lived and vomited blood from time to time for two days more, when he died. Pathological Anatomy.—The brain was healthy, with the exception of some opacity of the arachnoid, and considerable fluid in the ventricles. The aorta and left side of the heart contained coagula. The sharp edge of the liver was adherent to the colon; peritoneum natural. When the liver was raised an open cavity was exposed, which occupied the place of the stomach and extended from the duo- denum to the oesophagus. The walls of this cavity were formed anteriorly by the concave surface of the liver, the colon and by shreds of the coats of the stomach; posteriorly by gangrenous, dissolved and putrid masses of stomach ; to the left, by the spleen and portion of the coats of the stomach. Hence all that portion of the stomach which had formed the anterior wall, smaller curvature and part of the posterior wall had been vomited up several days before death; still the contents of the stomach had not passed into the cavity of the peri- toneum. The whole intestinal canal, especially the transversa colon was filled 48 New Materia Medica. with masses of blood; the entire mucous membrane of the oesophagus was gone, so that the muscular coat was exposed. A similar cases is reported in Vol. 1. p. 123 of this Journal. Case 3.—In a somewhat similar case the patient lived three months; after an apparent recovery he relapsed in the sixth week from im- prudence in diet; the pains in the oesophagus and stomach returned, also the nausea, vomitings, colics and constipation; he became very much emaciated, his face sunken and altered; putrid eructations and considerable distention of the epigastric region occurred; his. tongue was pale and somewhat moist; breath offensive ; pulse 66 to 68; skin natural. Notwithstanding the use of various remedies his abdomen began to swell, especially about the left hypochondriac region, forcing the false ribs outwards, and forming a swelling which extended down to the navel. He lost strength rapidly; his pulse became very fre- quent and small; his tongue dry, and features pinched. Notwithstanding his frequent vomitings the patient desired solid food. He finally died suddenly. Pathological Anatomy.—The stomach was found enormously dis- tended, so that it not only filled the whole left hypochondriac region, but the whole left side of the abdomen down to the iliac fossa; still the walls of the stomach were generally not much thinned. There were several quarts of a thick chocolate-like, extremely offensive fluid in the stomach. Beside gastritis, there were ulcers of various sizes and various degrees of cicatrization, near the pylorus ; some of these ulcers were an inch in diameter, with very thick and prominent edges. The opening of the pylorus did not exceed one line in diameter; the walls of the pylorus and upper part of the duodenum were at least half an inch thicker than natural and quite hard ; the cut surface of this indurated and hypertrophied portion presented a greyish white, and somewhat bluish appearance ; its tissue was porky, and it creaked under the knife ; hence it presented all the characteristics of true schirrus according to Audral. Antidotes.—The poisonous action of Nitric-acid may be prevented by neutralizing it. but it acts so rapidly that if much time is lost in seek- ing an antidote, irreparable mischief may be caused before the remedy is taken. If Chalk or Magnesia can be administered without delay, they ought to be preferred ; the plaster of house walls may be beaten down and made into a thin paste with water and used ; a solution of soap is another antidote of no mean value ; until either of these articles can be procured the patient should drink freely of any mild fluid which can be obtained, viz., of water, milk, sweet-oil, tea, coffee, in fact anything which will dilute the acid. As soon as Magnesia can be obtained it should be used ; it has saved several cases in which as much as two ounces of Acid have been swallowed. Carbonate of Potash given in mucilaginous fluids, has the advantage over Magnesia that it may be administered in a small volume. After the proper antidote has been given to a sufficient extent the use of diluents ought to be continued. Acidum Nitricum. 49 The treatment of the supervening gastritis does not differ from that of ordinary inflammation of the stomach.—Christison. authorities. 1. Hahnemann. 2. Orfila. 3. Pereira. 4. Chrystison. 5. Perry. 5. Frank's Magazine. (44.) Waring's Therapeutics. phenomena. Intellect.—Intellect usually unimpaired ; exalted imagination; in- difference to life. (2.) Great weakness of memory; vertigo on rising.(L) Disposition.—Great anxiety and agitation; inexpressible malaise; irritability. (2.) Sadness; anxiety; excessive nervousness and irri- tability; angry and excited, mood; indifference; hopelessness; des- pair. (1.) Ufa(l.—Headache; congestion of blood to the head; pressure and heat in the head; painful tension in the interior of the head; stitching and darting pains in the left temple; headache as if the head were surrounded by a tight bandage ; throbbing pains in the temples ; throb- bing headache in the left temple. (2.) Clinical Remarks.—This remedy is used very largely by Dr. Gray in the treatment of chronic headaches.—It is to be hoped that he will soon communicate his experience to the world. Scalp.—Clinical Remarks.—-In baldness, a liniment of Nitric-acid and sweet-oil is useful; it should be slightly pungent but not acrid. It will also cure Porrigo. (44.) Eyes.—Conjunctiva injected; eyes animated and haggard; eyes fixed; (2.) Muscat volitantes; short-sighted. Clinical Remarks.—It has been used successfully against inflamma- tion of the cellular tissue about the eyes, when it has terminated in suppuration and ulceration. In ulceration of the cornea. In gonor- rhoeal ophthalmia. Opacities of the cornea. For Dudgeon's remarks on Nitric-acid in ophthalmia, see Brit. Journ. Horn. Vol. 6, p. 503. Ears.—Difficulty of hearing; stitches in the ears; hardness of hearing from ringing in the ears. (1.) Clinical Remarks—It is a useful remedy against purulent otorrhcea. \ose.—Soreness and scurf in the nose; violent bleeding of the nose; unpleasant smell in the nose. (1.) Clinical Remarks—It has been used successfully against scrofulous and syphilitic eczema, and against polypi of the nose. It is especially useful against the terrible affection of the nose which attends malig- nant scarlet fever. Face—Face pale; yellow spots upon the edge of the upper lip; convulsive motions of the muscles of the face; countenance pale and cadaverous. (2.) Small pimples on the face, especially on the fore- head; pimples on the hairy border of the temple. (1.) Faoe pale and cold ; face sunken. (6.) Clinical Remarks.—It is useful against acne and erysipelas of the fac*. 14 50 New Materia Medica. Mouth.—Tongue of a light yellow color, dryness of the tongue; tongue yellow at its base and on its sides, and brown in the centre ; tongue humid and natural. (2.) Throbbing toothache; looseness of the teeth; ulcers in the mouth and fauces ; copious flow of saliva; sore- ness of the tongue; putrid smell from the mouth; bitter or sweetish taste in the mouth; great thirst. (1.) Violent pains in the mouth and oesophagus ; mucous membrane of the mouth and tongue pale ; ulcers in the mouth covered with yellowish-grey scabs emitting an offensive odor. (6.) Pathology.—Mucous membrane of the lips, mouth and tongue of a very pale color, and much shrivelled; mucous membrane of the tongue detached in several parts. (6.) Clinical Remarks.—It is homoeopathic to salivation, ulceration of the mouth, cancrum-oris, and aphthae. Throat.—Severe pain in the throat, extending through the oesophagus to the stomach ; burning heat through the oesophagus, into the stomach. (2.) Ulceration and dryness of the throat. (1.) Tonsils swollen ; difficult deglutition; violent pain in the throat, with burning thirst; ulcers in the mouth and throat covered with yellowish grey scabs, emitting a foul odor; mucous membrane inflamed, swollen and pain- ful ; increased pain during deglutition in the oesophagus; rough voice ; breath offensive. (6.) Pathology.—Mucous membrane of the oesophagus detached in patches, and the muscular coat much inflamed. (6.) Clinical Remarks.—The writer has cured one case of obstinate ulceration of the throat of long standing, with the 30th dilution of the acid. This case was non-syphilitic, and had resisted the venal allo- pathic routine of mercurials, Iodide of potash, &c, for many years. It is especially useful against the horrible affection of the nose and throat which attends malignant scarlet fever. In chronic inflammation and ulceration of the throat. It is especially homoeopathic to quinsy sore-throat. In syphilitic ulceration of the tonsils, uvula, root of the tongue and inner side of the lips, when the parts look as if lard or starch had been infiltrated into and beneath the mucous membrane. Aphthae of the mouth and fauces. Acute and chronic pharyngitis and oesophagitis, even of the membranous or croupous kind. Chronic inflammation of the palate, uvula, tonsils, mouth and fauces, attended with burning, stinging, soreness, and more or less follicular ulcera- tion. Chronic inflammation of the mucous membrane of the fauces, with soreness, redness and dryness of the throat, aggravated by every change of the weather. In obstinate ulceration and phagadaena of the throat, more or less diluted acid must be applied locally. (11.) Stomach.—Dull pains in the stomach, becoming very intense upon the slightest pressure; repeated nausea, and vomiting from time to time ; vomiting of a dark and glairy liquid, and finally of a liquid more clear and of a citron color; burning pains in the stomach; violent pains at the epigastrium ; vomiting of a mucous and yellow fluid. (2.) Acidum Nitricum. 51 Great thirst continually ; sour eructations ; nausea; heat and burning in the stomach. (1.) Pain in the stomach; retching and vomiting; vomiting of black liquid blood, also of portions of detached mucous membrane; distention of the epigastric and hypogastric regions which are painful to the touch. (6.) Pathology.—Stomach very much distended, and covered with dark spots ; stomach distended with gas, and containing a yellowish, floculent, non-fetid liquid; darks spots on different portions of the mucous membrane of the stomach; thickening and redness of the walls of the stomach. (2.) Perforation near the smaller curvature of the stomach ; portions of the mucous membrane detached from the mus- cular coat; dark spots on different portions of the mucous membrane ; enormous distention of the stomach; stomach containing a large quantity of thick, offensive, chocolate-colored fluid; mucous coat of the pyloric orifice very much thickened ; ulcers near the pyloric orifice— some of them in process of healing; mucous membrane of the pylorus bright red, but at the most dependent point, greyish brown, and dis- organized ; on cutting through the thickened and ulcerated mucous membrane, a grating sensation was felt, like that described by Andral when cutting through cancer of the stomach. (6.) Clinical Remarks.—Cardialgia, and heartburn, and pyrosis, which have resisted the use of alkalies are often curable by Nitric-acid. It is one of the most homoeopathic remedies for chronic ulceration of the stomach, even against the perforating ulcer. Unfortunately the symptoms of perforating ulcer are exceedingly obscure, owing possibly to the most frequent seat of the ulcer being in the upper portion of the anterior wall of the stomach, so that food, drinks and irritating substances rarely touch it. The symptoms are those of chronic°gastntis or mere dyspepsia, although many of these cases are remarkable for the slight inconvenience experienced previous to the completion of perforation. Young women with more or less anaemia and disordered menstruation are most subject to it, although it some- times attacks males. The attacks of perforation are often sudden ; a young woman apparently in good health may be attacked while putting up her hair; but many cases occur soon after a hearty meal; when perforation actually occurs, the symptoms are those of acute peritonitis, viz., incessant vomitingf hiccough, tension, tenderness and swelling of the belly, quick, thrilling pulse, and clammy perspirations. After perforation has taken place, the pain and distress never cease ; the severe pain at the epigastrium or right hypochondrium and the extreme anxiety and distress of the patient's countenance are more pathogno- monic than the vomiting, or state of the pulse. The attacks are often so sudden, that suspicion of poisoning is often excited. (11.) If perforation has been diagnosed, not a particle of food or drink should be swallowed—beef tea injections—suppositories of Opium and Arsenic may be used—bits of ice may be held in the mouth, but the fluid should be spit out again. (11.) . Nitric-acid is also homoeopathic to haematemesis, (11.) 52 New Materia Medica. It is the only known, absolutely homoeopathic remedy for hard cancer of the stomach, especially of the pylorus. (11.) Abdomen.—Abdomen distended and painful to the touch; tearing pains in the abdomen; violent colic; severe pains throughout the en- tire abdomen; pains increased from the lightest pressure upon the abdomen. (2.) Frequent pinching in the abdomen; cutting pain in the abdomen, in the morning in bed; excessive flatulence; rumbling in the abdomen; suppurating swelling of the inguinual glands. (1.) Muscles of the abdomen contracted; distention of the hypochondriac region, which is tender to the touch. (6.) Pathology.—Increased thickness and redness of the upper portion of the jejunum; dilatation of the calibre of the duodenum; inflam- mation and thickening of the peritoneum ; adhesion of the peritoneum to different parts of the walls of the abdomen ; duodenum and jejunum covered with a thick layer of a yellow serous substance, which can be readily detached; slight injection of the vessels of the perito- neum. (2.) Peritoneum healthy; mucous membrane of the duodenum destroyed; small intestines somewhat contracted and atrophied. (6.) Clinical Remarks.—It is homoeopathic to true peritonitis ; to ulceration of the bowels with diarrhoea, and haemorrhage occurring during typhus fever, dysentery, chronic diarrhoea, or phthisis. In habit- ual constipation Dr. Graves has occasionally derived remarkable benefit from it. In cholera Nitric-acid, largely diluted, has been used successfully by Sir James McGregor and Dr. Hope; when largely diluted and sweetened they say that it may be used as an ordinary drink in this disease. Injections of dilute Nitric-acid are very useful in chronic diarrhoea and haemorrhage from ulceration of the bowels.— In puerperal intestinal irritation where diarrhoea is a prominent symp- tom, Nitric-acid with or without opium is often very useful. (11.) Liver and Spleen.—It is supposed to exert more direct action upon the liver than the other acids, and to affect the stomach more quickly and severely. In chronic hepatitis, the symptoms will frequently be ameliorated and subdued by dilute Nitric-acid; if persevered in, it will cause slight soreness of the mouth ; sponging the body and the surface of the liver particularly, with the dilute acid is also often very useful.—In chronic affections of the spleen Amnesley recommends the internal and external use of this acid. (10.) Rectum and Stool.—Very frequent and urgent desire for stool, but without the ability to accomplish any thing; obstinate constipation, with constant desire to go to stool; (2.) Long pressing when going to stool; itching and pressure in the rectum. (1.) Painful and bloody stools, with tenesmus and prolapsus of the rectum ; prolapsus of the rectum. (5.) Discharge of a large quantity of offensive, black blood; constipation. (6.) Dr. Walter's drank accidentally and quite heartily of dilute Nitric-acid; some time after vomiting freely he had pain, griping, and flatus, followed by tenesmus and bloody stools, with headache and fever; the dysentery lasted two days. Clinical Remarks. — Dr. Chapman thinks that colic preceding the Acidurn Nii/ricum. 53 stool, itching of the rectum and hepatic disorder are indications for its use in diarrhoea and dysentery. Dr. Perry has cured four cases of pro- lapsus-ani, with the 30th dilution of Nitric-acid in alternation with the 30th dilution of Ignatia. We have cured one case of prolapsus-ani with the acid (30th dilution), given every night for six weeks. We have also cured one case of fistulu-in-ano, (complete) of two years' standing with the acid and Ignatia at the 30th dilution, giving them on alternate weeks, once a day. The strong acid may be applied to that soft, red, strawberry-like elevation which Houston of Dublin calls a vascular tumor of the rectum. (10.) Urinary Organs.—Frequent and ineffectual attempts to urinate ; after several attempts to urinate, he passes a few drops. (2.) Fetid urine, nightly desire to urinate. (1.) Clinical Remarks.—It seems to have of all the acids the most de- cided and specific action upon the kidneys. From a chemical position Nitric-acid has been advised in albuminuria, from the known fact that Acidum-nitricum is a most delicate test for albumen.—After taking Acidum-nitricum pain in the lumbar region and kidneys is observed, and from there to the bladder, attended with great urging to pass urine, followed by diminution, even suppression of the secretion of urine for some days, and enuresis. The urine burns when passing the urethra, is very turbid, has a bad smell and is very dark, even brown in color, depositing fibrous nubecula, and much brown-red, greasy sediment. The mucous membrane of the urethra is likewise affected as in the first stage of blenorrhoea ; pains in the orifice of the urethra commence very soon after the use of the remedy, as in case of stone in the bladder. It is not known whether albumenin the urine is produced by taking Acidum-nitricum. (Reil.) (10 ) In calculous diseases, more especially in the alkaline and phosphatic diathesis, Nitric-acid may be employed with advantage—Brodie speaks highly of its value—In extreme cases large doses must be given; the the effect of these large doses in correcting the alkaline quality of the urine is very remarkable—he also employed it as a direct solvent of stone, by injecting the dilute acid into the bladder. In chronic inflammation of the bladder Brodie also used these injections. (11.) In diabetes Dr. Bardsley found it generally productive of benefit, mitigating the thirst and heat, and diminishing the secretion of urine. Genital Organs.—Clinical Remarks.—Frank, in Vol. 1. No. 4 of his magazine reports six cases of rheumatism and gout, brought on by colds following syphilis, either cured, or greatly relieved by baths slightly impregnated with Nitric-acid. The same gentleman reports several cases of suppurating syphilitic bubos, and of secondary syphilitic ulcers upon the genital organs, cured by the internal use of Nitric- acid baths; many of these cases having previously resisted the use of Calomel, &c. (10.) Mr. Ely S. W. (March 9.) Irritation of that portion of the urethra traversing the glans. Twenty years ago Mr. W. caught a severe 54 New Materia Medica. gonorrhoea, which was cured in a few weeks. A month after the cure of the gonorrhoea, he felt the first symptoms of the irritation, which manifested themselves by a distracting titillation in the part, which was soon followed by burning on micturition. No signs of stricture existing, and his assurance that several physicians had already passed bougies into the bladder, without much difficulty, led us to suppose his case one of simple irritation of the urethra which could easily be removed by homoeopathic remedies. March 9. Canthar. IrV March 12. somewhat relieved. Canthar. again. March 19. No improvement. Stitching in the glans-penis in addition. Intense feeling of formi- cation in the urethra. Cannab. IrV March 23. No change of itching, pain in the glans at intervals. Acidum-nitricum 1 138 New Materia Medica. taken it nine times. When he had taken six doses he was almost well: when he had taken nine doses he was perfectly well, and re- mainedrso for at least four years.—Dr. Jesse Young. Case 2.—A girl, sick with chorea for a month; after taking three doses, she was very much improved; six doses cured her entirely. In this case it pricked severely every time it was taken.—Ibid. Case 3.—A lady, aged 19, had chorea for two weeks, her left side was almost constantly in motion; it did not prevent her sleeping; her general health was perfectly good, and no cause could be detected. She took an emetic of Tart.-ant.; then a large dose of Calomel and Jalap; then a purge every morning of Cream-Tartar and Jalap for seven days, when Dr. Young was actually startled for he found that the chorea had extended to the right side and was tenfold aggravated ; her arms, legs, head, face, tongue and every muscular part was in continual, and irregular motion; she could with great difficulty speak intelligibly ; the power of swallowing was lost to a great degree ; she could not walk one step, nor stand up without support; nor could she sleep day or night on account of the constant twitching and jerk- ing of the muscles. ' Dose.—One teaspoonful of powdered Root, three times a day; in five days she was much better; could walk 3 or 400 yards ; could speak and swallow as well as ever; slept well at night; her legs had but little irregular motion, her head was steady, and the muscles of her face scarcely agitated ; her arms were more affected than any other part. In seven days more she was quite well. It neither vo- mited, sweated, purged, or acted on her kidneys; the only sensation she had was an uneasy feeling, almost amounting to an ache through all her limbs, after every dose, and continuing for three or four hours. Case 4.—Was cured in a few days. Dr. Physick cured several cases with ten grain doses every two hours. - Dr. Wood cured a case after the failure of purgatives and metalic tonics; also a case of periodical convulsions connected with uterine disorder. Case 5.—A girl, aged 9, whose mental faculties were much dis- ordered, and who had lost nearly all power over the left arm and leg; bowels irregular, headache, and pain frequently shooting down the left arm. Was cured quickly. Case 6.—A very intractable case was cured by Dr. Otto. Case 7.—A girl, aged 18; chorea with considerable gastric de- rangement, with suppression of menses for five months. Dose.—Five grains every three hours ; no improvement for nearly a week ; then improved rapidly and was well in three weeks. Dr. Davis says we can no longer doubt, its efficacy in chorea, in all cases arising from undue irritability or mobility of the nervous system, especially when induced by exposure to cold ; in short, when chorea arises from a rheumatic irritation of the motor nerves and muscles, or of the anterior column of the spinal marrow. (11.) Actea Racemosa. 139 Drs. Garden and Chapman say that in large doses it causes anxiety, great restlessness, slight nervous tremors, and pains in the extremities. As it requires large quantities to produce these effects, it may be pos- sible that large doses only are homoeopathic to chorea. (11.) Vascular System.—Dr. Davis has never known it to produce a per- ceptible increase of any of the secretions ; nor has it the slightest stimulating properties. He has uniformly found it to lessen the force and frequency of the pulse, to soothe pain and allay irritability. In a word, he regards it as one of the most purely sedative agents we possess; he says it causes a depression of the pulse which remains for a considerable time. In acute rheumatism the only visible effects of the Actea are: diminution of the force and frequency of the pulse, disappearance or the arthritic pains and inflammation, with occasion- al vertigo, or disposition to fall on attempting to assume the erect attitude. Hence it seems to exert a decidedly depressing and seda- tive effect upon the vascular system. (11.) Like many other drugs which exercise a specific action upon the nervous system, the primary effect of Actea, when given in small doses, is slightly stimulating to both the nervous and vascular systems, caus- ing a slight increase in the force and frequency of the pulse, and followed speedily by a permanent depression of the circulation. When administering it for mild attacks of rheumatism, we have in several instances observed this primary and secondary action. Among the secondary effects which are sometimes strongly marked, are dimi- nished nervous irritability, and disposition to sleep. (10.) Mind and Sensorium.—Vertigo, impaired vision, dizziness, dulness in the head. Vertigo, fulness and dull aching in the vertex. Vertigo, anxiety and great restlessness. (23.) Head.—Acute pain generally through the head during the day, at times more severe on the left side. Remittent headache of long standing, more or less severe every day, but increased every second day. Dullness of the head and pain in the forehead and occiput. Dull, boring pain in the forehead, over the left superciliary ridge, continuing for two hours. • x Pain from the eyes to the top of the head, which seemed as if the nerves were excited to too much action, lasting three hours. Pain in the forehead, dryness of the pharynx; aching in the eyes, apparently between the eyeball and orbital plate of the frontal bone. The pain in the head is always relieved by the open air. (23.) Dr. Mears reports a decided impression on the brain, evinced by a distressing pain in the head and giddiness, with increased force and fulness of the pulse and flushed face. Dr. Garden had previously mentioned the tendency to affect the brain, somewhat like Digita- lis. (11.) Severe pain in the eye-balls, extending into the forehead, and in- creased by the slightest movement of the head or eye-balls. Dull 140 New Materia Medica. pain in the occipital region, with shooting pains down the back of the neck. (10.) Clinical Remarks.—1. A lady, act. 35, has suffered from dyspepsia for several months, and for nine days past from severe pain in the forehead over the right eye, and extending to the temple and vertex, with fulness, heat and throbbing ; and when going up-stairs, a sensation as if the top of the head would fly off. Coldness and chills, particu- larly of the arms and feet; faintness in the epigastrium; pain and regurgitation of food after eating. Actea-racem. 1. three drops, three times a day, afforded prompt and permanent relief.—Paine. 2. Mrs. W., aet. 47, has not yet passed the critical period, and suffers from various neuralgic pains incident to that time. Now suffers from severe pain in the head, particularly in the forehead and eyeballs. Actea-racem. 2. afforded prompt relief in a few hours.—Paine. 3. In a case with the following symptoms; dull pain inthe head, ful- ness in the forehead and eyes, pain the eyeballs, increased secretion of tears; fluent watery coryza, frequent sneezing, soreness in the throat, causing difficulty in swallowing; cough, particularly at night, caused by tickling in the throat; cured in two days by Actea-racem. 2.— Paine. Dr. Davis says it will relieve many cases of severe headache from simple irritation of the brain in delicate females.—Dose : A wine-glass- full of decoction of root, every three or four hours. In rheumatic headaches it has occasionally proved curative after the failure of Bryonia. (10.) Eyes.—Aching of the eyes. Aching pain in both eyeballs, rarely in one alone, continuing for three weeks after discontinuing the drug. Pain in the eyeballs; increased secretion of tears, constant dull aching pain in the right eyeball, and across the forehead, accompanied with nausea. Stinging of the eyelids; dullness and heaviness of the head and eyes, as if produced by cold. (23.) f Severe pain in both eyeballs, extending to the forehead and increas- ed by any movement of the eyes or head. (10.) Clinical Remarks.—A young lady, aet. 20, of light complexion, has suffered for several weeks past from ophthalmia; pain in the eyeballs, a sensation as if they were enlarged. Most severe in the morning. Prickling in the inner canthus, aggravated by reading. Inflammation of the eyelids, slight secretion of mucus only in the morning; sore throat; reading causes headache. Actea-racem. 1, three drops, three times a day, entirely removed all the pain in the eyeballs and head.— Paine. It seems homoeopathic to rheumatic and catarrhal ophthalmia; it may prove useful in sclerotitis and iritis. (11.) In rheumatism or neuralgia affecting the structures of the eye, it is a remedy of considerable value. Its action in these cases resembles that of Bryonia. (10.) Actea Racemosa. , 141 Nose.—Frequent sneezing and fluent coryza during the day. Copious coryza. Fluent coryza, aching and soreness in the nose, during the day. Fluent watery coryza; frequent sneezing; soreness in the throat, causing difficulty in swallowing. Very profuse greenish and slightly sanguineous coryza after rising; fulness of the pharynx, and constant inclination to swallow; dulness of the head, and pain in the forehead and occiput. (23.) Clinical Remarks.—Some authors say that they have never known it to produce a perceptible increase of any of the secretions ; others say that it operates powerfully upon the secreting organs and absor- bents, and that it is expectorant and diaphoretic. It certainly seems homoeopathic to catarrhal affections (11.) Mouth.—Offensive breath. Dryness and soreness of the lips. Un- pleasant taste in the mouth; accumulation of thick mucus upon the teeth. (23.) . Throat.—Dryness of the pharynx and inclination to swallow. Ful- ness of the pharynx and constant inclination to swallow. Soreness of the throat when swallowing; sensation of fulness, and stiffness of the neck. Sensation of rawness in the throat; hoarseness, which increased towards night; constant unpleasant fulness in the pharynx. Palate and uvula red and inflamed. (23.) Clinical Remarks.—It has cured chorea when attended with almost complete loss of the power of swallowing. (11.) In the sore throat and cynanche maligna a decoction of the root is recommended by Dr. Barton. (44.) It is an excellent remedy against dryness of the throat, or a dry spot in the throat, causing cough. Also in dry coughs proceeding from irritation and tickling at the lower part of the larynx. (10.) Appetite illld Stomach.—Eructations and slight nausea. Pain and regurgitation of food after eating. Loss of appetite. Repugnance to food. Nausea and vomiting. Sense of internal tremor in the stomach after breakfast. Faintness in the epigastrium, with repugnance to food. (23.) It requires large doses to produce nausea, and then almost only when taken on an empty stomach. * Clinical Remarks.—It is peculiarly homoeopathic to a faint and sinking feeling at the pit of the stomach (11.) Dr. Mears asserts that Actea produced upon himself a decided im- pression upon the brain, followed by uneasiness at the stomach, and violent efforts to vomit. It is highly probable that many of the gastric symptoms are due to the action of the drug upon the brain, rather than to any direct influence upon the stomach. (10.) Abdomen.—Flatulence, causing a sensation of fulness in the abdomen; Rumbling of flatus below the umbilicus. Fulness and pressure in the lower part of the abdomen. (23.) Stool.—Disposition to diarrhoea. (23.) 142 New Materia Medica. Urine. —Increased flow of urine. (23.) Genital Organs.— Clinical Remarks.—It has been supposed by some eminent physicians to be a good substitute for ergot in parturition, being dissimilar, however, in its mode of action, relaxing the parts and thereby rendering labor short and easy. Hence it is useful where there is great rigidity of the soft parts, such as occurs in females who have their first children late ; or in those who are remarkably firm, and muscular, or in whom the os-uteri dilates slowly from great muscular resistance and rigidity. (11.) In cases of parturition where the vagina is dry, and the os is rigid, this remedy will do good service. It facilitates labor by rousing into increased action the mucous membrane, and thus supplying the parts with a lubricator. In domestic practice itMs occasionally employed to produce abortions, and in a few instances with success. In these cases a' decoction of the root is used. (10.) Larynx.—Hoarseness ; unpleasant fulness in the pharynx. Constant inclination to cough, caused by a tickling sensation in the larynx, which almost prevents speaking. Short dry cough in the evening and at night; fluent coryza. (23.) Clinical Remarks.—Chs. Sumner, M.D., while attempting to ob- tain provings of Actea-racem., did not observe any decided symptoms from the medicine, yet was relieved of a very troublesome hacking cough of some months' standing. Dr. Garden thought highly of it in consumption. In some parts of the country it has become a very popu- lar remedy for coughs. Dr. Wheeler has found it useful in several cases of severe and protracted cough, especially in the chronic cough or bronchitis of old people. Dr. Hildredth advises it in acute phthi- sis, or gallopping consumption; he has often seen the most prompt relief from the decoction alone against the febrile excitement, or hectic paroxysms, also in allaying the cough, reducing the rapidity and force of the pulse, and promoting gentle perspirations; he has often seen the same happy influence exerted against those intercurrent conges- tions and inflammations so frequent in the second and third stages of consumption? especially when caused by taking cold. (11.) Actea is an excellent remedy in dry, irritating coughs, with great dryness of the mucous membrane of the throat and larynx. It is most happy in its effects at the 12th to the 15th dilutions. (10.) Chest.—The pain in the head continued for ten days, followed by coryza, with sore throat and gradual extension of the disease to the bronchial mucous membrane; dry short, and hacking cough night and day, continuing two weeks, which is uncommon ; the prover not having had a catarrh or cold for several years. Acute pain in the right lung, extending from apex to base, aggravated by inspiration. Lancinating pain along the cartilages of the false ribs, increased by inspiration. Soreness of the chest. Cold chills and prickling sensation, during the day, in the (female) mammae. Prickling sensation in the breasts. (23.) Actea Racemosa. 143 Clinical Remarks.—Actea is a useful remedy in rheumatic inflam- mations of the lungs, especially in that form of consumption which arises without any especial hereditary tendency, from carelessness and exposure to cold and wet. Dr. Garden used it successfully for twenty years. He says, shortly after commencing its use the hectic paroxyms are entirely checked, the night-sweats begin to diminish, the purulent expectoration is speedily improved, the cough becomes less trouble- some and frequent, the pulse falls from 120 or 130 to the natural standard, the pains in the breast and sides abate, strength and appetite improves. It is supposed to possess the peculiar power in an eminent degree of lessening arterial action and at the same time imparting tone and energy to the system. (11.) In one case of pericarditis following an attack of inflammatory rheumatism, we observed excellent effects from the use of 3d dilution of Actea. It has often proved serviceable in pleurodynia of long- standing. (10.) Superior and Inferior Extremities.—Dull pain in the right arm, deep in the muscles, extending from the shoulder to the wrist. (23.) Dr. Garden experienced pains in both the upper and lower extremities from the use of large doses. Clinical Remarks.—The efficacy of Actea in chorea has already been dwelt upon. The evidence of a favorable influence over rheumatism is of a decided character. Very many cases, including the severest forms of acute inflammatory rheumatism have been treated with re- sults satisfactory in the highest degree, every vestige, of the disease disappearing in from two to eight or ten days, without inducing any sensible evacuation, or leaving behind a single bad symptom. It is particularly useful in the early and severe stages of acute rheumatism. It is comparatively of little use in sub-acute and chronic rheumatism ; the more acute the disease, the more prompt and decided will be the action of the remedy. In large doses it causes vertigo, dimness of vision, and a depression of the pulse, which remains for some time. From thirty to sixty drops of the Tincture have usually been pre- scribed every two, four or six hours. It seems somewhat homoeopathic to rheumatism, or at least to rheu- matic pains, as it caused in one case, of Dr. Jesse Young's, an uneasy feeling, almost amounting to an ache, through all the limbs, occurring after each dose and lasting for three or four hours; while Dr. Garden says it causes great restlessness and pains in the limbs. Still it re- quires large doses to cause these effects. (11.) We have been in the habit of employing this remedy occasionally in rheumatic affections, during the past eighteen years. We have prescribed at all doses from the nauseous decoction of the old school to the highest homoeopathic attenuation ; and good results have followed both forms of the medicine, although experience has long since taught us to rely upon the latter form. It is most service- able in articular rheumatism of the inferior extremities, with much swelling, and heat in the affected joints, and pain on moving the parts. 144 New Materia Medica. Like Bryonia it exercises a special control over inflammations of the serous membranes; but its range of action, and consequently its applicability in rheuihatic affections, are decidedly inferior to this drug. (10.) Back.—Stiffness of the neck. (23.) Drawing pain in the lumbar region. Pulsating pains in the region of the kidneys. (2.) Clinical Remarks.—Actea is homoeopathic in rheumatism affecting the dorsal muscles, and in some cases of chronic nephritis. The Actea-spicata has been successfully employed in calculous affections of the kidneys. (10.) Skin.—Eruption of white pustules and large red papulae on the face and neck. Clinical Remarks.—A strong decoction is said to be an effectual remedy for scabies. (11.) Fever.—Occasional cold chill. (See Vascular System.) Sleep.—Very restless at night. ACTEA-SPICATA. hekb Christopher.—Baneberry. The tincture of the root has been usually employed. In large doses it acts as a purgative, and sometimes as an emetic. Ruckert advises it in prosopalgia, and in certain rheumatic and neuralgic affections of the face and head. AUTHORITIES. Petroz, (60). Linnaeus, (61). Colden, (62.) Lemercier, (63.) Ruckert, (64). Marcy, (10). phenomena. Intellectual Faculties.—Loss of consciousness. (60.) A sort of in- toxication. Disturbance of the cerebral functions. (63.) Furious delirium. (61.) Affections.—Sadness. Melancholy causing a distaste of life. Ob- stinacy. Complaints. Head.—Boring pain in the head. The head-symptoms are more intense at night; they are increased by walking, and are generally periodical. (60.) Frontal Region.—Pressure in the forehead, commencing early in morning. (60.) Temporal Region.—Lancinating pain in the temples. (60.) Vertex.—Pressure in the vertex. (60.) Actea-Bpicaia. 145 Occiput.—Hammering pain in the occiput. (60.) Scalp.—Sensation of horripilation in the hairy scalp. Eruption of small pimples in the hairy scalp. (60.) Cranial Bone.—Pain which seems to be located in the periostium and even in the cranial bone. (60.) Conjunctiva.—Injection of the Vessels of the conjunctiva. Ophthal- mia of a catarrhal character. (60.) Vision.—Blue colors appear in the objects which we look at. When fixing the eyes for a long time upon an object, spots appear before them. (60.) Tears.—Flow of burning tears. (60.) Ears.—The external ears are painful to the touch. When sneezing or masticating, lancinating pain in the ear. Murmur in the ears after sleeping, increased by mental emotions. (60.) N0SC.—Bruised feeling of the nose. Redness of the wings of the nose. Nasal secretion tinged with blood. Epistaxis, during an op- pression of the chest. (60.) Face.—Great sensitiveness of the face. Pain in the face similar to that of rheumatism. (60.) Clinical Remarks—A girl, of twenty years of age, had a chill and was speedily attacked with a violent pain which commenced in a carious tooth of the upper jaw. This pain was pulling and tearing in its character, and extended to the zygomatic bone, and to the temples, and was increased by the lightest touch, or any movement of the facial muscles. Three globules of Actea removed this pain in. a few hours. (60.) The cheek upon which he lies perspires easily. Sweat upon, the face. Cold sweat upon the forehead. (60.) Lips.—Slight cracks upon the lips. The skin around the mouth assumes a light yellow color. (60.) Saliva.—Increased secretion of saliva. (60.) Buccal Cavity.—Foetid breath. (60.) Suh-maxillary Glands. —Pain in the sub-maxillary glands when eat- ing. (60.) Pharynx.—Sensitiveness of the throat when speaking. Tearing pains in the throat, especially when respiring cold morning or orening air. (60.) Appetite.—Sharp appetite in the morning. Hunger with repugnance to meats. (60.) Nausea.—Nausea. Malaise after eating. (60.) Vomiting.—Inclination to vomit with giddiness. Vomiting of acid substances. Vomiting. (64.) 12 146 New Materia Medica. Stomach.—Cramp of the stomach. Painful sensation of pressure at the epigastrium. Cancer of the stomach. (60.) Clinical Remarks.—Dr. Roth has given this medicine with advan- tage in cancer of the stomach. It is particularly useful when there is much tearing and darting pain in the epigastric region, accompanied with vomiting. Abdomen.—General uneasiness in the bowels. Abdomen sensitive to the touch. Sensation of compression in the abdomen. Spasmodic contractions in the abdomen. Pain in the abdomen like that which precedes or accompanies menstruation, Pain in the abdomen like that which precedes diarrhoea. (60.) Hepatic Region.—Pulsations in the right hypochondrium. Actite or chronic hepatitis, (60.) Clinical Remarks.*—Dr. Roth commends Actea in acute and chronic hepatitis. Ruckert has also employed it successfully in hepatic af- fections. Region of the Spleen.—Insensibility of the left hypochondria. (60.) Flatulences-Expulsion of a great abundance of flatulence. (60.) Alvilie DisChafges.-^-Stools in the form of pap. Colic pains during .cue stools. (60-) Suspension of the evacuations. (64.) Clinical Remarks.^-In constipation from a lack of bile in the in- iteotinal canal, Dr. Lemercier has found this medicine quite serviceable, Urine.—Frequent desire to urinate. Frequent desire to urinate and pain .during the act. White sediment in the urine- (60.) Respiration.—Difficulty of breathing, like an attack of suffocation. Difficulty .of breathing, with lancinating pain in the epigastrium on taking a longibreath. Difficulty of breathing, with pain in the stomach. Whistling,respiration. Difficulty of breathing, with painful shocks in the abdomen at.each inspiration. Respiration seems difficult in con- sequence of weakness, especially obvious when expiring. Difficulty of breathing .withgjain in the hip. (60.) Rheumatic iPleurisy.—(60.) Clinical.Remarks.—This remedy is homoeopathic in rheumatic af- fections of the intercostal muscles, and in pleurisies which sometimes occur during attacks of inflammatory rheumatism. (10,) Reaulifiegioil.—Sensation of beating in the region of the kidneys. Calculi of the kidneys. Clinical Remarks.—Dr. Roth lias employed Actea with consider- able benefit in calculous affections of the kidneys. It is especially appropriate in those cases which occur in individuals of gouty dia- . theses. Sacro-lumbar Region,—Tearing pain in the loins. Bruised pain in the sacral region when lying on the side. (60.) Hands.—Pain and paralytic weakness of the hands. (60.) Actea-Spicata. 147 Clinical Remarks.—A women, forty years old, subject to rheumatic affections and haemorrhoids, had been attacked, apparently in conse- quence of a, chill, with severe pains in the articulations of the hands and thumbs, accompanied with swelling. The least movement rendered the pains insupportable. Three globules of Actea 30th, produced a decided amelioration in a short time. A second dose, three days afterwards, effected a perfect cure. (65.) Fingers,—The fingers are numb, cold, and discolored. (60.) Inferior Extremities.—Swelling of the lower limbs. Boring pain in the legs, which is relieved by extension. Weakness of the lower extremities after changes of temperature. Swelling of the joints after a little fatigue. Trembling of the thighs on raising them. Sensation of great lassitude in the knees. Inflammation of the knee-joint. (60.) Clinical Remarks.—In rheumatic affections of the large articulations, this is a remedy of considerable value. It has proved most beneficial in cases accompanied by biliary derangement, and is appropriate in both the acute and sub-acute varieties. (10.) Coldness.—Coldness after drinking. Rigors followed by heat, during which vomiting occurs. Eructations during the chill. (60.) Sweat.—Viscid sweat. Hot sweat upon the head. Malaise and cold sweat. Suppression of the perspiration, (60.) Clinical Remarks.—Colden advises a dilution of Actea for weak and nervous patients who are troubled with frequent cold sweats after slight exertions of mind or body. It is also homoeopathic in sup- pressed perspiration, especially when occurring in rheumatic subjects. (10.) Fever.—Cephalalgia which continues after the fever has subsided. Delirium during the fever. (60.) Strength.—Sudden lassitude without any appreciable cause. Lassi- tude after eating. Lassitude after speaking a long time. Debility from walking in the open air. (60.) General Symptoms.—Pulsations throughout the body. Fermentation of the blood. (?) The pains are generally tearing and pulling. The symptoms manifest themselves particularly after mental emotions, walking, fatigue, speaking, eating, by the use of salt meats, beer, and by inhaling ttye fumes of tobacco. Most of the symptoms appear in the morning, and especially when in the open air. Its action is most decided in affections of the parenchymatous organs, the seat of old inflammations, or of active sanguineous congestions. (60.) This medicine is especially suitable to men. (60.) The characte istic symptoms are weakness and tingling. (60.) 148 New Materia Medica. ADEPS. hogs' lard. authorities. Waring's Therapeutics. (44.) Frank's Magazine. (4.) Peters. (11.) CLINICAL RESULTS IN SKIN DISEASES. In Scarlatina : Inunction of the surface with lard was first proposed by Dr. Schneemann of Hanover, and has since been adopted success- fully by Dr. Mauthner of Vienna, Mr. Taylor of London, and others. The treatment has been further tested by Professor Ebers of Berlin, who treated twenty-two cases, eleven of which presented one or more of the severe complications, and of whom six died ; of the twenty-two, the inunction with lard was tried in thirteen cases, and the ordinary remedies in nine ; of the latter five died ; of the former, only one was fatal, and this was beyond hope when the treatment was commenced; the remainder recovered. Prof. Ebers concludes that the inunction with lard does not interfere with the development of the eruption; for this comes out on the third day and declines on the fourth or fifth. The complications of the disease disappear more favorably than under the ordinary treatment. No desquamation or anasarca ever follows the use of the lard. The inunction seems to destroy the contagious principle. The lard requires to be diligently rubbed in, over the whole surface of the body every morning and evening. (44.) Mauthner treated his own daughter, aged 15, successfully with it. (4-) In Measles, the Exanthemata generally, and in inflammatory and typhus fevers: In these diseases inunction with lard is strongly ad- vised by Mr. Taylor; he relates numerous instances in which inunc- tion with an ointment composed of equal parts of lard and suet, was attended with the best effects. No internal remedies were employed. He states that it reduces the force and frequency of the pulse, and when employed at an early period of the disease, that it wards off a typhoid condition. The dry and brown tongue becomes clear, the patient falls into a sound sleep, and delirium subsides; in fact, all the symptoms improve with a steadiness and rapidity not seen in other methods of treating fevers. (44.) In Erysipelas: Erasmus Wilson considers that inunction with lard is in every way superior to all fluid applications. He at first, at the suggestion of Mr. Grantham, relaxes the skin with hot water or steam, and then saturates the surface with hot lard, which is afterwards covered with wool. He also speaks highly of the value of lard inunc- tions, in the treatment of violent sprains. (44.) Mauthner also uses it in burns and erysipelas. (4.) JEihusa Cynapium. 149 In Itch : Professor Bennett used lard inunction in four cases of itch, and in each a cure was speedily effected. From these and other cases, he infers that the efficacy of Sulphur-ointment mainly depends on the unctous matter which it contains. It is of importance that the parts should be kept moist, and for this purpose, oil-silk so as to completely envelope the parts should be used. The same treatment has been found successful by Mr. Bazin, who found that six frictions during three days were sufficient to effect a cure of itch. (44.) In Consumption: In Frank's Magazine about twenty cases of con- sumption more or less successfully treated with lard inunctions are re- ported ; the hectic fever and sweats soon abated, and all the patients improved in flesh and strength; it may be tried in cases in which cod-liver oil cannot be used internally. In profuse sweats: Several cases are reported in which it removed profuse and debilitating perspirations in non-tuberculous persons. In Scrofula: It has also been used successfully. In all cases, the lard used should contain no salt; if the lard has already been salted, this should be worked out in water. J3THEK. {See Ether.) JSTHUSA CYNAPIUM. GARDEN HEMLOCK.—FOOL'S PARSLEY. AUTHORITIES. Roth's Materia Medica. (65.) Homoeopathic Examiner, Vol. 1. New Series, p. 400. (66.) Noack and Trinks' Mat. Med. (67.) Christison. (9.) Taylor's Medical Jurisprudence. (8.) Peters. (11.) Frank's Magazine. (4 ) TOXICOLOGICAL EFFECTS. This plant has received the common name of Fool's Parsley, from its resemblance to common Parsley, and the unpleasant accidents, which have occurred from mistaking the one plant for the other. It has a botanical alliance with Conium-maculatum, Cicuta-virosa, cles, irregular convulsive movements and desire to dance; also a curious state of the nervous system which becomes so acted upon by mental en otions, or the exercise of the will that muscular twitchings and convulsive movements are excited, a condition of body closely resembling that of a patient suffering from chorea and hysteria. Clinical Remarks.—Noack recommends it in mania saltatoria, as 10 162 New Materia Medica. it is homoeopathic to a state in which the slightest exertion of the will produces the most violent effect upon the over-sensitive nerves and muscles, and calls forth the most strange and almost unimaginable mo- tions of the limbs ; inclination to dance ; the most curious motions of the hands ; extraordinary agility of the limbs and extreme facility in the performance of the most fantastic motions. In Chorea.—St. Vitus's dance has been denominated an insanity of the muscles, and is very analogous to mania-saltatoria. Agaricus is ho- moeopathic to trembling of the limbs, subsultus, slight jerks of the muscles here and there ; twisting about of the arms, persistent con- vulsed state of the muscles of the head and neck. It is asserted by some physiologists, that the principal office of the cerebellum is to preside over and regulate the faculty of locomotion, and we have seen (see Case 12) that Agaricus acts specifically upon the cerebellum. (11.) Agaricus is only homooeopathic to the true nervous cerebral chorea, i. e. the most common form of it, or that which arises from a function- al disease of the brain, and in which the convulsive movements cease during sleep. Nux and Ignatia are homoeopathic to spinal- chorea, in Avhich the spasmodic action does not cease during sleep, for the spinal-marrow does not sleep. Hydriodate of Potash, Iodine and Actea-racemosa are homoeopathic to rheumatic chorea, which is apt to be attended with acute endo- or pericarditis. ' 1 have seen two instances in which chorea was attended with acute rheumatic inflam- mation of some of the structures of the heart. Agaricus may also prove homoeopathic to that most dangerous and almost always fatal variety called electrical-chorea in which the convulsive movements finally give way to coma and the patient dies with apoplectic symp- toms ; venous congestion of the cerebral and spinal meninges appears to be the only uniform abnormal condition observed in electrical chorea. (11.) Case.—A St. Vitus dance of five days' standing was not relieved by Bellad. ; Stramonium 6 helped a little; Ignatia not all; and thus three weeks passed by. Then Agaricus 6 was given and in six days there was some improvement; in ten days more there was a decided amendment; in ten days more the patient could walk ; in thirty-four days from the commencement of the use of Agaricus the patient was well; it was given regularly every four hours. 1 have effected cures with the Tincture in one-fourth part of the above time. (11.) In Cramps, Convulsions and Epilepsy.—It has long ago been recom- mended in the dominant school in epilepsy, especially in that variety induced by fright (Vogt, Dierbach), and is said to form the active part of Ragolo's secret remedy against this disease. (11.) This remedy has been employed empyrically for many centuries for the cure of epilepsy, and chronic enlargement and induration of the glands of the neck and throat. Teste considers its action to be some- what similar to Belladonna and Lachesis, and prescribes it only after ■these remedies have failed. Agaricus-muscarius. 163 In one case of hypertrophy of the brain, accompanied with almost constant tremblings of the limbs, the 3d dilution of Agaricus gave prompt relief. Another case of chattering of the jaws, and tremblings of the limbs, occurring during the debile stage of a typhoid fever, was speedily cured by this remedy. (10.) On the VasCHlar .System.—Like all the narcotic remedies Agaricus seems to act far more powerfully upon the venous than upon the ar- terial system. It seems to prevent the arterialization of the blood and render it more and more venous. It is more homoeopathic to venous congestion than to inflammation. (11.) On the Blood.—The body is in general livid, the blood fluid, so much so, that it sometimes flows from the natural openings of the body. All the vessels of the brain filled with dissolved, dark-red blood. Heart filled with black, fluid blood ; all the blood-vessels filled with black, fluid blood. On the IIcart.-^-Heart filled with black, fluid blood. Pericardium and arch of aorta much reddened, i. e., stained with the fluid blood. On the Pulse.—In one case the pulse became small and irregular and the body bedewed with cold sweat; in another the pulse was weak. Pulse small, quick, (80) slow, feeble, unequal, intermitting or undulating pulse. Fever.—Constant chilliness, with inability to get warm. Violent shaking chills through the whole body, with normal temperature of the face, cold hands, without thirst and subsequent heat. Sensitive- ness to cool air. General heat in the evening with redness of the cheeks, coldness of the hands and thirst; general heat at night in- termingled with chilliness, followed by sweat; general heat in the after- noon with headache and thirst, followed by aggravation in the evening, attended with hurried breathing and great languor. Clinical Remarks.—Agaricus ought to prove curative in some cases of intermittent fever; it may also prove useful in hectic fever, but its great affinity is for nervous fevers, typhus versatilis and delirium tre- mens. (11.) Sleep,—Irresistible drowsiness in the day-time. Drowsiness es- pecially after dinner; sleeplessness on account of pain and uneasi- ness in the legs. Sleep disturbed by desire to urinate with copious flow of urine, spasmodic cough, or coldness in the legs. Sleep inter- rupted by a multitude of dreams with fitful fancies, partly pleasant, partly unpleasant. On the MUCOUS Memhranes.—Many of the varieties of Agaricus cause the secretion of large quantities of yellow mucus. Thus, in a dog, poisoned with Agaricus-bulbosus, the stomach was found full of a thick yellow mucus; in another case the whole intestinal canal was filled with a thick yellow mucus; a woman evacuated an abundance of yellow mucus. (11.) 164 New Materia Medica. Skin.—Itching, burning and redness of various part's as if ftoiett. Miliary eruptions, close and whitish, with burning itching. Clinical Remarks.—It is one of the most homseopathie and useful remedies again3t frost-bites. LOCAL EFFECTS. Mind and Disposition.—Want of disposition to talk. Irritable, vexed mood, ill-humor. Listlessness, aversion to any kind of work. Fear- less frenzy with intoxication, accompanied with bold and vindictive designs. Menacing mischievous rage, with great strength. Vividness- of the imagination, ecstasy, prophesying, making Verses, singing, &c. Clinical Remarks.—It is one of the most homoeopathic remedies against acute delirium, mania, delirium-tremens, the delirium of ty- phus, &c. ; it shonld be borne in mind when Belladonna and other remedies fail. (11.) Sensofium.—Vertigo of various kind, especially early in the morn- ing as if intoxicated. Dullness of the head and dull pain as after intoxication ; dizziness, intoxication and stupefaction ; staggering to and fro, especially during a walk in the opefi air. Dizziness as if he would fall, with staggering and dimness of sight, coming on in paroxysms every five minutes. Clinical Remarks.-^lt is one of the most homeeopathie remedies against chronic dizziness resulting from frequent intoxication, or ha- bitual free use of strong liquors ; in dizziness from congestion of the1 brain, with threatening of apoplexy, especially in the stFtdious, slug- gish, m intemperate in eating and drinking. (11.) Headache.—Great weight in the head, especially in the forehead and temples; in the morning, a3 after intoxication, Drawing pain in the head. Tearing in the head. Pathology.-—Vessels of the brain very, turgid; all the sinuses of the dura-mater, as well as the arteries enormously distended witfc blood ; the arachnoid and pia-mater of a scarlet color ; clot of blood as large as a bean in the cerebellum. Clinical Remarks.—It is most homoeopathic to the headaches of persons subject to nervous twitchings and St. Vitus's dance, or to spi- nal irritation with great soreness, uneasiness and weakness down the spine, with or without derangement or enlargement of the liver. (11.) Also in the headaches of those who use wine and spirits too free- ly, or who become delirious whenever they are feverish or in pain, attended with twitchings, startings, grimaces and a state resembling pleasant intoxication. (11.) According to Black it is indicated in nervous and congestive head- aches in which fulness, sleepiness, and frequent inclination to yawn are present attended with relaxation and soreness of the whole body, pain in the back and a feeling as if all the joints were dislocated. Hence it would also seem suited to the headache and general derange-' ment which attends influenza. Agaricus-muscarius. 165 It is homoeopathic to congestion of the head, with pulsation in all the vessels, redness and heat of .the face, and delirium. Also to ca- tarrhal headache with aching in the forehead over the eyes, drawing pain in the forehead, extending to the root of the nose, rending pain in the forehead above the root of the nose, as if the brain were la- cerated, with burning pain in the nose and eyes, great dryness of the nose, profuse epistaxis and abundant discharge of thick viscid nasal mucus, followed by frequent dropping of water from the nose. I have used it frequently and successfully against many varieties of head- ache in nervous and hysterical persons. (11.) Scalp.—Painful sensitiveness of the scalp as of subcutaneous ul- ceration. Itching of the hairy scalp. Clinical Remarks.—It is homoeopathic to headaches attended with or followed by great soreness or tenderness of the scalp ; and against chronic tenderness of the scalp, such as occurs m persons with spinal irritation. (11.) Eyes.—Pressure in the eyes. Burning sensation in the eyes. Twitching of the eye-balls and lids. A viscid, yellow humor glues the eye-lids to one another. Short-sightedness, and dina-sightedness of both eyes. Yellowness of the eyes. Twitching of the eye-lids. Falling out of the eye-brows. Clinical Remarks —It is homoeopathic fto spasmodic twitching of the eye-lids and winking, such as occurs in nervous, verminous, or scrofulous children; to chronic inflammation of the meibomian glands ; to short-sightedness and dim-sig!htednes6 of both eyes 4 to musca? vo- iitantes from disorder of the watery spectrum, when everything seems as if obscured by turbid water; to incipient amaurosis when black motes hover before the eyes, or everything seems surrounded by a mist, or covered with a cobweb. (11.) Ears.—Itching redness, and burning of the ears, as if they had been frozen. Clinical Remarks.—It is homoeopathic to nervous pains in the ears; but especially against the pains, itchings and other inconveniences which attend frost-bites of the ears. (11.) Nose.—In blowing the nose, blood comes out of it, early in the morniRg, immediately after rising from the bed.; this is followed by violent bleeding from the nose. Sense of smell very acute. Clinical Remarks.—It is homoeopathic to epistaxis and frost bites of the nose; also to great sensitiveness and tenderness of the nose, .vith or without great acuteness of the sense ©f smell. (11-) Face—Redness of the face, with itching and burning, as if frozen. Bluish appearance about the eyes, nose and mouth. Pale, bloated face. Unnatural physiognomy. Clinical Remarks.—It is homoeopathic to frost bites of the face ; to ihxobbings and twilchings in the face* such as attend gum- • 1,66 New Materia Medica. boils, and abcesses about the face ; it is useful against the pimples of acne which occur on the faces of young persons, and a tendency to blueness and roughness of the skin of the face; also to chaps and fissures of the lips. (11.) Jaws and Teeth.—Violent tearing in the right side of the lower jaw. Clinical Remarks.—It is homoeopathic to neuralgia of the face ; to toothache from taking cold, especially when the teeth feel long and are very sensitive to pressure, when touched or while chewing ; to inflammation of the lining membrane of the alveolar processes. (11.) Mouth- —Swelling of the gums. Tongue is coated white and yellow. Foul smell from the mouth. Small painful ulcers at the side of the fraenum of the tongue ; aphthae in the mouth; salivation. .< Clinical Remarks.—It is homoeopathic to mercurial salivation ; also to ulceration and soreness of the mouth from gastric and bilious de- rangement ; and to afoul and bilious state of the mouth. (11.) Taste and Appetite-—A good deal of hunger, but no appetite. Morbid appetite, burning thirst. Flat, or hitter taste in the mouth, with yellow coating of the tongue. GreaJ fickleness of the appetite ; want of appetite may be followed for several days in succession by sudden fits of hunger, and ravenous appetite; then eating is followed by choking in the throat, oppression of the stomach, pain in the eyeballs, general dullness and heaviness. Clinical Remarks.—It is very homoeopathic to bilious dyspepsia, especially when occurring in very nervous and sensitive persons. (11.) Gastric Symptoms and Stomach,—Frequent rising of mere air. Hic- cough, eructations, and nausea. Eructations with qualmishness of the stomach; nausea relieved by eructations. Oppression of the stomach, with inclination to go to stool; or about the pyloric orifice; or extending up into the chest. Cramps of the stomach with pains towards the spine, shoulder-blades or collar-bones. Pathology.—Two large excoriations in the fundus of the stomach and one in the duodenum. Stomach full of thick yellow mucus. Stomach and intestines distended with foul, stinking air. Traces of mortification in numerous places on the mucous membrane. Congestion of mucous membrane near the pyloric orifice of the stomach. Fluid of black color in the stomach. The stomach studded with red spots; the mucous and muscular coats destroyed, so that nothing re- mained except the serous tunic {gelatinous softening.) Clinical Remarks.—Agaricus is one of the most homoeopathic re- medies against excessive flatulence of the stomach and bowels; against the fulness, oppression of the stomach which arises from flatulence, and produces the feeling as if the contents of the chest were compressed. It is most suited against the flatulence of nervous hysterical and bilious persons. (11.) Agaricus-muscarius. 167 Abdomen-—Pinching below the'umbilicus, attended with a bloated condition of the abdomen. Emission of a large quantity of wind, smelling like garlic, with smarting pain in the rectum. Pressure and sense of fulness in the abdomen even after a light meal; troublesome fulness in the whole abdomen, making sitting and breathing difficult; bloating of the abdomen. Cutting pain attended with the shifting to and fro of wind in the bowels, with bloating of the hypogastrium; eructations and emissions of wind give but slight relief. Cutting pains in the abdomen followed by liquid stools. Shifting of flatulence in the abdomen and loud rumbling. Pathology.—Omentum, pancreas, peritonaeum, external surface of stomach and small bowels much reddened, and all the blood-vessels filled with black fluid blood. Stomach and intestines distended with foul stinking air; traces of mortification in numerous places on the mucous membrane. Mucous membrane of the small intestines destroyed in various places. Ileo-colic valve much inflamed or reddened. Clinical Remarks. — Agaricus is one of the most homoeopathic remedies to excessive flatulence and tendency to diarrhoea, such as occur in nervous and hysterical persons, especially if there be marked bilious derangement; also in indigestion, colic and flatulence from irritation or sub-acute inflammation of the stomach and bowels (chronic It/is homoeopathic to pharyngitis ; also to the formation of an excess of uric-acid in the stomach. It is a singulaf coincidence that Agnus-castus has been supposed to exert a specific influence upon the spleen, and Scherer has found uric-acid in consi- derable quantity as a normal constituent in the juice of the spleen. (11.) Abdomen.—Shifting of flatulence, pressing and cutting in the epi- gastrium. 174 New Materia Medica. Clinical Remarks.—It may prove useful in some forms of dyspepsia and flatulence. Roth says it is homoeopathic against whiteness of the tonoue, bitterness of the mouth, loss of appetite, sensitiveness of the abdomen to pressure, swelling of the abdomen after eating, occa- sional pains in the hypogastrium, great accumulation of wind in the bowels, hardness of the stools, pains in the kidneys, and redness and muddiness of the urine. (11.) Liver and Spleen.—Hard pressure in the region of the liver. Clinical Remarks.—Dioscorides recommended it against dropsy, ascites, enlargement and other diseases of the spleen. Hippocrates recommended the seeds in diseases of the spleen. (11.) Stool and Anus.—Loose stools, some days in succession. Difficulty in passing the stools, which were not hard; they had to be pressed out, and seemed inclined to re-enter the rectum. Discharge of pro- static fluid when pressing at stool. Corrosive itching about the anus and perineeum. Clinical Remarks.—It has been recommended by Noack in chronic diarrhoea. In pruritus podicis and excoriations about the rectum; it is homoeopathic to corrosive itching about the groins, anus and peri- naeum; to acute, deep sharp stitches about the coccyx ; to painful spots near the anus while walking, as if there were subcutaneous ul- cerations. It has been recommended against fissures of the anus; and it has been said that a twig of it held iu the hand while walking will prevent any excoriation between the thighs, and of the feet. It has also been recommended against ascarides. (11.) Urinary Organs.—Disagreeable sensation in the back part of the urethra, after micturition. Frequent urination, the urine being copious and dark. Pain in the kidneys ; redness and muddiness of the urine. Clinical Remarks.—-It may prove useful against the uric-acid dia- thesis ; and also against the Oxalic-acid diathesis, as the recent ex- periments of Wohler and Frerichs in which the introduction of uric- acid into the organism by the primce-vice or by the veins, was followed by an augmentation of the Urea and oxalate of lime in the urine, af- ford tolerably strong evidence that the uric-acid in the animal orga- nism undergoes a decomposition into urea and oxalic-acid precisely similar to that which can be artificially produced by Peroxide of Lead. It may prove useful against the melancholy and despondency which attends the oxalic-acid diathesis. (11.) Genital Organs.—Feeble erections, without the sexual desire being excited. The penis is so relaxed that not even voluptuous fancies excite it. Diminution and slowness of the sexual powers, wnich are usually very easily and powerfully excited; the penis is small and flaccid (in a very healthy man.) Drawing along the spermatic cord. The semen runs out in a stream, without ejaculation, it has but little smell, and is scanty. Agnus'castus. 175 To prevent getting children, a man took for three months, morning and evening twelve grains of the Agnus-castus, by which the parts were weakened to such an extent that not only did the erections be- come deficient, but he lost his semen as he intended, and never be- gat children. A kind of yellow gonorrhoea. This drug has received the Greek name Lygon from the great flaccidity of the penis which it causes. Clinical Remarks.—Dr. Landerer of Athens uses the seeds of the Agnus-castus with the greatest success in gonorrhoea, curing cases in which even Cubebs had failed. Although it is said to thin the sper- matic fluid and produce pain in the testicles, still an ointment of it will remove pains in the testicles. (11.) In impotence arising from a paralytic condition of the muscles con- nected with the genital organs, Agnus is a remedy of great value. We usually prescribe it at the sixth dilution. (10.) Female Sexual Organs.— Clinical Remarks.—Dioscorides says it in- creases the flow of milk and brings on the menses; a decoction of the leaves and seeds in a bath is said to relieve inflammation and other diseases of the womb, and to remove hardness of the womb, testicles and ovaries. Hippocrates recommended the leaves steeped in wine against metrorrhagia; with wine and oil to expel the after-birth. Roth recommends it when the menses last from ten to eighteen days, and are preceded by headache, vertigo, and dimness of sight, and accompanied with pains in the loins and pelvis. When there isia deficient secretion of milk in lying-in women, the legs becoming much fatigued and swollen towards evening, with sallowness of the skin and disturbed dreams. (11.) It has often cured incontinence of urine following tedious accouche- ments. Also in relaxed conditions of the utero-genital organs, it has been successfully employed. (10.) Respiratory Organs.—A good deal of sneezing, with dryness of the nose ; tenacious mucus in the throat which it is difficult to bring up. Clinical Remarks.—Roth says it is useful against oppression of the ohest on going up-stairs, cough with raising of blood, followed by copious mucous expectoration, with paroxysmal attacks, especially in the morning, attended with palpitations and bleeding of the nose. (11.) Upper Extremities.—Hard pressure in the right axilla increased by pressure. Hard pressure in the upper arm, increased by contact; pres- sure, lameness, and jerking pain in the elbow, wrist, metacarpal bones, worse on motion. Clinical Remarks.—Noack has recommended it against the after-ef- fects of dislocations. It is homoeopathic to piercing and rending pains in the joints; pains as if from dislocation of the joints, especially in the shoulder joints; paralytic pain in the wrist-joint, only felt when turning the hand; gouty rending pain with swelling of the finger- joints; lassitude and tiredness of the limbs, increased by every motion. 176 New Materia Medica, It will also probably prove useful against gonorrhoeal-rheumatism. It had an ancient reputation against bruises and wounds. (11.) Lower Extremities.—Lameness, jerking, drawing, sticking pain in various parts of the lower extremities. Heaviness of the right foot; sensation as if a heavy load were attached to the tarsal bones, drawino the foot down, in any position of the foot. Tearing in the anterior joints of the left toes, more violent when walking. Clinical Remarks.'—-It is homoeopathic to piercing, aching, rending, and luxation-pain in the hip-joints; piercing, drawing and dislocation- pain in the knee-joints ; weakness of the ankles, with predisposition to sprain them. (11.) ALCOHOL AUTHORITIES. Christison. (9.) Garms.(33.) Brit, and For. Med. Chir. Rev. (18.) Ranking's Abstract. (13.) Peters. (11.) Huss. (34.) Marcy. (10.) ACUTE EFFECTS. According to Christison, authors who have treated of the actions of alcoholic and spirituous liquors on man, have distinguished three degrees in its immediate effects. 1) When the dose is small, much excitement and little subsequent depression are produced. 2) In the second degree the symptoms are more violent, excitement, flushed face, confusion of thought, delirium and various mental affec- tions, Varying with individual character. The majority of intoxicated persons become jovial, sympathetic and even indiscreet; many things which otherwise would remain a profound secret, are allowed to escape {in vino Veritas); others become sentimental and affectionate; some speak with incomprehensible suavity about learned subjects, politics, country; in some cases the coward becomes a hero in his own ima- gination ; others are always ready to quarrel or fight, and either com- port themselves as pugilists, or become almost murderous in their ferocity, but fortunately there are generally others not less drunk who are not only peaceable, but anxious to preserve the peace. Another class of drunkards always become depressed in spirits, sit quietly in a corner, are much absorbed in themselves and burst into tears and complaints over the most trivial occurrences. The perceptions are disturbed and often confused; the harmony between the intellect and will is broken up; the higher intellectual functions and even the com- mon processes of the understanding become more and more difficult, while the imagination and the lower impulses predominate. (9.) These symptoms are followed by dozing and gradually increasing somnolency, which may at length become so deep as not easily to be Alcohol. 177 broken. After the state of somnolency has continued several hours, it ceases gradually, but is followed by giddiness, weakness, stupidity, headache, sickness and vomiting. This degree of injury from Alcohol may prove fatal, either in it- self by the coma becoming deeper and deeper,— or from the previous excited state of the circulation causing diseases of the brain in a pre- disposed habit. There is a singular variety in the principal symptoms in this form of intoxication, even when completely formed: thus, when the stage of stupor is fully formed, the person is sometimes capable of being roused, sometimes immoveably comatose for a long time;—the pulse is sometimes imperceptible or very feeble, some- times distinct, or even full, generally slow or natural, seldom frequent, very seldom firm---the pupils are occasionally contracted, much more generally dilated, and in a few instances alternating between one state and the other-—the countenance is commonly pale, sometimes turgid and flushed—the breathing is for the most part slow and also soft, yet not unfrequently laborious, but very rarely stertorous. Convulsions are rare, having been observed twice only in twenty-six cases. Neither do any of the special symptoms seem to bear a marked rela- tion to the ultimate event; for many cases get. well when the pupils are much dilated, the coma profound and the pulse imperceptible. It usually happens that if the stage of stupor be completely overcome, recovery speedily ensues, without any particular symptom except headache, giddiness, sickness, and the customary consequences of a debauch. But on some occasions the comatose stage is succeeded by one which indicates much cerebral excitement—by flushed face, injected eyes, restlessness, a febrile state of the system, and delirium even of the violent kind. In other cases this affection puts on very much the characters of a slight attack of typhoid fever. (9.) In another variety of this second degree of intoxication, an apo- plectic disposition is called into action by the excited state of the cir- culating system, and death ensues from apoplexy, or some other disease of the brain, rather than from simple drunkenness. Thus, in some in- stances, extravasation of blood is found within the head after death ; but as this is a rare effect of intoxication, it must be considered as the result of poisoning with spirits, exciting 'sanguineous apoplexy in a predisposed constitution. In other cases the stupor of intoxication, after putting on all the characters of apoplexy for two days and up- wards, terminates fatally without extravasation ; here the poison operates by developing a constitutional tendency to congestive apo- plexy. In some cases an interval of returning health occurs between the immediate narcotic effects of the poison and the ultimate apoplectic coma, which is the occasion of death. (9.) Case 1.—Two brothers drank in half an hour, three bottles of porter in which twenty-four ounces of whiskey had been secretly mixed by a companion. In fifteen minutes after, one of them fell down insen- sible, and had no recollection of what happened for twelve hours; but he recovered. The other staggered a considerable distance for an 11 ITS' New Materia Medica. hour, and then became quite insensible and unable to stand. In fonf hours more, consciousness and sensibility were quite extinct, the breathing stertorous and irregular, the pulse eighty and feeble, the pupils dilated and not contractile, and deglutition impossible. He died in fifteen hours. (9.) Case 2.—A man drank thirty-two ounces of rum one afternoon and was comatose most of the ensuing night; on the next morning, though very drowsy, he was sensible when roused ; and in the evening he was considered convalescent; but two days afterwards he became de- lirious, and in two days more he died comatose, and congestion was the only appearance found in the brain. (9.) Case 3.—A workman after drinking eight ounces of rectified spirits by mistake for water, suddenly fell down senseless and motionless and remained so for eleven hours ; he then began to recover and came round so far that he returned to his work next morning; after this he continued to pass dark, pitch-like evacuations. In three weeks he became drowsy, mistook one thing for another, answered questions sluggishly, and had a frequent pulse and dilated sluggish pupils; in which state he continued for three weeks more. (9.) Case 4.-—A boy, aged eight years, took eight ounces of gin; he suddenly became motionless and insensible; in no long time he vomited ; he was now motionless, insensible, pale and cold; the pu- pils were contracted, the pulse feeble and hurried, the breathing ster- torous and slow; and he made ineffectual efforts to vomit, stimulants of all kinds had little or no effect on him for one-and-a-half days, when the breathing became more natural and his look quite intelli- gent; yet he could not answer questions, exhibited no sign of volition, and had a pulse as frequent as one hundred and sixty ; in twenty-four hours more the breathing became laborious and rattling, and the lips livid ; death occurred on the third day. The only morbid ap- pearances of any note were : general injection of the arachnoid, and effusion of frothy mucus into the bronchial tubes. (9.) Case 5.—-A boy aged seven, took nearly five ounces of undiluted whiskey ; he suffered for two days from the ordinary symptoms of ex- cessive intoxication, which were then immediately followed by epw leptic convulsions ; these • continued to recur with more or less vio- lence, but always frequently, for two months. (9.) As a general rule the symptoms in the second degree of intoxication are remarkably uniform, gradual and uninterrupted. But there are likewise some anomalies. Thus, occasionally after the phenomena of ordinary intoxication hare gone on gradually increasing without having attained a very great height, sudden lethargy supervenes at once, and may prove fatal with singular rapidity. (9.) Case 6.—A man reached his home in a state of reeling drunkenness, but able to speak and give an indistinct account of himself; he then become lethargic and died inHwenty minutes. There was no morbid appearance except some watery effusion on the surface of the brain and in the ventricles. (9.) Alcohol. 179 An anomaly of a different kind is sudden supervention of deep in- surmountable stupor, without the usual precursory symptoms, yet not till after a considerable interval subsequent to drinking. Case 7.—A lad aged sixteen, swallowed sixteen ounces of whiskey in the course of ten minutes, and pursuant to the terms of a wager, walked up and down a room for half au hour. He then went into the open air, apparently not at all the worse for his feat, but in a very few minutes, while in the act of putting his hand into his pocket to take out some money, he became so suddenly senseless as to forget to withdraw his hand, and so insensible that his companions could not rouse him. He died in sixteen hours. (9.) 3) The third degree of poisoning is not so often witnessed, because in order to produce it, a greater quantity of spirits must be swallowed pure and at once, than is usually taken, except by persons who have made foolish wagers on their prowess in drinking. Then there is sel- dom much preliminary excitement; coma approaches in a few min- utes and soon becomes profound, as in apoplexy ; the face is some- times livid, more generally ghastly pale ; the breathing stertorous and the breath having a spirituous odor; the pupils sometimes much contracted, more commonly dilated and insensible; and if relief is not speedily procured, death takes place, generally in a few hours, and sometimes immediately. The patient may recover if the iris re- mains contractile ; but if it is dilated and motionless on the approach of sight, recovery is very improbable. These cases generally die with the symptoms of pure coma; convulsions are not common, but occasional cases do occur in which the coma is accompanied with alternating opisthotonos, and emprosthotonos. (9.) Occasionally Alcohol acts as an irritant; after its ordinary narcotic action passes off, another set of symptoms occasionally appear, which indicate inflammation of the alimentary canal. Case 8.—A young man had been drinking brandy immoderately for several days, when at length he was attacked with shivering, nausea, feverishness, pain in the stomach, vomiting of every thing swallowed except cold water, thirst, and at last hiccough, delirium, jaundice, and convulsions; death took place on the ninth day. The stomach was found gangrenous over the whole villous coat; the colon was much in- flamed and all the small intestines red. (9.) DELIRIUM TREMENS. By some physicians, this disease is considered to be a form of alcoholic poisoning, or an alcoholism; that it is specific in its nature^ and that, it is analogous to Plumbism, Mercurialism, Ergotism or Narcotism. These physicians consider it as an entirely erroneous opinion, that the privation of an accustomed stimulus is the exciting. cause of the malady. A larger class of practitioners regard it as the delirious affection,. which follows the suspension of the habitual use of stimulants. They 180 New Materia Medica. make its essential character consist in the cerebral debility consequent upon the cessation of an accustomed excitement, although they admit a complication with the immediate effects of the stimulant in those cases which arise after a protracted debauch, when drinks finally be- came disgusting or can no longer be tolerated. The symptoms of morbid cerebral excitement proceeding from the direct agency of the alcohol, now become mingled with those resulting from a withdrawal of the stimulus. (11.) The symptoms of delirium tremens vary from the most trifling degree of tremor, wakefulness and delirium, accompanied with hallucinations and quickened pulse, to the highest degree of nervous depression and muscular and cerebral excitement. The first stage usually presents the following symptoms, and very generally in the following order.—A peculiar slowness of the pulse, attended with coldness of the hands and feet, which being generally bedewed with moisture, and from the effect of evaporation present a clammy, icy sensation. These are preceded and accompanied with symptoms of general debility, and usually a diminution of temperature, cramps in the muscles of the extremities, with giddiness, nausea, and occasionally actual vomiting; the bowels are sometimes open, some- times the reverse; nervous tremors of the hands and tongue, espe- cially of the latter, which is mostly moist and but slightly furred. These symptoms are accompanied with a dejection or depression of the mind, which is sometimes extreme, accompanied with frequent sighing and oppression, or sense of sinking at the praecordial region, anxiety and depressed state of the countenance, with short and dis- turbed slumbers. (13.) The second stage comes on with a marked increase of many of the symptoms above mentioned, the countenance of the patient assuming gradually a wild and more-anxious expression; he soon begins to have various mental illusions, or hallucinations ; he imagines that he sees loathsome and disagreeable objects, which constantly annoy and trouble him, and which he will attempt to catch with his hands, sup- posing they are upon his bed. He suffers from increased restless- ness, is excessively talkative, in fact in some cases the garrulity is extreme, and most commonly on the subject of his delusions. He is more sleepless, and at times absolutely so; so that by some writers this per-vigilium is considered as pathognomonic of this stage of the disease. The temperature of the surface of the body may increase, while that of the feet and hands remains cold and clammy as before. The general restlessness and hurry of manner increases ; the tongue is more coated with fur, and it is now so tremulous, that the patient cannot hold it still when protruded from the mouth. The urine at this time is usually scanty; the pulse is mostly frequent, above 100, and sometimes considerably so. The pupils are usually contracted, but he does not complain of intolerance of light, nor during the course of the disease does he complain of any pain about him ; and frequently when interrogated by his physician or his friends, will reply sharply that Alcohol. 181 he is quite well, that there is nothing the matter with him. After these symptoms have continued two or three days, and the case is about to terminate favorably, the gradual mitigation of the above symptoms is usually attended with yawning and drowsiness, with evident disposition to sleep; and this, as soon as it thoroughly seizes the patient, is frequently very deep or profound, lasting sometimes 6, 8 or 12, 14 or 18 or even 20 hours; and in most cases is so com- pletely critical, that it appears as it were to resolve, or almost to ter- minate the disease. (13.) Of such cases as terminate favorably this critical sleep may be said to constitute the third stage of the attack. But if on the other hand, the disease should take an unfavorable turn, the general symp- toms increase in violence; the mind of the patient labors under ex- cessive irritability; he makes frequent and violent struggles; there is more evident depression of the muscular, nervous and vascular systems; the pulse becomes quick, smaller and weaker; the tremor, too, affects nearly all the limbs; the patient is constantly talking or muttering to himself; the delirium increases in intensity; sometimes he dies in an attack of convulsions, and sometimes death is preceded by a subsidence of the general symptoms. (13.) CHRONIC EFFECTS. {Chronic Delirium. Tremens.) The name of Alcoholismus-chronicus is given to those groups of ner- vous symptoms, which affecting alike the motor and sensorial powers and the intellectual faculties of the individual affected proceed gener- ally in a slow and chronic course, and are not to be referred directly to any lesion of the nervous system appreciable during life, or dis- coverable on post-mortem examination. Such symptoms are to be met with in persons, who have long taken ardent spirits in excess. For the first six or eight years after giving way to this pernicious custom the health may be in no wise impaired; but after the lapse of eightor ten years addiction todram-drinking, sometimes to such an extent as to produce intoxication, but more generally without the patient being seriously affected, the symptoms may begin to show themselves, especially if he has had one or several attacks of delirium tremens, neglects to take his ordinary meals, and rarely takes any solid food except when he takes a morsel or two with each dram of raw spirits that he swallows. (34.) Dyspeptic symptoms will now appear; the hands will tremble much, especially in the mornings, but subsequently these tremors will con- tinue throughout the day, and are increased by exertion, while the bodily powers are much diminished. Unfortunately nothing will overcome this nervous debility so effectually as an additional glass of spirits. Next, he may complain of a peculiar sensation, as if a veil were suddenly passed before his eyes; this will occur chiefly in the morn- 182 New Materia Medica. ing, though it may be experienced likewise during the day, if the eyes are strained by looking fixedly at any object. Next the speech will become indistinct during the early part of the day, from a peculiar tremulous motion of the tongue. Sleep then becomes broken by frightful dreams, and often before falling asleep a creeping sensation will be experienced beneath the skin of the feet and legs, with spasms and cramps in the calves of the legs and other parts. Gradually these formications will be felt also during the day, becoming more urgent and painful, and causing an indescribable restlessness in the patient; shooting upwards to the nates, and then extending to the hands and arms. The patient often complains that he feels as if small ants or other insects were making their way beneath the skin. The tremors will now increase in the hands and arms, he will shuffle in his gait, especially when he first attempts to move forwards. The muscular power of the extremities will be found much diminished; the want of it being most felt when any unusual exertion is required. The knees will frequently give way, and when the patient attempts to grasp any thing it will slip from between his fingers. Gradually the weakness of the limbs becomes more apparent, and it extends upwards to the muscles of the trunk, so that at length he can neither stand or sit, but is obliged to remain constantly in a recumbent position. (34.) While this is taking place, the sensibility of the skin, hitherto un- altered, will begin likewise to diminish, first in the points of the fingers and toes, and subsequently over the backs of the hands and feet, to the forearms and legs. Ultimately the toes and legs may be- come insensible; the same may occur in the fingers and forearms, but less completely, and at a later period. Along with these symptoms, there may be more or less vertigo, sometimes merely to the extent of a sudden and transitory darkness before the eyes, but at other times he may fall immediately to the ground, if he does not lay hold of some object near him. Hallucinations of various kinds now come on, particularly in tho evening and before falling asleep, and these fantasies often banish sleep altogether. They vary much in character, but the patient often imagines that fie sees persons or objects around him, and occasionally hears voices and laughter. The pupils during this time are dilated and less sensible to light than usual. (34.) After appropriate treatment and abstaining from spirituous liquors, health may be in great part restored, and the patient remain compara- tively well as long as he observes a regular course of life and takes his ordinary meals. If he relapses into his former habits, the digestive functions will be more affected than formerly; there will be frequent vomiting of tough . acid mucus, with a sense of weight and distention at the epigastrium after taking food; emaciation will set in and the skin assume a dirty yellowish hue. Soon the formications and muscular debility will return, not alone, Alcohol. 183 but accompanied with painful eranaps and startings in the feet and calves of the legs. These startings resemble those produced by elec- tric shocks; at times they are only momentary, but often are more pro- longed. Soon they will extend to other parts of the body and become more like convulsions, under the influence of which the patient oc- casionally becomes insensible. Gradually these convulsions will in- crease in severity till they form complete epileptic seizures of daily occurrence, often followed by delirium and hallucinations. Vision will become imperfect, the letters of a book when the patient attempts to read, seem to run together into an illegible mass. The powers of thought and memory aire likewise totally diminished. (34.) Some improvement may still take place under medical treatment, but it will only be for a short time; new symptoms will show them- selves in the shape of pains in the legs, whieh are most severe in the afternoon, but which cease entirely at times, especially in the morn- ing. Even when these pains are least severe, -the patient still ex- periences a certain degree of restlessness in the legs, so that he con- tinually moves them up and down in bed. When the pains are at their height, it feels as if the flesh were torn or cut with knives. The strength will daily decline; diarrhoea come on; the skin assume the appearance of parchment; he becomes fearfully emaciated, lies in a condition of low muttering delirium and finally dies. (34.) There is great similarity between many of the symptoms of poi- soning with the salts of lead, and those of Alcoholismus-chronicus. But in lead-poisoning there is the very characteristic appearance of the blue circle upon the gums and likewise the attacks of colic, which, with but few exceptions, precede the other symptoms and are never met with in Alcoholismus-chronicus. Again, in patients suffering under lead-poisoning the breath has a peculiar and most nauseous smell, while the skin is of a dusky grey color, easily distinguishable from the yellow hue of habitual spirit-drinkers.. In lead poisoning also, we do not meet with the symptoms of chronic gastro-enteritis, or of hepatic affections, such as constantly accompany alcoholismus, while the latter is frequently preceded by one or more attacks of de- lirium tremens. It is not possible, however, to draw a line of distinction between paresis and an«esthesia-saturnina, and paresis and aneesthesia- alcoholica, or between the epileptic seizures and convulsions which may occur in both disorders. (34.) There is also some difficulty in distinguishing Alcoholismus-chro- nicus from chronic cases of arsenical poisoning. The tremors observed in slow poisoning with Arsenic are not relieved by a dose of Alcohol, nor are they more severe in the mornings than at other times, and they are generally accompanied by spinal pain and irritation. But, perhaps, the most marked distinction is to be found in the mental con- dition of the patient. In the more advanced stages of Alcoholismus- chronicus the mind seldom or never remains unimpaired ; vertigo, etinnitus-auriuin, muscae-volitantes and dilated pupils, with hallucina- tions and delirium are constantly present; while these symptoms are rarely or never seen in arsenical poisoning. (34.) 184 New Materia Medica. Mercurial fumes produce similar symptoms, but mercurial tremors are generally preceded by the specific action of this metal upon the gums, the teeth are often loosened in their sockets and salivation occurs ; but the mental faculties remain intact, and vertigo, scotomata and hallucinations are very seldom observed. In chronic-alcoholis- mus, loss of power of the limbs and tremors appear before any pain is felt in the affected members. In mercurial poisoning pain is one of the earliest symptoms ; the tremors produced by mercury are also much more severe and obstinate than those which result from Alcohol. In chronic poisoning with the fumes of Phosphorus, formications, tremors and muscular debility occur, but cerebral symptoms rarely happen. (34.) In chronic poisoning with Secale-cornutum the symptoms are some- times so closely allied to those of alcoholismus that thev cannot easi- ly be distinguished. But in poisoning by Secale, the symptoms are much more rapidly developed; they commence wiih severe pain in the stomach, and are accompanied with colic and jerking and convul- sive movements of the limbs, followed by paralysis and anaesthesia, though the brain is generally unaffected, and the skin does not assume the characteristic yellow hue. (34.) Besides the comparatively well known effects of certain vegetable and mineral poisons upon the system, certain stages and conditions of various chronic disorders occasionally present a striking" resemblance to the phenomena of Alcoholismus-chronicus. This is particularly the case in Paralysie generate des alienes. In short the symptoms of Alcoholismus-chronicus are closely allied to those of chronic poisoning in general. ON ANIMA.LS. Huss and Dahlstrom administered daily to three dogs of various ages, but of nearly equal size, six ounces of Swedish brandy. Intoxication, canine appetite and intense thirst were occasioned by each dose during the first three months ; but the dogs continued fat and apparently well. In the fourth month the bark of the animals became hoarse, they had a hoarse, dry hiccough and cough, the eyes were staring and full' of tears, hearing was- much diminished, and their sleep became rest- less with frequent subsultus and jerking of the limbs. After the completion of the fourth month the dogs trembled when they attempted to stand, their walk was shuffling and there was evi- dent weakness of the extremities, especially in the hind legs, so that they often remained in a sitting posture while taking food. Cramps and convulsive movements and subsultus next appeared in the limbs and trunk, both during sleep and when the animals were awake and and lying on their sides. The sight of other dogs, however, roused them at all times from their apathetic condition, and they endeavored even in the weakened state to attack and bite them. Their strenmach was unusually small, or atrophied in Alcohol. 195 sixteen; highly congested in ten ; false melanosis in two; softening of the mucous membrane in two ; hour-glass contraction in five ; un- usual thickening or hypertrophy in one ; i covered with copious muco- purulent secretion in one. Ogsten places much stress upon the unusually small size of the sto- mach, altogether different from any mere state of emptiness or na- tural contraction of the organ ; in short, he regards it as such an atrophy of the whole stomach as that viscus might have presented had its growth been arrested in early life. Thus, in one case the stomach was only half the ordinary size ; in a second it was not larger than that of an infant at birth; in a third as barely exceeding the diameter of the duodenum over the greater part of its extent; and in the remain- der as unusually or remarkably small as compared with the rest of the intestinal tube. I feel confident that there was no actual atrophy in many of these cases. I have seen many cases in which a large quantity of pure spirits had been taken, probably enough to cause death without the aid of other causes, in which the stomach seemed unusually small from the powerful corrugating action of the Alcohol, but such sto- machs could be easily stretched to their natural size. It is true, however, that many habitual drunkards take very little solid food, and hence as the stomach is very rarely fully distended, it may finally re- main almost permanently contracted. (11) Clinical Remarks.—Alcohol is homoeopathic to many forms of irri- tation and congestion of the stomach; it is a favorite remedy against dyspepsia from debility ; it relieves many forms of nausea and vomiting and may prove homoeopathic to the morning-Yomiting of pregnant women. It is also homoeopathic to acidity of the stomach and water- brash. (11.) According to our experience, about one dyspeptic in five can take brandy with benefit, provided, it is" employed in a very dilute form, and is drank during dinner. As a general rule it will disagree with dys- peptics, of a bilious temperament, while those who are nervous, or lymphatic, will be able to use it with impunity, and occasionally, with advantage. (10.) Bowels.—The small bowels generally partake of the chronic irrita- tion and congestion which obtain in the stomach ; but the symptoms do not all arise from chronic inflammation, but from the influence of the altered chyme which comes down from the stomach, altered com- position of the bile, imperfection in the nutrition in general, and of the composition of the blood. Hence, after death the small bowels may appear nearly healthy. But in higher grades of alcoholismus there will be more or less difficulty of digestion, colic pains, flatulence, per- sistent constipation, or alternations with diarrhoea, with putty-like, globular, blackish or light grey faeces, or constant diarrhoea with bilious discharges, or like clay dissolved in water, or slimy or bloody matters. A larger quantity of pure Alcohol also reaches the duodenum, mixes 196 New Materia Medica. with the bile, which loses its alkaline properties, and can no longer be precipitated into insoluble flocculi, by the addition of the acid chyme, as is normally the case ; in the natural state, this insoluble precipitate from the bile is not re-absorbed, but is cast out of the body with the feces; in drunkards, however, no such precipitate ensues, the bile remains fluid and unchanged by the chyme, and a large portion of it is re-absorbed. Hence the bilious disorders in topers and the frequent occurrence of jaundice. Large quantities of acid chyme and imperfectly digested food pass along the small intestines, and even reach the coecum and colon, when they also undergo a farther acetous fermentation. Hence the sour eructations, colic from acidity, irrita- tion and flatulence, and the dyspeptic troubles of drunkards. Pathology.—The small bowels in Peters' cases were literally filled with bile, and their mucous membrane thickly coated with a very tenacious mucus. In eight or ten of the worst cases, numerous and extensive patches of haemorrhagic effusion were found, with co- pious exudation of blood in and beneath the mucous membrane. (11.) Ogsten found unusual contraction of the intestines in six cases; softening of the mucous coat in two; enormous distention in two; atrophy in one case, the bowel being attenuated and translucent ; con- gestion of the duodenum in one. Clinical Remarks.—It is quite homoeopathic in diarrhoeas proceed- ing from an atonic condition of the mucous membrane of the intes- tines, and from chronic inflammations of this structure. It likewise proves curative in diarrhoeas caused slight irritation of the mucous coat in consequence of colds, improper food, &c. (10.) Omentum.—The appearance of this organ was generally very pe- culiar ; it was generally equally filled with an ashy grey slushy fat, but no large masses or lumps of fat were met with. Our attention was first called to this sign in Vienna; it is there regarded as so charac- teristic that a cadaver was often judged to be that of a confirmed drunkard, from a glance at the omentum, when the abdomen is first laid open. (11.) In Ogsten's cases the omentum was loaded with fat in four, coinci- dent, in all with abundant subcutaneous fat, in two with fat around the heart, in one with conversion of the vermiform appendages into large fatty masses. Mesentery.—This was always loaded with a thick layer, of whitish yellow fat. (11.) Liver and Portal-System.—Alcohol rarely or never causes acute inflam- mation of the liver intemperate climates ; but it often causes congestion, attended with jaundice ; also enlargement. The blood which returns from the intestines into the portal-system and liver, is more or less mixed with Alcohol, imperfect bile and other undigested and impure matters ; hence the abdominal venous plethora and subsequent affections of the liver. As much bile is returned to the liver, it is doubtless re-secreted from it again with great rapidity ; hence, among Alcohol. 197 other causes, the large quantity of bile which is usually found in the gall-bladder and small bowels. Abdominal dropsy only occurs in drunkards after the liver has been diseased, indurated or granulated for a long time. It is apt to remain isolated, or unassociated with general dropsy; even the feet and legs are not apt to swell. The contrast between the distended abdomen and emaciated extremities, is very striking in this form of dropsy. (4.) Pathology.—In Peters' cases the liver in moderate drinkers was found a little larger than natural, somewhat softened, and its external surface dotted with whitish patches of fatty infiltration, which extended but two or three lines into the parenchyma ; the color of the rest of the organ was of a rather darker red than natural, and the edges retained their normal sharpness. In excessive drinkers the liver was consi- derably larger, the edges more obtuse, and the patches of fat larger and more numerous. In old habitual drunkards the liver was very large, weighing at least six or eight pounds, and often ten or twelve ; the edges were very thick and much rounded ; the parenchyma almost white with fat, soft, fragile, and the peritoneal covering could be torn off in large pieces with great ease. Granular liver was found in four or five cases only ; and. gall-stones only twice. (11.) Ogsten found'the liver enlarged in thirty-two cases; granular in fourteen ; nutmeg liver in thirteen; fatty liver in twenty-four. Cirr- hosis was only present in five cases out of one hundred and seventeen. Clinical Remarks.—Alcohol is homoeopathic to enlargement of the liver, fatty condition of this organ, and to the nutmeg and granular liver ; also to biliousness and jaundice ; and the ascites from disease of the liver. (11.) Spleen.—Although the spleen in those who die of delirium tremens is generally enlarged, soft and brittle, and swells more rapidly and considerably when drunkards are attacked with intermittent fever, still no actual alterations of structure take place during the course of alco- holismus-chronicus, neither are there any symptoms referable to this organ. (4.) Pathology.—In Peters'cases this organ presented but few charac- teristic alterations. It generally retained its normal size, but was some- what congested and softened. Occasionally it was rather larger than natural, but as a rule, the small size of the spleen contrasted strongly with the very great size of the liver. (11.) In Ogsten's cases the spleen was indurated or hepatized in ten; enlarged in two ; atrophied in one; softened in one. It was softened in fifteen per-cent. of the cases, and hypertrophied in eighteen per-cent. Kidneys.—Pain and sensitiveness in the region of the kidneys are apt to arise after a debauch, when the urine may also contain albumen, or the serum of the blood, owing to a transient but decided congestion. At times the urine also contains the coloring matter of the bile, viz. when there is congestion or chronic disease of the liver; or an excess of phosphates or urates, especially when the liver is indurated ; or it 198 New Materia Medica. may become alkaline, when symptoms of paralysis arise. Drunkards are particularly apt to get disease of the kidneys when they are at- tacked with relapsing fever, and ague, or chronic rheumatism. Pathology.—In Peters' cases the kidneys were generally some- what enlarged, flabby, their cortical substance infiltrated in numerous small spots, with a whitish fatty or albuminous substance ; occasionally they were granular ; the pelvis and ureters were generally in a state of chronic slate-grey inflammation. (11.) In Ogsten's cases there was general fatty degeneration in one ; con- gestion in four; sometimes coincident with nutmeg liver and albumi- nous urine ; enlarged in thirteen ; atrophied in one ; buff-colored, with atrophy of the of the cortical portion, in four; with albuminous urine in five. Bladder.—In Peters' cases the bladder generally presented no un- usual appearance ; but in four or five of the worst cases there was a state of haemorrhagic exudation which rivalled in extent and severity that which has already been described as occurring in the stomach and bowels. (11.) When drunkards become weak or partially paralytic the bladder will partake of the debility of the rest of the system. Clinical Remarks.—In retention of urine from paralysis of the blad- der, bathing the hypogastric region with Alcohol, and allowing it to evaporate, is occasionally useful. LnngS.—Pathology.—In Peters' cases these were generally not much diseased; at least dyscratic organic disease of them directly at- tributable to Alcohol was not often met with. Congestion of the lungs was very common. Where large quantities of spirits had been taken shortly before death, the lungs were often found in a state of extensive splenization; they appeared perfectly saturated with dark blood, which soon changed to a florid red on exposure to the air, except that which flowed from the large severed vessels, for this remained thick, dark and tar-like. The parenchyma of the lungs was heavy and semi-solid to the feel, and somewhat softened, as the finger could easily be forced through it. The bronchi were almost always found reddened, some- what dilated, and more or less filled with catarrhal secretions. Dr. Peters feels obliged to call particular attention to the infrequency of phthisis in drunkards ; in the seventy cases he never met with a tubercular abscess, even of the smallest size, while a small number of chalky or obsolete tubercles was frequently noticed ; and cicatrices were also occasionally found marked by the presence of pucker- ing of the surface of the lungs, of solid lumps or stripes which were readily felt before the lung was cut into, and when this was done, they were found to consist of masses or stripes of callous, fibrous tissue, around which were rarely discovered a few discrete, grey, crude, small tubercular granulations. In every instance these appear- ances were strictly confined to the upper third of the superior lobes, Alcohol. 199 and all the rest of the lungs was entirely free from either recent or oid tubercular disease. (11.) Ogslen also says that so far as his 117 cases go, his observations bear out the correctness of the now commonly-received opinion as to the comparative immunity of drunkards from tubercular affections. In Barclay's Report of the fatal cases of disease of the brain, occurring during the last four years in St. George's Hospital, in ten fatal cases of delirium tremens; tubercles were found in the lungs, in six cases, once recent, and five times in the form of a cretaceous mass. In seventy-three of Ogsten's cases, there was effusion into the pleura in three cases; adhesions of the lungs in twenty-five cases; emphysema in twenty-one cases ; tubercles and those latent, in only one case. Ogsten says that the additional labor thrown upon the lungs, when Alcohol has entered the circulation after its absorption and the retarda- tion which takes place under these circumstances of their functional activity from this cause, as well as by the toxical effects of the Alcohol on the medulla oblongata, will alone go far to account for the frequency of morbid changes in these organs in drunkards ; still, there can be but little room for hesitation in attributing many of these morbid changes in part at least to other causes, such as exposure to cold. Ogsten places much stress upon the frequent occurrence of em- physema in drunkards; and emphysema, it is well known, almost ex- cludes tubercles. The emphysema of drunkards is supposed to arise from a lax or flabby, non-contractile or debilitated state of the lungs, as it never occurs unaccompanied by pulmonary collapse, or by one or the other form of pulmonary atrophy. There is probably a fatty degeneration, or some similar defective nutrition of the tissues of the lungs. Skin.—In the earlier stages of drinking the skin is soft, velvety and much disposed to perspiration; gradually this changes, and finally it becomes dry, rigid, thick, dirty or yellowish grey, and a variety of eruptions are apt to breakout, especially eczema and prurigo. Varices and ulcers of the legs also occur, but the latter may also be caused by eczema, erysipelas, accidental injuries, &c, but they are always difficult to heal and frequently break out afresh. The cellular and adipose tissues undergo various changes; at first they are generally the seat of a larger or smaller quantity of greasy, greyish-white fat, which is deposited partly under the skin, partly between the muscles, and partly in the omentum and in various por- tions of the abdomen. In the latter stages this is reabsorbed and emaciation occurs ; then we find a gelatine-like mass under the skin, followed by serous exudations and anasarca, or an excessive degree of emaciation. 200 New Materia Medica. ALCOHOL-SULHHUEIS. LIQUOK LAMPADII, CARBURET OF SULPHUR. AUTHORITIES. Homoeopathic Provings by James W. Metcalf, M.D. (26.) Peters (11.) Marcy (10.) GENERAL REMARKS. Lampadius, in 1796, while distilling a mixture of pyrites and char- coal, procured a clear liquid in the receiver, which he named Alcohol- sulphuris, or the Alcohol of sulphur. It consists of one equivalent of carbon and two of sulphur. (26.) It is a transparent, colorless, volatile and inflammable liquid, with a very pungent taste and peculiar odor, somewhat ethereal, and yet par- taking of that of sulphuretted hydrogen. It is insoluble in water, so- luble in alcohol and ether, and in the oils generally. Its solvent powers are remarkable, as it dissolves sulphur and phosphorus rapidly and in considerable quantities. (26.) LOCAL EFFECTS. Head.—Pain in the forehead, which draws towards the left temple and remains there for two hours. Pressive frontal headache, lasting almost all day, and accompanied with transient pains in the temple. Drawing and tearing pain, stretching from the forehead to the temples, lasting all day, more severe in the room and during rest, relieved by walking in the open air. Dull pain in the frontal region, with nausea and heaviness of the whole head. Thumping pain in both temples. Violent pressive pain in the right temple, with malaise, desire to vomit, and rumbling of wind in the bowels. (26.) Clinical Remarks.—It may prove useful in some forms of sick- headache, especially when the pain commences in the forehead and extends to one or the other temples. (11.) Eyes.—Burning and itching of the lids; pustules on the lids, lasting four days. Dilatation of the pupils, with quickness of the pulse. Abundant secretion of whitish yellow mucus in the eyes. Lachryma- tion of the eyes ; twitching and trembling of the muscles of the eyes and lids. (26.) Clinical Remarks.—It is homoeopathic to scrofulous affections of the eyes and lids ; to twitching of the eyes and lids, such as occurs in scrofulous, nervous and verminous children. (11.) Ears.—Pain in the ears as if some one were striking upon the tympanum with a dull instrument. (26.) Face.—Redness and puffines^ of the face; heat of the face and hands. Lancinating and tearing pains in the cheeks, extending up to the temples and lasting two months. (26.) Alcohol-Sulphuris. 201 Clinical Remarks.—It is homoeopathic to some rheumatic and neu- ralgic affections of the face. (11.) Mouth.—Dryness of the lips and mouth ; irritation of the cavity and isthmus of the pharynx, followed by a sensation of contraction in the •larynx, with gagging cough and quick breathing. Gum boils. Pasty, disagreeable taste in the mouth, with foul taste of the pharyngeal mucus ; bitter sharp taste in the mouth, or very repulsive acrid taste, or sweetish putrid taste. Great accumulation of saliva, with sweetish taste ; very frequent spitting, pale red swelling of the uvula and velum Burning and scraping in the pharynx and oesophagus. Clinical Remarks.—It is one of the most homoeopathic remedies to chronic pharyngitis, which is so often mistaken for chronic bronchitis ; to irritation of the pharynx, with much hawking and spitting, and gagging cough from the irritation of an elongated uvula, especially when these symptoms occur in bilious and"dyspeptic subjects. (11.) Stomaeh.—Very abundant eructations ; sour burning, acrid regurgita- tions {pyrosis) occurring one or two hours after eating. Continual acid regurgitations. Regurgitations of air with nausea, discharge of flatulence upwards and downwards. Burning in the stomach and hepatic region ; heat in the epigastric region, which ascends and occu- pies the whole chest; violent heat, ascending from the stomach to the head. Fullness in the stomach, with eructations, yawning, desire to vomit, and dizziness. (26.) Clinical Remarks.—It is homoeopathic to pyrosis and heartburn, to various dyspeptic and bilious derangements. (11.) Abdomen.—Great inflation of the abdomen, with rumbling of wind and tearing colic; colic-pains after eating; slight wind-colic from time to time, with desire to urinate ; colic-pains with loose stools and flatulence. Paroxysm of disagreeable pain in the left lobe of the liver. Soft stools, preceded by pain in the left lobe of the liver, and followed by pains in the caecal region. (26.) Clinical Remarks.—It is homoeopathic to flatulence, bilious derange- ment, bilious and flatulent colic, and congestion of the liver. (11.) CfECal Region.—Lancinating, twitching and pinching pains in the region of the caecum, not relieved by discharge of flatus and increased by pressure, by turning from one side to the other, and doubling-up the body. Dull pains in the region of the caecum. (26.) Clinical Remarks.—This is one of the few drugs which seems to exert a specific action upon the caecum. (11.) Stools,—Liquid stools ; slimy diarrhoea ; watery diarrhoea ; liquid diarrhoea, with violent pain in epigastrium ; sudden diarrhoea, after having dined with good appetite ; violent diarrhoea, with tenesmus and sour evacuations. (26.) Clinical Remarks.—It has cured a chronic diarrhoea, appearing every four or six weeks, attended with colic, the evacuations being liquid, frothy, yellowish, sour and attended with tenesmus. (26.) 202 New Materia Medica. Larynx.—Heat and irritation of the larynx; hoarseness and irrita- tion of the larynx, with continual desire to hawk: cough provoked by a tickling at the bifurcation of the bronchi. Slight dry cough. (26.) Clinical Remarks.—It is homoeopathic to chronic irritation of the pharynx and larynx, with constant desire to hawk and spit, with hoarse* ness and short cough. (11.) Chest.—Sensation of heat in the chest; congestion in the upper parts of the lungs; oppression of the chest; fullness of the chest. Slight stitches and pains about the chest. (26.) i Clinical Remarks.—It may prove homoeopathic to the first stage of tubercular disease of the lungs; it may prevent the tendency to irrita- tion and congestion of the upper parts of the lungs, which so readily lead to the fresh deposit of tubercles in consumptive patients. (11.) Limbs.—Pains in and eruption upon the arms and legs. Clinical Remarks.—It is homoeopathic to chronic rheumatism ; and to prurigo, and impetigo. (11.) Skin.—Sharp itching and stinging in different parts of the skin, as if from nettles ; itching in various parts of the skin, much aggravated by scratching ; bleeding and burning of eruptions when scratched; {prurigo) ; eruptions of impetigo on the back of the hands, the pus- tules are seated on an inflamed red base, contain a yellowish cloudy serum, and form thick yellowish scabs. (26.) Fever.—Great internal heat, with coldness of the hands and feet; general heat, headache, quick pulse, cramps in the calves of the legs and toes, without much thirst, and no perspiration. (26.) Pulse.—Quick pulse, it rises from 76 to 90 or 95. Sleep.—Sleeplessness from headache, dryness of the skin and gene- ral unpleasant heat, so that he is obliged to rise and bathe himself. (26.) ALLIUM-CEPA. COMMON ONION. AUTHORITIES. Wood and Bache Dispensatory. (7.) Vogt'sMat. Med. (20.) Dier- bach's Mat. Med. (6.) Waring's Therapeutics. (44.) Hering. (28.) Peters (11.) Marcy. (10.) Frank's Magazine. (4.) Graves' Cli- nical Lectures. (29.) GENERAL REMARKS. Onions contain an ethereal oil, which is colorless, very volatile, of acrid taste and smell, and which causes inflammation of the skin when applied to it; when this oil is burnt, sulphurous acid is developed. Fourcroy and Vauquelin found Sulphur and Phosphorus in combina- tion with this ethereal oil, and which give rise to the peculiarly dis- Allium.-cepa. 203 agreeable onion-odor; also an abundance of uncrystallizable sugar, a mucilaginous substance resembling gum-arabic, free phosphoric- acid, and phosphate of lime, acetic-acid, citra'e of lime, also pectic- acid. (7.) According to Dierbach onions are rarely used as a medicine, although they have often been recommended as an article of diet to dropsical persons, while the expressed juice in tea-spoonfull doses, sweetened with sugar, has been praised for the same purpose. (6.) Applied externally they also exhibit a diuretic action, whence the bruised bulbs have heen used in the form of cataplasms over the ab- domen in ascites. Consbruch and Jennerhave recommended theip in spasmodic ischury and strangury. (6.) Onions have been held to the nostrils for the relief of hysteric cramps ; and a decoction in milk has been used as an injection against ascarides. (6.) But still more frequently their irritating properties have been called in play in order to hasten the suppuration of abscesses, boils, buboes, either singly, or in combination with mustard, soap, &c. (6.) The vapor of onions irritates the eyes and causes lachrymation; when used in excess the peculiar odor of onions is exhaled from the skin, and in one instance it was unmistakably detected in the pus of a fistula. (6.) Children and delicate adults cannot well digest raw onions; they are apt to cause eructations, heart-burn, and cramps of the stomach. Epileptics should avoid them; also those subject to seminal emis- sions. (6.) Hippocrates was acquainted with the diuretic action of this plant, and also recommends its external use against falling out of the hair. In paralysis of the tongue, Celsus recommended the chewing of raw onions ; Appollonius used the juice in deafness. (6.) Vogt recommends them against infarctions of the abdominal or- gans ; flatulence ; chronic catarrhal affections, with tough, glassy mu- cus ; in diseases of the urinary organs, gravel, dropsy, &c. (20.) Pereira says raw onions are occasionally taken as an expectorant, with advantage by elderly persons affected with a winter-cough. A roasted onion is sometimes employed as an emollient.poultice to sup- purating tumors, or to the ear to relieve ear-ache. The expressed juice has been given to children, mixed with sugar as an expectorant. The large quantity of Sulphur and Phosphorus which the volatile oil of onions contains renders them an applicable remedy in many lung- affections. (11.) Sulphur, Graves says (see Clinical Lectures) will relieve chronic cough and long-continued congestion of the bronchial mucous mem- brane. It would appear that Sulphur when taken into the system is either eliminated by the kidneys in the form of sulphates, or exhaled from the skin and mucous membranes in the form of sulphuretted hydrogen, and in this way we arrive at some explanation of its bene- ficial action in diseases of the skin and chronic irritation of the bron- 204 New Materia Medica. chial mucous membrane. In fact, paradoxical and homceopathical as it may seem, Sulphur, although evidently stimulating, is nevertheless very efficacious in curing many diseases connected with or depending on inflammation or congestion. Thus what remedy gives such prompt and certain relief in that painful affection, piles ? How rapidly does that specific irritation of the skin termed scabies, yield to its use! The celebrated Hoffmann was in the habit of adding Sulphur to his cough prescriptions in all cases of chronic bronchitis in the aged and debili- tated, and Graves has no doubt that from five to ten grains of Sul- phur, taken three or four times a day, is one of the best remedies in chronic cough accompanied by constitutional debility and copious se- cretion into the bronchial tubes ; it has a tendency to produce eleva- tion of the pulse, increased heat of skin and sweating. It is most homoeopathic when the cough arises from a peculiar tickling or itching sensation about the throat-pit. (29.) Hering thinks that onions fill a chasm between Aconite and Ipecac; that it is peculiarly useful during many catarrhal epidemics. That it has a certain relation to Chlorine and to Phosphorus, and that it may be successfully used either before or after the use of Phosphor, or to complete with greater rapidity, cures which Phosphor has left un- finished. If would be more correct to assume that it has affinities with Sulphur and Phosphor. (28.) Hering thinks that in children it is suited to many affections of the head and eyes; to catarrhs and constant discharges from the nose; to sore-throat, cough, rattling in the chest, colic, flatulence, disorders arising from worms and urinary difficulties. It will often have to be aided by Iodine, Spongia, Sulphur and Phosphorus. (28.) In adults : it is also suited to catarrhal affections of the head and eyes; oppression of the chest, senile asthma, and the companying or alternating affections of the kidneys, bladder and urinary apparatus; disorders of the stomach and bowels, flatulence, chilliness, &c. (28.) It very closely resembles Assafoetida in its actions. (11.) A rather rare case of poisoning by Allium-cepa is reported in Frank's Magazine ; a man aged fifty years, of large frame, sanguine temperament, of regular habits and always having enjoyed excellent health, was attacked a quarter of an hour after having eaten a raw onion with his bread and butter at supper, with violent cutting pain in the bowels, frequent urging to urinate, with ability to pass only a few drops of scalding urine. Four hours later his physician found him walking through his apartments in extreme anguish ; at times he would throw himself on his bed, complaining of constant violent pain in the left lower half of the abdomen near the umbilicus, accompanied by the above-men- tioned urinary difficulty, with constipation, and violent thirst; his countenance had an expression of great anguish and despair; there was increased heat of the skin ; pulse somewhat accelerated, full and hard. The pain in the abdomen was increased by the slightest pres- sure. The contents of the stomach were removed by an emetic, &c, Allium-cepa. 205 and by the next morning the patient felt much better, but it required a day or two before he recovered completely. (4.) ^General Symptoms.—Feeling of weakness and debility, inclination to lie down. Yawning, with headache, and pressure in the stomach. (28.) Fever.—Chilliness, creeping in the back, especially at night, with increased urine, followed by heat and thirst. Heat, with rumbling in the abdomen, with catarrh, accompanied by thirst. Perspiration easily excited. (28.) Skin.—Itching. Needle-stitches in the skin. (28.) Sensorium.—Dizzy, dull and weak; despair with colic. (28.) Head.—Dullness, pressure, fullness, heaviness in the head, especially in the occiput and posterior portion of the vertex, with heat, (while having a catarrh.) Worse in the evening, better in the open air, aggravated by returning into a warm room. Electric shocks through the head. Stitches from the sinciput, or from within to the ear. (28.) Eyes.—Misty, weak, sensitive to light; with a catarrh. Lachry- mation (slight). Redness of the eyes, itching, stitches, sensibility, more of the left side, burning, smarting as if from smoke. (28.) N0SC—Fluid running from the nose, sneezing, acrid watery dis- charge excoriating the nose and upper lip. Fluent catarrh, with lachrymation, headache, heat, thirst, loss of appetite, cough worse in the room in the evening, better in the open air. (28.) Face.—Heat in the face. (28.) Taste.—Disgusting taste ; tongue coated with dirty mucus, Foul smell from the mouth and throat. Teeth dirty yellow. (28.) Throat.—Feeling of numbness in the throat. Pains in the throat at the root of the tongue, palate, and in the eustachian tube to the ear; as if a lump were in there. Dryness of the mouth. Hawking up of lumps of mucus. (28.) Gastric Symptoms and Abdomen.—Much thirst. Nausea mounts with a rush from the throat upwards. Disgust. Eructations, with heat, rumbling and inflation of the abdomen ; vomiting. Emptiness, weak- ness in the stomach. Pressure in the stomach, and tearing colic in the umbilical region, worse when seated. Transient flush; heat; violent pain in the left side, below, with desire to urinate, and burn- ing on making water. Inflation of the abdomen,—relieved by the dis- charge of flatulence. Very fetid, slippery flatulence. (28.) Clinical Remarks.—A physician who was very subject to colic, had a severe attack while upon a journey, and was obliged to stop at. a farmer's house ; he could get no medicine, and in despair ate a large raw onion; his colic was relieved instantaneously, as if by magic, and never returned again in like severity; the slighter at- tacks were always relieved by raw onions. Since then he has recom- mended them in more than twenty cases of colic, and always with 206 New Materia Medica. speedy benefit. He is satisfied that they are useful in cramp of the stomach, also in wind- and haemorrhoidal colics. He thinks this a new proof of the correctness of the Homoeopathic law, and Frank adds, he is doubtless right. (4.) Urinary Organs.—Pressure and other pains in the vesical region. Copious urine. (28.) Thorax.—Oppressed breathing from pressure in the middle of the chest. Cough and catarrh. (28.) ALLIUM - SATIVUM. COMMON GARLIC. AUTHORITIES. Wood and Bache's Dispensatory, (7.) Pereira, Mat. Med. (13.) Dierbach, Mat. Med. (6.) Vogt's Mat. Med. (20.). Teste. (30.) Peters. (11.) Marcy. (10.) GENERAL REMARKS. The peculiar taste and smell of Garlic depend on an essential oily which is very volatile, and may be obtained by distillation, passing over with the first portions of water. This oil consists of a peculiar organic radical, called allyle, combined with one equivalent of Sul- phur. The impure oil has an exceedingly pungent odor, and strong acrid taste; and when applied to the skin produces much irritation and even blisters. (7.) The effects of garlic on the system are those of a general stimu- lant ; it quickens the circulation, excites the nervous system, pro- motes expectoration, produces diaphoresis or diuresis, according as the patient is kept warm or cool, and acts upon the stomach as a tonic and carminative. It is also said to be emmenagogue ; applied to the skin it is rubifacient and irritant. Moderately employed it is bene- ficial in enfeebled digestion and flatulence, and is habitually used for this purpose by many who have no objection to an offensive breath. (7.) It has been given with advantage in chronic catarrh, humoral asthma and other pectoral affections in which the symptoms of inflammation have been subdued and a feeble condition of the vessels remains. It is used habitually and with great benefit in such affections occurring in children, as well as in the nervous and spasmodic coughs to which they are peculiarly liable. (7.) Some physicians have highly recommended it in old atonic drop- sies and calculous disorders ; and it has been employed in fever and ague. (7.) It is thought to be an excellent anthelmintic, especially in cases of ascarides, in which it is given both by mouth and rectum. The juice Allium-sativum. 207 in doses of a few drops is said sometimes to check nervous vomit- ing- (7.) If taken too largely, or in excited states of the system it is apt to cause gastric irritation, flatulence, haemorrhoids, headache and fever. (7.) Bruised and applied to the feet it is much used as a revulsive in disorders of the head ; it is especially useful in the febrile complaints of children, by quieting restlessness and producing sleep. Bruised in oil, it is often used as a liniment in infantile convulsions, and other cases of spasmodic or nervous disorders among children. (44.) It is also used to resolve indolent tumors ; and in cases of cuta- neous eruption. (44.) A clove of garlic, or a few drops of the juice introduced into the ear are said to be highly efficacious in atonic deafness. A garlic poultice applied above the pubes has sometimes restored action to the bladder in cases of retention of urine* from debility of that organ. (44.) Vogt says that the acrid ethereal oil which exists in garlic gives this remedy some affinity with the empretiymatic ethereal oils, and renders it serviceable in nervous and verminous diseases. Still its principal action is upon the skin and mucous membranes. A de- coction in milk is used internally and in clysters against ascarides and lumbrici ; it is also used against blenorrhceas of the lungs, genital organs and bowels ; in diseases of the urinary organs, such as gravel and dropsy. (20). Dierbach thinks that garlic acts more upon the skin and onions upon the kidneys. (6.) According to Medberg, garlic is very injurious to consumptive and bilious persons, and those suffering with haematuria. (6.) Kolb says that it readily excites flatulence, dizziness and plethoric attacks. (6.) Xenophon says that fighting-cocks were formerly fed with garlic, in order to make them more active and courageous. (6.) According to Merat and Delens' Diet. univ. de mat. med., vol. 1. p. 189 : " it sharpens the appetite, stimulates the stomach, facilitates the digestion and expels flatulence."—According to them it is an ex- cellent remedy for phlegm.—" Pounded garlic has been applied to the skin, on account of its stimulating properties in paralytic or rheumatic diseases; in about two hours after its application, it will draw a blister, like a mustard plaster." Murray furnishes the following sketch of the empirical uses of this drug. The anthelmintic and febrifuge properties of garlic were known even to Plinius and Dioscorides, and since have been verified by a number of physicians of the highest rank. Rosenstein, Taube, and the English physician Bisset, have even expelled taenia with garlic. According to Laurernbergins and Lind, garlic is not only a preventive of scurvy, but a real spe- cific for this disease. Celsus and Dioscorides recommended it in old chronic coughs, accompanied by dyspnoea, and a profuse expecto- 208 New Materia Medica. ration of ropy phlegm. In accordance with this recommendation it was used with success by Mead, Rosenstein and even Murray. Ro- senstein relates that, by means of garlic, he succeeded in stopping a chronic cough, with general prostration and excessive emaciation. —Three similar cases were cured by Teste. (30.) Fever.—Catarrhal fever, with predominance of coldness ; shiverings from day to day, coldness all over, with heat in the face, horripila- tions in the forenoon, and in the evening; general heat with malaise, thirst, tense pulse, sweat after twelve o'clock in the day time ; sweat with itching ; sour sweat; fetid sweat; vomiting during the fever. (30.) Clinical Remarks.—In low fevers, onions, or garlic bruised and applied to the feet were recommended by Sydenham. In intermit- tent fevers, garlic is a highly esteemed Hindoo remedy. It is, or was also formerly employed in Europe ; Bergius speaks highly of its virtues; he commenced with one clove night and morning, and in- creased the quantity until four or five were taken at a dose. (44.) Sleep.—Oppression of the chest during sleep ; coldness during sleep, which occasions frequent waking ; thirst at night, preventing sleep. (30.) Clinical Remarks.—Bruised and applied to the feet it is supposed to be especially useful in the febrile complaints of children, by quiet- ing restlessness and producing sleep. (44.) Skin. — Flacid skin; formication; excessive sensitiveness of the skin. Tension of the skin, in the joints; dry skin; white spots which afterwards turn yellow, and arc accompanied with stinging and itching, red spots in the back, hands, on the inner surface of the thighs, and or the genital organs. (30.) Clinical Remarks.—The quantity of Sulphur which onions and garlic contain may make them useful in many cutaneous com- plaints. (11.) Mind, Disposition and Scnsorium.—Vertigo when steadily looking at a thing for a long time ; short-lasting, and only on rising from a chair. (30.) Clinical Remarks.—As Kolb says that it readily excites flatulence, dizziness and plethoric attacks, it is doubtless homoeopathic to some forms of these disorders. (11.) Head.—Weight in the head; dull pain in the occiput in the morning, heaviness in the head, which ceases during the menses, and re-appears afterwards ; throbbing in the temples ; heaviness at the forehead, which scarcely allows one to open one's eyes. (30.) Clinical Remarks. Bruised and applied to the feet it has been re- commended by Sydenham in coma and cerebral affections. As it is homoeopathic to dizziness and plethoric attacks it may prove useful when given internally in small doses. (11.) Ears.—Buzzing in the ears. (30.) Allium Sativum. 209 Clinical Remarks.—Waring savs that in atonic deafness and otal- gia, the expressed juice of garlic is occasionally a useful application. In a severe case of otalgia he has seen the pain rapidly and entirely subside on garlic juice being introduced into the external meatus; the pain had previously resisted leeches, opiate injections, and counter- irritation. Wilde, however, (see Diseases of the Ear,) says that he has seen three cases, during one year, of violent inflammation of the membrana tympani and meatus caused by the use of garlic. (11.) Taste and Appetite.—Hot taste in the mouth, coming from the throat, exactly like the taste of garlic, immediately after taking the drug ; it continued the whole morning, and returned after the second breakfast, so strongly that it caused a flow of saliva, dryness of the lips and palate ; profuse flow of sweetish saliva in the mouth, in the forenoon, after eating ; more particularly in the afternoon and at night. Eruc- tations ; immediately sensation as if something cold were rising to the throat ; voracious appetite, burning eructations after eating. (30.) Stomach and Abdomen.—Straining to vomit, with retraction of the abdomen ; burning in the stomach, stitches of pain in the stomach ; twisting and pinching around the navel. (30.). Clinical Remarks.—It is recommended in dyspepsia of long stand- ing, occurring in old fleshy persons, whose bowels are deranged by the slightest deviation from their regular diet, when they complain of a flow of saliva after eating, of eructations and other gastric symptoms characteristic of garlic, and likewise of great weakness in the lower limbs, particularly in the knees. (30.) Stool.—Soft stools. Diarrhoeic stools, accompanied and succeeded by cutting pains in the abdomen and loins. Constipation, with dull pain in the abdomen, which continues almost all the time, (for eight days. (30.) Urine.—Profuse, whitish urine, (which is rendered cloudy by the addition of nitric acid.) (30.) Clinical Remarks.—Teste recommends Allium-sat. very highly in diabetes melitus, as a palliative. It has been used in retention of urine, in dropsy, and gravel. It would seem somewhat homoeopathic to Bright's disease. In calculous diseases and ulceration of the blad- der, Bransby Cooper relates a severe case, treated by Mr. Cline, in which, after a variety of remedies had been employed in vain, leek tea afforded the most astonishing relief. Cooper has used it several times since, sometimes with, at others without benefit. (44.) Genital Organs.—During the menses pimples break out about the vulva, and extensive excoriations occur on the internal surface of the thighs ; the spots are of a bright red color, and accompanied by itch- ing and smarting on the inner surface of the labia majora and the ori- fice of the vagina. (30.) Thorax.—Coryza, accumulation of phlegm in the throat in the morn- 10 210 New Materia Medica. ing, with heaviness in the head. Cough, with painful irritation in the windpipe ; difficult expectoration of a glutinous mucus ; cough in the morning, after going out of his room, with profuse expectoration of mucus ; almost continual rattling of mucus in the bronchia. Stitches in one side of the chest; stitches under the shoulder-blades and pec- toral muscles, increased while coughing and drawing a long breath. Embarrassed respiration. The chest symptoms are worse in the open air, after eating, and when stooping. (30.) Clinical Remarks.—It is recommended in cases of erythematous angina, not preceded by coryza, occasioned by a cold or by excesses at table, and attended with a sticky feeling in the throat, with dryness, tickling, heat, and a sense of rawness in the larynx, roughness of voice, hollow, dry, and not very frequent cough, dry heat on the back of the hands, and slight moisture in the palms, ail of which symptoms generally come on in the evening. (Teste.) In cases of chronic bronchial catarrh, with profuse mucous expecto- raticn, without acute pains in the chest, (especially in fat individuals.) In cases of permanent dyspnoea of long standing. In hooping cough, Dr. Dewees says he has never employed any remedy of equal service with Garlic in substance, to relieve the cough of habit, which often remains after hooping cough ; he* has used it repeatedly, and never seen it fail. A child, aged six or seven years, may eat one-third of a clove daily, gradually increasing the quantity. (44.) Back.—Stitches in the back; red spots on the back, apparently like tetter; tearing pains in the sacrum. (30.) Upper Extremities.—Painful sense of contraction in the arms; tear- ing pain in the fingers ; heat, followed by moisture, in the hollow of the hands. (30.) Lower Extremities.—Tearing pain in the hip-joint; intolerable pain in the united tendon of the iliac and psoas muscles, worse on motion. Painful lameness in the thighs ; boils on the thighs ; digging pain at the tibio-tarsal articulation ; stiffness of the feet; burning at the solea of the feet. (30.) Clinical Remarks.—Three cases of rheumatism of the hips were cured by Allium. (30.) General Symptoms.—General lassitude, especially, in the lower limbs, so that one dreads the fatigue of ascending a few steps only; lassi- tude, especially in the morning. The pains caused by Allium are mostly pressive pains from within outwards, or tearing pains. (30.) Aloes. 211 ALOES. AUTHORITIES. Vogt's Mat. Med. (20.) Pereira Mat. Med. (3.) Dierbach Mat. Med. (16.) Neligan Mat. Med. Peters in N. Y. Jour. Med., March, 1845. (25.) Braithwaite. (14.) Noack and Trinks. (19.) Peters. (11.) Marcy. (10.) Schoenlein. (24.) Wood and Bache. (7.) Oil the Nervous System.—Aloes does not act specifically, either upon the nerves of sensation or motion ; it may possibly exert a secondary action upon the great sympathetic nerve. Clinical Remarks.—It has been used successfully in some trouble- some nervous affections, such as hypochondria, melancholy, mania, cramps in the stomach, &c, when brought on by a suppression of the menstrual or haemorrhoidal discharges. Hemorrhoidal congestion of the spinal marrow is most common in the cervical portion, there is stiffness and drawing pain along the nape, with difficulty on swallowing; when the dorsal portion is af- fected there is stiffness of the arms, and compressing pain in the chest, which often amounts to dyspnoea and asthmatic attacks. (24.) Many cases of hypochondria and melancholy owe their origin to functional derangement of the liver. Aloes, which exercises a speci- fic action upon this organ, and promotes the bilious secretion, is quite homoeopathic in instances of this character. Among the phenomena accompanying this variety of hypochondria, we usually observe con- stipation, stools scanty, dry, and clay-colored. Aloes rouses into ac- tion the torpid liver, promotes the intestinal secretions, and thus regu- lates the bowels, restores the normal foecal discharges, and enables the nervous system to recover its impaired tqne. (10.) Vascular System.—It acts far more specifically upon the vascular system than upon the nervous ; it may, however, act specifically upon those parts of the great sympathetic nerve which accompany the blood-vessels into every part of the system. (11.) Aloes undoubtedly exercises a special action over the venous sys- tem of the abdomen ; but its operation is strongly marked upon the pelvic viscera. (10.) Blood.—It was once a common opinion that Aloes dissolved the blood, or increased its fluidity ; Lewis alleges that this is the condi- tion of the blood drawn from persons who are in the constant habit of using alloetics, although according to Schwenke, it seems rather to coagulate than dissolve the blood when added to some which has been drawn iiom a vein. It was also an old opinion that it proved einmena^ogue, from its power of dissolving the blood, and hence would be hurtful in scurvy and in all haemorrhages proceeding from a 212 New Materia Medica. lax state of the blood and system. It is probable, that Aloes acts in the same way upon the venous system that Iron does upon the arte- rial; they both diminish the quantity of fibrin in the blood, and in- crease the quantity of blood globules. (11.) Fever.—Dierbach says it is a heating remedy, which readily excites febrile symptoms in young persons, such as a quick pulse and a trouble- some sensation of warmth in the abdomen. The excited state of the portal system, which it so readily causes, may in some cases extend to the whole venous side of the circulation, and congestion to the head and chest, but especially to the abdomen may arise, attended with un- pleasant heat, anxious feelings and throbbings, with increased sensi- tiveness and distension of the abdomen, frequent stools, mixed with blood, or bloody stools with violent and cutting abdominal pains, piles, violent pains in the kidneys, hot, scanty urine, with burning while uri- nating, and pain in the back. Hanisch says, in very sensitive and plethoric persons it may cause an excited state of the whole vascular system, so that the pulse becomes fuller and harder, the mouth dry with thirst, scanty discharge of red urine, increased warmth in the ab- domen, throbbing and aching in the region of the liver, congestion to the head and chest, with oppression and anxiety, bleeding from the lungs and apoplexy. (25.) Haemorrhages.—Aloes is peculiarly apt to excite haemorrhagies, es- pecially and more frequently from the haemorrhoidal vessels and the womb ; occasionally from the kidneys and bowels, and rarely from the stomach, lungs, and head. (11.) Although it produces a slight specific action on the entire intestinal mucous membrane, its chief manifestations are in the lower portion of the large intestines. This action is so intense at the rectum, when large doses are employed, that venous congestions and haemorrhages are often occasioned. (10.) Clinical Remarks.—Aloes is one of the most useful remedies against vicarious haemorrhagies, such as occur from suppression of the men- strual or haemorrhoidal discharges. I have several times removed haematemesis from suppression of piles or menstruation ; also bleeding of the nose, and bleeding from the lungs. It may prove useful in he- morrhagic apoplexy, from suppression of one or the other of these dis- charges, and should be borne in mind in all vicarious haemorrhagies. (11.) Haemorrhages occurring in chlorotic patients are often permanently removed by the use of Aloes. The following symptoms are especially characteristic : emaciation, pale and waxen countenance, uterine irri- tation, irregular menstruation, leucorrhcea, heat and irritation in the rectum, haemorrhages from the nose, throat, lungs, and tectum, obstruc- tion of the portal circulation, large secretion of urine, active sexual feelings. (10.) Head.—Periodical headache, alternating with pains in the small of the back. Aloes. 213 Clinical Remarks.—In apoplexy and other cerebral affections, Aloes is a valuable remedy, especially when these affections arise from a suppression of the menstrual or haemorrhoidal discharges. (44.) Ir- regular haemorrhoidal congestion to the head, with the. attendant red- ness and heat of the face, illusions of vision and threatened apoplexy may be removed by Aloes. (11.) Serious affections of the head have sometimes disappeared on the occurrence of a haemorrhoidal flux, and therefore in persons who have been subject to this discharge, but in whom it has ceased, it may be advisable to attempt its re-establish- ment, with a view of relieving other and more serious disorders. (44.) In hemorrhoidal congestion of the brain, when the patient complains of dizziness, great heaviness and confusion of the head, and the choroid coat is blue with congestion ; illusions of sight, such as sparks, flies, and spider-feet, before the eyes, and an approach to amblyopia amaurotica. From time to time severe turns of vertigo set in, so that the patient becomes much agitated, and supposes that he is attacked with apoplexy. The attacks are more severe in hot weather and when constipation is present. (24.) Ears.—Drawing and stitching in the ears. Clinical Remarks.—A few drops of a watery infusion of Aloes put into the ears, and a tea-spoonful, night and morning, of the simple tincture of Aloes with Liquorice, has removed the most obstinate deaf ness, loss of smell, and congestion to the head. In hemorrhoidal con- gestion to the head, noises in the ears, illusions and hardness of hear- ing, are not uncommon. (24.) Mouth and Throat.—Heat and dryness of the mouth; redness and dryness of the tongue; taste like clay; diminished appetite, with thirst, or increased appetite ; bilious eructations, or taste of food. Dryness of the mouth and throat during the night, with large secretion of mucus in the morning, and bitter eructations. Clinical Remarks.—Aloes is homoeopathic to many cases of what may be called bilious sore-throat; i. e. when the irritation of an ex- cess of bile in the system causes more or less irritation in the pharynx. Many cases of catarrhal, rheumatic, or inflammatory sore-throat occur- ring in very bilious persons, often require an intercurrent dose of Aloes to remove the bilious derangement, before the other symptoms will yield to the usual remedies. (11.) Stomach.—Sensation of heat and tension in the stomach. Disten- tion of the stomach, and feeling of tightness across the stomach, ex- tending to each lobe of the liver. Increased secretion of gastric juice. (10.) Clinical Remarks—It has been recommended in derangements of digestion, depending upon debility of the muscular fibres of the stomach and bowels; against abnormal secretion of mucus, acid, or gas; in anorexia, dyspepsia, flatulent distention, and painful aching in the re- gion of the stomach, with acid, rancid eructations, sluggish digestion, constipation, especially when th.se disorders occur in bilious and. hy- • 214 New Materia Medica. pochondriacal subjects. Its bitterness is said to render it an admirable stomachic, which promotes both appetite and digestion , so ne think that it regulates the due secretion of the gastric juice, while the an- cients termed it the mima ventriculi. (11.) Waring recommends it in dyspepsia, occurring in persons of a re- laxed habit, or in those who have been debilitated by long illness, particularly if there is reason to believe that the duodenum is impli- cated. It doubtless acts specifically upon the portal portion of the vascular system of the stomach. It is the best remedy in haemorrhoidal congestion of the stomach and spleen, when there is congestion and enlargement of the spleen, when pressure on the enlarged spleen causes difficulty of breathing in the left side of the chest, when there are pains in the spleen, following the course of the vasa brevia, sour eructations, heartburn, or sour vomiting; when there is distension of and pain in the stomach, with sensation as if a warm fluid had been poured out into it, followed by vomiting of blood. (24.) In mild cases of dyspepsia, accompanied by an excess of the gas- tric secretions, water-brash, tasteless, or bitter eructations, and heart- burn, Aloes in a highly attenuated form often proves beneficial. It has also been employed with success in indigestion caused by a lack of the bilious secretion. (10.) Liver.—Aloes has been supposed to act upon the liver, from times immemorial. Aloe bilens rubram erpcllit. (Rhazes.) Aloe ad in- fernis intestinum bilem ducit. (Aretaens.) According to Sigmond their influence upon the liver is marked by the peculiar composition of the evacuations, the color and odor of which, and their peculiar pungent effect on the rectum, prove that an increased quantity of bile has been poured out. Wedekind assumes that the operation of Aloes upon the bowels depends on an increased secretion of bile, excited by its specific action on the liver, and asserts that as long as the stools are white or grey in jaundice, Aloes will not purge, even in large doses, while the purgative effect supervenes as soon as the faecal mat- ters contain bile. When there is an excess of bile it is apt to cause bilious dysentery and hepatitis. Vogt says that it exerts a special ac- tion on the liver and tends more to the restoration of a checked secre- tion of bile than any drastic purgative. Antyllus counts it among the remedies which evacuate yellow bile. It causes aching and tension and uneasiness in the region of the liver, bilious papescent stools, with heat of the whole body, while the evacuations are not watery and co- pious but faecal and bilious, and emit a peculiar putrid smell. (25.) Clinical Remarks.— Against slight functioiul derangements of t»e liver, Aloes is an excellent remedy. The symptoms for which it is particularly indicated are, irregular secretion of bile, the stools some- times containing an excess, and at other times a deficiency of this fluid ; heat, fullness, and pressure in the hepatic region ; dull pains in • Aloes. 215 the liver; lassitude, drowsiness ; yellowish tinge of the skin; feeble appetite; depression of spirits. (10) Vena Porta.—Another class of physicians think that Aloes acts pri- marily and specifically upon the portal system, and assume that their influence upon the liver and bowels is secondary to this. That it acts upon the vena porlarum is fairly to be deduced, from the very peculiar state into which the haemorrhoidil vessels are thrown by the conges- tions which so rapidly occur after a dose of this drug has been taken. Wedekind says it exerts a specific srimulant action on the venous system of the abdomen and pelvis, ^nd hence causes an increased se- cretion of bile, irritation about the rectum and vascular excitement of the sexual organs. It readily causes stagnation and accumulation of blood in the abdominal vessels, and the various affections and conse- quences of plethora abdominalis. (25.) Abdomen.—Pressure, tension, and heat in the region of the liver. Fullness, heat, and distention of the abdomen. Beating, boring, and stinging in the umbilical region. Diarrhoea, preceded by colic. Most violent colics. Discharge of a large quantity of fetid flatulence. Vio- lent cutting pains in the abdomen. (19.) Clinical Remarks.—It is one of the most homoeopathic remedies against plethora abdominalis ; also against many forms of bilious and venous congestive colics ; also against many haemorrhoidal and con- gestive colics. (11.) In hemorrhoidal congestion of the duodenum or malcena, when there is a peculiar cutting or aching pain about the navel, aggravated a few hours after eating ; when the umbilical region is distended and rather hard, the bowels constipated, and the faeces as if burnt; when there is a remarkable pallor of the external surface, coldness of the limbs and hands, and a peculiar pale yellow, earthy color of the face. Finally, there is a sensation as if a warm fluid had been poured out about the navel, the abdomen swells more and more, with a dou<>hy or mushy sensation to touch ; the more the abdomen becomes disturbed the greater is the pallor of the skin ; the pulse be- comes small, weak :u:d trembling, the extremities cold, the features shrunken ; finally black tar-like passages take place with much strain- ing. (24.) Bowels.—It is a specific purgative, for when applied externally to a blister it will operate upon the bowels (Gerhard); tincture of Aloes applied to a carious bone has excited purging (Mu.vro) ; an Aloetic pill applied to an issue has had the same effect (Pereira); also an Aloetic salve rubbed upon the abdomen (Dierbach). Dr. H^lleh injected a solution of half an ounce of socroline Aloes in six ounces of warm water into the jugular vein of a cow, which had suffered for six days with obstinate constipation and constant vomiting, which had withstood all ordinary injections and purgatine medicines ; the cow shivered immediately, followed by quickness of the pulse and respira- tion for one hour; then succeeded frequent urgings to stool, by which, however, only a small quantity of hard faeces were evacuated. The 216 New Materia Medica. same procedure was repeated the next day, when violent straining produced first the discharge of some dry dung, followed by profuse soft evacuations ; the vomiting ceased, and appetite and health soon returned. (4 ) The part of the bowels upon which it operates by preference, is a matter of dispute. Wood and Bache think that it has a peculiar af- finity for the large bowel, and acts rather upon its muscular coat than upon the exhalent vessels Cullen agrees to this and asserts that it rarely or ever produces more than one stool, which seems to be mere- ly'an evacuation of what may be supposed to have been already pre- sent in the great intestine. Hardly any dose under twenty grains will produce a liquid stool, which effect is always attended with pain and griping ; on the other hand the ordinary bulky and rather hard aloes- evacuation may, in innumerable instances, be constantly obtained from one to two grains. The slowness of its operation has also been advanced by Lewis in proof that it acts on the large rather than the small bowels, for Aloes hardly ever operates under ten or twelve hours, and often not till sixteen or eighteen, while even twenty-four hours may elapse. Finally, to be still more minute, Newman has conjec- tured that it acts more especially upon the circular than upon the lon- gitudinal muscular fibres of the.colon. Whether given in a large or small dose it hardly ever causes a copious evacuation, and an in- creased quantity does not produce a corresponding cathartic effect. (25.) But these authors forget its decided action upon the liver and bile. Its effects upon these are so distinct and characteristic that when added to other purgatives its peculiar effects do not take place until some hours after the evacuations caused by the other purgatives have taken place, and the Aloes stools differ from them both in color and smell. It rarely or never causes watery stools, but the dejections are always yellowish, greenish, or blackish and slimv, and often emit a peculiar offensive and almost, putrid smell ; the color and odor of the evacuations, together with their pungent effect on the rectum, prove thut an increased quantity of bile has been poured out. (25.) It may cause emaciation, striciure of the rectum, and enteritis. If its use be long continued it c;iuses dryness of the intestines, rigidity of the muscular coat of the bowels, especially of the colon and rectum, in consequence of which obstinate constipation may ensue. Very large doses may cause violent cutting abdominal pains, watery and long-continued diarrhoea, tenejmiiis.ajid inflammation of the lower por- tion of the alimentary canal. The faeces may be enveloped in a thin pellicle of altered intestinal mucus, or there may be discharges of membranous-like pieces from the rectum, or very lar^e rolled-up pieces of intestinal mucus. (25.) One of the most common effects of Aloes is irritation of the rectum, giving rise, in some instances, to haemorrhoids. Cullen has seen piles produced by large and frequent doses, with heat and irritation about the rectum and tenesmus. Fallopius says, if one hundred per- Aloes. 217 sons, who had used Aloes freely as a purgative, at least ninety be- came affected with a haemorrhoidal flux, which ceased when their use was omitted. (25.) Clinical Remarks.—Aloes is one of the most homoeopathic remedies against bilious diarrhoea and dysentery; it is also far more useful in haemorrhoids than Nux or Sulphur. According to Dr. Belcher, it is indicated in hemorrhoidal dysentery when the patient is restless and anxious, the face flushed, tormina troublesome, and tenesmus vehe- ment, the evacuations being dark green in color, or bloody, with offen- sive mucus ; when the abdomen is puffed up, the lungs oppressed, with frequent inclination to breathe deeply, and the pulse frequent. Also in dysentery in pregnant females, or those suffering with uterine congestion; or when it attacks emaciated persons, especially children with distended abdomens and tendency to marasmus. (7.) Tilt says he has never seen haemorrhoidal affections caused by Aloes, but he has often seen them relieved by it, and his experience is corroborated by that of Giacomina, Avicenna, and Stahl. In former times Aloes were regarded as the sacra anchora in the cure of haemor- rhoids of an asthenic character, although it produces active congestive piles. At times the moliininae haemorrhoidaliae pass over into flowing piles under the use of Aloes, while at others they cease without any discharge having been produced. Under the latter circumstances Ha- rnisch conjectures that the tonic and stimulating effects of the Aloes removes the debility of the vessels upon which the premonitory signs of piles has depended ; i. e. that the tendency to active congestion, produced by the Aloes overcomes the passive stagnation of blood which previously existed. Loeseke asserts that if Aloes be given before the accustomed flow of piles comes on, the flux will ensue ; but on the other hand if given while they are flowing a stoppage will be effected. (25.) Urinary Organs.—Strangury, flow of blood from the kidneys ; burn- ing while urinating; violent pains in the kidneys ; hot, scanty urine. Greenhow ascribes a diuretic effect to Aloes, and Moiroud injected four drachms into a vein of a horse with no other effect than producing the evacuation of a large quantity of urine. It has been repeatedly noticed that when squills and other diuretics failed to act, the addition of a small portion of Aloes has speedilv produced a copious diuresis. (19.) Clinical Remarks.—It has often proved useful in hemorrhoidal affec- tions of the kidney and bladder, when there is pain in one or both sides of the lumbar region, drawing pains along the ureters, towards the bladder, with scanty secretion of urine, and those derangements of the stomach which always attend kidney-affections, such as gastral- gia, with good appetite, and vomiting soon after eating. These symp- toms may increase until nephritic colic ensues, the pains are exceed- ingly severe, the abdomen is retracted, vomiting occurs, the urine is suppressed, until finally a quantity of dark blood-red urine is passed. 213 New Materia Medica. When the bladder is more particularly affected there are periodical, violent, and contracting pains in the neck of the bladder, especially while urinating ; when the pains are very severe entire retention of urine may occur, or when any water is passed it is only in drops or jets, never in a full stream. The pains continue after urination and extend over the pubis. The patients can neither sit in comfort or as- sume any position in which the perinseum is pressed upon. At first the urine is not altered in quality, but finally blood is passed. Some- times the urine is mixed with a large quantity of tough, ropy mucus. Harnisch says that aching in the region of the kidneys, with scanty discharge of hot urine, or tenesmus of the bladder from venous con- gestion of it, will often give way before the use of Aloes. (25.) Genital Organs.—It causes a determination of blood to the womb, and fullness of its blood-vessels, especially the veins, and thus uterine irritation and menorrhagia are apt to be induced or increased by it. Vascular excitement of the sexual organs, immoderate flow of the menses, racking pains in the loins and labor-like pains are frequently induced by it. Discharge of blood from the urethra, drawing and burning pain in the sacral region. Burning while urinating, aching and heaviness in the pelvis, erections and pollutions, and excitement of the uterine vessels. (19.) Clinical Remarks.—It is homoeopathic to hemorrhoidal affections of the uterut, in which there is aching in the region of the womb, press- ing-down pain, with some prolapsus, varicose swellings about :he neck of the womb, and in the vagina, with discharges of blood during the menstrual intervals; these discharges consist of a dark, pitch-like sub- stance and have a different odor from that of menstrual blood ; either before or after these haemorrhages there may be a discharge of tough, greenish leucorrhcea, with the peculiar odor of hgemorrhoidal mucus. By restoring the haemorrhoidal secretion Aloes will often relieve the sensations of aching and weight on the pelvis, the erections, pol- lutions, and tenesmus, which are often felt as premonitory symptoms of piles. (25.) Eberlee says that Aloes given in small but frequent doses deserves to be, accounted the best remedy we possess for those protracted, ex- hausting, and obstinate haemorrhages from the uterus, which occur in women of relaxed, nervous, and phlegmatic habits about the critical period of life. (25.) In amenorrhoea it is, perhaps, more frequently employed than any other remedy in the dominant school, entering into almost all the nu- merous empirical preparations which are habitually resorted to by fe- males, and enjoying a no less favorable reputation in ordinary prac- tice. Schoenlein recommends the injection of a solution of ten grains of Aloes in a small quantity of warm fluid, to be thrown into the rectum at the period when the catamenia should occur. He states that its action is more certain than that of any other emmenagogue. Dr. Atwell has used it in this way with decided advantage. (44.) Alumen.' 219 Chest.—Clinical Remarks.—Aloes will often prove serviceable in hemorrhoidal affections of the chest, when there are more or less of* the signs of congestion of the lungs, viz.: aching upon one or both sides of the chest, difficulty of breathing, cough, with expectoration of but little mucus, no fever, but livor of the face, lips, cheeks, and tongue, followed by more or less haemoptysis. (24.) ALUMEN.-(iH SULPHATE OF ALUMINA AND POTASH. AUTHORITIES. Vogt's Mat. Med. (20.) Pereira's Mat. Med. (3.) Waring's Therapeutics. (44.) Wood and Bache Dispensatory. (7.) Frank's Mag. (4.) Orfila. (2.) Peters. (11.) Marcy. (10.) ' GENERAL REMARKS. This is a compound of Alumina, 10.92 ; Potash, 10.OS ; and Sul- phuric acid, 33.68, and in its action it partakes of some of the proper- ties of all these articles. It is generally supposed to act very much like Sulphuric-acid, only somewhat less severely, and more purely as an astringent. Others have compared its action to that of Sulphate of Zinc, Acetate of Lead, Sulphate of Iron, &c.; but it differs widely from all these. In common parlance Alum is said to be a purely and simple astrin- gent remedy, but the Potash which it contains also renders it some- what of an alterative and deobstruent medicine. Besides, as all the Alums of commerce contain more or less of Sulphate of Iron, varying from five to seven parts in a thousand, it is also somewhat tonic and blood-improving in its action. The immediate topical effect of a solution of Alum is corrugation of fibres and contraction of small vessels, by virtue of which it checks or temporarily stops exhalation and secretion, and produces paleness of parts by diminishing the diameters of small vessels. It is by these local effects that Alum, when taken internally, causes dryness of the mouth and throat, somewhat increases thirst, checks the secretions of the alimentary canal, and thereby diminishes the frequency and in- creases the consistency of the stools, as observed by Wibmer, when taken in doses of three grains, dissolved in five drachms of water, several times a day. When taken internally in moderate doses it is absorbed into the system, and has been detected in the liver, spleen, and urine. Kraus has noticed that the urine becomes remarkably acid from the use of Alum. When taken in large quantities the astriction is soon followed by 220 New Materia Medica, irritation, and the paleness by preternatural redness ; it may thus ex- o>te nausea, vomiting, griping, and purging, and even an inflammatory condition of the alimentary canal—effects which may sometimes be induced by small quantities in persons endowed with unusual or mor- bid sensibility of the stomach and bowels. Barthez, from half drachm doses, solved in one ounce of distilled water, experienced a sense of contraction in the stomach, lasting for a quarter of an hour, followed by acute aching in the stomach. From one drachm doses, solved in two ounces of water, he merely felt a more decided sense of contraction of the stomach ; his appetite was never disturbed, on the contrary he rather thought that it was in- creased. From two and a half drachm doses he felt an inclination to vomit, lasting for a quarter of an hour, but no vomiting ensued; three drachm doses caused vomiting and constipation ; the vomiting was easy and not preceded by much nausea. Alum was detected chemically in his stools. Pathology.—From doses sufficiently large to cause death in ani- mals : The stomach was found filled with a large quantity of fluid; its internal surface, throughout all its extent was covered with a grey- ish substance, intermixed with greenish and bilious-looking particles ; the mucous membrane was extensively reddened or inflamed, espe- cially in the greater cul-de-sac, which was dark brown in color ; near the pylorus there was an extravasation of blood, and the mucous membrane was very red ; the coats towards the pylorus were extra- ordinarily thick and hard, as if they had been tanned, and were very firm under the knife ; the walls of the small bowels were slightly thickened, and coated with a yellowish-white granular substance; the large bowels were filled with a yellowish, offensive fluid. As Alum has been but little used by homoeopathic physicians, a large portion of the clinical remarks must be derived from allopathic sources; this is not to be regretted, because we take it for granted that homceopathists claim to know, not only all that is contained in old-school writings and experience, but a greal deal more. Hence we must take heed that our old-school brethren are not in possession of new or old facts with which we are not acquainted. (11.) LOCAL EFFECTS. Nervous System.—Alum is not supposed to act as prominently on the nervous system as Sulphate of Zinc, or Acetate of Lead. Nerves of Motion.—It is said, from its action in lead and other colics and in hooping cough, to be an antispasmodic ; but Copland thinks it cures lead colic by exciting the partially paralyzed muscular coat of the bowels and thereby enabling them to expel retained matters of a noxious description. Too little is known about its action upon muscular fibres and nerves of motion to hazard any decided opinion. (11.) Alumen. 221 Among the symptoms enumerated by Fournier, in the case of a lady who had taken a large quantity of Alum, we find "slight convul- sive movements." Orfila also alludes to a similar case. (10.) Nerves of Sensation.—It is not known that Alum acts specifically upon any of the nerves of sensation. (II.) Ganglionic Nerves.—It is generally supposed that the action of Alum upon the nervous system is confined to the ganglionic nerves; it may be propagated thence to the vascular system, as these nerves follow the blood-vessels into every part of the human frame. (11.) VASCULAR SYSTEM. Heart and Arteries.—The especial action of Alum upon the heart and arteries, apart from its astringent action has not been particularly investigated. Clinical Remarks.—In dilatation of the heart and aneurism of the aorto, Alum has been advised by Kreysig and Dzondi; Sundelin also mentions a case of supposed dilatation of the heart in which relief was gained by the use of Alum. Venous System.—Alum is supposed to exert not only a blood-coagu- lating, but also an antiseptic power on the venous blood. (11.) By astriction of the capillaries it may impede the return of blood from the arteries, and thus operate upon the venous system. (10.) Capillary System.—This seems to be the great field of the action of Alum. It exerts an astringent effect upon the capillaries of all the mucous and serous surfaces, upon the lymphatic and blood-conveying vessels ; hence it moderates or checks all profuse mucous fluxes aris- ing from atony of the parts; by exerting a tonico-astringent action upon the tone of the vessels, it prevents passive hasmorrhagies, and even opposes the tendency to liquefaction and putrefaction of the or- ganic mass when such is in operation. (11.) Lymphatic System and Glandular System.—It is not known whether Alum exerts any specific and peculiar action upon these systems apart from its tonic and astringent action. Fever.—Notwithstanding that Alum causes dryness of the tongue, mouth and throat similar to that which obtains in typhus and typhoid fever, it still has been strongly recommended in those diseases by Fuster, Fouquier, Dobler and Skoda. The two former recommend it in the second stage of abdominal typhus, when in consequence of ulceration of the abdominal mucous membrane and of its glandular apparatus, there are ichorous, offensive and blood-mixed loose stools. In IS3S, Drs. Dobler, Skoda, Herz, and Folwarenzy placed their sole reliance upon it; many hundreds of cases have been treated and saved by it. (44.) Blood. Clinical Remarks.—The value of Alum in menorrhagia and hse. 222 New Materia Medica. maturia has been already considered under the appropriate heads. In purely atonic haemoptysis it likewise proves serviceable. Dr. Theophilus Thompson considers that it is one of the best direct as- tringents that can be employed, and thinks that it acts more efficient- ly when allowed to dissolve in the mouth, than when taken in mixture. In atonic haematemesis, Alum thrice daily in combination with Opium proves serviceable, although it is of inferior efficacy to the acetate of lead. In haemorrhage from leech-bites, in that from the gums after the ex- traction of a tooth, and in other superficial haemorrhages, a saturated solution or the powder of Alum locally applied is often an effectual styptic. (44.) In haemorrhages whether proceeding from an exhala- tion or exudation from the extremities, or pores of the minute vessels, or from a rupture of a blood-vessel, a solution or in some cases the powder of Alum may be used with advantage to constringe the ca- pillary vessels, and close their bleeding orifices. (3.) Head, Mind, &C.—Great agitation, anxiety, restlessness have been observed as pathogenetic effects of Alum. (2.) Clinical Remarks.—It has been used successfully in a peculiar form of mental alienation in which the patient plagues his family con- tinually, keeps his or her bed almost entirely, without apparent neces- sity, has an appearance of enbonpoint from general bloating, but a sickly and sallow complexion, with burning down the oesophagus, tenderness over the stomach, cough and insupportable pain near the left groin or ovary. Under the use of Alum the patient will soon leave his bed, become rational and affectionate towards his family and attend to his duties. (4.) Nose. Clinical Remarks.—In profuse atonic epistaxis the injection of a solution of Alum into the nostrils often proves effectual in arresting the discharge. It is frequently also applied by means of a plug soaked in a saturated solution, and pressed up the nostril. (44.) Se- veral cases of polypus of the nose are reported as cured by simply snuffing up a solution of Alum. (4.) Alum reduced to an impalpable powder, and snuffed into the nos- trils, has in a few cases within my own knowledge, effected cures of copious catarrhal discharges. As an application to nasal polypi, we can vouch for its utility. (10.) Eyes. Clinical Remarks.—In purulent ophthalmia, a collyrium of Alum is a useful cleansing application. In the severer forms, a saturated solution of Alum dropped into the eye, is occasionally of great ser- vice. In the purulent ophthalmia of Egypt, Clot Bey found great benefit from dropping into the eye a saturated solution of Alum and Sulphate of Zinc. Dr. Rognetta speaks highly of its value. (44.) In the ophthalmia of India, commonly known as country sore eye, I can speak from experience of the efficacy of the following native preparation :—Place some finely powdered Alum on a heated plate of Alumen. 223 iron, and whilst the salt is in a state of fusion, add a small portion of lemon or lime-juice, until it forms a soft black mass. This while hot, is placed entirely round the orbit, taking care that none of its gets beneath the eye-lids, as it causes under these circumstances intense agony. One or two applications, each being allowed to remain on twelve hours, are sufficient in ordinary cases to effect a cure. (14.) In the ophthalmia of infants after the subsidence of acute inflam- mation, a collyrium of Alum is one of the most serviceable applica- tions which can be had recourse to. I have employed it with success in some hundreds of cases. It has also the recommendation of Ramsbottom, Lawrence, Pereira, &c. In ophthalmia tarsi, a similar collyrium is advised by Howard. In the purulent ophthalmia of infants it forms the most efficacious remedy we possess. In these cases it is usually applied in the form of the Alum cataplasm. In ecchymosis of the eye, an Alum poultice is an effectual application. It is made by agitating a small piece of Alum with the white of an egg until it forms a coagulum. This is placed between two pieces of linen rag, and applied to the eye for some hours. (44.) In the latter stages of conjunctival inflammation it is often proper. As regards topical applications to the eye, a certain amount of judgment should be used. In the first stage of ophthalmia, it is some- times considered expedient to cut short the disease by the application of a strong astringent solution. "It is not to be denied says Dr. Jacob, that such applications may have the effect of arresting the disease at once; but, if they have not that effect, they are liable to produce an increase of irritation." But as the details necessary for making the student acquainted with all the circumstances respecting the application of stimulating or astringent applications, in the first stage of ophthalmia, are too lengthened and numerous to admit of their proper discussion in this work, I must refer for further particu- lars, to the essay of Dr. Jacob's {Cyclopedia of Pracl. Med., art. oph- thalmia) as well as to the treatises of writers on ophthalmic surgery. I may, however add, that whatever difference of opinion exists as to the propriety of these applications in the first stage of ophthalmia, all are agreed as to their value after the violence of vascular action has been subdued. In the treatment of the purulent ophthalmia of infants no remedy is perhaps equal to an Alum wash. (3.) Ears. Clinical Remarks.—In purulent discharges from the ears, topical applications of a solution of Alum are often serviceable. We have frequently seen chronic ottorrhoea, disappear under the use of injections of Alum-water. (10.) Mouth.—Very severe pain in the mouth. Burning sensation in the mouth. Dryness of the mouth. (2.) Clinical Remarks.—In affections of the mouth involving a congested state of the mucous membranes, much benefit is often derived from the local application of Alum. 224 New Materia Medica, In ulceration and sponginess of the gums, whether mercurial or scorbutic, the lotion as for ulceration of the throat is found highly serviceable. It should be used several times daily. To scorbutic ul- cers very finely powdered Alum in substance, may be applied. (44.) It forms a useful astringent wash in certain states of mercurial sore mouth, (3) and is used wiih the best effect to check profuse piyalism, whether from the abuse of mercury or other causes. (3.) It is an excellent topical application in the form of powder, in profuse haemor- rhages after the extraction of teeth. Throat.—Aery severe pains in the pharynx. Burning in the mouth, pharynx and stomach. (2.) Clinical Remarks.—In catarrhal affections of the throat and fauces Alum is highly recommended as a local application. In chronic cases when the mucous membrane is much congested, and covered with mucus, which gives rise to a troublesome cough, Alum gurgles afford great relief and benefit. (44.) In ulceration and relaxation of the throat, a solution of Alum in water, or decoction of Cinchona, proves a very useful gargle for or- dinary cases. (44.) It has been employed successfully as a gargle in elongation and loss of contractile power of the uvula. As an internal remedy in chronic ulcerations of the mucous membrane of the throat and pharynx, it is a remedy of great value. We have cured cases of this kind with small doses of Alum, after having been baffled for months, with other medicines which at first appeared to be more homoeopathic. We are acquainted with a number of obstinate cases, which have been quite cured by the internal and topical use of the Rockville Alum spring water of Virginia. (10.) Stomach.—Burning heat, and tearing pains in the stomach. Nau- sea and vomiting. Distension of the stomach. Intense thirst. Pathology.—When confined in the stomach, Alum causes inflam- mation of the entire mucous membrane, worse near the great cul-de- sac, where it is of a deep brown color. The walls of the stomach are much thickened at the pyloric extremity, and hardened as if tanned. The walls of the small intestines are slightly thickened, and lined with a light yellowish substance. Traces of Alum may be found in the stomach long after it has been taken. (2.) Clinical Remarks.—In catarrhal affections of the stomach, Sir J. Murray speaks in the highest terms of Alum. In one aggravated case, attended with pyrosis, a complete cure was effected by Alum in elec- tuary. He considers that it renders the mucous coats more firm, and restores their tone and strength. (44.) He considers it especially useful in the peculiar affection of the stomach, attended by the frequent vo- miting of a large quantity of glairy fluid. (7.) In prescribing Alum it should be remembered that the vegetable astringents decompose it, by which the astringent property of the mixture is probably dimi- nished. (3.) Alumen. 225 Taken internally in large doses Alum excites nausea, vomiting, grip- ing, purging, and even an inflammatory condition of the intestinal canal,—effects which may perhaps be induced by small quantities, in persons endowed with unusual or morbid sensibility of the stomach and bowels; as in the case of the lady in whom dangerous gastro- enteritis was apparently induced by a single dose of a solution con- taining between ten and twenty grains of burnt Alum. Ordinarily, however, tolerably large doses of Alum may be given without any unpleasant effects. Thus Prof. Dumeril has given a drachm proper- ly diluted in chronic diarrheeas, within twenty-four hours ; Prof. Marc two drachms in passive haemorrhages, within the same period of time, and M.M. Kapeler and Gendrin have administered three drachms at one dose in colica pictonum. (3.) In habitual haemorrhages from the stomach, such as are sometimes observed in hard drinkers, repeated doses of the first decimal tritura- tion of Alum are highly serviceable. The modus operandi in these cases consists, probably, in the chemical or mechanical action exerted upon the mucous membrane of the stomach. Bowels.—Distention of the bowels. Burning pains in the small in- testines. Copious solid stools. (2.) Pathology.—The walls of the small intestines are somewhat thickened, and lined with a light yellowish substance. Clinical Remarks.—Alum was first used in colica pictonum, by a Dutch physician named Grashuis, and was afterwards in 1774, used in fifteen cases by Dr. Percival, with great success, and subsequently its efficacy was fully established. It allays vomiting, abates flatulence, mitigates pain, and opens the, bowels, when frequently other powerful remedies have failed. The modus operandi of Alum in lead colic is not very clear, but the theory of its action is, that it converts the poisonous salt of lead in the system into an innocuous sulphate, and in support of this view must be mentioned the fact, that other sulphates (as those of Magnesia, Soda, Zinc and Copper,) as well as free Sul- phuric-acid, have been successfully employed in the lead colic. But on the other hand, the presence of lead in the primae viae or evacua- tions, has not been demonstrated, though experiments have shown that when the acetate of lead is swallowed, the greater portion of it forms an insoluble, combination with the gastro-intestinal mucus, and in this state may remain some time in the alimentary canal. Alum has also been found successful in other varieties of colic not caused by lead, and unaccompanied by constipation. (3.) In large doses it acts as a purgative. In abdominal typhus, which was epidemic in Vienna, in 1838, chief reliance was placed on the internal exhibition of Alum. Under every phase of the disease, diarrhoea, delirium and debiiity, it is stated to have been equally beneficial. It was found particularly ser- viceable in checking the exhausting diarrhoea. (44.) In infantile cholera Alum has been found to be signally successful. 11 226 New Materia Medica. Of sixty-seven cases treated with it by Dr Diirr only seven died. The age of the children varied from the period of birth to fifteen months. (44.) In chronic diarrhoea, and diarrhoea mucosa, depending upon a relaxed condition of the mucous intestinal membrane, Alum given internally is often attended with great amelioration. Drs. Adair and Harrison speak favorably of it in this class of cases. (44.) In chronic dysentery, Alum was formerly held in high repute. It has been advised variously combined, by Birnstiel, Loos, Hunnius, Michaelis, Hargens, &c. Mosely and Jackson employed it, and Adair found it useful combined with Opium and aromatics in epide- mic dysentery, occurring among negroes. (44.) Injections of Alum-water, or of Alum whey are very useful in the copious and frequent haemorrhages which sometimes accompany piles, and abrasions of the mucous membrane of the rectum. Cases of this kind now and then reduce patients to a very low and dangerous con- dition, and appear to resist all internal remedies. The astringent and toughening effect of these injections, have in some instances, ar. rested the bleeding promptly and permanently. Rectum.—Smarting and burning at the rectum, after a solid stool; haemorrhoidal tumors after a hard stool. (2.) Clinical Remarks.—In prolapsus of the rectum, the injection of a solution of Alum proves serviceable. It may also be used in painful bleeding piles, when unattended by inflammation. (44.) (See Clini- cal Remarks under Bowels.) Kidneys and Bladder.—When Alum has been absorbed into the sys- tem, it has been found shortly afterwards in the urine. But in its passage through the kidneys and bladder, we are not aware of any sensations it produces. Clinical Remarks.—In haematuria, which resists the action of the acetate of lead and other ordinary remedies, the injection into the bladder of a solution of Alum is sometimes effectual in arresting the discharge ; this, however, should not be had recourse to until it has been ascertained that the bladder and not the kidneys, is the seat of the disease. Dr. Prout observes that he has never seen any unplea- sant consequences follow the use of this expedient; and that he has seen it arrest the most formidable haemorrhage, when all other reme- dies had failed and when the bladder had repeatedly become again distended with blood, almost immediately after its removal. If after the use of the injection, coagula remain in the bladder, they should be broken up by repeated injections of cold water. Alum may be given internally at the same time ; although as an internal remedy it is less efficacious than Gallic-acid. (44.) In catarrh of the bladder it is highly spoken of by Sir J. Eyre. In diabetes, under the idea that the discharge might be arrested by the use of powerful astringents, Alum in combination with other Alumen. 227 remedies of the same class, was advised by Dorer, Brocklesby and others, but Dr. Brisbane satisfactorily proved that it was incapable of arresting the disease. (44.) Kraus observes that the urine becomes very acid from the use of Alum. It has been used successfully against incontinence of urine (4.) In one case of irritable bladder, in which the patient was obliged to pass urine every hour or two, both by day and night, grain doses of the 1st trituration of Alum every four hours effected a cure in six weeks. Genital Organs.-#-Ma/e and Female. Clinical Remarks.—In gonorrhoea and gleet, the injection of a so- lution of Alum is often productive of benefit. Dr. Friedrich of Leip- sic also advised its internal use ; as well in the inflammatory as in the chronic stage. He states that under its use, all the symptoms subsided rapidly, and that he never saw any ill effects from its employ- ment. In obstinate cases it may be advantageously combined with cubebs. In gonorrhoea praeputialis, a solution of Alum applied on lint to the part, is generally effectual. (44.) In leucorrhcea, Alum combined with Aloes, proves highly service- able. It is also sometimes used in conjunction with Sulphate of Zinc. The decoction of oak-bark often forms a good vehicle. Dr. Burne found this solution most serviceable when simply applied continuously to the external parts. Dr. Dewees states that in some obstinate cases he has effected a cure by Alum and Nitre. (44 ) In menorrhagia and uterine haemorrhage, Alum internally has been advised by Lentin, Miiller, Hufeland, Dewees, &c.,and it often proves effectual in controlling the discharge. Dr. Ferguson regards it as a highly useful styptic and advises it in doses with syrup of ginger, three or four times daily. In purely atonic cases, Alum in solution may be used as a vaginal injection. It is inadmissible, if any in- flammatory symptoms are present. (44.) In morbid growths and ulcerations of the uterine cavity, or of the os-uteri, an Alum hip-bath and vaginal injections are strongly advised by Drs. Lange and Ashwell, and its utility in confirmed by Delmas Recamier and others. Care should be taken that the fluid passes well up into the vagina. (44.) In prolapsus uteri, the same measure is attended with the best effects. Dr. Nevins also speaks highly of a pessary composed of equal parts of powdered gall and Alum, enclosed in a fine muslin bag. (44.) It has been recommended internally and locally against hypertrophy, induration and excoriation of the womb. (4.) It will often cure obstinate ulcerated buboes rapidly, when applied locally. (4.) Windpipe.—Sense of constriction in the windpipe. Heat and burn- ing in the throat and larynx. (2.) Clinical Remarks.—In angina membranacea, called by Bretonneau, diphtheritis, great importance has been attached to the employment of local applications, and among others, to promote the expulsion of 228 New Materia Medica. the false membrane he recommends the insufflation of finely powdered Alum. (3.) The most effectual means of administration, is in the form of an impalpable powder, blown through a quill, upon the affected part. (7.) It is recommended as an emetic in croup in preference to Antimony or Ipecacuanha. Prof. Meigs states that it acts more cer- tainly and powerfully than those medicines and produces less pros- tration of the vital powers. (44.) In various anginose affections Alum is found highly useful, applied topically either in powder or so- lution. When the affection is attended with membranous exudation, its efficacy has been particularly insisted upon by Bfetonneau, applied in solution prepared with vinegar and honey for adults and in powder by insufflation in the cases of children. Velpeau in 1835, extended the observations of Bretonneau, and has used Alum successfully, not only in simple inflammatory sore-throat, but in those forms of angina dependent on small-pox, scarlatina, &c. (7.) For haemoptysis or spitting of blood, see Art. Blood. Chest —Oppression of the chest. Tightness across the upper part of the chest. Sense of heat and burning in the chest. (2.) Clinical Remarks.—In the chronic stage of hooping-cough no reme- dy has proved more efficacious than Alum given in increasing doses. A very excellent formula is recommended by Dr. Golding Bird, in which he combines it with Conium. (44.) Alum is supposed to exert a sedative power in diseases of the chest by J. Symons, London Lancet, March, 1844, p. 42. Dr. Simm of Ripon first recommended Symons to use it in hoop- ing-cough, he found it to answer his fullest expectations, thence led to use it in other thoracic complaints. It evidently so changed the expectoration as immediately to cause a copious discharge of mucus from the bronchi, and finally checked the superabundant secretion, did not produce thirst or any unpleasant symptoms and so far from aggravating the febrile state it often served materially to alleviate it. It produced neither nausea, pain, nor constipation, while it some- times relieved colic pains accidentally present. Alum forty-eight grains, syrup half oz., hot-water five and a half ounces, i. e. eight grains to the ounce, one grain to a drachm or tea- spoonful, children of three years, or three or four teaspoonsful per day, i. e. three or four grains per day, three to seven years, a dessert- spoonful three or four times a day, beyond puberty two tablespoons- ful per dose, adults twenty-four grains per day. In acute and chronic bronchitis, especially when expectoration was Topy. Even in very acute bronchitis in children with profuse secretion of mucus. In the acute bronchitis of old persons supervening upon chronic morning cough. In hooping-cough to allay irritation, restrain inflammatory tendency and diminish superabundant secretion. Alumen. 229 In nervous asthma. In phthisis. In general it does not interfere with expectoration, the first effect is usually a copious discharge of mucus, followed by a diminution in quantity, without any oppression-of chest or other indication of im- proper interference with the secretion. Extremities.—In ingrowing nails the local application of burnt Alum will often effect a cure in three weeks, and that after extirpation of the nail had failed ; the nail must be raised up so as to expose the whole of the sore and ulcerated part, which must then be dried and the Alum applied ; the crust formed by this application must be re- moved every day and a fresh quantity applied. (4.) Skin, — Creeping and coldness of the skin, soon after large doses, followed by heat and tingling of the same parts. (10.) Clinical Remarks.—In rupia, Mr Erasmus Wilson states, that in one very obstinate case he succeeded in healing the ulcerations, after other applications had failed, by injecting a strong solution of Alum beneath the undermined edges. To the ill-favored ulcers left by ec- thyma he advises the application of a solution of Alum, with or with- out Opium. (44.) To flat naevi Dieffenbach recommends the use of a compress of lint, to be firmly bandaged on the morbid structure, and to be frequently wetted with a solution of Alum. The lint should be disturbed as little as possible and the compression maintained, if necessary, for several weeks. When the naevus becomes white, flat, and firm, its speedy cure may be expected. (44.) To chilblains an Alum poultice is stated to be.an excellent applica- tion. It is only admissible in unbroken chilblains. (44.) To indolent and other ulcers, whether of the skin or mucous mem- branes, Alum has been found serviceable. It is particularly recom- mended by Dalmas. As it causes much irritation he advises it to be combined with Opium, and made into an ointment with lard : used thus it quickly determines the cicatrization of ulcers. It occasionally gives rise to great irritation. To repress the growth of fungous granu- lations, burnt alum sprinkled over the surface is very effectual. (44.) Fever.—Fever, accompanied by intense thirst, continued nausea and vomiting, sleeplessness, agitation, animated expression of the face, pain and distension of the epigastric region, frequent pulse, and burn- ing pains in the mouth, pharynx, and stomach. (2.) Clinical Remarks.—In intermittent fever Alum was at one time much used, it having been prescribed by Ettmuller, Lindt, Muller, and others. Lange and De Hera recommend it with aromatics or Sul- phuric-acid, or Ether, and Adair wiih Cinchona. It is rarely used at the present day. (44.) 230 New Materia Medica, ALUMINA .—(Agilla.) PUKE CLAY. AUTHORITIES. Hahnemann's Mat. Med. (1.) Noack and Trinck's Mat. Med. (19.) Jahr's Symptomen Codex. (32.) Teste's Mat. Med. (36.) Peters. (11.) Marcy. (10.) GENERAL REMARKS. Alumina is allied to Calcarea, Baryta-c, Magnes.-carb., Silex, Carb.-vegetabilis and -animalis, Graphite and Sepia. Teste with characteristic flippancy and assumption asserts that it is the Sepia of chronic diseases. The development of the curative powers of this drug are solely due to Hahnemann, and even as yet but little is known about and less is done with it in the Old School. Hahnemann recommended it especially in chronic disposition to eructations lasting for years, and to colds and catarrhs of the head of very long standing. Dr. Hirschel reports several cases of inflammation of the throat, chronic gonorrhoea, chronic induration of the testes in consequence of gonorrhoea, obstinate leucorrhcea and elevated papulous eruptions, burning red, violently itching spots about the organs of generation, cured by Alumina. (26.) The above experience of Hirschel is quoted by Teste as if it was his own (see page 327 of Hempel's Translation.) In fact we may state once for all, that Teste's book contains more lying and stealing ; more flippant and unjustifiable as- sumptions, and more brazen hardihood of assertion than any modern book on the Materia Medica with which we are acquainted. Still, his style of writing is so pleasant, the compilations from various authors have been so industriously pursued, that we are half willing to forgive him his barefaced assumption of experience not his own, although we cannot forgive his putting down any happy or absurd thought, or arbitrary distinction which may enter his head as if it were the soundest and most original experience which has ever been divulged to the world. (11.) It should always be borne in mind that Alumina is one of those sub- stances which requires a high state of attenuation to develop its reme- dial powers. But when thus attenuated its atoms acquire the power of reaching those tissues for which they have a specific affinity, and of producing impressions which cannot be produced by this substance in its crude and undeveloped condition. In its natural state it is inert like crude Mercury; but when its molecules are sufficiently subdi- vided, its latent qualities become developed like the subdivided par- ticles of Quicksilver when triturated into the blue mass. Alumina. 231 In view of this fact it will be apparent that Alumina should al- ways be prescribed in a highly diluted form. Most of the symptoms of Alumina occur in the morning and evening. The symptoms are usually worse when sitting quietly, and after eat- ing; and better when walking, especially in the open air. (10.) NERVOUS SYSTEM. Nerves Of Motion.—It is homoeopathic to various pains and weak- nesses in the nerves of motion, and fibrous tissues, arising from ar- thritic, or scrofulous irritation of these parts, or from an alkaline or phosphatic condition of some of the juices or fluids of these parts. (11.) From the experiments of Roth, and several French provers we infer that it exercises a depressing influence upon the nerves of mo- tion. Thus shaking and trembling of the limbs, and paralytic weak- ness of the extremities are characteristic phenomena of Alumina. (10.) Nerves of Sensation.—It is homoeopathic to various changes of sen- sation and pains arising from the causes above alluded, to, and others which cannot be more nearly designated. (11.) Upon the nerves of sensation Alumina operates as a depressor. This is evinced by the numbness and prickling sensations which oc- cur in various parts of the body during the provings. Ganglionic Nerves.—It probably acts more decidedly upon these than upon the cerebro-spinal nerves. It is homoeopathic to various pains in internal and external parts, and to various scrofulous, arthritic or phosphatic irritations of these nerves. (11.) VASCULAR SYSTEM. Blood.—The peculiar action of Alumina upon the blood can only be vaguely hinted; it is similar to that produced by the alkalies and alkaline earths in general, approaching towards a scorbutic or scro- fulous condition of this fluid, marked by thinness of the blood, pre- dominance of the white globules, deficiency of fibrin, albumen, iron and fat, with a probable excess of water and chlorides, leading to scorbutic or dyscratic inflammations, ulcerations, and deposits. (11.) Venous System.—It may act somewhat more decidedly upon this than upon the arterial, or rather it may tend to depotentize the arterial system in strict proportion as it may tend to cause a preponderance of the venous. (11.) Capillary Vessels.—This probably is the great field of the action of Alumina upon the blood and blood-vessels ; this remedy doubtless tends to produce an excess of white blood, rather than of red; to prevent the action of the capillaries and cause various ulcerative, scorbutic and dyscratic capillary actions. (11.) In its crude state Alumina is inert. But when its atoms are suffi- 232 New Materia Medica. ciently subdivided to gain entrance into the capillary-vessels, active impressions are produced both upon the capillary blood-vessels and nerves. The same thing is true of many other substances which have acquired new powers by the process of attenuation. (10 ) Glandular System.—Alumina doubtless acts specifically upon the glands and lymphatics and upon those nerves and vessels which sup- ply and control the operation of these organs. This is evidenced by its specific action upon the cervical, follicular and other glands, and upon the testicles. (11.) MUCOUS Membranes.—Alumina seems to have a specific affinity for many of the mucous membranes, especially those of the nose, ears, throat, larynx, and sexual organs. (11.) All of the mucous membranes are more or less affected by this substanqe. It produces irritation diminished secretion, and dryness of these tissues. The character of their secretions is also changed. It likewise renders them more sensitive to atmospheric changes, and to morbid influences generally. (10.) Sei'OUS Membranes.—Its action upon these parts cannot be certain- ly made manifest; it seems to act more decidedly upon the mucous than upon the serous tissues. (11.) By penetrating the minute vessels of serous membranes, the at- tenuated atoms of this drug do undoubtedly become capable of modi- fying their vital action. Thus an indirect specific effect is exerted upon their structures. (10.) Fibrous Tissue.—It seems to be homoeopathic to various pains and disorders of the cellular or fibrous tissues, arising from or connected with a scorbutic, phosphatic or scrofulous taint of the blood. (11.) For the reasons before given, we infer that all tissues are effected to some extent, by Alumina, in consequence of its action upon the capillary-vessels and nerves. Thus, among its pathogenetic pheno- mena, we have lancinating pains and burning sensations in the carpal and tarsal articulations, pleural pains, &c. (10.) Muscular System. —Its action upon this system is doubtless similar so that exerted upon the fibrous tissues in general. (11.) It is homoeopathic to certain weakened conditions of the muscles, with diminished animal heat, tremulousness, sense of weight, stiffness, numbness and fatigue in the whole muscular system. (10.) Cellular Tissue.—It seems to act more decidedly upon the subcu- taneous cellular tissue than upon the cutis vera; at least acne, urticaria, paronychia, cellulosa, rhagades, &c, to which it is more or less homoeo- pathic are affections of the cellular tissue rather than of the skin proper. (11.) Skill.—Tingling itching on all parts of the skin, causing to scratch one's-self a great deal. Small red or white pimples and blisters here and there; especially on the hairy scalp, forehead, nose, corners of Alumina. 233 the mouth, chin, neck and shoulders, with burning and itching pains. (19.) Itching rash on the arms and lower limbs, the parts bleed after scratching. Humid scurf and gnawing tetters. The cutaneous troubles come on at every new and full moon. (32.) Itching of the mammae. Itching at the verge of the anus. (10.) Fever.—Pandiculations, lassitude with chilliness, feverish pulse, want of appetite, eructations with heaviness in the abdomen. Fre- quent chills; chilliness during the day, in the warm room, even near the hot stove; chills in the night, so as to be awakened by the same ; shaking chills ; chilliness with constant eructations, bitter taste in the mouth, flow of saliva, great lassitude, dizziness, headache, especial- ly in the temporal region as if the head would fly in pieces. Chilli- ness during stool. Creeping chills in the evening on the slightest motion, sometimes with flying heat of the face, internal chilliness, with hot hands and ears. (19.) Paroxysms of fever in the evening, consisting of chilliness and shuddering over the whole body, especially over the back and feet, sometimes accompanied with heat of the face, and alternation of coldness and warmth, or followed by heat of the body and sweat in the face, generally without thirst. Heat with anxiety aod sweat especially at night, sometimes palpitations of the heart. Morning- sweat, especially when remaining in the bed after six o'clock. (32.) Clinical Remarks.—It may prove homoeopathic to several forms of chronic dyscratic fevers, or sub-acute inflammation, and to chronic and obstinate fever and ague, with a great predominance of coldness and debility; and to slow consumptive fevers under like circum- stances. (11.) Mind and Disposition.—Long-continued weakness of memory, in- ability to concentrate the mind ; confusion of ideas. Forgetfulness. Despondency, with inclination to weep. Timidity. Fear. (19.) Joyless and desponding. Anxiety, anguish, oppressive and vague fear- fulness, uneasiness as if he had committed a crime. Ennui, no de- sire to do anything. (32.) Nervousness. Irritability. Constant restlessness and dissatisfaction, which prevents sound, refreshing sleep. (10.) Clinical Remarks.—It may prove as useful as Baryta in the hypo- chondria of aged people, and in that arising from obstinate catarrhal and dyspeptic derangement. (11.) Alumina has sometimes proved serviceable in mental depression, diminished intellectual power, and nervous excitability arising from an impaired condition of the vital forces. It is also homoeopathic in mental ailments proceeding from excessive seminal and prostatic losses. The usual concomitant, symptoms in these cases are, general mus- cular debility, numbness and stiffness and trembling of the limbs, dis- agreeable sensation of failure of vital heat, heavy beating of the heart. (10.) Scnsorium.—Vertigo on turning, stooping, walking, sitting, so as to ' 234 New Materia Medica. fall. (19.) Want of ability to recollect things. Stupid dullness and numbness of the head, particularly, early in the morning. Vertigo as if everything were turning in a circle. (32.) Clmical Remarks.—It may prove homoeopathic to the vertigo of aged people affected with an atheromatous or earthy deposit in the coats of the cerebral and cardiac arteries. It may rival Baryta in the pre- vention of apoplexy under these circumstances. It may also prove useful in brain- and other affections arising from the phosphatic dia- thesis. (11.) Vertigo or swimming in the head, when occurring as symptoms of mere debility, or impaired vital heat, have been relieved by Alumina at a high potency. But in instances of this description it can only be regarded as a remedy of secondary value. (10.) Sleep.—Yawning and drowsiness. Lies awake for a long time on account of heat and restlessness in the limbs. Sudden starting from sleep, caused by disturbing dreams. Sleep full of disturbing dreams. (19.) Restless night-sleep, he tosses about, and wakes frequently, with heat and anxiety, especially after midnight; unrefreshing night- sleep, a mere slumbering, with sensation in the morning as if he had not slept enough. Deep, sound sleep, especially towards morning; sleeps until late in the morning, he wakes with difficulty early in the morning, frequently with languor, weariness and yawning. Symptoms at night, when in bed; uneasiness in the'limbs and tossing about; anxiety, asthmatic oppression and sweat when waking; great va- riety of dreams. Symptoms in the morning on waking. Lowness of spirits as if oppressed with grief. (32.) Clinical Remarks.—The sleep-phenomena to which this drug is homoeopathic, are symptomatic of other more important derangements of the organism. Among these conditions may by ranked, diminished power of the capillary-vessels and nerves, and as a consequence, di- minished animal heat in the tissues supplied by them. (10.) Head.—Pressure, as if by a weight in the temples. Hammering and pulsating headache, constrictive headache, with shaking chills in the evening; headache after dinner, increasing by walking and in the open air; feeling of soreness of the scalp. (19.) The head feels very heavy. Compression over the eyes, from the temples, from either side of the head, mostly in the evening, sometimes accompanied with a chill, or followed by nightly heat and sweat. Sensation in the head as if the contents of the head were in a vice, with sensation of weight on the top of the head. Stitches in the brain, sometimes with in- clination to vomit. Beating in the head, in the vertex, with tumult in the head, or in the morning on waking. Heat in the head; in the forehead, ascending from the stomach. The headache abates when the head rests quietly upon the cushion. (32.) Clinval Remarks.—It may prove useful against the chronic head- aches which attend or follow obstinate or severe fever and ague. (11.) The Alumina headache resembles that arising from excessive loss • Alumina. 235 of blood. It has cured throbbing and hammering headaches, brought on by slight exciting causes, occurring in sensitive anaemic subjects, and in those who have become much reduced by copious purulent discharges. (10.) Face.—Feeling of tension of the skin of the face. Tension in the face with heat; and with drawing in the jaws and cheeks. (19.) Flushes of heat in the face, every day. Roughness of the skin of the face, especially on the forehead. Violent itching of the face. Eruptions; miliary pimples in the face and on the chin, the right side of the nose, left comer of the mouth. Blueish lips during and after the fever, chapped lips. (32.) Clinical Remarks.—It is homoeopathic to thoroughness, and pimply condition of the face and forehead, and the fissures and chapping of the lips, which attends disorders of menstruation in many young girls. Also, against the clayey and earthen complexion and eruptions of the face and lips which follow fever and ague. (11.) Eyes.—Itching and stinging in the inner canthi and lids ; pressing and burning pain in the eyes. Nightly agglutination of the eye lids, with considerable inflammation of the conjunctiva. Burning pain in the eye; obscuration of sight; watery eyes, especially in the morn- ing. Squinting of either eye. (19.) Violent itching of the canthi and lids. Burning in the eyes, early in the morning on waking. Weakness, involuntary descension of and sensation of lameness in the upper lids. Copious lachrymation. Profuse secretion of mucus, especially at night, with dry eye-gum early in the morning. Dim- sightedness as if seeing through mist. (32.) Clinical Remarks.—It is homoeopathic to the weakness of the eyes and chronic conjunctivitis, which is sometimes connected with leucor- rhcea and disorders of menstruation. (11.) It is applicable in chronic inflammations of the lids, occurring in weak, lymphatic females, who have long suffered from leucorrhcea, and diminished and painful menstrual discharges. (10.) Nose.—Ulceration of the nostrils; they are sore and scurfy, with discharge of a quantity of thick, yellowish mucus. Ulceration of the Schneiderian membrane (Ozoena) with pain in the root of the nose and the frontal cavities. Bleeding at the nose. Stoppage of the nose. Fluent coryza in the left nostril, with stoppage of the right; followed by dry coryza and complete stoppage of ihe nose. Disposi- tion to catarrh for many years. (32.) Morbid sensitiveness of the nasal mucous membrane to cold. Nasal secretion diminished, and changed to a thick, yellowish mucus. (10.) Clinical Remarks.—It is homoeopathic to ozoena, and chronic ca- tarrh; it should always be borne in mind when Baryta, Calcarea and Aurum fail to cure. (11 ) " Alnmina 30th has cured morbid sensitiveness of the nasal mucous membrane to cold, dryness and tenderness of the Schneiderian mem- brane, and itching and obstruction of the nostrils. (10 ) 236 New Materia Medica. Jjars,—Heat and redness of the ears, in the evening. Discharge of pus from the ears. (19.) Heat and redness of the ear for many evenings in succession. Humming in the ears. (32.) Clinical Remarks.—It is homoeopathic to chronic and obstinate otorrhoea arising from a scrofulous affection of the mucous membrane of the ears. (11.) Mouth.—Feeling of soreness of the buccal cavity. Increased flow of saliva, (salivation.) Constant secretion of either sweet or sour tasting watery saliva. (19.) Dry mouth, early in the morning on waking. Increased secretion of saliva, especially in the afternoon or evening. Constant secretion of saliva. Musty, putrid smell from the mouth. (32.) Dryness and irritation of the buccal mucous membrane. Clinical Remarks.—In its primary action it is homoeopathic to dry- ness of the mouth and throat, similar to that which occurs in typhoid fever ; but this may be followed by a scrofulous or scorbutic state of these parts, attended with more or less profuse secretion. (11.) In slight feverish conditions, accompanied by great dryness of the mouth and throat, and a general prostration of the muscular powers of the system, we have occasionally witnessed good effects from a high attenuation of this medicine. (10.) Teeth.—Swellings about the gums. Ulcer at the gum. Discharging blood of saltish taste. Pains in the teeth on chewing, and soreness at the roots of the teeth. Tearing pains in the molars, extending to the temporal regions. Feeling as if the teeth were too long. (19.) Bleeding of the gums. Boring in both sound and decayed teeth, in the evening, with tearing and digging. The pain is most violent when chewing and pressing the teeth against one another; in such a case, the teeth are painful as if loose, or as if ulcerated about the roots, or as if they were violently pushed into their sockets (this last sensation was experienced in old stumps. (32.) Clinical Remarks.—It may prove useful against some gum boils, and scurvy of the mouth, but it is more than probable that most of the above so-called pathogenetic effects were accidental as they were felt in decayed teeth and old stumps (11.) We see no reason why Alumina in a properly attenuated form, may not produce the above enumerated pathogenetic results. If it is true, as is generally conceded, that it exerts a special action upon the ca- pillary system, it is not unreasonable to infer that impressions may be produced upon any tissue supplied with these vessels. Besides we have seen a sufficient amount of corroborative testimony to give full credence to the truthfulness of these pathogenetic phenomena. (10.) Pharynx and (Esophagus.—Hoarseness, dryness, roughness of the throat, inducing cough. Dry cough with sore feeling in the chest. Continual dry cough, impeding breathing, and causing headache, with inclination of vomiting. Spasmodic constriction, and violent pressing pain during deglutition in the whole length of the oesophagus. Sore- ness, stinging, roughness and burning in the throat. Dryness and Alumina. 237 burning in the throat as if caused by Capsicum. Increased accumu- lation of thick, tough, tenacious saliva, of a saltish taste, causing con- tinually hawking and spitting. (19.) Tightness from the pharynx down to the stomach, as if the food could not pass through. Inflam- mation of the fauces, with redness and livid border all round. The pain in the throat is most violent in the evening and at night, less in the forenoon, relieved by warm food or drinks. (32.) Scraping sen- sation in the larynx. Pain in the thyroid cartilage on touching it. Oppression in the chest. Dyspnoea. Cough with mucous expecto- ration in the morning. (10.) Clinical Remarks.—It is homoeopathic to a very common and trouble- some chronic affection of the pharynx in which this organ looks as if it had been dried, glazed or varnished, with or without considerable redness, and always with great dryness and stiffness of the throat, and more or less hoarseness. (11.) It is quite homoeopathic in dry coughs proceeding from dryness of the mucous membrane of the throat and larynx. Also to slight, hacking, morning-coughs with easy mucous expectoration. (10.) Taste and Appetite-—Astringent, styptic, bitter, slimy, flat, insipid, metallic taste. Acid in the throat, in the forenoon, or after supper, with subsequent bitter eructations. Entire absence of hunger and appetite, irregular appetite, at times excessive, at times deficient. Hunger without appetite, even when the stomach feels empty. After eating hiccough, noon and evening violent nausea and tremor. (19. 32.) Clinical Remarks.—It is homoeopathic to those forms of dyspepsia in which there is a deficiency of gastric juice and other gastric fluids. This may allow the food to ferment, followed by flatulence and acetic acid pyrosis. (11.) The gastric secretions are diminished in quantity and changed in quality by this drug. In consequence of this change in the fluids of the stomach, indigestion, acid eructations, nausea, and variable appe- tite result, as pathogenetic phenomena. Roth and others have re- peatedly cured these ailments in weakly and scrofulous subjects, by the higher dilutions of this remedy. (10.) Gastric Symptoms.—Feeling of coldness in the stomach. Pressure in the stomach, as if from a stone, extending to the throat. Violent constriction in the stomach, extending upwards. (19.) Heartburn after supper; after drinking water; with discharge of water from the mouth; frequent eructations; with oppression of the chest. Sour taste in the evening, with burning in throat like heartburn ; acid rising with heat in the mouth. Frequent nausea; especially during the chilly paroxysms; inclination to vomit, with desire to lie down. Nau- sea, with faint feeling at night, with arrest of breathing. Vomiting of mucus and water, preceded by retching. (32.) Clinical Remarks.—Teste says he has often derived the greatest advantage from the use of this drug against diseases occurring in aged females, which had apparently been primarily seated in the sexual system, but whose peculiar symptoms had completely disap- 238 New Materia Medica. peared with the cessation of menstruation. Generally these were cases of dyspepsia, with rush of blood to the face after eating, letter- ing redness of the tip of the nose, and upon the knees, sour eructa- tions, vomiting attended with paroxysms of suffocation, and returning every now and then with such violence that the life of the patient seemed in jeopardy; these attacks of cramps in the stomach general- ly took place in the evening or at night; the vomiting was soon fol- lowed by cutting pains, spasms in the bowels, cramps in the legs, and a violent diarrhoea, which relieved the majority of the symptoms. In one obstinate case, Alumina frequently produced a surprisingly speedy improvement; the vomiting and cramps of the stomach were perma- nently relieved, but the herpetic eruption on the nose, cheeks and chin remained, and Teste says he has never succeeded in effecting a cure of this form of acne, nor does he believe that other practitioners have been more successful. Gratiola, Cicuta-virosa and Carbo-ani- malis will often do a great deal when other remedies have failed. (11.) Abdomen.—Painful sensitiveness in the region of the liver, on stoop- ing. Fullness and distention, with rumbling in the intestines. Tear- ing, pinching, cutting pains in the abdomen, ameliorated by warmth. (19.) On waking up, pinching in the abdomen and tenesmus; she was scarcely able to reach the closet, where she had to lean against the wall in a fainting fit; she had no stool, but the pain in the ab- domen ceased after a good deal of tenesmus. Colicky pinching, and tearing in the abdomen, with chilliness in the abdomen, relieved by warm clothes. Colic, attended with flatulency. Violent cutting and rumbling in the whole abdomen; the pain rises up to the stomach; this is followed by an intensely painful oppression of the chest, which arrests the breathing. Sudden sensation as of burning in the ab- domen. Pain in the region of the kidneys. Lancinations and burn- ing in the lumbar regions. Pressing in both lumbar regions towards the sexual organs in the evening. Great distention of the abdomen, attended with rush of blood to the chest, after dinner, for several days. Great distention of the abdomen, attended with empty eructations and two loose stools, without relief. (32.) Clinical Remarks.—See anus and stool. Stool and Anus.—The rectum is inactive, as if it were deficient in peristaltic motion, and had not strength enough to press the contents out. Tenesmus without stool. Deficiency of peristaltic action of the intestines. Bearing down, during an evacuation; the stools are very hard, knotty and scanty. Discharge of blood from the rectum, during and after stool. (19.) Involuntary emission of urine, occa- sioned by bearing down in order to evacuate the intestines. Stools too scanty. Stools covered all over with whitish slime, hard, pre- ceded by oppression in the region of the stomach, which ceases im- mediately after the evacuation. Diarrhoea, succeeding colic. Diar- rhoea, attended with tenesmus. Chills over the whole body during an evacuation, in the evening. Pricking in the orifice of the rectum, Alumina. 239 after a difficult evacuation. Itching and burning at the orifice of the rectum; not relieved by scratching. (32.) Discharge of prostatic fluid during a hard stool. Itching of the anus. (10.) Clinical Remarks.—Alumina is one of the most homoeopathic reme- dies against constipation from very great dryness of the bowels; it should be used more frequently than Nux and Sulphur, as should Cal- carea, Plumbum, Baryta-carb., Bismuth, &c. (11.) Dr. Ficinius has used it in Diarrhoza-acida, and dysenteries, both grave and slight. According to Scila, Alumina is not exceeded by any other ant-acid remedy for celerity and certainty of action. Erd- mann of Dorpat always used it with the greatest confidence in the diarrhoeas of children arising from acidity in the prima-viae. Dr. Wiese of Thorn gave it successfully in seven cases of diarrhoea in children when caused by errors in diet, or when the presence of acidity of the stomach and bowels was more or less evident. Scila recommends it after four years' experience not only in infants against vomiting arising from acidity and obstinate greenish diarrhoea, but also in children up to four years of age. He never gave it without benefit, and in the majority of cases it alone sufficed to effect a cure. In several old and neglected cases in which the pains were very great, the remedy had to be continued for fourteen days before a cure was effected. It is said to be far superior to Magnes.-carb., and Cal- carea. (44. 11.) Urinary Organs. —Increased secretion of watery straw-colored urine. Pressure upon the bladder. (19.) For a whole day there in no eva- cuation, either of urine or faeces. Pale urine, with turbid sediment. White turbid urine, as if chalk had been stirred with it. Burning in the urethra when urinating. (32.) Frequent desire to urinate during the night. Pain in the kidneys during repose. (15.) Clinical Remarks.—It may prove useful in some scrofulous affections of the mucous membranes of the urethra, bladder, ureters and pelves of the kidneys ; also in phosphatic diseases of the urinary organs. (11.) In one patient, an aged gentleman, who had long been troubled with frequent desire to urinate during the night, in consequence of a paralytic attack, we witnessed material benefit from Alumina 30th, every night and morning continued for one week. In less than three weeks from the first dose, the difficulty was removed. Under its use his general health greatly improved, and his appetite and spirits returned to their original condition. (10.) Male Sexual Organs.—Tickling of the sexual organs and the thighs, Painful contraction in the right spermatic cord; the testicle of the right side is drawn up simultaneously; and is also very sore and pain- ful. The left testicle is hard and indescribably painful to the touch. Want of sexual instinct. Erections. Frequent and violent erections and involuntary emissions of semen. Involuntary emissions. (32.) Augmentation of the sexual appetite. (65.) 240 New Materia Medica. Clinical Remarks.—It is homoeopathic to enlargement and indura- tion of ihe testicles and to chronic gonorrhoea. (11.) It may prove beneficial in involuntary emissions of enfeebled and nervous'patients, and in cases of increased sexual desire, but with diminished executive power. (10.) Female Sexual Organs.—Menses appearing earlier than usual but less in quantity. (19.) The menses are scanty, and last only three days. Six days before the appearance of the menses ; she has a copious flow of mucus from the vagina accompanied by tremor, lassi- tude, and a sensation as if every thing were falling out of her abdomen. During the menses pinching in the abdomen and greater lassitude than usual; bloated abdomen and too large a flow of blood. The menses appears four days too soon, preceded by violent headache, which ceased on the appearance of the menses. After the menses had ceased to flow, the body and mind felt exhausted; a little work and moderate walking laid her prostrate, and made her feel low-spirited. Leucorrhcea with which she had been troubled, ceased. Leucorrhcea. Abundant leucorrhcea. (32.) Menses diminished in quantity. Pain- ful menstruation. (65.) Clinical Remarks.-It is probably more homoeopathic to amenor- rhoea than to menorrhagia, although if Catechu, which is a powerful astringent, will produce menorrhagia, so may Alumina. Roth prescribes it in scanty and painful menstruation, and in co- pious mucous leucorrhcea. (10.) Rademacher says Catechu has been recommended against menor- rhagia ; he not only does not believe it useful, but thinks it more apt to cause than cure it. Thus he noticed in a peculiar form of nervous fever when menstruation sat in at the usual time and even was not excessive, still the women would become worse and often fell into a stupid and delirious state. He generally found Catechu a useful remedy except in adult females, in whom it brought on menstruation from eight to fourteen days before the regular time, and in excessive quantities. He once gave it to a young woman with chronic diar- rhoea, and even then the menses sat in eight days too soon. This seems to be an extraordinary effect of Catechu, as this reme- dy is said to be one of the most powerful and certain of the vegetable astringents, and contains a large proportion of Tannin, viz., from 97 to 109 parts in 200. (11.) Larynx and Trachea.—Hoarseness. Dry cough with feeling of sore- ness in the chest. Long-lasting, dry cough, almost causing vomiting and impeding respiration. (19.) Irritation in the larynx, inducing cough. Violent, short, dry cough, which lasts a good while, attended with sneezing; and tearing, lancinating and pinching pain from the nape of the neck to the right axilla. Continued dry cough, attended with vomiting and arrest of breath, and lancinating pain, extending from the left side of the abdomen to the hypochondrium and the pit of the stomach. Cough, with copious expectoration, especially early Alumina. 241 in the morning. Feeling of temporary constriction of the throat. (32.) Scraping sensation in the larynx. Oppression of the chest, with pain in the thyroid cartilage on touching it. Morning cough with easy expectoration. (15.) Clinical Remarks.—Teste says he has seen a few doses of Alumina excite and maintain for two months (?) in succession a tearing cough, every paroxysm of cough being accompanied by involuntary emission of urine, which reduced the patient to despair. Every physician in full practice must have met with such cases in which no Alumina had been given. It is homoeopathic to the dry irritating cough which oc- curs in the first stage of phthisis from scrofulous irritation of the pha- ryngeal and laryngeal mucous membranes. To hoarseness from dryness or even follicular ulceration, or thinning and absorption of the mucous membranes of the air-passages. (11.) It is useful in chronic laryngitis, with morning cough, easy mucous expectoration, scraping sensation on coughing, sensitiveness of the larynx to the touch, and hoarseness. Also in coughs caused by dry- ness 6f the mucous membrane of the larynx and trachea. (10.) Chest.—Oppressive constriction of the chest. Sharp stitches in the chest, especially in the upper parts. Palpitation with irregular beats of the heart. (19.) Stricture across the chest, accompanied by a feeling of apprehension, when stooping in sitting; it passes off on raising the head in the afternoon. Oppressive pain in the chest. Pressure in the chest, followed by empty eructations, which do not produce any relief; the pressure sometimes reaches as far as the back, and increases by walking-in the forenoon. • Violent oppressive pain in the chest at night. Erratic stitches in the chest, sometimes aggravated by breathing, sometimes burning; lancination passing like lightning from the right loin to the left side of the chest, through the pit of the stomach, when breathing; when stooping, from the left side of the abdomen to the middle of the chest, at every inspiration. Palpitation of the heart every day on walking. (32.) Clinical Remarks.—It is homoeopathic to slow and sneaking dys- cratic irritations and inflammations about the lungs and air-passages, especially when the mucous membranes and follicular and glandular parts are especially affected. In the first stage of tubercular con- sumption, when the cough is dry and hacking, or almost incessant. (11.) Back.—Pain as if bruised, in the small of the back and in the back. Stitches and cutting in the scapulae, attended with chilliness, two days in succession. Violent pain allalongthe back; stitches and twitches, so that she is unable to stoop, or to raise anything with her hand; in- creased by breathing. (32.) Pain in the kidneys during repose. (15.) Clinical Remarks.—It is homoeopathic to a weakened and relaxed condition of the kidneys, which now and then remains after acute nephritis. It is also applicable in dull pains in the lumbar region, which are chiefly experienced .when sitting or lying in bed. (10.) Neck.—Itching in the nape of the neck,' violent itching of the neck 12 242 New Materia Medica. and chest, as if bitten by fleas ; without any visible eruption; on touching the skin, hard blotches are felt here and there. Stitches in the glands of the right side of the neck. Drawing and pressure in the glands of the left side of the neck. Swelling of the glands. Stiffness of the muscles of the neck, so that she cannot turn her head to the left side. (32.) Clinical Remarks.—It is homoeopathic to acnous and urticarious erup- tions on the nape and back. . Also to chronic enlargement and indura- tion of the cervical glands. (11.) Superior Extremities.—Violent tearing from the shoulder down to the fingers. (19.) Lameness and pain as if bruised in the arms, changing from side to side. Burning sensation and tension of the upper arms and fingers, and of the left elbow, as from a red-hot iron. Lancinations in the upper arm and the elbow; the pains seems to be in the bone. Gnawing behind the finger-nails, attended with tingling all along the arm, as high up as the clavicle. Swelling of the fingers. The tips of the fingers are disposed to ulcerate. (32.) Pain in the arms when raising them, or when keeping them extended in bed. Lancinating pains in the carpal articulations when using the hands. Paralytic weight in the arms. Cracks and fissures in the hands. (65.) Clinical Remarks.—It is homoeopathic to scrofulous irritation of the nerves and fibrous tissues which simulate rheumatic pains; also to a chronic tendency to ulceration of the hands and fingers, and to sub- cutaneous corrosion of the cellular tissue, and to superficial felons. (11.) It has been employed with advantage in obstinate cases of chronic periostitis, which had resisted the action of Silicea, Mercurius, and other remedies. It has also cured deep-seated pains of the legs and arms occurring in aged, gouty, and nervous subjects. (10.) Inferior Extremities.—Tearing through the whole of the lower ex- tremities. Tired feeling and heaviness of the legs. Tearing, sting- ing pain in the knees, with a feeling as if swollen. Tingling, itching, prickling in different parts of the extremities. (19.) Pain in the left hip as if bruised. Tearing in the thighs and legs, when sitting and lying down, especially at night. Pain in the< patella on pressing the hand upon it, or on bending the knee. Pain in the sole of the foot, on stepping upon it, as though it were too soft and swollen. Herpes between the toes. (32.) Numbness and stiffness of the legs during the night. Pain and sense of fatigue in the tarsal articulations when sitting. Burning sensation in the lower part of the toes. (65.) Clinical Remarks.—It is homoeopathic to the pains and weaknesses in the back and legs which attend phosphatic diseases of the urinary organs; also to swelling and pains in the legs and feet from athero- matous disease of the coats of the arteries; to rhagades, fissures, herpes and tendency to ulceration about the toes. (11 ) Numbness and stiffness of the legs on waking from sleep during the night, and weariness and paralytic weight of the legs, have some- times been relieved by high attenuations of this medicine. (10.) Ambra-Grisea. 243 General Symptoms.—Sticking, itching, crawling as if from ants in different parts of the body, mostly disappearing after scratching. Great lassitude and prostration," especially of the lower extremities. Most of the symptoms appear after dinner, improving on exercise and in the open air. (19.) Feeling of constriction, particularly in the in- ternal organs. Scrofulous affections of the mucous membranes. In- voluntary convulsions here and there ; twitching in the limbs. Great depression of strength. Great lassitude of the whole body, with chilliness and headache. (32.) AMBKA-GEISEA. GREY AMBER. AUTHORITIES. Hahnemann, Mat. Med. (1.) Peters in Horn. Examiner, New Series, Vol.2., 1846. (11.) Marcy, (10.) Teste, Mat. Med. Roth, (65.) GENERAL REMARKS. By some the Grey Amber is supposed to be a tallow-like product from the gall-bladder of the whale; according to Pereira it is pro- cured from the sperm whale and seems to be the indurated faeces (per- haps somewhat altered by disease) of the animal. Mr. Beale collected some of the semi-fluid faeces, and found that the dried mass had all the properties of Ambergris. It has a pleasant musk-like odor, which is supposed to be derived from the squid, or Sepia moschata, on which the whale feeds ; in support of this opinion it must be mentioned that the horny beaks of this animal are found imbedded in the masses of Ambergris. Swediaux was the first to trace its origin to the sperm whale ; Lecleuse was the first to suggest that it might be har- dened and altered faeces; Home the first to hint that it might be a hardened and altered secretion from the liver of the whale, or a kind of gall-stone ; Oken supposed that it was indurated bile-resin, which opinion is strengthened by the chemical analysis of Pelletier and Caventon; while J. J. Ferey conjectured that it was a species of adi- pocere arising from the decomposition of dead Sepia-octopedia, and the other kinds of Sepia which emit an amber or musk-like odor; and bases his opinion on the fact that the beaks and bones of those cuttle-fish are found in ambergris ; but as these are also the most com- mon food of the whale, it may have a double origin, one from the faeces of the whale, and the other from the spontaneous decomposition of dead cuttle-fish. When genuine, Ambergris has a peculiarly pleasant odor, not easily described or imitated, and which is exceedingly diffusive, especially 244 New Materia Medica. in solution, so that a very minute quantity is perceptible even when mixed with other perfumes; a grain or two rubbed down with sugar, and added to a hogshead of claret is very perceptible in the wine, and gives it a flavor, by some considered as an improvement. Boswell noticed, after taking thirty grains, quickness of the pulse, increase of muscular power, and of sight and hearing; also greater activity of mind, and of the sexual power. It was formerly much celebrated as a stimulant and anti-spasmodic, supposed to produce ex- citation and strengthening of the whole nervous system, and even to prolong life. In the east, it has long been used as an aphrodisiacum; hence its action may be the opposite in this respect of that of Agnus- castus, Conium, Camphor, &c. According to Noack and F. Hof- stetter, Ambra is said to exert a remarkably specific action on the organ of hearing, and as curative effects, old school physicians have noticed increase of muscular power, relief from intellectual weak- ness, and mental depression, increased power of seeing and hearing, and increase of the sexual power and fluids. Its action has been compared by old school physicians to that of Musk, Castor, Coffee, Valerian, &c, &c. It had also an ancient reputation for causing the re-appearance of suppressed eruptions, such as itch and herpes. On account of its stimulating properties Chaumeton and Cloquet, were led to give it in typhus fever. Musk according to Pereira is an irritant to the stomach, a stimulant to the brain and vascular system, and afterwards proves narcotic; for it causes eructation, sense of weight in the stomach, decrease or in- crease of appetite, gastralgia, nausea, vomiting and diarrhoea ; also frequency and fullness of the pulse, heaviness of the head, vertigo, headache, predisposition to epistaxis; and occasionally it brings on the menses; these effects are followed by disposition to sleep, heavi- ness of the whole body, and lastly long and deep sleep. In large doses it may bring on faintness, trembling in the limbs, and even con- vulsions. Yet it is • regarded by old school physicians as a most powerful anti-spasmodic, and nervine. Valerian causes headache, mental excitement, flashes of light be- fore the eyes, scintillations, giddiness, restlessness, agitation, and cold spasmodic movements ; in some it causes great agitation, and hea- viness of spirits; it accelerates the pulse, and augments the heat of the body. It intoxicates cats, who are very fond of it, rolling them- selves over the ground in outrageous playfulness, being violently agi- tated. Yet it is used to soothe nervous excitement, and as an anti- spasmodic. (11.) General Symptoms.—Talking irritates her, she is attacked with trembling through the whole body, especially in the lower extremities, and has to be alone for some time in order to rest herself. The symp- toms decrease by walking in the open air, but return when sitting. Profuse sweat, when walking, mostly on the abdomen and the thighs. Sweat over the whole day. Itching pver the whole body. The itch Ambra-Grisea. 245 is reproduced upon the skin, with a good deal of itching. Tetters are reproduced. Early, on waking up, the skin feels numb and is in- sensible as far as the knees, without being cold; the hands have but an indistinct sensation; the skin seems to have gone to sleep, but there is no tingling. Twitching in the limbs, and coldness of the body at night. When walking in the open air, one feels an agitation in the blood; the rapidity of the circulation increases, accompanied by greater weakness of the body. (1.) Spasms and convulsions of the muscles. Tearing or crampy pains in the muscles; aching pains in internal organs; single parts easily go to sleep. Jerks and twitch. ings of the limbs, the whole night, with coldness of the body. (32a Mind and Disposition.—Uneasiness the whole day, the chest feeling oppressed. The mind feels uneasy and agitated. Hurriedness in performing some mental labor. Irritated mood. She is irritated, lo- quacious ; talking fatigued her, unable to sleep at night, headache as if a heavy load on her head; oppression of the chest, had to sit up in bed, and was attacked with anguish and sweat all over. Distorted, grimaces, diabolical faces crowd upon his fancy; he cannot get rid of them. Anguish and tremor. Great depression of spirits. Despair. Constant alternation of depression of spirits and vehemence of temper. (1.) Anxiety in the evening. (32.) Clinical Remarks.—It is homoeopathic to despondency occurring in persons of a dry, bilious temperament. It is also applicable in great depression of spirits, and anxiety which are sometimes met with in highly nervous and sensitive organizations. (10.) Sensorium.—Feeling of faintness. Vertigo and a feeling of weak- ness in the stomach. Failing of strength; the knees give way. Dull- ness of the head, every morning the head feels muddled as after night- ly revelling, in the occiput; tensive; stupefying; great weakness of the head, with chilliness about the head, or vertigo. He feels con- stantly as if dreaming; stupid ; is not able to reflect upon any thing properly. Vertigo, violent,even dangerous; in the forenoon and after- noon, Alien walking in the open air. (32.) Clinical Remarks.—It has been successfully prescribed in stupid, dull conditions of the mind which often exist after excessive mental excitements, protracted grief, anxiety, &c. It has cured vertigo, with great nervous debility, sense of fatigue and general prostration of the forces of the system. (10.) Head.—Violent vertigo. Uncommon, even dangerous vertigo. He is always as if he were in a dream. Great weakness of memory. Headache every morning ; the head feels empty and desolate. Ob- tusion of the occiput. Oppressive headache in the forehead. Con- gestion of blood to the head for two days. Traction or tearing in the head, to and fro. When making an exertion, he experiences a lanci- nating and cutting headache. Falling off of the hair. Headache Vecomes tearing, and leaves behind it a certain obtusion of the head. (1.) Tearing in the head; on the top of the head and in the sinci- 246 New Materia Medica. put, with paleness of the face and coldness of the left hand. Stitch- ing and darting pains through the head. (32.) Clinical Remarks.—We have witnessed good effects from Ambra in cases of chorea accompanied by fits of severe headache in the vertex, occiput, and temporal regions. Also in neuralgic headaches of hysterical females. (10.) Eyes.—Tearing pain and lachrymation of the eyes. Pressure upon the eyes, which can only be opened with difficulty; pain in the eyes, as if they had been closed too firmly, especially early in the morning. Distended veins of the white of the eyes. Itching of the eye-lid, as if a stye would form there. Great obscuration of sight. (1.) In- flammatory redness of the white of the eye and injected condition of the vessels. (32.) Clinical Remarks.—Ambra apparently afforded decided benefit in a case of incipient amaurosis and partial loss of hearing in an old gentleman whose nervous system had become much impaired by grief for a domestic affliction. Under the use of this remedy at the 12th dilution both difficulties were nearly removed. (10.) gars.—Tearing in the right ear early in the morning, and frequent- ly in other places. Roaring and whistling in the ear, in the afternoon. Snapping, as of a spark from the electric machine, and noise as when winding up a watch Deafness of one ear. Hearing decreases every day, five days in succession. Violent tearing pain in the lobule and behind it. (1.) Tingling itching and titillation of the ears. (32.) Clinical Remarks—It has cured partial deafness, which had been preceded and accompanied by ringing in the ears, and great general debility. (10.) Nose.— Cramps of the right wing of the nose, towards the malar bone. Great dryness of the inside of the nose, although air passes through easily. Dried blood gathers in the nose. Bleeding from the nose early in the morning. (1.) Frequent sneezing, with tingling and dryness of the nose. Stoppage of the nose. (32.) Face.—Spasmodic trembling of the muscles of the face. Flying heat in the face. Jaundice-colored face. Pimples and itching in the whiskers. Tension of the check, as from swelling. Tearing in the upper part of the face, particularly near the right wing of the nose. (1.) Cramps of the lower lip. (32.) Clinical Remarks.—A middle aued lady, of a full habit, and pre- disposed to apoplexy, who had long been troubled with frequent flushes of heat in the face and head, was cured in three weeks by the 30th dilution of this medicine, a dose being taken morning and even- ing. (10.) Ja\VS and Teeth—Spasm of the lower lip. Stitching-aching in the jaws Pain in the jaws, as if they were being screwed together, or asunder. Considerably swollen and painful gums. Drawing pain, sometimes in the teeth of the right, sometimes in those of the left side. Bleeding of the teeth. (1.) Ambra-Grisea. 247 Mouth.—Fetid odor from the mouth. Tongue, mouth and lips fed quite numb and dry, early on waking up, accompanied, by a total want of thirst for several days. Smarting, and sensation of excoriation, in the interior of *he mouth; pain prevented her eating anything acid. Feeling of contraction in the salivary glands. (1.) Vesicles in the mouth, which occasion a pain as if they had been caused by a burn; little blotches under the tongue resembling small vegetable growths and feeling sore. (32.) Clinical Remarks.—It is homoeopathic to bad breath arising from imperfect digestion. The accompanying symptoms are usually, nausea, sense of weight at the pit of the stomach, heartburn, empty or acid eructations. (10.) Throat.—Rawness of the throat, as from a cold, for some days. Tear- ing in the interior of the throat, and in the back part of the fauces. Sore throat, as if something impeded deglutition. Secretion of mucus in the throat, with roughness and rawness. (1.) Clinical Remarks.—We have cured with Ambra, spasmodic choking in the throat when attempting to drink, in patients affected with hys- teria and cholera. (10.) Gastric Symptoms.—Frequent, empty eructations. Violent eructa- tations after dinner. Frequent, sour eructations. Heartburn, with suppressed eructations, when walking in the open air. Bitter taste in the mouth, early when waking up. Nausea after breakfast. (1.) Nausea and vomiting. (32.) Clinical Remarks.—In weak and nervous persons who suffer from indigestion, with distress in the stomach after eating, nausea, empty, or acid eructations, heartburn, bitter or pasty taste in the mouth, and depression of spirits, this is a remedy of considerable value. It re- moves both the dyspeptic symptoms, and gives tone and strength to the nervous system. (10.) Stomach and Hypochondria.—Burning in the stomach. Qualmish- ness about the stomach. (1.) Feeling of weakness in the stomach, obliging him to lie down, accompanied with vertigo. Pressure at the stomach, with tension or stitches below the pit of the stomach at night; spasm of the stomach. Pressure in the region of the liver. (32.) Clinical Remarks.—It has. cured burning and slight spasmodic pains in the stomach, sense of tightness over the region of the stomach and liver, sinking and weakness at the pit of the stomach. (10.) Abdomen.—Pressure below the scrobiculus cordis and in the hypo- gastrium, from time to time, also at night. Pressure in the epi- gastrium, hands and feet being cold. Aching in a small place.in the right side of the abdomen, in the region of the liver; the pain is not felt when touching the parts. Tension and inflation of the abdomen after every meal, even every time he swallows a drink. Clawing pain in the right iliac region. First clawing pain in the abdomen, 248 New Materia Medica. tnen, a little cutting in the epigastrium, which goes off by an eructa- tion. Incarceration of flatus. Violent colic in the evening. Colic, with a soft stool, early in the morning, two mornings in succession. Colic, with diarrhoea. (1.) Violent spasm in the abtlomen. Cutting in the abdomen; very violent in the evening; after midnight, with general sweat ; accompanied with loose diarrhoeic stools, early in the morning. (32.) Clinical Remarks.—It is appropriate in cases of distention of the abdomen, cramp-like pains and pressure in the abdomen, tightness extending from the stomach and liver, over the entire abdomen. (10.) Stool and Anus.—Tenesmus of the rectum. Scanty stools. Con- stipation. Itching of the anus. Stitches of the rectum. A quanti- ty of blood is passed with the soft stool. Pressure deep in the hypo- gastrium after the evacuation. (1.) Constipation, scanty stools, irre- gular, intermittent stools, sometimes every other day. (32.) Urinary Organs.—Pain in the rectum and simultaneously in the blad- der. The urine is turbid already while being emitted, yellow-brown; and formed a brown sediment. Bloody urine. Diminished secretion of urine. Frequent micturition at night. Urgent desire to urinate, early after rising, he often cannot retain his urine. Burning in the orifice of the urethra and rectum. Twitchings in the urethra and testicles. Tearing in the glans. (1.) During micturition : burning, smarting, itching and titillation of the pudendum and the urethra. (32.) Genital Organs.—Pain in the glans, as from ulceration. An itching pimple on the male parts of generation. Internal burning in the region of the seminal vesicles. Burning, biting, tickling and itching of the pudendum and the urethra during micturition. Swelling, soreness, and itching of the labia pudendi. Itching of the glans, which continues when sitting, lying, standing, or walking. Vehement, voluptously- delightful feeling in the interior of the genital organs, without any considerable erection or irritation of the external organs; this feeling continues for hours. The menses appear too early. Haemorrhage from the uterus. Profuse leucorrhcea at night. Discharge of blueish- white clots of mucus from the vagina. Leucorrhcea consisting of thick mucus, increasing from day to day, each discharge being pre- ceded by a stitch in the vagina. (1.) Clinical Remarks.—Roth commends it against mild leucorrhcea, only during the night, with stitches in the vagina before the discharge. It has occasionally been employed as an aphrodisaic, but with doubt- ful success. (10.) Larynx and Chest.—Accumulation of a greyish mucus, difficult to cough up, with scraping in the throat. Burning tittillation from the larynx to the abdomen. Tickling in the throat inducing cough. Cough, excited by a scraping sensation in the throat, only at night; occasioned by an excessive irritation ; every evening, with pain under the last ribs, as if something were torn off. Deep, dry cough, with Ambra-Grisea. 249 confluence of water in the mouth, and subsequent scraping in the throat. Spasmodic cough. (32.) Clinical Remarks.—In spasmodic, night coughs proceeding from irritation and tickling of the throat, this remedy is quite efficacious. Also in the short, hacking coughs which are often observed in hys- terical females. In a few instances we have,used it successfully in severe nightly paroxysms of hooping-cough. (10.) Chest.—Cough only at night, produced by an excessive irritation in throat. Accumulation of greyish phlegm in the throat, difficult to raise, with rawness of the throat. Violent convulsive cough, accom- panied by frequent eructations and hoarseness. Deep, dry cough, with accumulation of water in the mouth, and subsequent rawness in the throat. Burning in the chest. Stitch in the chest, extending to the back. Violent, dull stitch in the right mamma, intercepting the respiration. Wheezing in the chest. Oppression at the chest. Op- pression at the chest, with much uneasiness the whole day. Tight- ness of chest; she cannot breathe deeply, and yawning cannot reach its natural termination. Anguish about the heart, increasing even to the extent of arresting the breath, with flying heat. Palpitation of the heart, when walking in the open air, with paleness of the face. Violent palpitation of the heart, with pressure in the chest. Pressure in the praecardial region. Aching pain in the chest. Rheumatic pain on the right side of the chest, below the arm. Tearing pressure in the left side of the chest. (1.) Nightly tremor of the chest. (32.) Clinical Remarks.—It 'is indicated especially in oppression and tightness of the chest, increased by the slightest exertion; in asthma- tic respiration; shortness of breath, with great general debility, in scrofulous or cachectic subjects; also in accelerated circulation, pal- pitation of the heart, and prostration coming on after exercise in the open air. (10.) Back.—Violent pressure in the lower part of the small of the back. Single, violent, sharp stitches in the small of the back, inc- ed by the slightest motion. Painful tension in the muscles of inc. loins. Rheumatic pain in the back, on the right side. Pain in the back, as if the intestines were being compressed, with a heaviness in the back, as if he were not able to right himself. Stitches, burning in the sca- pula. Rheumatic pain in the right scapula. Drawing ache in the nape of the neck. Tearing in both shoulders. (1.) Superior Extremities —Tearing in the left shoulder-joint. Feeling as if sprained, paralysed. Numbn of the arms. Twitching in the arm. Tearing in the elbow ana lorearm. Arms and hands go to sleep at night. Cramps in the hands; fingers drawn crooked. Temporary paralysis of the hands. Painful coldness of the hands. Icy coldness of the hands in the evening. Tearing, stinging, stitches in the hands and fingers. Traction in the fingers and the thumb. (1.) Clinical Remarks.—We have seen the following group of symp- toms gradually disappear under the use of Ambra; great general de- 250 New Materia Medica. bility and nervousness, habitual coldness of the hands, numbness and prickling of the arms and hands, occasionally spasmodic pains first in the hands, and afterwards extending up the forearms, tremulousness of the arms and legs on speaking, or making any exertion. (10.) Inferior Extremities.—Tearing in different regions of the hip. Tear- ing in the left leg. Rheumatic tearing in the right leg. Heaviness of the legs. Tension in the thigh, as if the tendons were too short, especially when walking. Feeling of numbness in the limbs. Tem- porary paralysis of the knee. Cold feet. Cramps in the legs and almost every night, cramps in the calves. Tingling in the feet, they feel numb ; after rising, he felt like fainting ; darkness before the eyes; he could not remain up ; he had to vomit and lie down again. Arthritic pain the articulations of the foot. Stiffness of the feet; they feel weary and exhausted. Itching and burning of the soles of the feet; not removed by scratching. (1.) Clinical Remarks.—Ambra has proved curative in general loss of muscular strength and habitual coldness of the legs, frequent cramp- like pains in the calves of the legs and thighs, legs often feel as if asleep, trembling of the legs after walking, or making any exertion. (10.) Skin.—Numbness of the skin all over, as if gone to sleep, early in the morning on waking. Itching and burning of many places of the skin, as if from the itch; causes suppressed itch and herpes to re- appear upon the skin. Burning herpes. Dryness of the skin. (32.) Clinical Remarks.—It has cured prickling sensations in the skin, accompanied by coldness and diminished sensation of the affected part. It has afforded temporary relief in habitual and long-standing itching of the skin. (10.) Fever.—Chilliness with great weariness, as if he would go to sleep, four forenoons in succession, going off after dinner ; commencing in the morning with numbness and pain about the head, which goes off in the open air ; with headache after diarrhoeic stools; at night coldness of the body and twitches of the limbs, with restless, or in- ternal chilliness ; chilliness of single parts, followed by heat in the face. Flushes of heat with anxiety about the heart. Profuse night- sweat, two nights in succession. (32.) Sleep.—Uneasy sleep with anxious dreams. Vexatious, anxious dreams and talking while asleep, for eight nitjhts. Uneasy sleep at night, owing to coldness of the body and twitching in all the limbs. Startings as with fright in the evening, when falling asleep. (1.) Drowsiness in the day time ; inclination to stretch one's limbs. Rest- less night-sleep, full Df dreams. On waking early irt the morning, great weariness, especially in the upper part of the body, dullness of the head, nausea in the pit of the stomach. (32.) Clinical Remarks.—Perry has used it successfully in cases of sleeplessness from nervous irritation, with headache, anxiety, lassi- Ambra-succinum. 251 tude, general oppression of the system, and copious sweats. He also commends it in disturbed and unrefreshing sleep, causing the patient to wake up much fatigued, and with an indisposition to make the slightest effort. (10.) AMBKA-STJCCIN'UM. Ambra-succinum, or Ambre-jaune, as it is called by the French, is a kind of fossil resin, derived probably from extinct coniferae, occurring generally in small detached masses, in alluvial deposits, in different parts of the world. It is found chiefly in Prussia, and also occurs in considerable quantities near Catania in Sicily. It is most frequently associated with lignite, and sometimes encloses insects and parts of vegetables. In the United States it was found in Maryland at Cape Sable, near Magorthy River, by Dr. Troost. In this locality it is found associated with iron pyrites and lignite. It has also been dis- covered in New Jersey. . Amber is a brittle solid, generally in small irregular masses, per- manent in the air, having a homogenous texture, and vitrious fracture, and susceptible of a fine polish. It becomes negatively electric by friction. Its color is generally yellow, either light or deep; but it is occasionally redish-brown, or even deep-brown. It has no taste and is inodorous unless heated, when it exhales a peculiar, aromatic, not unpleasant smell. It is usually translucent, though occasionally trans- parent or opaque. Its specific gravity is about 1,07. Water and alcohol scarcely act on it. When heated in the open air it softens, melts at 548°, smell, and at last inflames; leaving after combustion, a small portion of ashes. Subjected to distillation in a retort fur- nished with a tubulated receiver, it yields, first, a yellow acid liquor; and afterwards a thin yellowish oil, with a yellow waxy substance, which is deposited in the neck of the retort, and upper part of the receiver. This waxy substance exhausted by cold ether of the part soluble in that menstruum, is reduced to a yellow micaceous substance, identical with the chrysene of Laurent. A white crystalline sub- stance, identical with the idrialine of Dumas, may be separated from the micaceous substance by boiling alcohol. Both chrysene and idri- aline are carbo-hydrogens. As the distillation proceeds, a consider- able quality of combustible gas is given off, which must be allowed to escape from the tubuline of the receiver. By continuing the heat the oil gradually deepens in color ; until towards the end of the dis- tillation, it becomes black and of the consistence of pitch. The oil obtained is called oil of amber, and the acid liquor is a solution of impure Succinic-acid. When Amber is distilled repeatedly from Nitric-acid, it yields an acid liquor, from which after it has been neu- tralized with Caustic-potassa; ether separates pure Camphor. Cam- 252 New Materia Medica. phor is also obtained by distilling to dryness powdered Amber, with an extremely concentrated solution of Caustic-potassa.. (7.) General Remarks.—In epilepsy, Amber was at one time much esteemed. It is well spoken of by Riverius, Beattie, Cullen and others. It has now fallen into disuse. In hysteria and some nervous and spasmodic affections it was employed, but is now rarely prescribed. (44.) Chest. Clinical Remarks.—In hooping-cough it was formerly employed. Dr. Alnatt considers that he has seen benefit from the application of a liniment, composed of equal parts of Succinic-oil and spirits of Hartshorn, well rubbed into the spine, night and morning. The bene- fit derived was probably due to the friction employed. (44.) AMMONIUM-ACETICUM. acetate of ammonia. {Sjpiritus-Mindereri.) AUTHORITIES. Waring's Therapeutics. (44.) Pereira's Mat. Med. (3.) Wood and Bache's Dispensatory. (7.) Vogt's Mat. Med. (20.) Dierbach's Mat. Med. (6.) Peters. (11.) Frank's Magazine. (4.) GENERAL REMARKS. The experience with this medicine is almost wholly clinical. It is usually regarded as refrigerant and diaphoretic, when given in doses of 31J. to 3viij. two or three times daily. Externally it has been applied as a lotion and collyrium. (44.) Dierbach regards it as the only specific diaphoretic remedy, with the exception of Dover's powders ; he regards it as one of the most powerful and certain reme- dies for the promotion of transpiration and perspiration. It is a very great favorite and unusually frequently used remedy in the dominant school, being used almost universally for the production of crises through the skin in febrile diseases, although it is less useful in the commence- ment of severe attacks when the fever and inflammation are violent, than when these have already somewhat abated and a skin crisis is about to occur, or as Wendt says, when there is a cutis-mollis et trac- tabilis. As it not competent to the removal of any severe febrile or inflammatory disease it is only used in the milder forms of synochal, irritative, typhoid fevers, and rheumatic fevers, and then generally has to be aided by other remedies; in gastric and bilious fevers after suf- ficient evacuations have been supposed to be effected; but more especially in catarrhal rheumatic fevers, as these are supposed to be attended with check of perspiration ; it has also been used in rheu- Ammonium-aceticum. 253 matic anginas, rheumatic pleurisies and pneumonias; in exanthematic fevers, such as measles, scarlet fever and small-pox, to aid the out- break of the eruption when this is retarded. In dropsy from checked perspiration, or injury of the skin, such as occurs after scarlet fever and in Bright's disease. On account of its ammoniacal basis it is supposed to approach somewhat in its action that of the exciting or stimulating remedies, although it causes so little heat of skin and activity of pulse that it has been regarded as the most excellent diaphoreticum non-calidum; but still it is regarded as better adapted to feeble constitutions, and to typhoid and debilitated states than most other allopathic antiphlogistic remedies. On the other hand, the neutralization of the Ammonia by means of the Acetic-acid renders it somewhat similar in its action to that of the neutral salts, although it is not so depressing and debilitating. Again, like vinegar and some other acids it is supposed to exert a peculiar action upon the biliary and urinary organs. This remedy was first made known to the medical public in 1621 by Raimund Menderer, a physician in Augsburg, but it did not re- ceive much attention until Boerhaave noticed it in 1732, in his Ele- ments Chemiae; it next found entrance into the Edinburgh pharma- copia in 1756. But singularly enough, some able writers on the Materia Medica, such as Sobernheim suppose that Boerhaave first discovered the remedy, and worst of all that Menderer was a Scotch physician who robbed him of the credit due to him. (11.) on the nervous system. Nerves of Motion. —This remedy is supposed not to exert the same irritating aption upon the spinal system and nerves of motion which the other ammoniacal remedies are known to do. Thus, Christison says that the second group of the order of alkaline poisons including Ammonia with its salts and the sulphuret of potassa have a double action on the system, for beside their local effects, they produce through the medium of the blood a disorder of some part of the nervous sys- tem closely resembling tetanus. (11.) Nerves Of Sensation.—With the exception of the relief of pain in dysmenorrhcea, the Acetate of Ammonia is not known to act specifi- cally upon the nerves of sensation ; but as dysmenorrhcea often depends upon the congestion of a womb which has not a sufficient outlet, and Acetate of Ammonia causes scantiness of menstruation, it may re- lieve the pain merely by lessening the congestion. (11.) Ganglionic Nerves.—It is supposed that this remedy acts more de- cidedly upon the ganglionic nervous system, especially that portion of the great sympathetic'nerve which controls the functions of the arterial system than upon any other portion of the nervous system. 254 New Materia Medica. VASCULAR SYSTEM. Heart and Arteries.—Sobernheim says it causes some increased heat of skin, together with a quicker, fuller and more undulating pulse, but that these phenomena cease on the breaking out of the perspira- tion which it is the specific action of the remedy to cause. (11.) VcilOUS System.—We have no absolute proof of any action upon this system, although some authors think that it acts upon the portal sys- tem and biliary organs like vinegar and the Muriate of Ammonia. (11.) Glandular System.—Vogt supposes that it acts specifically upon the lymphatic system like the Muriate of Ammonia. (11.) Fever. Clinical Remarks.—In febrile and inflammatory affections, and ex- anthemata, those medicines which determine freely to the skin are best calculated to afford relief. Of these, none will generally answer the purpose more uniformly than Liq.-Ammon.-A. It also forms a good auxiliary to more active measures. (44.) In inflammatory dropsy, Dr. Todd found Liq.-Am.-Acet. a very va- luable sudorific, particularly when combined with small doses of Tar- tar-emetic. Skin.—The solution of Acetate of Ammonia is a valuable diapho- retic much employed in the dominant school in febrile and inflamma- tory diseases. (7.) The late Dr. A. T. Thomson used it as a lotion with good effect in porrigo affecting the scalp. (7.) Face. Clinical Remarks.—It is sometimes used externally as a discutient, and Mr. Brande speaks of it as an excellent application in mumps, when applied hot on a piece of flannel. (7.) Pharynx and (Esophagus. Clinical Remarks.—In tonsillitis, the febrifuge mixture, (Liq.-Am., A. fj., Spts.-Ether-nitr., Vin.-Ant.-tart. a a, gij., Aq. fivss. M. Dose fiss. twice or thrice daily) will be found very useful, at the same time that the following formula may be advantageously used as a gargle. R. Liq.-Ammon.-acet., Spts.-Vin-rect. a a fj , Aqua fiv. M. Genital Organs. Clinical Remarks.—In the hydrocele of children it is strongly re- commended by Dr. Maushner, applied by means of compresses kept constantly moist. (7.) In dysmenorrhea it has been strongly advised by Cloquet and Patin. They found it very successful in relieving the paroxysms of pain. (44.) Kopp praises this remedy very highly, as a palliative in dys- menorrhoea; he give a tea- or dessert-spoonful every hour from the commencement of the pain until its relief; it only palliates, but is not severe in its action and does not produce secondary affections. Case 1.—A lady, aged 21, married for three years, without having Ammonium-aceticum. 255 any children, suffered most severely every monthly period with the most violent pains in the pelvis and back; on examination the uterus was found unusually small, and with a remarkably diminutive os; Spts.-mindereri was the only remedy which afforded any relief. (4.) Case 2.—A lady had suffered for seven or eight years at every monthly period with such violent pains lasting for five or six hours, until the free flow of the menses, that she threw herself about the bed in agony; every variety of treatment failed to relieve her until she took two doses of Spts.-Mindereri, fifty drops per dose, at an in- terval of a half hour; the pains were lessened by the first dose and ceased entirely after the second. At the next period, she took thirty- six drops on the first approach of pain, and the pains instead of in- creasing with great rapidity as usual, abated considerably; another dose was taken at the end of a half hour, followed by entire relief; the menses flowed for the first time without pain, and the lady was able to go about in two hours. (4.) Case 3.—A maiden, aged 19, with scanty menstruation, suffered for four or five days before each period with weight in the pelvis, pains, violent headache, nausea, vomiting, restlessness and sleepless- ness. These sufferings, which lasted five or six days, increased in severity from their commencement, until a scanty three days' men- struation sat in. Spts.-Mindereri, sixty drops in two doses removed almost all the symptoms, and when they re-appeared again on the third or fourth day, another dose again removed them all. After the use of this remedy for three months, menstruation occurred without pain, but was decidedly more scanty in quantity; when it was omitted menstruation again became more abundant, but was also attended with pain. (4) Case 4.—A young lady, aged 25, in addition to painful menstrua- tion, had a violent dry cough and great oppression of the chest at each monthly period. Spts.-Mindereri removed all the symptoms, but also lessened the flow quite decidedly. (4.) In dysmenorrhea Colombat says, with the view of producing a more rapid sedative action upon the uterus and to overcome the painful tormina which accompany the discharge we may give from forty to seventy drops of Spts.-Mindereri, in a glass of plain or sweetened water, at two doses. It allays the pain and in that way facilitates the flow of the menses; the first dose should be given as soon as the ma- laise and uterine pains are felt, and the second in a half hour; if the symptoms do not improve, a third dose may be given, but with some reserve in order to avoid what sometimes results from it, a diminution in the quantity of the flow. (11.) In menorrhagia and organic disease of the womb.—A married lady, aged 34, who had been much reduced by profuse menstruation, had had all the signs'of consumption and organic disease of the womb, for two years. She had lancinating pains in the womb, decided in- crease in the size and hardness of the organ, with ulceration, and pro- fuse discharge of sanious, very offensive pus mixed with shreds of 256 New Materia Medica. organic matter and black coagulae. Walking and sitting were very painful; and all her sufferings were much increased at the monthly period; the abdomen then became exceedingly tense and painful, so that the slightest touch could not be borne ; the lancinating pains be- came so incessant as to deprive her of all rest, and led in the course of a few days to a state of exhaustion which was only interrupted by frequent convulsive shocks and loud cries. At the end of five or six days of suffering, profuse menstruation would occur and relieve her from her intense suffering, but plunge her into a highly dangerous state of exhaustion. (4.) After the use of all other means, forty-drop doses of Spts.-Mind. was given on the second day of a monthly period, when all her suffer- ings had reached their height; the pains abated rapidly and ceased entirely in twenty minutes; and the menses became less abundant. Henceforth, thirty or forty drops would always relieve the lanci- nating pains and control, although not entirely abate the haemorrhage. The next monthly periods occurred without much suffering and the flow was .decidedly lessened. Examination by touch and speculum proved that the womb had lessened in size, the ulcerations had also improved and some of them seemed on the point of cicatrizing; the discharge was less abundant and offensive and she could sit and walk without pain. (4.) Case 2.—A lady, aged 32, had suffered with frequent menstruation and so abundant that she became decidedly weaker and thinner ; she also had a habitual dry cough, oppression of the chest, nausea, vo- miting and poor digestion; finally the menses occurred as often as twice a month, leaving her only four or five free days, and all her other symptoms were aggravated; Spts.-Mind. was given in twenty- drop doses, night and morning, followed by gradual diminution of the haemorrhages, so that in three months, the menses occurred only re- gularly once a month and lasted only four days; the other symptoms also disappeared gradually with the exception of the cough, which was also much better. (4.) Case 3.—A lady, aged 37, subject to profuse menstruation, lasting for ten or twelve days; followed by leucorrhcea, had had six miscar- riages, followed by dangerous haemorrhages ; these were succeeded by dry cough, attended with oppression of the chest, increasing in intensity with the metrorrhagia, which at one time lasted for three months, attended with heat in the genitals, extending through the whole abdomen, increase of cough, oppression, loss of appetite, nau- sea, vomiting, emaciation and daily loss of strength. Finally, her face became earthen, eyes dull, emaciation' great, skin hot and dry; pulse frequent, small and threadlike ; cough dry and frequent; oppres- sion constant; burning heat in the abdomen, entire loss of appetite, obstinate constipation, violent pain in epigastrium.and between the shoulders, burning thirst, constant nausea and frequent vomiting of mucous matters ; the lower portion of abdomen was tense and very painful. The neck of the womb was hot, soft, much enlarged and Ammonium Carbonicum. 257 sensitive, and the slightest touch caused bleeding; with all these sufferings she had an incessant inclination for coition. Spt. Mind. was given in forty drop doses, three times a day; in three days the haemorrhage had lessened three-fourths, with entire relief from the ac- companying symptoms; the sexual inclination had also almost ceased. On examination, after six weeks'treatment, she was found almostnatural in size ; and in three months she recovered her former flesh, strength and health. (4.) AMMONIUM CARBONICUM. CARBONATE OF AMMONIA. SUBCARBONATE OF AMMONIA. VOLATILE SALTS. SALTS OF HARTSHORN. BAKER'S SALT. AUTHORITIES. Hahnemann. (1.) Orfila. (2.) Pereira. (3.) Noack and Trink's. (19.) Jahr. (32.) Reil. (29.) Marcy. (10.) Peters. (11.) Wood and Bache. (7.) Waring's Therapeutics. (44.) Christison. (9.) GENERAL REMARKS. Carbonate of Ammonia is formed during the putrefaction or de- structive distillation of those organic substances which contain nitrogen. The anhydrous neutral carbonate can only be obtained by bringing together dry carbonic-acid and ammoniacal gases. Composition. One eq. of Nitrogen and three eq. of Hydrogen. An impure neutral carbonate may be made by submitting to dis- tillation in water a mixture of sal-ammoniac, and carbonate of soda or potash. One equivalent or fifty-four parts of the hydrochlorate of ammonia reacts on one equivalent or seventy parts of carbonate of potash, and yields one equivalent or seventy-six parts of chloride of potassium, one equivalent or nine parts of water, and one equivalent or thirty-nine parts of Carbonate of Ammonia. Carbonate of Am- monia is a constituent of rain water. (2.) Combined with Nitric-acid it is found in the Extract of Hyoscia- mus; in the distilled water of Lettuce; in the root of Helleborus- niger; and in the leaves of Aconitum-napellus. (11.) Finally, Ammonia is developed from the decomposition of most organic substances which contain nitrogen. It is also found in the urine of man, in combination with Phosphoric, Hydrochloric, and Uric-acids. (11.) Carbonate of Ammonia possesses the singular property of retain- ing permanently in a liquid state, the milk of the India Rubber tree. It not only prevents the milk from coagulating, but preserves it from decomposition. We have experimented with this liquid rubber se- ll 258 New Materia Medica. veral years after it has exuded from the tree, and have ascertained that it has retained all its peculiar properties perfectly. We doubt whether there is any other substance known, which ia capable of producing this effect upon the milk of rubber, for I have tested almost every conceivable article to effect the object, but with- out success. It operates in a similar manner upon the blood, in preventing coagulation and retaining it in a liquid state. From its influence upon liquid rubber in preventing decomposition, we may infer that it will exercise a similar effect upon the blood. If this be true it must prove a valuable remedy in those maladies which are accompanied by a crude condition of the blood, and an unusual tendency to decom- position of this fluid. Theoretically we should commend it in typhus, malignant scarlatina, malignant erysipelas, and diseases of a similar character. (10.) It is readily absorbed into the blood, and appears to act specifically upon the nervous system, especially upon the vertebral column. Its action is nearly the same when injected into the veins. In the first place, its effects are chiefly manifested upon the ganglionic and true spinal systems ;, then we observe its effects upon the circulation, respiration, secretions, and the muscular fibres. It is not like opium and alcoholic stimulants, a diffusible stimulant, and its effects are more transient than these substances. According to Billing it is a "local stimulant, and as such, excites momentarily the action of the heart, through the solar plexus." " It immediately unites with animal acids, and then circulates, or is diffused, not as a diffusible stimulant, but as a saline sedative. It therefore performs the double operation of a temporary local stimulant to the stomach and heart, and a sedative to inflamed capillaries else- where." Carbonate of Ammonia is a stimulant, excitant, diaphoretic, power- ful antacid, antispasmodic, in large doses, emetic, and under some circumstances expectorant. (10.) TOXICOLOGICAL EFFECTS. Injected into the veins it causes convulsions. (Seybert.) Internally, 2£ drachms, to a dog, caused gastric inflammation with tetanic convulsions, the body ultimately becoming curved, with the head bent backwards. {Opisthotonos.) Orfila. Wibmer found ljs grs. to cause no particular effect upon himself; 3 grs., increased pulse from 68 to 72, with throbbing headache ; 6 to 12 grs., usually, but not constantly, caused increased frequency of pulse; with disorder of brain, manifested by pain, heaviness, throb- bing, &c.; in one case, the disposition to cough, with increased secre- tion of bronchial mucus, was extraordinary. Pereira gave 15 grs., three times a day for two months, with no other effect than suspending epileptic fits during this time. Ammonium Carbonicum. 259 Huxham has detailed a remarkable case, illustrative of the ill effects resulting from the long-continued use of it. A gentleman had so habituated himself to the use of vast quantities of it, that at length he could eat it in a very astonishing manner, as other people eat sugar, or carraway seeds. The consequence was he brought on hectic fever; vast haemorr- hages from the intestines, nose and gums ; every one of his teeth dropped out,and he could in consequence eat nothing solid; he wast- ed vastly in flesh, and his muscles became as soft and flabby as those of a new-born infant; he broke out all over his body in pustules ; his urine was always excessively high-colored, turbid and very fetid; he finally died in the highest degree of marasmus. Clinical Remarks.—From the above cases we draw the inference that Carb. Ammonia is homoeopathic to some varieties of convulsions and tetanus ; to fevers and inflammations of a septic character and attended with a predominant alkaline and ammoniacal condition of the blood,such as occurs in typhoid, typhus, scarlet and other fevers; to scurvy and haemorrhages arising from an excessively alkaline state of the blood and diminution of the normal quantity of fibrin; to marasmus and exhaustion from the same causes. (11.) EMPIRICAL OPINIONS. Wood and Bache assume that Carb.-am. is stimulant, diaphoretic, antispasmodic, powerfully antacid, and in large doses emetic ; under certain circumstances they say it may prove expectorant, as when in the last stages of phthisis, it facilitates, by increasing the muscular power, the excretion of the sputa. As a stimulant, it has been exhibited principally in typhus fever ; its principal advantage is its power to increase the action of the heart and arteries, without unduly exciting the brain; dose as a stimulant, five to ten grains, every two, three or four hours, in pill or aqueous vehicle. According to Ables Ammonia is stimulant, antacid and rubefacient; as an antacid it is one of the best remedies in heartburn, and for the relief of sick-headache, when dependent on acidity of the stomach. Paris says, it is more powerfully antacid than the fixed alkalies; it is highly useful as a stimulant in those gastric affections which supervene upon habits of irregularity and debauchery; combined with opium, it affords a powerful resource in protracted diarrhoea, from debility of alimentary canal; in muscular weakness after acute diseases, and chronic rheumatism it is the best remedy; it is also beneficial in hoarseness from relaxed states of the throat; while in typhus fever it has b«en particularly recommended by Huxham and Pringle and many other physicians, and some have considered it superior to any other stimulant on these occasions. Dierbach says, it excites the vascular system, promotes perspira- 260 New Materia Medica. tion, even excites profuse sweat; or on the other hand increases the secretion of urine; promotes secretion of bronchial mucus, and facili- tates expectoration; while in large doses it causes tetanic, convulsive and paralytic symptoms. It is relied upon in suppressed eruptions; a'specific power has been ascribed to it in scarlet fever, in which it is used even through the inflammatory stage, although it is apt to csfuse fever and in- flammation ; it is also reccommended in intermittent fever. Vogt assumes that it causes more active metamorphoses and liquefaction in the vegetative organs; viz., increased secretion from the skin; more ready loosening of mucus from the bronchia; more profuse secretion of urine, with simultaneous absorption of lymphatic fluids from internal parts; increase and hastening of the menses ; in- creased flow of bile ; but the most marked of all, is it action on the skin; so that the ammoniac-remedies have always been considered as excellent diaphoretica; and next is its action upon the lymphatic, vascular and glandular systems, whence it is regarded as a fluidizing, absorption-hastening and resolvent remedy for the organs of these systems. In larger doses it causes stimulation to the point of over-heating, whence heat and congestion have generally been regarded as signs of too great irritation from Ammonia ; its expanding and dissolving powers then also become evident; excessive and very profuse per- spirations set in; also greater secretion of mucus, more profuse flow of urine, and in general more hasty and active metamorphoses, with great inclination to excessive expansion and liquefaction. This fluidizing [action may become excessive, overbalance the forma- tive power, and cause inclination, to solution and decomposition—we see this not only in the profuse secretions which it causes, but in the undermining of all the assimilative processes, viz., in the destruction of digestion, in the solution of the chyle and blood, the want of contractile power, the diminution of organic cohesion in all parts, in short, by the occurrence of a true scorbutic state : yet it is advised in affections of the intestinal mucous membrane, viz. in gastric fever, in mucous inflammations, and in chronic mucous states, with formation of viscid slime, in diarrhoeas and dysentery. Sobernheim advises it in typhus, with predominant affection of chest and abdomen, paralytic weakness, and laxity of the skin. P. Frank advises it especially in febris nervosa stupida with trem- bling, unequal and intermitting pulse. Pearson, Withering, Bodenius, Malin, and Wilkinson advise it in scarlatina with nervous symptoms; the latter used it for seventeen years successively; also in measles, urticaria, and erysipelas. Van Swieten relied on it in paroxysms of asthma. Others assume that its action is four-fold : 1st, that of the alkalies in general, producing chemical decomposition, and softening of the animal tissues, and possessing the power of liquefying or dissolving almost all the soft solids of the body; 2d, that of an ant-acid; 3d, Ammonium Carbonicum. i 261 that of a stimulant, or nervous irritant, the nervous affection produced hy Ammonia closely resembling tetanus, and therefore probably de- pending upon a specific irritation of the spinal marrow ; 4th, that of a saline sedative. (11.) general effects. On the Nervous System.—That the principal action of Ammonia is first manifested upon the ganglionic and true spinal systems, is evident from the spasmodic actions which it induces, and from the increased activity of the circulation, respiration, and the secretions. It does not affect the brain like opium and alcoholic stimulants, but appears to impress specifically the vertebral column. Among the effects of large doses, convulsion? have sometimes been observed. (10.) Nerves of Sensation.—It produces temporarily increased heat of the skin and a tendency to perspiration. Indeed it exalts momentarily the sensibility of all the organs, operating especially upon the sen- tient extremities of the nerves, and upon the capillaries. It causes much itching of the scalp, and of the whole surface of the body. From its stimulating effect upon the nerves and capillaries, it has been often employed in low forms of typhus, scarlatina and other maladies characterized by depressed nervous and vascular power. (10.) Nerves Of Motion.—It probably acts more specifically or powerfully upon the nerves of motion, than upon those of sensation ; it not only causes increased capability for muscular exertion, and a state in which all the nervous functions are executed with greater facility, but all the salts of Ammonia cause convulsions. (11.) Great Sympathetic Nerve.—By its specific action upon the solar plexus, it rouses into augmented activity temporarily, the heart, stomach, and lungs. Under its influence the activity of nearly every organ of the body is for a short time increased. Thus we have an increase of perspiration, of urine, of mucous secretions, and a tem- porary increase of muscular power. (10.) ON THE VASCULAR SYSTEM. On the Blood.—It is speedily absorbed into the blood, and exercises the remarkable power of inducing a more liquid state of this fluid. It counteracts all tendency to crudeness, coagulation, or decomposition of the blood, and on this account affords a reasonable ground for supposing that it may prove useful in those diseases which are accompanied, or eventuate in blood-deteriorations. According to Billing "it immediately unites with animal acids, and then circulates, or is diffused, not as a diffusible stimulant, but as a saline sedative. It therefore performs the double operation of a tem- porary local stimulant to the stomach and heart, and a sedative to in- flamed capillaries elsewhere." In cases of poisoning by this substance, sanguineous effusions are found in various parts of the body. (10.) 262 New Materia Medica, Physiological Remarks. — According to Lehmann, healthy blood contains either no Ammonia or only extremely small quantities of it; but in certain diseased conditions of the system very considerable quantities of Ammonia are often found in the blood, as well as in the urine. Winter thought that the presence of Ammonia in the blood explained the, phenomena of typhus fever, but Ammonia may be de- tected in the blood in all severe cases of acute diseases, especially in variola, scarlatina, yellow fever and Bright's disease; there is no more constancy in the presence of Ammonia in the blood during typhus than there is in the presence of the crystals of the triple phosphate in the excrements. (11.) Formerly the convulsions and coma which so frequently occur in Bright's disease were attributed to the accumulation of urea in the blood; but Frerich has given an entirely new explanation of the phenomena in question. He is of opinion that the symptoms of blood- poisoning are not immediately due to the accumulation of urea, but are occasioned by the carbonate of Ammonia which results from the decomposiiion of urea within the blood-vessels. He supports his opinion by observation and experiment; he states that where patients with Bright's disease are laboring under symptoms of uraemic poison- ing, such as coma and convulsions, that the blood always contains carbonate of Ammonia, which is sometimes so abundant as to be de- tected by the sense of smell, and to produce effervescence on the addi- tion of Muriatic-acid. He also gives the result of some experiments which he has performed on dogs. After injecting urea into the veins of dogs whose kidneys had previously been extirpated, he found that after an interval of from one and a quarter to eight hours they became restless and vomited, then were seized with convulsions, followed by stupor. Ammonia was detected in the expired air. Simultaneously with the commencement of the convulsions, and after death, the blood and the contents of the stomach contained large quantities of Ammonia. In another series of experiments, a solution of Carbonate of Ammonia was injected into the blood of the animals; convulsions came on im- mediately and often were very violent, but they were soon succeeded by stupor; the expired air was at the same time charged with Car- bonate of Ammonia and continued so for more than an hour, when the exhalation of Ammonia gradually ceased and consciousness re- turned. These experiments are certainly in favor of Frerich's notion that the Carbonate of Ammonia which results from the decomposition of urea in the blood is the poisonous agent in producing convulsions and coma in Bright's disease, and not urea itself. (11.) Lehmann and C. Schmidt found Carbonate of Ammonia in the blood of cholera patients. While I could detect urea in the blood, siys Prof. Lehmann,of such cholera patients as succumbed before the occurrence of the group of symptoms to which we apply the term uraemia, I always found the blood ammoniacal and the gastric mucous membrane in the dead body strongly alkaline, as soon as the cerebral symptoms peculiar to Ammonium Carbonicum. 263 uraemia had once set in. Moreover from the analogous experiment which I have instituted with the blood in Bright's disease and scarla- tina, I might have been led to the conclusion that it is not the pre- sence of urea, but of Ammonia in the blood which occasions the symptoms of uraemia. (37.) Bernard and Barresnil have made ex- periments corroborative of those of Frerichs. Stannius found that after the extirpation of the kidneys, and even after the simultaneous injection of urea into the blood, urea itself could never be found in the secretions, or at all events, in the gastric or intestinal juice, or in the bile, but was detected in the sero-sanguineous exudation in the abdominal cavity; but alter the death of the animals, the gastric juice, bile and all the other secretions were found to be extremely rich in ammoniacal salts. (11.) Physical Effects of Ammonia on the Blood.—Hufeland observed that the officinal, and probably all, the salts of Ammonia have the pro- perty, to a greater or less degree, of dissolving the blood corpuscules, even to the nucleus, although slowly, and the protein textures gene- rally. Whether they are thus endowed of themselves, or whether it is in virtue of Ammonia set free by the alkali of the blood, is a ques- tion ; but at all events it has been ascertained that free Ammonia is not essential to these effects. When blood is combined with an am- moniacal salt, it acquires, generally, a brighter red; but this soon passes into a brownish red hue ; it does not coagulate, but forms at best a loose, semi-fluid, cruor; the corpuscules begin to disappear ajid the whole becomes more limpid. Blood thus decomposed, progressively evolves distinct traces of Ammonia. It is very probable that we may partially explain, upon chemical grounds (solution and disengagement of Ammonia,) why large doses of the Ammonia act as poisons, and smaller doses, long continued, induce a scorbutic condition. Yet the same salt, judiciously exhibited, furnishes a valuable stimulant to the se- cretory and excretory apparatus. Clinical Remarks.—From this powerful action upon the blood it is easy to infer that Ammonia must be useful in some blood-diseases, and injurious in others. In scorbutis the quantity of fibrine is di- minished, hence the haemorrhages; Aminon.-c. also produces haemorr- hage in a marked degree. According to James the serum in scurvy has a marked alkaline reaction. Amnion.-c. is an alkali. Denis found scorbutic blood to contain seven parts of neutral soluble salts, while healthy blood only contains six. Denis and Henderson are of opinion that excess of salts in the blood causes scurvy. Firmy found marked alkalinity of scorbutic blood, and ascribes its non-coagu- lation to the large quantity of free alkali in such blood. Hence it would seem that Ammon.-c. is decidedly homoeopathic to scorbutus. Hemorrhages.—It produces a. scorbutic state with hemorrhages, hence Noack advises it — 264 New Materia Medica. in malaena; in morbus maculosus haemorrhagicus Werlhofii; in vomiting of blood ; in haemorrhoidal affections, such as flowing haemorrhoids ; in haemoptysis; in haemoptoe*; and apoplexia pulmonum. It causes a sensation of congestion to the end of the nose, blow- ing out of blood from, and bleeding from the nose after eating. We do not see that it causes vomiting of blood, and doubt whether it has any specific tendency to do this ; it may however act chemically and corrosively upon the stomach, and thus cause haemorrhage from it, as it induces inflammation of the stomach, even when introduced into the cellular tissue. As for haemorrhoids, it causes great swelling and protrusion of piles with pain, discharge of blood from the rectum during and after stool. As for haemoptysis, it causes cough with mucous or muco-sangui- neous expectoration, coughing up of blood, with burning and heaviness upon the chest, shortness of breath, redness and heat of face, nausea, anxiety, and trembling of the whole body. As for apoplexia pulmonum, it causes congestion to the chest— great heaviness upon the chest with pain—heaviness upon the chest, as if from accumulation of blood. It i» very decidedly homoeopathic to purpura haemorrhagica. (11.) Heart and Arteries.—By its action on the nervous system it aug- ments temporarily the muscular force of the entire organism. Through its local action upon the solar plexus, it stimulates into in- creased activity the heart and arteries. This augmented action is of but short duration, not excessive, and therefore not usually follow- ed by any reaction of a depressing character. This effect of Am- monia upon the circulation is accomplished .independently of any action upon the brain. (10.) Clinical Remarks.—It has often been employed in the last stages of certain diseases, like typhus, scarlatina, yellow fever, erysipelas, &c, to rouse temporarily the depressed forces of the organism. This effect is first manifested upon the heart and arteries, and then upon the respiration, the secretions, the animal heat, and the general muscular system. (10,) On the Pulse.—Under its influence the pulse is increased in fre- quency and fullness ; but as'the action of this stimulant is transient, the drug must be often repeated to secure a permanent influence. (10.) Fever.—Frequent chilliness towards evening, frequent paroxysms of feverish chilliness, blueness of the hands and nails, chattering of teeth and shaking ; sometimes these symptoms are followed by nightly heat, and by sweat early-in the morning. Alternate chilliness and heat, with sensitiveness to cold ; nausea, thirst, oppression of the chest, with stitches in the left side, tearing in the forehead, and dull- Ammonium Carbonicum. 265 ness of the head, alternate redness and paleness of the cheeks, pres- sure at the stomach, with disposition to eructations, accompanied by a violent coryza and sleeplessness; foV several days, during the cata- menia. Feverish heat in the head, with cold feet. Continual night-sweats. (32.) Clinical Remarks.—In scarlet-fever, the sesqui-carbonate is the most valuable remedy wo possess. It was originally prescribed by Withering, and has been extensively used by Drs. Peart, Strahl, Bodenius, Rieken, &c. Dr. Rieken considers that it acts partly by its fixed, and partly by its volatile principles. The first enters into the blood and ameliorates its crasis; whilst the second removes the depression of the nervous system. He speaks in the highest terms • of its efficacy and recommends that 3J.—pj, be dissolved in Aq. fvj., and that of this 3J.—3iv. be given every one or two hours, according to the strength of the patient, and the urgency of the case. It was found most useful in the nervous and inflammatory forms. More re- cently it has been strongly advised by Mr. Wilkinson, who has em- ploye* it successfully in above 200 cases. He does not depend, he states, upon its diuretic, nor diaphoretic qualities, but believes that it possesses the power of increasing the strength of the arterial action, at the same time that it diminishes its frequency ; that it supports the vis vile, without increasing the heat and irritability of the system, and by such means counteracts, the tendency in scarlatina -anginosa, and -maligna, to*ulceration and sloughing, and all the other evils attending it. (44.) In Austria, during an epidemic of scarlet-fever, commencing in April, 1841, Dr. J. Fischer treated 112 cases by Ammonium-carb., aided by occasional applications of cold water to the head; of which 105 re- covered, arid 7 cases terminated fatally. The disease generally sat in with feeling of constriction of the head, want of appetite, shiver- ing, alternating with flying heat, frequent, tense irregular pulse, burning dry skin, dysphagia, great restlessness and uneasiness of the body, nausea, vomiting, , bleeding at the nose, sometimes delirium, convulsions, (generally ceasing immediately after the appearance of the eruption,) itching and burning of the skin;—in many cases with violent rheumatic pains in feet, hands, shoulder and hip-joints. The eruption remained generally five to seven days, with exacerbation of violent fever in the evening—time of desquamation frequently from three to four weeks, followed at times by anasarca, ascites, hydro- thorax, swelling of the glands. The seven fatal cases were: two of hydrothorax, one case of an- gina gangraenosa, the four remaining came under treatment at a very late date, suffering from violent disturbance of the brain. (26.) Frank, in his Magazine, speaks of one case of scarlatina, cured by Ammonium-carb., with the following symptoms, &c.: Violent fever, throat symptoms decidedly bad, the characteristic eruption had hardly made its appearance on the fifth day, when Ammonium- carb. was administered; on the same evening the eruption came \ 266 New Materia Medica out beautifully, throat improving, fever diminishing and finally desr quamation went on favorably. (26.) Of four cases of scarlatina reported in Frank's Magazine, in two cases the eruption appeared as scarlatina levis, with violent throat symptoms. In the third case it appeared with cerebral disturbance, delirium, eyes fixed, and sudden screaming; the fourth case, a child, one and a half years old, with violent fever and convulsions and re- tarded appearance of the eruption, was1 successfully cured by Ammo- nium-carb., aided at times, by cold applications to the head. (2i\.) Of four cases more, reported by Frank, two were scalatina-levis and two, cases of scarlatina miliformis, cured by Ammon.-carb. (26.) A case of syphilitic eruption occurring after clap, chancre and bubo, in a man 38 years of age, cured by Ammonium-carb. in 2(3 days, is reported by Frank. (26.) In acute glanders, it proved successful, in a case which came under the care of Mr. Wilkinson. The treatment employed is thus summed up. 1. an incision into each of the Whartonian ducts*; 2. sesqui-carbonate of Am, in water, hourly, as concentrated as it could be swallowed ; 3. an opiate at bed-time, with wine and nourishment in such quantities as the patient could be prevailed upon to take. He places great stress upon the Ammonia having been given in a concentrated form. (44.) Ammonia is evidently homoeopathic to some varieties of fever and ague, and also to hectic fever, when the chills and sweats are pre- dominant. (11.) On the Mucous Membranes.—On the mucous membrane of the bronchial tubes, Ammonia appears to exercise a specific action. It stimulates the minute nervous and capillary structures of this part, and promptly augments its secretion. It has therefore been some- times successfully employed in the last stages of phthisis as an ex- pectorant. (10.) Skin.—Itching over the whole, or parts of the. body. The ichole upper part of the body is red, as if covered with scarlatina. Rash on the left side of the neck and the left lower arm. (32.) Clinical Remarks.—In lepra and psoriasis, Mr. Cazenave success- fully employs this salt. In syphilitic eruptions, Dr.Schedel states that he has seen this salt succeed when mercurials have failed. The remedy, he adds, is certainly disagreeable at first, and often causes nausea, but with a little patience the stomach is soon brought to bear it. In erysipelas, occurring in debilitated subjects, it proves highly useful; Dr. Watson observes that after a preliminary purgation, he commences its use and generally speaking a large proportion of his cases recover. (44.) In rubeola, urticaria, roseola, erythema, and in other diseases of the same class, Mr. Wilkinson also bears witness to the value of the sesquicarbonate. He states that for the last seventeen years he has administered this remedy, and that he has not only never lost a Ammonium Carbonicum. 267 patient in the above diseases, but has never had a case of the kind that has even appeared dangerous, or that has given him a moment's anxiety. (44.) In scrofula, the late Dr. Armstrong found that those cases attended by much debility, a languid state of the circulation, and deficient cutaneous secretion, were much benefited by the use of this re- medy. (44.) Mind and Disposition —Turns of anxiety—great anguish—vexed and vehement mood; excessive exaltation of the fancy; great ten- dency to start; excessive mirthfulness at one time, and at another immoderate laughter about trifles. (32.) Clinical Remarks.—In puerperal insanity, when great debility ex- ists, together with defective subcutaneous circulation and cold extre- mities, the Carbonate of Ammonium in alternation, with Camphor may be given every third hour with advantage. (44.) In mercurial erethism no internal remedy is more to be trusted than the sesquicarbonate, in conjunction with Camphor and other stimulants. (44.) In the nervous, excitable, anxious and tremulous conditions which often follow abuses of alcoholic stimulants and opiates, this is a re- medy of considerable power. It is also useful in similar conditions arising from undue mental excitements, like grief,excessive anxiety, &c. (10.) Cases of delirium tremens have been said to have been cured with Carb.-Ammon. alone, but Wood says, over absolute drunken- ness it has no control whatever ; but in slight disorder from alcoholic drinks it occasionally gives relief. In sick headache with excess of acid in the stomach it is often useful. In those sudden cases of col- lapse and loss of consciousness, which, if the patient survive, must be followed by febrile reaction or inflammation, it is admirably adapted and from the absence of any special stimulating action on the brain to those cases in which the reaction is likely to be attended with inflammation or great vascular excitement of the brain. In- stances of this kind not unfrequently occur in the cold stage of fe- brile diseases, the collapse of concussion of the brain, and the pros- tration of any sudden shock. (11.) Seiisorilim.—Great forgetfulness. Great absence of mind. The head feels muddled, dull and stupified. Vertigo. Vertigo with nausea and loss of appetite, sometimes relieved by a walk. (32.) Tempo- rary exaltation of all the faculties, mental and physical. An increased disposition to exercise the mind, but a lack of executive power. (10.) Clinical Remarks.—In typhoid and scarlet fever, accompanied by a general prostration of the forces, with a dull and stupid intellectual state, alternating occasionally with transient flushes of mental exhila- ration, this medicine is quite appropriate. Under such circum- stances we are in the habit of prescribing the first trituration. (10.) 268 New Materia Medica. Sleep.—Disposition to stretch the arms and feet. Spasmodic yawn- ing in the evening; sleepiness during the day; unconquerable sleepiness after supper ; nevertheless, he cannot sleep well at night. Uneasy, unrefreshing sleep, every night; groaning and sobbing during sleep. Frequent starting from sleep as if in affright; con- fused, anxious, frightful dreams. At night, attack of great anxiety, as if death were approaching, accompanied by cold sweat, audible pal- pitation of the heart, and involuntary*weeping; she was unable to move her eyes, or to speak, accompanied by labored breathing, and trembling of the hands ; vertigo at night; she has to sit up in bed; rush of blood to the head, at night; boring and lancinating pain in the head, sparks before her eyes, on waking at night. (32.) Head.—Chronic headache, headache with nausea. Sense of op- pressive fullness in the forehead, as if from the vapor of coal; tumult in the head, and pain as if the contents would issue through the fore- head. Drawing and tearing throughout the head. Painful throbbing and beating in the temples. (32.) Feeling of tightness, confusion and heaviness in the forehead. Pressing, hammering headache. Feeling as if the brain were loose ; painful stitches in the brain. (19.) Oppression and sense of fullness of the head. (3.) Pushing sensa- tion as if the forehead would burst, and the brain would protrude through the forehead. (12.) Clinical Remarks—It is curative in the dull, heavy headaches, with nausea, depression and nervousness, which folldw the next morning after excesses in drinking or eating —or prolonged watch- ing and mental anxiety. It is also useful in the oppressive head- aches, which often afflict paralytic subjects. In these cases again we prefer the first or second trituration. (10.) Scalp.—Violent itching on the hairy scalp. (32.) Eyes.—Violent stitches over the eye. Burning in the eyes, espe- cially in the evening with photophobia. Watery eyes. Weakness of the eyes. (19.) The eyes are inflamed and dim; agglutinated in the morning. Lachrymation; the white of the eye is .congested, as in incipient inflammation of the eye, the vessels of the cornea are distinctly visible-. Copious lachrymation, especially of the right eye. (32.) Clinical Remarks.—A very common symptom of yellow fever, is a congested condition of the conjunctiva, and a dimness of the eyes. When the energies of the system are failing, the blood is fast losing its normal composition, and its ability to generate sufficient coloric for the purposes of life, and the eyes become dull and congested, Ammonia in palpable doses would appear to be homceopathically in- dicated. We have occasionally witnessed this dullness and injection of the eyes in malignant scarlatina and in typhus, and have employed this remedy with benefit. (10;) Ears.—Diminished hearing; buzzing before the ear; pain behind the ear. Painful tingling and crawling in the ear. (19.) Illusion of hearing; he imagines he hears the ringing of bells. (32.) Ammonium Carbonicum. 269 Nos;-—.Discharge of bloody mucus from the nose. Bleeding at the nose. Stoppage of the nose, particularly at night. Frequent sneez- ing; dry chronic or fluent coryza. (32.) Clinical Remarks.—A case of epistaxis is related by Dr. Chapman, in a young woman, represented as anaemic, reduced in flesh, very pallid, and very dejected. She was twenty-two or twenty-three years of age, and had been subject far several years to repeated and copious bleedings from the nose. The only characteristic symptom that was mentioned in the letter of consultation, for the choice of a reme- dy for epistaxis, was, that is was brought on by washing the face and hands in the morning. Ammon.-carb. 3, was sent to her and after a few doses the bleeding ceased and recurred no more; she also re- covered strength, flesh, spirits and color. The cure was permanent. (12> .. . . ' Dr. Chapman also relates a case of critical epistaxis, caused it was supposed by latent measles, to which the patient had been exposed some three • months previously. The epistaxis continued to occur daily for a few days to an alarming extent. On the fourth day he complained of a severe pain in the forehead, and a sensation as if the brain was forcing itself out just above the nose. About a grain of the third trituration of Ammon.-carb. was administered. One of his serious bleedings had occurred just before. In three or four hours after he was covered with measles, and a few doses of Pulsatilla sufficed to effect a cure. (12.) Face.—Pale face ; oedematous countenance ; red spots on the face; sudden heat of the face; dry, cracked lips, with violently burning blisters on them. (19.) Violent pain on the right side of the face; hard swelling of the cheek, of the parotids and the glands on*1 the neck. White, herpetic spots on the cheek of the size of a small pea, which scale off continually. Small boils and indurations, emitting water and blood, upon the cheek, at the corners of the mouth and on the chin. Eruptions on the forehead resembling little boils. Herpe- tic scaly eruption^ around the mouth. Chapped lips and sore corners of the mouth. (32.) Clinical Remarks.—It has proved efficient in two cases of habitual and transient flushing of the cheeks, occurring several times during the day, with itching of the skin, and a great tendency to sweat. It is indicated in scarlatina, typhus, and yellow-fevers, when the face becomes pale and sunken, or covered with red spots, and oedematous, with injected eyes, and a general prostration of the forces of the or- ganism. (10.) It is almost specific against the flushings and gushes of perspira- tion, which are so apt to occur in women-at the change of life. (11.) Jaws and Teeth.—Tearing pain through all the teeth, and maxillary bone, extending to the ears ; worse on pressing the teeth together, and on going to bed. Drawing toothache, alleviated by warmth and pres- sure. Disposition of the gums to bleed. Caries. (19.) Abscess of 270 New Materia Medica, the gums, with discharge of pus. Toothache during the catamenia. Shooting in a healthy molar tooth, in the open air. Shooting pain in the teeth uninterruptedly for eight, days. Teeth feel loose. (32.) Clinical Remarks.—It is homoeopathic to scurvy of the gums; to many varieties of toothache, to inflammation of the periosteum and gum-boils. (11.) Mouth.—Great dryness and heat in the mouth. Feeling of swell- ing and contraction of the mouth. Increased accumulation of saliva. (19.) Pustules upon the tongue, with a burning and stinging pain. Redness and inflammation in the mouth and throat. (32.) Clinical Remarks.—Mr. Wallace states that he has seen some very severe cases of cancrum-oris cured by the internal use of this remedy in doses of grs. v., gradually increasing to grs. x—xx. every two or three hours, according to the severity of the symptoms. He advises the strong Nitric-acid as a local application at the same time. A liberal diet should be allowed. (44.) It may sometimes be used with advantage in low forms of scarla- tina, to rouse into activity the almost paralyzed mucous membrane of the throat, and thus enable the patient to throw off the distressing ac- cumulations of mucous and purulent matters. In cases of this de- scription we have often prescribed the 1st trituration of Ammonia with gratifying results. (10.) Pharynx and (EsoplMSUS.—Dryness, roughness, scraping and burning ing in the throat. Burning and feeling of obstruction in the oesopha- gus. (19.) Sore throat towards evening. Pain in the throat during deglutition, as if the right side were swollen. Dryness of the mouth. (32.) Pathology.—Red spots in the lower part of the mucous mem- brane of the oesophagus, with some thickening of the membrane. (3.) Clinical Remarks.—It is appropriate in cases of dryness and burning of the pharynx and oesophagus, accompanying chronic gastritis, and certain dyspeptic conditions. It often relieves a sensation in the oesophagus as if a foreign substance were lodged there. Also in palpable doses, in paralytic states of the muscles of the pharynx and oesophagus, it may be employed with benefit. (10.*) Taste, Appetite, and Gastric Symptoms.—Collection of saltish water in the mouth; she expectorates freely. Taste as of blood in the mouth, during the whole time of proving. Bitter taste in the mouth, early in the morning, and attacks of nausea the whole day. Sourish and metallic taste of food; frequent eructations. Frequent heartburn. Feverish chilliness in the morning, succeeded by hiccough; nausea and coated tongue. Continual thirst. Want of appetite, early in the morning; satiated after having eaten a little ; heat in the face during and after dinner. Qualmishness and inclination to vomit, every day, immediately after dinner. (32.) Want of thirst. (19.) Clinical Remarks.—In acidity of the primae-viae, heartburn and flatulence, particularly when occurring in cases of atonic dyspepsia, Ammonium Carbonicum. 271 or in hysterical females, the Carbonate of Ammonia, proves very efficacious. It may be repeated if necessary. (44.) It is applicable in those mild forms of dyspepsia which proceed from general debility. All the secretions connected with digestion are increased in quantity, and deteriorated in quality. Thus arise acid bitter eructations, bitter or sour taste, heartburn, nausea and distress after eating. In these cases we employ the 2d or 3d tritura- tion. (10.) Stomach. —Great pressure at the pit of the stomach after eating, succeeded by nausea and vomiting of the ingesta ; afterwards sour taste in the mouth; feeling of fullness and pain in the stomach; also on pressure. Pressure and constriction of the chest and stomach. (19.) Oppression at the stomach after dinner and supper. (32.) Pathology.—A small quantity of bloody serum in the stomach, of a nauseous odor, but without any smell of Ammonia. The mu- cous membrane appeared to have formed convolutions not unlike those of the brain. The upper part of the membrane dark red, and the convolutions below of a lighter red. The membrane thickened and soft. (3.) Clinical Remarks.—In drunkenness, after the stomach has been emptied, the sesquicarbonate may be given internally with advantage. Its application to the nostrils is also beneficial. (44.) In dyspeptic complaints, accompanied by preternatural acidity of stomach, and flatulence, without imfiammation, a properly-diluted solu- tion of Ammonia may be employed with a two-fold object; that of neutralizing the free acid, and of stimulating the stomach. It must be remembered that the healthy secretions of the stomach are of an acid nature, and that the constant use of Ammonia, or any other al- kali, must ultimately be attended with injurious consequences, more especially to the digestive functions. While therefore the occasional employment of alkalis may be serviceable, their long-continued use must ultimately prove deleterious. (3.) Through its influence upon the ganglionic system, the secretion of the stomach is increased, and its activity is temporarily augmented. The congested state of the stomach, which usually accompanies mania a potu, may sometimes be removed by this drug. (10.) It is more homoeopathic to alkaline- than acid-dyspepsia. (11.) Abdomen.—Violent cutting, pinching and burning pain in the ab- domen. Constriction and griping pain in the abdomen, with nausea and accumulation of saliva in the mouth. Constant rumbling of wind, with inclination for stool. Very great distention of the abdomen. Flatulent colic. Emissions of flatulence. (19.) Burning and boring stitches in the liver. Distention of the abdomen, with retention of stool. Rumbling and shifting flatulence in the abdomen. Contractive spasm deep in the hypogastrium, on stooping, also in the small of the back. Elastic swelling in the left groin, as large as the fist, in the 272 New Materia Medica. evening after lying down, with a pain as from a bruise in that place; she cannot rest on that side, on account of this pain, which is also ex- perienced upon the parts being touched; protrusion of hernia in the left groin. (32.) Pathology.—Mucous membrane of the coecum, and of the upper part of the small intestine, of a rose color. This color grows more faint as we approach the middle of the small intestine. Mucous membrane of the coecum softened and hypertrophied. Color natural, except a small portion nearest the stomach. A small quantity of bloody serum in the intestines. (3.) Clinical Remarks.—It is homoeopathic to accumulations of flatus in the intestines, in consequence of an enfeebled condition of these parts. In old and paralytic patients, in whom all the organs are slug- % gish and inactive, Ammonia may be used as a palliative with consider- able success. (10.) Stool.--Constipation. Retarded and hard stool, surrounded with streaks of blood Hard stool at first, followed by soft stool, mixed with mucus and blood, with cutting pain, before and after stool. Cut- ting pain in the rectum during stool. Tenesmus. (19.) Colic before and after the loose stool. After the evacuation sense as of scraping, then burning at the anus; discharge of a milky prostatic fluid; dis- charge of blood during, and after the evacuation. The varices of the rectum protrude, even though there is no evacuation ; they recede when lying down. Sleepless at-night, on account of a burning pain at the rectum; itching of the anus. (32.) Clinical Remarks.—It is useful against obstinate constipation pro- ceeding from a torpid and semi- paralytic condition of the bowels. By its general stimulant action upon the mucous membrane, the secre- tions are increased, peristaltic action is augmented, and the stools become regular. From the special influence which it exerts upon the small intestine, the coecum, and other portions of the intestinal membrane, it would appear to be indicated in a few sub-acute inflam- matory conditions of these parts, with obstinate constipation, such as are sometimes observed after prolonged attacks of enteritis. (10.) Urinary Organs.—Frequent urging to urinate, with scanty emission; and burning in the urethra during the passage of urine, especially at night. Increase in quantity, and frequent emission of urine, especial- ly in the evening and at night. Iuvoluntary emissions of urine at night. Cloudy, reddish, watery urine, mixed with blood. (19.) Great urging in the bladder; pains at the neck of the bladder. Discharge of urine, leaving chalky spots; stitching and cutting in both sides of the groin to the small of the back during the tenesmus, with discharge of a few drops only. Urine mostly cloudy, wheylike, very ammonia- cal and musty-smelling. (29.) Clinical Remarks.—In the healthy urine, Ammonia is assumed to exist in larger quantities than is actually the case; in point of fact the quantity of Ammonia in healthy urine is exceedingly small, and Ammonium Carbonicum. 273 Schercr and Liebig even convinced themselves of the absence of Ammonia in normal urine. Heintz found that the ordinary urinary sediments consist of Urate of Soda, with a little Urate of Lime, and only traces of Urate of Ammonia. In disease it is different. In ty- phus-fever, scarlatina, variola and Bright's disease, the urine often con- tains Ammonia; the urine is, however, richest in Ammonia when it undergoes decomposition within the bladder, as in cases of invete- rate vesical catarrh, or diseases of the spinal cord. Boussingault found O.OSl-g- of Ammonia in the urine of a healthy child,viged eight months, and 0,114-g- in that of a youth. Bence Jones believes that he has convinced himself, by numerous experiments, that after the use of Ammoniacal Salts, (he employed the Carbonate, Tartrate and hydro- chlorate of Ammonia) Nitric-acid might always be detected in the urine; and consequently that, the power of oxidation possessed by the organism is so great, that the nitrogen of the Ammonia is oxidized into Nitric-acid. (37.) It has a specific action upon the lining membrane of the kidneys, bladder and urethra. Clinical Remarks.—A case of diabetes is reported in Frank's Maga- zine as cured by Ammonium-carb. in a lady, aged forty-eight, past men- struating; symptoms: Violent thirst, dryness of the skin, constant chilliness, emaciation, oedema of the feet, with gradually increasing ascites, passing from fifteen to twenty quarts of urine daily, of a green- ish color, clear and without smell, appetite voracious. The length of time in effecting the cure not mentioned. (26.) In cases of urina- ry calculi, in which the urine is acid, and alkalis are indicated, espe- cially if the constitution is much debilitated, the Carbonate of Ammonia is the most preferable alkali for administration. At the same time that it corrects the acid diathesis, it determines to the skin, and gives a stimulus to the system generally. (44.) Dr. Barlow considers this remedy the most clearly indicated, and the most efficacious, of all others, in diabetes mellitus. The data on which he forms this opinion are well worthy of attention. He con- siders that the sugar found in diabetic urine, is not necessarily con- nected with, or dependent on, perverted action of the kidneys, but that it is formed in the primae-viae, in the early stage of the process of sanguinification. The saccharine particles of food are not changed in the stomach, whilst the starch, which most articles of vegetable diet contain in considerable quantity, not having its peculiar properties annulled, and its proneness to saccharine fermentation being favored by the warmth and moisture of the stomach, is converted into sugar, which being readily soluble, is absorbed into the circulation. The sugar thus absorbed takes the place of the proper and higher pro- duct, albumen, and being unable to perform the duties of the latter in the system is eliminated by the kidneys. According to this view, the first object will be of course, to avoid all saccharine and amylacious articles of food ; the second to introduce into the stomach a highly- azotized substance, and at the same time, diffusible stimulant,, to ex- 18 274 New Materia Medica. alt the assimilating powers of that organ ; both these indications ap- pear likely to be obtained by Ammonia. Dr. Barlow advises the Sesqui-carbonate in doses of—gr. v.—viij., with a few drops of Tr. Opii, in some light bitter infusion every six hours. At the same time animal food, together with cruciferous vegetables, as greens, brocoli, turnip-tops, &c, should be taken freely. On this latter point Dr. Barlow places much stress. He relates cases illustrative of the de- cided benefit to be derived from this treatment. (44.) Female Sexual Organs.—Catamenia too profuse and too early ; the blood very dark and passing off in clots, with spasmodic pain. Be- fore the appearance of the menses, constant heat and feeling of un- easiness, with violent pinching and crampy pain in the abdomen, with nausea,' accumulation of saliva in the mouth, chilly sensation and fainting spells. During the menses, alternate heat with chills, sen- sitiveness to cold, tearing pain in the forehead, and feeling of con- striction of the head, sometimes redness, then paleness of the cheeks, pressure in the stomach, feeling of fullness and trembling of the sto- mach, violent coryza; feeling of tightness of the chest. Watery, burning leucorrhcea. (19.) Violent acrid leucorrhcea, causing sore- ness. (32.) i Male Sexual Organs.—Increased weight of the scrotum. Nightly pollutions. (19.) Pain in the scrotum, and spermatic cords. Invo- luntary and continual erections, early in the morning, without any de- sire for coitus. (32.) Larynx and Trachea.—Hoarseness, roughness, or feeling of soreness of the throat. Accumulation of mucus in the throat. Rattling of mucus in the bronchial tubes. Cough, with feeling of tightness in the chest and pain in the head. Constant dry cough, as of dust in the throat. Violent night cough. Cough, with expectoration of mu- cus streaked with blood. Cough, with bloody expectoration, dyspnoea, redness and heat of the face, nausea, uneasiness and trembling of the whole body. (19.) Cough, with asthma in the evening, when in bed. Cough, with expulsion of bloody phlegm. Incipient pulmonary phthisis. (32.) Clinical Remarks.—In chronic bronchitis, and catarrhal affections occurring in debilitated constitutions, this salt given in such doses (^ss.—3J.) as to produce an emetic effect, will often be found service- able. In smaller doses it is also very useful in that form of catarrh which Laennec designates as "suffocative." (44.) In the advanced stages of croup, the sesqui-carbonate has been prescribed as a stimulant, expectorant, and occasionally as an emetic, in order to promote the discharge of effused matter. When the patient is greatly debilitated it may prove useful, but some caution is necessary in its use. (44 ) It is homoeopathically indicated, where the secretion of the laryn- geal or tracheal mucous membrane is increased, with hoarseness, roughness, or burning in the parts, tickling, hoarse cough, day and Ammonium Carbonicum. 275 night, and occasional turns of asthmatic respiration. In such cases we prescribe the 1st trituration. We cannot commend this remedy too highly in coughs of this description. (10.) Chest.—Dyspnoea especially at night. Short, quick breathing, with stitches in the chest. Long-lasting dyspnoea, with paleness of the face, in a warm room, or on ascending stairs. Congestion of blood to the chest. Feeling as if there was a heavy load on the chest, accompanied with pain : feeling of malaise and fatigue in the chest. Violent stitches in the sides of the chest and sternum, with dry cough and inability to lie on the affected side. Palpitation of the heart with constriction of the chest, after every exertion. Stitches through the heart. (19.) Asthma and palpitation of the heart after every exertion. Lancinations through the fleshy part of the chest. Frequent palpita- tion of the heart, with retraction of the epigastrium and sense of weakness in the praecordial region. (32.) Increased expectoration from the lungs. Accelerated respirations. Slight oppression and tightness in the upper part of the chest. (10.) Physiological Remarks.—In the healthy pulmonary exhalation on the other hand, small quantities of Ammonia may always be recog- nized with great certainty. Mouchard was the first who ascertained with certainty that Ammonia was present in the pulmonary exhala- tion ; by means of the colorless haematoxylin discovered by Erd- mann,he could detect it in the air of each individual respiration ; more- over when we employ Sulphuric-acid for the removal or determination of the water in experiments on the respiration, it is always found to contain Ammonia. I spent this morning with my friend, Benjamin W. Richardson, whose reseaches, proving Ammonia to be the constituent of the blood, which kept it in the fluid state, has won for him the last Astley Cooper Prize. The Doctor showed me some very interesting and really surprising experiments, clearly proving the existence of Ammo- nia in the breath. Among others, the following is worthy of notice : A glass plate was covered with a few drops of twice distilled hydro- chloric-acid. I then breathed upon it about sixty-five times, always taking a full breath and expelling it with force on the glass-plate, which was afterwards held over a gas-light to evaporate the fluid and induce it to crystallize. We then subjected it to the microscope, and found the most beautiful crystals of Hydrochlorate of Ammonia, which re- sembled—though better marked—the crystals of Hydrochlorate of Ammonia which were placed on another plate in order to compare their appearance with those formed by the breath on Muriatic-acid. The existence of Ammonia in blood, is shown in this way: A receiver not entirely filled with blood, was covered by a plate wet with Muriatic acid. The interspace being filled with the vapor of Ammonia, forms then the crystals of Ammonia. According to Dr. Richardson, the quantity of Ammonia may be ascertained approxima- tively, by using Chloride of Platinum, which will form with Ammo- nia, yellow crystals, the weight denoting the quantity thus formed. The existence of Ammonia varies in the breath of different person 276 New Materia Malica. according to the state of health, the same individual even, giving off sometimes more, sometimess less. More is given off fasting, than dur- ing digestion, and the air last expelled from the lungs during each ex- piration, contains the greatest proportion. I take with me an extract of his researches not yet published, in order to communicate it to the Congress of Physicians at Vienna.—L. Gluck. In some diseases the quantity of Ammonia in the breath is very much increased, especially in Bright's disease when coma and con- vulsions have set in, in cholera, yellow- and typhus fevers. (11.) Clinical Remarks.—In those forms of asthma, arising from, or con- nected with disease of the heart, Dr. Hope states that he has derived more benefit from this salt, than from any other remedy. In a very obstinate case which resisted all other means, a formula composed of Ammonium-sesqui-carb. and Antim.-tart. afforded great relief. (44.) In pneumonia, in the advanced stages, when the inflammatory symp- toms have subsided, and it becomes of importance to promote, expec- toration, Dr. Williams states that he has seen this indication well answered by the Sesqui-carbonate of Ammonia in doses of gr. v. or more, every two or three hours, as the urgency of the case may re- quire. He advises its exhibition in alternation with Infus. Senegae and with v.—x. drop doses of Tr. Lobelise Inflatae. (44.) It acts specifically upon the mucous membrane' of the bronchia, and its ramifications through the lungs, augmenting the secretion, and giving rise to a congested sensation in this structure. It also stimi- lates temporarily the lungs, increases the number of respirations, and causes slight dyspneea and some uneasiness of this organ. It is an excellent remedy against very troublesome, dry or moist, short coughs, day and night, with irritation of the bronchial membrane and its ramifications, and of the substance of the lungs; with dyspnoea after the slightest exertion, stitching pains through the sides of the chest, palpitation of the heart, accelerated respirations, worse on as- cending stairs; or from exertion of any kind, a general feeling of malaise. In advanced stages of pneumonia, when the lungs are approaching a paralytic condition, with a general loss of vital energy, this is a remedy of great value. It tends to re-establish the impaired vita- lity, and by promoting expectoration, and imparting to the pulmonary structures increased activity, it not unfrequently induces a permanent improvement of all the symptoms. (10.) Ammonium-carbonicum is homoeopathic to one form of hydrothorax; and occasionally will cure it when the disease has advanced to that stage where the effusion becomes general, as shown by oedema of the lower extremities, enlargement of the abdomen, &c. The following case, which occurred in a man of fifty-two years, of active habits, illustrates its prompt and remarkable power. He had been subject at times, and for many years, to hard cough, with mucous expectoration. Slow and intermittent pulsations of the heart, with occasional pains in the cardiac region. Now the co.ugh was hard, recurring in paroxysms. Great dyspnoea, worse when in a ho- Ammonium Carbonicum. 277 rizontal position. Inability to sleep. Breathing better when in an upright posture. Oppression increased when moving about, or ascend- ing an eminence. A continued feeling of fulness in the chest. Ab- domen much enlarged, partly, perhaps, by crowding downwards of the diaphragm, the liver, and the speen. Lower extremities swollen. Urine scanty. Anxious. Apprehensive of the worst consequences. This condition seemed to be dependent upon some cardiac disturbance, either functional or organic—possibly upon valvular ossification. After a great variety of remedies had been tried without benefit, and the case came to be regarded as beyond the reach of medicine, Am- monium-carb. effected an immediate, and rapid change for the better, so that the subject is now about his ordinary duties, and considers himself very well. Used in the 30th attenuation.—Win. E. Payne. Superior Extremities.—Heaviness and want of strength, with stiff- ness and coldness of the arms, at night. Twitching and trembling of the fingers. Violent tearing pain in the ulna. Coldness of the hands. Tingling in the points of the fingers. Numbness of the hands. The right arm feels heavy and is without strength. Rigidity of the arms and fingers in the morning, when taking hold of anything. Tearing pain in different parts of the upper extremities. (32.) Cluneal Remarks.—We have witnessed good effects from this remedy in very troublesome cases of neuralgic pains of the extremi- ties, coming on at short intervals, with spasmodic, jerking pains, and heaviness, and prickling sensation in the limbs. (10.) Inferior Extremities.—Feeling of lameness, fatigue and soreness of the lower extremities. Heaviness, trembling and great weakness of the legs. Violent pain in the hip-joint, on motion. Tearing in the knee-joints, patellae, heels, soles of the feet and toe-joints. Crackling noise in the knee-joint, on motion. Redness, swelling and painfulness of the great toe, with swelling of the foot, most painful in bed at night. Rapid swelling of the foot extending to the calf of the leg. Numb- ness of the lower extremities. Cold feet, even in a warm room. (19.) His legs are contracted; the tendons of the muscles of the legs feel too short; pain in the left leg, as from a sprain, when walking; un- easiness in the legs; twitches in the leg toward evening. Sudden and great weakness in the lower extremities. Great lassitude in the thighs and legs; sense as of scraping upon the femurs, at intervals. Frequent cramps in the legs. (32.) Back.—Pain in the back, worse on motion. (19.) Pain in the back, when stooping, as if the muscles were not strong enough to support ihe body, which constantly threatens to fall forward; pain as from a bruise. Shooting pain in the small of the back. Drawing pain from the small of the back to the legs. Drawing all along the back, beginning at the nape of the neck; stiff neck, when turning the head Swelling of the cervical glands, with itching eruption in the face and upon the skin. (32.) General Symptoms.—Violent headache after walking in the open air; 278 New Materia Medica. it continues through the evening. Cracking in the joints, when walk- ing. Violent rheumatic pain, with sensation as of drawing through all the limbs. Prickling sensation in different parts of the body. Hands and feet go to sleep, when sitting, passing off on exercise. Cold hands and feet, even in a warm room. Sleepiness during the day. Excessively tired and languid. Extreme lassitude. Glandu- lar swellings. (32.) . AMMONIUM-CAUSTICUM. AQUA-AMMONIA. SPIRITS OF HARTSHORN. AUTHORITIES. Noack and Trink's Mat. Med. (19.) Frank's Magazine. (4.) Jahr. (32.) Waring's Therapeutics. (44.) Orfila. (2.) Wharton and Stille's Med. Jurisprudence. (39.) Peters. (11.) Wood's Thera- peutics. (7.) Christison. (9.) Marcy. (10.) GENERAL REMARKS. « There are several varieties of Spirits of Hartshorn, viz. Liquor-Am- monie-fortior, prepared by receiving gaseous Ammonia in water un- til it becomes nearly saturated, and contains from 29 to 32 percent, of Ammonia. The Liquor-Ammonie-mitior is prepared by adding two ounces of distilled water, to every ounce of the stronger solution of Ammonia. The true spirits of Ammonia is prepared with officinal al- chohol instead of water, and has about the same proportion of Am- monia as the watery solution. When pure, the solution of Ammonia in water is apt to contain some Carbonate, the presence of which may be known by the pro- duction of a precipitate on the addition of lime-water. It is colorless, of a very pungent smell, and an exceedingly acrid, burning, alkaline taste ; it cannot be borne in the mouth without di- lution. (7.) TOXICOLOGICAL EFFECTS. When taken by accident undiluted, or insufficiently diluted, it pro- duces severe inflammation of the mucous membrane of the mouth, fauces and stomach, and may even vesicate or act corrosively. (7.) Much caution is also requisite in applying it to the nostrils, in order to revive fainting persons, or to rouse them from positive syn- cope. Several instances of severe inflammation of the air-passages are on record from this cause, some of which proved fatal. (7.) Case 1.—A little boy, two years of age, took about half an ounce of very pungent spirits of hartshorn ; he was very sick, bringing up at first stringy mucus of a light color, and then some more which was dark. The lips were swollen, the breathing was harsh, hurried, Ammonium- Causticum. 279 somewhat obstructed, and afterwards became somewhat croupy. He recovered. (39.) Case 2.—An ounce was taken in milk by a man who supposed it to be castor-oil, having poured it out in the dark. He took copious draughts of warm water, and vomited a quantity of matter like soap- suds. The inside of the mouth, upper lip, tongue and fauces were very white, and other parts excoriated. There was great difficulty in swallowing ; he felt as if on fire from his mouth to his stomach; his voice was husky; pulse small and frequent, and surface cold: = a kind of collapse, such as occurs in cholera. (39.) Case. 3.—The lips were excoriated with phlyctenae, the tongue swollen and deprived of its epithelium ; the mouth and palate abraded; the throat was so painful as to prevent swallowing, and pressure on the throat and course of the oesophagus caused great pain. (39.) Case 4.—A medical man, liable to epilepsy, was found in a fit by his servant, who tried to arouse him by holding to his nose a handker- chief dipped in Ammonia. On recovering his senses, he complained of burning pain from the mouth down to the stomach, great difficulty in swallowing, difficult breathing, hard cough, copious expectoration, profuse mucous discharge from the nostrils, and excoriation of the tongue. The bronchitis increased steadily and carried him off in three days. Post-mortem appearances: The nostrils were blocked up with an albuminous false membrane; the whole mucous coat of the larynx, trachea, bronchi, and even some of the bronchial ramifications were mottled with patches of lymph. Hence it seems to produce ,a true croupous inflammation. The gullet and stomach showed red streaks here and there ; and there was a black eschar on the tongue, and another on the lower lip. (9.) Case 5.—A lad while convalescent from fever, was seized with epilepsy, for which Ammonia was applied to his nose with such un- wearied assiduity, that suffocation almost resulted. As it was, dys- pnoea with severe pain in the throat and breast immediately succeeded, and death ensued forty-eight hours after. (9.) Case 6.—The patient had all the symptoms of a violent bronchitis, accompanied with redness and scattered ulceration of the mouth and throat, but he recovered in thirteen days. (9.) Case 7.—A druggist who inhaled, while asleep, the fumes of Am- monium from a broken carboy, awoke in three quarters of an hour, with the mucous membrane of the mouth and nostrils corroded ; a severe attack of bronchitis followed, during which he could not speak for six days. He finally recovered. (9.) Case 8.—A solution weak enough to allow the nose to be held over it, was injected into a naevus in a child two years old ; an attack of convulsions immediately followed, and in a minute the child expired. (9.) Case 9.—Orfila injected 60 grains of a pure solution into the jugular vein of a dog; immediately the whole legs were spasmodically ex- 280 New Materia Medica. tended, and at times convulsions occurred, followed by death in ten minutes. Post-mortem, appearances : Coagulated florid blood in the left ven- tricle ; black fluid blood in the right ventricle; complete exhaustion of muscular irritability. (9.) Case 10.—Half a drachm of a strong solution was introduced into the stomach of a dog, and secured by a ligature on the gullet: There was at first great agitation; but in five minutes the animal became still and soporose ; in twenty hours it was quite comatose. Post-mortem appearances: The only morbid phenomenon was a slight, mottled appearance of the villous coat of the stomach. Case 11.—A third dog, to which two and a half drachms of the Carbonate was given, died in twelve minutes: first it vomited; next it became slightly convulsed, and the convulsions gradually increased in strength and frequency, till the whole body was agitated with dreadful spasms; then the limbs became rigid; the body and head were bent backwards, and in this state it expired apparently suffo- cated in a fit of tetanus. (9.) Clinical Remarks.—The preparations of Ammonia would seem ho- moeopathic to true croupous inflammations of the nostrils, throat, larynx, trachea, oesophagus, and of the large and capillary air-tubes. I have already drawn attention to this fact in the Homoeopathic Examiner, Vol. I., 1846, p. 187. It is also homoeopathic to convulsions and tetanus. (11.) Antidotes: The vegetable acids, such as lemon-juice, vinegar,&c, When it has been inhaled, the vapors of Muriatic-acid may be very cautiously employed. (11.) EFFECTS ON THE NERVOUS SYSTEM. Nerves Of Motion.—In almost all cases of poisoning with Ammonia and its preparations, convulsions are observed, apparently shewing that these substances act specifically upon the spinal marrow. Aqua Ammonia injected into the veins, or even into the cavity of the pleura, or stomach, is apt to cause tetanic stiffness and convulsions. Pereira infers that it acts more upon the grey, than upon the white substance of the nerves and brain. Clinical Remarks.—Cullen thought it the best antispasmodic known ; he gave it in doses of four to six drops, in a wineglass full of plainj or orange-flower water. Pescay recommended it in tetanus. Hope recommends it in epilepsy; he says if taken at the first warning of an attack ii seldom fails to arrest it; Pereira quotes a case in his own practice, and another in that of Pinel, in which the inhalation of ammoniacal vapor immediately after the first warning of an attack of epilepsy, apparently averted its occurrence. He found it particularly useful in hysterical epilepsy, and in that form of the disease which Sauvages called Lypothymia, in which the patient is described as dy- ing away. (44.) Nerves of Sensation.—It is not known whether this remedy exerts Ammonium- Causticum. 281 any specific action upon the nerves of sensation, apart from its irri- tant, and croupous inflammatory action. (11.) Clinical Remarks.—Ducros and other French physicians have found the Liq.-Ammoniac applied with a camel's-hair brush to the palate and gums so as to cause a profuse discharge of tears and saliva, ra- pidly cured some obstinate cases of tic-douloureux. It was also found productive of great benefit in the same causes ; if given internally. Ex- ternally applied as a counter-irritant, it also often affords striking re- lief: (44.) ON THE VASCULAR SYSTEM. On the Blood.—The action of Ammonia on the blood has already been fully discussed when treating of Carbonate of Ammonia, (see page 257.) Clinical Remarks.—The preparations of Ammonia are more ho- moeopathic to scurvy and hemorrhages from deficiency of fibrin in the blood, than to any other forms of blood-diseases. In scrofula, the late Dr. Armstrong, found that cases attended by much debility, a languid state of the circulation and deficient cutaneous secretions, were much benefitted by Ammonia. (44.) In typhus-fever, small-pox, scarlet- fever, and other septic disorders, an unusually large quantity of Am- monia is developed, or liberated in the blood. (11.) In the bites of venomous snakes and insects, in which the poi- son is absorbed into the blood, Ammonia has long been used. It is certainly a powerful nervine stimulant in these cases, and is more efficacious than brandy or any other stimulant. It may be given internally in doses of ten to twenty minims in water or wine, every half hour or oftener, if the urgency of the symptoms require it. Externally it should be rubbed into and about the bitten part. The patient should not. be allowed to lie down or go to sleep : he should be kept moving about and his fears allayed in every possible way. In bites of scorpions, centipedes, mosquitos and other veno- mous insects, a liniment composed of equal parts of Ammon.-caust., Olive-oil and Opium, well rubbed over the bitten part, affords great relief. A few drops of the Amnion, may also be given internally. (44.) On the Ileart and Arteries.—The experiments of Blake show that Ammonia, introduced in large doses into the veins, acts by suddenly extinguishing the irritability of the heart. Small doses first lower arterial pressure, from debility of the heart action, and then increase it by obstructing the systemic capillaries. When injected into the aorta from the axillary artery, it causes great increase of arterial pressure, owing to the latter cause ; and then arrests the heart, while respira- tion goes on. Four seconds are sufficient for the Ammonia to pass from the jugular vein into the heart, so as to be discovered there by Muriatic-acid causing white fumes. (9.) Clinical Remarks.—Although in full quantities it extinguishes the irritability of the heart, still Wood says, in consequence of the energy, 282 New Materia Medica. and at the same time the brevity of its stimulant action, it is admi- rably adapted to all those cases of sudden depression or collapse, which if the patient survive, must be followed by febrile reaction, if not acute inflammation. The want of any special influence on the brain, adapts it peculiarly to those in which the reaction will likely be attended with inflammation, or great vascular excitement of that organ. Instances of the kind are nop unfrequently presented in the cold stage of febrile diseases, the collapse of concussion of the brain, and the prostration of any sudden shock. (11.) Pulse.—Weak, small,frequent. (19.) Fever.—Profuse perspiration, violent fever. (19.) Dry skin, shiv- ering, chilliness, violent thirst. (4.) Caustic Ammonia in small doses is said to act as a stimulant, excitant or calefacient; it produces a sensation of warmth in the mouth, throat and epigastrium, frequently attended with eructations. A temporary excitement of the vascular system succeeds, but this quickly subsides ; the heat of the skin is increased, and there is a tendency to sweating, which if promoted by the use of warm drinks and clothing, passes over into profuse per- spiration. (H.) Clinical Remarks. — Gerard of Lyons has used it with success as a sudorific in grave fevers, also in those arising from atmospheric in- fluences, i. e. in catarrhal-rheumatic fevers. Pugnet and Brachet have used it with astonishing success in catarrhal-rheumatic fevers, when the chill was well marked. (11.) Wood says, in all fevers .assuming in their progress a low form, requiring stimulation, this is one of the first of the diffusible stimulants which may be had recourse to. In typhus and enteric fevers, in the various exanthemata assum- ing a typhoid form, especially scarlatina, small-pox and malignant erysipelas, and even in the phlegmasia, when attended with the same state of the system, it may be used, yet in all these diseases the quan- tity of Ammonia in the blood is increased (see page 257.). Its ten- dency to produce softness or moisture of the skin adds to its useful- ness; and sometimes when the breath and exhalations from the patients have a sour smell, as they are apt to have in low fevers, its property of neutralizing acid may be considered a peculiar recom- mendation. We should not have been much surprised to have Wood recommending it when the breath was ammoniacal. Still he has doubtless often applied it unwittingly when that was the case, sup- posing the breath to be sour or musty. (11.) In continued fevers, which have existed for some time, and where all violent action has subsided, and the brain does not appear much disordered, it is occasionally of great service. Its diaphoretic action may be improved by diluents and warm clothing. In intermittent fevers it is sometimes of advantage, given during the cold stage, to hasten its subsidence. In the exanthemata when the eruption has receded from the skin, and the extremities are cold, it is sometimes of great benefit, on account of its stimulant and diaphoretic properties. Ammonium-Causticum. 233 When the recession arises from or is connected with, an inflamma- tory condition of the bronchial membrane it is inadmissible. (44.) Inflammations,—Caustic Ammonia is decidedly homoeopathic to in- flammation, especially to the so-called "croupous inflammations" of R0K1TANSKY. (11.) Pathology.—Nasal mucous membrane covered with an albuminous coating; uvula covered with a layer of lymph and mucus ; posterior surface of epiglottis, and entrance of rima glottidis covered with a false membrane; trachea and bronchi covered here and there with layers of pseudo-membrane. Clinical Remarks.—Caustic Ammonia is evidently more homoeo- pathic to croupous-inflammations than to any other variety. I sug- gested this remedy against membranous croup as early as 1846, also Bromine, the credit of which has been assumed by so many other physicians. (11.) In some inflammatory diseases, especially pneumonia and rheu- matism, when the violence of the vascular action has been reduced by proper treatment, Ammonia has proved serviceable. In alternation with Senega, Dr. Pereira has found it valuable in chronic pulmonary affections. Skill-—When applied to. the skin it causes pain, redness, vesication and more or less destruction of the part, thus acting first as a rube- facient, then as a vesicant, and lastly as a caustic, or corrosive agent, and may even cause gangrene. When given internally it is apt to cause perspiration. Physiological Remarks.—In the normal sweat, especially in that from the axillae, the occurrence of Ammonia is incontestible. Clinical Remarks.—Although it is a sudorific it has been recom- mended in the dominant school against the colliquative sweats of phthisis ; also against a dry parchment-like state of the skin ; in ex- anthematic fevers with suppression of the functions of the skin, and consequent nervous affections. It is said to be homoeopathic to scarlet-fever, because it induces a scarlet redness and burning hea.t of the skin, especially on the superior portion of the body, and upon the thighs and knees ; it also causes a scaling off of the epidermis, drop- sical effusions, inflammation of the throat and tonsils, and croupous inflammation of the throat and nose. Gerard of Lyons used it. diluted with water, to prevent the inflammation in cases of burns. Tinea and herpes are sometimes combatted happily by ammoniacal lotions; and the faculty of preventing deep-seated inflammations and suppura- tions has also been attributed to its local application. The Linimen- tum-ammonie is much used in rheumatic pains, inflammations of the throat and catarrhal affections of the chest, especially in children. The Liquor-ammonie fortior is used for its vesicatory effects, when Cantharides cannot be employed on account of the extreme suscepti- bility to strangury, or when it is desirable to raise a blister very promptly, as in cases of sudden and great prostration from gouty spasms in the'stomach, anginose affections of the heart, the sinking 284 New Materia Mxdica. spells of low fever, &c, and intolerable neuralgic or spasmodic pains. It has also been employed to obtain quickly a denuded surface for the endermic application of medicines, in cases of great emergency. It may be most conveniently applied by saturating a compress of folded linen, or piece of coarse flannel, which must be covered with a thick towel; for procuring a small blister, the top of a large wooden pill- box may be filled with lint, saturated with the liquid, and then in- verted and pressed upon the skin, so as to prevent the escape of the gas. A blister is produced usually in ten minutes and sometimes so soon as five, and even three minutes ; after which it should be re- moved to prevent cauterizing. (7.) Its use is recommended for Ringworm as being one of the most useful applications: it is advisable to limit the proportion of alkali to the amount of stimulation which it is desired to produce. MUCOUS Membranes.—The ammoniacal remedies have always been supposed to exert a specific action upon the mucous membranes. Pathology. The great peculiarity of its action, is the tendency to the formation of croupous inflammations and exudations which it is apt to cause. (11.) Head.— Dulness of the head. Pressure in the forehead, with sen- sation as if the head would burst, pressure in the temples. (19.) Clinical Remarks.—Three cases of Temulentia are reported in Frank's Magazine as cured bvLiq.-amm.-caust. in twelve to fifteen drop doses, in sweetened water every five, ten or twelve minutes. In two cases the functions of the brain were very much excited, and in one case there was complete absence of sensibility. (20.) Syncope. A case of syncope in a woman aged seventy-five, brought on by working in the garden, during the heat of the sun, in a bent position, was cured as reported by Frank by three, four- or five-drop doses of Liq.-ammon.-caust., on a piece of sugar. These attacks came on several times with trembling, coldness of the limbs, frequent yawning, and vertigo. (26.) Sage says, he obtained the most as- tonishing success with the vapor of Ammonia to animals asphyxiated with Carbonic-acid-gas; he thinks it acts chemically, the alka- line gas, against the acid one. Still, Ammonia causes its own peculiar form of asphyxia ; in fact, in that kind of asphyxia which occurs from Ammonia, the contractility of the muscular fibre is always enfeebled. (11.) In cases of atonic apoplexy, in which diffusible stimulants are admissible, Ammon.-caust. will be, found to be one of the best of these. The vapor may be also applied to the nostrils. In epilepsy, and congestions of the brain, arising from debility, Dr. Hope has found the internal use of Ammon.-caust. exceedingly effi- cacious. He proposes a formula by which he has secured the best results, of 12 minims Liq.-ammon. to an ounce and a half of water. If taken at the first warning of an attack it seldom fails to arrest its supervention. Pereira quotes a case in his own practice, and another in that of Pinel, in which the inhalation of ammoniacal vapor immediately after the first Ammon 'turn-Causlicum. 2S5 warning of an attack, apparently averted its occurrence. (44.) Yet all the ammoniacal remedies cause convulsions. (11.) In baldness, a stimulating wash composed of Ammon.-caust. has been found of great service. Eyes.— Clinical Remarks.—In amaurosis depending upon the de- creased sensibility of the nerve, the vapor of the strong solution directed properly against the eye, is occasionally of great service. It should be applied in a proper vessel, sufficiently near the eye to cause a smart- ing of that organ, together with a degree of redness, and a copious secretion of tears. It may be repeated every three or four hours. (44.) Nose.—Entire stoppage of the nose, with discharge of watery fluid. (19.) Pathology.—Considerable redness of the schneiderian membrane, which is covered with an albuminous layer. Clinical Remarks.—We have long been in the habit of using this remedy against catarrhs of the nose, coryza and ozoena, both internally and locally. It is quite singular, however, that Nitric-acid will relieve some cases in which Ammonia seems indicated,but does not cure. Still both Ammonia and and Nitric-acid are compounds of Nitrogen. (11.) Face.—Pale countenance, with features expressive of pain ; dis- figured countenance. Convulsions of the lips. (19.) (4 ) Clinical Remarks.—The use of Ammonia against tic-douloureux has already been alluded to; (see nerves of sensation.) (11.) Mouth and Tongue.—White-coated tongue. Burning and scraping at the root of the tongue. (19.) Tongue, gums and surrounding parts coated white, here and there covered with vesicles. (4.) Clinical Remarks.—It seems homoeopathic to some varieties of canker-sore-mouth, nursing sore-mouth, ulceration of the tongue and gums, and may prove useful in cancrum oris. (11.) Throat, (Esophagus, &C.—Heat and burning in the mouth, extending down to the stomach, causing impediment of breathing. Enlargement of the tonsils, dark redness of the velum pendulum palati, tonsils, and the posterior wall of the pharynx, the uvula is drawn up, and covered with white mucus. Scraping and burning in the throat. (19.) (4.) Pathology.—Considerable redness of the velum pendulum palati, its arches and of the mucous membrane of the posterior wall of the buccal cavity. A few intensely-red streaks in the mucous membrane of the oesophagus and stomach. (32.) Clinical Remarks.—Pringle used it against angina as a resolutive, but it is more especially homoeopathic to the pseudo-membranous affections of the throat and oesophagus, such as the diphtlieritis of Bretonneau. (11.) For chronic hoarseness, dryness of the throat from deficiency of secretion, and chronic asthma, the inhalation of it has been advised to 286 New Materia Medica. promote the secretion of a watery vapor from the mouth, fauces, trachea, and bronchi. (44.) I have found a few drops of Ammonia largely diluted with water, and the doses repeated several times a day, the best remedy against catarrhal and paralytic aphonia. (11.) Gastric Symptoms.—Violent pain in the stomach. Vomiting of blood. Increased thirst. (19.) Vomiting of the contents of the stomach, through the nose and mouth, with violent burning in the parts which are touched by the expelled substance ; vomiting of mere mucus. Painfulness and swelling of the pit of the stomach. (32.) (4.) Clinical Remarks.—Although it has caused vomiting of blood, yet Pinel used it diluted in four parts of water, as a haemostatic, and Gerard has checked the haemorrhage from cancerous ulcers. Noack advises it against violent spasms of the stomach and heartburn, also against nervous dyspepsia and gastrodynia, although it would seem far more homoeopathic to gastric disorders when arising from conges- tion or inflammation. (11.) Abdomen.—Painfulness and swelling of the pit of the stomach. Rumbling in the abdomen. (19.) Great- sensitiveness of the epi- gastrium. (4.) Pathology.—The ileum exhibits red spots here and there. (32.) During the cholera-season in Halle 1848-49. Dr. Reil used Liq.-ammon.-caust. with great success in the third stage of cholera- asphyxia, where other remedies had failed,—his mode of administering, was two drops of Liq.-amm.-caust. in gruel every ten minutes, which brought about a very favorable change, dyspnoea disappearing, the action of the kidneys and skin re-established, in fact all dangerous symptoms soon vanished; the remedy then was given at longer inter- vals. The above treatment in cholera is corroborated by Dr. Kurtz, who gave the Liq.-ammon.-caust. with success in cases where but little purging or vomiting occurred, or where this had almost ceased, with rapid sinking of the temperature of the skin and failing of the pulse, dyspnoea, threatening paralysis of the lungs and heart, asphyxia. (26.) In the year 1850, Dr. Kurtz, of Dessau, used Liq.-amm.-caust. as soon as the pulse flagged, and the temperature of the skin was sinking, &c. until reaction came on; if the discharges continued, he gave Veratrum or other remedies as indicated. (26.) Dr. Steart praises Liq.-amm.-caust. as one of the best remedies in cholera Asiatica. He has treated (as he says,) 142 cases with the loss of one; dose, thirty drops, to be repeated if necessary, in complete prostration. Dr. Ebers gave the Liq.-ammon.-caust. in six to eight drop doses, every fifteen minutes, in desperate cases. (26.) Stool and Anus.—Discharge of blood from the rectum. (19.) Several diarrhoeic stools after the vomiting, with burning at the anus, afterwards constipation; contraction of the anus, sphincter, and colon. (32.) Ammonia m - Causticum. 287 Urinary and Sexual Organs.—Increased secretion of urine. In- voluntary emissions of urine. (19.) The menses appear a fortnight too soon and too profusely. (32.) Clinical Remarks.—In amenorrhea and chlorosis Dr. Ashwell states that he has derived great benefit from a mixture of Ammon.-caust. and milk, thrown into the vagina daily. It has also been very success- fully employed by Lavagna in amenorrhea. (44.) Dr. Dewees relates a very obstinate case of pruritus in a female, which completely yielded to injections into the vagina of a mixture of 5SS.-3J. of the solution in fss. of water. " It succeeded like a charm." He adds that he has since successfully employed it in numerous cases. It should be freely injected into the vagina. (44.) The use of Am- monia in urinary diseases has already been alluded to when treating of Ammonium-carbonicum. (11.) Larynx, Pharynx, Trachea, Chest.—Increased secretion of mucus in the bronchial tubes. Violent cough with copious expectoration of mucus, especially after drinking. Stertorous breathing. (19.) Voice, low and feeble ; broken speech. Violent oppression of the chest; want of breath, desire to draw a deep breath, which is prevented by a pain in the region of the oesophagus, hurried, heavy, rattling breathing. (32.) (4.) Pathology.—Considerable redness of the velum pendulum palati, of its arches and of the mucous membrane of the posterior wall of the buccal cavity. The uvula is dried up and covered .with a mucous layer. The posterior surface of the epiglottis, and the entrance to the rima glottidis are very red and covered with a pseudo-membrane. Considerable redness of the whole of the trachea and c; the bronchi, covered here and there with membranous layer. (32.) Clinical Remarks.—Rayer advises its application to the velum pa- lati, in cases of simple idiopathic asthma. • He dips a roll of lint, a few inches long, into a mixture of four parts of the solution, and one of water, presses out the superfluous fluid, and immediately applies it for a few seconds to the velum palati. This at first causes a feeling of suffocation, with cough and much expectoration; but this soon passes off and great relief is experienced. It should be applied weak at first and may be repeated if necessary. Great care should be taken not to apply the mixture to the back part of the pharynx, as such an application may prove serious or even fatal. Rayer states that in one hundred cases he has employed this treatment with success, and with- out unpleasant consequences. (44.) In chronic Bronchitis an embrocation of Ammon.-caust. is advised as efficacious, and in fact in many pulmonary affections, such as chronic pleuritis, phthisis, &c, it will be found of permanent ad- vantage. General Symptoms.—Affections of the mucous membranes and organs of the chest. Contraction of the oesophagus and of the colon. (32.) Great prostration. (4.) Anxious countenance; pupils widely dilated. 288 New Materia Medica. Faintness and giddiness. He falls backwards insensible as if choked. Sense of constriction in the throat and of impending suffoca- tion ; difficult articulation and breathing; face covered with red spots, and bloody forth issues from the mouth and nostrils; tongue vividly red as if denuded of its epithelium, and in places, together with the cavity of the mouth, covered with mucus, as if with a false membrane. Great thirst, but the attempt to swallow causes violent coughing and mucous expectoration. Face burning to the touch; eyes red; pulse feeble, irregular, and frequent. Dr. Anache has seen good results from Amg) -caust. 3J. to |j. of lard in hydrarthrus, applied to the knee by means of a compress, to re- main about ten to fifteen minutes at a time, so as to cause redness of the parts only; then the knee to be enveloped in oiled silk, and the patient to remain in bed ; this process to be repeated daily. (2G.) ammoxiCm-mukiaticum. AMMONLE HTDKOCIILORAS. MURIATE OF AMMONIA. SAL-AMMONIAC. AUTHORITIES. Hahnemann. (1.) Pereira's Mat. Med. (3.) Dierbach, Mat. Med. (6.) Wood's Therapeutics and Pharmacology, (7.) Frank's Maga- zine. (4.) Waring's Therapeutics. (44.) Vogt's Mat. Med. (20.) Peters. (11.) Marcy. (10.) Fullgraff. (26.) Snelling. (46.) Schoenlein's Pathologie and Therapie. (24.) Chambers on Diges- tion and its Derangements. (47.) GENERAL REMARKS. This salt consists of about thirty-one parts of Ammonia, and sixty- nine parts of Muriatic-acid. Hence it is to be supposed that it par- takes in part of the action of these two remedies, although it neces- sarily has effects peculiar to itself. (3.) It is among the most ancient of remedies. It must have been known to the Hindoos ever since they have burnt bricks, as they now do, with the manure of animals; as some of this salt is usually found crystallized at the unburnt extremity of the kiln. In Egypt, Sal-Ammoniac is obtained by sublimation from the soot afforded by the combustion of camel's dung; the Muriatic-acid or Chlorine of this salt being derived from the common salt on which these animals feed, while the Ammonia is derived from the decom- position of the tissues. The Kalmucks have long carried on quite a trade in natural Sal-Ammoniac, obtained from the mountains of Tar- fur and other volcanoes of Tartary; it is also found in the neighbor- hood of Baswan in Persia, and even Mount Etna furnishes a consider- Ammonium Muriaticum. 289 able quantity to commerce. In modern times it is prepared chiefly, on a large scale, from the impure Ammonia obtained in the manufac- ture of coal gas, and in the destructive distillation of bones. (3.) It is most nearly allied in its action to Hydriodate of Potash, Muriate of Baryta, Chlorate of Potash, and Bromide of Potash. (11.) It may be interesting to mention that the substance which the an- cients termed Sal-Ammoniac derived its name from Ammonia, the name of a district of Lybia where the oracle of Jupiter Amnion was situated. Herodotus mentions the salt found in this district. (6.) PATHOGENETIC EXPERIMENTS. Counsellor Gumpert commenced with administering one-half or one drachm of the salt in twenty-four hours; increased the doses one drachm every three or four days, until finally from four to six drachms were given each day. When about half a pound of Sal-Ammoniac had been used in the course of four weeks, the following complex of symptoms would appear. (4.) A state of things which would exactly imitate a status pituitosus, or febris mucosa, attended with the most invincible repugnance to the remedy, so that even the thought of it would cause nausea.—The eyes would become dull, and present a peculiar glassy or watery shine ;—lassitude, sluggishness and prostration overpowered the whole body; —the tongue became coated and white; the patient experienced a constant shivering; hawked constantly and scraped his throat be- cause there was an incessant tickling there, although he did not get up much mucus ; there was a sense of emptiness in the stomach, although the patient could not bring himself to take food. The perspiration was generally increased ; the sweat broke out from the slightest ex- ertion. Much urine was excreted, of a strong ammoniacal, or even mouldy odor, although it generally remained quite clear. Glassy and tough mucus was occasionally evacuated by stool, but diarrhoea oc- curred only rarely. (4.) This state of things did not last long, before a formal attack of fever would prostrate the patient upon his bed; the paroxysms consisted of chills and fever, followed by profuse perspiration. These pa- roxysms resembled those of an ordinary fever and ague, and were followed by relief from the premonitory symptoms already alluded to, and from some of those of the disease against which it was given. In the course of eighteen months, Gumpert noticed five paroxysms like the above, all of which followed the seven day-type quite ac- curately ; they recurred regularly as long as the organism was suffi- ciently saturated with Sal-Ammoniac; they became slighter and finally ceased as the effects of the drug wore off; and could be reproduced again at pleasure by resuming the remedy. In one case the septimana set in after the Muriate had been used six weeks, and recurred regu- larly every Thursday for four weeks; the fifth paroxysm was slight, 19 290 New Materia Medica. and the sixth omitted, while the seventh was reproduced by repeat- ed doses of the drug. (4.) Clinical Remarks.—It seems homoeopathic to severe cases of gastric and mucous fever; also to quartan and septernary intermittent fevers. Its allied remedy, Kali hydriod., has also cured obstinate cases of fever and ague which had resisted Quinine. (11.) Wibmer took from ten to twenty grains per dose, and repeated it at the end of an hour; the effects were a sensation of warmth and oppression in the stomach, increase of appetite and digestion, and softness of the'stools, headache and increased desire to pass urine. (4.) Clinical Remarks.—It would seem homoeopathic to those gastric or humoral headaches which pass off after a free flow of urine. (11.) When applied locally it irritates the skin moderately; but if very freely applied it may inflame it. When taken internally in a powder it produces a feeling of cool- ness in the stomach ; but in solution it causes the contrary sensation of warmth, which, if the dose is somewhat large, may be attended with epigastric uneasiness or oppression. The secretions become notably increased, especially those of the bronchial tubes and other mucous membranes; urination and perspiration are also frequently induced, and menstruation is said to be promoted. Small doses are apt to constipate, while large doses cause loose stools and discharge of quantities of a tough glassy mucus. (20.) Clinical Re?narks.—It is homoeopathic to many of the disorders of persons of lax fibre with tendency to catarrhal or leucorrhoeal affec- tions, night-sweats and profuse day perspirations, to haemorrhages, to chronic sore-throat, chronic bronchial coughs and expectorations, and to muoous discharges from the bowels. (11.) With these effects, or rather preceding them, there is a liquefacient, falsely called an alterative influence, for Arnold found it to diminish the plasticity of the blood, and Fischer saw a scorbutic-like dyscrasia produced by the long-continued action of this salt. (20.) Clinical Remarks.—The dominant school have taken advantage of these liquefacient and excretive effects of this drug to force resolutions of tumefactions and the softening of indurations. (11.) It exercises a specific influence over the stomach, for Orfila, Smith, and Arnold observed that inflammation of the stomach ensued to whatever part of the body the salt might have been applied. (6.) Clinical Remarks.—It must prove specific against gastritis. (11.) In over-doses it causes vomiting and purging, with other symptoms of gastro-enteric inflammation. on the nervous system. In the inferior animals it has been found, when largely given, to cause great disturbance of the nervous system, as indicated by con- vulsions, paralysis and coma. Ammonium Muriaticum. 291 Nerves Of Motion.— Clinical Remarks.—It may prove useful in some muscular pains and paralysis dependent upon fatty degeneration of the motor-nerves and muscles. It is more or less homoeopathic to pains and other disorders, produced by the suppression of perspira- tion, or of some of the constituents of the urine, by which the Am- monia which should be excreted by the skin and kidneys is retained in the system. (11.) Nerves Of Sensation.— Clinical Remarks.—It may prove useful in some toothaches and neuralgias of the face arising from inflammation of the fibrous tissues about the parts, or in the fibrous envelopes of the nerves themselves. Also in some so-called neuralgic affections of the stomach, in which there are smaller or larger erosions or ulce- rations, and consequent exposure of some of the nerves to contact with food, drink, the secretions of the stomach, both healthy and un- healthy, &c. (11.) Ganglionic Nerves.—Vogt supposes that it exerts a peculiarly spe- cific action upon the ganglionic system, both nervous and vascular, as is evidenced by its powerful and specific action upon the stomach and portal system, and its peculiar relation to fever and ague, and the vegetative processes generally. (20.) ON THE VASCULAR SYSTEM. Heart and Arteries.—According to Sundelin, after its absorption it appears to reduce moderately the action of the heart and arteries, and in this respect belongs to the class of debilitating or temperant agents ; Vogt regards it as a cooling and antiphlogistic neutral salt, which follows well after Nitrate of Potash. Clinical Remarks.—In mild inflammatory fevers, especially those complicated with affections of the mucous or fibrous membranes, as in gastric, catarrhal and rheumatic fevers, it has long been employed for promoting secretion and hastening critical discharges from the mucous membranes, skin and kidneys. (4.) In vegetative-inflammations it is especially recommended. The Germans use it once in sub-acute inflammations, but often precede it by a few doses of Mercurius, Antim.-tart., Kali-nitricum if the fever- ish ot inflammatory symptoms run in the least high. (11.) Fever.—Chills and fever the whole day. Shaking chills, especially evenings and nights. Intermittent fever returning every seventh day, with chills and fever followed by profuse perspiration, with watery eyes, feeling of general malaise, formication, white-coated tongue, feeling of emptiness in the stomach, disgust for food, discharge of glairy, ropy mucous from the bowels, with occasionally diarrhoeic stools; urine of strong ammoniacal, musty smell, but clear accumulation of tough mucous in the throat, difficult to raise ; hectic fever. Profuse perspi- ration, having a urinous smell. Severe sweats early in the morning. (19. 26.) Chilliness, followed by heat, with a bloated red face; 292 New Materia Medica. thirst during both the chilly and hot stage. Frequent flushes of heat, with subsequent sweat. (31. 26.) Clinical Remarks.—In typhus and typhoid fevers, the Muriate of Ammonia has been advised by Hoffman, Jacob, Munro, Hillary, McCausland, Gmelin, and others. Dr. Copland states that he has frequently employed it, and Dr Con well found it of great service in the fevers of India. Schmidt prefers it in those cases attended by diarrhoea. It is rarely used at the present day. (44. 46.) In intermittent fevers, it was formerly employed and is stated to be capable of arresting the fits. Brocklesly and Pringle thought favor- ably of it, when the disease was of an inflammatory character. It is now rarely prescribed, although it is a most important remedy in some obstinate cases, especially when there are obstructions or infarctions in the abdominal organs, or more especially in the mucous membranes of these parts, or when the blood-poison can be removed by remedies which act upon the skin and kidneys. It is perhaps most homoeo- pathic to quartan and septernary fevers. (11.) In mucous fevers: This ought to be the great sphere of its action; it has also been used successfully against a status pituitosus intesti- norum, especially when it occurs in persons who eat abundantly of rich and fat food, and lead sedentary lives ; in persons with fat bellies, but who are still possessed of considerable vigor. It is said to be useful, although less so, in chronic catarrhs of the lungs and bladder. On account of the specific relation of Ammonium-muriaticum to mu- cous fever, it will be well to give a description of this peculiar dis- order. Schoenlein is the only modern writer who has described it. In its milder forms mucous fever may be mistaken for gastric or catarrhal fever; in its more severe ones, it is generally corlfounded with typhus or typhoid. It is a very deceptive and obstinate disorder, which often is only manageable in its primary stages, and may occur in most extensive and murderous epidemics. (24.) First stage: The patient loses all^appetite, has a disgust for food, or if he partakes of a little, the abdomen at once becomes distended, and there arises a sense of oppression and repletion which may be followed by vomiting of mucus and food. (24.) The tongue has a greyish-white mucous coating; there is an un- pleasant taste and feeling of much mucus in the mouth and throat; mucus is plastered over like a thick paste upon the fauces, uvula and tonsils. Or, all this exudation of mucus may suddenly become sup- pressed towards evening, and the mouth, tongue and throat will seem dry, red or brown, and as if varnished; quite as suddenly and gene- rally towards morning, these parts will become moist again, and thick tough mucus may be drawn out of the mouth in long strings, or may be hawked up from the throat with much noise and difficulty; or vo- miting of mucous matters may occur. (24.) The affection may spread downwards upon the lungs, and then there will be the most sudden alternations of dryness and a parched Ammonium Murieiticum. 293 condition of the bronchial mucous membrane, attended with oppression and great congestion of the lungs, to be followed at irregular intervals by the most profuse effusion of mucus into the air-tubes and all the symptoms of suffocative catarrh. (24.) If it spreads downwards upon the small bowels, there will be rumbling and colic pains, and from two to six stools per day, in which there is much tough albuminous mucus which may be drawn out into long strings, mingled with undigested food, more or less bile, and frag- ments of worms. There may be the same rapid suppressions and effusions of mucus from the bowels as have already been described as occurring in the lungs, mouth and throat; and attended of course with sudden variations, improvements and aggravations, of all the symptoms. (24.) The affection often extends to the genital and urinary organs, and then in women there will be discharges of tough, albuminous and ropy mucus from the vagina, while the urine will deposit a mucous sediment. (24.) The attendant fever generally occurs at first in the form of an in- termittent, with evening aggravations and morning intermissions ; as the disease progresses it assumes a remittent form, and may and will become continued and typhoid, unless arrested by proper treatment. c24-) After a while, a partial crisis may set in, and the patient seem al- most, well for several days, and then without known cause a relapse will occur, so that Schoenlein and Autenreith agree in saying that febris mucosa is a disease which will try the patience of both phy- sician and patient, and may thus with deceitful amendments and un- looked-for relapses, sneak along for thirty, forty or fifty days. (24.) After the disease has progressed awhile, the physician will often have to contend with congestive and sub-inflammatory affections of many organs, and with more or less ulceration of the stomach or bowels. (24.) Ammonium-muriaticum and Kali-hydriodicum are the principal ho- moeopathic remedies, although they may have to be assisted with Stibium, Pulsatilla and perhaps Mercurius or Arsenicum. (11.) VeilOUS System.—The Germans suppose that it. exerts almost as specific an action upon the portal system as mercury; and Sundelin hazards the opinion that it is a temperant agent to the arterial system, and an excitant to the venous capillary system. (11) Clinical Remarks.—Vogt recommends it in obstructions of the portal system, in some cases of malaena, icterus, in bilious fevers or those attended with slight inflammation, or obstinate irritation of the liver or spleen. (11.) Blood.—This drug causes a scorbutic-like state of the blood; in which there is no necessary increase of the watery particles, but diminution of the blood-globules and fibrine ; in chlorosis there may be an increase of fibrine and diminution of blood-globules; in scrofula 294 New Materia Medica. an increase of albumen, and deficiency of fat, fibrine and blood-glo- bules. (11.) Clinical Remarks.—Sal-Ammoniac is indicated in some blood-dis- eases, or dyscrasias; also against some haemorrhages. Lymphatic System.—It has always been supposed to exert a specific action upon the lymphatic vessels and glands. It excites a more active state of all glandular organs ; acts as a powerful resolvent reme- dy, and while it increases their power of absorption, it also stimu- lates the excretory actions of the skin and kidneys. It has been de- cided to act more powerfully upon the glandular tissues of the gastro- hepatic system, and of the uterine organs, than any others. (20.) Clinical Remarks. -It has often been used successfully as an excel- lent resolvent remedy against obstructions and infarctions of the vegeta- tive abdominal organs, such as enlargements or indurations of the mesenteric glands, in mesenteric marasmus, and other forms of abdominal scrofula. Also against scrofulous affections of the ovaries, and sup- pression of the menses in scrofulous subjects. (11.) ON THE TISSUES. On the MUCOUS Tissues.—It is supposed to exert a specific action upon the mucous membranes, especially those of the gastro-intestinal organs. It acts, although in a less degree, upon the pulmonary mu- cous membranes ; also upon those of the urinary organs ; while it ef- fects in a still less degree the mucous membranes of the female genital organs, merely because they are more isolated from the system than any others. (11.) Clinical Remarks.—It is thought to be most useful in mucous af- fections, when there is a very tough and glassy coating of mucus over the stomach and bowels, and more or less atony and torpor of these mucous membranes in connection with general obesity ; it is then regarded .as the best mucum incidens of all the neutral salts. On the pulmonary mucous membranes, on the other hand, it is sup- posed by those most experienced in its use, to be most beneficial, not when there is more atony and relaxation of these parts, but when the secretions are suppressed by inflammatory irritation and tension. In virtue of its mild antiphlogistic action, and of its specific tendency to- wards the mucous membranes it has been used with more or less suc- cess in angina-rheumatica, in catarrhus-inflammatorius. pneumonia- rheumatica, and sub-acute bronchitis, dysenteria sub-inflammatoria, urethritis, elytritis, &c. But we should have more confidence in Tartar-emetic, at least in the commencement of these affections, al- though Ammonium-muriaticum and Kalihydriodicum might soon come in play. (II.) Although it causes mucous discharges from almost all the outlets of the body, it is easy to find proofs from allopathic physicians that it will remove them. (11.) Ammonium-Muriaticum. 295 Case 1.—A chronic gonorrhoea which had resisted all remedies for several months, was cured in three days, by twenty-grain-doses, every three hours. (4.) Case 2.—A man had profuse mucous discharges from the bladder and violent urging to urinate, which had long resisted all remedies ; he was emaciated, was scarcely free from pressure on the bladder for five minutes at a time, whence he was obliged to sit upon the close stool almost constantly night and day, and discharged with great pain and straining a Berlin quart of bloody mucus ; he had constant fever. He took twenty-grain-doses of Sal.-ammon. every three hours, and was cured in three weeks.—Frank. 0)1 the Serous Tissues.—Next to the mucous membranes it is supposed to extend its action to the serous tissues, increasing the vegetative processes in them, especially their power and function of absorption, more particularly in the peritoneum and pleura. (20.) Clinical Remarks.—It exerts a far less powerful action upon mor- bid serous effusions, such as anasarca, or general dropsy, or in pleu- risy with effusion, or on peritoneal exudations, than its allied remedy, Kali-hydriodicum. (11.) The Muriate of Ammonia has been little employed in England in dropsical affections, but is held in high esteem in various parts of Eu- rope. It is stated to be particularly useful in dropsy dependent upon hepatic disease : and also in ovarian dropsy. In the latter affection, where there are so few remedies of even reputed efficacy, it should meet with a fair trial. It is favorably spoken of by Dr. Copland (44. 46.) On the Fibrous Tissues.—It is not generally or distinctly stated that this remedy exerts any specific action upon the fibrous tissues, but it has effected cures of indurations of the prostate, and other fibrous glands; also in thickenings and semi-fibrous conditions of the sto- mach, bladder and urethra; also of indurations of the liver, ovaries and uterus, when a large quantity of fibrous tissue of new formation is developed in these organs. (11.) See abdomen, p. 301. In order to give some idea of its action we append a few cases from Frank: (11.) Case 1.—An otherwise healthy man aged forty, had suffered for a long time with frequent urging to urinate, with small discharge of urine and persistent, pressure upon the bladder; also with pain in the perineum and involuntary flow of urine ; on examination there was no stricture of the urethra, but great enlargement of the prostate and probable thickening of the coats of the bladder. (4). Treatment.—Forty grains of Sal-ammoniac were given every two or three hours ; in fourteen days these doses acted powerfully upon the skin and kidneys ; in four weeks the painful urging to urinate was gone, voluntary urination took place less frequently; the urine depo- sited much thick mucous sediment, sweats occurred every night, and several small, thinly fluid and peculiar stools, took place each day 296 New Materia Medica. At the end of seven weeks there was no more pressure upon the bladder, he could retain his urine longer, and passed much more at one time, the pressing and bearing down was slight, and the pain in the peringeum only occasional ; while the involuntary urination had ceas- ed entirely. A severe miliary eruption broke out over his body, the perspirations continued, and the urine "deposited constantly a slimy and fibrinous, or filamentary sediment. At the end of six weeks more, although he fed himself up well, he remained emaciated, his urine still continued thick and sedimentous, his stools were thin and slimy, and his night-sweats persisted. A catheter could be passed easily and he was and remained, comparatively well, although the prostate was still somewhat enlarged. (4.) Case 2.—A lady with great enlargement and falling of the womb, suffered with frequent irregular and profuse haemorrhages, and with menorrhagia; she became extremely emaciated, her eyes dull, face and eyes sallow, with a permanent burning pain in the left hip, and great oppression of the chest. (4.) Treatment.—After two months' use of Sal.-ammon. in full doses, the hypertrophy of the uterus was entirely removed, and the hae- morrhages all ceased. (4.) Adipose Tissue.—It acts as powerfully upon this system as Liquor- potassae, or Kali-hydriodicum. (11.) Case 1.—Imagine a man about fifty years old, of middle stature, with a broad face, whose breadth was still more increased by a large mass of fat hanging beneath the chin ; imagine also a large head, with a broad neck, adorned with a fatty mass extending from one ear to the other ; two small ears pushed forwards and outwards by the fatty tumor; sallow eyes and face; lax cheeks, and thin hair, and you will have a true picture of the head of the patient. Place this head upon a delicately constructed bony frame, with small, thin hands and feet, scantily nourished arms and legs, then imagine on each arm a large mass of fat, which commenced at the deltoid muscles, passed over the shoulders to the nape, forwards upon the chest, and filling the arm-pits; a flabby pot-belly ; and finally two nates, whose ' proportions would be envied by many modern dames, and you would have a vivid idea of the funny figure which our patient presented when unclothed. (4). Treatment.—He was put under the use of Mur.-ammon. ; in the 6th week, the seven-day fever was established and recurred regularly every Thursday. When the patient abandoned the treatment, his belly was collapsed, there was only a trace of the fatty bolster on his neck, the nates were shrunken so that his clothes had to be made greatly smaller, and the swellings on the shoulders had much dimin- ished. After every paroxysm of the seven-day fever, the diminution of the swellings was too evident and remarkable to admit of doubt, while the general improvement of the patient's health was equally great. Before commencing the use of Sal.-ammon., his digestion was Ammonium-Muriaticum. 297 very irregular ; loss of appetite alternated with canine hunger, and constipation with diarrhoea; but all these disturbances ceased and his sallow complexion was replaced by a more healthy and animated one; his eyes became clear; his breathing, which had been much op- pressed, probably from accumulations of fat about the heart and in the chest, became quite free. (4.) * Skill.—Violent burning-itching over the whole body. Constant crawling sensation in the sub-cellular tissue. Eruption, similar to itch, on the back and lower extremities. Papulous eruption with itch- ing, followed by desquamation. Eruption like that of measles. Blis- ters as large as peas, with hard and inflamed base, and violent, ten- sive, burning pain, leaving scabs, after having been scratched open. Furuncles. (19.26.) Clinical Remarks.—In obstinate cases of acne simplex, great benefit has been derived from a lotion of Amnion.-mur., Alum, and Sulphuret of Potassa are sometimes useful. (44. 46.) Mind and Disposition.—Timid and melancholy; internal grief, with inclination to weep. (19.) Ill-humor, indifference. (32. 26.) Sleep.—Sleeplessness on account of chills ; fever followed by sweat. Restlessness, frightful or lascivious dreams. (19.) Excessive pain in the small of the back, rousing her from sleep, with painful lameness in both hips, and in the thighs. She is roused from sleep by a tearing pain in the right upper arm and in the legs ; the pain is in the bones, and begins at the heels. (32. 26.) Head.—Vertigo, with fullness and heaviness of the head, worse during motion, better in the open air. Tearing in forehead and tem- poral regions. Heaviness of the head, especially in the forehead. Feeling of tightness in the occiput. Fleeting stitches in the head, especially on the side of the head and temporal region, worse on stooping ; flushes of heat. (19.26.) Violent headache for several days ; headache on the top of the head. The occiput feels as if compressed by a vice ; this symptom is afterwards felt in both sides of the head, accompanied by excessive ill-humor. (32. 20.) Pathology.—The vessels on the surface of the brain are turgid. Collapse of the brain. (19.) Eyes.—Dimness of the eyes, with a peculiar glassy, watery appear- ance of them. Very painful sensation like hammering over the eyes. Burning in the canthi. Dim-sightedness. (19.) Tearing in the upper border of the right eye ; in the external canthus of the eye, in the eye-ball; agglutination of the eyes early on waking. (32.20.) Clinical Remarks.—In albugo, or white opacity of the cornea, Scarpa advises a collyrium of Ammon.-mur., followed by Cupri-acet. and Aq.-calcis. In some obstinate cases he found it aided the process of absorption. It is particularly adapted for albugo, when supervening upon an attack of small-pox. (44. 46.) 298 New Materia Medica. In ecchymosis of the eye (or black eye) a very good application, when black Bryonia cannot be procured, is the Muriate of Amm. in solution, mixed with bread or linseed, so as to form a soft poultice. It tends to prevent discoloration in all sprains and bruises. (44. 40.) When there is a premature arcus senilis, Sal.-ammon., and Kali-hy- driot. are often indicated. (11.) Nose.—Stoppage of the nose, with constant itching sensation, as if a large and rough body were lodged in the nose, accompanied with a constant desire to blow the nose. Coryza, with sore nose ; obstruc- tion of the. nose and loss of smell; dry coryza, with discharge of clear water. (32. 26.) Clinical Remarks.—It is more homoeopathic to catarrhal states of the nose, and various affections of its mucous membrane, than many other remedies much more frequently used. (11.) Ears.—Stitches on, and in the ear. Feeling of buzzing or thundering in the ears, and pulsations, especially at night. (19. 26.) FaCC.—Burning heat in the face, disappearing in the open air; ashy color of the face. Painful tearing in the bones of the face. Herpes labialis. (19) Complexion very pale. Swelling of the cheek, with enlargement of one of the submaxillary glands, attended with a throbbing and lancinating pain. (32. 26.) Clinical Remarks,—In face-ache, tic-doloureux, or a rheumatic af- fection of the face, Ammon.-mur. in large doses, repeated four times daily, has been found of great service in numerous cases, particularly when the pain partakes more of a rheumatic, than of a neuralgic character. It will not always succeed, but it often does. (44.) Teeth.—Violent tearing in all the teeth, with swelling of the gums. (19. 20.) Mouth.—Tongue covered by a white fur. (19.) Vesicles at the tip of the tongue, which burn like fire. (32. 26.) Clinical Remarks.—To enlarged and flabby uvula, Dr. Addison highly commends the application of the Amm.-mur. In this manner the cough, which is caused by the uvula falling upon the back of the glottis, may be relieved. (44. 46.) Taste, Appetite and Thirst. —Disagreeable, pappy, bitter, sour taste, with accumulation of saliva in the mouth. Violent thirst, especially in the evening. Anorexia. Loathing, disgust for food. (19.) Gastric Symptoms.—Oppressive eructations, tasting of the ingesta; bitter eructations, sometimes tasting of the ingesta, or accom- panied by hiccough ; regurgitation of the food; gulping up of bitter, sour water—frequent hiccough—attacks of nausea. (32.26.) ffisophagUS.—Sticking pain in the oesophagus. Dryness and feel- ing of rawness in the throat. Tickling and constant hawking on ac- count of accumulation of tough mucus in the throat. (19. 26.) Ammonium-Muriaticum. 299 Clinical Remarks.—Three cases of stricture of the oesophagus, re- ported in Frank's Magazine, as follows: Case 1.—A lady, sixty-four years of age, complaining of violent dysphagia, regurgitation of food, accompanied by a feeling as if the food were forced through a narrow place about an inch over the cardiac extremity of the stomach, Am- nion.-muriat. 3j. every two hours, continued for weeks, with only a few interruptions, effected a cure. (4. 26.) Case 2.—A man, aged thirty-seven, with the following symptoms: Dysphagia, regurgitation of food, which had to be forced down the second time, causing violent pain and burning in the region of the cardiac extremity of the stomach. Diagnosis given as : Strictura inflammatoria it.sophagi, Ammonium-muriaticum in doses of about 3j. every two or three hours, effected a cure in ten'days. (4. 26.) Case 3.—A lady, aged forty-six, of delicate constitution, with the following symptoms : Derangement of digestive organs, pressure in the stomach, constipation, pain in the lumbar-sacral region, emaciation and languor; super-added to it, a sudden painful feeling in the cardia and complete inability to swallow solid food. Amnion.-muriat., in the above very large doses administered for a week, brought about such a change as to enable her to eat any kind of food. (4. 26.) There are also two cases of scirrhus pylori, (diagnosticated as such) in Frank's Magazine, reported to be cured by the long-continued use of Amnion.-muriat. for six weeks and longer, in doses of 3ss. to3j. (4.) Stomach.—Empty or bitter eruclations. Hiccough accompanied by stitches in the chest. Nausea, after eating. Disgust and vomiting. Vomiting of frothy mucus. Frequent vomiting of a greenish fluid. Feeling of emptiness, and prostration as if caused by fasting too long, with aversion for food. Feeling of discomfort and heat in the stomach. Feeling of fullness and pressure in the stomach, accompanied by nau- sea, heat and heaviness in the stomach. (19.) Frequent drawing in the stomach, with disposition to waterbrash, and great qualmishness and even vomiting; gnawing or grinding in the stomach, as if from worms. (32 26.) Pathologv.—The vessels of the stomach are injected, exhibiting an arborescent appearance, and are dark-red. Mucous membrane in- flamed, and sometimes detached from the muscular coat. The mucous membrane of the stomach, in the direction of the spleen, is covered with a large number of small, gangrenous ulcers, penetrating the mucous membrane throughout. The mucous membrane of the stomach has become putrified, in the region of the spleen, and separated in pieces floating in a quantity of slimy fluid. Blackish, fetid, fluid in the stomach and ilium. (19. 26.) Trousseau strongly advocates this remedy in schirrus of the sto- mach. He stales that he derived decided benefit from it, administered every two hours. It is reported to relieve the vomiting and heart- 300 New Materia Medica. burn, so constantly attendant on this disease, more speedily and uniformly than any other remedy. (41.46.) It is probable that this remedy will prove almost as homoeopathic as Kali-hydriodicum to mucous flux, or chronic catarrh of the stomach In this disease, according to Chambers, there is usually found after death, more or less congestion of the capillaries of the stomach, and even of the larger blood-vessels ; and there is sometimes yellow, or dark-brown matter, looking like exuded blood mixed with the mucus. (47.) The constant sipping of weak potations, especially tea, seems in some cases to be the cause of gastric flux; at all events patients have been better for leaving off the habit. Indolent, sedentary persons seem more subject to it than others; females more than males: and the middle period of life, from forty to fifty, more than any other age. (47.) One peculiarity, Chambers has rarely failed to notice in patients thus affected, viz., that they have been of a desponding, easily de- pressed turn of mind; not absolutely melancholic, but disposed to dwell always on the gloomy side of everything, external or internal. (47.) The symptoms of gastric mucous flux seem to be closely propor- tioned to the quantity of mucus secreted, and consequently to the ex- tent of membrane involved. Where these are moderate, the difficul- ties of digestion are so slight as often to escape notice. There may be only a certain want of appetite and nutrition, and an incapacity for benefitting by the food taken, in no way distinguishable from si- milar symptoms arising in general anaemia and atony. But where the whole or greater part of the stomach is covered with mucus and enough is collected to interfere with the action of the gastric juice upon the food, phenomena of a well-marked character mani- fest themselves. Then there is a sensation of uneasiness, scarcely in the majority of cases amounting to actual pain in the epigastrium, coming on mostly at times when the stomach is empty. It is at first accompanied by a craving for food ; but no sooner is any taken than it excites a feeling of weight and distension within a very short time, often only relieved by actual vomiting. Where, however, the pain arising from the food is rendered very great by excessive sensitiveness, then there is often a disgust for eating, and an idea that the craving is a false sensation, so that patients will say that they have no appetite, but that there is an emptiness and " sink- ing" in the stomach. Strictly speaking, they have a desire for food, but this is accompanied in sensitive persons with so much nausea and disgust, that they refuse to recognize it as related to healthy appetite. (47.) In the empty stomach there often collects a considerable amount of mucus, which excites vomiting, without any other stimulus ; so that at times quite remote from meals, such as in the morning, a i Amm onium-Muriaticum. 301 large quantity of glairy mucus is thrown up with great relief to this nausea and other uneasy sensations. There is sometimes considerable distension of the stomach by flatus, and a sensation of spasmodic constriction when the stomach is empty, especially on lying down in bed at night, or in the morn- ing before breakfast. Indeed the recumbent posture seems to be particularly unfavorable in cases of gastric flux, and the nocturnal symptoms are often capable of relief by the simple expedient of sit- ting up. (47.) There is often constipation, and the motions are accompanied from time to time by a good deal of mucus. The urine is clear, and sometimes contains more mucus than usual. There is often a good deal of thirst, but no other marks of fever. (47.) In cases of long duration, there is a dull leucophlegmatic aspect, a feeling of weakness, cold extremities, and small feeble pulse. The matters vomited sometimes consist solely of food in a state of acid fermentation ; but it is not rare on some days to find a quantity of mucus, acid or alkaline, in long stringy masses. When the vomiting occurs at times remote from meals, there is sometimes no food at all in it, but merely a quantity of glairy fluid, as if the stomach had fill- ed with mucus which it then rejects. (47.) Gastric flux is sometimes accompanied by a similar condition of the bowels, and mucous diarrhoea, with all the varieties of intestinal worms may appear. The appearance of the tongue varies, and alone is not a safe index of the disease. It may be pale and flabby and covered with mucus ; or if there be much disorder in the salivary glands, or sub-acute in- flammation of the stomach, it may be red, raw, and glazed. (47.) It is very common for food enveloped in mucus and unable to be penetrated by the gastric juice, to take on acetous fermentation, and to produce acid eructations, heartburn and pyrosis of the oesophagus, and a painful collection of wind in the stomach, so that the distress resulting is of a spasmodic or distensive character, and appearing to be relieved by the passage of the wind, is attributed solely to that cause. (11.) Abdomen.—Great distention of the abdomen as far as the stomach, disappearing after stool. Cutting and sticking pain in the whole ab- domen, disturbing sleep at night. Sticking and burning in the right hypochondrium. Violent cutting pain in the abdomen, disappearing after stool. Flatulent distention. Cutting, sticking pain in the ab- domen. Profuse discharge of foetid flatus, with rumbling in the bowels, Flatulent colic. (19.) Splenetic stitches. Feeling of dis- tention in the groin. (32. 26.) Pathology.—The volume of the liver is diminished, its surface and edges exhibit a bright red color. Blackish, foetid fluid in the stomach and ilium, Enlargement of the muciparous glands in various parts 302 New Materia Medica. of the jejunum and ilium, with attenuation of the coats of these in- testines; the prominences contain incipient miliary ulcers. (19. 20.) Clinical Remarks.—It is homoeopathic to excessive flatulence; to a mucous condition of the stomach and bowels, and to enlargement and ulceration of the solitary glands. (11.) Liver.— Clinical Remarks.—It is probable that Ammon.-mur. may prove a remedy against that excessive development of imperfect or de- generate fibroid tissue which causes cirrhosis of the liver, kidneys, and other glandular organs. The liver becomes harder and heavier than natural; the interstices between the lobules become thicker and more solid. The kidneys become hard and white in a similar way, in one form of Bright's disease. Probably all other organs are liable to the same evil: fibroid degenerate tissue is sometimes found in greater quantity than the healthy tissue, which it displaces, and hence it is possible to have an increase of size and weight in the organ affected, although its ultimate tendency is to contract into itself, and to form hard and dwindled masses. So the liver is usually shrunk up and dwindled by this deposit of fibrous tissue in its interstices, the edges are rounded, and the outside covered with wrinkles and irregular depressions; so too are the kidneys, they finally become hard, small, and covered with scars, while the capsule is bound by the contracting cellular tissue so close to the viscus, that you can scarcely detach it without tearing. (11.) Stool and Anus.—Pain in the umbilical region. Constipation with constant cutting pain in the abdomen, and a feeling as if diarrhoea would set in. Soft stool, with pain in the abdomen. Frequent li- quid stools. Discharge of glairy tough mucus with the stool. (19.) Occasional intermission of stool for several days. Hard stool during the whole time of the proving; stool passes in scybalae, which can only be expelled by bearing down, always followed by a soft stool. Sore- ness of the rectum, several pustules being discovered by the side of it; bleeding from the rectum. (32. 26.) Pathology.—Small red spots on the rectum. Clinical Remarks.—It is most homoeopathic to a mucous state of the bowels ; to mucous flux, or diarrhoea; to dysenteria alba; to co- lics arising from inspissated mucus in the bowels; to mucous gastro- intestinal fever ; to ulceration and haemorrhage from the rectum. (1.1.) According to Chambers, the chief local symptom of mucous flux in the small intestines is not so much pain, as a sense of discomfort, felt two or three hours after a meal. The excretion of faeces is very irregular, and is accompanied by the discharge of a quantity of glairy mucus. Sometimes this mucus is so copious as to constitute a sort of diarrhoea, but generally the stools are hard and costive, though en- veloped in a slimy medium. The excreted matters vary greatly in appearance ; sometimes they are light colored and abundant, of a faint putrid smell, and containing principally unaltered food; some- times they.are dark, like pitch, scanty and slimy. There is often se- parated from them, when fluid, a good deal of oily matter, probably Ammonium -Muriaticum. 303 derived from the undigested adipose tissue of the food. The mucus too, may look like lumps of fat, being in white opaque masses ; at other times it has more the appearance of macaroni, being drawn out into adhesive strings. The appetite is always bad in intestinal mucous flux; there is also great langour and incapacity for exertion, coming on generally about an hour after food, accompanied in bilious cases, by an almost irre- sistible drowsiness, which lasts for several hours. Yielding to the drowsiness and taking a nap seems to make matters worse, for there is usually felt after such an indulgence, an intense headache or giddi- ness, which continues longer than the symptoms would have done, had the inclination to sleep been resisted. The depression of spirits is not so remarkable as the feeling of utter helplessness, both of body and mind, accompanied in persons naturally active, with a sense of shame at their unwonted apathy. Sometimes there is a semi-jaundiced state of the skin, and sometimes attacks of complete jaundice super- vene from the spread of the disease upon the mucous membrane of the gall bladder, &c. The tongue may be pale, flabby, wet and slimy ; or it may have a red base, and be irritated in patches. When the bowels are costive, the urine is apt to be thick andhigh- ^ colored ; but generally it is natural, or pale and watery. The pain in the abdomen is generally in the right hypochondrium, or in the coecum, or about the navel. Sometimes acute attacks of spas- modic pain about the waist come on, and the skin around the navel may become so sensitive that peritonitis may be erroneously suspected. There is almost always distressing flatulence, which produces a feeling of suffocation, from pressure of the diaphragm upwards; the same impediment to the motion of the heart, causes palpitation, irre- gularity and indefinable anxiety during the day, and frightful dreams at night. Intestinal mucous flux has very generally a periodic character. The patient is pretty well for a week, or a fortnight, or a month, and then the symptoms above described, or an aggravation of them, occur. A copious discharge of mucus in the stools follows, and then a temporary restoration to health. The flux of mucus seems to be of a critical character. This period in females often coincides with the menses, and leads them to suppose that their intestinal trouble arises from some latent disease of the womb. (47.) This periodicity is most readily observed, when the mucus collecting in the bowels is inhabited by worms. The irritation excited by these creatures around the anus is often entirely unperceived except in the catamenial week, and then is excessively annoying. (47.) Tenesmus also, not unfrequently accompanies the copious secretion of mucus, and sometimes the continuation of these symptoms is fol- lowed by haemorrhoids in the rectum. Children are also very subject to mucous flux and all its consequences. (11.) 304 New Materia Medica. Urinary Organs.—Great pressure on the bladder from above down- ward, accompanied with rigors, causing faeces to be forced out; great anguish at the neck of the bladder; discharge of urine, leaving white chalky spots on a wooden floor. (19.) Bright-reddish urine, with- out flocculi or sediment, during the catamenia ; bright-yellow urine, with a loose cloudy sediment; clayish sediment in the urine, after standing an hour. (32.26.) Clinical Remarks,—Ammon.mur. in large doses (3j. every throe hours) effected a cure in three weeks, as reported by Frank, in a man with violent pressure on the bladder and discharge of purulent mucus during micturition. The urging to urinate was so great as to oblige him to remain in the water-closet almost constantly,, where amidst the most violent pain, he passed in twenty-four hours nearly a quart of muco-pus, mixed with blood. The patient was very much emaciated, and had almost constant fever. (4. 26.) Several cases of dysuria and ischuria vera, have been cured, accord- ing to Frank, by large doses of Ammonium-muriaticum. In some in- stances the disease appears to have originated from enlargement of the prostate gland. (4. 26.) The very favorable curative results which physicians of every school have witnessed from the employment of Ammonium-muriat. in various diseases of the kidneys, formation of calculi, blenorrhceas of the urinary apparatus, and even strictures, are undoubtedly to be re- ferred to its specific action upon the mucous membranes of the uro- poetic system. (44. 46.) Sexual Organs.—Menses too early and lasting too long, accompanied with pain in the abdomen, dorsal and sacral regions. (19.) Leucor- rhcea with distention of the abdomen, without accumulation of wind. (32.) Metrorrhagia in a married woman, who had not menstruated for two months. (4. 26.) Clinical Remarks.—Frank reports a case of chronic gonorrhoea which had resisted various remedies, which was cured in three days by large doses (9j. every three hours) of Ammonium-muriat. (4. 26.) In the same Magazine there are also several cases of hypertrophy of the prostate gland, reported as cured or very much relieved by the long-continued use of large doses of Ammon.-mur. (26.) A case of hypertrophy of the uterus with profuse irregular menstruation in a married but childless lady, aged forty, was cured according to Frank in two months by the use of Ammon.-muriat. in large doses. (4. 26.) This salt is strongly recommended by Sundelin in amenorrhea, as an emenagogue in those cases in which the disease depends on, or is connected with inactivity of the uterus. (3. 46.) In Hydrocele a radical cure may sometimes be effected by the topical application of a strong discutient lotion. This plan of treat- ment is chiefly, if not solely adapted to recent cases, which have arisen from external injuries and those occurring in children. It was first performed by the late Mr. Kento in 1788 ; and was successfully employed in some cases by Sir A. Cooper. The lotion employed Ammonium-Muriaticum. 305 by both these surgeons was simply a solution of Amm.-mur. After a few applications it produces excoriation of the scrotum, and aids the process of absorption. (3. 46.) In uterine hemorrhages Dr. Copland considers that it will prove serviceable, in cases of debility and when the discharge is draining or remittent. It is most useful when there is hypertrophy of the uterus ; when there is simple congestion, Ammon.-acet. is most useful. (11.) In prurigo pudendi it will be found serviceable in allaying the in- tense itching. (3. 46.) It has been used as an injection in gonorrhoea. (44. 46.) Larynx, Pharynx, Trachea.—Dry cough, with stitches in the chest, especially under the false ribs of the left side, worse on lying on the side. Loose cough, with rattling of mucus in the chest (19.) Sore throat, stinging in the throat, during and between the acts of swal- lowing ; when yawning; external and internal swelling of the throat. Throbbing in the tonsils, and glands of the neck, accompanied by flushes of heat. Phlegm in the throat, expelled with difficulty. Dry cough arising from tickling in the throat. (32. 26.) Clinical Remarks.—A case of scrofulosis,in a boy aged thirteen years, as reported in Frank's Magazine, was cured by the use of Ammon.- muriat. (dose and duration of treatment not given). The condition of the patient when he came under treatment was as follows : Sub- maxillary glands hard and swollen, nose and upper lips also enlarged, fetid discharge from the nose, sometimes forming crusts in the nostril during the night, and when loosened in the morning, would leave the parts sore ; appearance of the face pale and bloated. (4.26.) Most remarkable results followed the employment of this remedy in the case of a dry, rapid, and suffocating cough, with inability to utter a word during the paroxysm. The paroxysms always came on at about six o'clock, P.M. and lasted from one-half, to one hour. There was suppression of the menses, but whether this occurred subse- quent or prior to the appearance of the cough, am unable to say. After many remedies had been tried without benefit, the cough im- mediately ceased upon the employment of Ammon.-mur. 30th, and menstruation returned, and was normal. W. E. Payne, Bath, Maine. Case of aphonia: A case is related by Dr. Gerner, in which a young lady, in consequence of exposure to cold, entirely lost her voice. Numerous remedies were tried in vain for three months. She at last. completely recovered her voice in three days, from the inhalation of ammoniacal vapor, disengaged from a mixture of the solution of the Muriate of Amm. and Carbonate of Potash. A few drops of spirits of Hartshorn internally, or the inhalation of a weak preparation of Harts- horn would have effected the same good result. (44. 46.) In hooping cough the Ammon.-mur. was recommended by Stoll at an early stage. Dr. Copland states that he has found it serviceable. All the alkalies are more or less useful in tussis convulsiva. (3. 46.) 20 306 Ammonium-Mur iaticum. In enlarged and flabby uvula Dr. Addison highly commends the application of the Am.-mur. In this manner the cough, which is caused by the uvula falling upon the back of the pharynx, is removed. (44. 46.) Chest.—Short, quick respiration, hot breath. Heaviness of the chest, especially at night, with restlessness, preventing sleep, feeling of constriction of the chest. Stitches in the chest, more on the left side, worse during inspiration and coughing. Pressing and stitches in middle of the sternum, as if something had lodged there. Increased action of the heart (19.) Shootings in the chest, coming on at regular intervals, as the beats in music. Asthma. (32. 26.) Pathology.—A few red spots on the anterior surface of the lungs. Collapse of the lungs. The fat which separates the base of the right ventricle from the auricle externally, contains a good deal of extra- vasated blood, the extravasation extending into the muscular tissue. Dark-red blood, which soon turns bright-red in the air. —The blood is less coagulable ; the fibrin is increased. Aneurismatic distention of the heart and large vessels. (19.) Clinical Remarks.—In phthisis tuberculosa incipiens it has been em- ployed with success, as we find seven cases reported cured or nearly so, in Frank's Magazine. (26.) Case 1. A tailor, aged thirty, cachectic for a year past, affected with dyspnoea and cough; at times his expectoration was mixed with blood. Cured in twenty days by large doses of Ammonium-muria- ticum. (4.) Case 2. Condition as in Case 1, apparently cured in fifteen days, by Ammon.-mur. 3j. every two hours. (4.) Case 3. A bookbinder, aged nineteen, of tolerably good consti- tution, had been sick for three weeks with cough, fever, and with muco-sanguineous expectoration ; after the use of Ammon-muriat. fvi. in doses of 3j. every two hours, a cure was effected in nine days. (4.) Case 4. A man, aged twenty-four, formerly affected with the itch, came to the hospital in the following condition: Cough, dyspnoea and feeling of constriction in the chest; under the use of Amm.-mur. fviii. in sixteen days, a cure was effected. (4.) Case 5, 6 and 7, were persons, more or less of phthisical consti- tution, with cough, copious purulent expectoration, dyspnoea, stitches in the sides and base of the lungs, quick pulse, with or withoutfever, and night-sweats; at times the expectoration was mixed with blood. (4.) By the use of Amm.-mur., in doses of 3j. every two or three hours, (with a few intermissions) for weeks and even two months, in one case, the patients were discharged as cured or at least very much benefitted. (4. 26.) In chronic pleurisy, chronic inflammations of the lungs, and con- gestions of the mucous membranes, Sir G. Lefevre speaks highly of the value of Ammon.-mur. It is a popular remedy with the German physicians. Kali-hydrodicum is generally more useful. Dr. Cop- Muriate of Ammonia. 307 land advises its use in hemoptysis. It appears to be chiefly appli- cable to passive cases in which the vital powers are much depressed. (44. 46.) In rheumatism of the muscles of the chest, and pulmonary dis- eases, Dr. Paris recommends a plaster principally composed of Mur. of Ammon. and states that is also efficacious in chronic swellings and indurations. (44. 46.) Mamma;.—Clinical Remarks.—In abscess of the mammae, or milk- abscess, a lotion originally prescribed by Justamond has been found of great service. It is composed of Ammon.-mur. 3J. Spt. Rosmari- ni Oj. Linen rags wetted with the solution are to be kept continually to the part. It is chiefly applicable in cases of induration of the mammae, after the abscess has suppurated. (44. 46.) Back.—Tearing pain down the sides of the neck. Violent pain and feeling of soreness in the sacral region, interrupting sleep, with laming pains in the hips and exterior of the thigh. Pain in the sacral region, obliging him to stoop. (19.) Pain in the small of the back, as if the parts were bruised or dashed to pieces, both when at rest, and in motion, and at night when in bed, she was not able either to lie upon her side or upon her back. Icy coldness of the back and be- tween the shoulders, not removed either by feathers or wool ; the coldness terminates in itching. (32. 26.) Clinical Remarks.—It promises to be useful in many cases of chro- nic pain in the back; in lumbago, and in back-ache from derange- ment of the kidneys ; also in the back-aches of sedentary, torpid and inactive persons, with great or some inclination to obesity, and*fatty degeneration of the muscles of the hips and loins. (11.) Upper Extremities.—Heaviness,numbness, rigid feeling of the arms. Drawing and tearing in the arms, hand and fingers. Tearing, as if in the marrow of the bones of the arms. Sticking, twitching and crawling in the points of the fingers. (19.) Burning and pressure in the right axilla. Small vesicles on the wrist-joint, first itching vehemently and then burning, when scratched ; large blisters and in- durations deep in the skin upon a hard base, itching and burning, be- come inflamed and form a red-brown scurf, which remains inflamed for a long time, around the right wrist-joint (with swelling of the spot); frequent tingling in the tips of the fingers. (32. 26.) Clinical Remarks.—It is homoeopathic to some rheumatic and neu- ralgic affections of the arms, especially when the fibrous tissues of the tendons and periosteum are mostly involved. It is also indicated in salt-rheum of the wrists and hands; in furuncles and impetigo. (11.) Lower Extremities.—Violent, boring pain in the lower extremities. Trembling, weakness in the legs. Stitches and tearing in the hips and thighs. Pain, as if the tendons of the leg were shortened, causing him to limp. Violent stitches in popliteal space. Pain with throb- bing tearing in external maleolus, and heel; twitching, tearing, 308 Ammonium- Citricum. crawling and stitches in the toes. (19.) Tension and traction in the tendons of the legs. Spasmodic contraction around the lower part of the left leg. Cold feet, in the evening, when in bed, it takes a long time to get them warm. (32. 26.) Clinical Remarks.—It is suitable to a peculiar form of pain in the lower extremities, depending upon the conversion of a portion of the muscular tissue into fat. If the patient is inclined to be fat and has a premature arcus senilis the diagnosis is pretty certain. According to Lee, in those in whom a premature arc is found, it is very com- mon to meet with irregular ill-defined muscular pains, such as would generally be put down as chronic rheumatism, yet with some doubt as to whether they are not in some degree neuralgic. Every physician must have met with such cases ; the pains being annoying, difficult of relief, seated generally in the bellies of the muscles, causing more or less stiffness, sometimes tenderness, even accompanying, but some- times consequent upon acute or chronic muscular rheumatism. Such pains pass under the common title of rheumatic, but their occurrence in so many instances in conjunction with the fatty arc, and often in a degree of severity proportional to its extent,has led to the supposition whether these vague pains may not be the result of fatty degenera- tion of the muscles. Rokitansky and others have met with this disease in the muscles of the calf of the leg, viz., development of minute particles of free fat between the primitive muscular fibres, and it was attended with considerable pain. The muscles most exposed to fatty degeneration of the muscular tissue, are the voluntary muscles, especially of the lower extremities ; it is also often met in the sub- stance of the heart. If Sal.-Ammon. fails, Kali-hydroid, should be used. (11.) Pente of Gottingen has used it as a powerful preservative against the ill-effects of suppression of foot-sweat. He dusts one stocking with a small spoonful of powdered Sal-Ammoniac, upon which some powdered chalk is to be spread. They are to be worn all night. In slight cases several repetitions of this process will suffice; in severe ones the stockings must also be worn during the day. The saline acid combined with the lime and Ammonia is disengaged; the feet feel an agreeable heat, followed by itching, and an abundant perspiration scarcely fails to set in. It is supposed to be most useful in suppressed foot-sweat in gouty and rheumatic subjects. (11.) AMMONIUM-CITRICUM. CITRATE of ammonia. authorities. Waring's Therapeutics. (44.) Peters. (11.) GENERAL REMARKS. A solution of Citrate of Ammonia may be made extemporaneously by saturating twenty grains of Carbonate of Ammonia, in six drachms Phosphate of Ammonia. 309 of lemon-juice. It most nearly resembles the acetate of Ammonia in its properties, may be used in almost all the diseases in which that is useful, and is rather more pleasant to the taste. In common parlance it is terped febrifuge and refrigerant. The experience with it is main- ly clinical. (11.) Stomach. —In gastric irritation depending on an atonic or relaxed condition of the mucous follicles, it is frequently productive of marked benefit. It is said frequently to remain upon the stomach when other medicines are rejected. (44.) Kidneys.—In diabetes, Prout considers it as the best diaphoretic we can employ, but says that it requires to be steadily persevered in, and to be aided by other remedies. A few drops of Digitalis will ac- complish more against a profuse flow of urine than huge doses of diaphoretics. As the inhalation of chloroform frequently causes a temporary saccharine diabetes, homoeopathists should try this remedy in true diabetes. (11.) Fever and Inflammation.—In the latter stages of inflammatory and febrile attacks the Citrate of Ammonia is said to be not only agree- able and refreshing, but also useful as a refrigerant, and diuretic. In scarlet-fever it is favorably spoken of by Dr. Watson. If the pulse be feeble and without hardness he advises it to be given with an excess of Ammonia. In these cases it was a favorite remedy with the celebrated Dr. Cheyne. (44.) AMMONITJM-PHOSPHOR1CUM. PHOSPHATE of ammonia. AUTHORITIES. Dunglison's New Rem. (16.) Braithwaite's Retrospect. (14.) GENERAL REMARKS. Phosphate of Ammonia is a result of the addition of Ammonia to a somewhat concentrated solution of phosphoric-acid. Theoretic Inferences.—From the facts of the frequent exist- ence of lithuria in gout and rheumatism, and the sudden elimination of uric-acid, and that when chemists have examined the structural thickenings in those diseases, they have found deposits of earthy matter, consisting for the most part of soda and lime, and from other considerations, Dr. Buckler infers that uric-acid exists in the blood,— not in a free state, or it would be passed continuously, but in a state of combination with soda or lime, or both. The predominance of lithic- acid in the urine, he considers, generally heralds recovery from an at- tack of gout or rheumatism. "Taking into account," observes Dr. 310 Ammonium-Phosphoricum. Buckler, " these two prominent facts, viz., the excess of lithic-acid found in the urine at the period of convalescence from an attack of gout or rheumatism, and the subsequent deposit of soda and lime in the white tissues, it occurred to me, that during the existence of these diseases, the lithic-acid might exist in the blood, in a state of combi- nation with soda and lime, in the forin of insoluble compounds, which the kidneys and skin refuse to eliminate. If then, any agent could be found capable of decomposing the lithates of soda and lime existing in the blood, and of forming in their stead two soluble salts, which would be voided by the kidneys and skin, we should thereby get rid of the excess of fibrin in the blood, the symptomatic fever, and the gouty and rheumatic inflammation, wherever seated, which have been excited by the presence of these insoluble salts. It occurred to me that phosphate of Ammonia might be the agent, provided it could be given in sufficient doses to answer the end without producing any unpleasant physiological symptoms. It would form, in place of the insoluble lithate of soda, two soluble salts, the phosphate of soda, which is remarkably soluble, and the lithate of Ammonia, also soluble, and both capable of being readily passed by the skin and kidneys. The excess of uric-acid would then be got rid of in the shape of lithate of Ammonia, and the soda floating in the round of the circula- tion, instead of being deposited, as it were, like an alluvial formation in the substance of the fibrous and cartilaginous tissues, would be taken up by the phosphoric-acid, and eliminated from the system." (16.) On the Tissues.—Fibrous Tissue. Dr. Buckler found that the thicken- ing of the white tissues, of long standing, disappeared under its con- tinued use; that it was decidedly serviceable in attacks of gout and acute rheumatism, and that in many old hospital cases of chronic rheumatism, the patients without a single exception, declared them- selves better. In every instance in the cases reported, it was found that where lithic-acid was present in the urine, it at once disappeared under the use of phosphate of Ammonia. From this he was led to suspect that it might prove also serviceable for dissolving uric-acid calculus ; but he had had no opportunity of testing its efficacy in this respect. (16.) Clinical Remarks.—These cases, however, are not considered con- clusive, as this salt exists in the urine in a state of health, and we have no reason to believe that it is not present in gouty and rheu- matic diseases also. Moreover, although there may be generally a predominance of uric-acid in the urine, in gout and rheumatism, it is by no means clear that these diseases are dependent on contamination of" the blood with undischarged urea and uric-acid, as has been main- tained by many. Phosphatic deposits indeed are frequently observed in conjunction with gouty affections, and in many instances it would seem, that tophaceous concretions contain no urate of soda, but in its stead phosphate of lime. In numerous cases of gout the phosphatic predominance is indeed marked. (16.) Phosphate of Ammonia. 311 M. Mattei of Bastia has published some cases, however, which appeared to him to exhibit its efficacy in doses of about 30 grs., and Dr. S. Edwards confirms its advantages in diseases which appear to depend on an excess of lithic-acid or lithates in the blood. In chronic articular rheumatism it appeared to him especially beneficial. His observations do not extend to its power as a solvent of lithic calculi, but his experience leads him to speak positively of its efficacy in ar- resting their increase, and perhaps formation. M. Mattei subse- quently says, he has used it in almost every variety of gout and rheumatism, and nearly always with the most beneficial results. He had frequently warded off attacks of gout by its early employment. Dr. Edwards had given it in fifteen cases, and in none had symptoms of heart-affections exhibited themselves. He had found it of essential service in those swellings which occur after gout, and also in pre- venting the accretion of chalk-stones. He had also directed it as an external application when these deposits appeared to be forming. Dr. Ruschenberger's experience, however, has been quite the re- verse of this in chronic rheumatism. He has used it in a number of cases, but records as the result of his observation, that it is " useless in the treatment of chronic rheumatism." The urine was tested be- fore and during its use, but no change was detected in its constitu- tion by reagents, nor was there any modification in its specific gravity or quantity. (16.) Dr. Edwards (referred to above) speaks quite confidently of the benefit derived from the use of this remedy in numerous affections; and it has been his practice to administer it at once in lumbago, pleu- rodynia, ischio-gluteal rheumatism, epicranial, cervical, and facial rheumatism; and has found it of peculiar service. In muscular rheumatism, acute or chronic, he has employed it with more success than in any other. In one case also of rheumatic ophthalmia, after the subsidence of the inflammatory symptoms, the pains about the eye and brow were alleviated within about sixteen hours. With re- spect to gout, his opportunities of applying the remedy had been limited, yet numerous enough to enable him to speak with certainty of its good effects. He first assures himself that the digestive func- tions are regularly performed (administering aperients as necessary) and then orders the phosphate in water every eight hours. In the third case in which he employed the salt it was strikingly bene- ficial. Case.—A poor man, a dispensary patient, a very gouty subject, had had an attack for two or three weeks, being confined wholly to his bed, or arm-chair. He had tried most of the renowned reme- dies, with little or no relief. On a Wednesday afternoon he com- menced taking the phosphate of Ammonia (two grains every eight hours,) and on the Friday morning following he attended at the dis- pensary, walking each way, and informed Dr. Edwards he had lost all pain, and that the swelling and stiffness were rapidly subsiding. To use his own words, "the second dose had acted like a charm." 312 Ammonium-Phosphoricum. On the Tuesday following he began his work again as a mason. He was ordered to continue the use of the remedy for a time, this being considered a point of some importance. (14.) On the MUCOUS Membranes.—In a trial made with it by Dr. Voigt, in doses only of about three grains, a series of alarming and highly irritative phenomena occurred, caused he thinks, by the violently ir- ritating action of the salt on the stomach: yet Dr. Voigt had good reason to suppose that the preparation employed was pure. In com- menting on this case, however, Dr. Ruschenberger, of the U. S. naval hospital, N. Y., states that he has employed the phosphate of Ammo- nia in nine cases, in doses of ten grains, repeated every four hours. In no case was the article used for less than a week, and in several it was continued three, four and even six weeks. LOCAL EFFECTS. Kidneys and Urinary Organs.—Clinical Remarks.—M. Mattei remarks that as a solvent of lithic calculi, he has no positive experience of its efficacy, but he testifies positively to its powers of arresting the increase, and perhaps the formation of them. In lithic-acid gravel, he has frequently used it, and experience has taught him, that it creates a very rapid decrease and disappearance of the red crystal- line sediment. It may be formed by saturating U somewhat concentrated solution of Phosphoric-acid with Ammonia. It doubtless resembles the Ace- tate and Citrate of Ammonia in its action, although it must have some of the effects peculiar to Phosphorus. It has recently been brought forward by Dr. Buckler of Baltimore, on chemical considerations, as a new remedy for gout and rheumatism, as a solvent of uric-acid cal- culus, and for diseases both acute and chronic, when connected di- rectly with the lithic-acid diathesis. The experience with it is pure- ly clinical. Dr. Buckler's theory is based on the following facts: the frequent existence of lithuria in gout and rheumatism; the excess of lithic- acid which is found in the urine at the period of convalescence from an attack of gout or rheumatism; and the quantity of urate of soda and lime which is found in the structural thickenings and tophi in chronic gout, and rheumatism. Hence he infers that in gout and rheu- matism the uric-acid exists in the blood, not in a free state, or it, would be passed continuously, but in a state of combination with soda or lime, or both, in the form of insoluble compounds which the skin and kidneys refuse to eliminate. Hence the indication would be to find a remedy capable of decomposing the lithates of soda and lime existing in the blood, and of forming in their stead two soluble salts, which would be voided readily by the skin and kidneys. It occurred to him that Phosphate of Ammonia would be the proper reagent, for it would form in place of the insoluble lithates of soda and lime, two soluble salts, viz., the phosphate of soda, which is remarkably soluble, and Phosphate of Ammonia. 313 the lithate of Ammonia, which is also soluble, and both capable of being readily passed by the skin and kidneys. The excess of uric- acid would thus be got rid of in the form of lithate of Ammonia, and the soda floating in the round of the circulation, instead of being de- posited, as it were, like an alluvial formation in the substance of the fibrous and cartilaginous tissues, would be taken up by the phosphoric- acid and eliminated from the circulation. The gouty or rheumatic inflammation which had been excited by the presence of the insoluble salts would abate, and the symptomatic fever and excess of fibrin would cease. Gout.—This reads very well, but in gout at least, there is also very marked derangement of the stomach and liver ; the most familiar of these ailments are impaired appetite, nausea, vomiting, flatulency, heartburn, acid eructations ; the stools also are always unnatural, most frequently too pale in color; but sometimes dark-green and very offensive. In many instances a spontaneous recovery from gout occurs when the patient is attacked with nausea and vomiting, accompanied by acrid bilious discharges from the bowels ; and these evacuations are often followed by immediate relief as to every local and constitutional symptom; sometimes the result will be an entire cessation of the paroxysm; at others the alleviation will be more partial ; but repeated experience has convinced many martyrs to gout that the degree of relief obtained is always proportioned to the copious- ness of the bilious evacuations. Pursuing this hint given by nature, when the spontaneous diarrhoea has been too scanty, Anthony White, late president of the Royal College of Surgeons of England, assists it with five grains of Calomel, which he says will then in a few hours produce copious bilious discharges ; the gout would be gone, and he would be well again. He seems to infer that the remedy should be homoeopathic to the curative endeavors of nature, not to the patho- genetic actions of the disease. (11.) When White took Colchicum singly, his dose was generally about sixty drops of the wine of the seeds, repeated every six hours. After three or four such doses the bowels were acted upon ; the evacua- tions had the odor of the Colchicum ; deeply tinted, scalding bile was passed, and he was well, for he needed no more. Hence, he infers, that, if a spontaneous evacuation of bile operates critically to the re- lief of the gouty paroxysm ; if five grains of Calomel produce relief; if just so much Colchicum or other medicine produces relief, as is suf- ficient to cause a copious discharge of bile, then it is demonstrated that the diminished or altered state of the biliary secretion which is always a concomitant of gout, is not to be classed among the secon- dary phenomena of that disease. Still it is to be supposed that Sir Benjamin Brodie knows as much about the action of Colchicum as Dr. Anthony White, and he thinks that Colchicum checks the secretions of the liver; (see Brodie on Joints, fifth English edition, p. 57.) where he says: " Wherever Colchi- cum is administered it appears to me to be advisable to give some 314 Ammonittm-Phosphoricum. small doses of the pilula hydrargyria or some other preparation of Mercury, at the same time, with a view to prevent the former remedy from arresting the secretions of the liver." Hence it would seem that Mercurius is most homoeopathic in gout when the stools are dark-green and offensive; Colchicum when they are pale and light-colored. These two remedies are too much neglected by homoeopathists ; Mercury, it is well known, produces many pains which are called rheumatic, but which might just as well be termed arthritic; and we have a well-attested case in which a severe affec- tion of the joints followed the excessive use of Colchicum. A few moderate doses of these remedies will greatly expedite relief from an attack of gout, and then the patient use of Bryonia, Cocculus, Pulsa- tilla, &c, as they are indicated, aided by abstemiousness in diet, and methodical exercise will prevent relapses. (11.) Rheumatism.—Dr. Buckler found the Phosphate of Ammonia de- cidedly serviceable in attacks of gout and acute rheumatism, and that in many old hospital cases of chronic rheumatism, the patients with- out a single exception, declared themselves better, and begged for a continuance of the medicine. Dr. Mattei of Bastia has published some cases which appeared to him to demonstrate the valuable agency of the Phosphate of Ammonia in gout and rheumatism. Dr. S. Ed- wards found it especially useful in chronic articular rheumatism; subsequently he published his farther experience in almost every variety of gout and rheumatism, and nearly always with the most beneficial results. He had frequently warded off attacks of gout by its early employment. Before using it, however, he generally gave a cathartic, and in acute articular rheumatism he used other general and local treatment. He found it of great use in subduing the swellings which so frequently occur after gout, and speaks highly of its powers in preventing chalk-stones, as well as of arresting them when forming. In some few cases of gout he used a lotion of it with good and soothing effects, especially when a concretion of urate of soda seemed to be forming. But Dr. Ruschenbergerof the United States naval-hospital at New- York, used it in nine cases, in ten grain doses, every four hours, in no case for less than a week, and in several it was continued three, four or even six weeks; with relief in one case only. Note.—According to the analysis of Berzelius, Phosphate of Am- monia exists in the urine in health. In Buckler's cases, in every in- stance, when lithic-acid was found in the urine, it at once disappeared under the use of the Phosphate of Ammonia. From this rapid dis- appearance of the acid from the urine he was led irresistibly to the conclusion that Phosphate of Ammonia must prove the best agent for dissolving uric-acid calculus. Dr. S. Edwards confirms its ad- vantages in diseases which appear to depend upon the presence of an excess of lithic-acid or lithates in the blood. In lithic-acid gravel Aromatic Spirits of Ammonia. 315 he has frequently used it, and experience has taught him that it creates a very rapid decrease and disappearance of the red crystal- line sediment. But Dr. Ruschenberger found it to exert no influence over the urine in rheumatism. AMMONIJE-SPIRITUS-AKOMATICUS. aromatic spirits of ammonia. The aromatic Spirits of Ammonia is a weaker but much more pleasant preparation than the simple spirits of Hartshorn. It is ren- dered so by the addition of alcohol, water, and the oils of lemon, cloves, nutmegs and lemon-peel. As it is fitted to fulfil the same in- dication as the simple spirit, it is much more used on account of its grateful taste and smell. Headache. It is often used in sick-headache, especially when there is great acidity of the stomach and the patient is pale, cold, and in- clined to be faint. In languor, syncope, hysteria and nervous debility it is said to prove very serviceable. In the flatulent colic of children, from two to four drops in milk or water are said to afford more speedy relief than any other remedy. In heartburn, nausea, and acidity of the prima-vie, it often proves speedily effectual. In amenorrhoza I have repeatedly used it with the most rapid and beneficial results. (11.) AMMONIACUM. GUM-AMMONIAC. The Gum resin of Dorema-Ammoniacum; of Heracleum-Gummiferum. authorities. Noack and Trincks, Mat. Med. (19.) Hahnemann. (1.) Wa- ring's Therapeutics. (44 ) Wood's Therapeutics. (7.) Pereira, Mat. Med. (3.) Frank's Magazine (4.) Dierbach's Mat. Med. (6.) Bri- tish Journ. Horn. (12.) Vogt's Mat. Med. (20.) Trousseau and Pidoux, Mat. Med. (38). Peters (11.) Marcy (10.) GENERAL REMARKS. Origin.—Ammoniac is the concrete juice of an umbelliferous plant denominated Dorema-Ammoniacum, six or seven feet in height, grow-' 316 Ammoniacum. ing in Persia and Afghanistan. All parts of the plant contain a milky juice. At certain seasons this exudes through punctures made in the plant, and hardens in the shape of tears, which are collected for use. It is exported from Bushire, and usually reaches Europe and this country through the ports oft Hindostan. Though usually imported from Bombay, it occasionally comes from the Levant. Properties. —It comes either in the shape of tears, or in aggre- gate masses, and in both forms is often mixed with impurities. The tears, however, are preferable, as the purest may be selected for use. They are of an irregular shape, usually more or less globular, opaque, yellowish on the outside, whitish within, compact, homogenous, brittle when cold, and breaking with a conchoidal shining fracture. The smell of Ammoniac is peculiar, and stronger in the masses than in the tears. The taste is slightly sweetish, bitter and somewhat acrid. It is partly soluble in water, alcohol, ether, vinegar and al- kaline solutions. Triturated with water it forms an opaque milky emulsion, called lac-ammoniacum, which, however, becomes clear upon standing. The alcoholic solution is transparent, but becomes milky by the addition of water. It is said to be a stimulant, although Trousseau and Pidoux deny that it has any stimulant properties whatever, having taken it in two- drachm doses without observing any such effect. Still, large doses are said to cause congestions; violent pains in the head, especially in the occiput and forehead; pains in the eyes, and dim-sightedness ; aching in the chest and spitting of blood; restlessness, loss of appe- tite, relaxation and weakness of the stomach, and diarrhoea. (11.) Wood says, like many other stimulants it may be given so as to prove diaphoretic, diuretic and emmenagogue, although its principal action is manifested upon the pulmonary, gastric, intestinal and uri- nary mucous membranes. (11.) Again, it is asserted that it is not merely a stimulant, but a nervous stimulant, although much less powerful and useful in nervous affec- tions, (except in those which arise from primary disorder of the mu- cous membranes) than Assafoetida, Galbanum and Olibanum. (11.) It is generally regarded as a trivial remedy,but that is only because it is so frequently used in inappropriate cases, and in too large or too small doses, and at improper times and stages of the diseases against which it is suited. general effects. On the Nervous System.—In addition to oiher properties it has been supposed to possess those of a nervous stimulant, in a somewhat less degree, however, than Assafoetida, and Galbanum. In this capacity it has been supposed to be useful in some affections of the optic nerve, in neuralgic and colicky affections of the bowels, in nervous and asthmatic affections of the chest; but in all these disorders its action Gum-Ammoniac. 317 on the nerves is probably secondary to that upon the mucous mem- branes of these parts. (11.) It is supposed by the old-school and by some homoeopathic writers to act specifically upon the nervous system; but our experience does not corroborate this opinion. The phenomena to which it gives rise, when administered both in health and in disease, do not indicate any special action upon the nervous apparatus. (10.) Nerves Of Motion.—It probably acts more decidedly upon the nerves of motion than upon those of sensation; it seems to exert a specific action upon the motor nerves of the chest, abdomen and limbs, as evi- denced by the cramps and pains in the chest and bowels, and the rheu- matic pains in the limbs which it removes. (11.) In large doses it acts as a cathartic, and as an irritant to the pul- monary mucous membrane, and sympathetically with these effects may arise some slight disturbance of the nerves of motion ; but we doubt its power of producing any direct specific action upon these nerves. Gastric derangements caused by indigestible food, are some- times followed by disorder of the motor-nerves but these effects are accidental and non-specific. (10.) On the Vascular System.—Although when used externally it acts as a local irritant, often producing a papular eruption, and sometimes considerable inflammation of the skin, yet it is generally thought to exert a very moderate excitant influence over the circulation. In large doses it often occasions a feeling of heat, weight or uneasiness in the stomach. (11.) Large doses cause sensations of chilliness, succeeded by slightly increased activity of the circulation, headache and other signs of feverish excitement. But its influence over the vascular system is not strongly pronounced. (10.) On the Blood.—Its action on this fluid is unknown ; it doubtless tends rather to increase the white, than the red globules. (11.) Fever and Pulse.—Increased circulation in the capillaries; pulse small, corded, quick and hard; tendency to chilliness and perspira- tion. Oil the Lymphatics and Glands.—It has generally been supposed to exert a specific action upon the lymphatics, glands and absorbents, and has been much used to promote the resolution of scrofulous tu- mors, chronic swelling of the joints, venereal nodes and tumefac- tions, and enlargements of the liver. It is said to increase the flow of lymph more than any other gum-resin. (11.) On the MllCOUS Membranes.—This is apparently the great centre of the action of Ammoniacum; it doubtless acts more specifically upon these parts and upon the mucous follicles and muciparous glands than upon any other tissues. It is homoeopathic to catarrhal affections of many of the mucous membranes, and also to catarrhal-rheumatic af- fections, and to scrofulo-spasmodic affections, such as scrofulous oph- 318 Ammoniacum. thalmia, when attended with much spasm of the eyelids ; scrofulous bronchitis, when attended with spasmodic or asthmatic affections of the muscular-fibres of the bronchial tubes, and in chronic, or scrofu- lous affections of the intestinal mucous membrane, especially when attended with spasmodic or colicky affections of the bowels. Vogt says it acts more powerfully than Assafoetida upon condensed secre- tions of mucus and lymph, influencing especially the mucous mem- branes of the chest, abdomen and genitals. Besides increasing the flow of mucus, it is said undoubtedly to possess the power of render- ing a thick and tough secretion more serous, and hence is thought to be more suitable in blenorrhoeas of viscid, than merely profuse mucus. In fact it is regarded as a mucum incidens et resolvens. It acts much less decidedly upon the serous membranes and cellular tissue. (11.) We have often prescribed it when an allopathic physician, in chronic affections of the mucous membranes of the pulmonary, di- gestive and urinary organs, but with slight benefit. In a few in- stances we have administered it homoeopathically in chronic asthma, coughs of aged persons, and chronic diarrhoeas, but its effects have generally been unsatisfactory. (10.) Skin.—A papular eruption is frequently caused by the application of ammoniac-plaster, which occasionally increases to a quite consi- derable degree of inflammation of the skin. Dr. Duncan has described a fatal case of diffuse inflammation following its use in a case of dis- eased knee-joint. (11.) LOCAL EFFECTS. Milld and Disposition.—Inability for mental labor. Not disposed to do anything ; feeling of discomfort, laziness. Out of humor. De- pression of spirits. (19.) Clinical Remarks.—It is homoeopathic to the dullness of mind and relaxation of body which so often arises in persons suffering from chronic mucous affections; also to some of the nervous and irritative phenomena which occur in like subjects, although less useful than Ambra, Assafoetida and Moschus. (11.) Head.—Feeling of heaviness of the head. Headache night and day. Pressing pain through the whole head ; also in forehead, over the eyes. Semi-lateral tearing in the head. Itching and prickling on the scalp. (19.) Sense of dullness in the forehead, with dimness of sight. Tearing in the right side. Pimples on the borders of the hairy scalp. (32.) ^ Clinical Remarks.—It is homoeopathic especially to headache, arising from disease of the nasal-passages and frontal-sinuses. (11.) Sleep.—Frequent yawning accompanied with a feeling of emptiness in the stomach, and watery eyes. Drowsiness during -the day-time, restless sleep at night. (19.) Eyes.—Pressure and tingling in the eye-ball. Feeling of dryness in the eyes, with sensation as if a foreign body were lodged between the Gum,-Ammoniac. 319 upper lid and the left eye. Dim-sightedness in the evening, and par- ticularly early in the morning, immediately after rising, and heat in the eyes. Photophobia, even in cloudy weather. (32.) Visus nebulo- sus, appearance as if fogs and clouds were before the eyes. (19.) Wichmann speaks of four cases where after the use of Ammonicum, the eyes became affected as follows: sparks and streaks of light be- fore the eyes, and dimness of sight almost amounting to blindness, all occurring in the evening. Similar effects have been observed in other cases by Stieglitz and Lentin. (26.) It is singular that all the at- tacks occurred in the evening; in some of the patients, rays and sparks seemed to shoot from the eyes; a burning candle seemed to be surrounded with rings of brilliant colors; others seemed to look through a thick fog, or cloud of dust. (11.) Clinical Remarks.—The specific action of Ammoniacum and Gal- banum on the optic nerve is undoubted ; Schwartz recommends it in amaurosis, although he refers to Wichmann's observation that it causes dimness of sight. It would seem most homoeopathic to af- fections of the eyes when attended with derangement of several or many of the mucous membranes. The tinctures of Ammoniacum and Galbanum are said to have been used locally with great success in vari- ous diseases of the eyes, such as scrofulous ophthalmia, ocular debili- ty from prolonged reading, spasmodic motions of the eyelids, oedema of the eyelids, weakness of the lachrymal duct, &c. A compress moistened with the tincture has been applied over the eye for one hour, then removed for several hours, and reapplied again. A burning heat is first felt; it lessens gradually and ceases within an hour, when the compress becomes dry. Richter says he has used it with much be- nefit in amaurosis, and adds that he has frequently performed a com- plete cure in cases where he hardly expected it, and in some where the disease had actually been present for several years. (11.) Ears.—Buzzing, roaring in the ears, with hardness of hearing. (19.) Increased secretions of wax. (10.) Clinical Remarks.—It doubtless acts specifically upon the mucous membranes of the ears, and doubtless will prove a more useful local application than many others more.frequently used. (11.) It has been useful in deafness, accompanied by great sensitiveness of the inner ear, and large secretion of wax. (10.) NOSC.—Frequent sneezing. Great dryness of the nose on awaking. (19.) Sneezing, followed by a copious flow of mucus. (32.) Clinical Remarks.—It is far more homoeopathic to influenza, and acute and chronic catarrh of the nose than many other remedies which are more frequently used. (11.) Face.—Pale countenance with sick feeling, preceded by frequent change of color. Drawing in the right malar-bone, towards the temple. Dartings from the region of the lower jaw, to the interior of the mouth. (32.) 320 Ammoniacum. Clinical Remarks.—It is homoeopathic to some neuralgic affections about the liver and cheeks which arise from a catarrhal affection of the sinuses, anterior and other nasal passages. (11.) Mouth, Pharynx, &C.—Great flow of saliva, scraping, burning sen- sation in the throat and oesophagus. (19.) Dryness of the mouth and throat, early in the morning on waking. Sense of fullness in the fauces and pharynx, with nausea. (32.) Clinical Remarks.—It is homoeopathic to many catarrhal affections of the mucous membrane of the mouth and pharynx ; also to many cases of chronic dyspeptic sore-throat, the so-called clergymen's sore- throat or chronic pharyngitis, which is so often mistaken for chronic bronchitis. (11.) It afforded prompt and permanent relief in a case of dryness of the throat, most troublesome in the morning, but always increased by in- haling the fresh air. The patient was a lady, twenty years of age, well in other respects, and had been afflicted with the ailment for more than one year. (10.) Appetite, Gastric Symptoms.—Want of appetite, eructation after eat- ing. Disgust, with inclination to vomit; impaired digestion, (19.) insipid taste. In full doses it readily disturbs the stomach. Clinical Remarks.—Both schools advise it in weakness of digestion. Noack says, it is remarkable that Wibmer says it causes weakness of digestion, yet calls it a stomachicum. It is most homoeopathic when there is a thin yellowish coating on the tongue, tastelessness, or in- sipid sweetish taste in the mouth in the morning, or a nauseous bitter taste in the mouth, disappearing after eating, loss of appetite, eructations after eating, nausea almost to the point of vomiting and great weakness of digestion. In short, it is homeeopathic to many gastric and bilious states, especially when occurring in scrofulous subjects. (11.) Liver, Spleen and Mesenteric Glands.—Clinical Remarks.—It has been used in disturbances of the biliary secretion, and in swelling, inclination to induration, and already formed induration of the liver. Schneider advises it in chronic jaundice ; in old obstructions and in- farctions of the liver, spleen and pancreas. It is most homoeopathic when there is a thin yellowish coating upon the tongue, and nauseous, bitter taste in the mouth, disappearing after eating. Still Wood says it has only been prescribed in obstructions and engorgements of the abdominal viscera, from a vague notion of its deobstruent power, al- though Paris found it valuable in mesenteric affections, by correct- ing the viscid mucous secretions of the intestines ; hence it may be most useful and homoeopathic in those affections of the liver and other abdominal organs, which commence in disease of the mucous membrane of the duodemum and are propagated along the ductis-com- munis to the biliary ducts, gall-bladder, &c. It deserves attention in scrofulous affections of the gastro-intestinal, and biliary mucous membranes. (11.) Gum-Ammoniac. 321 Abdomen.—Cutting pain in the abdomen. Wandering pains in the abdomen, chills and large slimy evacuation. (19.) Pinching. Vio- lent colic. Violent pressure in the pubic region. (32.) Clinical Remarks.—In a peculiar chronic affection of the stomach and bowels, marked by constant distress and burning about the epi- gastrium, continual rumbling and foetid flutulence, with papescent stools and general distress from and mal-assimilation of the food, Am- moniacum (1st to the 3d trit.) will often prove a remarkable pallia- tive, and frequently remove the disorder. (46.) It should be thoughtofin chronic dysentery; and when there is a mucous diarrhoea with co- licky pains and flatulence, connected with a feeble, or torpid, or scro- fulous state of the alimentary mucous membrane, and especially when this condition happens to be associated with a chronic cough, there is a double indication for its use. Some authors speak highly of its utility in long and obstinate colics depending upon thick mucous mat- ter lodged in the intestines. (11.) In colic pains and chronic diar- rhoeas accompanied by cutting pains in the abdomen, great weakness, and bilious, mucous discharges, it has occasionally been serviceable ; but it cannot always be considered a remedy of much importance. (10.) Stool and Anus.—Soft stool with discharge of flatus and rumbling in the abdomen. Mucous diarrhoea. Pressure in the rectum (19.) Insufficient stool; retention of stool. (32.) Fluid stools follow large doses. Clinical Remarks.—It is homoeopathic to mucous piles; to mucous diarrhoea, and to many other chronic affections of the intestinal mucous membrane. Noack recommends it in diarrhoea mucosa when attended with chills, cutting pains in the abdomen and profuse slimy stools; also in colic with diarrhoea, when there are violent cutting pains in the bowels, soft pappy stools, with profuse discharge of wind and much rumbling in the bowels. It is also recommended in the dominant school in abdominal cramps and flatulent colic. In all these cases, if smaller quantities fail, moderate doses of Lac-ammo- niacum will often prove useful. (11.) Urinary and Genital Organs.—Increased secretion of urine ; the urine contains a considerable quantity of urea and lactic acid. Burning in the urethra. A few drops come out after micturition. Stinging in the right spermatic cord, and penis. Itching of the pubic region. (19.) Clinical Remarks.—In passive dropsy it has been advised by Fordyce, but it is a remedy of inferior value. (44.) Frank says it has been used externally with success in many cases of hydrocele, especially in young persons. It should be thought of in chronic go- norrhoea and leucorrhcea, in diseases of the spermatic cord; in ten- dency to diabetes, in the uric- and lactic-acid diatheses, and in the peculiar forms of indigestion and urinary derangement which attend them. Its action on the urinary organs is said to be inferior to that of the balsams, but greater than that of any other gum-resin ; it 21 322 Ammoniacum. is most homoeopathic when there is an'increased flow of urine, follow- ed by dripping of a few drops, the urine being loaded with lactate of urea. It has been advised against haematurea and diabetes. (11.) Sobernheim says it causes a congestive state of the uterus, and even excites a flow of blood from it, and hence has obtained the reputation of an excellent emmenagogue, and has in fact afforded excellent ser- vice in amenorrhoea when there was local debility or torpor of the uterine mucous membranes. Schneider has recommended it in me- nostasia and dysmenorrhoea when arising from obstruction in the portal system, and in irregular menstruation. Also in amenorrhaea arising from chlorosis and in those hysterical affections which attend these disorders. (11.) It may prove useful in some cases of dysmenorrhoea and partial retention of the menses arising from a scrofulo-catarrhal hickening of the mucous membrane of the cervix. (11.) Larynx and Trachea.—Roughness of the throat. Continual tickling without any desire to cough. (19.) Clinical Remarks.—The complaints in which it is most frequently used are chronic catarrh, asthma and other pectoral affections, at- tended with deficient expectoration, without acute inflammation, or with a too copious secretion from the bronchial mucous membrane, dependent upon debility of the vessels. Chest.—The breathing is short, loud and accelerated, with anxiety, oppression and stitches in the left half of the chest, during inspira- tion. Pressure in the chest; dullness and numbness of the posterior part of the right half of the chest; with subsequent pressure deep in the chest. (32.) Clinical Remarks.—In spasmodic asthma, Ammoniacum often proves highly serviceable, relieving the symptoms in a remarkable manner. It is best given in alternation with Scillae, or with a small portion of Hyosciamus or Conium. Plasters of Ammoniacum applied to the chest also afford evident relief. (44.) In hysterical asthma it also proves most useful. It may be alter- nated with equal doses of Assafoetida. (44.) In asthenic pulmonary complaints, it proves useful by promoting expectoration when this is deficient, and by assisting its expulsion, when it accumulates in the air-passages, and the patient has not strength to expectorate. (44.) Pereira says in chronic cough with deficient expectoration, or in chronic catarrhs and asthmatic affections, with piofuse secretion, it sometimes affords slight relief; but although he has seen it extensively employed, he had observed it to prove use- ful in a few cases only. Quarin, Wedekind and Selle advise it when the mucus is tough, profuse and hard to be expectorated. Pe- ter Frank in chronic pulmonary and bronchial catarrhs, with nauseous, thinly-fluid and purulent-like expectoration ; Brumer, Quarin andBeh- rends in mucous asthma ; also in asthenic inflammation of the lungs, es pecially when the expectoration is checked. In alternation with Nitric acid it is said to be an excellent remedy in cases where large accu mulations of purulent or viscid matter exist with feeble or difficult ex pectoration. (11.) Amphisbcend- Vermicularis. 323 Especially in aged people who suffer during cold weather from bronchial affections attended with very great accumulations of mucus, and much difficulty in raising it up, is this medicine of service. In these cases, it should be employed in appreciable doses. It is also useful as a palliative in advanced stages of phthisis, and pneumonia. (10.) Upper Extremities.—Lancination in the shoulder-joints. The left arm feels weak ; rheumatic pain ; pain as if bruised, particularly in the elbow and left wrist-joint, accompanied with tearing in the right hand. (32.) Clinical Remarks.—It has been recommended in joint- and hip- pains, and in gouty nodes; but it is more homoeopathic to pains seated in the lymphatic vessels, and which are often mistaken for rheumatism. It is most specific against pains in the joints and limbs, when at- tended with affections of one or several mucous membranes, with derangement of the urinary organs, and excess of lactate of urea in the urine. (11.) Lower Limhs and Loins.—Weight and pressure in the lumbar ver- tebra, stitches in the loins, particularly during an inspiration. Rheumatic pain in the left side of the region of the pelvis ; stitches over the hip, when walking, obliging him to limp; in the right hip- joint, when sitting. Darting pain in the left thigh, along the crural nerve; violent pain over the knee, when walking. The knee feels swollen in the evening, when sitting, with pinching in the bend of the knee; stitches in the right, knee. Stitches and tearing in the ti- biae and tarsal-joint. Pinching, burning, tearing, drawing in the left foot. Tingling in the right foot. Swelling of the toes. (32.) General Symptoms.—Stinging, tearing,pricking pain, here and there, especially in the lower extremities. Uneasiness. Tired feeling and heaviness of the limbs, even after the slightest exertion. (19.) AMPHISBJENA-YEKMICULARIS. AUTHORITIES. Mure, in Homoeopathic Provings, by James W. Metcalf, M.D. (51.) general remarks. This is the poison of a genus of serpents belonging to Brazil and other parts of South America. It derives its name from the fact that its head is so small and its tail so short and thick, as to be with difficulty distinguished one from the other : while at the same time it has the power of moving either backwards or forwards, as occasion requires. The poison has been obtained by cutting off a portion of the lower jaw and immediately triturating it. The dried and powder- 324 Amphisbcma- Vermicularis. ed flesh of the Amphisbsena, is said to be administered by the na- tives of Brazil as a specific in dislocations, sprains and bruises. It is said by naturalists to be destitute of fangs and perfectly harm- less and inoffensive, living for the most part upon ants and other in- sects; if this be the case, this poison will be somewhatapochryphal. In point of fact all of Mure's provings are more or less suspicious and unreliable. LOCAL EFFECTS. Head.—Heaviness in the forehead and parietal regions. Great con- fusion and vertigo with swinging sensation, which seems to tend to one side and then to the other. Repeated strokes in the right side of the forehead. Sweat on the head. He experiences dreadful head- aches. Confusion as from intoxication when turning the head. (51.) Clinical Remarks.—It promises to be useful, in some cases of headache with great dizziness. (11.) Eyes.—Pain as from a stye in the infernal canthus of the right eye. Continual trembling of the right upper lid, and also of the left. Pain and lancinations, and feeling as if a grain of sand was in the eye. Fatigue of the eyes in the evening; pain and pricking when looking at the light; lacrymation and constriction of the left eye. (51.) Clinical Remarks.—It may prove useful in involuntary twitching of the lids, and in great debility of the eyes, or morbid sensibility to use. (11.) Face.—Prickings and heat over the cheek-bone, and dull pains on the cheek and right side of the inferior maxillary bone. Pains and lan- cinations attacking the whole right side of the head. Pains in the right lower jaw and some swelling, aggravated by the air and moisture. Very large and painful pimple on the left side of the upper lip, ending in suppuration. (51.) Clinical Remarks.—It seems homoeopathic to some neuralgias about the face, to gum-boils and acne. (11.) Mouth and Throat.—The teeth feel prolonged, with tooth-ache worse in the afternoon and evening. He cannot chew without pain, but the impression of liquids is not painful. Swelling of the tonsils. Difficult deglutition. (51.) Clinical Remarks—It seems homoeopathic to inflammation of the lining membrane of the alveolar processes, and to some inflamma- tions of the throat and tonsils. (11.) Ahdomea.—Protrusion of an umbilical hernia. Coldness and pains in the epigastrium. Tearing pain in the navel all day. Strangula- tion of an inguinal hernia. The hernia is painful, and pent-up air is perceived in it. Lancination like a dagger-strokeun the navel. (51) Clinical Remarks.—The above are doubtless entirely accidental effects in ruptured persons and in no wise attributable to the drug. (11.) Bitter-Almond. 325 Extremities.—Very painful swelling of the arm (2d day). Cramp in the legs. They drag in walking as though paralysed. (51.) Clinical Remarks.—Like Lachesis it may prove useful in some cases of simple or phlegmonous erysipelas; and in cramps and par- tial paralysis of the limbs. (11.) Skin.—Red miliary eruption (dry itch cured) in extensive plates of an elliptic form; furfuraceous desquamation takes place in every spot when the eruption is healed. The spots of miliary eruption of little red pimples extend over the whole chest, neck, and back, with itch- ing, more violent in the morning and diminishing until evening. A white vesicle forms by degrees on every papule and discharges a clear lymph, after which the eruption dries up on the fifth day. (51.) Clinical Remarks.—It is homoeopathic to some forms of eruptive disease, especially those of an erysipelatous or malignant character. (11.) General Symptoms. — Debility. Sadness and great, lassitude in the morning, removed when walking. Mild, tender sadness. Great pain throughout the vertebral column, aggravated by walking, moving the arms and stooping. Depression. Ennui. Impatience. (51.) Clinical Remarks.—It is homoeopathic to great exhaustion, such as occurs after grave or typhoid fevers, and depression of spirits ; it seems to be homoeopathic to spinal tenderness. (11.) AMYGDALA-AMARA. BITTER ALMOND. AUTHORITIES. Pereira's Mat. Med. (3.) Wood and Bache. (7.) Peters. (11.) British and Foreign Med. Chir. Rev., (18.) Marcy. (10.) Frank's Maga- zine. (4.) Christison. (9.) Taylor's Med. Jurisprudence. (8.) GENERAL remarks. Bitter almonds are brought chiefly from Mogadore. In external appearance they resemble the sweet almond, but are somewhat smaller. They are distinguished by their bitter flavor, and when rubbed with a little water by their remarkable odor, resembling the fragrance of peach blossoms. A crystallizable substance, called amygdalin, has been found to be a constituent of bitter almonds, and from four pounds of them Liebig obtained one ounce of pure amygdalin. It is white and odorless, with at first a sweet and then a bitter taste. It is quite soluble in boiling alcohol and water, but insoluble in ether. Submitted to distillation with Nitric-acid, it yields hydrocy- anic acid, oil of bitter almonds, formic acid, and some benzoic acid. 326 Amygdala-Amara. (3.) It was formerly supposed that the hydrocyanic acid and es- sential oil were primary constituents of the seeds, and it was to them that their peculiar operation upon the system was ascribed. It was, however, ascertained by M.M. Robiquet and Boutron that these principles do not pre-exist in the almond, but result from the reaction of the water; and Wohler and Liebig proved, what was suspected by Robiquet, that they are formed out of the substance amygdalin, the characteristic constituent of the almond. (7.) There are certain vegetable substances, not commonly regarded as poisons, but which become so by their reaction on one another. This is the case with the two substances, amygdalin and emulsin—the former obtainable from the bitter almond, the latter from the sweet. So long as these substances are kept apart they are innocuous, but \vhen brought together the emulsin transforms the amygdalin into an- hydrous prussic acid, and poisonous results at once ensue. Thus if emulsin be introduced into the stomach of an animal and amyg- dalin in its rectum, or vice versa, no effect is produced, the substance introduced into the rectum not being absorbed ; and the same is the case if (these substances be separately introduced into parts of the areolar tissue remote from one another. But if both of them are introduced separately into the most remote parts of the circulating current, their union takes place with rapidity, and immediate death is the re- sult, the body exhaling the odor of prussic acid. This result is also produced by the introduction of amygdalin into the digestive cavity, and of emulsin into the blood ; but it does not take place when the emulsin is introduced into the digestive cavity and the amygdalin into the blood; for the amygdalin being of the nature of a ferment, is not absorbed. TOX1COLOGICAL EFFECTS. This fruit is more or less poisonous to all classes of animals; but as is the case with most vegetable poisons, the larger herbivora are much less powerfully affected by them. Three quarters of a pound of bitter almonds given to a horse, merely caused dullness and a small pulse, while one drachm has killed some of the smaller animals, as pigeons. In small doses they sometimes act on man as irritants to the digestive organs, occasioning nausea, vomiting and purging. On some their effects are, first, sickness, generally tremors, then vomiting, next a hot fit, with an eruption of urticaria, particularly on the upper part of the body. At the same time the head and face may become swelled very much, and there may be a general feeling like in- toxication. The symptoms last only a few hours, and the rash does not appear and disappear as in urticaria. In large doses bitter almonds have caused serious and some times fatal consequences. (3.) Pierer mentions that three children after eating some of these seeds, were attacked in a few minutes with nausea, vomiting, loss of consciousness, loss of speech and convulsions. (3.) Bitter-Almond. 327 Mr. Kennedy has noticed the case of a stout laborer who died after the use of a great quantity of bitter almonds. Case 1.—A lad, aged fifteen, got access to a cask of bitter almonds, and consumed a large quantity of them with sugar. After a time he felt a pleasing sensation, then became suddenly giddy, fell down, and lost his consciousness and recollection. He was found lying insen- sible near the cask. Treatment.—Ammonia and Carbonate of Potash were admininis- tered, and the stomach-pump employed, till he was much relieved; then emetics were given and he threw off in the course of half an hour, as much as eight ounces Troy of bitter almonds. (48.) Clinical Remarks.—It is homoeopathic to giddiness, loss of con- sciousness and some forms of nervous and venous apoplexy. (11). Case 2.—A boy, aged three, was attacked soon after eating bitter almonds with pains in the belly, and could not stand up ; he vomited ; his eyes were closed, he was unconscious, cold, and limbs relaxed. His face was quite pale; lips, nose and ears white and cold ; the arms and legs also cold and relaxed; his belly was not tense but soft, and scarcely warm; the pulse and respiration scarcely perceptible ; the heart beat with but little energy; while the mouth was so tightly closed that it could scarcely be opened by any means ; he paid no attention to loud talking, but vomited when he was shaken. Treatment.—Emetics were followed by vomiting of bitter almonds, and he recovered in a few days. (48.) Clinical Remarks.—It is homoeopathic to syncope and exhaustion, with great paleness and coldness of the body, and feeble pulse ; also to lock-jaw. (11.) Case 3.—A man, aged seventy, with strangulated hernia, received an emulsion of twelve ounces of bitter almonds ; he took three-quar- ters of this in thirty-six hours, when the following signs of poison- ing occurred : His face was yellowish-grey and moist, eyes sunken, breathing heavy, with oppression of the chest, pulse small, tongue dry and somewhat coated, skin blue and bluish red, especially upon the scrotum where the blue verged upon a greenish yellow, so that the genital organs seemed gangrenous; the knees were drawn up against the body; the head drawn back between the shoulders; the urine was scanty and passed with pain; bowels constipated; the head was confused; the limbs weak and heavy, especially the right thigh. Treatment.—A solution of Carbonate of Potash in distilled water as recommended by Schaub, removed all danger in twelve hours. (4.) Clinical Remarks.—It is homoeopathic to excessive venous con- gestion, with great debility of the vascular system, and spasmodic ir- ritation of the muscular. (11.) Cases 4, 5 and 6.—Two girls, aged eight and three years, and a boy, aged six, ate from four to six bitter almonds a piece. In five 328 Amygdala-Amara. minutes the little girl was taken with nausea and vomiting, and be- came unconscious, speechless and almost motionless. Soon after the other girl, without previous complaint fell back- wards into such violent convulsions that her parents thought she had an attack of epilepsy, to which she had previously been subject; she then vomited, revived for a few moments and again became stupefied. They recovered in one and three hours each without taking anything but a few cups of tea. They had not the slightest recollection of the attack. The boy only experienced a little nausea. Clinical Remarks.—It is homoeopathic to epileptic attacks when attended with nausea and vomiting, and followed by great exhaustion and stupor. (11.) the essential oil of bitter almonds is active as a poison and has repeatedly been the cause of death. It is stated that in one year the daily papers of London furnished accounts of ten cases of poisoning by it. It is about] four times as strong as the medicinal hydrocyanic-acid of the United States Phar- macopoeia. It is of a yellow color, has a bitter acid taste ; the al- mond flavors and essences so much used in cooking are solutions of the oil in spirit, and often prove highly dangerous in the hands of ig- norant people. Enough Prussic-acid is contained in less than an ounce of most of these flavors to produce fatal effects and it is evident that smaller quantities might have the same result in children. Dr. Maclagan states that the ordinary essential oil consists of a peculiar oil (hydruret of benzule) to which its peculiar aroma and pungency are due, associated with anhydrous Prussic-acid. The Prussic- acid can be separated from the hydruret of benzule without impairing the peculiar flavor of the oil, and yet leaving it comparatively inno- cuous. It will not answer merely to agitate the oil with a large ex- cess of lime or caustic potash, as is usually done, and then distilling it, for the Prussic-acid is not thus sufficiently separated; a salt of Iron should be employed, which fixes it more effectually. Why the deadly ingredient should be allowed to remain in it, if it can be so readily removed, it is not easy to understand, unless the dominant school are more careless and reckless of human life than we are willing to sup- pose ; although the homoeopathists have used Aconite for fifty years and more, without a single case of poisoning by themselves or their pharmaceutists, while in the few years that allopathists have used it, cases of poisoning can be counted by scores (see Aconite, pp. 95 to 106). The placing of restrictions upon the sale of this and other ar- ticles of a pernicious character for the purpose of flavoring or orna- menting articles of food and confectionary, is of still more urgent im- portance than any restraint upon Arsenic. Prussic-acid is rather too potent a poison to be distributed to cooks and confectioners disguised with the pleasant odor of bitter almonds. (11.) Bitter-Almond. 329 The volatile oil, however, might probably be substituted with advan- tage for hydrocyanic-acid; as the acid contained in the oil is much less liable to decomposition, remaining for several years unaltered, if the oil is preserved in well-stopped bottles. It is four times as strong as the hydrocyanic-acid, and must therefore be given with caution. (9) Case 7.—A child, aged eight and a half years, took a teaspoonful of ratafia, containing seven drops of the oil of bitter almonds. She be- came immediately insensible, but had no spasms, the limbs were re- laxed, the jaws, however, firmly closed, the eyelids closed, but the eyes brilliant and glassy, although without expression. Treatment.—Cold affusion, emetics and stimulants restored her, and in twenty minutes her consciousness returned. (8.) Clinical Remarks.—This case also shows its homoeopathicity to loss of consciousness, great prostration and lock-jaw. (11.) Case 8.—A woman gave her child the expressed juice of a hand- ful of bitter almonds to cure worms. The child who was four years old, was immediately attacked with colic, swelling of the belly, gid- diness, locked-jaw, frothing at the mouth, general convulsions and insensibility, and died in two hours. (8.) Clinical Remarks.—It is homoeopathic to colic, meteorismus, ver- tigo, lock-jaw, general convulsions, and stupor. (11.) Case 9.—A. druggist swallowed by mistake, half an ounce of " al- mond-flavor." In half a minute he fell down in a state of syncope," his face being deadly pale, and his pulse imperceptible. In a few minutes he came to and vomited food and bile ; delirium with slight convulsions came on; he then became sensible again and conversed upon his condition ; but soon gradually relapsed into delirium, his eyes being prominent and brilliant; in a few minutes he became sen- sible for the third time and shortly recovered. He took about the equivalent of half a drachm of the oil. Clinical Remarks.—It seems to act as a depressor to the vascular system, and an irritant to the muscular; it is occasionally homoeo- pathic to delirium. (11.) Case 10.—A boy, aged twelve, was accosted by another in the street, who had a medicine-basket on his arm, from which he took a bottle and offered him some liquid, which he called almond-oil ; he took about a tablespoonful, and experienced shortly afterwards a burning sensation in his throat, and in about ten minutes he sat down on a door-step and became insensible. There were violent tetanic convulsions with complete opisthotonos, the head and neck being drawn backwards, the elbows drawn behind the back, and firmly fixed in that position ; the jaws were quite fixed; there was complete insensibility, and the pulse was scarcely perceptible. Treatment.—Cold affusion to the spine and the stomach-pump ; the stomach was well washed out with a large quantity of water, which was returned, smelling strongly of Prussic-acid. During the 330 Amygdala-Amara. treatment he suffered with strong convulsive twitchings of the muscles ; he recovered in about an hour. (48.) Clinical Remarks.—It has again proved homoeopathic to stupor and unconsciousness, with violent tetanic convulsions, opisthotonos, and great depression of the vascular system. (11.) Case 11.—J. D----, four years of age, took by stealth, four or five drachms of oil of bitter almonds, which was about being used as a flavoring extract. On reaching the passage adjoining, he stag- gered and fell, apparently insensible, and on a medical man being summoned, the following symptoms were present; countenance very much flushed; eyeballs remarkably prominent, accompanied with a rolling motion, and nearly protruding from their sockets; pupils widely dilated, and insensible to light; pulse full and strong, but slow; breathing stertorous; complete opisthotonos, and frequent con- vulsive action of the muscles of the face and neck. From the rigid contraction of the jaws, some difficulty was experienced in adminis- tering a strong solution of the sulphate of zinc ; the action of which was aided by irritating the fauces with a feather. This expedient was adopted to save time, while the stomach-pump was got in readi- ness. This being procured, the tube was speedily introduced into the stomach (not until the little patient had nearly divided it with his teeth,) several portions of warm water were injected, which soon re- turned with a good deal of undigested food, emitting strongly the characteristic odor of bitter almonds. Warm water was thrown into the stomach, until the fluid drawn up no longer presented the peculiar smell of the poison. Cold affusion was now resorted to, and con- tinued for some time, brandy and water administered, and repeated at frequent intervals. The patient having fallen into a state of collapse, mustard-cataplasms were applied to the epigastrium and the whole length of the spine; on the establishment of reaction, castor-oil was administered, which acted freely, and we soon had the satisfaction of observing returning consciousness. In half an hour he was suffi- ciently recovered to permit of removal, and in two hours he had en- tirely recovered his usual animation and cheerfulness.—Lancet, March, 1855. Clinical Remarks.—This is one of the few cases in which the vas- cular-system was irritated in like manner as the muscular-system fre- quently is ; it is probable, however, that the flushing of the face was rather venous than arterial, and may have arisen from the pressure upon the blood-vessels and consequent retardation of the blood, caused by the severe spasmodic pressure upon them. (11.) Sir B. Brodie happening to touch his tongue with a probe which had been dipped in the oil, suffered almost instantaneously, an inde- scribable sensation at the pit of the stomach, feebleness of the limbs, and loss of power over the muscles. These effects, however, were quite transient. Bitter-Almond. 331 Case 12.—A hypochondriacal man, aged forty-eight, who had long been tired of life, took two drachms of ol.-eth.-amygdal.-amar. at eight o'clock, and went to bed. In a few minutes his face became distort- ed, his eyes were turned up and fixed, and seemed to be forced out of their sockets ; his chest moved spasmodically and rapidly; in twenty minutes he was unconscious, with open and fixed eyes, immove- able irides, rattling in the throat, and progressively slower respira- tion ; his pulse and heart-beats were very slow, only thirty, and carcely perceptible, he could not swallow, and died in an half hour. Post-mortem Appearances.—With the temperature down to 40 Fahr. decomposition had progressed very rapidly in thirty hours ; the head, body and limbs were very livid, and all the superficial veins distended; the scrotum swollen and blue; from the nose and mouth, as often as the body was moved, there flowed almost purely bloody fluid; the nails were blue. The stomach and bowels were much reddened and distended ; the cardiac and pyloric orifices were more reddened than the rest of the stomach ; the inner surface of the stomach and duodenum was con- siderably reddened and covered with streaks of blood. The liver was of a steel-grey color and much enlarged ; there was dark-blue bile in the gall-bladder ; much dark violet-colored blood flowed from the cut surface of the liver. The spleen was of the same color as the liver, and the same kind of blood flowed from the cut sur- face ; it was twice as large as usual; both kidneys contained much blood, similar to that in the liver and spleen ; the bladder contained but little turbid urine ; both pleural cavities were almost filled with a bloody fluid. The heart was much relaxed and contained thin violet blood. The substance of the brain was soft; the blood in all the vessels and cavities smelt of bitter almonds ; there was a serous effusion on the surface of the pia-mater; the venticles contained bloody water; and the plexuses were crowded with blood. (4.) Clinical Remarks.—It is homoeopathic to venous congestion and decomposition of the blood. (11.) In animals, convulsions soon show themselves, and sometimes as- sume a tetanic character, accompanied by cries and other signs of pain ; at the same time the circulation and respiration are accelerated; but after a short time the signs of prostration replace those of con- vulsion ; the animal can scarcely support itself, and paralysis makes rapid progress; the motions of the heart and lungs subside, a pro- found calm supervenes and the animal dies without convulsions. (38.) In man convulsions are said to be less frequent; vomiting often oc- curs ; while colics, diarrhoea and meteorism are common. (38.) nervous system. Nerves of Sensation.—Its action is supposed to be less decided upon these, than upon the nerves of motion. (11.) 332 Amygdala-Amara. Clinical Remarks.—In prosopalgia ten or fifteen drops of a solu- tion of twenty drops of Ol.-Amygdal.-amar. in three drachms of al- cohol has been given with success three or four times a day. (6.) Nerves of Motion.—It seems to exert a specific action upon these parts ; convulsions are not uncommon in the human and animal sub- ject ; lock-jaw, tetanus, opisthotonos, and other spasmodic and con- vulsive attacks have repeatedly been produced by it, see cases 3, 5, 8, 9, 10 and 11. Still these effects are apt to be followed by great relaxation and collapse, very unlike the tetanic rigidity which remains after death from poisoning with Strychnine and Nux-vomica. (11.) Clinical Remarks.—Convulsions and epilepsy. A boy, aged sixteen, who had been epileptic for seven years, could always ward off his at- tack if he took Aqua-Amygdal-amar.-concent, soon enough; but it did not effect a radical cure. (4.) A young woman, aged twenty-two, in the eighth month of her first pregnancy, suffered frequently with severe headaches, and also had great swelling of the feet, face, arms, and in short, of the whole body. (Bright's Disease). After sitting in the sun a very violent attack of headache came on, attended with blindness, and followed in six hours by general tonic cramps, which lasted fifteen minutes and recurred at short intervals. She was bled and took several doses of Calomel, but the puerperal convulsions returned and lasted almost uninterrup- tedly for three hours; even when they ceased for a few moments consciousness did not return. Every variety of antispasmodic remedy was used without relief, and the dropsical swelling of the face and neck increased so rapidly that speedy death was expected. This state of things lasted for twenty-one hours in all, when Aq.-Amygdal.-amar.- concent, was given in twenty drop-doses. The cramp ceased at once after the first dose; the doses were repeated every hour with progres- sive improvement of the patient; a few drops afterwards sufficed to ward off any threatening of an attack. (4.) VASCULAR SYSTEM. Heart and Arteries.—Dr. Gregory experienced a hot fit, or fever; in case 2, there was coldness and relaxation of the limbs, paleness of the face, coldness and whiteness of the lips, nose, ears, arms and legs, while the pulse and respiration were scarcely perceptible, and the heart beat with little energy ; in case 9, the face was deadly pale and the pulse imperceptible ; in case 10, the pulse was also scarcely per- ceptible ; in case 11, the pulse was full and strong, but slow ; in case 12, the pulse and heart-beats were very slow, only thirty, and scarce- ly perceptible. Hence we have the right to conclude that it is a depressant to the arterial system. (11.) Venous System.—It has a great tendency to render the blood non- arterial and venous, and to produce great venous congestion. (11.) Blood.—It renders the blood thin, fluid, and purplish, (see case 12.) Bitter-Almond. 333 Fever.— Clinical Remarks.—Bergius affirms that from 500 to 1000 grammes of an emulsion of bitter almonds given during the interval of the paroxysm, will cure intermittent fevers, which will not yield to Quinine. Cullen, Hufeland, Frank, and especially Mylius, have ear- nestly supported this therapeutic notion. Mylius prefers bitter almonds to all other substitutes for Quinine ; he forms an emulsion with six or eight grammes of bitter almonds in 100 or 125 grammes of water, and administers this dose at one time, about an hour be- fore the expected paroxysm ; in this way he cured seventeen cases in the course of two months ; some required only three doses, others as many as twelve. Frank, who repeated the experiments of Ber- gius and Mylius, approves of their practice, only he adds to the emulsion four or eight grammes of the extract of lesser centaury. (38.) Frank, Hufeland and Richter have given it successfully against fever and ague (3.), Dierbach recommends adults to take seven or eight bitter almonds, three times during the apyrexia, or three drachms of bitter almonds to three ounces of water, with the addition of the extract of Centaurium minus. Frank says the re- medy which Hufeland relied upon most in simple fever and ague, was bitter almonds from ^iss.topj., water fiij.,to which jss. to 3J. of ext.- centaur.-min. was added. Frank and Wiebel often effected cures with one or two bitter almonds taken just before the paroxysm, which would then stay away entirely, unless other causes requiring dif- ferent treatment interfered. The powder against fever and ague, which was so highly recommended by Heurnius, consisted of burnt nut- megs, peach pits and bitter almonds each, 3j. Crato von Kraft- heim relieved Abbot Guarnerius of fever and ague with the expressed juice of carrots with sugar, and with a powder composed of five peach-pits, taken in the morning. The use of bitter almonds as an amulet against fever and ague is very common; three bitter al- monds are marked with certain Greek or other letters and then taken shortly before the expected paroxysm. (11.) Skin.—The smallest dose occasionally produces urticaria and other unpleasant symptoms. (44.) On the late Dr. Gregory they caused: first, sickness, generally tremors, then vomiting, next a hot fit, with an eruption of urticaria, particularly on the upper part of the body; at the same time the head and face swelled very much, and there was a general feeling like intoxication. These symptoms lasted only a few hours, and the rash did not alternately appear and dis- appear, as in common nettlerash. (3.) Clinical Remarks.—Notwithstanding its great homoeopathicity to skin-diseases, the emulsion as often employed in the dominant school as a wash to relieve irritation in various skin-affections, such as herpes, prurigo, acne, impetigo, &c. (3.) In acne rosacea, and im- petigo, the emulsion as a local-application has been successfully em- ployed by Dr. A. T. Thompson ; he states that he found it extreme- ly beneficial. In lichen tropicus, or prickly heat, Dr. Houghton 334 Amygdala-Amara. advises almond-emulsion to which a few bitter almonds have been added, when the itching is very distressing. (44.( Against obstinate herpes pressed bitter almonds (Phyllis-amara) has been given in doses of five or six grains three times a day; as a wash, an emulsion of bitter almonds has been used against excessive itching of the skin and porrigo, also against freckles and chloasma, or liver-spots. Dioscorides recommended them against herpes and ill-conditioned ulcers. (6.) Head.—Feeling of intoxication. In Case 1, there was giddiness, loss of consciousness and recollection, and complete insensibility; in Case 2, there was unconsciousness, although the jaws were so tightly closed that they could scarcely be opened ; he paid no atten- tion to loud talking, but vomited when shaken ; in Case 3, the head was only confused; Case 4 was unconscious, speechless and almost motionless; Case 5 was stupefied and convulsed ; Case 7 became immediately insensible, but had no spasms, the limbs very relaxed, but the jaws firmly closed; Case 8 had giddiness, lock-jaw, general con- vulsions and insensibility; Case 9 fell down in a state of syncope, followed by delirium and slight convulsions, succeeded by transient consciousness and alternating delirium; Case 10 fell down insen- sible and convulsed ; Case 11 fell insensible and convulsed with flushed face and dilated pupils . Case 12 was unconscious. (11.) Pathology.—Substance of the brain soft; serous effusion under the arachnoid; ventricles filled with bloody serum, and blood-vessels and plexuses crowded with blood. Clinical Remarks. —It is homoeopathic to venous congestion of the brain, especially when the white or motor portions are also irritated so as to cause convulsions, or lock-jaw. (11.) A young lady was attacked with violent hepatitis in consequence of suppression of menstruation from taking cold; on the 6th day she was suddenly seized with delirium, singing, picking at the bed-clothes, &c.; two doses of Aqua-Amygdal.-amar., twelve drops each, at intervals of half an hour, dispersed these threatening signs of phrenitis. (4.) Ac- cording to Dioscorides, five or six bitter almonds will suffice to dis- sipate drunkenness. Plutarch records that the son of the physician of the emperor Tiberius was able to keep pace with the most intrepid topers, by taking the precaution to eat several bitter almonds ; while Lorry and Gregory experienced a feeling of intoxication from eating a few, or ten or twelve. Trousseau and Pidoux remark that these facts, if true, do not impeach the correctness of Dioscorides'remarks, for Ammonium which produces a kind of intoxication, will dissipate the vapors of wine in a number of persons. (38.) It is most ho- moeopathic to venous congestion of the head, with tendency to serous effusion, and softening of the brain. (11.) Stomach.—Clinical Remarks.—A robust and plethoric woman, aged forty, who committed frequent errors in diet, and often took cold, was attacked with violent cramps in the stomach and other gastric derange- Bitter-Almond. 335 ments. Counter-irritant, resolvent, and diaphoretic remedies and emetics, all failed to afford relief, for the pain and cramps in the stomach recurred after every meal, until she was almost reduced to a skeleton. She then took three, and finally five bitter almonds every morning and evening, for half a year, when she was entirely cured. Bitter almonds have been recommended in the dominant practice as an excellent vehicle for various remedies, and as a substitute for the Hydrocyanic-acid in many stomach-affections depending upon an irritable condition of that viscus, when that remedy is indicated. Liver and Spleen.—It seems to exert a special action upon these organs, and is homoeopathic to enlargement, engorgement and venous congestion of these organs. (11.) Clinical Remarks.—Aetius gave it against abdominal-infarctions, and obstructions in the liver and spleen. This practice has been re- vived in latter times by Thillenius. (6.) Genital Organs.— Clinical Remarks.—A woman, aged thirty-seven, subject to cramps in the stomach, but otherwise strong and blooming, was attacked suddenly at night, in the thirtieth week of her ninth pregnancy, with violent labor-like pains; she feared an abortion, was much excited, greatly heated and red in the face ; complained of nausea, thirst, bad taste in the mouth, lassitude, and had a hot, dry skin, with a small spasmodic pulse. She took Aq.-Amygdal.-amar. every hour in twenty to thirty drop doses ; when she had taken 3ij -, the labor-pains ceased, but she was left with considerable stupefaction and dizziness. She was safely delivered at the full time of a healthy child, but was soon attacked with such violent after-pains that she was forced to cry out aloud. The water of bitter almonds again re- lieved her quickly. (4). Pitschaft recommends bitter almond-water to relieve painful menstruation. (3.) Chest.— Clinical Remarks.—Dioscorides used it against spitting of blood ; against inflammation of the lungs and kidneys. Aetius gave it more especially to promote expectoration, when the lungs were supposed to be filled with tough viscid mucus. In pneumonia Are- tseus used a decoction of barley, in which bitter almonds had been in- fused, as a valuable remedy against difficulty of breathing; Celsus used an infusion of bitter almonds to relieve cough. Antonius Mu- sae used it generally against suppurations of internal parts. (6.) 336 Amygdala-Dulcis. AMYGDALA-DULCIS. SWEET-ALMOND. AUTHORITIES. Pereira's Mat. Med. (3.) Waring's Therap. (44.) GENERAL REMARKS. Three varieties of the sweet-almond are known, of which the finest (the Jordan-almond) comes from Malaga. Other varieties of greater or less value are the Valentia, Barbary and Italian almonds. They are all odorless, and have a bland, sweetish taste. They have very slight medical properties. (3.) Throat.—Clinical Remarks.—The emulsion is said, freely adminis- tered to have the property of allaying cough: and to be frequently very serviceable in pulmonary affections to allay irritation and ap- pease the cough. Stomach.— Clinical Remarks.—In cardialgia or heart-burn, Dr. Dun- can states that peeled sweet almonds, six or eight at a time, some- times give immediate relief. (44.) Abdomen.— Clinical Remarks.—Almond-emulsion is often exceed- ingly serviceable in inflammatory conditions of the alimentary canal, shielding the inflamed surfaces from noxious substances, and allaying the irritation. Almond-oil, in large doses acts as a mild laxative. Skill.— Clinical Remarks.—In acne rosacea and impetigo the emul- sion, as a local application, has been successfully employed by Dr. A. T. Thompson; he states that he has found it extremely beneficial. In lichen tropicus or prickly heat Dr. Houghton advises its use, combined also with a few bitter almonds. The skin should be mois- tened with it twice or thrice daily, or when the itching is very dis- tressing. (44.) Anacardium-orientale. 337 ANACARDIUM-ORIENTALE. MALACCA-BEAN.—CASHEW-NUT. AUTHORITIES. Noack and Trinks. (19.) Jahr. (32.) Peters. (11.) Flora Ho- moeopathica. (50.) Strong's American Flora. (49.) Frank's Maga- zine. (4.) GENERAL REMARKS. The name is derived from two Greek words, ana, without—and kardia, a heart: because the pulp of the fruit, instead of having the seed enclosed, has the nut growing out at the end of it. Hahnemann in his account of this medicine (Chronic Diseases: Art. Anacardium.) Confounds Avicenna- with Semecarpus-Anacardium; the two trees belong in fact to different natural orders, one to the Personate, and the other to the Terebintacee, the nut of the Avicenna or Malacca- bean, being kidney-shaped, while that of the Semecarpus is heart- shaped. (50.) As the nut mentioned by Hahnemann is without doubt the fruit of the Semecarpus, and not of the Avicenna- or Malacca-bean,—by which name it is erroneously described in Gruhner's Pharm. and Mat. Med., but correctly in Dr. Quin's Pharm. Horn.—a description of the three is subjoined, viz., the nut described by Hahnemann, the Semecarpus and the Avicenna, by which it will be seen that Hahnemann's nut agrees with the former and not with the Avicenna. (50.) Hahnemann. Found in the forests of the East-Indies ; — be- tween the external black, shining, heart-shaped, hard-shell and the sweet- kernel, which is covered with a brown-reddish thin skin, there is a thick blackish juice contained in a cellular tissue, with which the Indians mark their linen in an indelible manner. In the fruit which we receive here, this juice which is commonly of the consistence of honey, is generally found dry. The Indians after depriving the nut of its external rind and juice roast and eat it with much relish. The fruit of this tree is full of an acrid-juice and in taste and ap- pearance resembles that of the common lemon ; to the apex of the 22 Semecarpus. Marking-nut tree Pentandria, Trigynia, Nat.-order, Terebin- taceae. Nut black, contain ing a corrosive resinous juice, at first of a pale milk-color, but turning black. Found in the mountainous dry forests of the East-Indies. The seed is ripe in Jan- uary and February. AVINCENNA-TORMENTOSA. Malacca bean. Didy- namia Gymnospermia. Personatse. Capsule co- riaceous, rhomboidal, compressed, one-celled, two-valved. Seed, one large, form of capsule, constructed of four fleshy folds; germinating in low lands along the coast of Malacca in the Indian Archipelago. 338 Anacardium-orientale. ruit grows a kidney-shaped nut, much larger at the end which is next the fruit than at the other, consisting of two shells, with a black juice between them. TOXICOLOGICAL EFFECTS. According to Dr. Stadeler there is found in the cellular interspaces of the fruit of the Anacardium-orientale, a balsam-like fluid, which has been used externally by V. de Mattes as a vesicant, and internally as a drastic remedy. This balsam consists of a fatty acid called Ana- cardic-acid, and a chemically indifferent substance called Cardol. This latter, i. e. Cardol, is an oleaginous fluid, which when rubbed upon the skin, causes an acute sensation of burning in from three to seven min- utes, followed by a whitish spot, which changes in six or eight hours into a vesicle filled with a whitish fluid, and which continues to sup- purate for ten or fourteen days. Professor Frerichs has frequently used the etherial extract of Car- dol, which is a dark-brownish oily liquid, as a blistering remedy. If it be painted with a small camel's-hair brush upon the sound skin, it dries in rapidly, and excites a slight burning and itching in a few minutes, gradually followed by redness and swelling. In the course of twelve hours, the epidermis rises in the form of wheals {urticaria tuberosa), which gradually change into flat, confluent vesicles, or bulle. (4.) The first, or wheal-like prominences of the epidermis, are firm and solid protuberances, like those of tuberous nettlerash. In the course of time this first or solid exudation is saturated and softened by an effusion of serum and breaks down into a sero-purulent fluid, which converts the wheals into white sero-purulent vesicles, which at first are not larger than a pea and remain flat, but which soon coalesce and form large flat bullae, which open and discharge a turbid, purulent fluid. In the course of a few days the epidermis over the bullae falls completely off, leaves the exposed cutis swollen and congested, and profuse suppuration persists for ten or twelve days more, provided the blistered part be not exposed to external irritation, or to motion or friction ; then the part skins over, and a brownish-red spot remains for some time. But if the sore spot be rubbed and scrubbed, or be exposed to much motion or friction it will of course not heal so soon; on the contrary, fresh exudations take place on the edges of the ulcer, and pass through the same metamorphoses as the original disorder; under peculiarly unfavorable circumstances the cir- cumference of the vesication will become very much reddened and swollen. (4.) The peculiar advantages of vesication with Cardol are supposed to be its cheapness, for with two drachms upwards of one hundred per- sons may be blistered, but more especially and peculiarly that the irri- tation of Cardol causes an effusion of plastic lymph from the capil- laries of the cutis, and that this exudation of plastic lymph is not a transient, but a long-continued one, and hence is a new and very useful form of counter-irritation. Malacca-Bean. Cashew-Nut. 339 Cantharides causes a marked effusion of serum; Tartar-emetic tends to cause a purulent exudation, and Anacardium an outpouring of plastic lymph. (4.) Clinical Remarks.— Anacardium is a rival of Rhus and Cantharides in eruptive disorders ; it is more homoeopathic than these to tuberous nettlerash. The natives of India are said to use Anacardium against the bites of snakes and scorpions; at first they take only a small quantity of the fresh nut, but gradually increase until they consume a whole nut. (11.) Case 1.—The worst case of external poisoning which has ever come under our notice, was produced in a lady who was exposed to the fumes of the nut while roasting. The face was so much swollen that for some time not a feature was discernible. The kernel when fresh has a sweet agreeable taste, and is eaten like chestnuts either raw or roasted. By age it loses its agreeable flavor and becomes rancid. (49.) Clinical Remarks.—This remedy deserves attention in erysipelas of the head and face, especially when the brain threatens to become affected, and more or less stupor or tendency to dullness of mind and forgetfulness is present. (11.) Case 2.—A man wore a Malacca-nut upon his breast to cure rheu-' matism; in the course of eight days he was attacked with itching upon the chest, and eruption of wheals upon the abdomen and in the arm-pits, attended with fever and loss of sleep at night. The wheals changedto bulla?, and secreted a yellowish fluid ; wartlike excrescences were also formed, with thickening of the epidermis,inflammation of the intermediate skin, and formation of yellow crusts. Clinical Remarks.—This case proves the homceopathicity of Ana- cardium to excessive itching and perhaps prurigo; to wheals, or ur- ticaria-tuberosa, which is simply an effusion of serum and a small quantity of plastic lymph in the cutis-vera ; it may also prove homoeo- pathic to lichen-urticatus, and to erythema-nodosum. It may also be used homoeopathically against the bullous cutaneous diseases, such as pemphigus, rupia. It has a popular reputation against warts, yet this case proves that it is homoeopathic to them. In short, it must be admitted as a great homoeopathic rival to Rhus, Cantharides, Euphor- bium and Urtica-urens in many erysipelatous, bullous and vesicular skin-diseases. (11.) Case 3.—Reil rubbed Anacardium on a small spot on the back of his hand ; during the first six days after, there was some itching and the skin became somewhat elevated ; during the next three days the skin peeled off in small white patches, leaving sore, uneven and shin- ing spots, upon which minute herpetic-like pustules arose, with much itching at night, and discharge of a fluid, which soon hardened into scabs. The inflammation of these parts increased for several days more, an eruption of wheals broke out over the whole of the back of the hand, with swelling extending up to the fore-arm, followed by a bran-like desquamation. 340 Anacardium-orientale. Clinical Remarks.—The phenomena of this case seem to point to its homceopathicity to scaly eruptions and to eczema-impetiginodes, as well as to urticaria and perhaps phlegmonous-erysipelas. (11.) Case 4,—An assistant in Gurner's homoeopathic pharmacy in Dres- den, attempted to powder fresh and juicy Malacca-nuts in a mortar; a little of the juice spirted into his face, followed in several hours by violent burning and itching, and an eruption of small vesicles which poured out a fluid when scratched. During the night his face swelled considerably, and in the morning it was covered with a number of pock-like vesicles; there was violent burning in all the swollen parts. By the second night the swelling of the face had not only increased, but similar vesicles had appeared on the backs of both hands, attend- ed with similar burning pains. The vesicles on the face broke during the next day and exuded a yellowish transparent fluid, which soon hardened into a yellowish transparent mass ; the burning was aggra- vated every evening, up to the fourth night, when an extremely pain- ful itching attended with acute pricking and biting, as if from insects, disturbed his sleep; to this was added violent rending pains in the teeth on the left side, which recurred again on the next day. The swelling and the other unpleasant accompaniments gradually sub- •sided,so that at the end of fourteen days there was only some trouble- some itching at night in bed. Clinical Remarks.—This case points to the homceopathicity of Anacardium to eczema-impetiginodes, to varioloid and small-pox, to erysipelas, especially when attended with excessive burning, itching, prickling and biting pains ; also to prurigo, and to neuralgia about the face and teeth, when arising from a concealed or suppressed ery- sipelatous or other cutaneous affection. (11.) Case 5.—A missionary rubbed some of the juice in the palm of his hand; the skin became black and could not be washed clean; in a few hours his eye-lids began to swell, and the swelling extended gra- dually over the whole of his face, head and neck, attended with such violent itching that he scratched himself sore. A salve of milk and oil produced no relief, but the juice of green indigo-leaves afforded much comfort. After the swelling subsided, the entire skin of his face and neck peeled off, without further unpleasant consequences. Clinical Remarks.—This case proves the homceopathicity of Ana- cardium to erysipelas of the head and face, and to the desquamative stage of severe cases of scarlet fever. (11.) General Clinical Remarks.—Dr. Weber of Hanover, recommends it in cases in which after inflammatory diseases the corporeal powers have been completely restored, but the mind has failed to regain its former strength. It is not merely in recent and manageable cases, but in chronic and intractable ones that Anacardium proves useful. It often happens after inflammatory fevers, after typhus and many cerebral affections that the capability for any mental application is lost for a long time, for weeks and months; but the majority of these Malacca-Bean. Cashew-Nut. 341 cases may be cured by suitable recreation, cold ablutions, abundant exercise in the open air, travelling, &c; in this way, the former health may not only be restored, but a freshness, elasticity and power of mind may be attained in a higher degree than was enjoyed before. Anacardium is not only useful in these cases, but also in those in- stances in which all these means have failed, and the patient for a lengthened period after recovery from acute disease has not regained his intellectual powers, although his physical force may be entirely restored. Case 1.—A lad, aged eighteen, after an attack of small-pox, re- gained his usual bodily strength, but became "silly;" his memory was deficient, reflective powers weak, and self-possession limited. Eighteen months passed by without any indication of improvement in his mental powers. He then took Anacard.-orient. 1st dilution, eight drops in water, every night; in fourteen days he was vastly im- proved ; he was quite rejoiced at the change in his head, as he ex- pressed it; Weber saw the patient frequently afterwards and repeated- ly satisfied himself as to his mental powers, as well as to his good- ness of memory. * Case 2.—A young and powerful man, aged twenty-two, evinced great dullness of manner after recovery from typhus; his memory be- came quite enfeebled ; he was constantly in the habit of forgetting commissions which he had to execute, suffered much ill-treatment in consequence, and finally was no longer employed or trusted; hence he became surly, angry and ill-tempered in his behavior. After he had been in this state for more than a year, he took Anacardium 1st, as above; and was almost well in three weeks. Zincum also de- serves attention in these cases. The Anacardium or Malacca-bean was used by the early Arabians in mental diseases, especially in loss of memory. Serapeon in his book de Simplicibus, quotes most of those Arabian authors who have written on the use of Anacardium-juice. Aben Mesuai says: Est bonus corruptioni sensus et memorie. Alcalahamen : Proprietas ejus est, conferre relaxtioni nervorum {paralysis.) Bedigoras: Removet oblivionem, et acuit sensum. Case 3.—A delicate lady, aged seventy, was afflicted with ulcers on the feet, and frequently with such violent attacks of vertigo, that she often fell unexpectedly from her seat. For several days a strik- ing falling-off in her memory had been observed, followed by an im- perfect palsy of the voluntary muscles ; whilst drinking, the cup would fall out of her hand, the fluid ran out of her mouth, and she only swallowed the liquid when a spoon was put in her mouth and allowed to remain ; her head was apt to fall upon her breast, so that she could only hold it up with difficulty; her features were distorted, her look wild, and her expression childish; she did not know those around her, was unable to speak, and only made unintelligible sounds. She stood up with difficulty, and when urged to move forward she could not move a foot, but sank back into her seat in a most childish manner. 342 A nacardium-orientale. Her breathing was free; skin rather cool than warm; pulse slow, moderately full and 60 per minute. She took Anacardium, 1st dilution, internally in drop-doses; she fell asleep, perspired profusely, and awoke in five hours; had no recol- lection of what had occurred, and could swallow with facility. She recovered perfectly in a few days ; a slight relapse eight months after was also quickly relieved by Anacardium. Case 4.—A delicate lady, aged seventy, was attacked with a severe eruption upon the face and chest, which was supposed to arise from poisoning with the ivy-vine ; some little time after this eruption had disappeared she was seized with such extraordinary forgetfulness and absent-mindedness that serious disease of the brain or an attack of apoplexy was feared. A few drops of Anacardium-tinct. in a wine- glassful of water, one or two teaspoonsful per dose, quickly relieved all threatening symptoms. (11.) ON THE NERVOUS SYSTEM. Nerves of Sensation.-—It does not seem to produce pain apart from inflammatory irritation, and hence seems to act far more decidedly, and as a powerful irritant to the vascular, rather than to the nervous system. (11.) Clinical Remarks.—It may prove useful in some inflammatory neu- ralgias, especially in erysipelatous subjects. (11.) Nerves Of Motion.—It seems to act even less upon the nerves of motion than upon those of sensation. (11.) Clinical Remarks.—It probably will prove as useful in rheumatism, paralysis and convulsions from suppression of eruptive diseases as Rhus is well known to do. (11.) Ganglionic Nervous System.—Its predominant action upon the vascu- lar system may lead us to infer that it acts specifically upon the great sympathetic nerve which presides so peculiarly over the circulatory, nutritive, se- and excretory operations of the system, and to assume that those cerebral affections which are so beautifully relieved by Ana- cardium arise from a sympathetic disorder of those portions of the great sympathetic nerve which are within the cranium. (11.) ON THE VASCULAR SYSTEM. Blood.—Its peculiar action upon the blood is unknown; but it may be inferred that it tends to produce an action upon this fluid opposite to that of the narcotics, which depress the arterial side and intensify its venous tendencies ; and similar to that of the irritant and phlogistic remedies, which excite inflammation and its consequences, such as heat, redness, swelling, pain, effusion of serum, sero-fibrin, and sero- pns. (11.) HeemorrhagCS.—If it is homoeopathic to any haemorrhages it is to Malacca-Nut. Cashew-Bean. 343 active and arterial haemorrhage, arising from inflammatory irritation and congestion. (11.) Heart and Arteries.—Anacardium, if taken in full doses internally, would doubtless exert as powerful action upon all the parts with which it comes in contact, as it does upon the skin. (11.) Clinical Remarks.—Inflammation : It must be regarded as a reme- dy of great power in many intense inflammatory diseases, especially of an erysipelatous character, and should often be kept in mind when Rhus, Euphorbium and Cantharides seem indicated. (11.) Fever.—Long-lasting shivering and tremor, early in the morning, with want of appetite. Chilliness over the whole body, with heat of the face. Feverish restlessness, with tremor of the limbs and feel- ing of prostration. Great heat of the body, with thirst, perspiration, hot breath, with shaking of the body on account of internal chilliness. Internal heat, with general cool sweat, especially about the head, with thirst, malaise, especially in abdomen and knees. Profuse sweat at night. (19.) Horripilation over the whole back, as from cold water being thrown upon him. Heat of the skin, with great thirst and dry parched lips. Great heat, especially in the night, with vehement thirst, without sweat. (32.) Clinical Remarks.—It is much less homoeopathic to pure fevers than to inflammatory fevers, and to erysipelatous and suppurative in- flammations. (11.) Venous System.—It is not supposed to exert any direct action upon this system, although some authors regard all erysipelatous inflamma- tions as venous rather than arterial phlogoses. (11.) Lymphatic and Glandular System.—It does not seem to act specifical- ly upon the lymphatics and glands, although it, doubtless, is often ho- moeopathic to affections of these organs, which arise from the absorp- tion of erysipelatous, eczematous or other cutaneous matter. (11.) ON THE TISSUES. MUCOUS Tissues.—It is not evident whether Anacardium exerts any specific or peculiar action upon the mucous tissues, apart from its ge- neral irritant, and vesicant action. (11.) Serons Tissues.—From its marked action in producing serous effu- sions it might be supposed that it exerts a more specific action upon the serous, than upon the mucous or fibrous tissues ; but we have no positive proof to this effect. (11.) Fibrous Tissues.—We have no positive proof that it influences the fibrous tissues in a specific manner; it is possible that it may be suited to many pains and other disorders of the fibrous tissues, arising from the suppression or non-development of some eczematous, urti- carious or erysipelatous disorder. (11.) Dermoid Tissue.—According to present appearances this seems 344 Anacardium-orientale. to be the great centre of its action; unlike Cantharides, which it otherwise much resembles in its action, it does not act specifically upon the kidneys or any other important organ, except perhaps the brain; unlike Rhus, whose action upon the skin it closely imitates, it appears to act far more specifically upon the brain, than upon the motor nerves and muscles; at least Anacardium cures some brain- affections quite as rapidly as Rhus cures some cases of paralysis arising from suppression or non-development of eruptive disorders. (11.) Skin.—The skin of the body is insensible to itching stimuli. Gene- ral voluptuous itching over the whole body, which spreads by scratch- ing. Heat in the skin of the whole body, when in bed with burning- itching and irritation of the skin, such as arises from much scratching; after the scratching the burning increases. (19. 32.) Clinical Remarks.—Anacardium is homoeopathic to many most im- portant skin diseases, viz., to urticaria-tuberosa or tuberous nettlerash; it may be used in varioloid and small-pox, also in bullous and phleg- monous erysipelas, and in scarlet fever, especially in the severe and malignant forms and in the desquamative stage ; in rupia and ecthyma it deserves attention; in chronic and obstinate forms of itch; in some severe or even malignant ulcerations, such as lupus, some syphilitic ulcerations, and even in ulcerous cancer. Its important relation to severe cutaneous affections has never before been pointed out. Jahr and his copyists and translators do not seem to have the faintest idea of the importance of this drug in cutaneous affections. (H.) The juice which is in the cells under the rind of the nut, is of such acridity that it is used by the natives to burn off warts, condylomata, and other excrescences, and to keep down excessive granulations in ulcers, both in men and animals. Cellular Tissues.—It is a question whether Anacardium does not act more specifically upon the cellular tissue than upon the skin proper; all its external manifestations seem to point to its proclivity to extend its operation to the sub-cutaneous cellular tissue—more so than Cantharides and Rhus, whose actions it otherwise mimics in a marked degree. (11.) Mind and Disposition.—Weakness of memory, memory very obtuse. Forgetfulness. Great timidity. Great indifference. Uneasiness. Depression. Misanthropic. Irritable, sensitive, contradictory. Ti- midity in all his actions. Want of courage, with stupid behavior. Madness. (19.) Apprehensiveness without cause. He laughs when h* ought to be serious. (32.) Weakness of mind, memory, and senses. Imbecility. Loquacious dementia. Melancholia in all its forms. Clinical Remarks.—The ancient writers recommended it chiefly in mental diseases, particularly in loss of memory, paralysis and spasms ; Malacca-Bean. Cashew-Nut. 345 and the Arabian physicians speak of it in the same affections, and also as a prophylactic in those disposed to paralysis. The Confectio-Anacardium became celebrated under the name Con- fectio-Sapientium, as a remedy against weakness of the mind ; but Hoffman called it Confectio-Stultorum, and condemns the internal use of it, as he says that people have been made mad by it, and lost their memory, and died miserably on account of using it too often. Hence the abuse of this drug made it hurtful: applied homoeopathically for the same diseases, it becomes a powerful and efficient remedy. Sensorium.—Every kind of intellectual labor is difficult for him. Dullness of sense, accompanied by dullness of the head and prostra- tion of strength. Any little effort of the mind causes a sensation in the brain as if bruised; mental illusions. He imagines he hears his name called by his distant mother and sister, attended with anxiety and fear of impending misfortune {presentiment.) Melancholic illu- sions ; he imagines he sees a coffin in a side-room upon which either his friend or himself is lying. (32.) Clinical Remarks.—Anacardium is homoeopathic to torpor of the brain, when arising from excessive intellectual labor, or remaining after fevers, especially erysipelas, or other eruptive fevers, or typhus, or intermittent. (11.) A case of hallucination in a dyspeptic, aged thirty years, is re- ported by Dr. Gerson, who relieved the dyspepsia by Puis., Ignat., Acid.-nitr., Sulph. and Sepia, but there remained a fixed idea with the patient, that a demon was pursuing him. In fact he thought it seated on the back of his neck, possessed with a double voice, which troubled him everywhere—this morbid condition was completely re- moved in six weeks by Anacardium 2d, night and morning a dose. (26.) Sleep.—Great drowsiness and dullness, especially in the afternoon. Twitching of the mouth and fingers during sleep. Sudden, frightful starting in bed just before going to sleep. Uneasy sleep and constant tossing about, on account of dull unbearable pain in the head. "V&ery sound sleep. Constant confused sleep, without dreams, with great heat, red cheeks, cold forehead, great thirst, feeling of soreness and dryness in throat. Vivid frightful dreams. (19.) Vivid dreams, ac- companied by great mental exertions, causing a headache as from bruises, which he feels even on waking. Anxious dreams, full of danger; he screams anxiously when asleep. (32.) Clinical Remarks.—It may prove useful against the restlessness, sleeplessness and cerebral pains and illusions which precede the outbreak of some eruptive disorders, such as scarlatina, variola and erysipelas. (11.) Head.—Vertigo on stooping, every thing turning black before the eyes. Headache, with a feeling of tightness and vertigo, worse on motion. Painful, stupid feeling through the whole of the head. Weight and pressure in the brain, especially towards the forehead. Violent tearing pressure and sharp jerking pain in the temples. (19.) Early 346 An acardium-orientctle. in the morning, after rising, his head feels so dull and heavy that he is scarcely able to carry it; he is obliged to lie down again, his head feels very heavy the whole day. Vertigo as if the objects or himself were wavering ; he is obliged to hold on to something. Pressure in the head. Violent pressure in the region of the right temples. Pres- sure from without inwards. Compression and dull pressure. (32.) Clinical Remarks.—It is homoeopathic to headaches arising from great debility and weakness of the brain, also from congestion, after the subsidence of severe eruptive or inflammatory diseases; also to the irritative headaches which precede eruptive disorders, or occur in consequence of the suppression of acute eczema, erysipelas, &c. (11.) Eyes.—Violent pressure in the eye-ball. Deceptive sight. Photo- phobia. Weakness of the eyes and obscuration of sight. (19.) Lu- minous vibrations before the eyes. Contraction of the pupils. Short- sightedness. Muscse volitantes. (32.) Clinical Remarks.—It has been used successfully against great weakness of sight, and commencing amaurosis; it has also been said to have partially removed shortness of sight. It may cure some eye-affections arising from the non-development of eruptive dis- orders, or those which follow herpetic eruptions about the lids, or from measles or erysipelas. (11.) Ears.—Pain in the ears as though there was an ulcer forming; worse on moving the jaws. Itching in the ear, with a discharge of brownish matter. Obstruction of the ears, and hardness of hearing. (19.) Cramp-like pain in various parts of the ear. Roaring before the ear; humming in the ears. (32.) Painful swelling of the exter- nal ear; hearing weak at times, unusually acute at others. Chronic deafness. Clinical Remarks.—It is homoeopathic to eruptive affections of the internal ear; to chronic eczema extending deep into the meatus, at- tended with more or less pain, redness, swelling, discharge and con- sequent deafness. To chronic deafness from a chronic erysipelatous or eczematous affection of the ear. It has also been recommended in difficulty of hearing and deafness from a debilitated or paralytic state of the auditory nerve, especially after the occurrence of some grave fever, or eruptive disorder. (11.) Nose.—Bleeding at the nose. Sense of smell diminished. (19.) Chronic coryza; and blenorrhoea from the nose. (32.) Frequent sneezing, followed by the most violent flowing catarrh, with lachry- mation. Distressing coryza, with catarrhal fever, icy coldness of the hands and feet, loss of smell, pains and cramps in limbs, feverish restlessness, &c. Dullness of the head, such as occurs in catarrhs. <1L>. ... Clinical Remarks.—It is homoeopathic to catarrh of the nose, aris- ing from a chronic eczematous or erysipelatous affection of the nares; also to the catarrhal affections of the nose, which arise in literary men Malacca-Bean. Cashew-Nut. 347 from congestion to the head and nose. It deserves more attention than it has received in catarrhal fevers and influenzas. (11.) Face.—Paleness of the face. He looks worn out, hollow-eyed, with a blue border around the eyes. Dry heat of the face, with a feeling of tightness of the head, and' pale face. (19.) Sickly, wan complexion. White scaly herpes on the right cheek, itching of the forehead; hard, red pustules on the forehead and in the corner of the left wing of the nose, with a feeling of soreness, for several weeks, drvness, burning of the lips. (32.) Clinical Remarks.—It is homoeopathic to vesicular erysipelas of the head and face (see page 339) and ought to be used in this affection quite as frequently as Rhus and Cantharides. It also deserves attention in crusta-lactea, eczema of the face, scald-head, and other eruptive affections. Jahr is unusually deficient in his pathogenesis of Ana- cardium, as far as refers to erysipelas and other eruptive affections about the head and face. (11.) Jaws and Teeth.—Cramp-like traction in the lower row of teeth of the right side, reaching up to the ear, returning every evening, for se- veral days. (19.) Clinical Remarks.—It deserves attention in some neuralgias of the face and teeth, which arise from the irritation of some eruptive or psoric disorder. (Seepage 340) (11.) Mouth, Pharynx and (Esophagus.—Fetid odor from the mouth. Pain- ful vesicles in the mouth. Tongue rough and coated with white fur. Scraping, rawness of the throat. (19.) Heaviness of the tongue, pressure in the throat-pit. (32.) Clinical Remarks.—It has been used against paralysis of the tongue; it is homoeopathic to some inflammatory affections of the mouth and throat, especially when of an erysipelatous character. (11.) Appetite, Taste and Gastric Symptoms.—Want of appetite, weak di- gestion, increased thirst, foul taste. Pressure and feeling of tight- ness in epigastrium, stomach and abdomen; nausea and inclination for stool, with malaise and irresistible desire to sleep. (19.) Bitter, dry- ness in the mouth and throat, insipid putrid taste of the food. Con- stant thirst, his breath is arrested when drinking. Capricious appe- tite. Pressure at the stomach, with a feeling of extreme exhaustion and physical prostration, with great thirst, also as if he had eaten too much, with distention of the abdomen ; shifting of flatulence in the ab- domen ; hypochondriac dejection ; burning eructation after meals and drinks, also in the morning. Nausea, early in the morning, with sen- sation in the stomach as of fasting, nausea with retching. (32.) Weak- ness of digestion and flatulence of hypochondriacs. Clinical Remarks.—It is homoeopathic to some of the forms of indigestion and hypochondria, which so often occur in highly intel- lectual persons; also to indigestion arising from the retrocession of some eruptive disorders, especially nettlerash, eczema and erysipe- 348 A nacardium-orientalc. las; and more especially to flatulence, heartburn, chronic pharyngi- tis, and canker-sore-mouth, when attended with great hypochondriacal depression of spirits, mental illusions, absent-mindedness, excessive forgetfulness, &c. (11.) Stool.—Frequent urging to stool; difficult expulsion of soft stool, on account of torpid action of the lower bowels and rectum; griping pain during stool; yawning and eructations after the same. (19.) Con- stant urging, with tardy expulsion, painful twisting and turning in the intestines. (32.) Clinical Remarks.—It is said to be most homoeopathic to constipa- tion, when arising from torpor of the liver, when there is aching in the region of the liver, light-colored stools, bitter taste in the mouth, tendency to acne, or erysipelatous and erythematous duskiness about the nose and chin. (11.) It is used by the natives in obstinate cases of diarrhoea. It is also useful when there is frequent urging to stool, during the day, for many days, without being able to expel anything, from torpor or paralysis of the rectum. It has removed troublesome chronic itching of the anus, and the varices of the rectum have become smaller and ceased to be painful under its use, except some soreness when one begins to walk. (32.) Urinary Organs.—Frequent desire to urinate; but little passing off. (32.) Clinical Remarks.—Wood and Bache say, the receptacle is a red- dish-yellow, and of an agreeable sub-acid flavor, with some astringency. It is edible, and affords a juice, which has been recommended as a remedy in dropsy. The natives of the Island make use of it also in obstinate cases of diabetes. Sexual Organs.—Want of excitability of the sexual desire. Dis- charge of prostatic fluid, with difficult or easy stool; also after the emission of urine. (32.) Clinical Remarks.—It is homoeopathic to persistent voluptuous itching about the scrotum ; to leucorrhcea, with itching and soreness ; and to the excessive sexual desire which attends these disorders; to involuntary emissions of semen at night, without lewd dreams, and seminal emissions at stool, and after urinating; and when the urine is turbid when emitted, and afterwards deposits a dirty sediment, which looks like clay when shaken. 32.) Larynx and Trachea.—Night cough, with scraping in the throat, racking cough, like hooping-cough, especially at night, and after speaking. Short cough, with expectoration of matter. Cough, with bloody expectoration, rattling of mucus. Roughness of the throat. (19. 32.) Clinical Remarks.—It deserves more attention in hooping-cough than it has received, especially when the cough is wearing and at- tended with vomiting of food, so violent as to force the blood to the head and eyes, most severe at night and attended with the rattling of much mucus in the air tubes. It is a little singular that its allied Malacca-Bean. Cashew-Nut. 349 remedy Cantharides has a wide-spread old-school reputation against hooping-cough. (11.) Chest.—Short breath; oppression and huskiness in the region of the sternum. Asthma, dyspnoea, with weeping, which relieves the oppression. Dull pressure, as from a plug in the right side of the chest. Feeling of soreness and rawness in the chest, increased by inspiration. Tearing, with a little pressure on the left side of the chest, reaching up to the heart, as though the whole side should be torn to pieces, especially, when stooping. Single lancinations in the chest. Pulsative lancination in the chest, about the heart. (19. 32.) Clinical Remarks.—According to the testimony of Garcias ab Horto, the East Indians make frequent use of it in asthma ; it is most ho- moeopathic to the asthmas which occur in persons subject to salt- rheum, eczema, or chronic erysipelas or nettlerash. (11.) The East Indians gave the kernel, steeped in whey, to those suffer- ing from asthma. Back.—Stiffness of the muscles of the neck. Pinching, pressing, tearing, sticking pain in the back and between the scapula?. (19.) Cracking in the scapulae and cervical vertebrae. Rheumatic drawing along the neck; hard pressure on both sides of the larynx, which sometimes interferes with deglutition. Intermittent prickings, with throbbing, on the left side of the chest, close to the neck. (32.) Superior Extremities.—Weakness and contractive pain in the arms. Tremor of the arms and hands. Pressure in the arm-muscles and -bones, with tired feeling in the same. Tearing and drawing, with a feeling of stiffness in the arm. Crampy jerks and pressure in the bones of the hands and fingers. Hot, dry hands; numbness of the fingers. (19.) Beats, as with a heavy body, intensely painful, in the centre of the left upper arm. Pimples, with red areolae, and pus at the tip, on the inferior portion of the upper arm, with painful itching during motion. Cramp-like, violent pain in the forearm, elbow, hands, fingers and muscles. Crampy or pulsative twitches in the fingers of the left hand. (32.) Clinical Remarks.—It is homoeopathic to some varieties of pains which occur in the arms from the suppression of eruptive disorders, such as salt-rheum. (11.) Inferior Extremities.—Drawing and uneasiness in the lower extre- mities, with a feeling of stiffness. Dull pressure in the thighs, some- times intermitting regularly, as beats in music ; cramp-like pressure in various parts of the lower extremities. Burning in the soles of the feet when sitting. The feet, which had been warm, become intensely cold when walking. (19. 32.) 350 Aletris-Farinosa. ALETEIS-FAEINOSA. STAR-GRASS. GENERAL REMARKS. It is a native of this country, and is found growing in almost all parts of the United States, in fields and on the borders of woods, flowering in June and July. The root, which is the officinal portion, is said to possess tonic, ex- pectorant, sudorific, narcotic and purgative properties. In full doses its use is often objectionable and sometimes hazardous, as it is drastic, even in small doses, and in larger ones causes vertigo, nausea and bloody stools ; still it is extensively used throughout the United States. The root is intensely bitter; the decoction is mode- rately bitter, less so than the tincture. In small doses it is decreed to be simply a bitter tonic; and enters into various preparations in the treatment of prolapsus, general weak- ness and obstructions. It may prove homoeopathic to nausea, vomiting, dizziness from dis- order of the stomach, diarrhoea, cholera-infantum and dysentery. It deserves a careful proving. 'ANAGALLIS-AEVENSIS. SCARLET PIMPERNEL. POOR MAN'S %VEATHER-GLASS. RED CHICKWEED. AUTHORITIES. Schreter Arch. Horn., see Metcalfe's Horn. Provings. (51.) Wood and Bache. (7.) c GENERAL REMARKS. This plant belongs to the order of Prinnelaceae in the rational sys- tem ; Pentandria, Monogynia, Linn. It is found near New-York, and on Long-Island, and Staten-Island, and is said to be the European species introduced. It flowers from June to October. (51.) It is in- odorous and has a bitterish, somewhat acid taste. The ancients esteemed it a counter-poison, and in modern times it has been used as a preventive of Hydrophobia; but at present no faith is placed in its alexipharmic powers. It is, nevertheless, not wholly inactive, as Orfila found three drachms of it sufficient to destroy a dog, with marks of inflammation of the bowels. Another species considered by Linnams as a mere variety of the A.-arvensis, is A.-ca&rulea, distinguished by its blue flowers. The medicinal properties of the two, as,far as is known, are the same. (7.) The expressed juice of the whole plant is used. (51.) Scarlet Pimpernel. Poor Mail's 'Weather-Glass. 351 Dioscorides says, " that the Anagallis has the power of mitigating and arresting inflammations. It draws foreign substances out of the body, and represses corrosive ulcers. Its juice evacuates the brain of phlegm, if used as a gargle, and discharged by the nose. It re- lieves toothache, if inserted into the ear of the opposite side; used with attic honey it cures spots on the eyes and disorders of the sight. Infused in wine it is good for those who have been bitten by serpents, and for those having diseased kidneys or liver. The plant with the blue flower is said to cause the prolapsed rectum to return, while that with the red is said the cause its descent by rubbing. Chomel says that is useful in mania and epilepsy. Hartmann, Myn- sicht, Willis and others, also consider it useful in the frenzy which comes on in continued fevers. It is employed by the handful in the drinks and decoctions prescribed for hypochondriacs. The alcoholic tincture of the flowers and the extract of the whole plant, especially if mingled with the flowers of Hypericum, are said to be remedies not to be despised in epilepsy. (51.) The homoeopathic provings are very incomplete and unsatisfactory ; they do not uphold its ancient or modern reputation, and offer but few hints for any new application of this remedy in disease. (11.) Mind.—Great flow of spirits for several days ; every thing caused pleasure. Hilarity. Mental powers very active. Clinical Remarks.—Its use has been much urged in epilepsy and mental disturbances ; and in hydrophobia, Suadicani in a long memoir strenuously urges its use, insisting that it is a specific to that disease, as Quinine is to intermittents. It is allopathic to melancholy and hypochondria. Dead.—Pressing aching in the sinciput. Spasmodic lancinations in the temples. Eyes.—Clinical Remarks.—It is said to cure spots on the eyes and disorders of sight. Throat.—Sensation of dryness and scraping in the throat. Clinical Remarks.—Used as a gargle it is said to be useful in de- taching phlegm. Stool.—Desire to go to stool. Well-digested stool. Itching in the rectum and pressure on the sacrum, as if from piles. Clinical Remarks.—Dioscorides recommends it in prolapsus of the rectum—the plant with the red flowers causing a descent of the bowel on rubbing, while that with the blue is said to cause its return. Urinary Organs.—Burning pain in the urethra when urinating; sen- sation as if the meatus were stopped up. Tickling itching along the urethra, inciting to coitus. Clinical Remarks. — It has been recommended against dropsy and renal and hepatic obstructions. Simon Pauli mentions a poultice of pimpernel, as a popular remedy in his country applied to the hands and feet of gouty subjects. 352 Anchusa-qfficinalis. Genital Organs.—Desire for coitus. Burning pain in urethra before coitus, ceasing during the act. Chest.—Pricking sensation in the chest. Violent trembling of the heart, with general trembling and coldness. Back and Extremities.—Tensive drawing, which ascends from the left shoulder into the nape, and recommences after it had ceased. Pain in the right metacarpus. Sensation resembling cramp in the finger. Sleep.—Agitated sleep. Fever.—Heat in the head, slight sweat on forehead, with lancina- tions in the eyes. Tremblings and chills. Clinical Remarks.—It has been recommended in the frenzy occur- ring in continued fevers. (51.) ANCHUS A- OFFICINALIS. BUGLOSSE-BORAGE. GENERAL REMARKS. This species of Anchusa is a native Europe, and unknown in the United States. It is a biennial plant, from one to three feet high, and was formerly much esteemed as a medicine. The root, leaves and flowers were officinal. These are inoderous and nearly tasteless. The root is mucilaginous and slightly sweetish, and the flowers very feebly bitter. The plant has some claim to the credit former- ly attached to it of possessing cordial and exhilarating properties. It was used by the ancients in hypochondriacal affections ; but as it was given in wine, the elevation of the spirits was probably due to the vehicle. In France the Anchusa-Italica, which is there known as Buglosse, is employed for the same purposes and in the same manner as Borago-officinalis. The dyer's " Alkanet" is another Anchusa (the " A.-tinctoria,,)} but though formerly employed in the treatment of several diseases, is now exclusively used as a coloring agent. AIDROMEDA-ARBOEEA. S ORRELL- TREE. GENERAL REMARKS. A beautiful indigenous tree, growing in the valleys of the Alleghany mountains, from Pennsylvania to Florida. The leaves have a very pleasant acid taste, which has given rise to the common name of the tree. They are used by hunters to allay thirst, and form in decoction a grateful refrigerant drink in fevers. The other species of Andro- meda are shrubs, and some of them ornamental. Dr. Barton in his Anethum Fceniculum. 353 collections states that a decoction of A.-Mariana is usefully employed in the southern states as a wash in a disagreeable ulceration of the feet to which the negroes are liable. The powder upon the leaves and buds of the A.-Speciosa is said to be a powerful errhine. (7.) This remedy deserves a more careful proving. (11.) ANETHUM FCENICULUM. fceniculum vulgare et duloe. Common and Sweet Fennel. GENERAL REMARKS. The sweet fennel is sweeter and more aromatic than common fennel seed, and is eminently entitled to the name of sweet fennel. The whole plant has an aromatic odor and taste, owing to a volatile oil by which it is pervaded; that cultivated here is sweeter and more aromatic than that from abroad, probably in consequence of its greater freshness. It is cultivated largely in Italy and Sicily for the sake of the shoots, which are eaten raw, or in salad, or boiled as pot-herbs. The odor of fennel-seed is fragrant, its taste warm, sweet and agreeably aromatic ; it is among our most grateful aromatics, and in this country much employed in the old school as a carminative and as corrigent of other less pleasant medicines, especially senna and rhubarb. In infants it is employed as a tea, or injection, to pro- duce the expulsion of flatus. In most of the ancient books on the practice of medicine we find it in common use as a modifier and corrective of cathartic infusions, to prevent griping, and to obviate flatulence. As far back as Hippo- crates can its employment be traced. Up to the present time no ho- moeopathic proving has been made of it, and we are only able, there- fore, to lay before our readers the very slight knowledge extant respecting it. ANETHUM-GRAVEOLENS. DILL-SEEDS. GENERAL REMARKS. This plant is a native of Spain, Portugal and the south of France, and is found growing wild in various parts of Africa and Asia ; it is cultivated in all the countries of Europe and has been introduced into our gardens. The seeds are the only part used ; their smell is strong and aromatic, 23 354 Angustura-Spuria. but less agreeable than that of fennel-seed ; their taste is moderately warm and purgent. They are seldom used in this country. In flatulent colic of infants, in hiccough of children, and vomiting immediately after nursing, it is in common use as a domestic remedy. It is supposed to impart tone to the stomach, and to rouse into increas- ed activity the digestive organs. It is not improbable that a careful proving might develop latent and valuable pfoperties which are now unknown. ANGELIC A-ARCH ANGELIC A. GARDEN ANGELICA. GENERAL REMARKS. This plant is a native of the north of Europe, and is found in the high mountainous regions in its southern section, as in Switzerland and the Pyrenees. It is cultivated in various parts of Europe, and may be occasionally met with in the gardens of this country. The whole plant has a fragrant odor and aromatic properties, but the root and fruit only are officinal. The root is spindle-shaped, an inch or more in thickness at its upper extremity, and beset with numerous long descending radicles. The fresh root has a yellowish grey epidermis, a fleshy yellow parenchyma, and when wounded yields a honey-colored juice, having all the aro- matic properties of the plant. The seeds, as the fruit is commonly called, are two or three lines long, oval obtuse or somewhat notched at the ends, flat and marked with a longitudinal furrow on one side, convex, with the angular ridgei on the other. It is an elegant aromatic tonic, but is little used in the United States. The Laplanders, in whose country it flourishes, are said to esteem it highly as a medicine and condiment. In Europe the stems are frequently made into a preserve, and in deserts in order to ex- cite the stomach. The dose of the root or seeds is from thirty grains to a drachm. (7.) ANGUSTURA-SPURIA. BRTJCEA ANTI-DYSENTERICA. False Angusiura-bark. AUTHORITIES. Jahr. (32.) Christison. (9.) Wood and Bache. (7.) Dunglison. (16.) Frank's Magazine. (4.) Peters. (11.) Am. Jour. Med. Sci- ences. (17.) Marcy. (10.) Snelling. (42.) False Angustura-Bark. 355 GENERAL REMARKS. (At the time when this drug was proved in this country under the direction of Dr. Hering, it was supposed to be derived from the Brucea-anti-dysenterica, and thence received its name. According to more modern investigations, however, it has been decided to arise from a variety of the Strychnos species, similar to, if not identical with the Nux-vomica. Pereira unequivocally pronounces it the Nux- vomica, and gives numerous cases of poisoning, which certainly would appear to substantiate his views, the symptoms observed being identical with those produced in acute poisoning with the Nux-vomica ; but the matter appears still to be involved in some doubt. Dunglison, however, looks upon the Nux-vomica as a different plant, and recom- mends the preparation of Brucin from the Brucea-anti-dysenterica in preference to the Strychnos Nux-vomica, in consequence of the Brucin from the latter being always combined with a small amount of Strychnia.) Under this title the European writers on Materia Medica describe a bark which was introduced on the continent mixed with the true angustura-bark, and which possessing poisonous properties, in some instances produced unpleasant effects, when prescribed by mistake for that medicine. It is distinguished by its greater thickness, hard- ness, weight and compactness; by its resinous fracture; by the ap- pearance of its epidermis, which is sometimes covered with a ferru- ginous efflorescence, sometimes is yellowish grey, and marked with prominent white spots; by the brownish color and smoothness of its internal surface, which is not like that of the genuine bark, separable into laminae ; by the white slightly yellow powder which it yields, by its total want of odor, and by its intense tenacious bitterness. Analysed by Pelletier and Caventou, it was found to contain a peculiar alkaline principle which they called Brucin, and upon which its poisonous operation depends. In consequence of its presence, a drop of Nitric- acid upon the internal surface of the bark, produces a deep blood-red spot. The same acid applied to its external surface renders it emerald green. In the true Angustura-bark, a dull red color is produced by the acid on both surfiices. (7.) The false Angustura was at first supposed to be derived from the Brucea-anti-dysenterica; and was afterwards referred to some unknown species of Strychnos, in consequence of containing brucin, which is a characteristic ingredient of that genus of plants. At present it is generally believed to be derived from Strychnos Nux-vomica, the bark of which according to Dr. O'Shaughnessy, exactly corresponds with the description given by authors of the false Angustura, and like it contains brucin. (7.) Pereira unequivocally pronounces it the Nux-vomica. It is classed among the simple tonics or bitters, and is very similar to them in its action, though perhaps rather more energetic in larger doses. In small doses its effects resemble those of Gentian, Calumbo. Quassia, &c. 356 Angustura-Spuria. TOXICOLOGICAL EFFECTS. Christison says, a species of bark, commonly called the false An- gustura-bark, was introduced by mistake into Europe instead of the true Angustura-cusparia, or bark of the Galipea-officinalis. It was long supposed to be the bark of the Brucea-anti-dysenterica; but is now known to be the bark of the Strychnos Nux-vomica. It is a poison of great energy. It gave rise to so many fatal accidents soon after its introduction, that in some countries on the continent all the stores of Angustura were ordered to be burnt. It contains a less proportion of Strychnin, but more of the alkaloid Brucin than Nux-vomica, the seed of the plant. According to Andral, Brucin is twenty-four times less powerful than Strychnin, but the bark itself is nearly as strong as Nux-vomica, for Orfila found that eight grains killed a dog in less than two hours. The symptoms it induces are nearly the same as those caused by Nux-vomica. It appears that during the intervals of the fits the sensibility is remarkably acute ; a boy who fell a victim to it implored his physician not to touch him. Case 1.—Professor Marc, of Paris, was once violently affected by this poison, which he took by mistake for the true Angustura to cure ague. He took it in the form of infusion, and the dose was only three-quarters of a liqueur-glass-full; yet he was seized with nausea, pain in the stomach, a sense of fullness in the head, giddiness, ring- ing in the ears, and obscurity of vision, followed by stiffness of the limbs, great pain on every attempt at motion, locked jaw and impossi- bility of articulating. Case 2.—Dr. Darwin has given an account of its effects on the Javanese criminals, who used formerly to be executed by darts poi- soned with the Strychnos tieute, the plant which yields the upas tieute, one of the Javanese poisons. The account quoted by him is not very authentic; yet it accords precisely with what would be ex- pected from the known qualities of the poison. He says that a few minutes after the criminals are wounded with the instrument of the executioner, they tremble violently, utter piercing cries, and perish amidst frightful convulsions in ten or fifteen minutes. (9.) Hahnemann, who evidently mistook the Angustura-spuria for the A.-vera, has the following remarks upon the effects of an over-dose of the medicine prepared from this bark. "The Angustura-bark pos- sesses most powerful medicinal properties, so that when obtained fresh from the tree, as it now generally is, it may, like all other highly powerful drugs, cause serious consequences when improperly ad- ministered. Case 3.—A child, six and a half years old, who had been given three teaspoonfuls of a decoction of Angustura, made of five ounces of bark, reduced by evaporation to five ounces of liquid, i. e., about an ounce and a half of the extract of Angustura, died in two hours under the following alarming symptoms. Tremblings, becoming violent in about half an hour; tetanic convulsions on touching the arm; eyelids False Angustura-Bark. 357 wide open; eyes fixed, staring and immovable; the jaws fixed; the lips wide apart, showing the whole of the front teeth; tension of some of the muscles of the face ; the limbs fully extended and stiff; the spine and head thrown violently back ; the body from time to time was slightly raised, and shaken by a violent shock, like an electric shock, along the back ; the cheeks and lips became blue ; the breath- ing interrupted. After a paroxysm of six minutes' duration the child breathed with much effort, the cheeks and lips becoming pale. There was frequent desire to drink coffee. Swallowing tepid water caused tetanic spasms. Pulse 200, spasmodic and irregular. The tetanus sometimes appeared of its own accord, at others from noise or from contact with anything, and the child continually cried out from fear of being touched. After the tetanus the eyes were closed; the face and forehead covered with perspiration ; cheeks and lips blue; moaning, apparently without pain. The whole body flexible and soft; the eyes glazed, with convulsive breathing at long intervals. Half an hour after death the whole body became stiff. After twenty-four hours, on opening the veins the blood was found liquid and brownish; the right lung pale and emphysematous externally, full of blood in- ternally. The left lung was blue externally, blackish at the division of the lobes, and very full of blood. Other facts also prove that too powerful doses of Angustura pro- duce spasmodic convulsions, giddiness, anxiety, and loss of con- sciousness. Case 4.—Dr. Wuerzner says that four persons, each of whom took ten or twelve grains of the extract of Angustura in the form of pills, were seized with stiffness somewhat analogous to tetanus in all the muscles of the body, with tremors of the jaws, and fell suddenly to the ground without losing consciousness. Symptoms much re- sembling these, only much less violent are related in the provings of this medicine on persons in health. (50.) Emmert, from thirty experiments on animals concludes that the following are the principal effects of Angustura-spuria. (4.) Difficult and at first quickened respiration ; frequent, and afterwards spasmodic pulse; an anxious, timid state of mind; diminished con- trol of the muscles, especially of the inferior extremities, spasmodic rigidity of the limbs, and frequently of the muscles of the chest; trembling as if from electric shocks; jerkings and startings, especially along the spine, excited by great, slight, or even scarcely perceptible impressions; attacks of Tetanus, especially in the form of opisthotonos, excited by the slightest causes; in these attacks the head and spinal column are bent back in the ex- tremest manner, and the limbs are stretched out; the chest, and limbs become fixed and rigid; the eyelids and pupils are extended to the greatest degree, and the eyes are projected rigidly and immoveably far out of their sockets ; the lower jaw is pressed firmly against the upper, and the face is distorted ; the pulse becomes slow, small and spasmodic ; respiration ceases almost entirely, and red parts become 358 Angustura-Spuria. blue. In from 1^ to 1^ or 2 minutes the tetanic paroxysms relax, the pupils and eyelids contract, the eyes sink back into their sockets, and the body becomes soft and flabby, respiration returns with difficulty and great exertion, but gradually becomes freer, and still remains ob- structed, and the arterial blood continues darker than natural; the pulse becomes more frequent, larger and freer, but still remains some- what tense and hard. The irritable and excitable state of the mus- cles still continues and the nervous attacks return at longer or shorter intervals. (4.) Consciousness and sensation are not at all lessened, but are rather heightened, and a certain timidity and fearfulness is developed which may be compared to the pantophobia of hydrophobia. No perceptible evacuations are caused by Anguslura-spuria ; vomit- ing does not occur, nor diarrhoea. (4.) After death the irritability of the muscles and nerves is not dimi- nished ; the involuntary muscles retain their irritability longer than the voluntary, and the heart is not paralyzed. The rigor mortis sets in more decidedly and quickly than common. (4.) Putrefaction is not hastened, and no organic post-mortem ap- pearances are found, except a great accumulation of venous blood in the large veins, and even in the arteries. Still this venous blood does not exhibit any other alteration, but coagulates in time like other venous blood, and undergoes the same changes from exposure to the air. The general effects of the remedy are experienced in about seven minutes, and occur suddenly; it proves rapidly fatal, often in the first attack of tetanus. Convalescence is slow, and the lower limbs re- cover more slowly than the upper. Death takes place from a general nervous affection, attended with spasmodic rigidity of the chest and consequent obstruction of the circulation. (4.) Case 5.—A man, aged 52, had suffered for fifteen years with a neuralgia frontalis intermittens, which returned every two years, occurred regularly after dinner for three months ; it had been relieved once with China but this now failed ; he took twelve grain doses of Pulv. Cort. Angusturae, twice a day ; he had slight stupefaction after the third dose ; but half an hour after the fourth, he was taken with vertigo after rising from his chair, fell back and had spasms in his legs ; which were relieved by rest and excited by the slightest motion ; his speech was hurried and attended with spasmodic contractions of the muscles of the face (slight trismus); his face was pale, pulse weak and quick, skin soft and head covered with perspiration. All these symptoms ceased in 1^ hours ; the paroxysms of neuralgia were much altered, so that on the third day only some slight pressing head- ache was left, and this ceased in twenty-four hours more and left him quite well. (4.) On account of the large quantity of Brucea which the false Angustura contains, it will be proper to make a few remarks on this substance. False Angustura-Bark. 559 B R U C E A. The alkaloid Brucea or Brucin, was discovered by Pelletier and Caventou in 1819, in the bark of the false Angustura, Brucea-anti-dy- senterica. It is found also in small quantities, in Nux-vomica and in the St. Ignatius bean. Pure Brucin, obtained by a process of precipitation is of a white color, and in regular crystals of the form of oblique prisms, having a base representing a parallelogram ; it has a pearly lustre, and very bitter taste. With acids brucea forms neutral salts, which differ from the salts of strychnia. EFFECTS ON THE SYSTEM. It acts energetically on the animal economy in the same manner as false Angustura, but much more strongly. It is similar in its opera- tion to strychnia, but is considered to be weaker in the proportion of one to ten, according to Pelletier; of one to twelve according to Magendie and one to twenty-four, according to Andral. It requires four grains to kill a rabbit, whilst half a grain of strichnia is suffi- cient. A tolerably strong dog, to which three grains of Brucea had been given, was affected with symptoms resembling tetanus, but did not die. Pelletier is of opinion that Brucin or rather the alcoholic extract of false Angustura, might be substituted in practice for the extract of Nux-vomica; its action is nearly the same, while there is no danger of its acting too violently. Andral has frequently prescribed it, and his deductions are that it is far more under control than strychnia. Like strychnia it has been given in cases of paralysis with varying success. It would appear to have acted most beneficially in that, re- sulting from lead poisoning. M. Bricheteau, from his observations on man, and M. Bouchardat from his on animals, infer that Brucin is more active than is usually admitted. In paralysis succeeding apoplexy, the former employs it with much advantage, and asserts with M. Andral in its being more manageable than strychnia. He is of opinion, that no benefit is to be expected from it in paralysis until six months have elapsed from the attack of apoplexy. Earlier than this it may induce serious effects, owing to its toxical effects on the cere- bro-spinal system. He commences with about the sixth of a grain, and increases the dose each day by the same quantity, so long as no effect is induced. Should convulsions supervene it must be discon- tinued, until the effects are decidedly diminished, when it may again be augmented. Magendie administered it with success in one case of atrophy of the leg, and another of the arm ; and Lepelletier suggests its use in impotence. (16.) 360 Angustura Spuria. EFFECTS ON THE NERVOUS SYSTEM. Nerves Of Motion.—Some interesting experiments were made by Emmert to show that it acts on the spine directly, and not on that organ through the medium of the brain. If an animal be poisoned by inserting the extract of false Angustura-bark into its hind legs after the spinal cord has been severed at the loins, the hind legs as well as the fore legs are thrown into a state of spasm: or if the medulla oblongata, be cut across and respiration main- tained artificially, the usual symptoms are produced over the whole body, by the administration of it internally or externally—the only difference being that they commence more slowly, and that a larger dose is required to produce them, than when the medulla is not injured. On the other hand, when the spinal cord is suddenly destroyed after the symptoms have begun, they cease instantaneously, although the circulation goes on for some minutes. (9.) It is undoubtedly true, that the great centre of the action of this drug is upon the anterior or motor portion of the spinal column, and upon the motor nerves and muscles generally. In this respect it is very similar in its action to that of Nux-vomica, Strychnine, Ignatia, and Cocculus. (11.) Many physicians suppose that it exercises a specific action upon the brain, because the intellectual faculties are occasionally disturbed during its operation. This mental disturbance is usually only mo- mentary, and occurs when the system is violently effected by the drug. Flourens and Orfila, who made many experiments with the bark, suppose that its principal specific effect is upon the spinal marrow. (10.) Nerves of Sensation.—It does not act specifically upon these parts, but has occasionally effected cures of so-called neuralgias ; it is most homoeopathic to pains arising from compression of the nerves, in con? sequence of violent spasmodic action of the muscles; in this respect it differs from Belladonna, Stramonium, Conium and Plumbum, which produce relaxation of the muscles. (11.) In some instances it renders the nerves of sensation morbidly sen- sitive. Orfila alludes to one case of this kind, and a medical friend has witnessed a similar effect from a few doses of the first tritura- tion. (10.) Ganglionic Nerves.—We have no evidence that it acts specifically upon these nerves, but it may be supposed that it does act upon those portions of the great sympathetic nerve which preside over the in- voluntary muscles. (11.) In animals poisoned by it, it has been observed that the involun- tary muscles preserve their irritability, while that of the voluntary muscles is lost. (10.). False Angustura-Bark. 361 ON THE VASCULAR SYSTEM. Ileart and Arteries,—It doubtless acts specifically upon the muscular coat of the heart; and also upon that of the arteries, as we believe with Hunter, Charles Bell, Carpenter and Hartshorne, that all the arteries have a muscular coat, which is endowed, like the other mus- cular tissues, of hollow viscera, with ja power of alternating contrac- tion and relaxation ; that this arterial contraction is exerted in im- mediate connection with and succession upon the beat of the heart; the arterial systole thus combining with that of the ventricles of the heart to make up the pulse. In case three, the pulse was 200, spasmodic and irregular; in Emmert's cases the pulse was frequent and afterwards spasmodic ; or slow, small and spasmodic, afterwards becoming more frequent larger and freer, but still tense and hard ; in case five, the pulse was weak and quick. (11.) Clinical Remarks.—It is homoeopathic to spasms of the heart and arteries. It is antipathic, but might prove curative to cases like the following : A feeble, spare old lady, found on rising in the morning, that she had lost to a great extent, the use of both arms, and that they were cold; on examination no pulse could be felt in either arm, except at the axilla, and there it was feeble ; by the continued use of heat, friction and other stimulants, the usual temperature and the muscular power were for the most part restored, but the limits of pul- sation were but little extended; and this continued to be so while the patient remained under observation, which was several years. If the pulse had depended upon the mere tonicity of the arteries, the pheno- mena of this case could not have occurred ; it can only'be explained on the supposition of a paralysis of the muscular coat, thus preventing " the arterial systole." In a deficiency to a greater or less degree of this " arterial systole" we have the explanation of the fact so often observed by physicians, that the force of the pulse does not always correspond with the force of the heart's action. In short, we may as- sume that Angustura, Nux-vomica, Strychnine, Ignatia and Brucea act specifically upon the arterial, or vaso motor nerves. (11.) Angustura produces both a direct and an indirect action upon the arterial system. Its direct action, like that of Nux, Ignatia, &c, is in the first instance exciting—rendering the action of the heart and arteries morbidly active, and sometimes irregular, but followed sooner or later by a corresponding depression, which sometimes amounts to paralysis. This paralysis is most apt to attack the blood-vessels of the extremities, but may prostrate the entire circulatory apparatus. (10.) Its indirect action is due to its impression upon the spinal-marrow. Whenever this structure is morbidly excited, whether by natural causes or by the operation of drugs, a great variety of reflex pheno- mena are superinduced, like accelerated and irregular respiration, in- voluntary spasmodic movements of different parts of the body, morbid 362 Angustura-Spuria. sensitiveness of the entire surface, and an accelerated and irregular action of the heart and arteries. It is therefore no easy matter to determine what phenomena are produced by this active substance from an actual impression upon the vessels of circulation, and what are reflex symptoms arising from its action upon the spinal-marrow. (10.) Fever.—It is supposed to be most homoeopathic when there is a chilly feeling, dread of the open air, great coldness, shuddering with a good deal of thirst, and sweat while walking. Rapid pulse, in- tense thirst, general trembling, or involuntary jerkings of different parts of the body, great sensitiveness to touch, symptoms all increased by mental emotions, noise, light, or motion. Clinical Remarks.—A delicate youth, aged eighteen, had suffered for two months with a regular tertian fever and ague, which had re- sisted all remedies. He then took Angustura-spuria in small doses, followed by a slight abatement of his attacks in a few days, when half an hour after taking a dose he felt generally unwell, followed by a convulsive state with very violent agitation of his limbs, distension of the epigastrium, fixed and glistening eyes ; this state lasted for one and a half hours, in spite of all antidotes. The next day he had no attack of fever, and the Angustura was continued in very small doses, followed by a speedy recovery. Similar effects^were observed in several other cases. (4.) We have prescribed it with prompt benefit in the case of a young lady who had suffered for several months with daily febrile paroxysms dependant upon chronic spinal irritation. The fever commenced about noon, without any previous chill, and was usually accompanied by the following symptoms : very rapid and feeble pulse, intense thirst, extreme sensitiveness of the entire surface of the body, dull pain in the forehead, sensitiveness of the eyes to light, rapid and painful respiration ; irritability, flushed cheeks, and general sense of uneasiness. The remedy was administered at the 3d dilution, at in- tervals of four hours, for three days, when the febrile symptoms ceased, and the patient rapidly convalesced. (10.) Venous System and Blood.—It seems to have a marked tendency to increase the quantity of venous blood in the system. In case three, the cheeks and lips became blue ; the blood in the veins was found liquid and brownish ; the left lung was bluish externally and very full of blood. In Emmert's experiments, red parts became blue ; the ex- ternal blood was darker than natural, while there was a great accumu- lation of venous blood in the large veins and even in the arteries. Still the majority of these effects may arise from the tetanic rigidity of the chest and consequent obstruction of respiration, and from pres- sure upon the veins and arteries by the spasmodic state of the muscles. Clinical Remarks.—It is homoeopathic to venous congestions, and False Angustura-Bark. 363 antipathic to an excessive arterial plethora, and to inflammation in general. (11.) It is most appropriate in cases of venous congestions dependant upon epilepsy, hysteria, and other maladies accompanied by spinal and nervous irritation. In these cases it should never be employed stronger than the third dilution, else serious aggravations will be likely to result. (10.) Lymphatic System.—We have no proof that it acts specifically upon the lymphatic vessels or glands. (11.) Cluneal Remarks.—It is not homoeopathic to many dyscrasias or blood-diseases. (11.) ON THE TISSUES. UlUSCUlar Tissue.—Next to the motor-nerves it doubtless acts most specifically upon the muscles. The general effect of Angustura-spu- ria is to produce convulsion of the spinal marrow and of the voluntary muscles. Tetanic spasms, periodically excited, or aggravated by noise or contact, fright, swallowing of liquids, or feeling the pulse with undisturbed consciousness and increased sensibility, opisthoto- nos ; trismus. Clinical Remarks.—It is antipathic to paralysis, debility, great weariness, with nervous and mental irritation, and vacilitating and trembling gait.—It is homoeopathic to a disagreeable sensation of loss of mobility, owing to rigidity of the muscles, to spasmodic convul- sions, tetanus, opisthotonos, trismus Inability to bend the lower ex- tremities, and acute pain upon every attempt to do so. In animals which have been poisoned with it, the irritability of the involuntary muscles is preserved for a time, while that of the voluntary muscles is lost. FiblOUS Ti Sues.—It does not seem to act specifically upon the non- contractile fibrous tissues. (11.) Serous Tissues.—We have no evidence that it acts decidedly upon any of the serous membranes. (11.) MllCOUS Tissues.—It seems to act somewhat specifically upon the mucous membranes of the nose, throat and large bowels. (11.) Sleep.—Drowsiness in the day-time, sleep full of dreams, orgasm of the blood. Mind and Sciisorium.—Gloomy, discontented, taciturn mood, anguish, tendency to start (in animals). Want of mental energy, with drowsi- ness. Dullness particularly in the sinciput, with heaviness in the head and drowsiness. Vertigo as if he would fall, in the evening. Clinical Remarks.—It is homoeopathic to dizziness, dullness of the head, drowsiness and despondency ; it has been suggested in apo- plexy, and is used in the old school in paralysis consequent upon apoplexy. (11.) 364 Angustura- Spuria. It has been used with benefit in gloomy, taciturn, peevish, and ob- tuse mental conditions, following excessive mental and physical ex- citements, hysteria, and epilepsy. (10.) Head.—Pain in the forehead, in the evening, after a long walk in the sun : over the left eye, or behind the brows, which feel as if' swollen, and across the root of the nose. Creeping digging in the vertex. Dartings in the head, worse during a walk, and particularly in the sun ; in the right temple, with fullness of the head, or with dartings in the ear. Buzzing sensation in the left temple. Great fullness and pressure in the head, accompanied by spasmodic twitchings of different parts of the scalp. Clinical Remarks.—It is homoeopathic to venous congestion of the head and consequent headaches. (11.) In congestive headaches, caused by long-continued depressing emotions, by violent fits of anger, and by severe and protracted mental labor, it has been found serviceable. (10.) Eyes.—Redness and inflammation of the canthi, with itching ; itch- ing of the eyes, with burning and injected condition of the vessels in the canthi. The eyes are painful as if they contained sand. Dim, bloated eyes. Lachrymation and redness of the conjunctiva (in animals). Staring, protruded immoveable eyes. Dazzling of the eyes. Obscuration of sight. Twitchings of the eyebrows and eyelids while reading. Dilatation of the pupils. Painful pressure of the eye- balls. Clinical Remarks. It seems homoeopathic to catarrhal inflammation of the lids, or at least to venous congestion of the eyes, and spasms of the balls and lids. (11.) It has cured involuntary tremblings and twitchings of the eyelids, with painful fulness and pressure in both orbits, and dimness of sight. It is also homoeopathic to drooping of the lids from partial paralysis. Also to involuntary trembling and unsteadiness of the eyeballs. (10.) Ears.—Darting in the ears, at times in one and then in the other. Tingling and humming in the ears. Buzzing in the ears increased by stooping or walking rapidly. Clinical Remarks—It is appropriate in ringing or buzzing in the ears, and fullness and pressure in the brain, which sometimes pre- cede and follow epilepsy, hysteria, and apoplexy. (10.) Nose.—Pain across the dorsum of the nose, internally. Tickling in the nose, with heaviness in the head. Violent sneezing, preced- ed by pulsations in the nose. Violent fluent coryza, with lachryma- tion, restlessness, sleeplessness, feeling of coldness in the head, dry- ness of the mouth, and copious secretion of mucus in the throat. Clinical Remarks.—It deserves more attention than it has receiv- ed in catarrhs of the head, and influenza. (11.) Face.—Paleness of face. Bluish color of face, particularly of the cheeks and lips. Each single muscle of the face is put upon the False Angustura-Bark. 365 stretch. Quivering sensation in the lips. Lock-jaw, the lips being quite open, and the anterior teeth exposed. Grinding of the teeth. Sweat on the forehead and in the face after the paroxysm of spasm. Itching herpes, with scaling off of the skin. Increase of existing rash. Feeling of heat in the cheeks, but without any external feeling of warmth. Clinical Remarks.—It is homoeopathic to lock-jaw, to spasms of the face, perhaps to Saint Vitus' dance; also to gritting of the teeth. (11) It is remedial in spasmodic twitchings of the muscles of the face, in bloated and livid conditions of the face, such as precede and ac- company drunkenness, fits, and other congested states of the vessels of the face and head. (10.) Teeth.—Fleeting, tearing pains in all the teeth and gums, aggravated by cold. Clinical Remarks.—It is homoeopathic to excessive grinding of the teeth. (11.) Mouth, Pharynx and (Esophagus.—Increased secretion of mucus in mouth and fauces. Dryness in the oesophagus, and burning pain in the pharynx, as if occasioned by rancid grease. Mouth open, and frequent disposition to sigh. Spasmodic closure of the mouth, causing an inability to speak. Clinical Re/narks.—It is homoeopathic to catarrhal irritation of the throat, with dryness and burning. Also to dyspeptic irritation of the throat, arising from the regurgitation of rancid fat from the stomach. (11.) It has relieved spasmodic contractions of the pharynx and oeso- phagus when attempting to swallow food or drinks. In paralysis of these parts it is worthy of attention. (10.) Appetite and Gastric Symptoms. Constant loss of appetite. Hunger with loss of appetite. Violent appetite. Bad, pappy taste. Pres- sure at the stomach, with palpitation of the heart, fermentation in the bowels, and vomiting of the injecta. Risings in the stomach, followed by pain, but without provoking vomiting. Clinical Remarks.—It is homoeopathic to great want of appetite, with a bad, pasty taste in the mouth, rising of rancid greasy sub- stances from the stomach, and palpitations arising from derangement of the stomach. (11.) In dyspepsia, with frequent eructations, tasting of food, pains in the stomach, cramps, tremblings and feelings of contraction in the stomach, it bids fair to rival Nux-vomica. From the general char- acter of the drug we infer that it is appropriate in certain cases of gastralgia, and other neuralgic affections of the stomach. (10.) Stomach and Ahdomen.—Sensation in the stomach as of long fasting. Burning and heat at pit of stomach. Griping in the abdomen, parti- cularly at the umbilical region ; succeeded by vomiting and diarrhoea. Colic, with nausea and drowsiness. Colic ceasing after an evacua- 366 Angustura-Spuria. tion. Pinching and rumbling in the bowels. Red raised rash on the abdomen. Cramplike pain at the pit of the stomach. Eructa- tions, followed by pressure and pain in the stomach. Pathology.—In animals poisoned with this substance, no morbid appearances have been found in the stomach or bowels, thus indicating that the symptoms are reflex in their character. (10.) Clinical Remarks.—A middle aged lady, tall, thin, and of a ner- vous temperament, was attacked after a ride of two hours' duration with excruciating cramplike pains in the stomach and bowels. She took Colocynth, Nux, and finally a large dose of Laudanum, without relief. On arriving at the bed-side of the patient, eight hours after the commencement, of the attack, we found her nearly exhausted and still suffering intensely. Two doses of Angustura-s. third dilution, at intervals of twenty minutes entirely removed the pain. In several other instances of a similar character, where Nux ap- peared to have been indicated, but had failed to afford relief, we have used this remedy with prompt benefit. (10). Stool and Anus.—Costiveness. Frequent small evacuations of bloody mucus, with griping pains in the abdomen. Copious, soft, loose, evacuations. Great disposition to diarrhoea, with colic and fla- tulence. Frequent emission of flatulence. Itching of the varices towards evening. Clinical Remarks.—It may prove useful in some attacks of dysen- tery and diarrhoea, especially when preceded by costiveness. (11.) It has occasionally cured chronic constipation produced by an im- paired condition of the muscular structure of the digestive apparatus. It is most efficient when the large intestines are chiefly involved. (10.) Genital and Urinary Organs.—Lancination in the urethra. Violent burning. Clinical Remarks. —'The most important constituents of the Angus- tura-s., are Gallic-acid united with Brucin. From analogy, there- fore, we infer that it may prove to be indicated in chronic nephritis. (10.) As a remedy in incontinence of urine from a paralytic state of the neck of the bladder, we can vouch for its utility. (10.) Chest.—Panting, breathing.—Interrupted convulsive and suppressed breathing. Oppression of the chest. Painful soreness of the chest, worse when lying on one side. Shooting below the mammary re- gion, increased by respiration. Beating of the heart scarcely per- ceptible. Palpitation of the heart. Pain in the right side of the chest. Pathology.—Lungs engorged with dark blood, and less crepi- tant than in the natural state. The blood continued in the cavities of the heart, black, partly fluid and partly coagulated. Clinical Remarks.—It is homoeopathic to the most violent tetanic False Angustura-Bark. 367 spasms of the chest, and may prove so in spasms of the bronchial tubes and spasmodic asthma. (11.) We have recently used the sixth dilution, at intervals of an hour, in a troublesome case of irregular, jerking, and painful respiration, with entire success. Relief was given almost immediately, and the cure was complete in four hours. The symptoms in this case were dependant upon spinal irritation. (10.) Back.—Crampy sensation in the back. Painful weariness in the loins, and region of the sacrum. Violent jerkings along the spinal column, particularly along the lower portion, as if occasioned by electric shocks, with slight raising of the trunk. Violent opistho- tonos. Clinical Remarks.—It is homoeopathic to spasms proceeding from the spinal column, and to spinal irritation. (11.) Against the violent, cramp-like pains, which accompany the pas- sage of calculi from the kidneys to the bladder, it is an excellent re- medy. It is worthy of trial against the pains which arise from chronic affections of the kidneys. (10.) Upper Limbs.—Stiffness of the* shoulder-joints. Rigidity of the upper limbs. Tearing in the arms. Cramp-like pain in the dorsum of the hand. Free motion of the upper extremities, while the lower extremities are rigid and painful upon every attempt to bend them. Lower Limbs.—Feeling of lameness in the right thigh. Stiffness of the joint. Rigidity of the extremities. Bruised feeling in the limbs. Cramplike pain above the knees. Weariness in the knees. Inability to bend the lower extremities, every effort to do so being attended with acute pain. Clinical Remarks.—A remedy of value in the rigidity, and lame- ness which often affect the limbs of paralytics. Also in morbid sen- sitiveness, and involuntary and painful jerkings of the legs, it has afforded relief. We have observed its curative power in two cases of chronic stiffness, and neuralgia of the knee-joint. (10.) ANGUSTURA-VERA. galipea officinalis or galifea-cusparia. cusparia-febri- FUGA. True Angustura-Bark. authorities. Hahnmann (1.) Noack and Trinks (19.) Jahr (32.) Wood and Bache (7.) Flora Homoeopathica (50.) Bell's Materia Medica (48.) Peters (11.) Marcy (10.) Snelling (42.) Fullgraff (26.) 368 Angustura- Vera. GENERAL REMARKS. Angustura was first made known in Europe in 1788, by Dr. Ewer of Trinidad, and was called from the town of St. Thome d'Angus- tura, on the Orinoco. Its botanical source was long unknown till Humboldt and Bonpland announced the discovery of the plant in their travels in tropical America ; but even after this it was for a long time involved in doubt, since by them it was long supposed that the medicinal bark was produced from the Bonplandia-trifoliata, (the name which was bestowed upon this tree by Wildenow in honor of its discoverers,) but Dr. Hancock, who resided in the district which yielded the bark for some years, has conclusively shown that the me- dicinal bark is obtained from a different species of the same genus, which differs essentially from the plant described by Bonpland; the one being a magnificent stately tree sixty to eighty feet high, while the one described by Hancock never exceeds twenty feet. This latter then, under the name Galipea officinalis, is the Angustura-vera and as such has been received into the various pharmacopoeias. It is a small tree, irregularly branched, rising to the medium height of twelve or fifteen feet, with an erect stem from three to five inches in diameter, and covered with a smooth-grey bark. The bark is generally brought from the West-India ports packed in casks; but according to Mr. Brande, the original package formed in Angustura or its neighborhood, consists of the leaves of a species of palm, sur- rounded by a net-work made of sticks. The pieces are of various lengths, for the most part slightly curved, easily quilled, sometimes nearly flat, from half a line to a line or more in thickness, pared away towards the edgqs, covered externally with a light yellowish-grey, or whitish-wrinkled epidermis, easily scraped by the nail, and internally of a yellowish-fawn color. They are very fragile. According to Fischer it contains volatile oil, bitter extractive, a hard and bitter resin, a soft resin, a substance analogous to caout- chouc, gum, lignin, and various salts, among them carbonate of Am- monia. The volatile oil, which may be obtained by distillation with water, is of a pale-yellowish color,lighter than water, of an acrid taste, and of the odor of the bark. Cusparin is the name given by Saladin to a principle, deposited in tetrahedral crystals, when an infusion of the bark is treated with absolute alcohol, at common temperatures and allowed to evaporate spontaneously. Brande was inclined to think that Cusparin was identicalwithCinchonia. The virtues of the bark probably reside in the volatile oil, and bitter principles. (7.) Angustura had long been used by the natives of the countries where its grows, before it became known in Europe. It was first taken to Europe about seventy years since, and is now ranked among the of- ficinal remedies throughout Europe and America, although not much used. Cusparia, or True Angustura*Bark is bitter flavored, accompanied by a peculiar and somewhat aromatic pungency. Its odor, especially True Angustura-Bark. 369 when fresh from the package is rather nauseous and fishy. It ex. hales Ammonia when heated with caustic potassa. General Symptoms.—Cracking in almost all the joints, but it is not audible. Itching in the evening, when in bed ; after rubbing the parts, flat, very painful ulcers make their appearance. Fainting fits, weakness, paralysis. Paralytic weakness in the hands and elbow- joints, accompanied by chilliness and want of animal heat. (1.) Clinical Remarks.—Hancock employed it extensively in the malig- nant bilious intermittent fevers, dysenteries and dropsies of Angustura and Demerara, and speaks in strong terms of its efficacy in these com- plaints. It is probable, however, from the testimony of physicians in Europe and in the United States, that it is better adapted to tropica] diseases than to those of temperate climates. (7.) It seems homoeopathic to nettle-rash, when followed by flat, painful ulcers. (11.) Fever.—Early in the morning, chilliness in bed, without any subse quent heat. Internal shiverings at three o'clock in the afternoon, with violent thirst, without subsequent heat, several days in suc- cession. In the afternoon, shivering with goose skin, abating in the open air, without any thirst, for several days in succession. Increas- ing warmth over the whole body. Internal and external heat. (1.) Clinical Remarks.—It was at one time considerably used in place of Peruvian bark as a febrifuge; but it has not been found successful in the treatment of intermittents in northern latitudes. (7.) More recently Mr. Brande has spoken favorably of its febrifugic properties, and relates instances in which it has proved successful. Alibert, however, gave it a fair trial, and found it of little value; and general experience has pronounced the same verdict. (44.) Pereira recommends it on the authority of Winterbottom in " ady- namic continued fever," especially when complicated with great dis- order of the digestive organs. Merat and De Lens assert that the natives of the country where it is indigenous, regard it as superior to Quinine in the treatment of in- termittent fevers. They also employ it like Quassia and Columbo in dysenteries. Brettonneau of Tours used it in several cases, but was unsuccessful. According to Trousseau and Pidoux, Reydellet and Niel of Mar- seilles have administered the Angustura in powder, in five cases of vernal intermittent with entire success. Fodere has succeeded but three times in eight cases. These acts are qualified, however, by the reflection that oftentimes the most insignificant remedy will cure an intermittent, more especially that occurring in the spring, a simple stimulant being sometimes all that is needed to enable the system to throw off the morbific influence. In order to give weight and value to a remedy it should succeed in the case of a tertian or quartan, of marked type, which has lasted from fifteen days to a month. (42.) 24 370 Angustura- Vera. Mind and Disposition.—Discouragement, peevishness. Dissatisfac- tion. Liveliness and activity of the mind. Clinical Remarks.—It is usually thought to have no special in- fluence upon the brain and nervous system, but is generally regarded as a stimulant tonic, in small doses acceptable to the stomach. (11.) Many of the phenomena enumerated by Noack and Trinks as due to this variety of Angustura, belong properly to the false Angustura. It has been ascertained that much of the bark which was formerly sold in Europe was composed of a mixture of both varieties, so that we are left in some doubt with regard to the pathogenetic and thera- peutic effects peculiar to each kind. It is probable that whatever influence may by exerted by this sub- stance upon the mind and disposition, should be attributed to its ge- neral tonic properties rather than to any direct influence over the brain and nervous system. (10.) Sensorium.—Sense of contraction of the head, when walking rapid- ly. Sudden great dulness of the head. Great absence of mind. Inability to concentrate the mind. (32.) Clinical Remarks.—It seems homoeopathic to the dulness of the head, &c, which often attend dyspepsia, or general nervous debility and torpor of the system. (11.) It has been much used in the West Indies in bilious intermittent fevers and in bilious dysenteries. From its successful employment in these cases, we infer a slight alterative action upon the liver; and it will doubtless prove homoeopathic in the dullness, depression, and other mental conditions dependant on functional derangement of the liver. (10.) Sleep.—Great sleepiness in the evening, until nine o'clock, after- wards one is wide awake until after midnight. Uneasiness, early in the morning, frequent yawning and want of disposition to do any kind of work. Frequent yawning with stretching of the limbs. Uneasy sleep. (1.) Clinical Remarks.—It is indicated in drowsy, stupid, and indolent states, which are symptomatic of jaundice, liver complaints, and other maladies accompanied by bilious disorder. (10.) Head.—Contractive, pressing head-ache. Head-ache with heat in the face, especially at night. (19.) Gloominess and dullness of the head, as after a previous intoxication, great apathy of the mind. Drawing and oppressive pain in the temporal region. Vertigo in the open air. (1.) Clinical Remarks.—It seems homoeopathic to the head-aches and dullness of the mind which arise from excessive intellectual labor, from dyspepsia, or bilious derangements. (11.) It has occasionally afforded relief in nervous head-aches arising from excessive sanguineous, and seminal losses. But the benefit in these instances has been only temporary, thus proving its remedial True Angustura-Bark. 371 power to be due to its general stimulant and tonic action, and not to any real specific influence upon the nerves themselves. (10.) Eyes.—Violent burning in the eyes. Soreness of the eyelids. The eyes are red and burn ; in the morning they seem to be agglutinated. Early, on rising, dimness before the eyes, as if the cornea were ob- scured. (1.) Clinical Remarks.—It may prove useful in the irritation of the eyes, which attend some dyspeptic and bilious complaints. (11.) Ears.—Stitches. Burning in internal ear. Very painful, tearing twitching in the internal ear. Tearing in a tumor over the right mastoid process. (4.) And cramps in the external ear. Clinical Remarks.—It may deserve more attention in diseases of the ears than it has yet received. (11.) Face.—Tensive pain in the temporal muscles, when opening the jaws. Lame, painful feeling in the masseter muscles. Cramp-like pain near the articulation of the jaw, in the muscles. Sensation of corrosive soreness deep in the nose. (1.) Clinical Remarks.—It seems homoeopathic to some painful and spasmodic affections of the muscles of the face, and to act some- what specifically upon the muscles and motor nerves; but it is very probable that the above symptoms were produced by the Angustura- spuria. (11) A young lady aged about eighteen years, of a nervous temperament, tall, slender, and pale, had been afflicted with intermittent neuralgia of the face for seven months. The paroxysms usually came on shortly after breakfast, and continued at intervals until bed-time. She had taken Quinine, Arsenic, and Mercury allopathically, and had been under homoeopathic medication for several weeks without material benefit. On the 10th of Jan. 1857, the case presented the following symp- toms. Acute pains in both cheeks, occasionally darting through the eye-balls, and temples, greatly aggravated by stooping, stepping, or by mental excitement, general debility, depression of spirits, frequent chilly sensations, occasionally nausea and looseness of the bowels. Four doses of the first dilution were prescribed daily, and at the ex- piration of six days all unpleasant symptoms had disappeared. (10.) Jaws and Teeth.—Great dryness of mouth and lips without any thirst. Drawing pain in the teeth and upper jaw. (19.) -When chewed it leaves for some time a sense of heat and pungency in the mouth, throat and fauces. (44.) Gastric Symptoms.—Taste in the mouth like that of peach-kernels. Bread tastes sour. Nausea during a walk, as if he would faint, ac- companied by great lassitude all over, not relieved by sitting down. Many eructations after a meal; empty, bilious eructations ; extremely painful pinching stitches in the tip of the tongue. Roughness, dry- ness of tongue, palate and fauces, worse on swallowing. Great de- 070 oil Angustura- Vera. sire for cold drinks. Frequent hiccough. Nausea, especially during a meal. (1.) Clinical Remarks.—It seems to act upon the stomach somewhat similar to Cocculus, and Nux-vomica, and may be employed against acidity, nausea, bilious derangement, flatulence, dryness of the mouth and throat, especially when there is an excessive desire for cold drinks, with more or less lassitude and inclination to faint. In the dominant school it is regarded as a valuable remedy in cases of dys- pepsia, with diarrhoea, and loss of appetite. In cases of flatulency attended with nausea, if taken an hour before dinner it will often restore appetite and digestion. (11.) It has been used successfully in 'enfeebled states of the stomach caused by abuse of stimulants, and irregularity in eating. Also in nausea and general debility accompanying slight functional derange- ments of the liver. Its curative power in these instances is pro- bably attributable to its general tonic properties. (10.) Stomach.—Cramp-like pinching pain below the pit of the stomach in the evening, when sitting. Cutting tearing in the pit, increased by moving the trunk, after dinner. (1.) Clinical Remarks.—In large doses it evacuates the stomach and bowels, and is often employed for this purpose in South America. (7.) It has been recommended in dyspepsia and other diseases in which a tonic treatment is demanded. (7.) It has the advantage over Peruvian Bark that it is less apt to op- press the stomach. It is said to promote digestion, increase the appetite, expel flatus, and does not cause constipation. (44.) Abdomen.—Early in the morning, diarrhoea comes on after previous colic, and nausea ; the last evacuation was mere slime. Cutting under the short-ribs, also in the left lumbar region, and hypogastrium, with pressure towards the rectum. Cramp-like colic when walking. Pressure in the hypogastrium, accompanied by anguish. Fermenting and loud rumbling in the abdomen, as if diarrhoea would come on, accompanied by incarceration of flatulence. Painless shifting of wind, grumbling and gurgling in the intestines, continuing almost unceasingly for three hours. (1.) Clinical Remarks.—In large doses it is apt to vomit and purge; it seems homoeopathic to wind-colic, to excessive formation of flatulence, and great rumbling in the bowels, to diarrhoea with or without slimy stools. (11.) Many of its pathogenetic symptoms correspond with those of China, and it is therefore now and then employed with advantage in diarrhoeas, flatulency, and other abdominal troubles, in which China is indicated, but fails to afford prompt relief. In the last stages of cholera-infantum, it has sometimes been prescribed with speedy bene- fit. (10.) True Angustura-Bark. 373 Stool and Anus.—Indications of diarrhoea, with dragging through all the intestines, also with shiverings over the face. Sensation in the rectum as if it would protrude, followed by a yellow, soft and copious evacuation. Three very thin stools in the space of four hours. Emission of fetid flatulence. (I.) Diarrhoea with pinch- ing pain in the bowels, accompanied by nausea, also discharge of slime from the rectum. Tickling, itching about the anus, as if caused by ascarides. (19.) Clinical Remarks.—It is said to be particularly efficacious in bilious diarrhoeas and dysenteries. (7.) In the latter stages of diarrhoea and dysentery it may be given with advantage. In the diarrhoea of children when the faeces are loaded with mucus it proves useful. Dr. Lettsom speaks highly of its efficacy. (44.) It is also said by Bell to be particularly useful in dysentery and chronic diarrhoea, especially that form of diarrhoea to which persons who have resided in warm climates are frequently subject, and which often assumes even in this country, more or less of a dysenteric character. (11.) Several physicians have found the use of this remedy in choleroid diseases of the greatest importance, and especially during epidemics. One of our most experienced and busy practitioners has used it in numerous cases, with invariable success. And when we carefully peruse the pathogenesis of the remedy we see no reason why its range of use will not entitle it to the highest consideration, in di- arrhoea and dysentery, when accompanied with cutting, crampy or drawing aching pains in the abdomen, especially in the lower abdomen, and spasm of the muscles. It is appropriate in diarrhoeas of typhus and intermittent fevers, and in many of those which accompany excessive weakness of the entire system. Merat and De Lens assert that it is used with success by the natives of the countries where it is indigenous in dysenteries. We have witnessed its good effects in low forms of cholera infantum. (10.) Urinary Organs.—Frequent desire to urinate, with scanty dis- charge. Tenesmus of the bladder, followed by the emission of a quantity of white urine, Tenesmus after micturition. Burning after micturition. Orange-colored urine, which becomes quickly turbid. (1.) Clinical Remarks.—It seems homoeopathic to some derangements of the bladder and urinary organs, such as often attend dyspeptic com- plaints, especially when the urine is white as if loaded with phos- phates, or is orange-colored and easily becomes turbid, attended with tenesmus of the bladder and scanty discharge of urine. (11.) It has proved curative in cases of scanty, red or orange-colored urine, accompanying intermittent fevers. (10.) Genital Organs.—Traction in the left spermatic cord, alternating with twitches accompanied by a sensation of shivering in the neighboring- parts of the scrotum and thigh. (1.) 374 Angustura- Vera. Clinical Remarks.—It may relieve some painful affections of the spermatic cord, such as are apt to occur in dyspeptic individuals, or in those affected with derangement of the kidneys and bladder. (11.) Larynx and Trachea.—Titillation in the larynx, inducing a dry, short and hacking cough, continuing for a long time. Tenacious phlegm in the throat, which it is difficult to hawk up. (1.) Clinical Remarks.—It may prove useful against some troublesome hacking coughs, such as arise from irritation or dryness of the throat, or are sympathetic of some derangement of the digestive organs. We recently administered a few doses of the third dilution to a consumptive patient who was afflicted with a dry, hacking-cough, proceeding from a tickling at the throat-pit, and at the upper part of the lungs, accompanied by great oppression of the chest, and found that each dose produced an aggravation of all the symptoms. The medicine was omitted for several days, but no reactive amelioration ensued. A few weeks fafterwards, the same remedy was again pre- scribed, and with preciselythe same results. (11.) Chest.—Cutting pressure in both sides of the chest; at first only during an expiration; afterwards the pressure changed to cutting thrusts, continuing even when the breath was held, feeling of tightness of the chest; palpitation of the heart. Painful sensitiveness of the chest; even on slight pressure. Pain in the muscles of the chest. (1.) Clinical Remarks.—It is homoeopathic to some of the pains in the chest and derangement of the action of the heart which occur in con- sequence of derangement of the digestive organs. (11.) Back and Neck.—Early in the morning, when in bed, pain in the small of the back, as if every thing were broken; after having risen from the bed, she was unable to pick up anything from the floor, until several hours had elapsed; this symptom was followed by hunger, cutting pains in the abdomen and loose stools, which finally became slimy. Squeezing pressure in the small of the back, as if the parts had been bruised by blows, interrupting sleep. Tension in the muscles of the back. (1.) Painful stiffness, resembling a drawing between the scapulae, and in the nape of the neck, early in the morn- ing, when in bed ; when rising, she was unable to move her arms on account of the pain, nor was she able to turn her neck, the whole forenoon ; this symptom occurred several mornings in succession, lasted until noon, accompanied by langor of the whole body. (32.) Pretty violent trembling in the muscles of the neck, on the left side. (1.) Clinical Remarks.—It promises to be one of the most important homoeopathic remedies in lumbago, and spinal irritation. (11.) Superior Extremities.—Painful twitching in the deltoid region. Lameness, a feeling of paralysis is experienced on keeping the arm extended for any length of time. Stiffness in the joints of the elbows, Aniseed. 375 accompanied by lassitude of the forearms. Cramp-like traction in forearm, hand and fingers. Aching of the humerus as from a bruise. (1.) Feeling of numbness in different fingers. (19.) Clinical Remarks.—It seems to act powerfully upon the muscles and motor nerves of the arms, and may prove useful in some painful spasmodic or partial paralytic affections of these parts. (11.) Some physicians are in the habit of employing it against the weak- ness, stiffness, and numbness which sometimes remain in the ex- tremities after severe attacks of rheumatism and paralysis. (10.) This medicine, according to Noack and Trinks, has a remarkable specific action on the motor and spinal nerves. The two following cases exhibit its curative action in this respect. Case 1. A lady, about fifty years old, oppressed with gloom, of a saturnine complexion, suffered much from pain in her spine, at the nape of the neck, and the sacrum especially; at either of these places the pain was much increased by pressure. She had great dif- ficulty in walking, and seemed threatened with paralysis of the lower limbs. She had a sensation of tremulousness, and uneasiness in the muscles of the neck. Various means were resorted to for her relief, with little or no effect. Finally Angustura was prescribed and very materially re- lieved her. She is cheerful, the pain much less, and she walks with much more ease and comfort. Case 2. Another lady about the same age, was also threatened with paralysis of the lower limbs. There was considerable aggra- vation of her sufferings from a few doses of Angustura, followed by amelioration. Lower Extremities.—Tremulous stitches in the left thigh, and in the upper border of the ilium, extremely painful, and felt only when sitting. (1.) Clinical Remarks.—It seems to act less specifically upon the lower extremities than upon the upper. (11.) A N I S U M . ANISE--ANISEED. AUTHORITIES. Trousseau and Pidoux (3S.) Wood and Bache (7.) Peters (11.) Waring's Ther. (44.) Snelling (42.) Marcy (10.) GENERAL REMARKS. Aniseed is a native of Egypt, subsequently introduced into Spain and the Levant. It is also cultivated in the South of France. The fruit (seeds) alone is used, although the whole plant shares its me- 376 Anisum. dicinal properties. The odor of the fruit is agreeable and quite pro- nounced ; the taste is sweetish aromatic, and slightly hot and stimu- lating. The Spanish Anise is that most esteemed. It yields both a fixed and essential oil. (38.) The properties which depend upon this volatile oil, are imparted sparingly to boiling water, freely to alcohol. The volatile oil exists in the envelops of the seeds, and is obtained separate by distillation. Their internal substance contains a bland fixed oil. (7.) TOXICOLOGICAL EFFECTS. A case of poisoning is on record from the accidental admixture of the fruits of Conium-maculatum, which bear some resemblance to those of Anise, but may be distinguished by their crenate or notched ridges. They are, moreover, broader in proportion to their length, and are generally separated into half fruits, while those of the Anise are whole. (7.) Head.— Giddiness. Vague pains in the head. Clinical Remarks.—It may be often given with advantage in head aches ; especially those of nervous and hypochondriacal persons, and in those depending upon a depraved state of the alimentary canal. (38.) Useful in giddiness arising from indigestion and flatulent distention of the stomach. Also for pain and pressure in the head from over- loading the stomach. (10.) Chest.— Clinical Remarks.—In Phthisis Dr. Prout is of opinion, that Aniseed has considerable power in allaying the irritation on which the cough depends. He simply infuses the bruised seeds in hot water. Dr. Watson says that he has tried this as a vehicle for Camphor, when the same dose in other vehicles has failed, and that it has frequently been followed by a marked abatement of the frequency and violence of the cough. (44.) It is also stated that asthmatics are sometimes greatly relieved of their oppression by smoking the seeds of the Anise. (38.) In consequence of the reputation of some remedies of this class it has been prescribed in acute chronic catarrhs, and in mucous fevers. (38.) Mamma?.— Clinical Remarks.—We have seen nurses allay the colics of infants by themselves drinking a decoction of aniseed, and their milk certainly had a perceptible odor of anise. It has enjoyed a considerable reputation for increasing the secretion of milk, where it is deficient. This may be only through the digestive organs which are thus assisted. It is difficult, however, to account on these grounds for the very manifest increase of milk which often follows the appli- cation of cataplasms and fomentations of Aniseed to the breasts. (38.) Stomach.—Clinical Remarks.—Its carminative and stomachic pro- perties are well known. It is frequently used to assist digestion Wild- Chamomile.—May- Weed. 377 after a meal, especially by hypochondriacal persons, and asthmatic patients frequently find through this a relief from the flatulence which torments them. (38.) We have frequently seen nurses calm and allay the colics of in- fants by themselves drinking an infusion of Anise, and we are confi- dent that the milk of the women had quite a perceptible odor of Aniseed. It has enjoyed quite a reputation for increasing the lacteal secretion. (38.) Its principal range of use, however, is in those states of the primae viae marked by anorexia, dyspepsia, nausea, vomiting, &c, &c, ap- pearing to depend upon an exaggerated or vitiated secretion from the pharyngial and gastric mucous membranes, which are charged with a tough, transparent, viscid mucus, discharged with difficulty, and giving rise to spitting, heartburn and painful vomiting. (11.) Urinary and Genital Organs. — Clinical Remarks. — Hippocrates ascribes to it both emmenagogue and diuretic virtues ; he says, Anisum vino maceratum bibendum propinato ad uterum expurgandum ; and again, confert Anisum et que urinam movent. Galen confirms this observa- tion : urinam ciet, digerit et flatus reprimit. (38.) Anisum-St ellatum, (see Illicium-Anisatum.) ANTHEMIS-COTULA. CHAMOMILLA-FCETIDA. MANZANILLA-LOCA. Wild-Chamomile. May-Weed. Dry Chamomilla, Stinking Chamomile. May-weed grows abundantly both in Europe and in the United States and is found in the vicinity of inhabited places, growing among rubbish, alongthe side of roads and in waste grounds. The whole plant has a strong, disagreeable smell and a warm bitter taste ; its disagreeable odor is an obstacle to its general use. In Europe it is given in nervous diseases, especially hysteria, and is supposed like Assafoetida to possess antispasmodic and emmena- gogue powers. It will vesicate, if applied fresh and bruised to the skin. The flowers are less disagreeable than the leaves. Matricaria Chamomilla, (see Chamomilla.) 378 Anthemis-Nobilis. ANTHEMIS-NOBILIS. ROMAN, OR COMMON CHAMOMILE. GENERAL REMARKS. All parts of the plant have medicinal properties, but it is only the flowers that are officinal. There are two varieties of flowers, the single and double ; the single, or yellow are more odorous than the white or double, and more stimulant to the stomach, because the volatile oil upon which these properties depend, is much more abundant in the central or yellow florets. The odor of Chamomile is fragrant and peculiar, the taste bitter, and warm and somewhat aromatic. The flowers contain a minute portion of Tannic-acid, a bitter principle and a volatile oil, upon which their medicinal virtues depend. On distillation they also yield a small quantity of a substance resembling Valerianic-acid. In small doses, frequently repeated, it is said to be a mild tonic, operating like the simple bitters, but with a somewhat more exci- tant influence on the stomach, owing to its volatile oil. In large doses it is apt .to prove emetic, more so than most other simple bitters. Its relation to Valerian renders it carminative, emmenagogue, an- tispasmodic and somewhat anodyne. Chamomile poultices applied to the ears are very useful in inflam- matory ear-ache. It has been used internally and externally against obstinate ulcers. Fevers.—By the ancients it was used in the treatment of inter- mittent fevers and continued to be esteemed among the most valu- able remedies in that complaint, down to the period of the dicovery of Peruvian-bark. Even after that period, it long continued to re- lain some reputation as a febrifuge, being employed in cases which resisted the bark, and especially in the remission of remittent fevers, before the febrile phenomena had sufficiently subsided to justify the use of the more powerful remedy. In some cases, however, of in- termittent and remittent fever, large draughts of warm Chamomile- tea given immediately before the paroxysm, the patient being kept warm in bed, will prevent the recurrence of the fever, either by operating as an emetic, or by a joint tonic and diaphoretic action. Cullen cured many cases of fever and ague with it in powder- form—but it was apt to cause diarrhoea. It is mostly homoeopathic when there is nausea, vomiting and diarrhoea. In febrile and bilious diseases there is often a good deal of retch- ing from the presence of acrid bile in the stomach, which may thus be promptly relieved. It is much used in the convalescence from acute febrile diseases, and it is thought well adapted to those slight cases of debility, fre- Roman, or Common Chamomile. 379 quently occurring, especially in sedentary females, in which stronger medicines might prove hurtful. In these cases the cold infusion, which is more acceptable to the palate and stomach, should be used. Trousseau and Pidoux say, that it was the Peruvian-bark of the ancients. Galen says, the Magi of Egypt dedicated it to the sun, in consequence of its efficacy against fevers. Dioscorides recommends the powdered flowers to prevent an attack of fever and ague. Al- though it will not cure as many cases as Bark and Quinine, it will succeed at times, where these more powerful remedies fail ; Trous- seau and Pidoux explain this by stating that such patients have an idiosyncrasy against Bark and Quinine, and an idiosyncrasy in favor of Chamomilla. Homceopathists can easily learn to distinguish these cases. The celebrated R. Morton made comparisons between the effects of Bark and Chamomilla in fever and ague and often prefer- red the latter; one of his colleagues Elisha Coyth affirms that he has witnessed the signal efficacy of flowers of Chamomile very mi- nutely and carefully pulverized, and regards it as certain as Bark itself. Morton recounts three cases in which he failed with Bark, but cured with Chamomilla ; his testimony is the more important, as he was so well convinced of the general efficacy of Bark, that he never used other remedies unless this failed. F. Hoffmann pre- ferred Chamomile to Peruvian-bark in substance. Schulz gives a case of quartan-fever which had resisted the most celebrated reme- dies for thirty-six months, cured by Chamomile. Pilcairn preferred it to Peruvian-bark. It is decreed to be-most useful in vernal inter- mittents, occurring in large cities, and in nervous persons. Stomach.—Although it is an emetic it is said to be particularly adapted to cases of general debility, in which the stomach partici- pates in a greater degree than other organs. The gentle stimulant influence of its volatile oil on the stomach is said to render it pe- culiarly applicable under such circumstances. In mild dyspepsia with defective appetite, flatulent eructations or slight colicky pains from wind in the stomach or bowels it is said to be often given with advantage. It has already been stated that in large doses it is apt to cause vomit-" ing ; to produce this effect, it is best given in the form of warm infusion, and in large draughts, so as to aid the medicine by the nauseating effects of the tepid water. In this way it is often given with advan- tage in the dominant school and in domestic practice, in cases of spasm of the stomach arising from undigested food or other irritating matters in the stomach and attended with sensations of nausea, or in- effectual efforts to vomit. Indeed in any case of irritable stomach, when that organ seems unable wholly to free itself from its contents, it may be aided by large draughts of warm Chamomile-tea. The tea is often also administered along with other emetics, or shortly after- wards to promote their action, or to render it more easy, by giving the stomach a greater bulk to act upon. 380 Anthemis-Pyrethrum. Dierbach recommends it highly in spasmodic affections of the ab- domen, in colicky pains, flatulence, painful menstruation, in hysterical and hypochondrical affections, in great nervous debility from exces- sive loss of semen, in diarrhoea and dysentery. The celebrated Bag- livius regarded it as a specific against colic-pains ; his words are : Antidotum colice est chamomilla, a quacumque demum causa oriutur. Cullen says, its tendency to act upon the bowels renders it useful in colics and dysentery, but not in diarrhoea. It has been used against the meteorism of malignant fevers, as a drink and injection. N.B. The German Chamomile will be treated of under the head of Chamomilla, or Matricaria-Chamomilla. ANTHEMIS - PYRETHRUM. ANACYCLUS-PYRETHRUM--PELLITORY. GENERAL REMARKS. The. plant is a native of Levant, Barbary and the Mediterranean coast of Europe. The root is the part used under the name of Pel- litory of Spain. Its taste is peculiar, slight at first, but afterwards acidulous, saline and acrid, attended with a burning and tingling sensation over the whole mouth and throat, which continues for some time and excites a copious flow of saliva. It is a powerful irritant, and has been used almost exclusively in the dominant school as a siliagogue in certain forms of headache, rheumatic and neuralgic affections of the throat and toothache ; or as a local stimulant in palsy of the tongue and throat, and in relax- ation of the uvula. An alcoholic extract is sometimes used by den- tists as a local application to carious teeth, with a view to its benumbing effects before plugging. In homoeopathic practice it may be used in mercurial salvation ; in inflammations of the mouth, throat and gums. ANTHRISCUS-CEREFOLIUM. CHiEROPHYLLUM-SATIVUM.--SCAND1X-CEREFOL1UM. Chervil. AUTHORITIES. Wood and Bache (7.) GENERAL REMARKS. An annual European plant, cultivated in gardens as a pot-herb, and supposed by some physicians to possess medicinal powers. It Steinkohlen-kali. 381 has a strong agreeable odor, especially when rubbed, and a pungent slightly bitterish taste. These properties it owes to a volatile oil, which may be separated by distillation with water. It is said to be deobstruent, diuretic and emmenagogue, and has been recommended by different authors in consumption, scrofula, dropsy, cutaneous and scorbutic affections, and as an external application to swollen breasts, bruises, and other local complaints or injuries. It is, however, a very feeble medicine, and is more employed as an addition to broths than as a remedy. (7.) ANTHRAKOKALI. STEINKOHLEN-KALI. AUTHORITIES. Wood and Bache (7.) Dunglison (16.) Possart (70.) Peters (11.) Snelling (±2.) Marcy (10.) GENERAL REMARKS. This preparation, introduced by Dr. Polya, is of two kinds, the simple and the sulphuretted. The simple Anthrakokali is formed by adding 160 parts of porphyrized mineral coal to 192 parts of a concentrated and boiling solution of caustic potassa, contained in an iron vessel, the whole being well stirred together. When the mix- ture is completed, the vessel is taken from the fire, and the stirring- continued until the whole is converted into a homogeneous black powder. The sulphuretted Anthrakokali is prepared in a similar manner, six- teen parts of Sulphur being mixed with the mineral-coal before it is added to the caustic potassa solution. Dr. Polya recommends these preparations both internally and externally, in scrofula, chronic rheu- matism, rheumatic tumors of the joints, and certain herpetic affec- tions. The dose is a grain and a half, three or four times a day, mixed with two or three times its weight of sugar, or powdered li- quorice root. For external use sixteen grains may be rubbed up with an ounce of lard, to form an ointment, to be used by friction. (7.) Polya affirms, that Anthrakokali exerts its influence on the skin generally, and especially on the chronic cutaneous affections. It has also been given beneficially by Felsach in scrofula and chronic rheu- matism. The dose of the simple and sulphuretted preparations employed by these physicians was gr. iss. three times a day. M. Gibert employs it externally in chronic cutaneous affections, in the form of ointment. (16.) In the Vienna general-hospital it was used in more than 800 cases, with very unsatisfactory results, although the remedy was persisted in 382 Anthrakokali. for two, three or even five months. Sigmund used the simple form in eleven cases of herpes without any benefit; the sulphuretted variety then cured only two of these cases. Clarus and Radius were equally unsuccessful in Leipzig. (11.) It is highly probable that, many of the phenomena attributed to this substance are referable to the Sulphur which it contains. Its marked effects as well as numerous individual symptoms upon the skin and other tissues, which Sulphur impresses specifically, lead to this con- clusion. (10.) SYMPTOMS. Head.—Headache. Cloudiness of the head. Heaviness of the head, accompanied by languor and restlessness. Mouth.—Dry mouth. Bad taste in the mouth. Coated tongue. Pharynx and ffisophagUS.—Dryness of the pharynx. Heat from the fauces to the stomach. Burning in the pharynx, with slight dysphagia. Appetite.—Want of appetite. Burning thirst. Rough, acrid, burn- ing taste. Stomach.—Feeling of heat in the stomach. Vomiting of black mucus and bile. Violent vomiting of green or yellow bile, accom- panied with violent fever. Abdomen.—Distention of the abdomen. Pain and rumbling in the bowels, with papescent, or dark stools. Colic with flatulence. Tym- panitic distention of the abdomen. Stool.—Blackish stools. Papescent stools, with pain and rumbling in the bowels. Bilious discharges with fever. Urinary Organs.—Copious pale urine. Burning in the urethra, or itching at the orifice. Urine pale, offensive and having an alkaline reaction. Copious emission of pale urine, with earthy sediment ad- hering to the sides of the vessel. Genital Organs.—Frequent erections. Burning or itching in the urethra, or at the orifice of the urethra. Menses appear too early. Chest.—Oppression of the chest and violent palpitation of the heart, followed by sweat. Extremities.—Sweat on the hands and feet, and in the axillas. Weary, bruised feeling in the limbs. Sleep.—Sleeplessness, with general perspiration, rapid pulse, and great restlessness. Fever.—Chills alternating with heat, followed by slight perspira- tion, and rapid pulse. General moisture of the skin, with hurried pulse, headache, restlessness, weary and bruised feeling. Violent fever, with vomiting of yellow or green bile, and with bilious stools. General night-sweats. Clammy morning-sweats. Sweats on parti- cular parts. Skin.—Pustulous pimples, like blotches, with violent itching, ap- pearing in the night, and passing off again in the day-time. Chronic Stibium. 383 erysipelas. Redness and heat of the skin, disappearing when the sweat appears. Burning and turgescence of the skin. Urticaria. General moisture of the skin, with rapid pulse, headache, restless- ness, weary and bruised feeling. General Symptoms.—Cutaneous troubles. Weak and bruised feeling in the limbs. ANTIMONIUM-CRUDUM. STIBIUM. AUTHORITIES. Wood and Bache (7.) Lancet (52.) Hahnemann (1.) Teste (36.) Marcy (10.) GENERAL REMARKS. Antimony as a medicinal or poisonous agent, seems to have been first supplied to the world by the alchymists towards the close of the fourteenth century. It was known to the Greeks and Romans under the name it maintains in chemical language, Stibium. Basil Valen- tine, a German monk, first drew attention to it as a therapeutic agent, lauding a preparation of it of his own invention, as a universal spe- cific, but owing probably to the extent of this pretension, he did not succeed in establishing its claims. It was not until a century after this that the famous Paracelsus reintroduced Antimony into the me- dical world. But it was received with disfavor, and the parliament of Paris, deeming it a dangerous poison, passed a law against its use. It was finally entered in the State Register of medicine of Paris in 1637, under the head of " purgatives." (52.) Metallic Antimony, sometimes called Regulus of Antimony, though not strictly officinal, has been lately incorporated into the U. S. Dis- pensatory. Antimony exists in nature, 1st, uncombined, 2d, as an oxide, 3d, as a tersulphuret, and 4th, as a sulphuretted oxide. It is found principally in France and Germany. All the Antimony of commerce is extracted from the native tersul- phuret, which is by far the most abundant ore of this metal. The ore is first separated from its gangue by fusion. It is then reduced to powder, and placed on the floor of a reverberatory furnace, where it is subjected to a gentle heat, being constantly stirred about with an iron rake. The heat should not be sufficient to cause fusion. This process of roasting is known to be completed when the matter is brought to the state of a dull greyish-white powder, called Antimony- ash. By this treatment the Antimony is partly teroxidized and partly converted into antimonious acid, while nearly all the sulphur is dissi- pated in the form of sulphurous-acid-gas, a portion of tersulphuret, 384 Antimoni um-Cradum. however, remains undecomposed. The matter is then mixed with tartar, or with charcoal impregnated with a concentrated solution of carbonate of soda, and the mixture heated in crucibles, placed in a melting furnace. The charcoal reduces the teroxide of Antimony, while the alkali unites with the undecomposed tersulphuret, and forms with it melted scoriae, which cover the reduced metal, and di- minish its loss by volatilization. Antimony is imported into the United States principally from France, packed in casks. A portion is also shipped from Holland, from Trieste, and occasionally from Cadiz. The Spanish Antimony is generally in the form of pigs ; the French in circular cakes of about two inches in diameter, flat on one side and convex on the other; and the English in cones. The French is most esteemed. Antimonium-crudum then is the native tersulphuret, purified by a process of fusion ; it passes also under the name of Artificial-sul- phuret of Antimony. The crude Antimony as it occurs in commerce, is dark-grey externally, and exhibits internally, when broken, a bril- liant steel-grey color, and a striated crystalline texture. Its good- ness depends upon its compactness and weight, and the largeness and distinctness of the fibres. It is entirely soluble in muriatic-acid, by the aid of heat, with the evolution of sulphuretted hydrogen. The muriatic solution when added to water, is decomposed with the production of a white powder, (oxychloride of Antimony). Sulphuret of Antimony requires to be livigated in order to fit it for exhibition as a medicine, when it takes the name of prepared sul- phuret of antimony. Allopathic use of Antimony. This substance has been employed in medicine from a very early period. In the writings of Hippocrates, Galen, and Plinius, we find frequent allusion to it as a remedy in a great variety of maladies. It is one of many drugs which has been lauded by one generation of doctors, sneered at by the next, de- nounced as poisonous and totally unsafe by the next, revived again as a cure-all by the next, prohibited by legal enactments by the next, again and again revived and repudiated up to the present mo- ment, when its advocates appear to be in the minority. Among the diseases for which it has been empyrically used, may be cited, various chronic cutaneous affections, scrofula, intermit- tent fevers, rheumatism, gout, chronic gastritis, dropsy, dysentery, marasmus, bronchitis, worms, scrofulous ophthalmia. At the present time this preparation of Antimony is not employed by our empyrical brethren. (10.) GENERAL EFFECTS. Oil the Nervous System.—Its action upon the ganglionic and true spinal-systems is not strongly pronounced, but from its pathogenesis we consider it a depressor of the nervous forces. This depressing Stibium. 385 influence is due in part to a direct action upon the nervous sys- tem, and partly to its specific effect upon the stomach. When the latter influence is predominant, the reflex phenomena are first ex- citory and afterwards depressing. (10.) Nerves Of Sensation.—It impairs to a slight extent the integrity of the nerves of sensation, and renders the prover somewhat indiffe- rent to their ordinary stimuli. Thus, among its pathogenetic effects, we find numbness of the extremities when at rest. (10.) Nerves of Motion.—Under its influence, the force of the entire mus- cular-system is impaired. Among its phenomena are, great lassi- tude, weariness, and actual diminution of muscular power. (10.) Great Sympathetic Nerve.—From its effects upon the functions over which this system presides, we infer that here also it acts as a depressor. Under its influence, the action of the heart, and the respirations are diminished, and digestion is checked. (10.) On the MUCOUS Membranes.—It operates specifically upon the mucous membrane of the respiratory apparatus, giving rise to augmented secre- tion of mucus, cough with itching and roughness of the affected parts, and hoarseness, and upon the mucous membrane of the stomach, causing nausea, flatulent distention, and vomiting of mucus, mixed with food. (10.) Fever.—Quotidian and tertian fevers, with gastric symptoms, like want of appetite, eructations, loathing, nausea, vomiting, coated tongue, bitter taste, tension and pressure at the stomach, little thirst, pain in the chest. (1.) Much chilliness, and no heat. Shiver- ings along the spine, without thirst. Shiverings over the whole body, early in the morning, with heat in the forehead, without thirst. General sweat. Sweat during sleep. Gastric and bilious fevers. (1.) Quotidian or tertian fevers, with loathing, nausea, vomiting, cutting pain in the bowels and diarrhoea. (36.) Clinical Remarks.—In imperfectly developed intermittent fevers, commencing with irregular shiverings along the back and on the body, without being followed by heat, thirst, or sweat, and accom- panied by much gastric derangement, like nausea, loathing, and vomiting of mucous and partly digested food, and frequent eructa- tions, this remedy often affords prompt benefit. A layman recently cured himself of the above group of symptoms, with a few doses of the 6th attenuation, repeated every two hours during the apyrexia. It is often servicable in certain stages of gastric fevers, after the more urgent symptoms have been subdued. (10.) Skin.—Suppurating and long-continued eruption upon the cheeks. Cracks at the corners of the mouth. (36.) Blotches and vesicles, like stings of insects, on many parts of the body, especially in the face and in the joints of the extremities, coming on with itching and disappearing after a few hours. Pustules with red or brown scurfs, here and there. Itching of the whole body, especially the chest, 25 386 Antimonium-Crudum. back, neck and limbs. Red vesicular pimples, like varicella, with stinging pain when pressed upon. Eruption resembling nettle-rash. (1-)° Clinical Remarks.—It has been most successfully employed in eruptions caused, or thrown out by gastric derangements. Also in pustular eruptions it is quite homoeopathic and has often effected cures when used in high attenuations. We have often relieved the intense itching of porrigo, lichen, and eczema with the 30th attenua- tion, repeated at long intervals. (10.) Mind and Disposition.—Loathing of life. Sadness, with weeping and impressibility. (36.) Ill-humor, depression of spirits, irritability, and aversion to talking. (1.) Sensorium.—Weakness of the head. Aversion to mental effort. Taciturn and apathetic dementia. (1.) Clinical Remarks.—In one case of stupid delirium, caused by the sudden disappearance of a nettle-rash, two doses of the 2d tritura- tion of this medicine restored the rash, and cured the delirium. It is an appropriate remedy in delirium, nausea and vomiting, and other unpleasant symptoms arising from repelled measles, scarlet- rash, &c. (10.) Head.—Rush of blood to the head. Gnawing pain on the top of the head, apparently in the periosteum. Fatiguing itching of the head, with falling off of the hair. (34.) Dull, stupefying pain in the whole head, with nausea in the pharynx and stomach, and sweat When walking in the open air. Continual burning pain in the fore- head and temples, from within outwards. Headache as if her fore- head would burst, with feeling of intoxication, and desire to be alone and taciturn. (1.) , Scalp.—Itching of the scalp, with falling off of the hair. (36.) Small, flat tubercles, here and there, upon the hairy scalp, of the size of small peas, painful to pressure, and with titillation all around. Red, hardened, and slightly elevated spots on each side of the fore- head, itching like nettle-rash, going and coming. (1.) Clinical Remarks.—It has been prescribed with great benefit, in chronic eczema of the scalp, characterized by frequent paroxysms of intense itching. The ancients often employed it in scald-head, and occasionally with success. Although inferior to Rhus, Ledum, Sulphur, and this class of medicines, it certainly is worthy of consideration, in crust a lactea, porrigo, lichen, &c. (10.) Eyes.—Redness and inflammation of the eye-lids. Chronic blephar- ophthalmia (of children). (36.) Redness of the eye-lids, with fine stitches in the eye-ball. Redness of the left eye, with dread of light on rising in the morning, and with secretion of mucus in the inner canthus. Red, inflamed eyes, with itching and nightly agglutination. Inflammation of the eyes. Rheumatic ophthalmia. (1.) Stibium. 387 Ears.—Redness, burning and swelling of the ears, as from mos- quito-bites. Swelling and redness of the whole internal canthus, with periodical itching. Continual roaring in the ears, especially when all is still, and worse in the afternoon. Painful roaring in the ears. Impaired hearing. (1.) Clinical Remarks.—It is homoeopathic to slight eruptions around, and within the' ears of children, accompanied by occasional turns of itching. (10.) Nose.—Crusts and cracks of the nostrils. Stuffingof the nose. (36.) Stoppage of the nose, particularly in the evening. Dry coryza. Fluent coryza, particularly in the morning. Bleeding of the nose for several days in succession. Both nostrils become chapped and covered with crusts. Sore nostril, with drawing pain. Feeling of soreness and obstruction of the nostrils when inspiring air. (1.) Clinical Remarks.—In several instances we have seen sore nostrils, with frequent accumulation of crusts, cured by the use of a high at- tenuation of this drug (10.) Face.—Suppurating and long-lasting eruption upon the cheeks. Cracks at the corner of the mouth. (36.) Dry lips. Sore and pain- ful cracks at the corners of the mouth, returning after five, eight and twelve weeks. Red, burning, suppurating eruptions on the face. Red pimples, with pus at the tips, on both sides of the nose, painful to pressure. Flat pimples on the cheeks, not red, itching when touched, with a yellowish scurf. Rash on the face resembling nettle- rash. (1.) Clinical Remarks.—It is most homoeopathic in chronic pustular eruptions upon the face, running into crusts, and causing a painful soreness of the affected parts. According to our own experience, the higher attenuations are far more efficacious in these cases, than cruder doses. (10.) Teeth and Jaws.—Gnawing pain in carious teeth, after every meal. (36.) Tooth-ache in a hollow tooth, worse at night than in the day- time. Profuse bleeding of the gums. Shooting toothache, in the evening when in bed, and after dinner. Stitches in the tooth when inspiring air. Toothache is renewed after eating—-is aggravated by applying cold water, and is relieved in the open air. (1.) Mouth.—Cracks at the corners of the mouth. (36.) Violent ptya- lism from the nose and mouth. Sensation of scraping (rawness) in the velum palati, with much phlegm upon it, which could only be ex- pelled by long hawking. White coat upon the tongue 'in the fore- noon. Bad breath, with sore throat and impeded deglutition. (1.) Taste and Appetite.—Loss of appetite for a long time. Eructations tasting of ingesta. Loathing, nausea, and desire to vomit. (36) Violent thirst, with dryness of the lips. Thirst in the evening. Cutting colic, with loss of appetite. (1.) 388 Antimonium-Crudum. Gastric Symptoms—Habitual sensation in the stomach as if over- loaded. Constant eructations of wind. Bread and pastry particu- larly occasion nausea, and cutting colic. Aggravation of gastric symptoms by wine, even when diluted with water. (56.) Bitter eructations like bile. Gulping up of a fluid which tastes of the in- gesta, in the afternoon. Nausea after a glass of wine. Persistent and severe nausea, and vomiting. Vomiting and diarrhoea. (1.) Clinical Remarks.—It is a most appropriate remedy in chronic gastritis, characterized by frequent attacks of nausea and vomiting, eructations with taste of the food last taken, great thirst, especially during the night, white coat upon the tongue, loss of appetite, flatu- lency, and griping pains in the bowels. It rarely fails to relieve this group of symptoms. It is also homoeopathic to obstinate nausea and vomiting occurring after the sudden disappearance of some cu- taneous eruption. (10.) Stomach.—Stomach feels as if overloaded. (36.) Cramp-like pains in the stomach. Pain at the stomach as from excessive fullness, with appetite. Cramp of the stomach. Painfulness of the stomach on pressure. Tension and pressure at the pit of the stomach. (1.) Abdomen.—Cutting colic, with loss of appetite. Flatulent dis- charge from the bowels. Cutting in the bowels and diarrhoea. (36.) Distention of the abdomen after eating. Cutting in the bowels, with nausea and accumulation of water in the mouth. Pinching pains in different parts of the abdomen, with sense of tension in the hypo- chondrium. Clinical Remarks.—An excellent remedy in dyspeptic conditions characterized by distention of the abdomen after eating, occasional cutting or pinching pains, diarrhoea, nausea, water-brash, sense of tension over the abdomen and stomach, loss of appetite, and frequent flatulent discharges from the bowels. (10.) Stool.—Alternate diarrhoea and constipation. Hard, difficult stool. Constant secretion of a yellowish-white mucus at the anus. Cutting pains in the bowels and diarrhoea. (36.) Hard, difficult stool, with or without tenesmus. Disposition to diarrhoea which does not take plaoe. Liquid stool. Discharge of mucus from the rectum, with emission of flatulence. Much flatulence soon after eating. (1.) Urinary Organs.—Frequent and profuse emission of urine. Chronic catarrh of the bladder. (36.) Brown urine. Dark-red urine. Fre- quent micturition, with discharge of much mucus, and burning of the urethra, with pain in the small of the back. Cutting during mic- turition. (1.) Clinical. Remarks.— In the days of Paracelsus,, it was used as a remedy in gonorrhoea, and dropsical affections. From its patho- genesis, it is evident that it bears very slightly upon the urethra, bladder, and kidneys, but the symptoms are not sufficiently positive to render it an important drug. in these maladies. Whatever good Stibium. 389 results might have been produced in these cases by the ancients, were probably due to its general antiphlogistic properties, rather than to any direct specific local operation. (10.) Sexual Organs.—Irritation at the extremity of the urethra. Noc- turnal emissions, with dreams, also without dreams. Pressure in the womb as if something would come out. Discharge of an acrid fluid from the vagina. (1.) LaryilX and Trachea.—Chronic angina, with sensation as if a foreign body had lodged in the throat, which gives rise to a constant desire to swallow. (36.) Roughness and dryness in the throat, early in the morning. Extreme feebleness of voice. Loss of voice when- ever he became hot, returning by rest. Constant hawking of yel- lowish mucus from the posterior nares. Frequent dry cough. Severe, dry cough with a sense of scraping in the larynx. Cough with discharge of viscid, thin phlegm. (1.) Clinical Remarks.—It is appropriate in dry, morning-coughs, with scanty and difficult expectoration, hoarseness, and scraping in the larynx, and bronchi. It is also homoeopathic to bronchial catarrh, with great feebleness of voice, and severe morning-paroxysms of cough. (10.) Chest.—Cough and oppression on the chest. (36.) Violent and continual itching of the chest, the whole day. Burning in the chest when coughing. Suffocative catarrh. Oppression of the chest early on waking. Deep, sighing breathing, as from fullness of the chest, for several days, in the afternoon and after dinner. (1.) Back.—Rheumatic pains in the back of the neck and loins. (36.) Pain in the small of the back, during the day. Violent itching of the back for a fortnight. Violent pain in the small of the back when rising from a chair, or from bed. Red vesicles over the shoulders. (1.) Clinical Remarks.—For rheumatic pains of the back, shoulders, and extremities, this medicine deserves some consideration. Its homceopathicity in these cases, is not strongly marked; but as several eminent physicians of our own school have used it with be- nefit, and Hoffmann, Kunckel, and Hermann of the other school deem it an important remedy in both rheumatic and gouty pains, it is worthy of trial. It is quite probable that Antimonium-crudum, like Antimonium-tartaricum, relieves these pains by its .general anti- inflammatory action, rather than by any direct specific operation upon the affected parts. (10.) Upper Extremities.—Painful inflammation of the tendons of the arm and hand, and of the elbow, with intense redness, and contraction of the arm. Arthritic pains in the fingers. (36.) Drawing pains in the fingers and their joints. Painful lameness of the muscles of the upper arms, when bending them, as if they were too much contracted, or weakened by this contraction. Quivering drawing in the muscles 390 Antimonium-Crudum. of the upper arms, passing off by warmth, and returning in a draft of air. (1.) Lower Extremities.—Numbness of the legs during rest and while sitting. Pulling pains in the lower limbs. Callosities on the soles of the feet. (36.) Drawing pains in the hip-joints, when walking, especially when moving the thighs from before backwards. White, hard itching tubercles on the legs, of the size of a small pea, and sur- rounded by a small red circle. Stiffness of the knees. Painful stiff- ness of the knees. Drawing pains in the legs as far as the knees. (1.) Clinical Remarks.—When gouty or rheumatic pains of the extre- mities are accompanied with much stiffness, nausea, and white coat- ed tongue, Hering advises this medicine. Noack and Trinks com- mend it in acute gout of the limbs, with prominent gastric derange- ment. Our own experience with it in these complaints is quite unsatisfactory. (10.) Sleep.—Great sleepiness during the day, and early in the morning after waking,—with great indisposition to leave the bed. In the evening she feels overwhelmed with sleep. He falls asleep late. Uneasy sleep at night on account of itching stitches here and there, going off by rubbing. Frequently roused from sleep by an intoler- able itching of the chest, where he felt pimples. He wakes in the night, with a general sense of warmth, burning itching, and sensa- tion of excoriation of the anus. Sleep disturbed by disagreeable dreams. (1.) Clinical Remarks.—It is particularly indicated in great drowsiness on waking in the morning, and during the day, accompanied by gastric and bilious derangements. In restless and disturbed sleep arising from chronic gastritis, it sometimes affords relief. It is also appropriate in drowsy, stupid conditions occurring during the course of acute eruptive maladies, especially when nausea, vomiting, eructa- tions, and other gastric symptoms have been present. (10.) General Symptoms.—Gastric derangements. Rheumatic and arthri- tic inflammation of the neck, back, and extremities. Emaciation and exhaustion. Catarrhal and bronchial difficulties. Characteristic Peculiarities.—Symptoms aggravated by wine, bread and pastry. He feels better when at rest, and in cool air. Symp- toms apt to reappear after the third week. Tartar-Emetic. 391 ANTIMONIUM-TARTARICUM. TARTAR-EMETIC. Tartrate of Antimony and Potassa. Tartarized Antimony. AUTHORITIES. Wood and Bache (7.) Christison (9.) London Lancet (52.) Jahr (32.) British Journal of Horn. (12.) Waring's Therapeutics (44.) American Journal of Med. Sci. (17.) Marcy (10.) Peters (11.) Fullgraff (26.) Snelling (46.) Frank's Mag. (4.) GENERAL REMARKS. Tartrate of Antimony and Potassa was discovered in 1631, by Adrian de Mynsicht. It consists of two equivalents of Tartaric-acid, 132, one of potassa. 47.2, one of teroxide of Antimony, 153, and three of water 27=359.2. It is evident that it contains Tartaric- acid and potassa in the precise proportion to form bitartrate of po- tassa, or cream of tartar, and consequently it may be viewed as a compound of one eq. of cream of tartar, and one of antimonial ter- oxide. The excess of acid in the bitartrate may be considered as united with the teroxide ; and on this view it is a double salt, com- posed of the tartrate of potassa, united with the tartrate of teroxide of Antimony. It is in the form of transparent colorless crystals, which possess a nauseous metallic styptic taste, and have usually the form of rhombic-octohedrons, unless prepared from the oxychloride, when it crystallizes in tetrahedrons. (7.) It is a combination of the oxychloride of Antimony and cream of Tartar. The physiological facts which we at the present time possess, re- garding the effects of Antimony, are very limited. Pereira sums them up in his peculiarly comprehensive and masterly style. Herbivorous animals, it would seem, bear larger doses than those which are car- nivorous or omnivorous. Magendie found that Tartar-emetic pro- duced the same effects when thrown into the veins, as it did when given by the stomach. He considered that its chief action was con- fined to the intestinal canal and lungs. Traces of pneumonia, gas- tritis and enteritis were found after death. Rayer, Bonnet and Campbell found no such lesions of the lungs. (9.) TOXICOLOGICAL EFFECTS. There is little peculiarity in what is hitherto known of the symp- toms of poisoning with Tartar-emetic in man. Cases in which it has been taken to the requisite extent are rarely met with: and it has seldom remained long enough in the stomach to act deleteriously. 392 Antimonium- Tartaricum. But its action on animals would appear from the experiments of Magendie to be somewhat peculiar. He found that dogs, like man, may take a large dose with impunity, for instance half an ounce, if they are allowed to vomit; but that if the gullet is tied, from four to eight grains will kill them in a few hours. His subsequent experiments go to prove that death is owing to the poison exciting inflammation in the lungs. Case 1.—Six or eight grains dissolved in water were injected into a vein; the animal was attacked with vomiting and purging and died within an hour. Post-mortem appearances, redness of the whole vil- lous coat of the stomach and intestines, and also the lungs were of an orange-red, or violet color throughout, destitute of crepitation, gorged with blood, dense like the spleen, and here and there even hepatized. A larger quantity caused death more rapidly without affecting the ali- mentary canal; a smaller quantity caused intense inflammation there and death in twenty-four hours, but the lungs were always more or less affected. It is a fact too, worthy of notice that in whatever way this poison enters the body its effects are nearly the same. This is shown not only by the researches of Magendie just mentioned, but likewise by the experiments of Schloepfer, who found that a scruple dissolved in twelve parts of water, and injected into the windpipe, caused violent vomiting, difficult breathing, and death in three days ; and in the dead body both the lungs and stomach were much inflamed, parti- cularly the former. It further appears from an experiment related by Dr. Campbell, that, when applied to a wound, it acts with almost equal energy, as when injected into a vein. Five grains killed a cat in this way in three hours, causing inflam- mation of the wound, and vivid redness of the stomach. He did not find the lungs inflamed. Magendie infers from his own researches, that Tartar-emetic oc- casions death when swallowed, not by inflaming the stomach but through means of a general inflammatory slate of the whole system subsequent to its absorption,—of which disorder the affection of the stomach and even that of the lungs are merely parts or symptoms. The later experiments of Rayer tend in some measure to confirm these views, by showing that death may occur without inflammation of any kind being excited anywhere. (See physiological effects.) Orfila has proved by analysis the important fact that Tartar-emetic is absorbed in the course of its action, and may be detected in the animal tissues and secretions. He found that when it is applied to the cellular tissue of small dogs, two grains disappear before death ; that Antimony may be detected by his process throughout the soft textures generally, but especially in the liver and kidneys ; but that it is quickly discharged from these quarters by the urine. Hence in an animal that died in four hours, he found it abundantly in the liver and still more in the urine ; in one that survived seven- Tartar-Emetic. 393 teen hours, the liver presented mere traces of the poison, but the urine contained it in abundance, and in one that livid thirty-six hours, there was a large quantity in the urine but none at all in the liver. He also found that Antimony is to be found in the urine of persons who are taking Tartar-emetic continuously in large doses for pneu- monia. Where Tartar-emetic is swallowed by man, it generally causes vomiting very soon and is all discharged ; and then no other effect follows. But if it remains long in the stomach before it excites vomiting or if the dose be large, more permanent symptoms are some- times induced. The vomiting recurs frequently and is attended with burning pain at the pit of the stomach, and followed by purging and colic pains. There is sometimes a sense of tightness in the throat, which may be so great as to prevent swallowing. The patient is likewise tormented with violent cramps. Among the cases hitherto recorded, no notice is taken of pulmonary symptoms, which might be expected to occur if Magendie's experiments are free of fallacy. (9.) tartar-emetic in large doses. The late introduction of large doses of Tartar-emetic into the practice of the old school, having excited some doubt as to its poisonous qualities, it becomes a matter of some moment to possess positive facts upon the subject. The following cases may therefore be noted, which will satisfy every one that this substance is sometimes an active irritant. Case 2.—This case occurred in consequence of an apothecary having sold Tartar-emetic by mistake for Cream of Tartar. The quantity taken was about a scruple. A few moments afterwards the patient complained of pain in the stomach, then of a tendency to faint—and at length was seized with violent bilious vomiting. Soon after that he felt colic pains, extending through the bowels, and accompanied ere long with profuse and unceasing diarrhoea. The pulse at the time was small, and contracted, and his strength failed completely ; but the symptom which distressed him most was frequent rending cramps in the legs. He remained in this state for about six hours, and then recovered gradually under the use of Cinchona and Opium ; but for some time afterwards he was liable to weakness of digestion. Case 3.—This case, where the dose was forty grains, proved ktal, although the person vomited soon after taking it. The symp- t>ms illustrate well the narcotico-acrid action often observed in aiimals. The poison was taken voluntarily. Before the person wis seen by M. Recamier, who relates the case, he had been nearly two days ill with vomiting, purging and convulsions. On the thfd day he had great pain and tension in the region of the stomach, am appeared like a man in a state of intoxication. In the course of theday the whole belly became swelled, and at night delirium super- 394 Antimonium- Tartaricum. vened, and next with an aggravation of the symptoms, the delirium became furious, followed by convulsions and he finally died during the night. Case 4. Severe effects have also been caused by so small a dose as six grains. A woman who swallowed this quantity, wrapped in paper, was seized in half an hour with violent vomiting, which soon became bloody. In two hours the decoction of cinchona was ad- ministered with much relief. But she had severe colic, diarrhoea, pain in the stomach, and some fever; of which symptoms she was not completely cured for five days. Case 5. Another case has been published where a dose of four grains caused pain, vomiting and purging, followed by convulsions, failure of the pulse, and loss of speech ; recovery took place very slowly. (9.) of large doses. While these examples prove that Tartar-emetic is occasionally an irritant poison in doses of a scruple or less, it must at the same time be admitted that it is uncertain in its action as a poison. This ap- pears from its late employment in large doses in inflammation of the lungs. The administration of Tartar-emetic in large doses, was a common enough practiced so early as the seventeeth century and was also occasionally resorted to by physicians between that and the present time. But it is only of late years, that by the recommenda- tions of Rasori and Laennec that it has again become a general prac- tice. According to this method Tartar-emetic is given to the extent of twelve, twenty, or even thirty grains a day in divided doses; and not only without producing any dangerous irritation of the alimentary canal, but even also not unfrequently without any physiological effect whatever. Doubts were at one time entertained of the accuracy of these state- ments of the continental physicians; but these doubts are now dis- pelled, as the same practice has been tried in Britain. Rasori ascribed the power the body possesses of enduring large doses of Tartar- emetic without injury, to a peculiar diathesis which accompanies the disease, and ceases always with it. And it is said that the same patients who, while the disorder continues, may take large doses with impunity, are affected in. the usual manner, if the doses are no' rapidly lessened, after the disease has begun to give way. The tes- timony of Laennec on the subject is impartial and decisive. He ol- serves he has given as much as two grains and a half every tvo hours until twenty grains had been taken daily, and once gave foty grains in twenty-four hours by mistake; that he never saw any ham result; and that vomiting or diarrhoea were seldom produced, tnd never after the first day. The power of endurance he found todi- minish, but not as Rasori alleges, to cease altogether, when the ftrer ceases, for some of his patients took six, twelve, or eighteen gains Tartar-Emetic. 395 daily when in full convalescence. Christison's observations correspond with Laennec's, except as to the effects of large doses during con- valescence, of which effects he has no experience. He has seen from six to twenty grains, given daily in several doses of one or two grains, check bad cases of pneumonia or bronchitis, without causing vomiting or purging after the first day, and also without increasing the perspiration. At the same time he states that he has twice seen the first two or three doses excite so violent a purging and pain in the stomach and bowels, that he was deterred from persevering with the remedy. But in continued fever he has repeatedly found that the doses mentioned above did not cause any symptoms of irritation in the stomach or intestines. The large quantities mentioned have even been given in a single dose, without greater physiological effects. Christie has given a scruple in one dose, in cholera, with the effect merely of exciting some vomiting and several watery stools. But he states that in one case symptoms were induced like those of a case of violent cholera. (9.) (See " Stool.") The leading features, indeed, in every case of poisoning with pre- parations of antimony are vomiting, purging, spasms; symptoms in a word, analogous to those of cholera. (52.) The same large doses have been given by some in delirium tremens, without any poisonous effect being produced. A correspon- dent of the Lancet has even mentioned that on one occasion after gradually increasing the dose, he at last wound up the treatment, successfully as regarded the disease, and without any injury to the patient, by giving four doses of twenty grains each, in the course of twenty minutes. (9.) Prof. Forget of Strasburg, gave Tartar-emetic to a robust man laboring under acute articular rheumatism, first in eight grain doses, then in doses of 10. 15. 20. 30. 40. 60. and lastly 72 grains, without any disorder of the intestinal canal or general disturbance. In three days he took ten drachms ! He was relieved for a time, but a relapse occurred, and he was finally cured by Colchicum. (44.) These facts are peculiarly perplexing when viewed in connection with its great activity as a poison in comparatively minute doses, in some well authenticated cases. Christison after a recapitulation of the facts, draws the conclusion that the substance is not so active a poison as was till lately supposed, though uncertain in its action ; but it is probable that in connection with this there is an idiosyncratic tolerance of the mineral in many constitutions, and more especially in certain diseases, upon which this apparent immunity greatly de- pends. Christison thinks that in general we may anticipate violent effects from a large dose. (46.) The following case of poisoning resulted from a smaller dose than any yet mentioned and displays convincingly the very energetic action of the remedy in some cases. Case 6. The patient was a delicate, strumous man, suffering from 396 Antimonium- Tartaricum. pneumonia, (first stage,) with pleuritis on right side : Stethoscopic indications well marked ; intense pain in the chest, great difficulty in inspiration, and general symptoms of inflammatory fever. Bleeding affording no relief, a pill was prescribed of calomel and opium, "and a mixture containing a free dose of Tartar-emetic, viz., one-third of a grain, to be taken every four hours." About half an hour after the ■first dose the patient became restless, cold and faint, then purged and pomited, the symptoms continuing violently without cessation. For the time the pain in the chest was gone and the breathing free, but vomiting, purging and prostration extreme ; pulse small, surface cold, legs cramped. In fact it was a case strictly analogous with Asiatic- cholera, but the cause, plainly enough, was an over-dose of Tartar- emetic. Opiates and brandy effected a speedy cure. As the mixture contained in all three grains of Tartar-emetic, and its solution was not complete, in consequence of a want of care in its preparation, the patient may have got a larger dose, but probably not over 1^ to 1! grains. (52.) Case 7. Was produced by yet a smaller dose, and occurred in the case of a stout active well built man, who applied for relief for a cold, remarking at the same time that caution was requisite, if an antimonial should be prescribed, as he was peculiarly sensitive to the action of that substance. A diaphoretic being deemed necessary, fifteen minims of wine of antimony were ordered to be taken at bed-time. There was no mistake in the dose, as the prescriber saw it dispensed and knew the wine to be of the proper strength. The dose was taken, and the symptoms that followed were very severe, and such as no medical practitioner would be prepared for under such circumstances. The nausea was incessant for many hours, and the prostration so great as to render the patient unable to leave his room for three or four days. There was no purging, but abdominal pain, griping, faint- ness and general exhaustion. (52.) The fact has also been developed during the recent poisoning in- vestigations in England, that in Bolton, England, the druggists are in the habit of vending powder of tartarized Antimony under the name of " quietness" or "quietners," containing four grains of Tartar- emetic, to women with drunken husbands, with simply the verbal directions to divide the powder into four equal parts, each one of which is considered a dose. This has given rise to a trial on sus- picion of poisoning, on which, although the woman was acquitted, it was fully proved that the Antimony was administered, and that the effects followed the dose. The case was as follows: Case 8. The deceased was an operative cotton spinner, and subject to periodical outbreaks of drinking every two or three months ; other- wise temperate. While in his usual health and not under the influence of liquor, he was seized with pain about the region of the stomach, followed next day by a burning sensation, which was treated by his physician as dyspepsia. He had suffered from similar symptoms on previous occasions. He gradually became worse, complaining of Tartar-Emetic. 397 sickness, constant inclination to vomit, and in addition burning heat and great prostration of strength. Suspicions of poisoning being awakened he was guarded against a repetition of the dose, but it was too late. The symptoms increased in severity, and he ultimately died from pure exhaustion. Pathology.—Body emaciated ; extensive adhesions of the pleura : the lungs were natural in weight and size : but the left of the lower lobe was congested; the stomach was inflamed, particularly next the heart: the duodenum was inflamed, as were all the small intestines: the upper part of the rectum contained hardened faeces: the right kidney was congested; the bladder was inflamed; the rest of the body was in a healthy condition : the liver was healthy, but congested. There was no purging or cramps in this case, which gave rise to some doubts as to the death being caused by antimony, but otherwise the symptoms all indicated it. As in the casetof mercurial leaden and cupreous impregnation of the system, there is likewise an antimonial sign which is perfectly pathognomic. It is indicated in all these substances by the state of the gums and teeth, but that of copper and antimony have not been so fully described. In copper impregnation it is not so much the free margin of the gum, as the parts of the gum next the teeth, which are coated with gum sordes; whilst in antimonial impregnation it is not the teeth, but the whole surface of the gums, both within and with- out, that assumes the appearance of the brightest pink velvet, with a raised pile. (52.) Case9. This appearance was particularly well marked in the case of a chemist's assistant, who was under treatment with James' powder for broncho-pneumonia. After taking about one drachm of James' powder in five grain doses in three days, the above appearance of the gums was noticed, accompanied by severe prostration. The patient had been getting two grains of camphor with every five of James'pow- ders. The antimony was discontinued, and a good recovery obtained under the use of the polygala senega root. (52.) Case 10. Precisely the same appearance was observed in the case of a tin-plate-worker, whose principal complaint was of extreme prostration. The strength returned in both these last cases as the gums became healthy. (52.) Case 11. Dr. Richardson instituted another experiment on a dog by the inhalation of Antimonuretted Hydrogen Gas which proved fatal in three hours and forty-five minutes. There was both purging and vomiting. The breathing generally outlasts the heart's action ; the respiratory system being the ultimum moriens. Pathology.—As before great congestion of all the viscera, and of the blood vessels. Blood as before loosely coagulated. Lungs in- flated and full of blood. Bronchial surface pale and coated with a frothy mucus. Both sides of the heart full of blood. Brain, liver and kidneys congested. On larger curvature of stomach as before, was the same sort of redness marked out much in a similar manner. 398 Antimonium- Tartaricum. Case 12. Dr. Janonich dissolved twelve grains in four ounces of fluid, as an experiment, and took tablespoonful doses every four hours ; after the first dose he experienced vertigo and nausea; after the second, shivering over the whole body, cold sweat, nausea, and retching to vomiting; after the third, great praecordial anxiety and oppression, two attacks of vomiting of much mucus and bile, rum- bling in the bowels without pain or diarrhoea; profuse and constant perspiration, abundant flow of saliva and thirst; at the fourth dose, frequent nausea, vomiting and one stool; after the fifth, such a state of apathy that he was indifferent to life or death, and his pulse be- came quite slow, there was no burning or pain in the stomach or bowels, but he felt such a repugnance to the remedy that he could not take any more ; much rumbling in the bowels was followed by another stool, and the nausea, perspiration, lassitude and apathy continued for many hours ; the next day, he was comparatively well. (4.) Case 13. Twenty to twenty-five grains of Tartar-emetic were taken by mistake; in a few minutes there was an insufferable feeling of warmth in the epigastrium, then violent pain in the forehead like clavus hystericus and some dizziness ; in half an hour moisture in the forehead and nape; vomiting for twenty or thirty minutes; the headache, dizziness and redness of face increased; Castor-oil caused a return of vomiting, eructations, and ejection of bilious matters; the burning feeling in the stomach and small bowels increased to such a degree that he became very restless ; the pulse weak and 80, tongue white, throat dry, taste unpleasant; inclination to sleep. A gentle purgative relieved the nausea, and he slept for an hour; some vertigo and a slight feeling of warmth in the stomach remained. On the next day his mouth was very sensitive, the gums bled, with a slight spongy appearance like scurvy, lasting two days. (4.) on the mucous tissue. There is some reason to suppose that the vapors of antimony may prove injurious when inhaled. Case 14. Four persons, constantly exposed in preparing antimonial compounds, to the fumes of antimonious acid and chloride of antimony, were attacked with headache, difficult breathing, stitches in the sides and back, difficult expectoration of viscid mucus, want of sleep and appetite, mucous discharges from the urethra, loss of sexual pro- pensity, atrophy of the testicles, and a pustular eruption on various parts, especially the scrotum. (9.) Froriep relates that it has produced pustules in the mouth, throat and fauces, identical with the small-pox pustule, even to the depression in the centre, and regards it as a distinct indication of its homceopathicity to small-pox and varioloid. Whether taken in large doses, or in very minute doses long con- tinued, it produces inflammation of the buccal cavity, of the veil of Tartar-Emetic. 399 the palate, and of the pharynx. The mucous membrane of these parts is not only found red and swollen, but dotted here and there with ex- coriations, and vesicles. From the symptomatic indications derived from its operation upon the pulmonary apparatus, it is evident that it also produces a similar condition of the mucous membrane of these parts. It produces redness and inflammation of the stomach, but according to Majendie this should be referred to the specific influence which it exerts over the stomach, independent of its direct local irri- tation. This specific influence will manifest itself promptly, if the Stibium in solution be injected into the veins. Inflammation of the intestinal mucous membrane is another effect of large doses of this substance. (10.) THROAT. Case 15. A delicate man, with severe bronchitis, took ten grains of Tartar-emetic dissolved in seven ounces of water in the course of one day; his chest-symptoms were considerably ameliorated thereby, but a very intense angina set in at once. The whole mouth, together with lips, became as much swollen as in excessive mercurial salivation; the tongue became bright red and dry in the middle ; the soft palate and pharynx were equally intensely reddened and covered with vesicles or pustules, some of which burst open, and the whole of these parts were so swollen and glued with tough mucus that the suffering patient could not swallow even the smallest portion of drink, and his breathing was also much impeded; this state was attended with great fever and some nocturnal delirium; no vomiting or purging were pro- duced. Frequent gargling with a warm decoction of oat-meal effect- ed some relief. (4.) dermoid tissue or the skin. The effects of Tartar-emetic on the skin are worthy of notice ; but they have not yet been carefully studied. Some facts tend to show that even its constitutional action may be developed through the sound skin. Mr. Sherwen attempted to prove by experiments on himself and two pupils, that five or seven grains in solution will, when rubbed on the palms, produce in a few hours nausea and copious perspiration. His observations have been confirmed by Mr. Hutchin- son. But Savary, on repeating these experiments, could remark nothing more than a faint flat taste and slight salivation. Sometimes it has appeared to cause severe symptoms of irritant poisoning when applied externally to excite a pustular eruption, and even death. Case 16. In the case of an infant two years old, soon after its spine had been rubbed with an antimonial ointment, it was seized with great sickness, and frequent fainting, which in forty-eight hours, proved fatal. (52.) This, however, is probably an exceptional case, as the constant use of a similar application, is unattended with any ill consequences. (46.) 400 Antimonium- Tartaricum. Clinical Remarks.—Although its constitutional action is not often developed through the sound skin, its Ideal effects are unequivocal and severe. When applied to the skin it does not corrode, but excites inflammation, on which account it is much used in place of can- tharides. It does not blister, but after being a few days applied, it brings out a number of painful pustules; if it be persevered in, the skin ulcerates ; and if it be applied to an ulcerated surface, it causes profuse suppuration or even sloughing. (9.) Case 17. Some years since a girl was admitted to one of the provincial hospitals with an anomalous pain of the shoulder blad#. Tartar-emetic ointment was used once or twice rather freely: the consequence was, a large crop of pustules, which healed and broke out again and again, without any further application of the ointment. This continued uninterruptedly for three or four months, until the sur- geon looked upon the remedy as worse than the disease; and the case was lost sight of as incurable. This would seem to prove its local absorption and elemination for an indefinite length of time. (52.) Its peculiar property of exciting a pustular eruption may also sometimes be displayed after its internal administration. Case 18. An Essex farmer had been taking the Tartar-emetic for six days in half-grain doses, every three hours, while suffering under acute pneumonia. The characteristic eruption made its appearance over the whole body, the patient was so well covered with pustules, that the friends of the patient mistook the eruption for small pox; a natural error. (52.) Case 19. Dr. Bockh, of Greifenhagen, ordered a fisherman to take two grains of Tartar-emetic in solution in the course of thirty-six hours, for the cure of pneumonia. Scarcely twenty-four hours after the last dose there appeared an eruption exactly resembling that caused by the external application of the salt. It consisted of small papulae or vesicles, which rapidly enlarged and became full of pus, and of a deep red color at the base, resembling mature variolous pus- tules. In the course of a few days they became dry and crusted at the top. The eruption appeared first on the inner surface of the fore- arm, then over the whole back, where the pustules were partly solitary, partly grouped. Neither vomiting nor sweat attended the formation of the pustules, but they were preceded by some watery stools. The cure of the pneumonia advanced most satisfactorily. (12.) Clinical Remarks.—When the medicine has purged Dr. Richardson thinks he has usually observed that the skin was dry, and thinks that the absence of diaphoresis was probably the cause of the catharsis. (52.) Case 20. A man with pneumonia took ten grains of Tartar-emetic in solution in thirty-four hours ; about twenty-four hours after the last dose an eruption appeared which resembled in the closest particulars Tartar- Emetic. 401 that produced by Tartar-emetic ointment; it consisted of pimples and vesicles which increased rapidly in size and filled with pus in two days; they were surrounded with a red base and resembled closely mature pustules of small-pox or smaller pustules of cow-pox. They were exceedingly painful, but most of them dried up in a few days and formed crusts; a few became longer than the others and then resembled the pustules of Ecthyma. The eruption commenced on the inner surface of the right forearm, then spread over the whole back, where the pustules were both isolated, grouped, and confluent. Neither vomiting, purging, or perspiration was caused by the drug. The pneumonia was rapidly cured, together with a fever and ague, and consequent dropsy, with which the patient was also troubled. (4.11.) Cask 21.—A girl, aged fourteen, took twenty grains of Tart.-emet. in the course of two weeks when a pustular eruption appeared exact- ly similar to that caused by the ointment when applied to the skin. (4-11.) Clinical Remarks.—The homceopathicity of this medicine in variola is strongly marked ; and it is now recognized by the physicians of our school as one of the most important remedies. A man, twenty-eight years of age, of bilious temperament, vacci- nated in his youth, was taken with the ordinary premonitory symp- toms of variola, such as chilliness, fever accompanied with thirsty feeling of soreness in the throat, headache and cough, for which he received Aconite and Belladonna in alternation for about twenty-four hours, after which, the fever abated. As there were cases of variola in the neighborhood, I suspected at once this case to be one, before the characteristic eruptions had made their appearance, and he was di- rected to take Stibium -r-5-Papaveraceae, growing in the Southern and Western States, Mexico, the West Indies, Brazil, and in many parts also of Africa and Southern Asia. It has an erect, somewhat glaucous, bristly stem, with alternate sessile leaves, sinu- ated and prickly at the angles, and usually marked with white spots. The flowers are solitary, yellow or white, with two or three prickly deciduous sepals, four or six large petals, about twenty stamens, and four or six reflexed stigmas. The whole plant abounds in a milky, viscid juice, which becomes yellow on exposure to the air. From the statements of different authors, it may be inferred that the plant is emetic and purgative, and possesses also narcotic properties. The juice, which is acrid, has been used internally in obstinate cutaneous eruptions, and as a local application to warts and chancres, and in diseases of the eye. The flowers are stated by De Candolle to have been employed as a soporific. The seeds, however, are most esteemed. They are small, round, black, and roughish. In doses of two drachms, infused in a pint of water, they are said to act as an emetic. In smaller doses they are purgative. An oil may be obtained from them by expression, which has the cathartic properties of the seeds. (7. 54.) ARGENTUM-CHLORATUM. CHLORIDE OF SILVER. AUTHORITIES. Wood and Bache. (7.) punglison's New Rem. (16.) Snelling. (46.) GENERAL REMARKS. Chloride of silver is prepared by the decomposition of a solution of nitrate of silver by an excess of a solution of chloride of sodium. It appears as a precipitate. Prepared in this way it is of a white color, devoid of taste, and not soluble in water, but soluble in am- monia. In the light it speedily changes, especially when much divided, or when moist; and sometimes assumes a dark violet hue, as the chlorine is given off. It suffers no decomposition when 494 Argentum- Chloratum. united with vegetable matters. It must be dried and kept protected from the light. (16. 46.) It is considered as almost certain, that in administering the ni- trate of silver, in consequence of the presence of chloride of so- dium, the phosphates, &c, in the food and in the secretions, it resolves itself into the chloride, phosphate or albuminate of silver; com- pounds far less energetic than the original salt. The experiments of Keller, who analyzed the faeces under the use of this drug, confirm this view. Such being the inevitable result when the ni- trate is given, the question arises how far it would be expedient to anticipate the change, and give the silver as a chloride ready formed. (16.46.) It is readily prepared by adding a solution of common salt to one of nitrate of silver as long as it produces a precipitate. As first thrown down it is a white curdy substance, but it soon becomes discolored when exposed to the light. It has been used, rubbed on the tongue in syphilis, and internally in epilepsy, chronic dysentery and diar- rhoea, and other diseases in which the nitrate of silver has been given. Dr. Perry administered it at the Philadelphia Hospital, Blockley, in chronic dysentery with the immediate effect of dimi- nishing the number of stools. The crystallized Ammonio-chloride of silver has been given in syphilitic affections in doses of the fourteenth of a grain. (16. 46.) In syphilis. M. Serre describes several cases of syphilis in which the preparations of silver were administered. The first patient was a soldier, thirty-six years of age, of athletic constitution, who at the time of his admission had several extensive chancres on the prepuce, so close to each other, as almost to form one large continuous sore, four or five lines in diameter. After a few days' rest, and the use of baths, M. Serre ordered the chloride of silver in frictions on the tongue in the quantity of one-twelfth of a grain. The ulcers were treated with simple cerate. After the second rubbing the patient experienced violent colicky pains, which were not severe enough, however, to in- duce a discontinuance of the remedy. Scarcely had a grain of the chloride been employed, when the secretion from the ulcerated parts became less; the surface of the chancres lost the kind of greyish border which they possessed, and cicatrization proceeded rapidly. The frictions were continued, and the condition of the patient went on improving. At the end of two months, he left the hospital. In the five subsequent cases the same plan of treatment was pursued. The chloride was used exclusively, according to the iatraleiptic me- thod. The symptoms were various ; irf addition to chancres, there was in one case a suppurating bubo; in another syphilitic vegeta- tions at the margin of the anus ; and in a third fissures in the same part. In the seventh case in which there were chancres, gonor- rhoea, and extensive rugous blotches on the nates, the chloride of silver was rubbed on the tongue, and applied topically in the form of ointment. The eighth patient who suffered with large condylomata, Cyanuret of Silver. 495 as well as with ulcers in the neck, took the chloride in pills to the extent of nine grains in the course of treatment; frictions with the ointment of silver were also applied to the affected parts. (16.) In nervous affections. Dr. Perry as was stated above has admin- istered it with great advantage in epilepsy, chronic dysentery, chro- nic diarrhoea, and other affections in which nitrate of silver is pre- scribed internally. Twelve grains given daily for three months pro- duced no unpleasant symptoms; and in no case did discoloration of the skin succeed. In epilepsy three grains, given four or five times a day produced effects similar to those of nitrate of silver, but more marked. In chronic dysentery, half a grain to three grains, taken three times a day, produced immediate diminution in the number of the evacua- tions, and relieved the tormina ; inducing at the same time an im- provement in the character of the stools and other symptoms. Si- milar testimony is afforded by Kopp, and Dr. Dunglison states that , he has very frequently prescribed the chloride, and on the whole it has appeared to him to be equal to the nitrate in the class of cases mentioned by Perry. (16. 46.) ARGENTUM-CYANURETUM. CYANURET OF SILVER. AUTHORITIES. Wood and Bache. (7.) Dunglison. (16.) Snelling. (46.) GENERAL REMARKS. This is a preparation of nitrate of silver, ferro-cyanuret of potas- sium, sulphuric-acid and distilled water. It is of a white color, de- void of taste, not soluble in water, but soluble in ammonia. Like chloride of silver when exposed to the air, its surface becomes of a dark-violet hue. It is dry and .should be kept preserved from the light. It experiences no decomposition when mixed with vegetable matters. (16. 46.) From experiments made by Dr. Letheby, he concluded that it is a local irritant, producing great vomiting and a congested state of the vessels of the stomach—that when it has been dried before its in- troduction into the system no other ill-effects follow, but if it be ad- ministered in a moist state, it is then capable of being absorbed, and perhaps decomposed ; for an albuminous solution has the property of dissolving the cyanide, and, moreover, the contact of it with any of the chlorides of the systemic fluids would produce a double decom- position, and the formation of a soluble cyanide, whose effects would be similar to that of cyanide of potassium. (16. 46.) The dose capable of killing a dog is five grains ; its specific action appeared to Dr. Letheby to be upon the brain, producing occasional 496 Argentum-Iodatum.—Argentum-Muriaticum-Ammon. convulsions, always coma, paralysis, a peculiar sighing respiration, a fluttering, irregular and tumultuous action of the heart, and it ultimate- ly kills by a- gradual exhaustion of the involuntary acts, death tak- ing place in from one to three hours after its administration. (16. 46.) ARGENTUM-IODATUM. IODIDE OF SILVER. AUTHORITIES. Dunglison. (16.) Snellino-. (46.) GENERAL REMARKS. Iodide of silver is obtained by mixing a solution of nitrate of silver with one of iodide of potassium. The yellowish flakes, produced by the admixture of the two fluids, are then washed several times with distilled water, and dried in an oven. Iodide of silver is of a pale-yellow color, but becomes under the ac- tion of light and air of a deeper yellow. It has no taste, and is neither soluble in water nor ammonia. The latter property serves to dis- tinguish it from the chloride or any cyanuret of the same metal. Like the chloride, the iodide should be kept in a dry dark place. (16. 46.) We have already indicated its therapeutic powers under the head of Argentum. It was one of the remedies successfully used by Serre, in his experiments on cases of syphilis, and is detailed at length under the head named. (46.) It is supposed to possess the general properties of nitrate of silver, but may be used without the danger there is in administering that drug of discoloring the skin. Dr. Patterson found it generally suc- cessful in curing the affections of the stomach of the Irish pea- santry, in the treatment of which nitrate of silver had previously been s found successful. He also succeeded in curing several cases of hooping-cough with it, and in a very short time—and a case of dys- menorrhoea of very long standing was also much relieved. Its effects in epilepsy were less satisfactory. (16.46.) ARGENTUM-MURIATICUM-AMMONIATUM. {Argenti et Ammonice-Chloridum.) CHLORIDE OF SILVER AND AMMONIA. AUTHORITIES. Dunglison's New Rem. (16.) Snelling. (46.) GENERAL REMARKS. This preparation is obtained by saturating by the aid of heat, li- quid ammonia, with freshly precipitated, and carefully-washed chloride Metallic-Silver. 497 of silver. The Chloride of silver and Ammonia has a bluish-white color, the peculiar smell of Ammonia and a burning almost caustic taste. In the air it gradually exhales Ammonia, and acquires all the properties of simple Chloride of silver without, however, losing its form of original composition, if the crystals be kept in the Ammonia in which they were formed, they do not undergo the slightest change in their color from the effect of light. (16. 46.) This remedy is one of those employed with advantage by Serre in syphilis. Another preparation, the Liquor-argenti-muriatlci-ammo- niati, has long been recommended by Kopp, in cases of chronic ner- vous affections. He found it of great efficacy in St. Vitus-dance. (46.) ARGENTUM-METALLICUM. METALLIC-SILVER. AUTHORITIES. Dierbach's Mat. Med. (6.) Vogt's Mat. Med. (20.) Jahr and Possart. (32.) Teste, Mat. Med. (36.) Pereira's Mat. Med. (3.) Laurie. (69.) Hahnemann. (1.) Fullgraff. (26.) Peters. (11.) • GENERAL REMARKS. According to Dierbach, in olden times, the heavenly bodies, viz., the sun, moon and stars were supposed to exert peculiar influences over certain parts of the body; thus the sun was supposed to affect the heart, and the moon the brain. A connection between the me- tals and the planets was also universally believed in, and even the same names were given them, thus gold, corresponding to the sun,was called solx and used in diseases of the heart, while silver, corres- ponding to the moon, was called luna, and used in diseases of the brain, and especially in epilepsy, which was regarded as so complete- ly under the influence of the moon that it was formerly called morbus lunaticus. Basil Valentine even went so far as to think that cold dropsies were produced by the influence of the cold moon, and hence also included them in the class of lunatic diseases curable by silver, although Dierbach tells us, that silver has been repeatedly observed to have caused fatal dropsy when given against epilepsy; Vogt also says that it has caused cachexia, emaciation and dropsy, although he too tells us that it was used in olden times in dropsy, ulcerous cachexia and other obstinate diseases of the vegetative system. G. A. Richter says, in some instances, when given against epilepsy, the original dis- ease has been supplanted by a fatal dropsy, complicated with indura- tion of the liver. From the experiments of the homoeopathists, we find no proof that it is homoeopathic to dropsy, except that it has caused a painless, slightly reddened swelling of the wrist and lower- half of the fore-arm. Vogt says it was once regarded as diuretic, but 32 498 Argenium-Metallicum. that latterly we hear little or nothing of this effect; but in the expe- riments upon the healthy the metallic silver causes frequent urging to urinate and more profuse flow of urine ; while the nitrate is said to have caused violent irritation of the urinary organs, increased secre- tion and involuntary discharge of urine. Noack regards this effect as so marked that he has recommended it in diabetes; hence it may prove homoeopathic to dropsy with increased flow of urine. (11.) LOCAL EFFECTS. According to Dr. Huber, metallic silver acts principally upon the following parts : 1. The Articulations. The action of silver upon the articulations is so uniformly the same, and so certain, that but few remedies equal it in this respect. Clinical Remarks.—Noack and Trinks recommended it in coxalgia, but especially in certain affections of the elbow and knee; in rheu- matic and arthritic affections of the joints. Huber advised it in ar- thritis-articularis, arthralgia, arthritis, coxalgia, omagra and gonagra. ^.2. The Bones, especially the long bones, and upon the cartilages, particularly the cartilaginous surfaces of the ears, eustachian tube, tarsal cartilages, cartilages of the nose, false ribs, &c. Clinical Remarks.—Noack and Trinks recommend it in mercurial cachexia, and Huber in congestive and inflammatory affections of the bones and cartilages, and of their membranes, such as the periosteum and synovial membranes; in ostalgia, ostitis, periostitis, perichon- dritis, &c. But it is very doubtful whether it is as useful as Meze- reum, Kali-hydriod., &c. (11.) 3. The Muscles, tendons and ligaments, especially those which are in the neighborhood of joints, also upon the psoas, triceps brachialis, &c. Clinical Remarks.—It seems to act specifically upon many of the fibrous tissues ; Huber recommends it in psoitis. Doubtless in acute inflammatory attacks it will have to be preceded by Aconite, Bryonia, Colchicum, Stibium, &c. (11.) 4. Upon certain Glandular Organs, such as the salivary glands and testicles. Clinical Remarks.—Huber recommends it in inflammation of the salivary glands ; also in orchitis, nocturnal emissions, diminution of the sexual instinct and other affections of the testicles. (11.) 5. Upon the Heart. Huber recommends it in spasm of the heart, . and Noack in some heart-affections. Mind and Disposition.— Increased cheerfulness and disposition to talk the whole day, (reaction), discouraged. (19.) Anxiousness. Lowness of spirits and indisposition to talk. (32. 54.) Vertigo with obscuration of sight. Clinical Remarks.—Silver may act somewhat similar to Aurum in producing marked cheerfulness and even hilarity. (11.) Metallic-Silver. 499 Sleep.—Restless night, full of dreams about disgusting objects. (21.) Clinical Remarks.—It has been recommended against sleepless- ness, especially when the sleep is disturbed by jerks and starts in the muscles. (11.) Head.—Vertigo. Pressure and tearing pain in the region of the right and left temporal bone, increased by contact. Giddiness and stupefaction of the head. Spasmodic jerking of the right temporal muscle, the occipito-frontalis muscle, also the muscles of the side of the neck, and cervical region. (32.) Clinical Remarks.—It may prove homoeopathic to some of the head- affections which attend epilepsy; at least Huber noticed complete dizzi- ness on entering a room after a walk ; while slumbering he was seized with dizziness, so that it seemed as if his head was falling out of bed ; also while dozing in the afternoon, a violent electric shock which pro- ceeded first from the left, then from the right hip, disturbing his sleep; another shock more violent, was afterwards felt in the left arm. (11.) Eyes.—Violent itching in the corner of the eyes. (19.) Nose.—-Violent bleeding at the nose, on blowing the same, return- ing again three hours later. (19.) Fluent coryza, with constant and profuse secretion of mucus ; excessive fluent coryza. Beating in the left nostril as if the muscles were raised from off the mucous mem- brane. (32.) Faec—Drawing pain in the muscles of the face. Painful, gnawing pressure in right malar bone. Tearing in the region of the left malar bone. (19.) Ears.—Cutting stitches in internal ear, extending to the brain. Cutting pain in the Eustachian tube. Feeling of obstruction in the ear. (19.) Titillation in the throat in the region of the orifice of the right Eustachian tube, extending to the internal ear ; very soon afterwards the same was experienced on the left side. (21.) Jaws and Teeth.—Toothache as if the teeth were loose. The gums are painful when touched. Loose, readily bleeding gums. (32.) Mouth, Pharynx, &C. Dryness of the tongue and buccal cavity; the tongue adhered to the palate. (21.) Vesicles on the tongue, sore and burning. (32.) Pains in the parotid gland, and swelling of the submaxillary glands with stiffness of the neck, and difficulty of swallowing as if there were internal swelling of the throat, so that he is obliged to force every mouthful down his throat. Viscid saliva in mouth ; viscid, grey-jelly-like mucus in the throat, which can be easily hawked up in the morning. Clinical Remarks.—Huber had always been very subject to slight attacks of tonsillitis, which ceased entirely while he was experiment- ing with silver. It promises to be useful in some cases of chronic pharyngitis, probably of the follicular kind. (11.) Appetite.—Aversion to every kind of food, even when merely think- ing of it, one is speedily satiated. A good deal of appetite, even 500 Argentum-Metallicum. when the stomach is full. Gnawing hunger, not removed by eating (32.) Clinical Remarks.—It, tends to increase the appetite, and may also increase the secretion of gastric juice. Gastric Symptoms.—Stomach.—Heartburn. Constant nausea and qualmishness. Gagging-up of an acrid, badly-tasting fluid, followed by scraping and burning in the fauces. Pressure in the pit of the stomach. Painfully oppressive distention of the abdomen. Cutting in the abdomen. Loud rumbling in abdomen. (32.) Clinical Remarks.—Metallic-silver is said to have caused colic by being handled. (3. 54.) It deserves attention against excessive gnawing hunger the whole day ; in heartburn, with retching of a bitter-acrid badly smelling liquid into the throat, with heat of the head, and followed by a sense of rawness, roughness and burning in the throat. (11.) Stool. Frequent urging to stool, with scanty discharge of faeces. Dry, sandy stool. Vomiting during stool. Contractive colic after the morning stool. (32.) Urine.—Frequent and copious emission of urine. (32.) Clinical Remarks.-—Noack thinks it Is useful against diabetes; it has an old reputation against dropsy. (11.) Genital Organs.—Contused pain in the testicles. Emissions. (32.) Clinical Remarks.—Teste says that it has cured a yellow-greenish go- norrhoea, of an indolent nature, which produced a very profuse discharge. Teste also states that it has cured seminal losses, without erections, and without atrophy of the penis. (89. 54.) Teste recommends it in scirrhous ulceration of the neck of the uterus, and relates the follow- ing case, which was much relieved. The patient was a washer wo- man of Boulogne, aged fifty years, tall, thin, emaciated and of a very irritable temperament, whose father had died with a cancer of the tongue. The disease was of long standing. This woman, whose face was of a straw-color, down to the lips inclusive, (—a characteristic symptom of the cancerous diathesis,) was troubled with constant dis- tension of the hypogastrium, which was exceedingly sensitive to con- tact. She felt constant lancinating pains in this region, which she compared to pricks with a pin. There was a tension in the groins, and from time to time crampy pains in the thighs. Her breath was foetid and foul, her appetite pretty good; the digestion took place without pain at the stomach, the alvine evacuations were irregular, she was often taken with a diarrhoea, or rather lienteria. The urine was pale, foetid and profuse, especially at night. The-neck of the uterus, which was very much swollen, presented only a spongy mass, so deeply corroded with ulcers, in different directions, that it was impossible to discover the os-tincae. The purulent, ichorous, and some- times bloody matter, which flowed from these ulcers, filled constantly the vagina, from which proceeded .such a horrible stench, that it would have been impossible for one to remain ten minutes in the same room Metallic-Silver. 501 with this unhappy woman, whose approaching death seemed inevitable. Argentum effected a general improvement almost instantaneously. The diarrhoea ceased and the stools became natural. The desire to urinate was diminished one-half. The shooting pains in the hypo- gastrium diminished, so that the patient was almost free from them for days. A circumstance which appears remarkable, was, that the discharge, although still purulent, lost almost entirely its foul smell— in less than three days.—Fleshy, rose-colored granulations, of a very satisfactory appearance showed themselves, at the neck of the uterus. For two or three weeks the patient continued to improve, but finally died. (89. 54.) LaryilX, Trachea, &C.—Sore throat, as if the fauces were swollen ; with difficult deglutition. Roughness and scraping in the fauces. Mer- curial angina faucicum, with raw and sore feeling, when swallow- ing or expelling the air. Boring and digging in the throat. (32.) Raw and sore pain in the larynx, also when coughing. A good deal of mucus on the chest. Cough caused by a cutting in the windpipe, with watery expectoration. Paroxysms of short rattling cough, in the day-time, with easy expectoration of a thickish, whitish substance. Sensation in the larynx, in the region of the throat-pit, as if there were a wound, worse when talking and singing. (32.) Clinical Remarks.—This agent has been used very successfully for chronic laryngitis, especially in the case of lawyers, ministers, and generally of persons who are obliged to speak a great deal and for a long time in succession. (89.) Laurie recommends it for laryn- geal coughs with the following symptoms. Cough, excited by laughing, or attended by a feeling of sqreness and rawness in the throat, and sometimes with accumulations of viscid mucus in the palate, which caused a disagreeable scratching or scraping sensation. (90.) Chest.—Pressure at the chest. Pressure and stitching in the ster- num and sides of the chest. Cutting in the sides of the chest, when drawing breath and stooping. Cramp-pain in the pectoral-muscles and near the ribs. (32.) Clinical Remarks.—Avicenna recommended silver-filings for palpi- tation of the heart. (89. 54.) It has often been recommended against chronic laryngitis, with an irritating short-hacking cough, with watery expectoration, or of a white thickish, loose mucus, looking like boil- ed starch, without taste or smell. Trunk.—Pain in the small of the back, as if lamed and bruised, or drawing, tearing in the shoulders and scapulae. (32.) Clinical Remarks.—It promises to be useful when there is coldness of the sacrum, as if the skin and muscles had been tonched with a piece of ice. Upper Extremities.—Tearing and spasmodic drawing, with pressure, also tension in the arms and hands. Pressure, with tearing in the 502 Argentum-JS"Uratum. bones and joints of the hand and fingers. Contraction of the fingers (32.) Clinical Remarks.—We have already seen that Huber supposes that it exerts a specific action upon many of the joints, bones, muscles, tendons, ligaments, &c.; it is most homoeopathic when there is a painful lameness of almost all the joints of the fingers, excessively violent electric shock in the arms, painless twitching and jerking of the muscles of the arms, painless jactitation of the muscles about the shoulder-joints ; inflammation of the tendons, with redness and contraction of the tendons of the arm. It promises to be useful in paralysis agitans. The most violent pains are felt about the left fibula and right shoulder. (11.) Lower Extremities.—Coxagra, with paralytic aching-pain in the hip-joint when walking. Muscular twitchings in the thighs. Crampy cutting and tearing in the knees and ankles. Crampy feeling in the calves, with pain as if the muscles were contracted. Pain as if bruised and beating in the tarsal-joints. Tearing in the bones and joints of the feet and toes. Numb feeling in the heel and tendo Achilles. (32.) Clinical Remarks.—Huber thinks that it acts specifically upon the muscles about the joints, and is apt to produce involuntary jacti- tation of these muscles. It deserves attention in lameness and pain as if sprained about the back, loins and hips, with pain in the glutei muscles and muscles of the hip-joint, as if bruised, with weak- ness of these parts, as if the ligaments and muscles had become re- laxed ; repeated attacks of painful lameness, as if penetrating the marrow of the bones in short, in many arthritic and neuralgic pains about the back, loins, hips, thighs and legs. (11.) Skin.—Stinging in various parts of the skin, like flea-bites. Stitches in various parts of the skin, as of electric sparks, in the day-time. (21.) Sore and burning pimples. (32. 54.) ARGENTUM-NITRATUM. NITRATE of silver. Lunar Caustic. AUTHORITIES. Pereira's Mat. Med. (3-.) Christison, on Poisons. (9.) Waring's Ther. (44.) Trousseau and Pidoux, Mat. Med. (38.) Noack and Trinks. (19.) Snelling. (46.) Jahr's Manual. (32.) London Lancet. (52.) Wood's Therapeutics aud Pharmacology. (7.) Wood and Bache. (7.) Peters' Dis. of Eyes, p. 57. (11.) Peters' Dis. of Married Females, p. 81. (11). Teste, p. 116. (36.) Condie, Dis. of Children. (80.) Barlow's Pract. Med , p. 417. (81.) Lawrence, on Eye. (82.) Wilde, on Ear. (83.) Acton, Dis. of Urinary and Nitrate of Silver. 503 Generative Organs. (84.) Grisolle, Pathologie Interne, Tome 11, p 15. (85.) Braithwaite's Retrospect, Vol. 35, p. 159. (14.) Meigs' Dis. of Uterus. (86.) Marcy, in N. Am. Jour. Horn, Vol. 5, p. 94. (10.) Jahr and Possart. (32.) Watson. (54.) ' GENERAL REMARKS. Nitrate of Silver results from the application of Nitric-acid to me- tallic silver. When pure, it forms transparent, colorless, right-rhom- bic prismatic crystals. When heated it fuses : if the temperature be increased decomposition ensues, and metallic silver is obtained. The fused nitrate forms, on cooling, a whitish striated mass, having a crys- talline texture. The salt is soluble in both water and spirit. It does not deliquesce; when exposed to the solar-light, and in the atmos- phere it blackens. Nitrate of silver in a glass-tube hermetically seal- ed undergoes no change on exposure to light. (3. 46.) TOXICOLOGICAL EFFECTS, Orfila found that it acted on animals as a powerful corrosive poison. When dogs were made to swallow it, gastro-enteritis was induced : (yet we find our allopathic brethren giving it in intestinal irritation, and ulcerations of the lower bowels). No symptoms indicating its absorption were observed. Dissolved in water and thrown into the jugular-vein it produced difficult respiration, convulsive movements and speedy death. (3. 46.) On man the local action of nitrate of silver is that of a caustic or corrosive. This might be expected from observing its action on al- bumen and fibrin, substances which form the principal part of the animal textures. If a solution of nitrate of silver be added to an al- buminous fluid, a white curdy precipitate is formed, composed of al- bumen and nitrate of silver. This precipitate is soluble in caustic ammonia, and in solutions of nitrate of silver, albumen and chloride of sodium. After some time it becomes colored, and ultimately blackish, from the partial or complete reduction of the silver. The action of nitrate of silver on milk, as well as on fibrin, is analogous to that on albumen; that is, a white compound of nitrate of silver, and of these organic substances is at first formed, but gradually the metal is reduced. These facts assist us in comprehending the nature of the changes produced by the application of nitrate of silver to the different tissues. (3. 46.) Case 1. Boerhaave has noticed a case of poisoning with this sub- stance, but in very brief terms. He says, it caused gangrene. Schloe- pfer, in his thesis, notices a case by Dr. Albers of Bremen, in which croup was brought on by a bit of lunar caustic dropping into the windpipe. M. Poumarede has related an instance of poisoning with an ounce of the nitrate of silver in solution. A few hours afterwards the individual was found insensible, with the eyes turned up, the pupils dilated, the jaws locked, and the arms and face agitated by convulsions. A solution of common salt was immediately given as an antidote. 504 Argentum-Nitrat um. In two hours there was some return of consciousness and an abate- ment of the convulsions, but still complete insensibility of the limbs, with redne*ss of the features, and pain in the stomach. In eleven hours he could articulate. For thirty-six hours he continued subject to fits of protracted coma ; but he eventually recovered. Sixteen hours after taking the poison he vomited a large quantity of chloride of silver. (9. 46.) ' Esquirol mentioned a case, in which nitrate of silver was given freely during a period of eighteen months, at the end of which time the patient died, and the stomach was found destitute of the mucous coat over one-half of the inner surface, with several points of cor- rosion down to the peritoneal coat. (7. 46.) Clinical Remarks.—We infer from the above, that as the Nitrate of Silver produces no distinct dyscrasia, but merely simple inflamma- tion and ulceration or corrosion, that it is homoeopathic to many varieties of simple inflammation and ulceration. Also to convulsions, especially when they arise from disease or disorder, inflammation or ulceration of the stomach, or are connected therewith. It is homoeopathic to some forms of coma. (11.) In large doses Nitrate of Silver acts as a corrosive poison and gives rise to such symptoms only, as might naturally arise from such an agent. The phenomena in such examples are prompt, severe, and limited in number. But in very minute and repeated doses, it produces a great variety of symptoms in various parts of the organism. Among the first effects which have been observed, may be named a direct and positive action upon the abdominal ganglionic system. Kopp remarks, that the " Nitrate of Silver exercises a pe- culiar dynamico-material effect upon the ganglionic system, the func- tions of which are powerfully affected by that drug. The results of that action are manifestly and specifically observed (by sympathy) in those organs whose action depends upon the pneumo-gastric nerv^ ; after that in the whole nervous system." As we advance, its entire specific operations will be noticed. (10.) Pathological Anatomy.—In men and animals : Dark rose-color- ed, or bluish-red, or blackish-red, black-spotted, or blackish green lungs ; the posterior portions of them are affected in particular, and either equiformly, or in places only. Condensation of the lungs, as in hepatization; they neither crepitate nor float on water. Much blackish blood in the lungs. Crepitating, anaemic, almost emphysematous lungs. The heart appears bluish-black and is distended with a great quantity of blood ; black blood in the left ventricle. Emptiness of the arteries of the heart. Much black blood in the veins. Con- traction and smallness of the stomach. Paleness of the mucous mem- brane of the stomach. Small black spots, of the size of a pins head, near the pylorus, consisting of corroded portions of the mucous mem- brane, and forming true perforations—giving the affected portion a sprinkled appearance. Transformation of the gastric mucous mem- Nitrate of Silver. 505 brane into a soft pulp; whitish-grey eschars near the pylorus; cherry-redness and inflammation of the stomach in several spots, with very great thinning, even of the muscular coat in others. Dark cherry-red coloring and softening of the mucous membrane of the duodenum. Thickening of the walls of the bladder. Metallic Silver has been found in the choroid plexus, the pancreas, bones, and skin. Clinical Remarks.—From the above pathological effects we infer that Nitrate of Silver is homoeopathic to contraction and probably in- duration of the stomach; it may also produce paleness of the mucous membrane of the stomach when it is congested or inflamed ; it should also be borne in mind in perforating ulcer of the stomach, although we have found Arsenicum and Morphine given in alterna- tion, very effectual in this interesting but dangerous disorder; it may also prove useful in gelatiniform softening of the stomach, such as often occurs in cholera infantum and other exhausting disorders ; it isof course homoeopathic to inflammation and inflammatory softening of the gastric mucous membrane. (11.) It also seems homoeopathic to congestion and hepatization of the lungs. (11.) EXPERIMENTS ON THE HEALTHY. Schaebert experimented on himself with Nitrate of Silver; he first took one-eighth of a grain in one-half ounce of distilled water, in the morning, while fasting, and only observed a very unpleasant metallic taste and slight burning in the throat; several repetitions of the same experiment only produced like results. (4. 11.) After taking one-fourth grain, the burning in the throat was some- what more persistent; after taking three half-grain doses, in the course of three days, the burning sensation became decidedly severe, stools and pulse were not altered, the tongue acquired a dark bluish color in a few places, there was an increased feeling of warmth in the stomach, and slight nausea, disappearing after eating. (4. 11.) After the lapse of a few days, he took one grain, one and a half hours after dinner, and experienced an intense burning in the throat, attended with nausea and retching, without actual vomiting, but with a paroxysmally increased feeling of warmth and some spasm in the sto- mach ; the tongue had a dirty brown coating for several days, and a slight diarrhoza occurred towards evening and continued the next day, relieving the pains in the stomach entirely. Besides this, he experi- enced annoying and dull pains in the head, attended with a peculiar de- jection of spirits, and restlessness. In three days all these symptoms disappeared; but eight days afterwards he took one and a half grains in the morning, fasting; the nausea and inclination to vomit which ensued were immediately relieved by hearty eating, but he felt unwell the whole day, and had dull pains in his head. (4. 11.) The above experiments were made with large and crude doses, and consequently but few of the physiological effects of the drug were 506 A rgentum-Nitratum. produced. Under the appropriate heads, will be found many charac- teristic symptoms from infinitesimal doses by different healthy prov- ers. (10.) Clinical Remarks.—It would seem homoeopathic to inflammation of the throat, when attended with burning pains; to nausea, vomiting, warmth, and burning in and spasms of the stomach; to pains in the stomach relieved by eating; to dyspepsia, when attended with head- ache, and a peculiar depression of spirits. The above and following experiments with comparatively massive doses, are peculiarly impor- tant, as there can be-little or no mistake about the genuineness of the effects produced; when infinitesimal doses are used in experiments upon the healthy, it is safe to conclude that nine-tenths of the supposed symptoms are accidental or imaginary occurrences. (11.) Frank took small doses of the Nitrate, while he was in perfect health; he soon became indisposed; derangement of the stomach, heart-burn and water-brash set in, and lasted several days after he dis- continued the Silver; he had never suffered in this way before. These symptoms disappeared, but a neuralgic pain in the left infraorbital re- gion gradually developed itself and lasted the whole winter; the pain was persistent, and generally not very severe, but occasionally it would become quite severe for a few moments. (4. 11.) Simultaneously the action of the heart became somewhat irregu- lar; at times there would be an intermission of its beats, with an evi- dent and unpleasant feeling in the chest; if his attention was strongly directed to this point, the action of the heart became still more irregu- lar, but exercise in the open air did not affect it. He had at the same time a constant feeling of fullness in the epigastrium. Sudden and violent exercise of his muscles, such as jumping, or going fast up- stairs, and some mental emotions, would produce rather violent palpi- tation of the heart; and all the above symptoms were apt to be in- creased at night while in bed. (4. 11.) Clinical Remarks.—It would seem that in Nitrate of Silver we have a truly homoeopathic remedy to facial neuralgia, especially when pre- ceded or attended with acidity of the stomach, heart-burn, and wa>- ter-brash; also for palpitations and irregular action of the heart, when arising from nervous disorders, mental emotions, or gastric derange- ment. (11.) Some time afterwards, Frank took four doses a day,- for two days, of one-tenth grain each; then two-tenths of a grain,Tour times a day, for two days more; then three-tenths, four times a day, for one day; then four-tenths as often, for one day; then five-tenths, three-fifths, four-fifths, one grain, and one and one-fifth grains, each four times a day, for one day, when he became so unwell that he had no further inclination to pursue his experiments. He became and remained constipated for eleven days; on the tenth day he began to have an aching sensation of fullness in the stomach, after very light meals of bread and milk; his whole abdomen became very much distended on the eleventh day ; on the twelfth, violent head- Nitrate of Silver. 507 ache was added to the above symptoms, and it was with the greatest difficulty that he could force himself to take any food; his nights Were restless, so that he could not stay in bed after 4, a.m. On the thir- teenth day there was still greater disgust for food, with foulness of taste and tongue; on the fourteenth day he again had violent headache, without feeling otherwise unwell, but his night was so disturbed, that he was obliged to rise at 3 o'clock; he could only force down one glass of milk during the whole of the next day, during which the very violent headache continued, without nausea; finally, he was much re- lieved by taking two cups of strong black coffee, his supper tasted ex- cellently, but on the following day he could only take very small quan- tities of food, on account of heart-burn. His desire for food and drink was very slight. (4. 11.) Clinical Remarks.—It would seem homoeopathic to constipation, to entire loss of appetite and disgust for food; aching and fullness in the stomach, with heart-burn and water-brash; to violent headaches re- turning every other day, and lasting for two days; and to great wake- fulness and restlessness at night. (11.) Many of the above symp- toms doubtless arose from absorption of the Silver into the blood. (11.) Nearly all the above symptoms detailed by Frank were, without doubt, due to the specific influence of the Nitrate upon the pneumo- gastric nerve. The dyspeptic condition of the stomac}i, the violent headache, &c, being reflected from a primary irritation of this nerve. Another prover who might take the drug as Frank took it, would very- likely experience a still larger group of sympathetic phenomena. Another still, taking it in imponderable doses, would probably experi- ence all of the effects of the other provers, and a large number of other phenomena which would naturally arise from a more interior and vital operation of the medicine. Farther on, these dynamic symp- toms will be enumerated. (10.) In another series of experiments, Frank took one-fourth of a grain mixed with three grains of sugar of milk; he experienced a very bit- ter taste, with warmth on the tongue and in the throat; drinking a lit- tle distilled water caused slight eructations, and sensations such as at- tend a catarrh of the pharynx and larynx. A few hours after, the same dose was taken solved in one drachm of distilled water, followed by a sweetish taste and sense of warmth in the mouth; an hour afterwards he took half a grain solved in one drachm of distilled water, and experienced the same sensations in a somewhat greater degree; a scratching sensation in the larynx, which caused him to hawk and cough; in a quarter of an hour more he felt a warmth between the shoulder- blades and breast-bone, (probably in the oesophagus,) which gradually changed into a slight aching in the epigastrium, attended with insipid eructations; one grain doses, in one ounce of water, only caused a very bitter taste and transient nausea. (4. 11.) Clinical Remarks.—It seems homoeopathic to catarrhal affections of the pharynx and larynx, to cough proceeding from irritation of the throat and uvula, or from the stomach and oesophagus. (11.) 508 Argentum-Nitratum. Wood and Bache simply tell us that in very small doses, repeated two or three times a day, Nitrate of Silver produces no other observa- ble effects than those of a gentle tonic and astringent; as improved appetite, invigorated digestion, and perhaps a tendency to constipation. Taken more largely it causes warmth of stomach, and some gastric uneasiness, indicating an irritant action, which, upon a still further in- crease of the quantity, is evinced by gastric pains, sometimes nausea and vomiting, and occasionally also by griping pains in the bowels, with either diarrhoea or constipation. As to the degree of irritant ef- fect, much depends on its mode of administration, and the condition of the stomach at the .ime. (7. 46.) antidotes. The best antidote for the poisonous effects of Argentum-Nitratum, is common Salt. When this substance comes in contact with the Ni- trate, Chloride of Silver and Nitrate of Soda are produced, the former compound being comparatively innocuous. When the local use of Nitrate of Silver occasions pain, relief is afforded by washing the parts with a solution of salt and water. Ap- plied to the hair and nails, the Nitrate stains them black, as in the case of the cuticle, and in consequence, it is one of the substances employed as a hair dye. When recently applied, the black tint of the hair, and even of the cuticle, may be removed by washing with a so- lution of Chloride of Sodium, and then with Aqua-Ammonia, to dis- solve the Chloride of Silver which is produced. (88. 54.) The tincture of Iodine, followed by a solution of Hyposulphate of Soda, or a solu- tion of Cyanuret of Potassium, will also remove stains of the skin produced by this remedy. (88. 54.) The stains upon linen produced by a solution of Nitrate of Sil- ver, may be removed by wetting the linen in a solution of Bichloride of Mercury, in the proportion of one part of the Mercury to thirty-one of water, rubbing the linen well, and then washing it with cold water. (27.) To detect Silver in stained hair, the latter is to be treated with Chlorine or Iodine, by which Chloride or Iodide of Silver is produced, which is soluble in Ammonia and in Hyposulphate of Soda. It is precipitable from its solution in Ammonia by Nitric-acid. (3. 54.) Part of the black color of the hair stained by the Nitrate, depends on the formation of Sulphuret of Silver. (3.) In order to remove Nitrate of Silver-blackness, one drachm of Aci- dum Nitricum dilutum was. taken daily in a pint of barley-water, and the face and hands were sponged twice a day with the same; this was continued for several weeks, when to Dr. Ure's great surprise, hands and arms were nearly as white as ever they had been, while the face and rest of the body remained very blue. (11.) ON THE VASCULAR SYSTEM. On the Blood.—Nitrate of Silver acts on the system at large through the circulation ; of its absorption, or rather of the absorption of the Nitrate of Silver. 509 metal in one form or another, there can be no reasonable doubt. Or- fila found Silver in the liver of animals, to which the Nitrate had been given, six months after its administration; in seven months, however, it had disappeared. In addition to this, we have the indis- putable evidence of the discoloration of the skin produced by it. Al- though it forms compounds with albumen and fibrin which are in- soluble in water, still it is a fact of great importance in explanation of the operation of the salt on the system that the albuminate of the Nitrate of Silver is soluble in an excess of albumen, and conse- quently in the blood. Ficinus and Seiler, quoted by Berzelius have' proved the presence of silver in the chyle and in the blood of the portal-system and in that of the vertebral arteries by direct experi- ment. It has also been detected in the urine, (see Kidney). (88. 11.) According to Frank, if Nitrate of Silver does not come in contact with an excess of saliva, only a portion of it is converted into Chlo- ride of Silver by means of the Chloride of Soda contained in the spittle ; while another portion enters into combination with the ptya- line in the same way as it does with albumen, which com- pound is soluble in acids and alkalies, and hence capable of being absorbed into the blood. (4. 11.) It has also been proven that even when Nitrate of Silver arrives in the stomach undecomposed, that it is not entirely changed into Chloride of Silver by the free muriatic acid contained in the gastric juice; but that on the contrary a portion of it combines with the organic portions of the gastric fluids in like manner as it does with albumen. Dr. Dreyer of Moscow thinks that it possesses a certain peculiar and specific power of urging the fibrin of the blood to a more ener- getic vitality by consolidating its parts, while Kopp found that when he let blood from a vein flow into a solution of eight grains in one ounce of water, that it coagulated with great rapidity and quite firm- ly. (11.) Frank concludes that it coagulates the albumen of the blood; also that it diminishes or prevents the absorption of oxygen ; it prevents the putrefaction of organic substances and the decomposition of the blood by preventing, or very much limiting the formation of sul- phuretted hydrogen. (11.) It appears from the above that Orfila was mistaken in inferring that the Nitrate of Silver is simply a perturbating agent when introduced into the veins ; while by its facility of decom- position, it cannot enter the blood through any of the ordinary chan- nels in a quantity sufficient to develop any remote action. When two grains in solution were injected into the jugular-vein of a dog it died in six minutes, difficult respiration being the chief symptom ; the third part of a grain caused death in four hours and a half, violent tetanus having preceded death. (9. 46.) In both animals the blood in the heart was found very black and the lungs gorged or vivid red. (9. 46.) According to Mr. Blake, the salts of silver when directly intro- 510 Argent u m-Nitratum. duced into the blood, do not act on the heart, but operate by causino obstruction of the capillary-system. If they are injected into the aorta, the systemic capillaries ars obstructed, the nervous system is consequently oppressed, respiration is arrested through the medium of this nervous oppression, and death takes place by asphyxia; the heart continuing to beat vigorously. If again they be injected into a great vein, immediate obstruction of the pulmonary capillaries takes place, so that the blood ceases to be transmitted to the left side of the heart. (9. 46.) Heart and Arteries.—When given internally it does not often pro- duce.general febrile or inflammatory action. Wood says: In any dose in which it is ordinarily given, its influence upon the general functions is not striking. There may possibly be some increase in the frequency and force of the pulse, and the general temperature ; but these results are much less observable than from the more power- ful of the vegetable tonics. (11.) But we have already seen from Frank's experiments that it causes the action of the heart to become somewhat irregular, attended with an unpleasant feeling in the chest; while exercise or mental emotions would produce rather violent palpitations. (11.) In minute doses it stimulates and invigorates the entire ganglionic system, augments the vitality of the heart and arteries, equalizes the circulation, increases the animal heart, and imparts a sense of increas- ed strength and vitality to the whole system. If the dose be increas- ed so that its primary chemical and material action shall be speedily manifested upon the stomach, ah opposite result occurs, and we ob- serve a depression of the nervous and vital forces, and a correspond- ing loss of power in the heart and arteries, with irregular circulation, deranged digestion, neuralgias, tendency to spasms, debility, &c. (10.) Clinical Remarks.—We would infer from the above that while Ni- trate of Silver is homoeopathic to many external and superficial in- flammations, it is not so to many internal ones, except those of the stomach, bowels, bladder, vagina, &c, to which in fact it is always applied locally. (11.) It is especially appropriate in cases of enfeebled circulation, and imperfect calorification, which have been superinduced by too much mental exertion, care, grief or other depressing emotion, together with dietetic errors, and sedentary habits. Under such circumstances attenuated doses are capable of rousing into activity the ganglionic system of nerves, and thus of restoring the impaired tone of the cir- culatory vessels. (10.) In angina pectoris it has been administered in the interval of the paroxysms, with occasional success, by Dr. Coppe and Dr. Copland. (3.) Wood says, in many local inflammations it acts powerfully as an antiphlogistic (?) remedy. But, though generally effective, the remedy will not always succeed, and, if it fail, may sometimes do harm by its excitant, phlogistic or corrosive influence in acute cases. When Nitrate of Silver. 511 the local affection is the result of the general state of the system, when it is complicated with fever and plethora (to which it is not ho- moeopathic) and, especially in the highest state of inflammatory ex- citement, the Nitrate of Silver will fail. Nor as a general rule should it be applied under these circumstances. (11.) Veiions System.—It is not positively known whether it exerts any specific action upon the venous system, although it has caused the accumulation of much black blood in the veins; black blood in the left ventricle, much blackish blood in the lungs, &c, &c, when in- jected into the veins ; but these are all probably local corrosive ef- fects upon the blood. (11.) Glandular System.— It has no known specific action upon the glands. Clinical Remarks.—It has never been used much in any glandular affections, nor in any scrofulous or dyscratic disorders. (11.) ON THE NERVOUS SYSTEM. It is evident, that the Nitrate in small quantities, and the Chloride and Oxide of Silver in larger proportions, are absorbed into the vascular system and thus conveyed to all parts of the body, and consequently also to the nerves, with which they doubtless come in immediate con- tact. Upon these they may exert an irritant or astringent, or tough- ening action, and probably the salts of silver may also enter into a chemical combination with some of the constituents of the nervous mass, especially the albumen, and that an actual and tangible albumi- nate of silver may be there formed, as it is in the blood, and in other parts of the system. In the case of poisoning, before quoted it pro- duced convulsions, and hence it seems to act decidedly upon the motor nerves of the spine and brain, while clinically it has been found more useful in epilepsy and other spasmodic disorders than in neuralgia, or other affections of the nerves of sensation.'(11.) Wood gives a somewhat similar view of its action in nervous af- fections ; he assumes that it is absorbed into the blood and that its action is somewhat astringent, causing contraction of the tissues like Nitrate of Lead, though in a less degree; that it produces a slight increase of the vital cohesion of the molecules of those nervous tis- sues, which it reaches through the blood; by thus producing a slight cohesion of the molecules of the tissues, they give them a greater power, while by a gentle excitation, they call this power into a some- what higher exercise. The organized nervous substance, not only of the great nervous centres, but of the individual nerves, take on a con- dition of greater firmness or compactness, which enables them, if pre- viously weakened, to perform their proper function more regularly and efficiently. It ought not to be regarded as an antispasmodic, although it cures convulsive disorders, but a tonic, to the nervous system. (11.) We quite agree with Mueller of Vienna, when he asserts "that this 512 Argentum-Nitratum. agent effects the organism in two distinct ways. In the first place it affects the nervous system in a peculiar manner ; and secondly, it has great powers in producing organic changes in the body." Accord- ing to this gentleman, it impresses specifically the motor-and sentient nerves, but especially of the abdominal ganglions. The superior ganglia and the pneumogastric nerve are specifically acted upon by the Nitrate, according to Vogt. While in attenuated doses it imparts tone to the motor- and sentient nerves, and exalts the functions of most of the organs, in large doses it operates as a depressor, and gives rise to various organic changes throughout the entire organism. Upon the brain it probably exercises no direct action, since most of the supposed cerebral phenomena are reflected from the ganglionic system. In our judgment its chief specific action is upon the anterior por- tion of the spinal marrow. We infer this from the phenomena to which it gives rise. (10.) Clinical Remarks.—Wood says that epilepsy is that one of the nervous affections in which the Nitrate of Silver has been given most frequent- ly, and in the treatment of which it has the highest reputation. It is certainly among the remedies which have proved most effectual, so far as testimony can avail to decide the question. Every one knows that epilepsy from the very nature of its sustaining cause is often quite incurable ; that the Nitrate, therefore, should very frequently fail is nothing more than might be expected. (11.) Pereira says, in epilepsy it has occasionally, perhaps more frequently than any other remedy, proved successful, but its methodus medendi imperfectly un- derstood. This indeed is to be expected when it is considered that the pathology and causes of epilepsy are so little known ; and that as Dr. Sims has justly observed,^very thing connected with this disease is involved in the greatest doubt and obscurity, if we except the description of a single fit and that it returns at uncertain intervals. Pereira conceives Georget's dictum, condemning its administration, as " cauterizing the stomach to cure a disease of the brain," to be " absurd and unwarranted," in view of the many facts we have, esta- blishing its efficiency ; but at the same time he remarks that in the few instances in which he has seen it tried, it has proved unsuccess- ful ; but this may have been because it was not continued for any length of time, on account of the apprehended discoloration of the skin. (3.46.) Waring thinks that its efficacy is inferior and less uni- form than that of the Salts of Zinc and Copper. (44. 46.) Lead, Arsenic and Conium, from their well known effects in producing palsy, ought to prove the most useful antipathic remedies against epi- lepsy, and other convulsive disorders ; but singularly enough, they are scarcely or ever used in the dominant school. I have made a few experiments with Lead, which induce me to infer that cures may be effected with it. (11.) The allopathic employment of this drug in epilepsy cannot be too Nitrate of Silver. 513 much condemned. Under the most favorable circumstances it does not cure more than one in twenty cases, according to our opinion, and when we consider the discoloration of the skin to which it so often gives rise, and the functional and organic disorders it produces, even these occasional cures do not justify its use. From consider- able observation upon this subject, we believe that at least one in five are cured by judicious homoeopathic remedies, such as Zizea, Arteme- sia, Belladonna, Strammonium, Ignatia, Hyosciamus, Plumbum, Aga- ricus, &c. (10.) 2. As regards its use in epilepsy, Pereira states that it exercises a specific influence over the nervous system; at least, he says, that he infers this, partly from the effects observed by Orfila, when injected into the veins of animals, and partly from its curative effects in epi- lepy and chorea. The effects observed by Orfila were difficult res- piration, and convulsive movements, which would lead us to infer that Pereira regards the Nitrate of Silver as somewhat homoeopathic to epilepsy, in which disease he states that it has proved successful more frequently than any other remedy. We know of but one instance in which it has produced convulsions in the human subject, although in dogs it quickly causes convulsions, vertigo, and fainting fits. The distinctive peculiarity of epilepsy is the occurrence of convulsive movements simultaneously with loss of consciousness; according to Hufeland the loss of consciousness is the most essential pathog- nomonic symptom, for the weakest convulsion with unconsciousness is epilepsy, while even the most violent spasms, if consciousness re- main, are not epileptic. According to Noack, metallic silver causes vertigo and infringement of the consciousness, also vertiginous sleep- stupor ; feeling of cloudiness in the head, also of dullness and emptiness, sudden confusion of the head with dimness before the eyes ; while Portal, Wepfer and Vicat are said to have noticed premonitions of an epileptic paroxysm from its use, probably in epileptic patients. In the experiments upon the healthy it has also been noticed to cause spasmodic twitching in the forehead and temples, also in the lateral muscles of the neck, along the thyroid body, and in the nape ; twitch- ing and trembling of the muscles of the thigh, cramp in the calf of the legs. It must be owned that many other remedies produce effects much more like epilepsy than the above, so that a priori a homceo- pathist would judge that it would prove a very uncertain and slow remedy against epilepsy. Still it is said to have gained much and apparently deserved celebrity in the treatment of epilepsy, although in many cases the cure was very long and tedious. Professor Carron is said to have treated a large number of cases with marked success, and cured more than twenty genuine cases with it. In one case Vj-th of a grain was taken twice a day by a patient in whom the fits came on every fortnight; in the course of three months the fits oc- curred only once a month ; after six months, only once in seven weeks, and at the end of twelve months he was entirely cured. In a second case, of several years' standing, the Nitrate was taken for three months 33 514 Argen tum-NHratum. without benefit, but then there occurred a marked improvement, for in- stead of having a fit every week, the patient began to have only one in two months, then two in three months, both of which happened within ten days of each other ; in eleven months he was cured of his epi- lepsy, and of a strabismus also. In a third case, eighteen grains a day were taken for three years, with no sensible effect at all, except that of curing an epilepsy of nearly twenty years' standing. Sobcrnheim says, it sometimes effects a cure very slowly, and often it acts only as a palliative, and the diminished or apparently cured disease returns after a longer or shorter interval with greater intensity. Watson says, the Nitrate of Silver used to be thought highly of in epilepsy, but the truth is, in giving it we run a great risk of obtaining its dis- coloring effect, for the sake of a very small chance of curing the epi- lepsy ; if it do good at all, it must be given for some time together, and the probability is that it will not do good even then. (11.) Epilepsy is an essential disorder or irritation of the white or motor substance of the brain, or of some of the motor nerves and muscles, occurring in transient paroxysms. No pathologico-anatomical appearances either in the brain, or other parts occur so constantly as to enable us to infer that the epilepsy is solely and exclusively dependent for its origin upon them. Thus Graves of Dublin reports a case in which a very fine, robust and in- telligent boy, aged nine years, ate five or six hard, unripe pears and drank a large quantity of butter-milk, then fell into a state of insensi- bility and was convulsed ; from that time forth he was subject to epi- leptic fits ; they annually became more frequent and severe, but the vigor of his intellect was not impaired until after the disease had con- tinued six years, when he gradually lapsed into idioticy; for many years he had several epileptic fits daily; twice a year they would re- turn ten times daily, and finally terminate in outrageous madness, when the fits would subside, showing that the irritation had extended from the white substance of the brain to the grey. This state of things lasted for sixteen years, and after death the scalp, cranium, dura mater, arachnoid, pia-mater, together with the cortical and me. dullary substance of both cerebrum and cerebellum were all perfectly healthy; the spinal marrow and its investments were quite normal. (U). Fright is said to cause nearly one-third of all the cases, and this or other mental emotions to cause a still larger proportion of parox- ysms. (11). Sorrow is said to cause from two to fourteen per-cent. Idiotcy, mania, chorea and other spasmodic affections are said to cause from eight to ten per-cent. (11.) A certain number of cases arise from malformation of the skull; or from thickness of it, or from bony projections pressing upon the brain, or from caries of the sella-turcica, or from ossification or tumors of the dura-mater, and from organic disease, such as abscess, tu- bercle, hydatids. &c, of the brain itself. Wenzel thinks he always Nitrate of Silver. 515 found disease of the appendages of the brain, and Bouchet found in- duration of the brain in twelve cas§s out of eighteen; while Ferrus almost always found hypertrophy of the brain. Epilepsy may also arise from disease of the spinal marrow. Guislain thought he found induration of the olivary bodies in two-thirds of his fatal cases. (11.) Some cases of asthma and palpitation of the heart are supposed to be epileptic in their nature, as they sometimes pass over jnto epilep- tic attacks, which then may become habitual, without being always preceded by asthma or palpitation.' However this may be, tran- sient irregularities of respiration or circulation may bring on attacks of epilepsy in the predisposed.- (11) Disturbances of the digestive organs, such as indigestion, over- loading the stomach or bowels, constipation, worms, &c, often cause epileptic attacks, which cease when the cause is removed. (11.) Derangements of the sexual organs, irregular or surpressed men- struation, or disease of the uterus or ovaries, or onanism, or excessive coition, or abstinence may excite epilepsy. Still there must be a natural predisposition to the disease, to render these causes operative in this manner. (11.) Suppression of eruptions or of feet- or other perspirations may cause epilepsy. (11.) As regards the treatment, Ammonia, Chloroform and Ether are al- most the only remedies which can be used, effectively during the par- oxysm. (11.) When epilepsy has been brought on by fright, or generally occurs during sleep, Opium is the most important remedy; it may be used during the pfroxysm, if possible, and during the intervals, to prevent a return ; Ignatia and Artemisia also deserve attention in these cases. (11.) When suppressed eruptions or perspirations are exciting causes, Sulphur and Artemisia are useful. (11.) When there are derangements of the sexual organs Cuprum^ Pul- satilla and Platina have proved useful, and lately the Bromide of Potash has been used empirically by Sir Charles Locock, in hysterical and menstrual epilepsy; it has been noticed that experimenters, from taking ten-grain doses of Bromide of Potash, three times a day, would become impotent; Locock therefore thought he would try it in cases connected or unconnected with epilepsy, in which there was a great deal of sexual excitement and disturbance, and this he did with much success; he had also given it in fourteen or fifteen cases of menstrual- or hysterical epilepsy, and it has only failed in one, and in that one the patient had fits, not only at the time of men- struation, but also in the intervals. (11.) Case.—Fourteen months ago he treated a lady who had had hys- terical epilepsy for nine years, and had tried all the remedies that could be thought of by various medical men, without effect. She began to take the Bromide of Potash just after having passed one of her menstrual periods, in which she had had two attacks. She took 516 Argentum-Nitratum. ten grains, three times a day, for three months ; then the same doses for a fortnight previous to each rnenstrual period; and for the last three or four months she had taken them for only a week before men- struation. She did not have an attack during the whole period of fourteen months. I have cured similar cases with Baryta-muriatica, Belladonna, Stramonium and Camphor. (11.) When epilepsy arises from colic, constipation or indigestion, Nux- vomica, Hyosciamus, Chamomilla, Cuprum, Plumbum, and Nitrate of Silver are the principal remedies. (11.) When it is caused by worms, Turpentine is an important remedy, also the other worm medicines, especially Santonine; Turpentine should also be thought of in those cases which arise from irritation of the urinary organs, and from flatulence. (11.) Among the empirical remedies which have been found most use- ful are Oxyde of Zinc, Nitrate of Silver, Valerian and Belladonna. Of these Zinc is considered the most useful and safe. In thirty-one favorable cases, Herpin effected twenty-six cures, and failed only in six ; in five unfavorable cases he effected two cures and failed in hree. (11.) Valerian is thought to be almost as useful as Zinc ; still, of seven favorable cases, Herpin only cured four ; and of two unfavorable cases, only one. (11.) Belladonna was very useful in Debreyne's hands. With Cuprum, Herpin cured four favorable cases out of six; but no unfavorable cases. (11.) Artemisia is thought to rank next to Valerian, (11.) m Selinum-palustre is placed by Herpin before Valerian and next to Zinc, as he cured four favorable cases out of five, and one un- favorable case. (11.) If epilepsy frequently arises from induration of portions of the brain, or of the olivary bodies, Plumbum, Nitrate of Silver, Zincum, Cuprum, Alum and other astringent and toughening remedies must be more or less homoeopathic. (11.) In those cases which arise from ossification of the membranes of the brain, or from bony projections from the skull or dura-mater, the long-continued use of Phosphoric-, or Muriatic-, or some other acid might be tried. (11.) When there is hypertrophy of the brain, Iodine, Hydriodate of Potash, Baryta-muriatica, or Bromide of Potash should be tried. (11.) The diet should be carefully regulated ; constipation obviated; pains taken that the functions of the skin be well kept up; the urine should be examined frequently, to see whether a sufficient quantity of urea is excreted ; the mind should be kept tranquil, but agreeably employed; fresh air and moderate exercise enjoined, &c, &c. In plethoric cases a strictly bland, vegetable and farinaceous diet should be directed; in anaemic cases, full diet, with meat, and even wine and ale. (11.) j In chorea it has been successfully employed by Dr. Powell, Dr. Nitrate of Silver. 517 Uwins, Dr. Crampton, Lombard and others. (3. 46.) But Agaricus, Belladonna, Stramonium, Iodine and the Hydriodate of Potash are far more useful and safer remedies. (11.) In mercurial palsy the Nitrate of Silver has been successfully em- ployed Dr. Sementini. He gave it in a gradually-increased dose, and in twenty days or more the cure was effected. Similar results fol- lowed its use in five cases. (44. 46.) Arsenicum, Sulphur and Strychnine will probably prove more useful and safe. (,11.) ON THE TISSUES. Dermoid Tissue and Skin.—Applied to the skin it produces first a white mark, owing to its union with the coagulated albumen of the cuticle ; gradually this becomes bluish-grey, purple, and ultimately dark-brown, and then black, owing to the partial reduction of the silver. If the integuments be moistened, and the Nitrate applied three or four times, it causes at the end of some hours vesication, which is usually attended with less pain than that produced by Can- tharides. In some cases it excites acute pain. In one case in which Pereira applied it freely to the scalp for a cutaneous affection, fever with delirium was produced, which endangered the life of the patient, a girl of six years. This fact is deserving of notice, because in Mr. Higginbottom's " Essay on the use of Nitrate of Silver'" we are told, that applied as a vesicant, it causes scarcely any constitutional irritation, even in children. In a few days the black and destroyed cuticle cracks and falls off, without any destruction of the subjacent cutis vera. (3. 46.) There is another effect upon the skin following its internal ad- ministration, which would prove its absorption, even though other evi- dences of it were wanting. The peculiar blueness of slate color, or bronze hue of the skin, has been produced in many patients who have continued the use of the Nitrate during some months and years. In some cases the patients have been cured of the epilepsy, for which they took the medicine, and in others it has failed entirely. In some cases the discoloration undergoes no diminution for many years, and in others it gradually fades in intensity. The corion is the essential seat of it. Dr.Baddeley found that blisters rose white,a proof that in his mind the coloring matter was below the epidermis. But in some instances the cuticle and corpus mucosum of the face and hands par- ticipate in the tint. In one instance the mucous membrane of the stomach and intestines was similarly tinted. A case is mentioned by Wedemeyer, of an epileptic patient, who was cured by Nitrate ot Silver, but eventually died of diseased liver and dropsy ; all the inter- nal viscera were more or less blue. (3. 46.) The discoloration of the skin is usually regarded as incurable and permanent, but it has been reported that in one case washes of di- lute Nitric-acid diminished it. If this be true, it would be well to combine with the external, the internal exhibition of Nitric-acid. It has been suggested to combine the Nitrate of Silver with Nitric-acid 518 Argentum-Nitratum. in its administration: and the suggestion certainly is deserving of attention. A steady course of Cream of Tartar is also reported to have cured a case of discoloration of the skin. (3. 40.) Clinical Remarks.—It would seem that Nitrate of Silver is homoeo- pathic to many discolorations of the skin, to vesications and ulcera- tions. (11.) As it is evidently absorbed into the blood and acts prominently upon the skin and kidneys, it may possibly prove to be a remedy against those intractable cases of disease of the supra-renal capsules which are attended with Bronze skin. (11.) The late Dr. J. F. Peebles of Virginia, found it remarkably effi- cient in certain cases of Jaundice connected with an irritable condi- tion of the stomach and small intestines. (88.11.) It may prove useful against chloasma, macula; hepaticae, and iYgckIgs Of all surgical remedies, says Trousseau, Nitrate of Silver is the most useful, and it ought to take the same rank in surgery that Qui- nine and Opium take in medicine. Nor is it any less important to the practitioner of homoeopathy; for as a vitality-modifying agent, it has no superior. The instances in which it is homceopathically in- dicated as a topical application, are quite numerous and important. This will be fully appreciated by those of our school, who receive similia similibus curantur, in its most expanded and liberal significa- In disease the vitality of the affected tissue is altered by a morbid agent acting directly upon the part. If the morbid agent is virulent and impresses actively the tissue, it may lead to disorganization be- fore the natural recuperative forces of the system can neutralize its action. It is in such cases that another vitality-modifying agent, more harmless and tractable in its nature, may be brought to bear in such a manner as to destroy the effect of the primary morbid in- fluence. If this second agent can be applied directly to the dis- eased spot, instead of first passing into the stomach, from thence into the blood, and finally from thence to the disordered structure so much the better, provided the drug is homceopathically indicated. In other words, if a drug when locally applied, is capable of neu- tralizing a primary morbid influence and of substituting in its place a harmless and self-curing drug-action, such drug is strictly homoeo- pathic. (10.) f Among the effects ascribed to the local application of JNUrate oi Silver to the skin, we may cite a vesicular condition, resembling erysipelas. . . M. Jobert De Lambelle first employed it topically in erysipelas, and with marked success. He admits the importance of attending to the general state of the system in both surgical erysipelas and that dependent upon an internal cause ; but he deems the local manifesta- tion of the disease still more important. He therefore advises the application to the affected parts, twice daily, of a pomade composed Nitrate of Silver. 519 of two parts of Nitrate of Silver and four parts of lard. This pomade, besides the black color it produces, causes a vivid irritation and the development of an acute vesicular inflammation. In eruptive diseases like small-pox, zona, impetigo, &c, Bretton- neau advises light cauterizations over the eruptions, in order to arrest their progress. (See " Skin.") (10.) Skin.—From internal use : peculiar discoloration of the skin, (ar- gyria) from the bluish-grey, violet, or bronze-colored tints to the real black. Small, itch-like pimples, (vesicular) bleeding when scratched, and becoming covered with bleeding scurfs. Pustulous ecthyma, coming on after itching, or pain in the affected part. Wart- shaped excrescences on the skin. (1.) From external use : Vesicular inflammation resembling erysipelas. Vesicular eruption like varicella. Pustules like those of small-pox, from repeated light applications to the same parts. Inflammation fol- lowed by ulceration of the skin, from repeated and thorough appli- cations. (10.) Clinical Remarks.—As an external agent its use is extremely valua- ble. It is employed sometimes as a caustic, and as such it has some advantages over potassa fusa, and the liquid corrosives. Thus it does not liquefy by its application, and hence its action is confined to the parts with which it comes in contact. It is used to remove and repress spongy granulations in wounds and ulcers, and to destroy warts, whether venereal or otherwise. It is applied to chancres on their first appearance, with the view of preventing bubo or secondary symptoms. This practice has the sanction of Hunter. Pereira has several times seen it fail, perhaps because it was not adopted suffi- ciently early. (3. 46.) The application of Nitrate to punctured wounds is often attended with most beneficial results. Although a caustic and corrosive remedy, it prevents or subdues inflammatory action in a surprising degree and homoeopathic manner. It is as well adapted to poisoned as to simple wounds. To promote the healing of ulcers, it is a most valuable re- medy. In large indolent ulcers, particularly those of a fistulous or callous kind, it acts as a most efficient stimulant. To small ulcers, it may be applied so as to form an eschar, and when at length this peels off, the sore is found to be healed. Mr. Higginbottom asserts that in every instance in which the eschar remains adherent from the first ap- plication, the wound or ulcer over which it forms invariably heals. Dry lint will in general be found the best dressing for sores touched with the Nitrate. (3. 46.) Nitrate of Silver has been proposed by Mr. Higginbottom as a to- pical and homoeopathic remedy for external inflammation. It may be applied with great advantage to subdue the inflammatory action of erythema, of paronychia or whitlow, and of inflamed absorbents. In 520 Argentum-Nitratum. some cases it is merely necessary to blacken the cuticle; in others Mr. Higginbottom recommends it to be used so as to produce vesi- cation. The application of the solid Nitrate of Silver is said to be a most effectual remedy for the different forms of porrigo, which affect the heads of children. The caustic should be well rubbed into the parts. Pereira has never known this practice to fail, or to cause the loss of hair. When the greater portion of the scalp is involved, the different spots should be cauterized successively at intervals of some days : for as already mentioned, fever and delirium ha6 followed a too extensive use of the remedy. (16. 46.) In psoriasis the same medicine was found by Dr. Graves most effectual. An aqueous solution of the Ni- trate is also valuable as an astringent or alterative wash in other skin diseases, as impetigo. (44.46.) Marks upon the skin resulting from the accidental contact of Ni- trate of Silver maybe removed by applying the tincture of Iodine and following this by the Hypo-sulphate of Soda. Another agent which speedily Removes the stain is the Cyanuret of Potassium. (7. 46.) In herpes zoster, or shingles, a similar mode of treatment is recom- mended by Erasmus Wilson. He states that it acts beneficially, and brings the cure to a more speedy termination than if left to itself. (44. 46.) In pemphigus after the bullae have burst, and excoriations remain, Mr. E. Wilson found that the best application to promote a cure was a solution of the Nitrate of Silver. (44.46.) In molluscum simplex, he advises touching the tumors with the solid Nitrate, and in some instances, he opens the tumors with a lancet, and applies the Nitrate to the interior. (44. 46.) Erythema infantum is. greatly benefitted by being pencilled with a weak solution of the Nitrate. (44. 46.) In frambesia or yaws, Mr. Mason derived great benefit from the di- rect application of the Nitrate to the tubercles; and in one recent case this treatment being continued for a few months, the papulae disap- peared, and no other tubercular yaws were formed. (44. 46.) Encysted tumors, according to the experience of Mr. Erasmus Wil- son, are effectually cured by laying them open with a lancet or bis- toury, pressing out their contents, and injecting the cyst with a solu- tion of the Nitrate, or touching its internal surface with the solid caustic. He much prefers this plan to the painful process of excision. (44. 46.) In scrofulous enlargement of glands, eye, Mr. Balman considers that much mischief is done by the indiscriminate use of Iodine frictions, and prefers in the absence of all inflammatory action, pencilling the parts with the solid Nitrate a few times, at intervals of a week or ten days. (44. 46.) ' In porrigo, psoriasis^ impetigo, and other cutaneous diseases which have resisted milder remedies, the solid Nitrate, locally applied, has Nitrate of Silver. 521 been found effectual. It should not be applied extensively at once, but small portions should be successively cauterized at intervals of a few days. (44. 46.) Although it is a corrosive or ulcerative agent, yet in many forms of ulcers, the Nitrate is effectual and homoeopathic in establishing a healthy surface, and promoting cicatrization. To healthy ulcers, if extensive, or if exuberant granulations exist, to weak and indolent ul- cers, and also to irritable ulcers, the Nitrate may be used with advan- tage. Mr. Higginbottom advises, when the ulcer is not very extensive, and free from inflammation, to apply the Nitrate in substance to the sore, and also very lightly to the surrounding skin ; a scab forms and in most cases when suppuration ceases and the scab is removed, the cicatrization is complete. After the application of the Nitrate, the ulcer should be covered with gold-beater's skin and exposed to the light. If suppuration continues, an incision is to be made with a lan- cet in the centre of the eschar, to allow of the escape of the pus. (44. 46.) It must be more efficacious than Lead-washes and other simple astringents, because even if it be somewhat astringent in its action, it is also homoeopathic to inflammation and ulceration. (11.) As an application to dissection wounds, it is advised by Mr. Stafford; it should be applied to the parts surrounding the wounds and along the inflamed absorbents, if inflammation has supervened. It seemed in some cases to arrest the progress of the disease. It should be applied as early as possible, and not allowed to interfere with the constitutional and other treatment. (44. 46.) As a preventive against hydrophobia, Mr. Youatt, a most competent authority, extols the Nitrate of Silver. Immediately on the bite being discovered, the caustic should be freely applied to the wound; an es- char forms, and the ulcer should be allowed to discharge freely for some weeks. Mr. Youatt states that he has employed it four times on his own person when bitten by rabid dogs, and that by the early and free use of this remedy he has experienced no ill consequences. Others, however, have not been so successful in its use, and it appears on the whole that excision of the part is the safer plan. When, how- ever, the Nitrate is used, it should be sharpened to a point, and applied freely to every recess and sinuosity of the wound. The same remarks apply to the bites of the cobra and other venomous snakes. (44. 46.) In small-pox the local application of the Nitrate to the pustules, has been proposed as a means of arresting the disease in the vesicular or papular stage, and also of preventing subsequent pitting or cicatriza- tion. This treatment has been particularly recommended by Velpeau, Brettonneau, and Serres. The apex of the pustule is to be removed, and a sharp pencil of the Nitrate to be inserted into each; but the process is tedious and painful, and as has been shown by Girardin, not without danger. A solution of the Nitrate has been successfully substituted; it is to be applied lightly over the surface by means of a camel's-hair brush. (44. 46.) Brettonneau and Serres recommend the cauterization of variolous 522 Argentum-Nitratum. pustules by Nitrate of Silver, in order to cut short their progress. It is principally useful as a means of preventing pitting, and should be employed on the first or second day of the eruption. The solid caus- tic is to be applied to each pustule, after its apex has been removed (3. 46.) Although Nitrate of Silver is said to have caused a pustular erup- tion upon the skin, still it is not nearly as homoeopathic to small-pox as Tartar-emetic ; it is much better to rely upon the internal use of this latter remedy, aided by the external use of a weak solution or oint- ment of it, if it be thought advisable. (11.) In erysipelas, Nitrate of Silver is used by many surgeons as a-cau- tery, both to the inflamed and the surrounding healthy parts. But Pe- reira says he has so often seen the disease continue its course as if nothing had been done, that he has lost confidence in its efficacy. He states that he has found Tincture of Iodine much preferable. (3. 46.) To stop the progress of irritation or erysipelatous inflammation, it should be applied in a circular form around and at a little distance from the inflamed portion. Mr. Higginbottom reports favorably of ap- plying the Nitrate to burns and scalds. (3. 46.) In erysipelas, the Nitrate of Silver as a local application was first proposed by Mr. Higginbottom. Previous to its use, the surrounding skin should be well washed and afterwards dried; the Nitrate may then be applied, care being taken that no interstices are left through which the inflammation may pass and extend itself. This measure is often effectual, but it must be confessed, it occasionally fails, probably in a great measure from the careless manner in which it is applied, and the neglect of proper caution. Another form of application is to pencil the whole of the inflamed surface with the Nitrate, either in substance or solution, so as to cause a slight amount of discoloration. The parts are then to be exposed to the air and kept cool. Tincture of Iodine is thought to be more effectual. (44. 46.) Velpeau thinks a solution of Sulphate of Iron, a much more useful application in erysipelas than Nitrate of Silver. It is evident that as erysipelas is often a constitutional affection, and Nitrate of Silver does not produce constitutional, but only local inflammations, that it must often be inadequate to the cure of this disorder when merely locally applied. It is better as a general rule, to use suitable internal reme- dies, such as Tartar-emetic, Belladonna, Rhus, Apis, &c, conjoined with proper constitutional measures, such as proper diet} cooling drinks, slight saline laxatives, like the Citrate of Magnesia, aided by gentle demulcent local applications, or weak solutions of the proper specific remedies, than to depend mainly upon local applications. (11.) In what is termed surgical erysipelas, we are in the habit of em- ploying it topically, after the manner of Lambelle. As the disease in these instances does not arise from an internal cause, we run no risk in arresting the local inflammation promptly. But when the malady depends upon an internal constitutional cause, we prefer to rely upon appropriate internal specifics. (10.) Nitrate of Silver. 523 In several instances we have applied a saturated solution to the healthy skin around erysipelatous spots, and have apparently arrested the further progress of the disease. (10.) As a general rule, topical applications of this substance to the skin are inappropriate where the external affection is a manifestation or symptom of some internal disorder, but are often exceedingly useful in mere local maladies. (10.) Cellular Tissue.—When Nitrate of Silver is applied to an ulcer, it produces a white film, (owing to its union with th« albumen, and per- haps also with the Chlorides, of the secretion.) This film in a few hours assumes a dark color, and ultimately forms a black eschar. This hardens, and in a few days becomes corrugated, separates at the edges, and at length peels off altogether, leaving^ the surface of the sore in a healthy condition. (3. 46.) In this respect it differs greatly from Arsenic, and some similar agents employed topically as an application to ulcers. Arsenic acts by destroying the vitality of the denuded surfaces, or mucous mem- branes with which it comes in contact in a sufficiently concentrated state, causing eventually the death of the structure, which is thrown off by a slough as a foreign substance. The Nitrate of Silver, on the contrary, acts as a caustic, causing instant chemical decomposition of both the healthy and morbid tissues with which it comes in contact, ceasing only its action when its powers are exhausted. Arsenic, on the other hand, has a peculiar affinity for diseased structures, and will cause the death and separation of morbid tissue, leaving the healthy parts underneath intact, and in the most favorable condition for heal- ing. <46.) MUCOUS Membranes.—When applied to mucous membranes, a white compound of the Nitrate with the animal matters of the secreted mu- cus is formed, and this defends the living tissues, in a measure, from the action of the caustic, so that its effects are not so violent as might be expected. Thus the solid Nitrate may be applied to the mucous surface of the vagina, and even to the os-uteri, in cases of leucorrhcea and gonorrhoea, oftentimes without exciting any pain or inflammation; in some instances, however, it produces smarting pain, which lasts for several hours, but no serious effects have resulted from its use, even when by acciderTt, two drachms of Nitrate have been left to dissolve in the vagina. (3. 46.) Its chemical effects on the other mucous membranes are analogous to those mentioned; but the pain which it produces varies with diffe- rent membranes, and with the same membrane in different states. Its application to the conjunctiva is attended with acute pain, though in general it soon subsides. On all these surfaces it acts as an alterative- antiphlogistic, or astringent. (3. 46.) According to Schloepfer, when introduced into the trachea, it caused inflammation of the windpipe and pneumonia, passing on to hepatiza- tion of the lungs, (probably through its action as a local irritant, and 524 Argentum-Nitratum. by directly inducing inflammation, (46.) but no symptom of a remoter action, or any signs of the absorption of the medicine. (46.) Taken internally in small doses, it affects the mucous membranes of the digestive apparatus, the air passages, the urethra, the uterus and the vagina, and the eyes. It excites the capillary vessels of these structures, causing in the first instance, a slight sense of irritation, of tingling and itching, with slightly augmented secretion of mucus, fol- lowed in from two to four days by a feeling of dryness in the parts, and impaired mucous secretion. (10.) Externally applied in the solid form, or in a saturated solution, it enters into combination with the secreted mucus, whitening the mem- brane, producing a burning and smarting sensation, which lasts from one minute to an hour or two, according to the thoroughness of the application and the part acted on. Soon after the cauterization the membrane becomes swollen, the mucous secretion is suspended for a period, varying from a few hours to several days, after which the mem- brane recovers its normal tone and its usual healthy action. Its spe- cial pathogenetic and clinical relations will be noted under the appro- priate heads. (10.) FibrOUS Tissue.— Clinical Remarks.—In chronic arthritis, particu- larly in that of the hip-joint, Mr. Jobert employs frictions of the dis- eased part with the Nitrate. An ointment containing the Salt is rubbed in daily over the spot, which is then covered with a poultice to pro- mote absorption. The treatment is continued until the disappearance of the disease. If the ointment be very strong, it causes great irrita- tion. It is reported to be successful. (44. 46.) In articular effusions, a solution of the Nitrate, or the application of the caustic in substance, drawn across the joint, previously moistened, at intervals of about a quarter of an inch apart, has been successfully employed by Dr. Moritz, of Coblentz. In either case the epidermis raises in blisters, containing serum. When this is dissipated, the ap- plication is to be repeated. In twenty cases in which Dr. Moritz employed this treatment, a cure was effected, whether the effusion was the result of gout, rheumatism, scrofula, or wounds. (44. 46.) Intellect and Morale.—Sorrowful disposition. Anxiety, which in- duces one to walk quickly. Irritated mood. Apathy, with great de- bility and tremulous weakness. Hypochondriac and gloomy mood. Anxiety in the precordial region, sighing, and oppression after dinner. (1.) Spiteful, malicious disposition, with disposition to spit at people, and to commit other indignities. (10.) Head.—Vertigo, with blindness, and violent headache. Dizziness of the head, like that which precedes an epileptic attack. Excessive congestion of blood to the head, with throbbing of the carotid arteries, obliging him to loosen his cravat, accompanied with heaviness, stupe- fying dullness of the head, great melancholy, weakness of mind, and inability to express himself suitably and coherently. Incisive motion through the left hemisphere of the brain, extending from the occiput to Nitrate of Silver. 525 the frontal protuberance, recurring frequently and decreasing rapidly. Head painful, and seeming to be enlarged. The headache is relieved by tying a handkerchief tightly around the head. Generally the head- ache is accompanied with chilliness, and sometimes with a general increase of the temperature of the body. Vertigo in the morning, with headache. (I.) Clinical Remarks.—In headaches, vertigo, and other cerebral disor- ders, dependent on derangement of the abdominal ganglionic system, attenuated doses of this medicine have often proved curative. If the cerebral ailment is accompanied with irritability, moroseness, and ma- licious humor, the indication for the remedy is still stronger. It is homoeopathic to cerebral congestions, with temporary imbecility and headache, which often precede and follow epileptic paroxysms. From the suggestion of Dr. Gray, in Jahr's Manual, page 136, we have been induced to use it in brain disturbances arising from moral causes, and often with excellent effects. Severe neuralgic headaches caused by over-working the mind, by grief, anger, fear, &c, have often yielded readily to a few doses of the third attenuation. (10.) In insanity, observes Dr. Copland, the Nitrate of Silver has been recommended by Agricola and Kesler, and in circumstances truly in- dicating the propriety of tonics, and when insanity has been occasioned by depressing and exhausting causes, and in purely nervous cases, it may be of use. It has been considered as more peculiarly suited to the complication of mental diseases, with epilepsy. When, however, this association is dependent upon vascular or structural disease of the encephalon, little or no benefit can result from it. He adds that in one case in which he prescribed it, he was obliged to discontinue it; but that in two others of melancholia, with chronic irritation of the diges- tive mucous surface, he found it of service. (44. 46.) In hysterical headaches, Dr. Graves speaks highly of the efficacy of the Nitrate of Silver. When the paroxysm has abated, the greatest good may be obtained from it, continued for five or six days at a time. When the'bowels are constipated, it would be well to alternate it with Colocynth. In this way it may relieve not merely the headaches of hysterical young women, but those of men, particularly the habitual stomach-headache, to which delicate and literary men are so subject. (44. 46.) Scalp.—Extremely troublesome itching, creeping and crawling of the hairy scalp, with sensation as if the roots of the hairs were pulled upwards, causing a disposition to scratch all the time. Itching blotches, worse when scratched. (1.) Clinical Remarks.—In tinea capitis, Dr. Graves advises the local ap- plication of a solution of the Nitrate of Silver. He advises it to be strongly rubbed into each spot, for which purpose a small piece covered with fine linen and tied to the end of a slender stick, should be employed. When a large portion of the scalp is affected, it requires some perse- verance to apply the solution effectually. The hair should be cut 526 Argentum-Nitratum. short, not shaved; the scales should be removed by diligent ablution. The solution should be applied and repeated not oftener than once a week. The head should also be kept moistened with simple cerate. Three days after the first application of the caustic, the head may be washed with yellow soap and water twice a day, and the cerate re- placed after each dressing. In this, as in other cutaneous affections of long standing, it should always be a matter for consideration how far it is safe suddenly to check it. It is advised by Dr. Graves, to estab- lish a seton at some distant point, before venturing upon it. (44. 4G.) On the Hair and Nails.—Applied to these parts, the Nitrate stains them black, as in the case of the cuticle; and in consequence, it is one of the substances employed as a hair-dye. When recently applied, the black tint of the hair, and even of the cuticle, may be removed by washing with the Chloride of Sodium, and then with Ammonia-water, to dissolve the Chloride of Silver which is produced. (3. 46.) A solution of Cyanide of Potash also removes with facility Nitrate of Silver stains, whether upon the cuticle, the hair, or elsewhere. Stains upon the hands may be readily removed by moistening a hit of the Cyanide and rubbing it smartly over the discolorations. (10.) Eyes.—The conjunctiva of the eyes and lids is red as blood. The eyes filled with mucus in the morning on waking. Itching of the canthi. Burning and dryness of the eyes early in the morning when waking. Redness of the canthi, and the caruncula lachrymalis swol- len. Dampness of the eyes and slight agglutination of the lids in the morning. Ophthalmia with intense pains. Opacity of the cornea. Ophthalmia, alleviated by cold application and open air aggravated in a warm room. (1.) Rolling of the eyes, with dilatation of the pupils, and insensibility of them to light. Contracted pupils. Dimness of vision, with anxiousness, heat of the face, and lachrymation. Tran- sient, but perfect blindness, with vertigo. Clinical Remarks.—As a remedy in diseases of the eye, Nitrate of Silver may be advantageously employed either internally or locally. provided it corresponds homceopathically with the symptoms. In all cases depending upon a constitutional cause, internal medication is absolutely essential; while simple local disorders may be readily and permanently removed by topical applications. Scrofulous ophthalmia may be cited as an example of the former class. In this instance no one would think of relying upon collyria or other local applications to effect a cure, but internal medicines capable of reaching the deep- seated cause of the disturbance, would be carefully sought for. In order to cover the totality of the symptoms of such a case, an internal remedy must of necessity be prescribed. (10.) But when the eye-affection is local and unaccompanied by.any gene- ral vice or disturbance of the system, the homoeopath may with great propriety apply his remedy directly to the diseased part. By this means the natural morbid influence is overcome by the direct action of the drug, so that the parts again speedily resume their normal condi- Nitrate of Silver. 527 tion. Farther on it will be seen that Dr. Dudgeon has expressed similar views upon this point. (10.) With regard to the topical use of this substance, we are of opinion that it is usually employed much too strongly. In ophthalmias, it is quite common to use applications of from two to four grains to the ounce of water. Such applications may in many instances overcome the primary morbid inflammation, but it often leaves a drug-inflamma- tion quite as tedious and intractable behind. Considerable experience has taught us that very weak lotions, frequently applied to the affected parts, are quite sufficient to supercede the original disorder, and to place them in a favorable condition for speedy recoveries. We usually prescribe, therefore, from one-fourth to one-eighth of a grain of the Nitrate to the ounce of distilled water, and direct frequent applications to be made, until decided improvement occurs. Internally it has been found most useful in ophthalmic inflammations of a.sub-acute character. Among the characteristic indications for its use are, redness and swelling of the conjunctiva and the canthi, burn- ing and dryness of the eyes, or moderate lachrymation, intense pains in the eyes, mucous or muco-purulent secretion, impaired vision, flushed cheeks, the symptoms being relieved by cold applications and aggravated by remaining in a warm room. In these cases the medicine should not be prescribed stronger than the third attenuation. (10.) In some diseases of the eye, Nitrate of Silver is, in the dominant school, a most valuable remedial agent. It is used in the solid state, in solution, and in ointment; the solution is applied as a wash or in- jection, or by a camel's-hair pencil. In deep ulcers of the cornea, a cone of the solid Nitrate is often applied; in superficial ones, a solu- tion is generally employed. There is one drawback to the use of this substance in ulcers of the cornea, as well as other affections of the eye, viz., the danger of producing dark specks in the cornea, or of staining the conjunctiva, and this occurrence is not very rare in allo- pathic practice. I have seen several instances even in wealthy and beautiful females, although Velpeau says he has employed it in many hundred cases without ever observing such an effect, probably because they occurred in public practice, and did not fall under his observation again, months or years afterwards; the blackening is not produced immediately. (11.) In both acute and chronic ophthalmia, M. Guthrie employs this Salt in the form of ointment. In acute cases, he says two or three applications will arrest the disease. While many allopathic surgeons hesitate to use Nitrate of Silver in the first stage of acute purulent ophthalmia, all are agreed as to its value in the second stage of the disease, as well as in chronic ophthalmia. Besides the diseases of the eye already mentioned, there are many others in which the oculist is said to find this Salt of the greatest service as a caustic, astringent, or stimulant. (3. 46.) 528 Argentum-Nitratum. A moderately concentrated solution is regarded as an excellent ap- plication in ophthalmia, with ulcers of the cornea. (7. 46.) In purulent and gonorrheal ophthalmia, Mr. Guthrie recommends an ointment containing the Nitrate. He directs the Salt to be reduced to an impalpable powder, (an important point,) and great care should be taken that no metal utensil be used in its preparation. It may be applied either with a fine brush, or with the point of the little finger. It causes great pain for an hour or two, but when this subsides, much relief is often experienced. A strong solution is preferred by many general practilioners, a few drops applied twice or thrice daily; should this cause great pain, a small portion of Olive-oil dropped into the eye affords relief. Mr. Walker advises applying the Nitrate in substance freely to the conjunctiva for a few seconds once a day, insinuating the point beneath each lid. (!) It is said not to be admissible in that form of ophthalmia which supervenes on small-pox. Many surgeons are opposed, however, to this practice, as somewhaf too heroic. Mr. Wal- ton, among others, opposes it, considering that applications such as the above which cause pain, are productive of harm; that they greatly irritate the conjunctiva, and induce chronic inflammation. The eye should be well cleansed of purulent matter, previous to its application. (44. 46.) In the purulent ophthalmia of infants, Dr. Mackenzie states that he derived much benefit from a solution of the Nitrate, applied by means of a camel's-hair brush to the conjunctiva. (44. 46.) In scrofulous ophthalmia, a wash composed of Nitrate of Silver is stated to be efficacious, but Dr. Waring says that in his experience most benefit is derived from the treatment first proposed by Mr Worm- wold, and subsequently advocated by Drs. Hocken and Lanyon. The eye-lid is put on the stretch, so as to present a smooth surface, and after being slightly moistened, the caustic is to be passed once or twice lightly over it, so as to produce a slight blackness of the skin. A sin- gle application often suffices to remove altogether the lachrymation, the photophobia, &c. Iodine applied in the same manner is said to be equally efficacious. Another mode of treatment proposed, is to pencil the lining membrane of the nares with the Nitrate in substance, or with an ointment (one-tenth) of this substance. The insufflation of it is also advised. (44. 46.) In indolent ulcers of the cornea, which resist constitutional treat- ment, the local application of the Nitrate will in most cases establish a healthy action. (44. 46.) In opacity of the cornea, it will also be found serviceable. Mr. Bell and Dr. Hamilton have testified to the efficacy of this application. (44. 46.) Ophthalmia neonatorum. Several cases were successfully cured by Dr. Dudgeon, with Argent.-nitr. 6th, internally, and Argent.-nitr. gr.j. to Aq.-dist. |j. externally, dropped into the eyes twice a day. (26.) Inflammation of the eyes, with pressure and collections of mucus, obliging one to wipe them. Scarlet redness of the eye. Nightly ag- Nitrate of Silver. 529 ghitination. Blood-red canthi, with swelling of the lachrymal gland. Clusters of congested vessels coming from the canthi. Redness, puffiing and swelling of the conjunctiva. Pustules, ulcers and specks on cornea. (32.) Dr. Dudgeon, after quoting the effects of Nitrate of Silver upon the eye, observed by Dr. Muller, of Vienna, from small doses taken in- ternally, remarks: "The symptoms of Nitrate of Silver, which we owe to the industry of Dr. Muller, are the more valuable as they were not produced by the local action of Silver upon the eye, but by its ac- tion when taken internally in small doses, (from the 2d to the 30th di- lution ;) they afford a remarkable corroboration of the long-credited specific action of Silver upon the eye, and he believes it proves the em- ployment of eye-washes containiug lunar caustic to be efficacious in virtue of their homoeopathic action. They teach us, moreover, that in Nitrate of Silver we possess a remedy of remarkable powers in some very important and dangerous inflammations of the eye; a remedy, which to judge a priori, is second to none in affections of the mucous membrane of the eye, especially in those of a. hemorrhagic charac- ter; a posteriori we have ample proofs of its efficacy from the records and experience of the old school. It may be objected that the Allo- pathic cures were effected by the local applications of solutions of lu- nar caustic to the eye, and that they were owing to the general stimu- lant, astringent, or corrosive properties of the drug, and that the quan- tity used was such as to be quite opposed to the notion of a Homoeo- pathic specific action. To this, Dudgeon says, he may reply, that the stimulant or astringent properties of a solution of lunar caustic dropped into the eye, are insignificant as compared with those of many other substances that have little effect in inflammatory diseases of the eye; one obvious reason of this being, that the instant the solution comes in contact with the secretions of the eye, it is decomposed, and an inert Chloride of Silver is formed, which is speedily washed away by the gush of tears which ensues; thus the action of the caustic is but mo- mentary, and the quantity often infinitesimal." Dudgeon also says, " that he must be allowed to say a few words respecting the use and utility of local applications in eye-diseases." Many eye-diseases are of a strictly local character, attended by no constitutional symptoms what- ever; whilst others again are eminently dependent on the constitu- tion of the patient. It is obvious then, that though it would be vain to attempt the cure of constitutional eye-diseases by local remedies, there is no absurdity in treating a purely local disease by local means. For his own part, his experience of the local employment of Nitrate of Silver, especially in opth.-neonatorum, and the severer kinds of ca- tarrhal ophthalmia, has been so striking, that he would be very sorry to dispense with this remedial means in these and other diseases. The solution which he has been in the habit of employing, contained from two to four grains of the Nitrate to an ounce of distilled water, and should be carefully introduced beneath the eyelids with a camel's 34 550 w Argentum-Nitratum. hair pencil, once every two, three or four days, according to the seve- rity of the symptoms. Peters' Diseases of Eyes, p. 58. (11.) This remedy has been used very successfully in simple, acute and chronic ophthalmia, catarrhal ophthalmia, purulent ophthalmia, scrofu- lous ophthalmia, thickening of the palpebral conjunctiva, deep ulcers of the cornea, tumors of the eye, and staphyloma. (82.) When used for staphyloma, tumors of the eye, or ulcers of the cor- nea, it may be applied by using the solid stick pointed in the form of a cone. In other cases it should be applied in the form of a solution, either by using a camel's-hair brush, or by dropping it into the inner canthus of the eye, by means of a glass rod, when the eye is closed and the head turned back. When the eye is opened, the solution is then at once diffused over the whole conjunctiva. The latter method is to be preferred in cases where we wish to make the application to the whole conjunctival surface, and are using a very weak solution, as of one or two grains to the ounce of distilled water. (27.) Nose.—Discharge of a whitish purulent fluid, intermixed with lumps of blood. Excretion of a large quantity of bloody serum from the left nostril, with great danger of suffocation (in animals). Disagree- able obstruction in the superior portion of the nose. Itching in the nose. Violent itching in the nose, obliging him to rub it constant- ly until it looked raw. Dullness of the sense of smell. Much sneez- ing. Coryza, with constant chilliness, sickly look, lachrymation, sneezing, and such a violent stupefying headache that she had to lie down. Ulcers in the nose, becoming covered with yellow crusts. (1). Clinical Remarks.—In several cases of chronic catarrh, with ulcera- tion of the Schneiderian membrane, offensive muco-purulent and bloody discharges, loss of smell, frequent catarrhal headaches, and occasional formation of crusts in the nostrils, we have derived much benefit from the internal use of the third dilution of the Nitrate, and occasional topical applications, by means of a suitable syringe, of mo- derately strong solutions of the drug. By the same means we have cured a few cases of herpetic eruptions extending into the nostrils. But in these instances a long course of antipsorics is usually requir- ed. (10.) In coryza M. Tessier speaks highly of the efficacy of pencilling the interior of the nares with a solution of the Nitrate. (44. 46.) Eai'S.—Ringing in the ears and deafness. Whizzing, and feeling of obstruction and hardness of hearing in the left ear. Painful stoppage of the ears with headache. Clinical Remarks.—Wood and Bache recommend its external exhi- bition in foetid discharges from the ear. (7.46.) In deafness depending upon a thickened state of the membrana tympani, Mr. Toynbee states that a great improvement, if not a total cure, will follow the use of a solution of the Nitrate. Proceeding from the exterior of the orifice of the meatus, the passage may be touched to an extent varying from one-half to two-thirds of its length Nitrate of Silver. 531 every three or four days. In some cases the membrana tympani may also be washed with a solution. (44. 46.) In obstinate otorrhoea, Mr. Wilde advises the application of the Ni- trate lightly, to the external auditory passage. (44.46.) Face.—Convulsion of the facial muscles, with spasmodic closure of the jaws. Paleness of the face. Convulsions of the upper lip (in animals). Mouth, Lips, Teeth and Jaws.—The teeth become affected and de- cayed. Constant pain in the teeth, especially when chewing, when eating sour things, and when introducing cold substances into the mouth. Dull pain in the left side of the lower jaw. (1.) Black teeth. Spongy, easily bleeding, butneither painful, nor swollen gums. Blue ness of the tongue. (3.) Dry tongue. Ptyalism. Ulcerated crusts on the mucous membrane of the mouth. (1.) Clinical Remarks.—In inflammatory affections and ulcerations of the mucous membrane of the mouth and fauces, Nitrate of Silver is sometimes a most valuable application. When the fibrinous exuda- tion of croup commences on the surface of the tonsils and arches of the palate, its further progress may be stopped, according to Mr. Mack- enzie, by the application of a solution of Nitrate of Silver. The solid Nitrate has been introduced through an aperture in the trachea, and applied to ulcers on the inner surface of the larynx, in a case of phthi- sis laryngea, with apparent benefit. (3. 46.) Wood and Bache recommend it as a healing wash, (a solution of half a grain to the ounce of distilled water) for the mouth, in the case of ulcers produced by Mercury. In the inflammation of the mouth from mercurial salivation, M. Bouchacourt found a concentrated so- lution of the salt, applied to the gums, base of the tongue, &c, with a camel's-hair brush, very useful; also in aphthous affections of the mouth, and spongy gums. (7. 46,) Dr. Symonds speaks of it as highly efficacious in aphthous ulcera- tions of the mouth, when applied in substance to the ulcers. (44. 46.) In ptyalism he also states that in his experience, the best local ap- plication is the Nitrate of Silver, either in substance or in a strong so- lution, applied by means of a camel's-hair pencil to the gums. (44.46.) FailCPS.—Heat in the pharynx. Sensation as if the veil of the palate were swollen, when moving the tongue, and on swallowing. Dark redness of the uvula and fauces. Pain in the right side of the throat, as from an ulcery sensation or as if a splinter were lodged in the throat, when swallowing, eructating, breathing, stretching and moving the neck. Sometimes an undulating jerking and pulsating was felt in the throat, continuing for several days. Paroxysm of cramp in the oesophagus. Spasmodic contraction of the oesophagus, with great distention of the stomach, feelings of strangulation, faintness, nausea, ptyalism, ineffectual efforts to eructate; but relieved in half an hour by frequent and violent belching of wind. (22.) Clinical Remarks.—In hooping-cough, after the acute stage is passed, 532 Argentum-Nitratum. the Nitrate is strongly recommended by Trousseau. It is also spoken of in high terms by Berger. Dr. E. Watson relates several cases cured by the application of a solution of the Nitrate to the glottis in the manner advised in croup. (44. 46.) In croup a strong solution of the Nitrate of Silver was first employ- ed by Prof. Mackenzie of Glasgow; more recently it has been suc- cessfully employed by Dr. Horace Green, Kesteven, Blakeman, and Bryan. The last physician employed a stronger solution than the others. A small piece of sponge attached to a piece of whalebone, is to be dipped into the solution and the tongue being depressed by the handle of a spoon, it is to be applied freely for a few seconds to the larynx. Great immediate relief and subsequent cure are said to have followed its application in several cases. The employment of the solid Nitrate instead of the solution, not only in croup, but in all laryn- geal, and pharyngeal inflammations is recommended by-Dr. Peronneau of Paris. Dr. Hatin also employed it in many cases, and in the ma- jority with decided advantage. An assistant is directed to place the child on his knees; with one hand he fixes the hands; with the other he holds the head firmly. The operator places himself in front, hold- ing in the left hand an instrument to keep the mouth open and depress the tongue. In the right hand he holds a porte-pierre, bent like a sound, containing a piece of the caustic projecting some lines. The tongue being depressed, the tube containing the Nitrate, is passed into the posterior fauces, and rapidly passed over all points for a second or two. The operation is to be repeated twice; the second almost im- mediately after the first. It is said to afford almost immediate relief. Moist warm air diffused through the chamber, and the application of hot water externally to the throat, greatly aid the above measures, and should never be omitted. (44. 46.) In diphtheritis the local application of a solution of the Nitrate as above, is strongly advised by Dr. West, Mr. Brown and others. (44.46.) In cynanche-maligna, Prof. Mackenzie spoke highly of the efficacy of applying a solution of Argent.-nit. to the mucous membrane of the throat. It may be applied with a camel's-hair brush, once or twice a day, according to the severity of the symptoms. (44.) In hypertrophy of the tonsils, the application of the solid Nitrate is advised by Mr. Cusack. It is to be applied to successive portions of the surface, so as to produce a succession of small eschars. By this means a cure is effected in about six months. (44. 46.) In scarlatina Dr. Brown advises the application of a solution of the Nitrate to the fauces, whether ulceration be] present or not. It is to be used once or twice daily. He states that previous to adopting this treatment, he lost half his cases, but subsequently during the same epidemic he lost only one in fifty. (44. 46.). Appetite.—Persistent, nauseous metallic taste. Excessive thirst (in animals). Loss ef appetite. Disgust. (32.) Stomach.—Nausea and vomiting ; black vomit. Haemorrhage from the stomach. Transient warmth in the stomach ; burning heat in the Nitrate of Silver. 533 stomach, and in the chest. Transient gastric pains. Heaviness and aching in the stomach. Violent cardialgia. Violent gastritis, soon passing over into gangrene. (32.) If introduced directly into the stomach, of course it evinces an irritant action, thus, although some English physicians say that they have given it in four or five-grain doses without injury, yet a single grain has often caused gastrodynia, spasms of the stomach, diarrhoea or constipation, nausea and vomiting. Even if it do not exert a spe- cific action upon the stomach, yet it has often been used success- fully against gastric affections. Thus Johnson says it cures eructa- tions of an acid burning fluid and of gas from the stomach, which often commence during meals and continue for hours after, although it is a little singular that the Nitric-acid in the lunar caustic should not aggravate acidity of the stomach. The same writer says in al- most every case it relieves irritation, flatulence, cutaneous chilliness and discomfort promptly, and even the melancholy, which often attends dyspeptic affections ; yet we are told that if used long, even in small doses, it will cause various disturbances of the digestion, and Faber has seen extreme dejection and sadness ensue from a short use of it. Other authors vadvise it against spasmodic tightness of the chest, spasms of the stomach, and such chronic stomach-affections as depend upon a morbid sensibility of this organ, also in pyrosis and gastralgia, viz., Autenreith, James Johnson, Rueff, &c. It has also been em- ployed to allay chronic vomiting from disordered innervation, or from organic disease of the stomach, and to relieve gastrodynia. Vogt says, we generally have no. bad effects from its internal use unless it attacks the stomach. Lementini says, a. pustular eruption frequently appears upon those who are taking this remedy, and when this occurs we may be assured of the beneficial influence of the medicine ; yet Autenreith advises it in spasms of the stomach, with burning pain, frequent regurgitation of water, constant vomiting, &c, arising from the suppression of itch, or other metastasis, or from simple acidity of the stomach ; and Vogt tells us that the usual dose is one-eighth to one-fourth of a grain gradually increased until nausea, aching and other affections of the stomach and digestion ensue. In all these dis- orders it is most homoeopathic when there is also palpitation or irre- gular action of the heart. (11.) A prominent effect of Silver is the production of colic ; Dierbach even places it in company with Lead, in a class of metals which cause obstinate colics, when taken in a finely-divided state, or when fumes from them are inhaled ; he says, it agrees with Lead, in causing a peculiar and obstinate colic, as has been repeatedly observed in per- sons who count large sums of silver-money daily; yet it is generally regarded as an antispasmodic remedy in old-school parlance. By others it is regarded as a powerful tonic and astringent remedy, and tonicity and constriction approach more nearly to spasm than to anti- spasm ; however this may be,'it has been used successfully against spasms of the stomach, in tremor cordis and stenocardia, while Vogt says, it is specific against colica uterina. (11.) 534 A rgentum -Nitratum. To the violent action excited by Nitrate of Silver, when directly admitted into the blood, its effects, through the medium of the stomach bear no proportion or resemblance. Thus, when twelve grains of the salt were introduced into the stomach in the solid state, its ef- fects were so slight as not to be distinguishable from those of the liga- ture on the gullet, placed there to prevent its discharge by vomiting. When introduced in a state of solution, however, and in a larger dose, (in the dose of thirty-six grains for example) it is more energetic. Death ensued in thirty-six hours, but without any particular symptoms; and in the dead body the villous coat of the stomach was found gene- rally softened, and corroded near the pylorus by little greyish eschars like those formed by this poison on the skin. Hence it appears that Nitrate of Silver does not always act remotely, but often simply as a local irritant and corrosive. The corrosion it produces is incompati- ble with its absorption in large quantity. (9. 46.) The safety with which large doses of the Nitrate in many cases are administered internally, must depend on the presence of an excess of mucus which normally lines the internal coat of the stomach and of chlorides and free hydro-chloric acid contained in this viscus. These form with the Nitrate new compounds, (albuminates and chlorides) less energetic in their local action than the Nitrate. It is deserving of especial notice that larger doses may be administered without in- conveniencing the stomach in the form of pill, than in solution—in consequence, probably of the latter acting upon a larger surface. Dr. Powell has given fifteen grains in the form of pill, while he rarely found a stomach which would bear over five grains in the shape of a solution. It is said that by beginning with small doses and cautious- ly increasing them, it may be continued for a considerable period without inducing any change in the corporeal functions, though all the while it may be exercising a beneficial influence over disease, evinced by its amelioration of certain affections, such as epilepsy. It is said to have caused an eruption. If the dose be too large it occasions gastrodynia, sometimes nausea and vomiting and occasionally purging. Taken in an excessive dose, it acts as a corrosive poison, but instances of this kind are rarely met with. Boerhaave mentions an instance in which it caused excruciating pain, gangrene and sphacelus of the first passages. (3. 46.) All the above effects are referrible to its local action, and from them we have no evidence of its absorption, or of the nature of its in- fluence over the system generally. But the discoloration treated of under the head of " Dermoid tissue," fully proves that absorption does lake place when administered in small but long-continued doses. It exercises a specific influence over the nervous system; at least this is to be inferred from the effects observed by Orfila when it was injected into the veins of animals, and partly from its occasional curative powers in affections of this system, such as epilepsy and chorea. (46.) Clinical Remarks.—In chronic affections of the stomach, especial- Nitrate of Silver. 535 ly morbid sensibility of the gastric and intestinal nerves, it has been favorably spoken of by Autenreith and Dr. James Johnson. It has also been employed to allay chronic vomiting, connected with dis- ordered innervation, as well as with disease of the stomach (scirrhus and cancer), and to relieve gastrodynia. (3. 46.) For its influence on the stomach and bowels, it might be em- ployed in minute doses as a stimulant, or tonic, in debilitated states of their functions ; but other remedies answer the indication so much more conveniently and effectively, that it is very seldom used for this special purpose. Still as it has been supposed to exercise a peculiar influence over the nervous tissue, it has been recommended in certain painful affections sometimes dependent on dyspepsia, as gastrodynia and pyrosis, and it has been found useful in morbid sensitiveness of the stomach. (7. 46.) It has been empirically re- commended on account of its alterative or homoeopathic action upon the mucous membrane in a state of chronic inflammation, or ulcera- tion ; and has been strenuously recommended even in active irritation or acute inflammation of the same tissue. (46.) Dr. Wood knows of no remedy, in chronic gastritis, so effectual as Ni- trate of Silver. He has used it habitually since the first recommenda- tion of it, and with the happiest effects in the most obstinate cases. He is not in the habit of using it in mild cases, but in those severe and ob- stinate forms of the affection, which have set all ordinary means at defiance. The cases in which it appears to be most beneficial were those at- tended with incessant vomiting of food, and often with a smooth, dryish tongue, apparently destitute of papillae. He used it too whenever he had occasion to suspect the existence of ulcers of the stomach. One case of yeasty vomiting, of a most obstinate character, and probably dependent on an ulcer near the pylorus, yielded in the course of two or three months to this remedy. (7. 46.) Case.—One most striking instance in which it was probably the means of saving life, is mentioned by Dr. Wood. It was that of a female patient in the Pennsylvania Hospital, who had been reduced to the last degree of emaciation and debility, and whose death was looked for hour by hour. The stomach had long refused to retain food, and the slightest nutriment induced vomiting. I directed that nothing whatever should be taken into the stomach except a little cold water, and pills of Nitrate of Silver with Opium, repeated three or four times a day : life being sustained by the injection of rich soups with Laudanum into the bowels. The vomiting ceased under the treatment; in a few days a disposition for food returned, which was cautiously indulged, and the patient went on gradually improving until her health was perfectly restored. Dr. Wood thinks that the oxide or chloride will not at all answer in these cases, and that the re- medy should be given upon an empty stomach. (7. 46.) The value of the Nitrate of Silver in dyspepsia was first establish- ed by the late Dr. James Johnson, who relates many cases attended 536 Argentum-Nitratum. with morbid sensibility and hypochondriasis, which yielded to its use. He considered that its probable action consisted in lessening the sus- ceptibility of the nerves, and thereby rendering them insusceptible of irritation. In some cases he thinks it may be advantageously alter- nated with Quinine. Dr. Copland also bears witness to its efficacy. (46.) In gastralgia, particularly when attended by sour vomiting or py- rosis, the Nitrate has been successfully employed by J. Johnson, Os- borne, Boudin, Hudson, Brigger, Steinitz, and Mr. Langston Parker. From the experience of these writers, it would seem as if there are few, if any remedies which exercise a more powerful and beneficial influence. Dr. Symonds, in bearing testimony to its efficacy, states that he has found it chiefly useful in those cases which present a com- bination of nervous irritability with chronic or passive congestion of the stomach. (44. 46.) According to Hartmann, Argent.-nitr. is homoeopathic in cramps of the stomach, especially in females with too frequent and profuse men- struation ; great nervousness, and pain so severe as to oblige one to double over, accompanied by violent vomiting of acrid, sour, bitter- tasting fluid of a yellowish-green color. (4.26.) Case 1st.— Gastritis in a single woman, aged forty-one years, periodically subject to this affection ; I observed the following condi- tions : vomiting of every thing, even the smallest amount of liquid she took, violent pain in gastric region, tender to the touch; cramps ex- tending to the sternum, with tormenting headache, and consider- able thirst; had taken no food for several days ; gave Ars., Cupr.,Nux, Stibium, and Ipec. with only partial benefit during a period of four days, when I resorted to Argent.-nitr. 1st, a powder to be taken once in three hours, which was followed by the most gratifying results, for after twenty-four hours she was so much better, that further medica- tion was unnecessary. (4. 26.) Case 2d.— Cramp of the stomach in a man, aged seventy-one years, subject to this condition, with the following symptoms : chills, follow- ed by cutting, crampy, pinching pain extending over the whole of the epigastric region, obliging him to double up at times; towards morning frequent vomiting, thirst, tenderness on touch, also pain over sternal and iliac regions, perspiration over the whole body, rumbling in the abdomen, with incarcerated flatus. Dr. Widemann prescribed Ar- gent.-nitr. gr. 1. to oz. 4. of water with Sacc. Liq., a table-spoonful to be taken every three hours, and gradually at longer intervals; it effected a cure in eight days. (4. 26.) Case 3d.—Dr. Lane reports a case in a woman, aged twenty-six, who had been sick five years, having become very much emaciated and weak, complaining of a constant drawing-gnawing sensation in the gastric region, with severe paroxysms of pain, ending in vomiting of a quantity of clear, saltish-tasting fluid; followed by an aversion to all food, or a feeling of weight and fullness ; bowels regular ; pulse small and weak; expression anxious. Argent.-nitr. for ten days, gradually increased to gr. iv. daily, effected a cure. (4. 26.) Nitrate of Silver. 537 In ulceration of the stomach the Nitrate of Silver is regarded in the dominant school as a valuable medicine, inducing a healthy action of the mucous membrane, and apparently favoring the process of cicatrization. (46.) It is clear from the above testimony that the dominant school have hit empirically and unwittingly upon the right homoeopathic use of this remedy in many diseases of the stomach. It is evidently homoeopathic to irritation, inflammation and especially ulceration of the stomach, and homoeopathic physicians use it much too little in these disorders. Frank's experiments also prove that it is homoeo- pathic to acidity, pyrosis, vomiting and hypochondriasis, especially when attended with palpitation and irregular action of the heart. (11.) Dr. A.Houghton has employed the second and third dilutions of this medicine, with satisfactory results, in gastralgia, and other morbid derangements of the stomach, accompanied by much distention of the stomach, pyrosis, acidity and nausea. Dr. Houghton informs us that his success in these cases has been better with these dilutions, than with larger doses, as he formerly prescribed it, when an allopathist. In old and obstinate cases of dyspepsia, this gentleman commends this remedy most highly. (10.) Nitrate of Silver deserves attention in perforating ulcer of the stomach. The symptoms of this disease are sometimes obscure, but in a great majority of cases they are distressing, and according to Budd, when the disease has lasted some months, they are generally significant enough. (11.) The most constant symptom is pain in the stomach, which is generally referred to a small spot, and is more severe after meals, when the stomach is distended, and when its vermicular movements are going on. The pain usually abates as the stomach gets empty, to be renewed again by the next meal. Now and then, however, pain is also felt when the stomach is empty. Together with the pain, there is some degree of tenderness, or soreness at the epigastrium; but this is often slight, and like the pain, is generally referred to a small spot. Besides the pain at the epigastrium, pain is very com- monly felt in a small space in the corresponding part of the back. There is also occasional eructation of sour fluid, and now and then, perhaps only once or twice in a month, the patient vomits his food..(ll.) Unless the ulcer be large, there is complete absence of fever and of thirst, the appetite is commonly but little impaired, and the patient does not fall away perceptibly in flesh, or in strength. The pain at the stomach after meals, the sour eructations and the occasional vomiting are often the only symptoms of the disease for months ; the patient heeding them but little, and following his ordinary course of life. It is of great importance to watch the vomits closely, for where ul- ceration is really the cause, streaks of blood will seldom fail to be found some time or another, and in many cases more considerable ejection of blood occurs. These streaks of blood are of the highest value in a diagnostic point of view, because they are extremely rare 538 Argentum-Nitratum. in other diseases which may be mistaken for simple ulcer. The he- morrhage may increase to haematamesis ; or the blood may be trans- mitted downwards with the food, and then may appear in the stools. I have cured cases with Arsenic and Opium, but lunar caustic de- serves attention. (11.) Andral's experiments on dogs proves that starvation will produce evident signs of inflammation of the stomach, such as bright redness, softening and numerous ulcerations of the mucous membrane. A strict bread and water-diet will cause a loss of appetite, the stomach becomes weak, there is uneasiness across the stomach, spleen and liver; and the latter is torpid. The bowels are confined, or they are relaxed, with slimy discharges, unaccompanied with pain ; yet the swollen red tongue indicates the existence of irritation of the mucous membrane of the digestive canal; the pulse is quick and feeble ; and the clam- my skin, vertigo, debility, headache and sleeplessness show how much the constitution suffers from diminished nervous power and excessive destruction of the tissues. In these cases, and those similar ones so frequently met with in delicate females, with perverted and deficient appetites, in whom the very thought of food excites loathing, specific remedies alone will not' avail; a methodical course of feeding and even of stimulation must be resorted to. (11.) Bowels and Stool.—Constipation. Transient or continued diarrhoea. Evacuations dry and consistent, while they were usually loose. Re- peated itching at the anus, inducing him to rub until he became sore. Awakened in the night by a colic, followed by sixteen greenish, foetid and mucous discharges, and emissions of flatulence. Bloody stools, with great debility. Sharp, darting stitches through the abdomen, , especially during a sudden transition from rest to motion—on the left side. Colic pains around the umbilicus for several days. (32.) Clinical Remarks.—Dr. Boudin of Marseilles has employed it in typhoid fever, as a remedy for the inflammation and ulceration of the ileum which constitute the most constant lesion in that disease. When the gastric symptoms predominate, he gives the Nitrate in pill, in doses varying from the fourth to the half of a grain. When diar- rhoea is the principal symptom, he administers, night and morning by injection, a solution of the salt, containing three or four grains to six fluid ounces of water. The injections appear to be useful in promot- ing the cicatrization of the intestinal ulcers, and were found to ex- tend their operation as high up as the small intestines. (7. 46.) In chronic diarrhoea, especially in that kind attendant on phthisis, Dr. McGregor of Dublin, has found the Nitrate of -Silver, alternated with Opium a valuable remedy. Whatever may be its remedial value when internally administered, its occasional effect of staining the skin, should render the practitioner cautious in its exhibition. This effect proves the absorption of the medicine, and it is alleged that it shows itself, (like other forms of mineral impregnation) first upon the tongue and fauces. According to Dr. Branson, an indication of Nitrate of Silver. 539 the approach of discoloration is furnished by the occurrence of a dark- blue line on the edges of the gums, very similar to that produced by Lead ; but somewhat darker. This discoloration of the skin is said to be removed by a steady course of Cream of Tartar. (7.46). Graves of Dublin also regards it as one of the best remedies which can be administered in the diarrhoea of phthisis. (44. 46.) Ulcera inteslinorum. Breithaupt reports a case of a patient affected with ulcers of the intestines subsequent to an attack of typhus and dysentery, where all hopes of recovery had nearly been given up,— he received Argent.-nitr., one-twelfth to one-sixth of a grain, four times daily—a favorable change became very soon perceptible, the bloody discharges became less frequent, and the cure effected very speedily. (4. 26.) In ulceration and hemorrhage of the bowels, dilute Nitric-acid, by the mouth and by enema, is a much more manageable, and perhaps useful remedy, than Nitrate of Silver. (11.) In chronic enteritis great benefit, is said to have accrued from the Nitrate of Silver, though Dr. Wood thinks that it is less efficacious than in gastritis. It probably seldom enters the small intestines, or at least penetrates far into them without being decomposed. In ulcer- ative affections and chronic inflammation of the small intestines, it has appeared to him less effective than Sulphate of Copper. (7. 46.) Trousseau urges its use in infantile diarrhoea. In cases attended with tormina, and glairy or bloody stools, he gives morning and evening an enema consisting of eight ounces of distilled water to one or two grains of the Nitrate, according to the age. (38. 46.) Argent.-nitricum, gr. j. to Aq. oz. j. is recommended by Kurtz in diarrhoea with greenish, watery discharges, slight pinching pain in the bowels, accompanied with sour taste in the mouth ; also a solu- tion of gr. j. to ij. Aq. oz. j. in doses from twenty to sixty drops. Aphthae and diarrhoea aphthosa. Dr Hauner has seen excellent re- sults from Argent.-nitr , externally and internally administered, in diar- rhoea of children connected with aphthae. (26.) In obstinate diarrhoea of children, when the Acetate of Lead and other allopathic astringents have failed in arresting the discharge, the Nitrate of Silver often proves effectual. Dr. Willshire observes on this point, "I know nothing like Argenti-nitras for stopping the diar- rhoea, even if it does no more than this—but I think that it does far more. It appears to me to alter the general assimilative functions." (44. 46.) In acute dysentery Trousseau was among the first strongly to re- commend it, both in the form of pill and enema. In dysentery, acute and chronic, the Nitrate of Silver has recently been extensively em- ployed, and has attained a high character as a remedy in these affec- tions. The following is a brief sketch of the mode of treatment advo- cated by Dr. Hare of the Bengal Med. service ; and which in other hands has also been found highly successful in the acute stage. (It may not be amiss for us to copy it entire, as a valuable hint in this 540 Argentum-Nitratum. obstinate affection. (46.) He commences his treatment with the use of large enemas thrown into the colon, in the manner first introduced by Dr. 0. Beirne. The patient is placed on the left side, and the flexi- ble tube of a stomach-pump is cautiously introduced, per rectum, about six or seven inches, or at any rate until it reaches above the sigmoid flexure of the colon ; three, four or even six pints of warm water or milk and water, are then injected, and this on returning per rectum, will, in many instances, be accompanied by large masses of hardened faecal matter. If much does not come away, he advises its repetition twice or thrice. It requires to be employed daily. Should the re- tained faecal matter have given rise solely to irritation, or inflamma- tion, these will yield to the appropriate remedies, but should they have been retained such a length of time that ulceration has taken place, then Dr. Hare advises the employment of enemas composed of fifteen grains of the Nitrate to two pints and a half of distilled wa- ter, in the same manner as the preceding ones. Dr. Hare observes that it has often been found that when small injections of the Nitrate with an ordinary glyster-pipe, have been employed in dysentery, and the patient has died, the ulcers which had been reached by the Ni- trate were perfectly healed, whilst those beyond the reach of the ap- plication, had gangrened and death had ensued. From this Dr. Hare rationally concludes that if the ulcers of the rectum healed under the application of the Nitrate to their surface, those beyond, which cannot be reached by the ordinary injection apparatus, would also heal if sub- jected to the same application. He consequently employs the long flexible tube, and by this means applies the Nitrate in solution to the whole surface of the transverse colon, the chief seat of dysenteric ul- cerations. Dr. Hare who has extensively followed this mode of treat- ment, as well as many other medical officers in India, bear witness to the great success which has followed its adoption. In conclusion it should be remembered that it is not always easy or even practicable to introduce the tube as recommended above. The natural sharp fold at the junction of the rectum and colon may cause obstruction, and Mr. Earle has shown that the bowel not unfrequently makes a horizontal curve to the right before descending into the pelvis. Great caution is therefore necessary in the introduction of the lube, other- wise the intestine maybe perforated, or other serious mischief ensue. It may also be fairly questioned whether so large a quantity of the Nitrate as fifteen grains, may be applied to an extensive mucous sur- face, without absorption, thus causing serious constitutional disturb- ance. (44. 46.) In chronic dysentery, the above treatment, with some modifications, is equally applicable. Dr. McGregor, who has had extensive expe- rience in this disease as it occurs in India, recommends the Argentum Nitratum. He also gives it internally, and adds that the effect is often wonderful; but its action must be watched, particularly on the stomach; though its action on this organ is less marked than that of Sulphate of Copper, or Acetate of Lead, while its action on the ulcers is much Nitrate of Silver. 541 more beneficial. The Nitrate as a remedy for dysentery was employed in the form of enema by Dr. Osborne, of Dublin, in 1831, and Dr. Hudson states that it has been in common use in Dublin since that date. He adds that in his own practice, as well as in that of others, the best effects have followed its use. In conclusion, Dr. Waring adds his testimony to that of all the others, when given internally. He has employed it extensively in the later stages of acute and in chronic dysentery, in doses never exceeding a grain and a half daily, and in almost every instance its administration has been followed by speedy and permanent improvement. Its effects are often very remarkable. He has never seen any ill effects follow its use, though given to a child two years old. (44.46.) In cholera, Mr. Garlike states that he has successfully employed the Nitrate of Silver. The mode of application which he advises, is to inject into the colon by means of a long flexible tube, a solution of the Nitrate. Ten minutes afterwards, he administers another enema of gruel, containing Opium. In the first case in which he employed this treatment, the patient was in a state of collapse, apparently sink- ing fast. After the introduction of the Nitrate, the purging ceased, but the vomiting continued; after forty-eight hours, the bowels acted naturally. A complete cure followed. Several others were treated in precisely the same way, with equally happy results. (44. 46.) The above clinical extracts are from standard allopathic works, and comprise the experience of the old school with regard to this drug in bowel affections. The homoeopathic physician who is familiar with the recourses of his own school in this class of maladies, will have no occasion to resort to these violent and doubtful measures. He has remedies far more efficient and harmless for almost every conceivable ailment of the organs under consideration, and he will prefer to employ these thoroughly, before resorting to a caustic. We quite disagree with Trousseau, when he asserts "that we cannot repeat sufficiently often the harmlessness of this remedy, and how little founded are the fears of those physicians who dare not administer it internally." We do not hesitate to enrol ourselves among "those physicians who dare not administer it internally," according to the method of the standard writers of the other school. (10.) In Asiatic cholera, in some instances as much as grs. x. to Aq. oz. j., at one dose, have been administered through a glass tube, in cases with profuse and violent discharges per rectum, even though there may be a considerably high degree of cyanotic condition; but it is contra-indi- cated in the developed state of asphyxia, after collapse or paralysis. (26*) Argent.-Nitratum appears to exercise its controlling influence not only on the discharges in cases of cholera, but it ought not to be over- looked in the premonitory stage ; neither when the discharges per rec- tum continue after the absolute cholera symptoms have subsided, espe- cially when accompanied by cardialgia, or pain in hypochondriac- and prsecordial-regions; again it is known that Argent.-Nitr. is strongly 542 Argentum-Nitratum. indicated in all "catarrhal" irritations of the gastro-intestinal mucous membrane. (26.) Fr. Hartmann reports a case of tenia sol. in a lady with profuse ir- regular menstruation, passing during such periods much thick, coagu- lated blood. Present symptoms: Severe paroxysmal pain in gastric, hepatic, and abdominal-regions, with nausea, retching and vomiting of tough slime, with icterous color of the face. Argent.-Nitr. 2d, a pow- der three times a day for a week, during which patient discharged masses of fragments of tape-worm, after which patient gradually re- covered. The menstrual difficulty led to the administration of the above remedy. (26.) On the Kidneys.—Silver has been found in the urine of persons who have been taking the medicine internally. A young man who had used the Nitrate for some time, observed that his urine became muddy soon after being passed, and that the sediment became black if exposed to the light; and when the sediment was digested in Ammonia, Chlo- ride of Silver was detached by neutralizing the Ammoniacal liquor. (9. 46.) Urinary Organs and Urine.—Emission of a few drops of urine after he had done urinating, accompanied with a sensation as if the interior of the urethra was swollen. Burning sensation in the urethra during micturition. Heat, itching, and tittilation of the urethra in the morn- ing during urination. (32.) Increase of gonorrhceal symptoms while taking the medicine. (10.) Violent irritation of the urinary organs. Increased secretion of urine. Involuntary urination, (in animals.) Frequent and copious emission of a pale urine. Scanty and rare emission of a dark-yellow urine. Inability to pass urine in a project- ing stream. (32.) Under the influence of Nitrate of Silver taken internally, Frank found the quantity of urine/to diminish considerably; the solid consti- tuents of the urine did not lessen in a marked degree, but there was a not inconsiderable diminution of urea; it lessened one and five-tenths grammes, or about twenty-two grains daily. The uric-acid disappears almost entirely under the continued use of Nitrate of Silver. Hence it is supposed that the Nitrate enters into combination with the nitro- genized constituents of the blood and organism generally, and prevents their metamorphosis and excretion. (4. 11.) On the other hand, the quantity of inorganic salts in the urine is in- creased considerably, and this increase is much too great to be accounted for by the mere excretion through the kidneys of- the few grains of Silver which are taken; whence it is supposed that in entering into combination with the protein-containing substances such as saliva, ca- sein, gastric juice, blood-serum and fibrin, it precipitates the inorganic salts which are contained in them, and these precipitated salts are finally excreted through the kidneys. (4. 11.) Clinical Remarks.—It is evident from the above, that Nitrate of Silver is homoeopathic to scanty secretion of urine; to deficiency or Nitrate of Silver. 543 entire extinction of urea in the urine; to deficiency of the inorganic Salts and Chlorides. (11.) It may prove homoeopathic to Bright's disease when there is a great deficiency of urea and uric-acid in the urine. (11.) It is antipathic to ureous diuresis, or the azoturia of Willis, which is characterized by an excess of urea; the attention of the profession was first called to this disorder by Drs. Bostock and Prout. The urine is generally pale and transparent, but sometimes brownish, is acid when first discharged, and somewhat heavier than in health, the specific gravity averaging 1.020, but at times rising to 1.035; it soon decomposes and becomes alkaline; Nitric-acid added to it usually oc- casions after a short time, crystallization with the urea, thus indicating an excess of urea; it is said that the daily discharge of urea has equalled nine and a half ounces, while in the healthy state it is only from one-half to one ounce. The symptoms are: much thirst, some- times increased appetite, a sense of weight or dull pain in the back, a. sinking, gnawing or other uneasiness at the pit of the stomach, and more or less debility and emaciation, with an anxious expression of countenance; but the skin is not as dry and parched, nor the thirst as insatiable as in saccharine diabetes. It is apt to attack persons of spare habit and nervous temperament, and generally occurs in those of middle age, and in men more frequently than women; still children are not exempt from it, and sometimes perish under it without the cause being known. From the sallowness of the complexion which often attends it, it is frequently mistaken for bilious derangement. (11.) It is more or less homoeopathic to anureous diuresis, or the anazo- turia of Willis, marked by a copious secretion of a colorless or straw- colored urine, of a density scarcely exceeding that of water, of a faint odor, a weak acid reaction, becoming slightly ammoniacal on stand- ing, and containing very little urea. The attendant symptoms are thirst, a parched mouth, a craving appetite, gnawing in the epigastri- um, constipation, dryness of the skin, depression of spirits, debility and emaciation. Colchicum is the antipathic remedy to this disorder, and I have several times effected cures with it, before I became ac- quainted with the homceopathicity of Nitrate of Silver. I have kept anazotureous urine for months in a vial, always slightly, and frequently not at all corked, and under every variety of temperature, and little or no decomposition has taken place. This contrasts strongly with the rapid decomposition which takes place in albuminous, saccharine, and azotureous urine. (11.) Retention and excess of urea in the system is the cause of much disease and irritation; it is probably quite as frequent an occurrence as retention and excess of bile; many severe headaches, pains, con- vulsions, attacks of asthma, palpitations, vomitings, diarrhoeas, &c, &c, arise from this cause; many obstinate eruptions arise from de- rangements of the kidneys, and also much sallowness of the com- plexion, which is only too frequently mistaken and treated for bilious- ness. (11.) 544 Argentum-Nitratum. Colchicum is the antipathic remedy for retention of urea in the system; I have seen much benefit from itsuse before I was acquainted with the homceopathicity of Nitrate of Silver to this disease. (11.) Male Genital Organs.—Want of sexual desire, the sexual organs having become shrivelled. Painful coition. Frequent nightly semi- nal emissions. Chancre-like ulcers on the prepuce. (32.) Clinical Remarks.—In gonorrhoea of the male, the introduction of a bougie smeared with an ointment of Nitrate of Silver, is occasionally a most effectual cure, but the practice is a dangerous one. In one case, acute and nearly fatal urethritis was brought on by its employ- ment. The patient was a dresser at one of the London hospitals, and had practiced this mode of treatment in many instances on the hospi- tal patients with the happiest results. An aqueous solution of the Salt has been successfully used in chronic gonorrhoea. (3. 46.) In gonorrhoea, the Nitrate in solution often proves an effectual injec- tion. Ricord advises it at the outset of the attack. He states that by this means the attack may invariably be cut short, in the first stage. A similar opinion is expressed by Dr. Graves, Mr. Acton, and other experienced writers. The injection is to be repeated, desisting, how- ever, if the discharge is rendered thin and bloody, an ordinary effect of the application. A weak solution of Zinc or Alum should then be had recourse to. (44. 46.) In the chronic stage of gonorrhoea, this injection also often proves serviceable. (44. 46.) The Argentum-Nitratum has been very useful in gonorrhoea, when locally applied, at or previous to the first appearance of the discharge. It is generally used in the proportion of ten grains to the ounce of distilled water, and applied by means of a glass syringe. It should be repeated twice or three times at intervals of twenty-four hours. (45. 54.) Mr. Druitt recommends a dilute and almost homoeopathic injection of the strength of two grains to eight ounces of water, repeated twelve times at intervals of four hours. This is the best practice, and that which is followed by Carmichael. See Am. Jour. Horn., Vol. 4, p. 139. (54.) In strictures of the urethra and (esophagus, bougies armed with lu- nar caustic in the points, are occasionally employed with great advan- tage. When the common bougie is formed, {cereolus simplex,) the point of it should be heated with a conical piercer, and the caustic in- troduced while the composition is quite soft. The point of the bougie should then be rubbed on a piece of polished marble, till no inequa- lities in the size of it appear. (3. 46.) Notwithstanding that the application of Nitrate of Silver to stric- ture of the urethra has been advocated by' Mr. Hunter, Sir E. Home, Mr. Wilson, Dr. Andrews, and others, it is now but little employed; yet its safety and efficacy in many obstinate cases, when the simple bougie fails, is undoubted, from repeated observation. It is commonly supposed that it acts by burning or destroying the stricture; such is Nitrate of Silver. 545 l not the fact. It induces some change in the vital actions of the part, which is followed by relaxation of the narrowed portion of the canal, but which change it is as difficult to explain as the subduction of ex- ternal inflammatory action by this salt. (3. 46.) According to the law similia similibus, the explanation is very easy. Waring says, a sound should be first passed down to the seat of the stricture, and subsequently a bougie, or an instrument for the pur- pose, armed with the caustic should be passed down and firmly pressed on the stricture. Unless this point is carefully attended to, the caustic will come in contact with the urethra in front of the constrict- ed portion and cause ulceration. This, however, is not the only danger, as the caustic has in many cases become loose, and remained in the passage, an accident likely to be followed by severe consequen- ces. Serious haemorrhage, also, occasionally follows the application, and it is on the whole an unsafe mode of treatment; although, in ca- ses where there is some degree of permanent stricture which is ex- ceedingly irritable, a slight touch with a caustic bougie will often afford speedy relief. It should never be employed if the urethra has been damaged by the previous use of the common bougie or catheter: in this case it will produce spasm. Sir Benjamin Brodie objects to the use of the bougie on four grounds:—1st, Although the caustic often relieves the spasm, it also frequently induces it. 2d, Haemorrhage is a more frequent consequent of the caustic than of the common bougie. 3d, Where there is a disposition to rigors the caustic is almost certain to produce them. Ath, Unless used with great caution it may produce inflammation of the parts behind the stricture, terminating in the for- mation of abscess. (44. 46.) To primary chancres the Nitrate of Silver is one of the best local applications. Immediately after the first appearance of a chancre the caustic should be applied in substance freely to the whole surface, so as totally to destroy its character. By adopting this practice in the earliest stage of the sore, the venereal poison is decomposed, and its absorption into the system prevented. If the chancre has existed some days and the poison has been absorbed, the application of the caustic can be of little value. To indolent buboes the Nitrate is some- times applied locally, with the view of stimulating the parts and hastening the process of absorption. (44. 46.) Mr. Acton advises the cauterization of chancres with this article if the patient is seen before the sixth day, and states p. 263 Dis. of Urinary and Generative Organs, that a gentleman who had a simple excoriation on his penis, unwisely cauterized it freely, and by this proceeding produced a pustule precisely similar to chancre. (84. 54.) This, though emanating from an allopathic source, seems decided evidence of the homceopathicity of topical applications of Argentum Nitratum to chancre. (54.) We desire to add our testimony to that of the author just cited with respect to the great utility of topical applications of the solid Nitrate to chancres in their first stages, and before the virus has passed from N 35 546 Argentum-Nitratum. the local sore. In these cases the poison is actually destroyed, so that ' nothing is left to be absorbed and to contaminate the system. Reliance can only be placed upon this summary treatment, when the virus is concentrated at the chancre. With equal confidence we commend the abortive treatment of the very first stage of gonorrhaa, by satu- rated solutions of this drug, as advised by Ricord. While the in- flammation is yet very slight and confined to the extremity of the urethra, the malady may always be cut short abruptly by a single tho- rough application of this solution. (10.) In spermatorrhoea, cauterizing the urethra as a means of arresting the involuntary spermatic discharges has been recommended. It was subsequently introduced into France and adopted by Lallemand, who strongly advocates the practice as the most efficacious. Ranking of Norwich also advocates it. (44. 46.) This remedy was first used in spermatorrhoea by Lallemand, whoap- plied it to the prostatic portion of the urethra and mouth of the ejacu- latory ducts in the solid form by means of a stilette, which was pass- ed down the urethra in a closed canula, and there the stilette being protruded, the parts were cauterized by a rotary movement of the hand, and the stilette being again withdrawn into the canula, the whole in- strument was removed from the urethra. A similar method is now employed by Mr. Henry Thompson. He uses a closed canula with a stilette at the end of which a piece of sponge is attached. This is saturated with a solution of one or two drachms to the ounce, and when passed down the urethra is protruded- so as to cauterize the parts and then being withdrawn into the canula, the instrument is taken from the urethra. See Lancet, April, 1852, p. 296. (52. 54.) Acton (Dis. of Urinary and Generative Organs, p. 175) applies it in the same disease by means of a syringe attached to a properly- constructed catheter, using a solution made in the proportion of ten grains to the ounce. (84.) This is the better method. (54.) Acton injects a solution of this salt in the proportion of two'drachms of the Nitrate to four ounces of water in cases of chronic inflamma- tion of the bladder, when the mucous membrane of that viscus secretes a ropy, thick, tenacious matter, p. 153. (84. 54.) Professor Lallemand of Montpelier has been very successful in chronic cystitis, by touching the internal surface of the bladder with solid Nitrate of Silver. The patient feels the moment it is applied a sharp pain at the neck of the bladder, and in the rectum, described by them as not unlike a pinch—but much more supportable than the continued dull pain of chronic catarrh of the bladder. Then follows an irresistible desire to pass water, with burning along the urethra, and discharge of a few drops of blood. This desire is renewed every moment, causing violent but futile ef- forts at micturition. These gradually decrease, and on the 2d or 3d day there is no Ion- Nitrate of Silver. 547 ser any pain in making water, and a few small grey eschars, like burned paper, come away with the urine. This occurs in a large number of patients. In some the suffering is excessively severe, yet the physician must be careful not to interfere too much, as inflamma- tion is necessary to the cure, i. e. an acute inflammation cures a chronic one. (11.) • In a majority of cases one cauterization effects a cure—a 2d or 3d may be necessary, bat Lallemand never saw a case requiring the 4th. (H.) . . In chronic inflammation of the bladder, Dr. McDonnell advises in- jecting into the bladder a solution of the Nitrate of Silver. He di- rects the bladder to be first washed out. with warm water; the solu- tion to be then injected and allowed to be retained for a few seconds; never above a minute. The quantity of injection used should never exceed 4 ounces. Should the urine be rendered shreddy, or bloody, Opium and fomentations should be used. In all cases the cure has been permanent. (44. 46.) Female Sexual Organs.—Uterine haemorrhage. Excited condition of the capillaries of the uterus. Uterine congestions. Suppression of a mucous leucorrhcea. (32.) Inflammation of the mucous membrane of the vagina. (10.) Clinical Remarks.—In some forms of leucorrhcea the application of Nitrate of Silver either in the solid state or in solution is attended with beneficial effects. This practice was first recommended by Dr. Jewel. It is most successful in cases dependent on local irritation, or sub-acute inflammation, and not arising from constitutional debility. The solution may be applied by means of a bit of lint or sponge, or may be injected by means of a syringe with a curved pipe. Its strength must vary according to circumstances. In some cases the solid Nitrate has been applied to the cervix uteri and vagina by means of a silver tube. (44. 46.) In leucorrhcea the nitrate in solution, is advised by Dr. Jewel as a vaginal ejection. It may also be applied in substance. Dr. Hud- son states that in uterine leucorrhcea he has derived great benefit from the internal administration of the nitrate. He relates several cases illustrative of its efficacy. (44. 46.) It appears from the statements of M. Ratier, that Ricord, the emi- nent surgeon of the Hopital des Veneriennes, at Paris, was the first who employed the Nitrate of Silver in the solid state in the gonor- rheal and other discharges of females. (11.) Numerous medical men in other countries, as well as in France, have confirmed the results of Ricord. In Britain Drs. Balbirnie and Hannay have published memoirs on the subject. The treatment by the solid Nitrate of Silver has been found of great benefit, not only in old gonorrhceal and leucorrhoeal discharges, but also in acute recent gonorrhoea, before the inflammatory symptoms have been subdued. 548 Argentum-Nitratum. The Nitrate of Silver, locally applied, is a most potent antiphlogis- tic !!! remedy. Dr. Johnson has witnessed numerous cases of acute gonorrhoea in females cured by two or three applications—the burning, uneasiness, and pain induced usually are only felt after the first ap- plications. Several reflections suggest themselves here—we first find that the acute inflammation caused by the application of Nitrate of Silver cures chronic inflammation. Next we find that the acute inflamma- tion induced by Nitrate of Silver cures the acute inflammation of go- norrhoea. (11.) Yet all acute inflammations are not identical, and there must be a difference between gonorrhoeal and lunar caustic-inflammations, yet the latter is eminently adhesive, and we know that gonorrhoeal inflam- mation is most apt to cause stricture, which is'an adhesive inflamma- tion, although as a rule inflammation of mucous membranes, is mu- cous or suppurative, rarely adhesive, while that of serous membranes is almost always adhesive, much more rarely suppurative. (11.) Dr. Hannay, of Glasgow, has used lunar caustic locally in three hundred cases of gonorrhoea in women, and says he fearlessly gives it out as an infallible and safe remedy for this disease without any one drawback, but in the vain fear of persons of no experience, or of such as are determined to oppose it. (11.) In gonorrhoea of the female, a solution of the Nitrate of Silver, or even this caustic in the solid state has been applied with the best effects. In many cases it arrests the discharge permanently in twenty- four hours. It often causes an increase of the discharge at first, but after a few repetitions it diminishes and is arrested (3.) In pruritus pudendi Dr. A. J. Thompson states that in one very ob- stinate case, which resisted all other remedies, he found decided be- nefit from pencilling the parts once or twice daily with a solution. (44. 46.) In vaginitis, it is our best remedy, if occasionally brought into con- tact with the interior surface of the vulvo-uterine canal, in suitable strength. In this manner we have several times cured distressing and obstinate cases of this malady. (10.) In amenorrhoea Dr. Lubanski speaks highly of applying the Nitrate in substance, lightly, to the os uteri, at the time of the expected ap- pearance of the menses. He states that in all cases, excepting where the amenorrhoea is symptomatic of some other disease, it proved ef- fectual. It has also been found successful by Dr. Egan, who recom- mends its employment in obstinate cases. (44. 46.) In a case of menorrhagia in a girl, aged 17 years, of supposed doubtful character, who was suffering for two weeks with profuse menstrual discharges, at times ceasing for a while and then again coming on suddenly and violently, accompanied by very severe pain in the uterine- and ovarian region, extending to the sacrum and thighs, Dr. Patzack ordered Argent.-nitr. 3d, one grain every 3d hour, and effected a cure in three days, (26.) Nitrate of Silver. 549 In the early stage of cancer of the uterus Dr. Ashwell states that he has derived much benefit from the application of Nitrate of Silver in solution, to be applied by means of a speculum, and states that he has found it particularly useful in those cases where the mucous mem- brane lining the channel of the cervix, or around the margin of the os uteri, has been red and tender, when there have been obvious ul- cerations, or a tendency to softening. The character of the mucous membrane generally improves after three or four applications. (44. 46.) In ulceration of the os and cervix uteri, the application of the solid Nitrate has been advised and practised by the highest obstetric au- thorities of the day. The real amount and character of the disease should in the first place be clearly ascertained by the speculum. That the practice is not devoid of danger is shown by a case re- lated by Dr. Williams of Swansea, in which in consequence of the inflammation caused by the application of the caustic, the edges of the os tincae even so closely united as to require to be separated by an operation, to allow of the escape of the menses. (44. 46.) It has been successfully applied to ulcerations of the os and cervix uteri by Marcy. In the N. Am. Jour, of Horn., Vol. 5, p. 94, he uses the following language. " In all cases of ulceration of the os and cervix uteri which resist treatment by internal remedies, and the other reme- dies which have been enumerated, we are in the habit of cauterizing the ulcers by Nitrate of Silver. These applications we repeat every five, six, or eight days, according to circumstances, until the ulcers assume a healthy appearance and the healing process seems satisfac- tory. Nor is it in ulcerations alone that Nitrate of Silver applications are homoeopathic; for abrasions with destruction of the epithelium and granulations of the uterine os and cervix, may be produced by ap- plications of the solid Nitrate in health, as well as cured by similar applications when they exist as morbid phenomena. (54.) Cllfst and Air-Passages.—Suffocative cough for several days. Hoarse- ness, tickling, and roughness of the throat. Dry cough from tickling and irritation of the throat and larynx.- Paroxysms of violent palpi- tation of the heart with faintish nausea. Aching, tensive pain in va- rious parts of the chest. Nightly palpitation. (32.) Oppression of the chest. Quickened and difficult respiration. Laborious panting and whistling breathing. Gasping for breath, and paroxysms of suffo- cation. Blood-spitting. Burning in the chest. Violent pleuritic stitches in the chest, preventing respiration. (19. 26.) It is said to be particularly remarkable in Orfila's experiments that it always caused a difficulty of respiration to the point of suffocation, and Vogt says, if we add to this, Wolff's observation, that it exhibits really specific powers against trembling and spasm of the heart, and recollect that Orfila never found it to excite vomiting or inflame the duodenum when injected into the veins, we are almost justified in drawing the conclusion, that it acts upon the superior nervous ganglia and upon the glossopharyngeal nerve in like manner as other metals 550 Argentum-Niti atum. act upon the solar plexus. Even in ancient times it was advised against asthmatic affections and palpitations. (11.) Clinical Remarks.—In spasmodic asthma the Nitrate of Silver given n the intermission will be found in many cases to reduce the force and frequency of the paroxysms. Dr. Waring has thus employed it with decided benefit. (44. 46.) This remedy has been applied with apparent success in pharyngi- tis and laryngitis both acute and chronic, but particularly the follicular variety. Dr. Horace Green, of New-York, who has been the most strenuous advocate of this mode of medication, employed a solution of the crystallized Nitrate of the strength of from two to four scru- ples to a fluid ounce of distilled water, and makes the application by means of a probang or piece of curved whalebone, with a sponge at- tached to the end of it, as recommended by M. Trousseau. Before attempting to penetrate the glottis, he accustoms the membrane to the irritant impression by applying the solution daily, for several days to the parts immediately about the opening. When the sensibility of the lips of the glottis is thus somewhat blunted, he passes the sponge saturated with the solution through the rima-glottidis into the cavity of the larynx. lie recommends that the patient on opening his mouth " should take a full inspiration and then breathe gently out," at the moment in which the sponge is introduced. This is carried over the top of the epiglottis along the posterior surface of this cartilage, and then suddenly pressed downwards and forwards through the apperture. A momentary spasm of the glottis takes place, by which the sponge is compressed and the fluid forced out of it. The application should generally be made every other day for the first two weeks, after which it may be repeated, two or three times a week, till a cure is effected. Wood's Pract., vol. 1, 3d ed. 1852, p. 786. (54.) Mamma1.—Stitching pains in the breasts. Tenderness and enlarge- ment of the breasts and axillary glands. (32. ) Clinical Remarks.—In fissured or excoriated nipples the application of the solid Nitrate of Silver is of great service. It should be in- sinuated into all the chaps and cracks, and the nipple afterwards washed with tepid milk and water. (3.) The nipple should be first carefully dried, before the Nitrate is applied, the pain caused by it soon disappears, and a few dressings of Zinc-ointment will complete the cure. It is said to be very effectual. (44. 46.) Heart.—Irregular action of the heart; palpitations. Violent palpi- tation of the heart with nausea. Nightly palpitation. Stinging itch- ing of various parts of the body, most violent around the left nipple. Clinical Remarks.—Nitrate of Silver, Zinc, Cuprum, Nux, Ignatia, &c. are more or less homoeopathic to epilepsy of the heart. In this disorder, according to Wunderlich, there is a sense of spasm or cramp about the heart; the pulse and heart intermit for four or six beats; the expression of the patient is as if something frightful had happen- ed to him ; he is speech- and motionless ; he has internal anxiety and Nitrate of Silver. 551 oppression of the chest, and a violent pain extending from the heart up the neck into the head, with more or Jess stiffness of the neck; the patient describes these daily pains and the inexpressible anxiety as indescribably dreadful; when the attack passes over there is some rapid action of the heart, for a little while. (11 ) Superior Extremities.—Painless, light red swelling about the wrist joint, extending towards the middle of the forearm. Clinical Remarks.—In removing warts it is also very effectual; it may be repeated once or twice a week until their removal is effected. (44. 46.) In onychia, a resolution of the disease has appeared to follow black- ening the diseased portion with the Nitrate in substance or solution. Mr. Liston indeed regards it almost as a specific. (44. 46.) Lower Extremities.—Paralytic heaviness and debility of the lower limbs, so that she did not know where to put them. Rigidity in the calves, with great debility and exhaustion, as from fatigue, scarcely permitting her to walk across the room. Great debility and weari- ness in the calves as after a long journey. Neuralgic pains in the hips, thighs and knees. (32.) Clinical Remarks.—To corns the local application of the solid Ni- trate is advised by Mr. Higginbottom. The corns should be first soaked in hot water, and pared down. The Nitrate should be lightly passed over the surface, and repeated every ten or twelve days until the corn is destroyed. (44. 46.) ARNICA-MONTANA. MOUNTAIN ARNICA. GERMAN LEOPARd's-BANE. Mountain Tobacco. Ptarmica Montana. Panacea-Lapso- rum. Wohlverleih. Fall-Kraut. AUTHORITIES. Hahnemann. (1.) Noack and Trinks. (19.) Jahr. (32.) Hempel on the use of Arnica. (80.) Hirschel's Archiv. (81.) Ruckert's Clinique. (64.) Peters. (11.) Fullgraff. (26.) Snelling. (46 ) Dier- bach's Mat. Med. (6.) Sobernheim's Mat. Med. (57.) Vogt's Mat. Med. (20.) Hamilton's Flora Homoeopathica. (50.) Teste's Mat. Med. (36.) Inman on Muscular Affections, mistaken for Spinal Irri- tation. (5S.) GENERAL REMARKS. The Arnica-Montana is a species of the genus Arnica, family of the Radiata, class syugenesia polygamia superflux. It was first cor- rectly described byTaberna? Montanus, a naturalist of the 16th cen- turv. It grows on the high mountains of the south of Europe, and in the plains of the north of France, where some varieties of it exist, 552 A rnica-Mon tana. distinguished by the large size of its leaves, the height of the stems, &c. (36.) It is a perennial, herbaceous plant, having a woody brown- ish, horizontal root, ending abruptly, and sending forth numerous slen- der fibres of the same color. The stem is about a foot high, cylin- drical, striated, hairy, and terminating in one, two, or three peduncles, each bearing a flower. The radical leaves are ovate, entire, ciliated and obtuse; those of the stems, which usually consist of two opposite pairs, are lance-shaped. Both are of a bright green color, and some- what pubescent on their upper surface. The flowers are very large, and of a fine yellow orange color. The calix is greenish, imbricated, with lanceolate scales. The ray consists of about fourteen ligulate florets, twice as long as the calyx, striated, three toothed, and hairy at the base; the disc of tubular florets, with a five lobed margin. (36.) It is also found, according to Nuttall, in the northern regions of North America, west of the Mississippi. It has been introduced into England, and might, no doubt, be cultivated in this country. Water extracts its virtues. A bitter principle has been extracted from the flowers, which has been considered to be identical with that discovered in the seeds of the Cytisus-Laburnum, and hence named Cytisin. It is yellow, bitter, nauseous, deliquescent, soluble in water and diluted Alcohol; insoluble in ether. It is powerfully emetic and cathartic, and is supposed to be the active principle of the plant. (7. 46.) Wood and Bache say that Leopard's-Bane is a stimulant, directed with peculiar energy to the brain and whole nervous system, as mani- fested by the headache, spasmodic contractions of the limbs, and dif- ficulty of respiration, which result from its use. It acts also as an irritant to the stomach and bowels. It is much used by the Germans, who give the root and flowers with advantage in amaurosis, paralysis, and other nervous affections. They say that it proves serviceable in that disordered condition which succeeds concussion of the brain from falls, blows, &c, and from this circumstance has received the name of panacea lapsorum. It has also been recommended in intermittent fever, dysentery, diarrhoea, nephritis, gout, rheumatism, dropsy, chloro- sis, and various other complaints. It seems to be peculiarly useful in diseases attended with a debilitated or typhoid state of the system, to which it is adapted by its stimulating properties. The powdered flowers and leaves are sometimes used as a sternutatory, and the in- habitants of Savoy and the Vosges are said to substitute them for to- bacco. (7. 46.) Notwithstanding the acrid and bitter taste of this plant, it does not, according to Linne exercise any deleterious action on herbivorous ani- mals. Oxen and goats, he says, eat it with pleasure. (36.) The Arnica of Bohemia was the one which was formerly the most valued. It was prescribed in the form of infusions, decoctions, and locally. The root, stem, and blossoms were successively given a preference by physicians, who, however, gave up the root for the rea- son that it rapidly loses its taste and aroma by drying. It is this root, but fresh, which is used for Homoeopathic preparations. (36.) Mountain-Arnica. 553 For a long time popular empiricism had availed itself of the pro- perties of Arnica, when a Belgian physician, Fehrius or Fehr, drew the attention of his colleagues to this plant. The facts published by him tended to show that the Arnica, whether used internally or exter- nally, was a specific remedy for sanguineous .effusions, sugillations, ec- chymosis, &c. A large number of German, Swedish and French practitioners confirmed Fehr's observations, and its use soon became quite extensive. According to Murray, it was successfully used against the following maladies: external lesions, such as are caused by a blow or a fall, or contusion ; a certain form of fall pleurisy ; cachexia; oedema; atrophy; traumatic peripneumonia ; suppression of the menses, or lochia; uterine haemorrhage; calculous nephritis; gout; muscular contractions; gangrene ; jaundice produced by contusions; paraplegia ; hemiplegia; paralysis of the bladder; amaurosis, caused by a cerebral affection. (36. 46.) Stoll used it with success in certain forms of dysentery, especially in epidemic dysentery, and also cured with it several cases of inter- mittent fever, a circumstance which induced him to term it the Qui- nine of the poor, a designation which, however, it does not seem to deserve. (36. 46.) More recently it has been lauded as a remedy for spasms, convul- sions, tetanus, convulsive cough, trembling, and even for the itch; but this last is not to be relied on. Murray mentions the accidents which it is capable of producing in over-doses, to be vomiting, anxiety, sweats, an aggravation of pain around injured parts, which, however, never lasted long, sensitiveness of the abdomen, weakness of the sen- ses and nerves, tingling, lancing and burning pains, or shocks resem- bling those produced by the electric fluid. (36. 46.) Honieeopathically, the sphere of Arnica comprises, all traumatic lesions, {contusions, cut or torn wounds,) with their immediate conse- quences, {internal or external haemorrhages, fractures, luxations, sprains, traumatic fever, syncope, tetanus, paralysis, pneumonia, hepatitis, entire absence of all those specific actions upon the absorbent, muscular and fibrous systems which he is inclined to expect. The irritant action upon the throat and stomach are again corroborated; also the specific action upon the right side of the head and brain, the tendency to bleed from the nose, and outbreak of per- spiration ; also the proclivity to dysenteric affections, and the specific action upon the posterior wall of the stomach, and upon the spine; it promises to be useful in many cases where there is a sense as if the stomach were overloaded, although nothing has been eaten, in flatu- lency, tympanitic distention of the abdomen. (4. 11.) Mountain-Arnica. 559 2. With the Root. The Tincture of the Root, one part to six of Alcohol, has been taken in doses of from six to thirty-six drops, and even forty or fifty drops, with little or no effect; sometimes eructations were caused, also a lit- tle confusion of the head and more frequent discharge of flatulence. In one experimenter, however, six drops excited sympathetic distention of the abdomen, cutting pains in the bowels and discharge of much offensive flatulence without relief; seventy-two drops caused a feeling as if the zyphoid process were pressed violently inwards, with pier- cing pain under the sternum, vertigo, aching pain inthe temporal bones and orbits, palpitation of the h§art, and quickness of the pulse, disturb- ing sleep at night; the bowels were rather constipated, the sense of hunger increased, but the appetite considerably lessened. (4. 11.) An infusion of the root caused slight periodical aching in the region of the cardiac orifice, and periodical aching pain in the right hypo- chondriac region, apparently in the liver, or duodenum; other experi- ments caused pain in the stomach and oesophagus, with tendency to drowsiness, entire loss of appetite and dullness of the head, and gene- ral lassitude; or fullness of the stomach, distention of the abdomen, frequent discharge of flatulence and urging to stool, with tendency to constipation; also violent pains, like those caused by suddenly getting up, or from long-continued stooping, extending along the whole of the dorsal vertebrae, not seated in the muscles of the back, but rather aris- ing from violent contraction of the diaphragm or of the stomach, which might have been forced violently against the spine; two hours after- wards, this pain concentrated in the upper part of the dorsal vertebrae, between the shoulders, as is the case in violent cramps of the sto- mach ; in other experiments the stomach itself was distinctly felt to con- tract violently and spasmodically. (4. 11.) In females, it produced a feeling of emptiness in the stomach and canine hunger, but Attended with entire loss of appetite and a certain amount of disgust for all food, also, aching pain in the forehead; stomach-ache, which recurred at intervals, with an unpleasant sensa- tion of repletion, although the stomach was empty, and some acridity in the mouth. The following case is very illustrative of many of the pathogenetic effects of Arnica. The patient thus describes the commencement of his sufferings. He had been making an Opodeldoc of Arnica. (12. 26.) "I went to bed languid and exhausted; my sleep was much dis- turbed, and I awoke six or seven times, each time dreaming that I was dying, and that my bed was surrounded by my friends, assembled to take their last leave of me. On the following day I had intense head- ache, which was accompanied with a feeling of great weight and heaviness in the eyes, and a sensation of oppression and drooping in the eye-lids, as if they could not be raised. The left wrist was pow- erless for half an hour, with the feeling generally that I could not use my arms. I had the sensation of an oppressive weight at the upper 560 Arnica-Montana. part of the chest, with a feeling of constriction in the throat. In walking I was feeble, as if I had been suddenly blighted with old age, this was on the second day. (12. 46.) "My subsequent sensations were, a want of power in both ankles, with a feeling of a heavy weight on each instep. There was in my throat as it were, the sound of a subdued whistle. There was a feel- ing at the upper part of my head as though the brain was sore or ten- der. There was a total want of appetite for two days, during which time I loathed the very sight of food. I suffered from a constant dry cough, which shook the whole frame. I felt as if 1 was bruised over the whole body. The testes felt hard, and there was swelling and tenderness in them. The thighs were of livid color, with blue and yellowish marks, presenting the appearance of a ' black and blue' eye, as it is called. There was also a sensation of a great weight across the lower part of the loins, and a feeling of being drawn in, as if a cord were bound tightly across." " During the first two or three days, there were ever and anon, a few patches on the face, and especially the forehead, disappearing and re- curring, which resembled the Arnica rash, with dullness and pain in the head; repugnance to food, which lasted during the whole illness; eructations ; pains in the limbs, as from a bruise; loss of strength, and of all sense of health; the sensation of being good for nothing; some coryza." (12 .46.) After a few days, the larynx aud trachea became affected. He had a dry, short, and hacking cough. The chest then became affected; he had pains over the thorax, stitches with cough, which increased the pain; aching pains of the chest; a great deal of hypochondriacal anxiety; there was great tightness of the chest, with difficulty of re- spiration. He had been suffering with this progress of Arnica symptoms about a fortnight, when he was one night overtaken with great cardiac dis- tress; stitches in the cardiac region; faintness; feeble, hurried, and variable pulse ; irregular rythm of the heart; the horror of instant death. Aconite and Ars. were given to him. In a week after he went for a few days into the country, but it was fully a month from the com- mencement of his sufferings from Arnica, before he was delivered from this medicinal disease. The effects on the mind and disposition were no less remarkable than those on the body. He is naturally cheerful, kindly and genial; throughout this arnicated perturbation of his system, he was down- cast, waspish and peevish. (12. 46.) THEORETICAL OPINIONS. Dierbach says that its effects are very characteristic, and that its action upon the skin is the most marked, the functions of which it can arouse from the most torpid state; the outbreak of perspiration which sometimes assumes a red color on the chest, is one of the most con- stant symptoms. (11.) Mountain-Arnica. 561 Not unfrequently one notices a feeling of formication, and a prick- ling piercing spasmodic sensation, which has been compared to slight ulectric shocks; in large doses it sometimes produces a sensation of coldness over the whole surface of the body. (11.) The primae viae are soon attacked by Arnica, and eructations, sto- mach-ache, retching, nausea, vomiting, colic, tenesmus, at times diar- rhoea, but more frequently constipation, increased flow of urine, and a painful itching of the genitals, have often been noticed. (11.) Its influence upon the organs of the chest is marked by anxiety, op- pression, palpitation of the heart, and dry irritative cough. It often excites headache, attended with dizziness; the smell of the flowers is apt to excite sneezing, whence the name of the plant, which is properly Ptarmica. It is generally believed to possess the power of absorbing blood which has exhaled from the blood-vessels (ecchymosis,) and is then apt to cause pain in the injured part. The pains produced by Arnica are said to be far less severe if the patient moves about his room, than when he lies in bed. Clinical Remarks.—From the above effects of Arnica, it would seem homoeopathic to profuse perspiration, and to some diseases attended with this symptom; also to numbness, prickings and jerkings, such as precede apoplexy, or attend paralysis; to disorders attended with great chilliness of the whole body, such as fever and ague, the chills of hectic fever, influenza, debility, &c.; to many dyspeptic derange- ments of the stomach, to colic, spasms of the stomach, tenesmus, dys- entery, occasionally to diarrhoea, but more frequently to constipation; to profuse urination, and perhaps diabetes; to prurigo and itching of the genitals ; to congestion of the chest, dry irritating cough, and pal- pitation of the heart; to headache, attended with vertigo; catarrh of the head, &c. (11.) According to Dierbach, it has been found useful in the dominant school in nervous, mucous and putrid fevers, and malignant intermit- tents; in extravasations from external injuries, in chronic inflamma- tions of the chest which have arisen from violent blows or falls, in con- cussion and softening of the brain, paralysis, clonic cramps, epilepsy, &c; also in dysentery and chronic diarrhoeas, chronic haemorrhages, in gout, rheumatism, dropsy and cholera. (11.) According to Vogt, it is an acrid, aethereal-oily, or exciting remedy which in small doses acts specifically upon the vegetative side of the nervous system, and upon the motor functions; he would describe more exactly the sphere of its action by saying, that it is at those points where the nerves and arteries lose themselves in the organic struc- tures, and where the veins and lymphatics arise, viz., in the capillary vascular system, especially that of the membranous structures, viz., the external skin, the fibrous membranes, the tendons and sheaths of the muscles, the ligaments of the joints, the periosteum, serous and synovial membranes, the pleura, peritoneum, &c. In these parts, in virtue of its exciting or acrid powers, in combination with its sethereal- 36 562 Arnica-Montana. oily properties, it excites the actions of the nerves and vessels, hastens the natural metamorphoses of the tissues, or arouses them from torpor and inactivity, or retains them in a certain stage of organic vitality when they tend towards colliquation or putrescency. (11.) Given in larger doses, it either affects the stomach especially, and causes scraping in the throat, burning extending down to the epigas- trium, spasmodic painful contraction of the stomach, with flow of much saliva into the mouth, unpleasant sensation of nausea, cardialgia, eruc- tations, retchings, vomiting, followed by colic or diarrhoea; or it may affect the whole organism, especially the brain and spinal marrow, and excite vertigo, stupefaction, confusion of the head, flimmering before the eyes, noises in the ears, anxiety, timidity, oppression at the pra> cordia, inability to stand up, followed by increased pulsation of the arteries, violent congestions of blood towards the terminal branches of all the blood vessels, especially to the head, chest and abdomen, atterfd- ed with palpitations of the heart, pulsations in the epigastrium, greater development of heat, and irritation of all the tissues, marked by for- mication, prickling, piercing, trembling, subsultus, &c.; finally the secretions are stimulated, especially those of the skin, mucous mem- branes and kidneys, which not unfrequently are attended with hae- morrhages. (11.) Clinical Remarks.—From the above we conclude that Arnica is ho- moeopathic to active haemorrhages from the capillary vessels, especially of the skin, mucous membranes and kidneys; to active congestive and paralytic affections, when attended with palpitations,pulsations,formi- cation, pricklings, tremblings, and subsultus; to active congestions of the head and threatenings of apoplexy, when there is dizziness, dull- ness and confusion of the brain, flickering before the eyes, noises in the ears, anxiety, and inability to remain upright; to active conges- tions and cramps of the stomach, dyspepsia, colic, &c. In the dominant school it is regarded as indicated in asthenic affec- tions, in atony, debility and inclination to paralysis, especially in the metamorphoses of the tissues, and also when there is a tendency to decomposition or dissolution, to putrescency or colliquative dischar- ges. (11.) In asthenic fevers it has generally been regarded as indicated in the old school, when there was a torpid, stupid and paralytic condition, marked by indifference, dejection of spirits, drowsiness, with dull un- sympathetic look, or in the highest degrees of sopor, even of stupor, and when there are similar signs of a depressed, sunken, inactive and torpid nervous reaction, approaching to paralysis. But Arnica is apt to produce drowsiness, anxiety, timidity, dejection of spirits, lassitude, dizziness, &c. (11.) It has been strongly recommended in true typhus fever in the nervous stage, when there were nervous symptoms of a stupid or paralytic kind, coupled w ith a tendency to putrid decomposition; its powerfully exciting but not heating and stimulating action upon the nerves, and its invigorat- ing action upon the venous system are supposed to render it peculiarly Mountain-Arnica. 563 • useful in these cases, especially when bluish or brownish petechiae are present, with a peculiar slate of oppression or inactivity of the vascu- lar system, and a torpid state of the nerves; also when metastatic ab- scesses occur, or patches of ulceration or gangrene, and when the skin is sodden, cool and sticky; in some cases of scarlet fever, measles, or small- pox, when attended with similar symptoms, ithas also been found useful. It is also thought to be indicated in asthenic affections of the ali- mentary canal, such as gastric-nervous fevers, nervous-mucous and bilious fevers; in nervous fevers attended with colliquative diarrhoea; in typhous-bilious-putrid dysenteries, &c. In asthenic affections of the pulmonary mucous membranes, such as nervous catarrhal fevers. (11.) ON THE NERVOUS SYSTEM. Oil the Nerves Of Motion.—Arnica is supposed to act more specifically upon the nerves of motion than upon those of sensation, at least Dr. A. T. Thompson is of opinion that Igasaures of Strychnia, or Brucia, exists in the plant, and empirically it has been found useful against some affections of the motor nerves, such as paralysis. (11.) Clinical Remarks.— According to Vogt, it has been recommended more especially against such paralyses of the limbs and internal or- gans which remain after concussions or injuries, particularly after con- cussion of the brain or spine; it is also very useful in other paralyses which arise from a metastasis of an originally vegetative disorder, and in the latter stages of paralysis when connected with apoplexy. It is much more useful and safe in paralysis which is connected with the extravasation of blood in or upon the brain, spine, or other nerves, than Nux or Strychnine, for it promotes absorption while it gently sti- mulates the nerves, whereas Nux merely irritates the nerves. (11.) ON THE VASCULAR SYSTEM. On the Blood.—It is not known exactly what is the alteration of tne blood produced by Arnica; as it is apt to produce haemorrhages, some suppose that it lessens the quantity of fibrin and thins the blood*. It has been known to produce haemorrhages from the nose, kidneys and skin ; whether these were caused by irritation and congestion, or from simple extravasation, remains for others to decide. (11.) IlflMnorrhagCS.—It has been known to produce more or less profuse bleeding from the nose; Vogt says it excites the secretions of the skin, mucous membranes and kidneys, which are not unfrequently at- tended with haemorrhages; Dierbach says the perspiration excited by Arnica, sometimes assumes a reddish color upon the chest, (ll.) Clinical Remarks.—According to Hahnemann, 250 years ago, a physician named Fehr first made known to the profession the virtues of Arnica against extravasation of blood produced by falls, blows, &c, although it had long before been used in domestic practice, and hence received the name of Panacea-lapsorum. Vogt says that it is much relied upon in bruises and concussions, and the consequent extravasa- 564 Arnica-Montana. tions of blood and suggillations, whence it has received the common name of Fall-herb. Dierbach says that Tabernaemontanus, physician to one of the ancient Electors of Saxony, informs us that it was a com- mon practice among the Saxons to use this remedy against the conse- quences of severe falls or blows, or when they had injured themselves while at work; he also adds that it was a favorite domestic remedy in Dantzic, in Prussia, against injuries, but as the plant did not grow there, it was imported in casks from Lower Saxony. (11.) In passive haemorrhages, especially in putrid or scorbutic effusions of blood, Vogt says that Arnica often affords excellent results, viz., in morbus maculosus Werlhofii, and passive metrorrhagia. Sobernheim also recommends it in passive or paralytic haemorrhages, such as arise from a debilitated or paralytic condition of the capillaries, especially in scorbutic, septic and petechial haemorrhages. Also against extra- vasation of blood, or sero-lymphatic effusions caused by violent con- tusions, falls, or concussions; it may also be regarded as the main remedy in concussions of the brain and spine. Vogt also recommends it against suppressed haemorrhages, such as suppression of the menses, haemorrhoidal flux, or lochia; also against profuse abnormal haemor- rhages, such as bloody perspiration, bloody flux, &c. (11.) Frank says that it promotes the absorption of blood when it has been extravasated, by some unknown process, but one which has been substantiated by experience in thousands and thousands of cases. (11.) On the Heart and Arteries.—It has rendered the pulse quick and ir- regular; also fuller and quicker; quickness of the pulse and perspira- tion ; an infusion of the root has caused palpitation of the heart and quickness of the pulse, disturbing sleep at night. Case 1.—A sensitive but healthy man took six grains of Pulv. Rad. Arnicae against influenza and headache; in former times he had taken sixteen and eighteen grains with impunity, but in eight minutes he was seized with such violent palpitations, that he could scarcely speak a word; his look was fixed and anxious, he had general coldness of the body and very violent vertigo, with anxiety and stupefaction; his jaw fell down. Wine-vinegar relieved him in half an hour. (4. 11.) On the Veins.—The exact action of Arnica upon the venous system is supposed to be that of simple increase of absorption, as is seen in the rapid manner in which it removes extravasations of blood, and effusions of serum, such as occur after falls, blows, &c. On the Capillaries.—Arnica is supposed to exert a specific action upon the capillary blood-vessels; but the capillaries may be divided into those of secretion, and those of nutrition ; it is more particularly upon the capillaries of secretion which this remedy is conjectured to develop its peculiar action; hence it is supposed to be more useful in haemorrhages, perspirations, mucous fluxes, dropsical effusions, &c, than in hypertrophies of different tissues and organs. As the capilla- ries must be regarded as tubular continuations of the arteries, and the Mountain-Arnica. 565 commencement of the veins, Arnica must be suited to arterio-venous congestions and inflammations, and perhaps to veno-arterial or typhoidal disorders; it is also decidedly homoeopathic to irregular distribution of the capillary circulation in which some parts are very pale and cold, and others too red and hot. (11.) Fever.—Great internal heat, hands and feet being cold, accompanied by chills over the whole body. Dry heat while in bed, with violent thirst; heat becomes intolerable to him; he tries to uncover himself, but he feels chilly upon doing so, or even when making the slightest motion in bed. When lying for some time without stirring, he feels hot, especially about the head; he is obliged to shift its position con- stantly. A violent shivering through him when gaping. Several transitory sweats over the whole body at night, accompanied by an- guish. Nightly sour sweats. Nightly thirst. Chilliness mostly in the evening. Fever early in the morning; first, chilliness, afterwards attack of heat. Shaking chills without any thirst. Orgasm of the blood in the evening, accompanied by dizziness of the head ; he feels pulsations in the whole body. (1. 26.) Clinical Remarks.—In fever and ague : a tedious tertian fever was finally checked with Bark and Mercury, but relapsed in three weeks; was again stayed by Bark, but returned in six weeks as a quartan; now an infusion of one ounce of Arnica flowers in two pounds of water, was given in divided doses; at. first anxiety and violent cramps about the praecordia were caused, as has often been noticed, but ceased after the third or fourth dose ; the patient only had one slight attack of fever and ague, and did not relapse after using the Arnica for three weeks. (4. 11.) Case 2.—A simple tertian which had lasted four months, was treated with an infusion of 3J. of Flor. Arnicae in six ounces of water, to be drank gradually before the expected paroxysm; the patient was attacked with dimness of sight, and had the hardest paroxysm she had had for a long time; a stronger dose, before the next attack, produced con- siderable dimness of vision, vertigo, trembling, anxiety, violent vomit- ing and diarrhoea, lasting for several hours, followed by a deep and long sleep, after whicli she remained perfectly well. (4. 11.) Case 3.—A tertian which had lasted two months, was cured by using tea-spoonful doses of an infusion of one ounce of Arnica in six ounces of water—twelve ounces were used in all. (4. 11.) In typhus and putrid fevers, Acetic-acid is often the only remedy which is necessary, as has been proven in many epidemics prevailing in whole villages and cities, but when the pulse and strength begins to fail, then Arnica maybe used with great success in alternation with the Acetic-acid. (4. 11.) Stoll's indications for the use of Arnica in typhous, putrid and mucous fevers, were absence of all true inflamma- tory symptoms, when there was great prostration, an almost natural pulse, dry tongue, or one covered with much mucus or sordes, the pa- tient being dull, drowsy, partially deaf, and slightly or gently delirious, and when a miliary or petechial eruption appeared. (4. 11.) 566 Arnica-Mmtana. On the Lymphatics and Absorbents.—The action of Arnica on the lymphatics, lacteals, and absorbents, is supposed not to be nearly as great as upon the blood-vessels; the veins appear to absorb these sub- stances only which are completely dissolved in water; the lacteals, such substances as are not actually dissolved, but merely emulsioned, particularly the oils and fats; the lymphatic system is closely allied to the lacteal, but the office of the lymphatics is to collect the albumi- nous matters which have everywhere transuded from the blood-vessels, or been set free by changes going on in the soft parts; the function of the lymphatic glands is that of changing albumen into fibrin, and there- by compensating for the constant waste of fibrin which is going on in the wear and tear of the muscular system, amounting to not less than sixty-two grains per hour. (11.) Clinical Remarks.—Vogt recommends Arnica against cold swellings, especially when they arise from metastasis of rheumatism; in swell- ings of glands, tumors of the liver and spleen; even in atrophy from disease of the mesenteric glands. Sobarnheim says from its great power of producing absorption, it is very useful in atonic dropsy, and ought to be used much more frequently than it is. (11.) ON THE MUSCULAR SYSTEM. Fasciae and Tendons.—Arnica is almost specific in those muscular pains which are so apt to occur in the weakly invalid; these pains may occur wherever there are voluntary muscles or their tendinous prolongations; the trunk is more commonly attacked than the limbs, the abdominal walls more often than the thoracic, and the legs more constantly than the arms; they are generally mistaken for the pains of neuralgia, hysteria, spinal irritation, indigestion, or disease of some internal organ. The tendinous parts are more frequently the seat of pain than the muscular, for every muscular fibre terminates at each end in tendinous fibre, and these are inserted into the bones; hence, whenever a muscle contracts, there are four strains upon the tendinous fibre, viz., one at each end of the muscle, and one at each of its inser- tions into bone; hence these pains are at least four times as numerous as all the muscles in the body. The following.are some of their va- rieties: (58. 11.) When the gastro-cnemius muscle of the leg has been over-stretched or over-strained, the pain is confined almost exclusively to the origin and insertion of the tendo-achillis at the lower end of the calf of the leg, and in the heel; here it is often mistaken for a frost-bite. When delicate females first attempt to sit up after a severe fit of ill- ness, unless the head and shoulders be well supported, they are apt to get a severe pain in the aponeurosis of the trapezius, and occipital in- sertion of the same muscle. The back-ache of pregnant women, who have to keep erect all day with an extra burden to support, is a familiar instance; also the severe pain produced by the unusual strain thrown upon the erector muscles of the back while leaning over a table to cut out dress patterns; every midwife is familiar with the excessive sore- Mountain-Arnica. 567 ness complained of after delivery, arising from the immense muscular exertion required in the birth of the child; this muscular ache often reaches a high pitch of severity, so as to cause a burning pain be- tween the shoulders, by many consecutive hours work at the micro- scope, in making specimens, taking notes, and raising and lowering the head continually. (50. 11.) When the pain is seated in a muscle, it is generally described as an ache; when the muscle has been severely exercised, it changes into a burning-ache; when the sensation is referred to a tendinous part, it is spoken of as pain. The muscular aches often increase to cramps, or intense spasm, or contraction, coming on suddenly, attended with swelling and hardness, accompanied with severe pain of variable du- ration, and passing off slowly with a vibrating, twitching, or creeping sensation. The feebler the patient, and the more sensitive and irrita- ble, the more apt are these muscular and tendinous pains to occur. Case 1.—A lady, aged fifty-four, after an attack of bronchitis, had intense pain between the shoulders and occipital region of the head, as if some one was hurning her with a hot iron; also pains in the loins and small of the back; a continual grasping pain all over the abdo- men, so severe when she walked that she was often obliged to stop; while in bed the abdominal walls were apt to be drawn up into lumps, on one side or the other, from a cramped state of the external oblique muscle. The cramp and swelling over the region of the liver was at times so great that she was supposed to have enlargement of that organ. This lady who had been blistered on almost every part of the back and head, been leeched on the nape, between the shoulders, and over the abdomen; who in short had had blisters by dozens, and leeches by hundreds, would probably have quickly recovered under the use of Arnica. (11.) Cask 2.—A party ofge ntlemen on a severe pedestrian excursion, were all tired on the first day, and that was all; on the second day some began to have frequent stitches in the side, could not sleep ou the side, but only on the back; on the third day the pains in the side were ter- ribly increased, and the whole sides were so tender that they could not bear the touch of the clothes. (58.) Case 3.—An editor accustomed to write twelve hours a day, often complained of severe and sometimes intense pain in a small spot cor- responding with the tendinous portion of the rhomboideus major of the left side; this was at times so agonizing as to preclude any atten- tion to business; it was instantly relieved by going to bed ; he had had this pain for many years, and it had been referred by different physi- cians to diseases of the liver, of the gall-bladder, to indigestion, &c.; the pain frequently changed its seat, now on the right side, then on the left, but always confined to a space between the spine and scapu- lae; sometimes, though rarely, he had pain in the spine and occiput; it was muscular, arising from contraction of the rhomboideus, a thing of which everv one must be aware who writes for a long period without rest. (58. 11.) 568 Arnica-Mon tana. Case 4.—A delicate medical student, accustomed to long walks, was attacked with apparent peritonitis, affecting the region of the coe- cum and ascending colon; he was suddenly seized with pain in the right iliac region and loins, but which was really seated atthe junction of the right obliquus externus muscle with its aponeurosis. (58.) Case 5.—A phthisical lady, after a fit of illness, attempted to knit and sew; she was seized with what she supposed to be severe head- ache, and pleurisy about the upper part, of the lung; but the pain was really seated in the trapezius muscle, in its course from the occiput to its claviculo-scapular attachment; these pains often seem to be pro- longed into the occipito-frontalis, to the insertion of the stemo-mastoid, and'the origin of the temporal muscles, so that a large portion of the head is painful. (58. 11.) Case 6.—Next, to the trapezius muscle, the longissimus dorsi and erector spinae is most frequently affected, as might be supposed from the work it has to perform in keeping the body erect during sitting, standing and walking; continued stretching of its strong fibrous apo- neurosis, such as occurs in stooping, becomes almost intolerable after a time. A delicate nurse, accustomed to carry a heavy infant, had had back-ache for a long time, and finally fainted away; the back-ache rarely came on before noon, then it seemed as if hot water had been poured down her back, getting hotter and hotter till bed time; it was always relieved by throwing the head and shoulders back, and was well the instant she lay down. (58.) Case 7.—A lady had had lumbar pain for ten days; after lifting something she was suddenly seized with intense pain in the small of the back on the right side; a lump rose up the size of a small lemon in the fleshy part of the longissimus dorsi, evidently cramp; she al- most fainted, and had a severe rigor. (58.) Case 8.—A lady reduced by headache, menorrhagia and diarrhoea, was suddenly awakened by intolerable pain in the right flank, and a swelling, the size of an egg, attended with vibrating sensations; no position gave relief, except the curious one of lying across the bed, with her face over one side and the feet over the other, with a hard pillow under the affected part, to stretch the cramped muscles as much as possible; the pain now extended toward the median line, with a swelling under the right ribs, and a drawing or grasping feeling in the external oblique muscle. She had previously been a victim to muscu- lar pains in many other parts; her first attempt at walking after a long illness, was attended with intense cramp in the rectus abdominis and external oblique; she suffered habitually during pregnancy from aching in Poupart's ligament, and often had to rest her head for an hour at a time to escape from spasm or burning ache in the trapezius; she has had pain in the tendinous expansion of the triceps extensor cubiti from resting her head on her hand, and is no stranger to pain in the pubic insertion of the rectus abdominis. The quadratus lumborum is some- limes the seat of muscular pain, and the glutei muscles which have a great deal to do in keeping the body erect and raising it up after stooping. Mountain-Arnica. 569 Case 9.—A lady had much pain in the right quadratus muscle, which had been mistaken for disease of the liver; with pain in her thigh and leg from a habit of sitting on the edge of a chair and rock- ing herself towards the right side, constantly using her right leg to steady herself. A woman after stooping a good deal, was seized at night with intense pain at the lower part of the back and over the left gluteal region, recurring with every turn she made; towards morning it left the one side and attacked the other less severely; the slightest movement brought on the suffering. (58. 11.) ON THE TISSUES. On the Cellular Tissue.— Some authors suppose that Arnica exerts a specific action upon the cellular tissue, and not merely upon the capil- laries which ramify in this substance. (11.) Clinical Remarks.—In an ordinary bruise, the cellular tissue sus- tains a greater or less degree of disruption ; blood is extravasated, and swelling results. If an arterial branch of considerable size has been ruptured, a tumor forms rapidly, and is distinctly fluctuating, consist- ing of escaped blood yet in a fluid state; after a time partial coagula- tion takes place, the clot being arranged at the circumference of the swelling, and the fluid portion occupying the centre. In a healthy state of the system, and an active condition of the veins and absorb- ents, many ounces of blood may be absorbed in a short time, i.e., in a few days; but we are often obliged to contribute towards absorption by proper remedies, and among these Arnica is one of the most useful and important, especially when the blood remains fluid; when it is firmly coagulated, Muriate of Ammonia may be required. In furuncles and boils.—Boils are defined as a limited inflammation of a small portion of the skin and cellular tissue, ending in the death or sloughing of the latter, accompanied by laudable suppuration. Ar- nica is regarded as one of the most useful and specific homoeopathic remedies against boils. Teste, with very lame logic, says Arnica acts principally upon the muscles and cellular tissue, and hence boils are the cutaneous affection which it most readily causes and cures. Teste also assumes that it will cure internal maladies arising from the retro- cession of boils and acne. Case 1.—A man aged thirty, had suffered for months with boils on his face, neck and shoulders; after they disappeared, an intense an- gina sat in, and this alternation of diseases had been going on for several years. Teste prescribed Arnica, which arrested the throat disease in a few days, and the boils have not since appeared. On the Dermoid Tissue and Skin.—Dierbach says that its action upon the skin is the most marked, and ranks it among the Diaphoretica Mi- tiora; he also mentions that the Arnica perspiration sometimes as- sumes a red color on the chest. Hahnemann mentions two varieties of eruption produced by Arnica: First, a sort of pustule, very painful to touch, with a red, inflamed 570 A rn ica-Mon tana. base; this led him to administer it in boils, and with success; he also found it useful in preventing the return of boils in persons subject to them. Second, a vesicular eruption, described by Hahnemann as an itching miliary one. (11.) Dr. Black has noticed eruptions several times from the external use of Arnica. Case 1.—A lady, with an irritable skin, and liable to erythema of the face, applied fifteen drops of the tincture in an ounce of water, to her nose, which had been bruised, and the skin slightly broken: in twenty-four hours the skin became slightly red, and a very small ve- sicular eruption appeared, attended with itching, lasting four or five days; the nose swelled a great deal. This lady also applied it at another time, to a toe inflamed by the pressure of her shoe, and the same effects followed. (11.) Case 2.—A gentleman applied it to a bruise upon the elbow, and in a few days an eruption like pin-heads, with redness of the skin, appeared. (11.) Case 3.—A lady with a very irritable skin, applied the tincture very much diluted, to allay the irritation of flea-bites; it caused a very irritable and slightly vesicular eruption about the size of medium pin- heads. (12. 11.) Case 4.—A lady applied from twenty to thirty or forty drops of the tincture in an ounce of water, to a sprained wrist, for fourteen days; on the twelfth day a slight redness and small miliary eruption of the skin appeared, attended with great itching; in two days more this in- creased very much, the whole fore-arm and hand were greatly swol- len and red, the surface covered with numerous small semi-transpa- rent vesicles, with red bases; in some parts they were confluent, at- tended with great heat and excessive irritation from the itching; some of the eruption faded away, but the redness and swelling continued. On the eighth and ninth days the swellirfg had spread beyond the el- bow, but there was no eruption on this part; on the tenth day there was heat and itching of the face, the skin became red, and some eruption broke out on the malar bone; the swelling and redness soon included the left eye-lids, but no eruption appeared there. When the irritation had completely subsided in the arm, the skin remained red for some time, covered with slight scales, and almost as hard as leather; there was little or no fever. (12.) Case 5.—Dr. Russell reports a similar case; a lady, aged fifty,ap- plied a lotion of one part of Arnica to eight of water, to her foot and ankle, for a sprain; on the next day the instep was very red, but pain- ful, intolerable itching, oedematous, arid a few vesicular elevations were visible; the rest of the foot, ankle and lower part of the leg soon par- ticipated in the affection; the pain was great enough to deprive her of sleep,'and continued for a fortnight. (12.) Case 6.—Dr. Russell observed similar, but less severe symptoms follow the use of Arnica to the fore-arm of a gentleman. Cases 7 and 8.—I have seen two very annoying cases, both on the Mountain-A rn ica. 571 legs of gentlemen, in which Arnica was used for sprains of the an- kles; the eruption resembled that of erysipelas, and was almost as se- vere; also several slighter attacks. (11.) Drs. Black and Russell didjiot derive any benefit from Rhus and other homoeopathic remedies, in- and externally; Sweet Oil and Lime- water will afford relief. Dr. Black suggests the use of Arnica in ec- zema, or salt-rheum, in vesicular erythema; also in the miliary erup- tion attendant on rheumatism, gastro-enteritis, and perhaps puerperal and typhus fevers. Case 9.—A man aged seventy, fell from a chair and bruised his hand; diluted Tincture of Arnica was applied: the next day the in- jured hand was of a dark blue color, almost black, the face, neck, breast and back were in a state of erysipelatous inflammation; the injured hand became covered with vesicles of various sizes, some of them as large as a pigeon's egg, which gave the skin the appearance of a rhinoceros hide; the pulse was quick and patient depressed; in fourteen days several pustules appeared, which passed off with the erythema, and the patient recovered. (11.) Head.—Vertigo. Obtusion of the head. Burning in the head, ac- companied by a dull, continued pain, as if the head were being dis- tended from within outwards. Burning in the brain, the rest of the > body being cool. Throbbing headache in the temples. Headache over the eyes, extending towards the temples, with a sensation as if the integuments of the forehead were spasmodically contracted. Aching, with traction, in one half of the skull, beginning at the ear and coming out at the top of the head. Violent stitches in the fore- head when coughing. Jerking stitches in the forehead and temples; headache in the left temple, returning from time to time, pricking and tearing. Jerking, lancinating headache when stooping, as if every- thing would issue from the forehead, accompanied by nausea, qualm- ishness, tearing headache. Pain resembling severe electric shocks. (1.26.) Clinical Remarks.—In injuries of the head and face.—A girl of four years fell, in coming down-stairs, on the left side of her face, her nose and forehead. Her left cheek was red and blue from the contusion, her nose greatly bruised, with abundant bleeding from it, and great paleness of the face. A solution of Arnica and water was applied, and some Arnica taken internally. The child at the end of some hours was perfectly'well. The lotions, however, were renewed, and the next morning nothing could be perceived, excepting a very slight blue mark on the bridge of her nose; no swelling had supervened. (80. 20.) Feeling of tension, heat and swelling of the face, which are often produced by travelling on coaches or railways, may be relieved by Arnica, taken internally, and bathing the parts with a solution of Ar- nica. (SO. 26.) In apoplexy and paralysis.—Arnica has been used in paralysis since 572 Arnica-Montana. the time of Junker in 1736, and although it was for a time supplanted by Nux and Strychnine, its use was revived by Schneider in 1S21, who preferred the etherial oil of Arnica in the paralysis which re- mained after apoplectic attacks, and by Graefer, who used the flowers against paralysis from injuries. (4. 11.) In dropsy of the head.—Golis rendered himself famous by his suc- cessful use of Arnica in the latter stages of dropsy of the brain. The celebrated Neumann has seen the most decided good effects from the in- and external use of Arnica in acute hydrocephalus. (11.) Concussion of the brain is often accompanied by congestion, depres- sion of the cerebral action, stupor, &c. All these symptoms are either prevented or relieved by speedily washing the parts which have re- ceived the shock, with the tincture of Arnica, which should at the same time be given internally. A linen compress may be applied to the part, and moistened more or less frequently, according as the in- jury is more or less considerable. As soon as the above-named symp- toms have disappeared, the use of Arnica must be stopped, the rest is to be left to nature. The smaller vessels of the brain, when torn, have frequently been healed by Arnica. Secondary haemorrhage in the brain, congestion of blood, secondary suppurations and effusions of lymph, have fre- quently been prevented by the proper and speedy application of the tincture of Arnica. The following two cases will show that Arnica may sometimes even restore health, when the concussion had already lasted for a good while. Case 1.—A strong man of sixty years, who was addicted to drink- ing, had fallen through a trap-door into a cellar. Several hours after- wards he was found, apparently lifeless, with his head lying upon the fragments of some earthen vessel, his feet resting upon the stair-case, and blood had rushed from nose, mouth and ears. He had been some- what revived by washing him with vinegar and water, by introducing vinegar into his mouth, and by causing him to smell qf the Spirits of Hartshorn. During the night he lay in a state of stupor. In the fore- noon he had frequently been attacked by shiverings and vomitings,the latter especially after eating soup. He was unable to lift up the right arm without help. I was sent for in the afternoon. % On the right side of the forehead I discovered a wound of about one-quarter of an inch in length, both ears being full of blood. The right side of the face was tinged blue by extravasated blood; the whole right half of the head was very painful; the right side of the neck, chest and upper arm was swollen, and marked with extravasated blood; he felt thirsty, was constantly desirous of blowing his nose, which was always followed by bleeding from the nose; there was also extravasation of blood behind the conjunctiva, with irritation of the brain, vomiting and delirium. Six days after the fall, by the in- ternal and external use of Arnica, he was completely restored. Case 2.—A stout young man fell from his horse, and was dragged Mountain-Arnica. 573 to a considerable distance. He was picked up in a state of stupor. I applied Arnica in the same way as in the previous case. The next day he was able to walk out, and on the third day he was entirely re- stored. (80. 26.) Apoplexy.—Case 1.—A man, aged seventy-two years, was suddenly seized with a fit of apoplexy while standing; before falling to the around, he complained of feeling dizzy, now he lay unconscious, his fower jaw hanging down, the extremities of the left side insensible and paralyzed ; he talked incoherently, without being able to articulate distinctly; often raised his right arm, pointing to the head; his pulse was very full, and intermitted every seventh beat; his face was red. Under the use of Arnica he gradually recovered in the course of a few days. (64. 26.) . Case 2.—A middle-sized man, aged fifty-three years, with short, thick neck, rather addicted to brandy, was taken with an apoplectic fit, for which he was bled. After a few days, when he came under ho- moeopathic treatment, he was in the following condition: Frequent awaking during the night, with attacks of hiccough and gulping up of fluid, followed by shuddering, stretching, repeated about every half hour, without being conscious of it. During the day he had pressure in the forehead, with buzzing in the ears, vertigo, sparks before the eyes, illusion of sight, general malaise, coldness of the extremities, shiverings through the body; pulse 60, tolerably strong, and irregular, with burning itching of the skin. Arnica 3, two drops, repeated the second day, effected a cure in three days. After a lapse of five months, he had another attack with a similar train of symptoms; at night, hiccough, &c, with noise and rumbling in the abdomen, rigidity of the body, vacant look and un- consciousness for about an hour, followed by cough and renewed respi- ration, with foul breath and cold sweat; this condition recurred seve- ral times but each in a less intense form. Arnica 3d freed him from this condition in a few days. (64. 26.) Case 3.—A school teacher, aged thirty-seven years, had an apo- plectic fit five years ago, and since then his memory had failed him to a very marked degree. A few doses of Arnica 3d restored him completely. (64. 26.)* . Dropsy of the brain.—Case 1.—A delicate boy, aged two and a half years, five weeks subsequent to an attack of measles, was found in the following condition: Violent headache, squinting of the eyes, is afraid as though he would fall, and actually does fall backwards occa- sionally; vomits; twitching of the arms and hands; screams; .will only lie on his back; is at times unconscious, difficulty in rousing him; head hot, pupils dilated, breathing oppressed; urine scanty, of a reddish tint; pulse quick and small. Aconite and Belladonna were administered without apparent success. Under the use of Arnica 3d, with an occasional dose of Merc-sol. 2d, he recovered in two weeks. (64. 26.) Case 2—In a case of hydrocephalus aculus, where Aconite and 574 Arnica-Montana. Belladonna were administered without any apparent benefit, Arnica 6th brought about a happy result. (64. 26.) Case 3.—An attack of encephalitis, in a girl aged twenty-one years, after a severe fall on her head, followed by an aggravated train of symptoms, was cured by Arnica 4th, except temporary blindness, which was cured by Bell, and Opium. (64. 26.) A man, aged thirty-five years, having received severe blows about his head, was suffering from the following symptoms, with increase of the headache from day to day: —Pressing pain in the forehead, with burning heat in the brain, and coolness of the rest of the body; in- crease of pain after eating, with heat of the face, roaring in the ears, and contracted pupils; nausea early in the morning; dislikes smok- ing, contrary to his usual taste; tenesmus, constipation; disturbed sleep by unpleasant dreams ; feverish towards evening, and ill-humored. After taking Arnica 6th for two days, all the above morbid conditions disappeared. (64. 26.) In alcholismus chronicus, vertigo spuria, or ocular dizziness.—A tall and rather cachectic man, aged forty-nine, who had been in the habit of taking ten or twelve drinks a day, was attacked with weak- ness in the arms and legs, glimmering before the eyes, and noises in the ears; during the last week the debility had increased so much that he could scarcely walk; his sleep was disturbed with phantasies and formications, and he had the following kind of attacks of vertigo, often several in an hour, then only one in several hours: without any warning and in any situation, all objects would seem to move with a shaking motion, either towards him or from side to side, or to fall over; he would soon begin to stagger about with them, if he did not seize hold of something; in a few minutes he recovered himself, his illu- sions of sight disappeared, but he felt as if intoxicated; all his func- tions were normal, but his face was red, eyes injected, and pupils di- lated, but his sight was good. An infusion of Flowers of Arnica, in increasing doses for six weeks, restored him. (4. 11.) Mind and Disposition.—Absent-minded. Confusion of thoughts. Weakness of memory. Disinclination to mental occupation. Unea- siness of the mind and body. Hypochondriac anxiety. Excessive sensitiveness of the mind. Quarrelsomeness and peevishness. Ob- stinate and headstrong. Hopelessness. (19. 26.) Clinical Remarks.—In the muscular pains which have been and will frequently be referred to, the patients often lay peculiar stress upon the mental depression produced by the perpetual recurrence of the suffering; the despondency does not arise simply from the pain, but from that feeble condition of the body upon which the pain de- pends; we all know that when a patient is weakly, low spirits are common. (11.) Sleep.—Frequent yawning. Frequent yawning, without any sleepi- ness. Sleepiness. Sleep full of dreams, and not refreshing. Anx- Mo untain-A mica. 575 ious, heavy dreams the whole night. He has terrible dreams, screams aloud while asleep, which wakes him up. Starting up while asleep. Lamenting when asleep. Loud, unintelligible talking when asleep. Involuntary expulsion of faeces while asleep. Sleepiness during trie day. Somnolence, frightful dreams. While falling asleep at night, he is roused from sleep by a peculiar sensation of heat in the head; this is followed by anguish when awake; he dreads similar attacks, and is afraid that he may have an apoplectic fit. (1. 26.) Eyes.—Cramp-like tearing over the left eye-brow. Contraction of the pupils, with obnubilation of the head. Staring eyes, denoting an- guish. Dilatation of the pupils. Stitches in the eyes. Burning in the eyes. Occasional flow of tears, which burn like fire. Drawing pain in the right eye-ball. (1.) Obscuration of sight. (19.26.) Clinical Remarks.—Injuries of the eye.—Case 1.—.Mrs. H., while engaged in frying a pancake, a portion of the fat squirted into her eye. The agony it produced was intense. She applied a solution of Ace- tate of Lead, by the advice of a surgeon. I saw her the following day. On examining the eye, the vessels were turgid, and the eye presented a high state of inflammation. She felt shooting pains in the eye and temples, with flowing of tears; the parts around the eye and cheeks were inflamed. Arnica both externally and internally in solution was ordered, and the consequence was a cure in three days. (80. 26.) Case 2.—Mrs. N. A., aged twenty-eight, while running up-stairs, struck the angle of the forehead, just over the eye, causing a wound of an inch and a half in length, and a quarter of an inch in width; the bleeding was profuse. In eight hours after the use of Arnica, both internally and externally, in solution, the wound was closed, present- ing at the spot scarcely any inflammation, and only a mark, as of a wound newly healed. The patient was astonished and gratified at the'speedy restoration. (80. 26.) Case 3.—Mrs. P., aged twenty-five, while in bed, her child hap- pened to pass her foot across her mother's eye, lacerating with the toe- nail the transparent cornea, causing all the concomitants of a high de- gree of inflammation. Arnica both externally and internally brought about a cure in less than a week, leaving no scar perceivable, except on minute examination. (80. 26.) Case 4.—A gentleman fell from a carriage, knocking his head against the hard pavement, bruising his cheek, temple and eye dread- fully. The swelling was very great, and the pain intense. The eye was closed, bloodshot, and the eye-lids lacerated. Arnica was given iu solution both internally and externally; the parts were entirely healed in eight days. (80. 26.) Case 5.—A young girl, while running behind a carriage, fell with her.head against the foot steps behind, lacerating one of her eye-lids, and causing great swelling of the parts. After examining the extent of the injury, the parts were brought together, and Arnica in solution 576 A mica-Montana. applied externally and Arnica 6th internally, effected a cure within four days. (80. 26.) Cask 6.—A man while passing a field of rye, two weeks ago, had a small particle of the same blown into one of his eyes, causing a small depressed ulcer of the cornea, with inflammation of the surrounding vessels. Arnica externally and internally, twice a day one drop of the tincture in some water, effected a cure in seven, days. (64. 2G.) Case 7.—A man, aged thirty years, hit his eye accidentally three days ago. Symptoms as follows: the eye much inflamed; opacity of the cornea, on the same a small whitish-grey spot; sclerotica injected; flowing of tears from the eye, and photophobia. Tinct. Arnica, ten drops in water, applied externally, effected a cure. (64. 26.) Case 8.—A young man, aged eighteen years, received a severe kick from a horse on his right eye, in consequence of which severe in- flammation ensued, with swelling of the eye-lids, flow of tears, and violent pain. Arnica 6th continued for six days, effected a cure, ex- cept the flow of tears and violent pain, which were cured by Euphra- sia. (64. 26.) Case 9.—A lady, aged thirty years, in the fifth month of gestation, was suffering from the ill effects of a cold bath, taken fifteen months ago, from the following symptoms: Very frequent mouches volantes; sewing or reading causing her great pain and obscuration of sight, with dull pain over the eyes, and feeling of tightness of the head. Arnica 3, a dose every morning, effected a cure in four weeks. (64. 20.) Case 10.—A boy, aged twelve years, had received a fall a year ago on the arcus supra orbitalis of the left side, causing myopia of that eye. The use of Arnica diluted with water externally, and Arnica 21st internally for one month, restored his natural sight. (64. 26.) Case 11.—In consequence of a commotio cerebri, an amaurotic con- dition developed itself in a middle-aged man; the vision of the right eye gradually became impaired, so that everything appeared to him as though he was looking through a dense fog, until he could not distin- guish light from darkness, although on examining the eye nothing ab- normal could be seen. Sixteen doses of Arnica 2d restored his eye- sight completely. (64. 26.) In rheumatic inflammation of the eyes.—A robust man, aged fifty, after taking a severe cold, was attacked with general rheumatic fever, which finally settled in both eyes; he had lachrymation, pierciug and rending in both eyes and their neighborhood, increased in bed and by warmth; the conjunctiva was much reddened, and he could no longer bear the light. Confinement to a dark room for fourteen days, repeated bleedings, leeches behind the ears, purgatives and diaphoretics were used with- out avail; then fourteen days more were expended in the use of vari- ous rheumatic remedies and external applications, even Corrosive-sub- limate wtfs used in- and externally, but the eye-affection increased so that the pains extended over the whole head and face, and the ball of Mountain-Arnica. 577 the eye resembled a piece of raw meat. An infusion of Arnica was now used, and in seven days he was comparatively restored; the remedy produced profuse sweats and urinations. (14. 11.) Ears.—Intermittent pressure in both ears, in the region of the tym- panum. Dull stitches through the internal ear. Humming in the ears. (1.) Ringing and buzzing in the ears. (19. 26.) Clinical Remarks.—Case 1.—A boy broke a lucifer match in his ear in endeavoring to remove some wax. The ear became much in- flamed; fever was present, and shooting pains passing from the ear to the head were severe ; the past night had been oneof continued ago- ny. Arnica, both internally and externally applied, afforded great re- lief, and on the fourth day he was quite well. (64. 26.) Case 2—A boy nine years old, in consequence of having taken a severe cold, became affected with partial cophosis of both of his ears. Allopathic treatment had been resorted to in vain, when finally after three months' homoeopathic treatment with Arnica, a cure was effected. (64. 26.) Case 3.—A small, active boy, aged nine years, took cold after being overheated, and was attacked with hardness of hearing in both ears, which almost amounted to complete deafness; there was no foreign body, nor excess of wax in the ears; he only complained of constant noises in his ears, supposed he heard wind instruments or the striking of a clock; he had no pain. The greatest variety of internal and external remedies were used without effect; galvanism was used for several months, until finally, after being almost deaf for five months, he was cured in three weeks by drinking an infusion of Arnica. (4. 11.) Case 4.—An officer had gradually been becoming deaf for thirteen years; ear-trumpets, ear-oils, douches of Carbonic-acid gas, &c, did not help him; the external use of an infusion of Arnica, and after- wards of the Ethereal Oil of Arnica, produced much relief. This cure caused a great sensation in Hanover, and Medical Counsellor and Professor Krause was led to use it in several cases of deafness, with, much success. (4. 11.) Case 5.—A healthy farmer, aged seventy-four, had been losing his hearing for several months; he was quite deaf in his right ear, and almost so in his left. Instead of drinking an infusion of Arnica, as he had been ordered, he poured some of it in his ears, every three hours, and recovered his hearing entirely in eight days; he lived five years longer, became somewhat deaf several times, but was always relieved by the Arnica. (4. 11.) Nose.—Lancinating pain in the nose. Swelling of the nose. Fre- quent bleeding of the nose. (1. 26.) Clinical Remarks.—According to Hahnemann, Kreuss, and Har- tung, Arnica is homoeopathic to bleeding of the nose, when caused by external violence, or when there is a sensation of crawling and prick- ling in the nose and forehead, with heat; or when during epistaxis the blood is liquid, bright red. (24. 26.) 37 578 Arnica-Montana. Face.—Pale, sunken countenance. Dry heat of the face, with cold nose and absence of thirst. Hot, red swelling of the cheeks, throb- bing, twinging pain; swelling of the lips, with intense heat; the rest of the body being cool. Cracked lips. (19. 26.) Jaws and Teeth.—Toothache, with swelling of the cheek. (32. 26.) Clinical Remarks.—Arnica is homoeopathic according to Hartung, after the extraction of teeth; it stops bleeding quickly, and also some- times cures toothache with throbbing, pressing pain, with sensation as if the teeth were too long, with congestion of the gums, worse on touching, and hard swelling of the cheeks. (64. 26.) Case 1.—A lady was suffering terribly with toothache, heat and swelling of the gums, and drawing, stitching pain in the teeth of the right superior maxillary bone, extending up to the ear; face red, burning hot, with swelling of the cheek; worse in the air and on ap- plying heat. She had two teeth plugged a few days ago. Arnica 30th gave almost instantaneous relief. (64. 26.) Mouth.—Dryness in the mouth, with great thirst. Dryness in the mouth, without any thirst, early in the morning, with putrid taste. (1.) Pharynx and (Esophagus.—Feeling of dryness in the throat. Sting- ing and burning in the throat. Burning and scraping sensation in the oesophagus, with shivering. Pressure and violent stitches in the oeso- phagus. Difficult deglutition. (19. 26.) Taste and Appetite.—Putrid, slimy taste in the mouth. Repugnance to meat and broth, desire for vinegar. Want of appetite, the tongue being coated white and yellow. Bitter taste. (32. 26.) Gastric Symptoms.—Bitter taste in the mouth. Putrid, slimy taste. Sputa mixed with blood. Empty eructations. Early in the morning eructations tasting of rotten eggs. Gulping up of saltish water. Nausea and disposition to vomit early in the morning. Heart-burn. Nausea. Qualmishness of the stomach, with empty eructations. Retching, unto vomiting. Vomiting of coagulated blood. Violent pressure on the sternum, over the pit of the stomach. Violent jerks under the stcmach. (1.26.) Clinical Remarks. -Arnica is often useful against the muscular pains and soreness which remain after severe vomiting; the violence of the suffering often suggests the idea of inflammation, neuralgia, or hysteria, as it is often attended with a rapid pulse, disorder of the stomach and bowels, and great tenderness of the walls of the abdo- men. (58 .11.) Case 1.—After a severe attack of vomiting, a lady complained of in- tense pain in the trunk, which shot up to the head and neck, and down to the hips and knees; she was constantly moaning from its severity; it started as if from a focus, and rushed in radiating lines to all parts and in all directions; up and down along the erector-spinae, vibrating, twitching and tearing; the pain was constant, but there were severe aggravations; it was equally severe in the external and internal ob- Mo untain- Arnica. 579 lique, transversalis, rectus abdominis, quadratus lumborum, latissimus dorsi, pectorals, gluteal and crural muscles; the attachments of the diaphragm were also mapped out by the painful spots. (58. 11.) Stomach.—Feeling of repletion of the stomach, accompanied by loathing. Pressure in the pit of the stomach. Pinching, spasmodic griping in the stomach. Flatus, accompanied by pressure at the sto- mach. Oppression at the heart. Pressure, as if a stone were lying in the stomach Rumbling in the stomach, with colic. Aching trans- versely across over the pit of the stomach, with dyspnoea. (1.) Stitches, burning, distention, drawing and painful throbbing in the region of the stomach.. Violent cramps of the stomach, with distention of flatus. (19. 26.) Clinical Remarks.—In Haematemesis.—A servant girl, in conse- quence of ill-treatment, became affected with haematemesis, for which she was treated allopathically for five weeks without receiving any benefit therefrom. She also complained of general malaise and a feeling of soreness through her whole body,with almost constant nau- sea, pain in the stomach, and vomiting of everything she partook of, always co-mingled with blood. A perfect cure was effected by Arnica 6th in four days, by Dr. H. B. Harris. (81. 26.) In Dyspepsia.—A woman, aged forty-two years, suffering for years from dyspepsia, and subject to indolent ulcers about her legs, which at present appear to be forming again. After every meal, pain and heaviness in epigastrium, with heat and pressure over the forehead and temples; nausea, at times vomiting; dizziness on walking in the open air, distention of abdomen before and after eating; restless at night, with bad dreams, and a feeling of general malaise in the morning on eating. Arnica 12th effected a cure of dyspepsia, and the ulcers of her legs re-appeared again.—(Neville Wood.) (81. 26.) Abdomen.—Spasm in the hypogastric region. Pressure below the last ribs. Stitches under the false ribs of the left side, intercept- ing breath. Tense distention of the right side of the abdomen, when at rest; the part is painful as from an internal wound; when cough- ing, blowing the nose, or setting down the foot, it feels painful as if it had been shaken, torn or cut to pieces ; it is even painful when merely touched externally; the pain is relieved by the emission of flatulence, and rages every day from morning until two o'clock in the afternoon. Pain in the region of the liver. Tearing and pinching over the um- bilicus. Sharp stitches in both loins. Sharp thrusts through the ab- domen. Retraction of the umbilicus. Rumbling of flatus in the ab- domen. Colicky pains. Fermenting flatus in the abdomen. (1. 26.) Clinical Remarks.—Arnica promises to be an efficient remedy against the so-called "phantom tumors" of the abdomen. (11.) Case 1.—A washerwoman had a great deal of washing once a fortnight, and used a high tub over which she was constantly stoop- ing; then a tumor would form, occupying the position of the rectus abdominis muscle, sometimes one segment, sometimes another; it 580 Arnica-Montana. was attended with pain, and seemed to double her up; any heavy day's work would bring it on; if the bowels were costive, straining at stool would bring it on. (58.11.) Case 2.—A young woman was supposed to have a tumor of the ab- domen; a swelling, about the size of the palm of the hand was found in the left hypochondriac region; it was raised, very firm, painless to touch; it remained unchanged for six weeks, when a blister was ap- plied, and the tumor left that side but appeared on the other, and again succumbed to a blister; the so-called tumors travelled successively over every part of the fleshy walls of the abdomen; blisters pursued them unrelentingly, and at last the patient was cured; the tumor was noth- ing more than cramps in isolated parts of the external oblique, rectus, and probably other muscles. Arnica, or Conium, or Belladonna would probably have removed the first one, and the others would not have occurred. (58. 11.) Case 3.—A woman was admitted into a hospital with a tumor in right side of abdomen ; on examination, no tumor was there; but after a severe fit of coughing, intense pain came on in abdomen, and doubled her up; these severe pains was always attended with a lump which went away with a beating sensation. (58. 11.) In spasms of the abdominal muscles.—The abdominal walls are very frequently the seat of pain and cramp, or spasm; the complaint in some is most urgent at the epigastrium, in the upper portion of the rectus muscle, and is frequently mistaken for disease of the stomach; in others on the left side, where it is mistaken for neuralgia, or disor- der of the spleen; in others on the right side, and is supposed to in- dicate disease of the liver, or distention of the colon; others, again, complain equally of all these spots. (58. 11.) Case 1.—A laboring man, accustomed to lift heavy weights, often had severe pain about the ensiform cartilage; it sometimes took him half an hour to go half a mile, and he was often fairly doubled up with pain; different segments of the rectus muscle were frequently cramped; lumps, or isolated cramps in the left external oblique, and pains in the region of the erectores spinae often occurred. (58.11.) Stool—Tenesmus, with emission of flatulence. Flatus smelling like rotten eggs. Tenesmus, followed by a copious, thin, or pap-hke sourish smelling stool, giving great relief, (every day four or five times.) Tenesmus every half hour, when nothing except slime was passed. Hard, difficult stool, with pressure in the abdomen. Diar- rhoea, with distention of the abdomen previous to stool. Aching in the rectum. Freouent, small stools, consisting only of slime. Frequent stool; after every stool he is obliged to lie down. White diarrhoea- like stool. Diarrhoea resembling brown yeast. Constipation. In- voluntary stool at night, when asleep. Undigested stool. Blind haemorrhoids. (1. 26.) . , Clinical Remarks.—Case 1.—A girl aged two years and sixmontns, was affected with liquid, foaming, acrid and very offensive smelling Mountain-Arnica. 581 discharges from her bowels, several times daily, with much flatulence and distention of the abdomen: appetite deficient, with bad smelling eructations; sleep at night restless and interrupted; temperature of the body variable; countenance of an ashy-colored hue ; malaise, irri- tability of temper, and some cough. Tinct. Amica-radicis, six drops in three ounces of water, divided in six doses during twenty-four hours, effected a cure in three days. (64. 26.) Frank decides from the experiments with Arnica, that it irritates the alimentary canal from the mouth to the anus; that it acts more upon the muscular fibres than upon the blood-vessels, and hence faci- litates the peristaltic contractions of the bowels more than it does the secretions or absorbents. It should be used in dysentery much more than it has been, as it is one of the most homoeopathic remedies to this disorder; it was a favorite remedy in dysentery with the late Dr. Cur- tis, who used it both by mouth and injections. It is also one of the most important remedies against flatulence, and will often succeed where Carbo and other appropriate remedies fail; also in diarrhoea, with co- pious, thin, sourish, or yeasty stools. Some old-school physicians have hit upon its use in dysentery. Frank says the excellent action of the Root of Arnica has been proven in many epidemics of dysen- tery. Vogt recommends it in persistent atony of the bowels, with an habitual and truly colliquative diarrhoea, when there are also purulent decompositions of internal organs; in cases where inflammation does not keep up the suppuration, but a truly dissolving and decomposing process is at the bottom of it. Dr. Kitchen, of Philadelphia, had his attention called to the use of Arnica in dysentery by a friend, who, after the use of the ordinary weak remedies for two or three days, determined to take hap-hazard the strongest remedy in his case; this was the Tincture of Arnica, all the other medicines being in pellets; to his surprise he was soon relieved and perfectly well in twenty-four hours, though there had been excessive pain and bloody and mucous discharges; Dr. Kitchen was thus led to try it, and found it a most valuable remedy in the dysentery of 1853. He put six or eight drops of the Tincture in a tumbler half full of water, and gave one tea- spoonful every half, one or two hours, according to the severity of the symptoms ; it generally allayed the pain in a very short time, and fre- quently the bloody discharges, leaving only mucous ones; the symp- toms most benefitted by Arnica were the pains of all kinds attendant on the disease, especially the bearing-down; also the difficulty in passing water, and the bloody and mucous discharges; in some cases, Arnica alone effected a cure in twenty-four, or forty-eight hours; in other cases it had to be continued for some days, and even aided by other remedies, such as Aeon., Merc.-ccrr., Ars., Sulph., &c; recent cases were more rapidly helped than chronic ones, although it was at times useful in these. (11.) Dr. Toothaker having often prescribed Merc, Ars., Coloc, &c. with less satisfactory results than he expected, was led to use Arnica on Dr. Kitchen's recommendation; he gave it in the 3d attenuation 582 A rnica-Montan a. every half hour; the beneficial effects were marked in a few hours, and recovery was rapid. (11.) Urinary Organs.—Frequent desire to urinate, with copious emission of urine. Retention of urine, with tenesmus of the bladder. Tenes- mus of the neck of the bladder, the urine dropping out involuntarily. Cutting pain in the orifice of the urethra, at the termination of mictu- rition. Brown urine, with brick-red sediment. A small quantity of red urine. (1. 26.) Clinical Remarks.—Arnica has been recommended especially against paralysis of the bladder, arising from extravasations of blood in con- sequence of injuries of the spine. Case.—A patient who had suffered for three years with paralysis agitans, was suddenly attacked with entire retention of urine; only a few drops of urine would flow when hard pressure was made over the bladder, but the catheter could be introduced easily; Arnica was given in infusion, in half tea-cupful doses, several times a day; there was no improvement for three days, but suddenly on the fourth night he passed an enormous quantity of urine involuntarily; the remedy was continued, and the next day he passed urine voluntarily three times, and afterwards had no return of the ischuria for five months, when a relapse was cured on the fourth day, after taking eight doses of Ar- nica. (4. 11.) Gross (see Diseases of the Urinary Organs, p. 232,) says, in para- lysis of the bladder, consequent upon typhoid or other fevers, mastur- bation and general exhaustion, few remedies are as serviceable as Arnica; he thinks it is a powerful stimulant, which acts with peculiar energy upon the nervous system, and hence well adapted to all cases of this malady when dependant upon general debility; he gives from forty to sixty drops of the Tincture three times a day, watching its effects with care, as it may cause vertigo, purging, headache, vomit- ing, and spasmodic twitchings, when given in these large doses. (11.) Genital Organs.—Violent sexual desire and continued erections, (in a weak old man.) Several pollutions in one night, with voluptuous dreams. Symptoms as if the menses would make their appearance. A girl of twenty years, who had not had her courses for one year, but was otherwise healthy, had an attack of nausea in the pit of the sto- mach, immediately after taking the medicine; this was followed by a lump of blood passing through the vagina. (1. 26.) Clinical Remarks.—Mr. M., aged thirty years, received six days ago a severe blow on the right testicle. Symptoms as follows:— Scrotum very much relaxed ; right testicle enlarged about three or four times its natural size, hard and hot, very painful on motion and to the touch; constant sharp pain when at rest along the funiculus to the in- guinal region; funiculus swollen, and very painful; stitching pain in the forehead; bitter taste in the mouth; tongue coated white; frequent shivering over the body; pulse sluggish and small. Treatment.—A suspensory bandage to be applied. Arnica 6th in- Mountain-Arnica. 583 ternally, and Tinct. Arnica diluted externally, cured in eight days. (64. 26.) In the case of a single woman, aged eighteen years, of good consti- tution, who lost her menses fifteen months ago after having taken cold. Pulsat., Graph., Sepia, Sulph. and Rhus were given without effect. Besides headache and slight pain in the chest, nothing else troubled her. Arnica 12th, three days before the usual period of menstrua- tion, brought about the desired effect. (64. 26.) Griesselich says, Arnica has been used to produce abortion; also has been used with success in homoeopathic doses against metrorrha- gia. (64. 26.) Arnica administered immediately after confinement, prevents severe after-pains and milk-fever; also against sore nipples, used externally. (64. 26.) Some of the pains of irritable uterus have a muscular origin, as well as a nervous; Dr. Grumsdale regards the phenomena of some cases of retroversion and anteversion of the unimpregnated womb, as due to irregular contraction of its walls; in these instances Arnica may prove a useful remedy. (11.) In Sweden, in alternation or combination with Tart.-emet., it is re- garded almost as a specific emmenagogue. It is also used against ab- dominal plethora, when there is a suppression of the menses or piles. (4. 11.) Dierbach says that infusions of Arnica and other herbs, are favorite remedies among French women against the disturbances which are apt to arise at the change of life and cessation of the men- ses; Dr. Gray thinks Tincture of Sanguinaria a specific against the chills, flushes and perspirations which are so annoying to many wo- men at the change of life. (11.) Larynx and Trachea.—Sneezing; violent coryza. Hoarseness early in the morning. Frequent sneezing. Vapor, as of rotten substances, coming out of the mouth during an expiration, for two days. Dry, short, and hacking cough, as if from a titilation in the trachea, every morning after rising. Cough at night during sleep. Cough in chil- dren, produced by weeping and lamenting. Pain in the chest, as if it were raw, with roughness of the throat during cough. Haemoptoe. Cough exciting vomiting. (1. 26.) Chest.—Short, panting breath. Dyspnoea. Oppression at the chest, with anguish, pains in the abdomen, and headache. Excessive diffi- culty of breathing. Cutting aching, with pressing through both sides of the thoracic cavity, increased by inspiration. Pain in the left side of the chest, like pricks of pins. Stitching pain in the chest, accom- panied by a short cough, which increases the pain, and by continued asthma. Stitches in the right side, left breast and sternum, during a deep inspiration. All the joints of the bones and cartilages of the chest feel painful as if bruised, during motion and breathing. Op- pression at the heart. (1. 26.) Violent palpitation of the heart. (19.) Clinical Remarks.—Sore nipples are cured by bathing them once a 584 Arnica-Monta na. day with a solution of Arnica. Before giving suck to the baby, the nipples should be washed with water for the purpose of removing the alcohol. (80. 26.) In spasm of the Diaphragm.—In this disorder we find a constrictive pain around the body, pain shooting from the back to the epigastrium, and from side to side; painful respiration referred to every part of the diaphragm's insertion, and a sudden catch in the breathing not referri- ble to the intercostals, or abdominal walls; in these cases Arnica and Hyosciamus are useful remedies. (11.) Pain referred to a small spot, about the size of a shilling, below the mammae, commonly the right, is frequent during pregnancy; it is tender to touch, and corresponds with the upper termination of the linea semilunaris; the pain is pretty constant, much increased by lying on the affected side; it may come on during the third month and continue till full term; its wearing character greatly depresses the patient's spirits; occasionally a similar pain is felt at the lower end of the linea semilunaris; they both arise from a stretching of the fibrous tissue. (11.) Notes on Arnica in Pleurisy and Pneumonia.—a.) In pneumonia- notha Arnica is an excellent remedy, if the irritation of the vascular sys- tem is very moderate, with a sensation of soreness of the chest, cough not frequent, and the expectoration of slime is streaked with blood. b.) Characteristic indications for the use of Arnica in pleurisy, are especially uneasiness in the affected side; a constant desire for change of position in bed; a painful soreness of the chest, with general in- ternal heat, with cold hands and feet; or when the patient complains of stitching pain in the affected side, with* feeling of tightness of the chest, and frequent dry cough, causing increase of pain. (Hartmann.) c.) If the expectoration in pneumonia is watery and foaming, or brown, of foul odor and mixed with foul blood, and brings no relief, then Arnica will be the best remedy; also if stitching pain remains after a deep inspiration, in traumatic inflammation after surgical opera- tions and extensive injuries ; not less useful in rheumatic form, espe- cially when there is a certain degree of mental depression; also in nervous and torpid inflammations. (Biichner.) d.) According to Watzke, Arnica is indicated in the first stage of pneumonia in strong built individuals, with consensual irritation of the brain. (26.) e.) According to Peschier, in the remaining pain in the chest, op- pression and dyspnoea, after the inflammatory condition has been re- moved by Aconite and Bryonia. (26.) f.) Dr. Wurmb, of Vienna, says: as Arnica is one of the few reme- dies which cause resorption, it is a pity that it is overlooked loo often by physicians in cases such as pleurisy; although Arnica appears to act more speedily when there is an exudation of plastic lymph, never- theless it is very efficacious in serous exudations. (26.) g.) The physiological provings of Arnica completely show its speci- fic sphere of action on the lungs and pleura, with its numerous symp- toms of bleedings from the substance of the lungs, and its prompkaction Mountain-Arnica. 585 in arresting haemoptysis, but the employment in pneumonia, &c, has been, I am sorry to say, hitherto too much overlooked, as it is not only indicated in pneumonia from mechanical injuries, but also in its idio- pathic form, if the vascular excitement does not run too high. (Ch. Mul- ler.) (64. 26.) Case 1.—A case of violent pain in the chest, in a man aged thirty- four years, brought on by heavy lifting. Symptoms as follows: vio- lent stitches on a deep inspiration; coughing on motion, over the right superior half of the chest and axilla; cough, with difficult raising; slimy sputa; breathing and speaking difficult; violent pain in the fore- head ; dizziness, almost fainting at times, with everything turning black before the eyes; 'appetite impaired; bitter taste; tongue coated white; pulse full, moderately frequent; great prostration and emacia- tion. Arnica continued for five days at intervals, restored the patient, except the headache, which was cured by Rhus. (64. 26.) Case 2.—A soldier, aged twenty-four years, of short stature and good constitution, complains since a few days of violent pain in the chest, with the following symptoms: stitches in the integumentary parts of the right half of the chest; expectoration scanty, streaked with blood; great uneasiness of the body; feeling of tremor, and pul- sation of all the vessels of the head; much feverish heat; very little sleep, and tossing about in bed at night; tearing headache, mostly in temples and forehead ; much thirst; very little or no appetite ; white, furred tongue; pulse 90 and 32 respirations in a minute; no stool for twenty-four hours. Cure effected by Arnica 6th in three days. (64. 26.) Case 3.—M., aged twenty-four years, sanguine temperament, just recovered from an inflammatory affection of the brain, cured by Hyosc, was taken with pneumonia. Symptoms: violent stitches in the side; feeling of fullness in the chest; breathing short, dyspnoea; short, dry, painful cough, with difficult expectoration of sputa streaked with blood; face red, appeared swollen; violent heat, with thirst; eyes sparkling, pupils not dilated; tongue dry; disgust for every kind of nourishment; urine yellowish-red; tenderness of the abdomen, with- out stool for twenty-four hours; pulse quick, hard and full; apprehen- sion of death. Cure in eight days by Arnica 6th. (64. 26.) Notes on Arnica in Haemoptysis.—a.) If the blood is coagulated, dark, appearing without straining, with tightness of the chest, stitches in the thorax, burning palpitation of the heart, considerable heat in the abdomen, with general malaise, almost fainting; or else if haemoptysis appears on vomiting and coughing, the blood bright red, foaming mixed with coagulated lumps intermingled with slime, sometimes with tick- ling under the zvphoid cartilage, stitches during cough, in the head, and a feeling of soreness of all the ribs ; it is likewise indicated after injuries to the chest, &c. (Hartung, Hartmann.) (64. 26.) b.) According to Kreuss, Arnica is indicated also in haemoptysis dynamically induced by continued coughing, with violent tickling in the throat-pit, and oppressive feeling in the cardiac region. (64. 26.) 586 Am ica-Montana. c.) Weber says: I have cured haemoptysis caused by injuries, sometimes of long standing, by Aconite and Arnica in alternation. d.) According to Knorre, Arnica has been very useful in phthisical patients, when haemoptysis was induced by apparent slight causes, such as moderate exercise of the body, movements of the arms, stooping, lifting, grasping, &c. e.) Griesselich has found Arnica useful in haemoptysis when caused by the growing of tubercles in phthisical subjects. (64. 26.) Case 1.—Mrs. B., aged twenty-four years, received about a year's ill treatment bodily. Condition as follows: a feeling as if everything was rushing to the head on walking, causing a great deal of heat, sometimes palpitation of the heart, more noticeable in the pit of the stomach, causing a marked depression there, with much burning; soon afterwards a rising of blood in dark lumps, without cough, coming into her mouth; precordial region very sensitive to the touch, causing sharp stitches about the heart; is obliged to lie down, with fainting; appetite wanting, stool hard, menses regular, but less in quantity; looks pale and haggard, is feeble and unable to do anything. Arnica 6th, continued for a week, restored the patient. (64. 26.) Case 2.—A man aged sixty-two years, of strong constitution, san- guine-choleric temperament, had the itch when twenty years of age, cured by Sulphur; had never been troubled with any affection of the chest; was attacked with haemoptysis without any apparent cause, (had taken half a bottle of wine at dinner the day before.) Symp- toms: for half an hour spitting of bright-red foaming blood, mingled with small lumps of blood and slime, apparently coming from the large right bronchial tube, as there appeared a slight depression, with a tick- ling beneath the spot, causing vomiting, flushes of heat, with conges- tion to chest. During a fit of palpitation of the heart, the expulsion of blood increased. Pulse very small, contracted and slow; face pale, hands and feet cold; at times a tendency to fainting. Arnica 6th effected a cure in three days. (64. 26.) Case 3.—M., aged twenty years, had been skylarking, during which his chest was stepped upon. Condition as follows: face deathly pale, cold, complaining of great prostration, with a feeling of faint- ness; on slight coughing, brought up a quantity of dark blood; stitches and burning heat in the chest; violent palpitation of the heart; pulse very small and frequent; externally painful sugillations, but no frac- ture. Arnica 6th internally, and Tinct. Arnica with water externally, effected a cure in ten days. (64. 26.) Case 4—M. had a fall from a tree; the night following violent haemoptysis with a feeling of tightness of the chest; after coughing, expulsion of dark blood at first, followed by about half a pound of bright blood. The next night lost about a pound of dark blood; com- plains of burning heat under the sternum ; pulse rather full. He gra- dually recovered under the internal use of Arnica 6th, in a period of nine days. (64. 26.) Case 5.—H., aged thirty-one years, nervous-sanguine temperament, Mountain-Arnica. 587 has had the itch twice, and two years ago haemoptysis, from which he is suffering at present. Symptoms: paleness of the face, general malaise, emaciation, cough caused by constant tickling in the larger bronchial tubes, with soreness beneath the sternum; two or three times expectoration of blood during the day; respiratory murmur less distinct in the left lower lobe of the lung; pulse 90. Arnica stopped the haemoptysis in a few days, and the rest was cured by Ammon.- carb. 30th in two months. (64.26.) In Pleurodynia.—Arnica is especially suited to one variety of this disorder; there is a muscular pain, which from its close resemblance to pleurisy, is often mistaken for it; it consists essentially of muscu- lar pain and frequently of cramp in the intercostal muscles; there are few persons who have not had experience with stitch in the side from running, an exertion which involves the fullest action of which the in- tercostals are capable, both in working the body as it sways about with the alternate flinging of the arms and legs, and from the great effort made to aerate by full inspirations, the increased quantity of blood which is thrown upon the lungs. The intercostals have also a great deal to do in keeping the body erect and turning it from side to side, as well as assisting in respiration; hence weak persons threatened with phthisis, growing persons and delicate women are particularly obnoxious to these pains. They commonly come on at night, or to- wards evening, or after some unusual exertion, such as sneezing, coughing or laughing; they are not severe at. first, but wearing, and as they often come on in the act of turning around in bed. they interfere with sleep; they resemble the genuine pain of pleurisy, as they are always aggravated and often induced sharply by taking a deep inspi- ration, the sudden catch being decidedly marked. (11.) The so-called hysterical pleurodynia is also a muscular affection; it is so very common, that there is scarcely one young woman in three who escapes it altogether; it is generally situated in the left side, at times in the right, and occasionally in both; it may be attended with swelling, i.e., muscular cramp; the sufferings it causes are often very severe, and occupy the patient's thoughts, to the exclusion of every- thing else; the pain is muscular, although it is generally regarded as neuralgic, and as one of the symptoms of spinal irritation; it has its seat under the breast, at a spot corresponding to the commencement of the sheath of the rectus muscle, or at a place corresponding with one of the digitalions of the serratus magnus and external oblique; it is also met with extending along the margin of the ribs at the points of origin of the external oblique. This pain in the side is frequently at- tended with another at the insertion of the rectus muscle into the pu- bis, and at the inner end of Poupart's ligament; these pubic pains are generally mistaken for disease of the womb. (58. 11.) Back.—Pain in the os-sacrum, as after a violent thrust or fall. The small of the back is painful, as if it had been beaten off. Pain in the small of the back; he felt stitches in that part when coughing,breath- 588 Arnica-Montana. ing deeply, or walking. Arthritic pain in the back and limbs. Pain as from bruises in the back. Tingling in the vertebral column. Cut- ting thrusts between the scapulae, extending into the thoracic cavity, when walking. Pain of the right scapulae towards the back, as after a violent shock or fall. Cramp-like pain in the cervical vertebrae. cramp-like tensive pain in the muscles of the neck, when sneezing or yawning. Pimple on the side of the neck, which, when touched, is affected with a stinging pain. (1. 26.) Clinical Remarks.—It is evidently homoeopathic to muscular pains and cramps in the muscles of the neck and shoulders, especially in the tra- pezius and rhomboideus. It is suited against a large proportion of those muscular pains which are so constantly mistaken for the pains of spi- nal irritation. We should remember that the chief, if not the sole use of the spinous processes is for the insertion of muscles; the spine forms the point d'appui for nearly every muscle of the body. Is the head to be kept erect, the muscle springs from the spine; are the sca- pulae to be drawn back, the arm to be raised, the shoulder to be moved, the muscles by which these operations are effected arise from the spine; is the body to be kept erect or to be turned, still the muscles use the spine for their centre of operations; are the thighs to be raised by the psoas, the antagonistic muscles of the other side of the spine must be brought into operation, so that the spine maybe fixed, and not bent upon the thighs. In short, there is scarcely a motion of the body in which one or more muscles attached to the spinous processes are not brought into operation, and there is, therefore, throughout the whole day an almost constant and unremitting strain upon the fibres by which the muscles are inserted. In weakly and delicate persons, large por- tions of the muscles of the back will be painful or even tender to touch, and these pains will be constantly mistaken for those of rheu- matism, neuralgia and spinal irritation. (58. 11.) Superior Extremities.—Drawing and aching in the left shoulder, when standing straight. Broad, sharp stitches below the axilla, from without inwards. The arms feel weary, as if bruised by blows, so that he was unable to bend his fingers inwards. Drawing, cramp-like pain in the long bones of the fingers and the fore-arm. Tingling in the fingers. Painful concussion or shock in the arm, as if produced by electricity. Twitches in the left upper arm, as if a nerve were put upon a stretch. Twitchings in the muscles.of the upper arm.. Intermittent, painfully pressive tearing, apparently in the bone. Tingling in the fore-arms. Tearing pain in the arms and hands. Burning stitches in the fore-arm. Pain as from a sprain, in the wrist, (chest, back, and hips.) Lancinating tearing pain. Tingling and crawling in the hands. Cramps in the fingers. (1. 26.) Clinical Remarks.—Case 1.—Mrs. Upsdill, aged sixty, jammed her fingers in a door, causing her great agony. The nails were blue, the parts squeezed very much swollen, and all round the nails puffi- ness ; an effusion of matter appears to surround the nails ; she suffers Mountain-Arnica. 589 intense shooting pains, accompanied with some fever and headache. I ordered Aconite and Arnica in alternation to be taken, a lotion of Arnica tincture to be used during the day, and a poultice at night. On the next day the pains were gone. There is a white margin round the nail, the blueness is much diminished, the swelling is les- sened. She continued the Arnica, quite recovered, and her nail was saved. (80. 26.) Case 2.—A boy while playing with his school-fellows, was thrown violently on a heap of stones; he fell on his right side; his arm and elbow received the shock of the fall. The whole of the arm was swollen, and the pain considerable, but-neither fracture nor dislocation. By the internal and external use of Arnica, a cure was effected in a week from the time the injury took place. (80. 26.) Pain in the hands occasioned by rowing, or any other unusual and fatiguing manual labor, may be relieved by washing them with a solu- tion of Arnica. (80. 26.) Wounds.—A sharp instrument penetrated a lady's index-finger. The wound did not bleed, but violent plunging soon took place in the finger, with swelling of the veins; the finger became hard, and the pain ex- tended along the fore-arm and the arm as far as the axilla, and the heat was very great in the part which had received the injury. One drop of the Tincture of Arnica dropped upon the wound produced instanta- neous relief, and the wound healed without any further application. (80.26.) A man, otherwise healthy, having had a severe attack of rheuma- tism some years ago, was taken very similar after a severe cold. Is lying in bed almost motionless, not able to move either hands nor feet, complaining of violent tearing pain in the limbs. In the toes, fingers,, hands, knees, and elbow-joints, a feeling of prickling like needles, and a sensation as if the limbs were going to sleep, alternating with vio- lent tearing pain; appetite and stool wanting, increased thirst, sleep disturbed on account of pain. Arnica Tinct. in water, internally, effected a cure on the third day. (64. 26.) Inferior Extremities.—Trembling in the lower extremities. Tear- ing pain in the lower extremities. Pain as from a sprain in the hips, (back, chest, wrists.) Drawing, pressive pain in the left hip-joint. Pain in thighs when walking, as from a blow or contusion. Drawing cramp-like pressure in the muscles of the left thigh, when sitting. Stitches in the knee, (and in both middle-fingers.) The knee-joints have no firmness, they vacillate when standing. Sometimes sudden absence of power in the knees, they bend, whilst the feet are numb and insensible. Pain as after a violent blow, over the calf of the right leg, accompanied by lassitude of the legs. Grinding pain from above downwards in the left calf; the pain then extends into the thigh, thence crossing behind the os-coccygis, and finally terminating at the right iliac bone. Tearing in the heel. Tingling pricklings in the soles of the feet, at one and the same place. Lancinating, tearing, 590 Arnica-Montana. arthritic pain in the big toe, with some redness. Single shocks in the big toe. Sense as of tingling in hands and feet, and lancinating pains in divers joints. (1. 26.) Clinical Remarks.—Case 1.—A young lady, while dancing, ran a splinter into her foot in such a manner, that it could not be extracted by pulling; it was found necessary to remove the subjacent soft parts to extract it. After extraction, the patient took three globules of Ar- nica, and the foot was bathed in a strong solution of Arnica. In four days the foot was almost well, and no inconveniences have resulted. (80. 26.) Case 2.—While jumping out of a carriage, a young lady's foot be- came entangled, and the horses dragged her along to a considerable distance. The foot was turned outwards. After the reduction of the dislocation, bandages moistened with a solution of Arnica were ap- plied, and in the course of three days she used her foot as usual. (80. 26.) Case 3.—A porter, while carrying some weight on his shoulders, slipped in going down the steps. He felt the concussion throughout the whole frame, but especially in one of the joints of the foot. The foot Avas very painful, and swelled considerable. The symptoms were completely removed in a few hours, by washing the foot with a solution of Arnica. (80. 26.) Blisters on the feet, occasioned by walking, are easily removed by washing the feet with a solution of the Tincture of Arnica. (80. 26.) Case 4.—A man, otherwise healthy, having had a severe attack of rheumatism some years ago, had a return of the disease after a cold, with the following symptoms: Is lying in bed almost motionless, not able to move either hands or feet, complaining of violent tearing pain in the limbs. In the toes, fingers, hands, knees, and elbow-joints, a feeling of prickling like needles, and a feeling as if the limbs were going to sleep, alternating with violent tearing pain; appetite and stool wanting, increased thirst, sleep disturbed on account of pain. Arnica Tinct. in water, internally, effected a cure on the third day. (64. 26.) Pain in the plantar fascia, and sometimes so complete a stretching of the fascia and the ligaments of the foot so as to destroy the plantar arch, and make the person flat-footed, is common in the weak from too much walking; weakness of the ankle is not uncommon from a similar cause; severe pain at the insertion of the tendo-achillis some- times occurs, and may be almost permanent. (11.) In chronic rheumatism.—A powerful young man, aged twenty-thri after much exposure and dissipation, was attacked with weakness 0i tne right leg, soon followed by increasingly violent rheumatic pains, and a small painful swelling in the sole of the fool; he recovered in a few weeks and remained well for a year, when he again took cold; violent irritative pains sat in below the tendo-achillis and the inner side of the calcaneus, which prevented walking, followed by a hazel- nut sized, hard and painful swelling, not unlike an exostosis; the rheumatic pains gradually extended upwards to the hip, and persisted Mountain-Arnica. 591 for nearly two years, with only occasional periods of relief, notwith- standing the use of all kinds of rheumatic remedies, and nearly two hundred Russian vapor-baths; painful swellings also arose on the back of the hand. He now took one-half of an infusion'of 3J. and ^iss of Flowers of Arnica in six ounces of boiling water, every morning and evening; in eight days he was free from pains in the hand, and in four weeks he was relieved of all his disease; a relapse several months after was removed by the same treatment, and he remained well for two years. (4. 11.) Vogt recommends it against old and atonic rheumatisms occurring in weakly persons, when the membranous parts are especially affected, and exudations and effusions have occurred; also in arthritis rheuma- tica occurring in debilitkted persons, even if some fever be present, provided the disease be obstjnately localized in some part. In chronic atonic gout. General Symptoms.—Deeply penetrating, dull stitches in the limbs, here and there. Sense as of pricking in the skin. Stitching pains. Finepricklings in almost every part of the body. Burning and cut- ting pains here and there. Jerks and shocks in the body, as by the electric fluid. Itching rash, produced by moistening the skin with the tincture. Sudden twitches of single muscles, almost in every part of the body. The pains increase on motion. Twitchings in all the limbs, especially in the feet and shoulders, with heat of the feet. Painful and excessive sensitiveness of the whqle body. Heaviness in all the limbs; paralytic pain in all the joints, during motion, as if the joints were bruised. Tremor of the limbs. (1. 26.) Dr. R. Ludlam has used a low dilution of this remedy with the most gratifying results in obstinate dysenteries. He found it to relieve an incessant and harassing tenesmus in plethoric subjects, better than any other remedy, and especially if the case occurred during the ex- treme heat of summer. Its value in this direction lacks much of being over-estimated. ARISTOLOCHIA-SERPENTARIA. VIRGINIA SNAKE-ROOT. AUTHORITIES. Wood and Bache. (7.) Snelling. (46.) Serpentaria, in old-school parlance, is a stimulant tonic, acting also as a diaphoretic or diuretic, according to the mode of its application. Too largely taken it occasions nausea, griping pains in the bowels, sometimes vomiting and dysenteric tenesmus. It is said to be admira- bly adapted to the treatment of typhoid fevers, whether idiopathic or symptomatic, when the system begins to feel the necessity for support, but is unable to bear active stimulation. In exanthematous diseases in which the eruption is tardy or has receded, and the grade of action 592 Aristolochia-Serpentaria.—Armoracia. is low, it is thought to be useful by promoting the cutaneous affection. It has also been highly recommended in intermittent fevers. (7. 46.) Dr. J. W. Ludlam has been in the habit of employing for many years, a warm infusion of this root as a remedy in obstinate sick-head- aches. In debilitated females suffering with this complaint, it fre- quently affords the most prompt relief. In convalescence from low forms of fever, it is also a favorite pre- scription. These facts are significant to the Homoeopath. Note.—As there are no less than twelve species of Aristolochia noticed in the U. S. Dispensatory, it may be well for the practitioner to pay particular attention to the description of the plant, in order to avoid confusion. "The A.-Serpentaria is an herbaceous plant with a perennial root, which consists of numerous slender fibres proceeding from a short horizontal caulx. Several stems often rise from the same root. They are about eight or ten inches in height, slender, round, flexibose, jointed at irregular distances, and frequently of a purple or reddish color at the base. The leaves are oblong, caudate, acumi- nate, entire, of a pale yellowish-green color, and supported ,on short petioles at the joints of the stem. The flowers proceed from the joints near the root, and stand singly on long, slender, round, jointed peduncles, which are sometimes furnished with one or two small scales, and bend downwards so as nearly to bury the flower in the earth or decayed leaves. There is no calyx. The corolla is of a purple color, monopetatous, tubular, swelling at the base, contracted and curved in the middle, and terminating in a labiate border, with lanceolate lips. The anthus six or twelve in number, are sessile, at- tached to the under part of the stigma, which is roundish, divided into six parts, and supported by a short fleshy style upon an oblong angu- lar, hairy, inferior germ. The fruit is a hexangular, six-celled cap- sule, containing several small flat seeds. The plant grows in rich, shady woods, throughout the Middle, Southern, and Western States. It flowers in May and June." (7. 46.) ARMORACIA. HORSE-RADISH. AUTHORITIES. Pereira's Mat. Med. (3.) Wood's Therapeutics and Pharmacolo- gy. (88.) King's Dispensatory. (100.) Wood and Bache. (7.) Watson. (27.) EMPIRICAL OPINIONS. It is regarded as stimulant, emetic, diuretic, anti-scorbutic, and ru- befacient. (100.) Horse-Radish.—Arsenic. 593 GENERAL EFFECTS. It promotes the secretion of urine, causes the patient to perspire, and its odorous emanations cause copious secretions from the lachry- mal glands. An infusion of this substance may be taken to produce vomiting in cases of poisoning by narcotic substances. Nose and Eyes.—Armoracia causes increased secretion from these parts, and is homceopathically curative in catarrhal affections of these organs. (27.) Larynx.—This article specifically affects the larynx, and experience has demonstrated that it is very serviceable in some forms of hoarse- ness. (3.) Stomach.—It produces vomiting. Clinical Remarks.—Useful as a condiment in enfeebled states of the stomach. (7.) Kidneys.—Increases the secretion of urine. Clinical Remarks.—Has been used in dropsy, attended with a fee- ble state of the system, impaired digestion, and an atonic condition of the kidneys. (7.) Said to be peculiarly adapted to dropsical affec- tions occurring in drunkards. (88.) An infusion of the root in cider, drank freely, and as warm as can be borne, while the patient is kept warmly covered up, has caused copious diuresis and diaphoresis, and cured dropsy in a few weeks. (100.) ARSENICUM-ALBUM. ACIDUM ARSENIOSUM. (U. S.) ARSENICI OIYDUM ALBUM. (D.) Arsenious-acid. Arsenic. White Arsenic. White Oxyde of Arsenic. As. 03., equivalent 1240. 1 or 99. 34. AUTHORITIES. Hahnemann. (1.) Pereira. (3.) Peters' Dis. of Married Females. (11.) Peters' Dis. of Eye. (11.) Wilson on Skin. (72.) Hartmann. (70.) Watson, of Utica. (54.) Christison on Poisons. (9.) Bank- ing's Abs. (13.) British and Foreign. (18.) American Jour, of Med. Sci. (17.) London Lancet. (52.) Wharton and Stille. (39.) L'Art Medicale. (73.) British Journal of Hom. (12.) Dierbach's Mat. Med. (6.) Jahr. (32.) Noack and Trinks. (19.) North Am. Jour. of Hom. (67.) Frank's Magazine. (4.) Waring's Therapeutics. (44.) Orfila. (2.) Teste's Mat. Med. (36.) Marcy. (10.) Fullgraff. (26.) Snelling. (46.) Trousseau and Pidoux. (38.) Peters. (11.) 38 594 Arsenicum-Album. GENERAL REMARKS. Arsenic belongs among the electro-negative, or acid minerals; it is found in many countries, but not in very large quantities; among the European countries, Germany is most celebrated for its production of Arsenic, although it is also found in Spain and Sweden. Occasion- ally it occurs in a pure form, but more frequently in combination with Cobalt, Nickel and Iron, and still more frequently with Sulphur; at times it is combined with volcanic products. (6. 11.) Native Arsenic {Arsenicum-nativum) is found in Saxony, in the Hartz mountains near Andreasberg, in Alsatia, Hungary, Norway, and Siberia; it is also prepared artificially by roasting Arsenical-pyrites in a retort; the so-called Cobalt-pyrites is a combination of Arsenic with Metallic Cobalt. (6. 11.) Metallic Arsenic forms two native sulphurets, viz., Orpiment and Realgar. (3. 11.) Orpiment, or Yellow Arsenic, or Arsenicum-citrinum, seu flavum, vel luteum, is a vulgarization of the term Auripigmentum ; it is also called the Yellow Sulphuret of Arsenic, or Arsenicum Sulphuratum Citrinum. It is found in its natural state in Hungary, Tyrol, Tran- sylvania, &c. Persian Orpiment, which is brought to Europe by way of Smyrna, is much prized for its internal metallic golden lustre; Chi- nese Orpiment, and that of Hungary, Bosnia and Servia, is less prized. (6. 11.) False, or artificial Orpiment, also called Kings-yellow, or Gold-yel- low, is prepared by sublimating one part of Sulphur with two parts of White Arsenic; it is a much more violent poison than the natural or fossil Orpiment. (6.11.) , The other Sulphuret of Arsenic, is called Red Arsenic, Realgar, or Sandaracha; also Red Sulphuret of Arsenic, Sulphuretum Arsenici rubrum, &c. The finest specimens are found in Transylvania, al- though it is also met with in the Hartz mountains, Hungary, Bohemia, in the neighborhood of Etna, Vesuvius, and other volcanoes; also in China and Japan. It has a scarlet-red color, which in some speci- mens is tinged with yellow or brown. (6. 11.) An artificial red Arsenic, or Realgar, is prepared in Germany by the distillation of Sulphuret of Iron, or Sulphur-pyrites, or crude Sul- phur with Arsenic-pyrites. Red Arsenic is less poisonous than the yellow; and the natural less so than the artificial. (6. 11.) As the word Pyrites has often been used, it may be well to give Webster's and Dana's definition. It is derived from a Greek word, meaning fire, and is defined as a combination of Sulphur with Iron, Copper, Cobalt, or Nickel, presenting a white or yellowish metallic lustre. The term was originally applied to the Sulphuret of Iron, in allusion to its giving sparks with steel. The sulphurets of other metals, or those of Copper, not presenting the colors stated, are not termed Pyrites. (11.) Clinical Remarks.—We translate from Trousseau and Pidoux'a Arsenic. 595 Materia Medica, the following ancient uses of Arsenic. Two prepa- rations were then in use, neither of them the white oxide or arsenious acid, (which is now officinal with us,) viz, the yellow sulphuret, or orpiment, and the native red sulphuret, or realgar. (46.) Under the name of Arsenic, the ancients understood only orpiment, the yellow Sulphuret of Arsenic. At the present day, and indeed for a century past, we have been in the habit of designating as Arsenic, par excellence, only the white oxide or arsenious-acid. Dioscorides is the first whom we find treating of the arsenical preparations, {nepi rrjc, "laBptKnc lib. 5, Cap. 121, 122.) Under the name of 'Apoevtuov, (Arsenic,) he speaks evidently of the native yellow Sulphuret of Ar- senic {Orpiment) mingled, according to Harles, {de Arsenici usu in medicind, Norimb, 1811, p. 50.,) with a certain quantity of Arseni- ous-acid; and under the name of oavdapaicn, (Sandaracha,) he speaks of the native red Sulphuret, {Realgar.) He says, Arsenicum vim habet septicam, stypticam et escharoticam, cum morsione violenta; simul constringit, et capillos demit. Sandaracha easdem habet vires ox prius: meditur alopecia et leprotico ungui, cum pice juncta, nee non phthiriasi, oleo mixta. Prodest itidem contra narium orisque ulcera, reliquaque exanthemata cum oleo rosarum administrata; aque ac contra condylomata. Datur guoque pulmonum suppura- tione laborantibus, cum mulso. Sujfitio etiam, addita resina, admi- nistrate adversus tussim inveteratam, vojpore ipsius per siphonem ore sucto. Cum melle propinata vocem clarifacit, et asthmaticis in potione cum resina porrigitur.*■'' (38. 46.) * Arsenic has a septic, styptic and escharotic power; (the latter being a pecu liarly violent mordent action,) and at the same time, while it constringes, it emp- ties the capillaries. Sandaracha has the same powers, though perhaps in a greater degree. When combined with pitch, it will relieve baldness and leprosy, and com- bined with oil, it also relieves pityriasis. It is successfully used also against ul- cers implicating the mouth and nares, and when combined with oil of roses, is very successful in the exanthemata; as well also in condylomata. It is also given in suppuration of the lungs, carefully mixed with water, wine and honey. It is successful also combinad with pitch, in inveterate chronic coughs, the vapor being inhaled into the lungs through a tube. Drunk with honey, it will clear the voice; and combined with pitch, it may even be used as a potion for asthmatics. (46.) Realgar, as may be seen from this passage, was much more used in medicine than Orpiment, probably because its poisonous properties were a little less active. The authors who follow Dioscorides, the Arabs and " Arabists," have also generally preferred the realgar or red Sulphuret, {Sandaracha,) to Orpiment, or yellow Sulphuret, {Ar- senic.) (38.46.) We find also in Pliny, therapeutic indications for the use of Arse- nic. * Sandaracha valet purgare, sistere, excalefacere, perrodere. Sum- ma ejus dos styptica. Celsus {De Re Medica, lib. 5, cap. 5,) Galen {De simpl. med. facult. passim.,) Scribonius Largus, {Compos, medic, 123, 226, 237,) copy Pliny and Dioscorides. Coelius Aurelianus {Morb. Chron., lib. 4, cap. 3,) among other qualities of Orpiment, mentions its power of killing intestinal worms, and of curing " cceliac 596 Arsenicum-Album. maladies," when administered in enema. And in fact, all authors down to the Arabs, including" the Galenists, concur in according to Orpiment, and especially to Realgar, the properties mentioned by Dioscorides. (38. 46.) * Sandaracha is purgative, heating, escharotic, and lasting in its effects, but above all other qualities stands its styptic properties. (46.) It will be seen that the ancients were acquainted with many of the principal medical uses of Arsenic ; viz., against leprosy, malignant ulcerations, chronic bronchitis, phthisis, chronic skin-diseases, asthma, &c. What would Dr. Hunter say to its use by inhalation 1 (11.) The Arabs, Rhases, Mesue, Serapion, Janus de Damas, and Avi- cenna, (or more properly Abu-ebn-sina) vaunted Arsenic, undoubtedly from their own experience, but partly also, perhaps, on the faith of Galen. Arsenici omnes species calendae (calentae, 1 Eds.,) sunt, et com- burentes. Medentur scabiei, et ulceribus putridis, et leprae ulcerosa, her- peti praeterea esthiomeno et pediculis, nee non asthmali, si vel cum Mo suffumigatio aut epithema fiant. (Rhazes, De Re Med., lib. 3, cap. 33.*) (38. 46.) * All the preparations of Arsenic are hot and burning, (escharotic.) They cure the itch, putrid ulcers, herpes exedens, lice, and even asthma, if inhaled, or used as an epithem. (46.) Avicenna uses very much the same language. Omnes species Ar- senici escharoticae sunt, antisepticae. Arsenicum citrinum et rubrum abradit pilos, et convenit alopeciae. Fit ex eo emplastrum ad vulnera. Cum adipe et oleo confert scabiei et ulceribus sahafat {lepra ulcerosce) et putridini ad cutem ; abstergit uritque. Ceratum factum ex eo, confert contra herpetem esthiomenon ulcerosumque in ore et in naso. Datur quoque in potionibus cum hydromele ad pulmonis suppuratos et tussim antiquam sputumque sanguinis et saniei, quandoqucetiaminpilulis con- tra asthma, et, in clysteribus, contra haemorrhoides ani. Canon., lib. 11, tract. 11, cap. 49.*) (38. 46.) * All the preparations of Arsenic are escharotic and anti-septic. Arsenicum- Citrinum and Rubrum are depilatories, yet are suitable in baldness. A plaster suitable for wounds, is also made of Arsenic. With lard and oil it is beneficial in the itch and lepra ulcerosa, and to gangrenous ulcerations of the skin. It is an abstergent and escharotic. An ointment is made from it, curative to creeping herpes and ulcers in the nose and mouth. It is given also in the form of draught combined with honey for old coughs, expectoration of pus, bloody and sanious sputa; sometimes even in pill for asthma, and in clyster for hjemorrhoids of the anus. (46.) Later the Arabians themselves scarcely employed Arsenic. We hardly find in the writings of the physicians of the fifteenth and six- teenth centuries any mention of this medicament. Theodore employed it solely against ulcerating scrofula. Guy de Chauliac for the pur- pose of making an eschar in hydrocele. (38. 46.) However, after the sixteenth century, the epoch in which medicine like all the other sciences was making an effort to emerge from the night and darkness of the middle ages, the external use of Arsenic was somewhat revived; but it was but seldom that a practitioner dared Arsenic. 597 recommend its internal exhibition. Von Helmont counselled the use of the arsenical preparations in the treatment of ulcers; but he for- mally proscribed its use internally. Tagault indicates in the most ex- plicit manner the use which should be made of it in the treatment of cancer. Arsenicum ad curandos tumores ulcerantes externe primatum abtinet, modo quis noverit eo recti uti. "Arsenic applied externally for the cure of ulcerating tumors, deserves the highest place—a use of it which has lately been most properly revived." Lemery (Cours de Chimie,) Wepfer (Cicut. aquat. hist.) notice only to condemn the essays which had appeared recommending the internal exhibition of Arsenic, and above all, reprehending its use in intermittent fever. In the course of the eighteenth century, however, a multitude of writers appeared to defend its claims as a febrifuge; but Stoerck, who had called the attention of the profession to the utility of so many vegetable poisons, arrayed himself against it with singular animosity. It aroused in the mind of the medical public a greater prejudice against poisonous preparations than would have been thought possible. (38. 46.) Arsenic then fell for some time into profound discredit, whence it was rescued by Fowler and some other English physicians at the end of the last century. (38. 46.) Lastly in our own day, Harles, whose interesting monograph many arc familiar with, has essayed to re-establish it in the favor of the medical world. (38. 46.) Arsenious-acid, commonly termed White Arsenic, is first distinctly mentioned by Geber. (3. 11.) It will be seen that the ancients recommend it in itch, leprosy, herpes, simple and gangrenous ulcerations, chronic coughs, suppura- tion, phthisis, asthma, haemorrhoids, cancer, intermittent fever, &c, &c. Hahnemann's intimate acquaintance with the writings of ancient medical authors led him to revive much of their experience, and made his own experiments with drugs upon the healthy infinitely more sug- gestive to him than they possibly can be to his less learned follow- ers. (11.) Besides the two native Sulphurets, viz., Orpiment and Realgar, there are two native compounds of Arsenic with Oxygen, viz., Arsenious and Arsenic-acids. (3. 11.) The Arsenious-acid, or White Arsenic, is the one we are more particularly interested in; it is prepared in large quantities in Sile- sia, Bohemia, Saxony, and at Cornwall in England. It is manufac- tured on a large scale at Altenburg and Reichenstein in Silesia, from the ore called Arsenical Iron, or Mispickel; in Cornwall it is prepared from the White Mundic, or another variety of Mispickel, found with Tin ore. Arsenical Iron is also found in many localities in Connec- ticut, but more particularly in New-Hampshire, and is not rare in any of the New-England States, or wherever pyritous ores are found along the range of the primary rocks of the Appalachian chain ; but we do not know that Arsenic is prepared in any quantity in the United 598 Arsenicum-Album. States. Arsenious-acid is also found in the ashes of many plants, in certain soils and in some mineral waters. (3. 11.) The Altenburg Arsenical Iron is composed of Sulphur 20.65, Iron 35.62, and Arsenicum 43.73. The Reichenstein Arsenuret of Iron is composed of Sulphur 1.77, Iron 32.25, and Arsenic 65.88. (3. 11.) After being reduced to powder, the Arsenical Iron ore is roasted in a muffle furnace by which the Arsenicum is converted into Arsenious- acid, which is conveyed in the state of vapor, called Flowers of Arsenic, Huttenrauch, or Srnelting-house smoke, by the Germans, into a condensing chamber, where it is deposited in a pulverulent form, and in this state is called Rough Arsenious-acid, Gift-mehl, or Poison- flower, by the Germans. (3. 11.) This rough or crude Arsenious-acid is refined by sublimation; the product is a glassy mass, called Glacial White Arsenic, or Weissen Arsenik-glas by the Germans, which is sometimes purified by a second or third sublimation. If it contain any Sulphuret of Arsenicum, a lit- tle Potash is mixed with it, to prevent the sublimation of the Sulphur. (3. 11.) In Cornwall, the rough Arsenious-acid is deposited in the long horizontal flues of the burning-houses employed in smelting tin ore. From these burning-houses it is brought to the Arsenic works, from all parts of Cornwall. It is first separated from the Sulphur in a common reverberatory furnace, but having an unusually long flue. The heat applied is low at first, so that the Sulphur is dissipated be- fore the Arsenic is volatilized; then the heat is gradually increased; afterwards the fire is extinguished and the Arsenic removed from the flue. (3. 11.) Arsenic, as all chemists are aware, combines with Oxygen in three proportions, forming Sub-oxide of Arsenic AsO., Arsenic-acid AsOs., and Arsenious-acid As03. The latter is by far the most im- portant in its chemical, commercial, and medical relations. It is usually obtained from Arsenical Pyrites and Arsenical Cobalt by roast- ing them in reverberatory furnaces, condensing the vapors, and then submitting their results to a second sublimation. (10.) Its specific gravity is about 3.6, (3.529, Taylor,) and 100 parts of boiling water dissolves 9.68 parts of it. It is also soluble in Alcohol, and in oils. It has an insipid, sweetish taste, but leaves upon the palate an acrid sensation. When put on ignited charcoal it evolves a vapor having an odor like garlic. These facts with regard to specific gravity, solubility, taste and odor are noted in all chemical works as common and familiar to all,—as with alcohol and other similar sub- stances. We have personally verified these facts. (10.) Traces of Arsenious-acid have been detected in Tartar-emetic, Phosphate of Soda, Sulphuric, Phosphoric, and Hydrochloric-acids, and occasionally in human bones, in the form of Arseniate of Lime. and in the Phosphoric Salts which are found in the blood. In the two last instances, the quantity of Arsenic which now and then natu- Arsenic. 599 rally takes the place of Phosphorus, is very small; but a knowledge of the fact is of considerable importance in a medico-legal point of view. (10.) Some of the above statements are doubtless correct; but others made the chemical experiments by which they were established. It was at one time supposed, upon the authority of Orfila, that Arsenic was a natural constituent of the human body, but his own admission of his error many years ago, (in 1842,) and repeated subsequent trials, by Lehman and others, have proved that this is not ihe case; it exists neither in the bones or the soft parts. (39. 11.) toxicological effects. The effects of excessive doses of Arsenious-acid upon different in- dividuals are by no means uniform. It may destroy life by producing gastro-enteritis, with its usual phenomena of vomiting, purging, burn- ing pains in the throat, stomach, and intestines, heat, constriction, dryness and tightness of the throat, with intense thirst, difficult deglu- tition, small, feeble, rapid and irregular pulse, tenseness and hardness of the abdomen, with pain on pressure, short and laborious respiration, cold clammy sweats, dry and sometimes coated tongue, anxiety, ex- treme restlessness, and great prostration of the entire forces of the system. (10.) Or it may expend its power chiefly upon the cerebro- spinal and vascular system, giving rise to faintness, trembling, syn- cope, paralysis, convulsions, spasmodic twitchings, delirium, insensi- bility, and coma. (10.) , . A more full and accurate account of Christison and Pereira s opin- ions of which the above is a short abstract, will be given subsequent- ly; in the meantime as we happen to possess a copy of Hahnemann's original treatise on Arsenic, published in 1786, we will give Hahne- mann's views It may be well to add that the treatise of Harles, of which Trousseau and Pidoux think so highly, that they follow and copy it quite servilely, is based on that of Hahnemann. This little duodecimo of 276 pages is characterized by that immensity and ac- curacy of learning which distinguished Hahnemann's earlier writings, and is not surpassed by that of his well-known treatise on Hellebore. Among the authorities consulted by Hahnemann, were Bergmann of Toxicology, rionmanns .\ieu. ivai. oymc..., ..v,b.—.~ -—----,-., (1733), Haller, Gmelin, La Force (1710), Letters of Madam de Se- vigne, on the poisonings of the Marchioness de Brinvilliers, Merveau, Maret and Durande of France, Paracelsus, edition of 16/9, Bonet, Van Helmont, Stalil, Storck, Peter von Abano, Sala Sennert, Mus- grave, Brocklesbv of England, Rounow's Swedish Impactions (1778) Alphonius and Massaria of Italy, Amatus Lusitamis Bac- cius, Borelli, and at least twice as many more authorities of all ages and languages. (11.) 600 Arsenicum-Album Hahnemann's 3d chapter is devoted to the consideration of three degrees of poisoning with Arsenic. The first degree is, where a large quantity is taken under circum- stances favoring its full effect.; viz., on an empty stomach, or with heating liquors, in persons with irritable nerves and choleric tempe- raments, subject to spasmodic and inflammatory affections, or shat- tered by anger, grief, jealousy, or fear, overloaded with acrid bile, or affected with chronic disease. (1. 11.) If several or many of these favoring influences are present, the most violent and rapidly fatal form of arsenical poisoning, in the first or highest degree will occur, and death may ensue in from three to thirty hours. (1. 11.) Symptoms: 1. The poisoned person first experiences a cold shud- dering, which seems to pervade the whole body; while an inexpres- sible anxiety, or nausea, which seems to oppress the chest as well as the stomach, a cold deathlike svveat, and a general trembling of the limbs, alternate with one another in frequent paroxysms. (1. 11.) 2. The hands, feet and tip of the nose become cold, blue circles form around the eyes, while the oppressed pulse gains in hardness and quickness. (1. 11.) 3. Now follow violent attempts at vomiting, which although very forcible are not fruitful at first, and finally become almost ineffectual from spasmodic closure of the cardiac orifice, and emptiness of the stomach of everything but Arsenic, which is tenaciously plastered on its walls. The patient complains of burning and tearing pains in his throat, oesophagus and stomach, and knows not what to do with him- self. 4. The Arsenic continues to ravage and destroy the stomach with- out compelling it to full and beneficial vomiting; it clings fast to the villi of the mucous membrane, and contracts it as boiling water would, and irritates the bloodvessels to progressing inflammation, without having previously induced beneficial and judicious evacuations. The whole nervous system trembles and struggles, and we see greater evidences of involuntary or intentional destruction than of prosperous reaction. Nature seems to feel her dreadful enemy too oppressively to gather strength and courage to oppose and overcome it, yet she at- tempts it from time to time in repeated ineffectual struggles. 5. The fruitless retchings, the fever, the frightful chills, the anxiety, the internal heat and unquenchable thirst increase ; the breathing be- comes quicker and hotter, more spasmodic and violent; and the glis- tening eyes project from their sockets. The inexpressible anxiety, and the burning, rending and overpowering pain in the epigastrium tortures the patient with a progressive increase. (1. 11.) 6. At first the abdomen is contracted; afterwards when inflamma- tion and irritation of the stomach, liver and spleen occur, it becomes hot and distended; the attempts at vomiting become irresistible and incessant; the panting and gasping lungs, the dry parched tongue, and gaping mouth seek refreshment from cool air and water. The Arsenic. 601 stools and urine are suppressed ; the vomits have a disgusting smell and color, and may be mixed with blood. Cutting and griping pains in the bowels ensue, especially around the navel; the patient is be- side himself, so that he does not hear and see correctly, while his ex- pression is frightfully anxious and fearful. (1. 11.) 7. We now see evidences of the omnipotence of the corrosive destroyer, which persists in its internal ravages without check or mercy, in the livid frothy lips, the swollen and trembling tongue, the agonizing expression of the bloated face, the viscid sweat on the cold forehead, and the lead-colored circles around the staring eyes. (1. 11.) 8. The miserable sufferer no longer looks like himself, but seems a wretched and tortured stranger from another sphere; he screams frightfully, or wimpers despairingly in broken or angry words for help from agony, fire and death; then tosses and struggles violently. (1. 11.) 9. Soon after this we see signs of loss of feeling and sensation ; he becomes more quiet; his breast heaves less frequently; the vomit- ing ceases; his black parched lips tremble, and his pulse becomes extinguished, and involuntary putrid stools of a most offensive smell and appearance occur. (1. 11.) 10. The pupils dilate ; the death-rattle is heard in the throat of the dying and unconscious sufferer ; jerks and spasms convulse his stiffen- ing limbs, and icy-cold features ; his stertorous breathing becomes fearfully slower and slower, and finally with a last spasmodic gasp a ghastly corpse alone is left, the staring eyes and gaping mouth of which fill us with horror. (1. 11.) The first stage of the affection as described in paragraphs 1 to 5, occupies about one-half of the whole duration of the attack ; the second stage, described in paragraphs 6 to 8, about three-eighths of the last half; and the last stage (see paragraphs 9 and 10) occupies only the last eighth of time. All the sufferings are increased if acids, stimulating drinks, or Opium are used. (1. 11.) In Hahnemann's second degree of poisoning with Arsenic, life may persist for several days, and requires more than four grains of white Arsenic to produce it; it is most apt to occur in not very impressible, fully grown and not unhealthy persons, especially those who have much mucus in their stomachs, or have taken food just before or with the Arsenic, or have drank freely of simple diluent drinks, and have not been harassed with aggravating mental troubles. He does not give a very full account of this degree ; simply states that the phenomena are similar to those of the first degree, only they occur less rapidly, have various less violent episodes, and intercur- rent remissions. The inflammation of the stomach and neighboring parts, the contraction and cauterization of the mucous coat of the throat, stomach and bowels seems to take place more slowly and in- terruptedly, apparently from the gradual solution of the little Arsenic which has got into, or remains in them. (1. 11.) The anxiety, oppression of the chest and the retchings are more intermitting, and not so oppressive and suddenly overwhelming; the I 602 Arsenicum-Album. fever increases, still it has some remissions; the cutting, gnawing and burning sensations of the first degree, are more intermixed with twisting, aching, colicky, griping and gnawing pains ; the face swells more; the abdomen is harder ; and vesicles, like aphthae, arise in the mouth. But more especially, this second degree is characterized by more frequent, offensive and bloody discharges from the bowels, with gradually increasing gripings, and less frequent vomitings. The strength of the patient fails more gradually, and his consciousness re- mains until the last, when convulsions may occur, and an incessant hiccough, which admits of no palliation or relief. But this degree has peculiar agonies, which are sometimes wanting in the first; as the pains are less severe and constant, there is more opportunity for the occurrence of remorse, despair, grief, contrition, and other mental emotions which harass the soul. The strange admixture of bodily pain and mental agony, often finishes what the poison alone was too weak to accomplish, and the more stealthy approaches of death are aided by regret for the past, and hopelessness for the future. (1. 11.) If the patient receives only moderately good treatment this second degree may pass over into the third, in which death does not occur, but a long-lasting chronic disorder ensues. Remitting, but oft-recur- ring cramps occur in the limbs, but especially in the feet; repeated paroxysms of fever set in, attended with colic-pains, spasmodic con- traction of the abdomen, intermixed with headache, heat and thirst. After one of these feverish attacks, in which both vomiting and diar- rhoea are apt to recur, the whole remaining force of the poison is apt to be thrown upon the limbs; they become paralyzed, or so much contracted, that the patient cannot extend them, at least not the legs. If proper evacuations are neglected, the irregular attacks of fever re- turn more frequently, the pulse becomes intermitting, the eyes become dim or fixed and sallow, the mouth bitter, the headache and oppression of the heart and chest insupportable, and the contracted limbs are visited with burning, itching neuralgic pains, somewhat similar to those of gout, but not followed by alleviation of the other symptoms. These may be succeeded by a very violent attack of fever, and a miliary eruption over the whole body, the vesicles of which often be- come confluent and contain an exceedingly acrid fluid. At times the whole affection is terminated happily by one of these critical fevers and eruptions, but more frequently it is not, and the whole aggregate of sufferings is increased, because the remains of the unantidoted, or unremoved poison is still too great. In the latter case, the contrac- tions of the limbs are followed by absolute paralysis; the gout-like pains still rage violently, but the eruption dries up, and the skin peels off; the surface remains tender for a long time ; the limbs, especially the feet, swell; the irregular attacks of fever still recur, and are at- tended with stomach-ache and colic; palpitations are not uncommon, and opisthotonos, or the eclampsia of Sauvage, in which there is violent bending of the body backwards, with convulsions and reten- tion of consciousness, may occur. The patient may recover from Arsenic. 603 this, but remain feeble, cachectic, with irregular febrile chills, oppres- sion of the stomach from the slightest food or drink, or with attacks of vomiting directly after meals, bitter, unpleasant taste in the mouth, pains in the head, dryness of the skin, burning in the palms of the hand, yellowness of the skin and eyes, painful and irregular dis- charges from the bowels, restlessness, dejection of spirits, dropsical swellings, night-sweats, &c. All these symptoms point to the scal- ing-off of eschars, and consequent suppurating patches in the stomach or bowels. If these corrosions were not very deep, they may heal over and the patient finally recover. The thoughtless and excessive use of Arsenic by careless physi- cians may lead to somewhat similar results to those produced by the intentional poisoning with Aqua-toffana. There may be gradual emaciation, a nameless and indescribable ill feeling, loss of strength, slight, almost imperceptible and irregular attacks of fever, sleepless- ness, disgust for food and drink, and for everything pleasant in life, and a cachectic appearance ; the scene may be closed by dropsy, black miliary eruptions, eclampsia, or colliquative sweats, or diarrhoea. (1. 11.) It should be borne in mind that Hahnemann was but thirty-one years of age, when the above careful and graphic description of the effects of Arsenic was given. He has described the gastro-enteric and paralytic varieties of arsenical poisoning with great truthfulness. He has not dwelt so fully upon the more obscure and larvate forms as some later writers have done. (11.) Christison says : The symp- toms of poisoning with Arsenic may be advantageously considered under three heads. 1st Class.—In theirs* set of cases there are signs of violent ir- ritation of the alimentary canal, and sometimes of the other mucous membranes also, accompanied with excessive general depression, but not with distinct disorder of the nervous system. When such cases prove fatal, which they generally do, they terminate for the most part in from twenty-four hours to three days. (9. 46.) 2d Class.—In a second and very singular set of cases, there is little sign of irritation in any part of the alimentary canal, perhaps trivial vomiting or slight pain in the stomach, but sometimes neither; the patient is chiefly or solely affected with excessive prostration of strength and frequent fainting; and death is seldom delayed beyond the fifth or sixth hour. (9. 46.) 3d Class.—In a third set of cases, life is commonly prolonged at least six days, sometimes much longer, or recovery may even take place after a tedious illness ; and the signs of inflammation in the alimentary canal are succeeded or become accompanied, about the second or fourth day or later, by symptoms of irritation in the other mucous passages, and more particularly by symptoms indicating a derangement of the nervous system, such as palsy or epilepsy. The distinctions now laid down will be found in practice to be well de- 604 Arsenicum-Album. fined, and useful for estimating in criminal cases the weight of the evidence from symptoms. (9. 46.) 1st Class.—In those cases where inflammation of the primae-viae is the prominent symptom (the most frequent of all), the person com- monly survives about twenty-four hours, seldom more than three days; they have proved fatal in a few hours, and others have lasted for weeks. On the whole, if the case is much shortened, or length- ened, its complexion is apt to be altered. In the mildest examples of this variety, recovery takes place after a few attacks of vomiting and slight indisposition for a day or two. (9. 46.) In regard to the ordinary progress of the symptoms, the first of a decisive character are sickness and faintness. In some instances the sickness and faintness, particularly where the poison has been in so- lution, have begun a few minutes after it was swallowed. Thus in a case mentioned by Berndt, in which a solution of Arseniate of Potass was swallowed, the symptoms began violently in fifteen minutes; in one related by Wiedberg, where the oxide was given in coffee, the person was affected immediately on taking the second cup ; in an- other the patient was taken ill in eight minutes; in one mentioned by Lachese, of Angers, violent symptoms commenced within two min- utes after the poison was swallowed in prunes ; in a case communi- cated to me (Christison) the symptoms set in with violence ten min- utes after it had been taken dissolved in tea; and in a case of poison- ing with orpiment in soup, mentioned by Valentini, the man felt un- well before he had finished his soup and set it aside as disagreeable. It is a mistake, therefore, to suppose, as I have known some do, that Arsenic never begins to operate for at least half an hour. Neverthe- less it must be admitted that, in general, Arsenic does not act for half an hour after it is swallowed. On the other hand, its operation is seldom delayed beyond an hour. Lachese, however, quotes an in- stance, when the interval was two hours, and where the issue was fatal. The Arsenic had been in very coarse powder. Mr. Macau- ley, of Leicester, has communicated to me (Christison) a case, where the man took the poison at eight in the evening, went to bed at half pastnine.and slept till eleven, when he awoke with slight pain in the stomach, vomiting and cold sweats. In this instance the dose was seven drachms, and death took place in eleven hours. (9. 46.) Professor Orfila has noticed an instance, where there appears to have been scarcely any symptom at all for five hours. The case of a Mrs. Smith, tried in Edinburgh, in 1827, is probably another of the same kind. A white draught was administered in a suspicious man- ner at ten o'clock in the evening; the girl went immediately to bed; and no symptom appeared till six next morning, from which time her illness went on uninterruptedly. In two of the preceding cases it will be remarked that sleep intervened between the taking of the poison, and the invasion of the symptoms. It is, therefore, not improbable that the retardation of the symptoms is due to the inactivity of the animal system during sleep. There is a limit, however, to the pos- Arsenic. 605 sible interval in such cases. It seems impossible that the action of the poison should be suspended for three entire days. Yet death has been ascribed to Arsenic in such circumstances. A child three and a half years old, having swallowed eight grains with bread and but- ter, but being made forcibly to vomit by emetics, presented no decided symptom at the time, or for three days more; but on the fourth day difficult breathing ensued, with anxiety of expression, frequency of the pulse and heat of the skin ; and next day death took place. There was no morbid appearance found in the body, and Christison says, commenting upon the case, that he cannot admit that the poison was the cause of the symptoms and the fatal event. (9. 46.) Soon after the sickness begins or about the same time, the region of the stomach feels painful, the pain being of a burning kind, aggra- vated by pressure. Violent fits of vomiting and retching then ensue, especially when drink is taken. There is often also a sense of dry- ness, heat and tightness in the throat, creating an incessant desire for drink, and this affection often precedes the vomiting. Occasion- ally it is wanting, at other times so severe as to be attended with suf- focation and convulsive vomiting at the sight of fluids. Hoarseness and difficulty of speech are commonly combined with it. The matter vomited is green or yellow, but sometimes streaked or mixed with blood, particularly where the case lasts longer than a day. (9. 46.) In no long time after the first illness, diarrhoea makes its appearance, but not always. In some cases, instead of it, the patient is tormented by frequent ineffectual calls; in others the great intestines are scarcely affected. About this time the pain in the stomach is excruciating, and is often likened by the sufferer to afire burning within him. It likewise extends more or less downwards, particularly when the diar- rhoea or tenesmus is severe; and the belly is commonly tense and tender, sometimes also swollen, though not frequently, sometimes even, on the contrary, drawn in at the navel. When the diarrhoea is se- vere, the anus is commonly excoriated, and affected with burning pain. In such cases the burning pain may extend along the whole course of the alimentary canal from the throat to the anus. Nay, at times the lips and mouth are also inflamed, presenting dark specks or blisters. (9. 46.) Sometimes there are present, likewise, signs of irritation of the lungs and air-passages—almost always shortness of breath, (which, howev- er, is chiefly owing to tenderness of the belly)—often a decided sense of tightness across the bottom of the chest, and more rarely decided pain in the same quarter, darting through the upper part of the chest. Sometimes pneumonia has appeared a prominent affection during life, and been distinctly traced in the dead body. (9. 46.) In many instances too, the urinary passages are affected, the patient being harassed with frequent painful and difficult micturition, swelling of the penis, and pain in the region of the bladder, or if a female, with burning of the vagina and excoriation of the labia. Sometimes the irritation of the urinary organs is so great as to be attended with total 606 Arsenicum-Album. suppression of urine. During the late contentions among chemists, physiologists, and physicians, the most contradictory statements have appeared. Flandin and Danger alleging that it is always suppressed, Orfila that it is always secreted, and Delafond that it is never sup- pressed, but always diminished, sometimes to one-sixth of its normal amount. There is, however, no invariable rule in this matter, and in fact, urinary symptoms are seldom present unless the lower bowels also are strongly irritated, but are then sometimes wanting. (9. 46.) When symptoms of irritation of the alimentary canal have subsisted a few hours, convulsive movements often occur. They commence on the trunk, afterwards extend over the whole body, are seldom violent, and generally consist of nothing else than tremors and twitches. Cramps of the legs and arms, a possible concomitant of every kind of diarrhoea, is particularly frequent and severe in that caused by Arsenic. The general system always sympathizes severely with the local de- rangement. The pulse commonly becomes very small, feeble and rapid soon after the vomiting sets in, and in no long time it is often imperceptible. This state is naturally attended with great coldness, clammy sweats and lividity of the hands and feet. Another symptom referrible to the circulation, which has been observed, though rarely, is palpitation. (9. 46.) The countenance is commonly collapsed from an early period, and almost always expressive of great torture and extreme anxiety or de- spair. The eyes are red or sparkling; the conjunctiva often so in- jected as to seem inflamed, the tongue and mouth parched, and the velum and palate sometimes covered with little white ulcers. Deliri- um sometimes accompanies the advanced stage, and stupor also is not infrequent. Coma occasional!)' precedes death. Very often, howe- ver, the patient remains quite sensible to the last. Death in general comes on calmly, but is sometimes preceded by a paroxysm of con- vulsions. In some instances it takes place quite abruptly, as from a sudden deliquium, as in a case mentioned by Dr. Dimock of Edin- burgh. The patient, a girl who had taken two ounces intentionally, rose from bed without help two hours and a half afterwards, went to a chair at the fireside, and had scarce sat down when she expired. (Two or three similar cases will be related in this article. (9. 46.) Various eruptions have at times been observed, especially in those who survive several days, but they are more frequent in the class of cases to be described hereafter, in which life has been prolonged for a week or more. The eruptions have been variously described as resembling petechiae, or measles, or red miliaria, or small-pox. In a case mentioned by Guilbert, a copious eruption of miliary vesicles ap- peared on the fifth day, and for fifteen days afterwards. They were attended with perspiration and abatement of the other symptoms, and followed by desquamation of the cuticle. Another external affection which may be mentioned is swelling of the whole body. (9. 46.) In some cases of the kind now under consideration a short remis- sion, or even a total intermission of all the distressing symptoms has Arsenic. 607 been witnessed, particularly when death has been retarded till towards the close of the second or third day. This remission, which is ac- companied by dozing or stupor, generally occurs about the beginning of the second day. It is merely temporary. In these cases (such as are now referred to) death often occurs about twenty-four hours after the poison is swallowed, and generally before the close of the third day. But on the one hand life has been sometimes prolonged, with- out the supervention of the symptoms belonging to a different variety of cases for five or six days, nay, even for several weeks; and on the other hand, the symptoms of irritation of the alimentary canal are sometimes distinct, although death may take place in a much shorter period than twenty-four hours. (9. 46.) Such is an account of the symptoms of poisoning by Arsenic in their most frequent form. It will of course be understood, that they are liable to a great variety as to violence, as well as their mode of combination in actual cases; and that they are by no means all pre- sent in every instance. (9. 46.) According to Pereira, who follows Christison very closely, the symptoms produced by the ingestion of a large dose of Arsenious-acid, are not invariably alike, but put on three forms. (54.) Form 1st.—Acute Poisoning, with Symptoms of Gastro-enteritis. In this form of Arsenical poisoning, nausea and vomiting come on soon after the poison has been swallowed, and are attended with burn- ing pain in the throat and stomach, which soon extends over the whole abdomen. Pain and vomiting are, however, not invariably present. Frequently there is a sense of heat, dryness, tightness, and constric- tion of the throat, accompanied by incessant thirst, and occasionally with an almost hydrophobic difficulty of swallowing. The lower part of the alimentary canal soon becomes affected, indicated by the burn- ing pain, which is increased on pressure, by the hard and tense con- dition of the abdomen, by the diarrhoea, (the stools occasionally being bloody,) by the tenesmus, and by the occasional heat and excoriation of the anus. (3. 54.) When the lower part of the alimentary canal is powerfully irritated, the urino-genital apparatus becomes affected, and thus there may be difficulty in passing the water, with burning pain in the genital organs. The urine is frequently diminished and sometimes suppressed. The constitutional symptoms are a quick pulse, which is at the same time small, feeble, and irregular. There are cold, clammy sweats; the ac- tion of the heart is irregular, giving rise to palpitation; the breathing is short, laborious, and often painful; the tongue is dry and furred, and the membrane lining the air-passages feels hot and oftentimes painful. Although in this form of acute arsenical poisoning, the gastro-enteritis is the principal, and in some cases the only affection, yet there are generally observed some symptoms indicative of disorder of the cerebro- spinal system; sometimes in the form of tremblings or cramps in the limbs, or delirium, and even in the last stage, insensibility. Occasionally 608 Arsenicum-Album. also eruptions take place, which are frequently attended by itching of the skin. (3. 54.) In this form of poisoning, death usually occurs in from twenty-four hours to three days after the administration of the Arsenic; but Dr. Christison, quoted by Pereira, says that Pyl has recorded a case where death occurred in three hours after swallowing the poison. (3. 54.) Case 1.—A young man took an unknown quantity of Arsenic on an empty stomach; in half an hour violent retching and contraction of the stomach, followed quickly by severe vomiting; he then acknow- ledged* what he had done. Large quantities of milk were given, but the symptoms increased; six or eight hours after the patient's face was pale and very anxious, he answered in a very low voice, com- plained of the most intense pains in the abdomen, great oppression in the praecordial region; he had incessant vomitings, and felt as if his stomach and bowels were being torn out with pincers; there was great restlessness, headache, dizziness, cramps in the calves of the legs, small suppressed pulse, great thirst, and very frequent stools mixed with slimy and fatty masses. (4. 11.) Treatment.—The Liquor Ferri-oxydati Hydratici was given at first in doses of two table-spoonsful, then one spoonful every half hour; at first he vomited it off, but soon retained it; at the end of twelve hours in all, he was in a profuse sweat, had a feeling of warmth in the ab domen, his pulse had risen, his face was red, and he had much thirst; he slept quietly at night, and was quite well the next morning, with the exception of weakness of the whole body, but especially of the limbs; tenesmus was relieved by injections of oil. (4.11.) Case 2.—Arsenic taken in soup produced frequent vomiting of slime and bile; also of greenish-yellow bitter fluid; the pulse was very small and extraordinarily frequent; there was great restlessness, unquenchable thirst, dizziness, and cramps in the calves, with lividity of the face. The incessant vomiting, the diarrhoea, cramps in the legs, and livid skin caused the case to be mistaken for sporadic cho- lera. (4. 11.) Case 3.—A man put two ounces of Arsenic in his wife's dinner; she took but little, as it tasted badly, but in half an hour was attacked with violent burning in the throat, and severe pains in abdomen; the evening and night were passed in great agony, with violent vomitings and burning thirst; she was left until the third day without medical advice, and was then in the most distressing condition; she was ex- ceedingly exhausted, had blue circles around her eyes, her tongue and mouth were dry and inflamed, she had burning thirst, was excessively fearful, had pains and tremblings in all her limbs, tearing pains in the stomach and bowels, frequent fruitless retching, violent vomitings and incessant diarrhoea, by which only mucous and greenish substances were evacuated. She died on the sixth day. (4. 11.) Post-mortem.—Tongue coated with a dirty, yellow covering; the anus gaped open and a greenish stuff flowed from it; the blood was black and fluid in all parts of the body; the whole peritoneum was Arsenic. 609 reddened; the inner surface of the stomach was almost black, and as if swollen and thickened; the internal surface of duodenum and upper part of jejunum very dark red. Portions of the larynx and oesopha- gus were almost black. The stomach contained a yellowish-red fluid; the small bowels a moderate quantity of yellowish stuff, and an unnatural and profuse secretion of yellowish intestinal mucus; the cavity of the pleura at least eight ounces of reddish water, and there was a spot on the pleura three inches in diameter, covered with a gelatinous recent false membrane, into which vessels had already commenced to shoot, although it was so loosely attached to the pleura that it could easily be removed. (4. 11.) Case 4.—A man took Arsenic intentionally, had the usual pains and vomitings, but only ejected white mucus; his face was covered with sweat, his eyes were quite red and protruding, and he trembled vio- lently. (4. 11.) Post-mortem.—The whole inner surface of the stomach was inflam- ed; the blood in the large vessels was thick, but not coagulated, and resembled whortleberry-juice in color; the heart was filled with dark syrup-like blood. (4. 11.) Case 5.—A healthy woman, aged sixty, partook of some soup in which six grains of Arsenic had been put; she had the usual gastric symptoms and diarrhoea; she recovered, but her hair fell out profuse- ly. (4. 11.) Case 6.—A man took only five or six spoonsful of the same; he vomited about forty times in four or five hours; took two quarts of sweet milk, and suffered for a week with violent burning pains in the stomach and bowels, with nausea and frequent vomiting; for a long time after he had much acidity of the stomach, and vomited easily after light meals ; six months subsequently he was suddenly attacked without known cause with violent vomiting and diarrhoea; he complained fre- quently of chills, fever, thirst, headache at irregular times, especially at night, emaciation and debility, pains in the joints, trembling of the hands, and weakness of sight. (4. 11.) Case 7.—The wife of the above, aged forty-eight, strong and healthy, took only three table-spoonsful, and had violent vomitings and pains in stomach; for several days she remained weak and with- out appetite, suffered with indigestion and nausea, frequent vomitings, restlessness, fever, headache, debility, frequent falling asleep and loss of feeling in the right leg and arm; a cough which she had before, was increased. (4. 11.) Case 8.—A robust servant girl, aged twenty, took four spoonsful, and had the same gastric symptoms; she had weakness of her feet, and also troublesome pains in her temples for five weeks. (4. 11.) Case 9.—A healthy girl, aged seventeen, took two spoonsful, and was so severely affected that she lost her consciousness; she reco- vered slowly, and suffered with loss of appetite and weakness of her legs for eight days. (4. 11.) Case 10.—A healthy man, aged thirty-eight, took eight spoonsful, 39 610 Arsenicum-Album. but suspecting something, drank eight pints of warm water; he vomited freely and seemed to recover quickly, but two weeks afterwards he was attacked with general debility of the whole body, especially of the legs, in which he felt a peculiar heaviness and lassitude, particularly from the knees down to the ankles; also unpleasant sensations in the stomach, frequent griping inclination to diarrhoea, loss of appetite, heaviness and aching in the head, roaring in the left ear, dizziness, pain in the temples, and a peculiar restlessness, relaxation and absent- mindedness. (4. 11.) Case 11.—A healthy coachman, aged twenty-two, took three spoonsful; he had the usual gastric symptoms, drank much warm wa- ter and sweet milk, and recovered promptly, with the exception of weakness of the legs, oppression of the chest, and hoarseness. (4. 11.) Case 12.—A woman, aged twenty-eight, took a drachm of Arsenic; had the usual gastric symptoms, became unconscious, and gradually recovered: she had profuse sweats on the fourth day, and on the ninth, a dysenteric diarrhoea occurred. (4. 11 ) Case 13.—A man took from four to six grains of Arsenic on a full stomach; slept all night, but waked in the morning with the usual gastric symptoms; twelve hours after his face was pale, his head ached violently, his eyes were injected; he vomited mucus and blood; he took half-drachm doses of Oxide of Iron; after a few doses, the retchings, vomitings and pains in stomach ceased; he took an ounce of Iron in all, and recovered. (4. 11.) Case 14.—A lad, aged seventeen, ate a meat-pie, which was in- tended for rats, and contained half an ounce of Arsenic. He was soon in a state of great anxiety and restlessness, with pain in his throat and stomach; vomited often; pulse 112 and hard; skin warm, tongue white and dry, with great thirst; after drinking freely, he vomited some yellow mucus streaked with blood; these symptoms were quickly followed by general coldness, cramps of the legs, coldness of the limbs, and collapse. In six hours he was sleepy, very sensitive to cold, and vomited a yellowish fluid mixed with mucus from time to time; no pain or sensitiveness of epigastrium, but the cramps extended up the limbs; pulse fell to 70, and was small; it soon became weak and irregular, varying from 70 to 140; the cramps, which were not pain- ful, extended up over the abdomen; he was quiet and sleepy, and died in fourteen and a half hours. (4. 11.) Post-mortem.—Muscles firm and rigid ; some congestion, but no fluid in cavity of pleura; heart firmly contracted, almost cartilaginously hard and very red, like all the other muscles; left ventricle empty; right, filled with dark fluid blood; some yellowish-green bile in gall- bladder; much yellowish viscid fluid in stomach; vascularity of sto- mach and bowels; rectum much distended; bladder contracted, but pale. (4. 11.) Case 15.—In another badly described case there was a small per- foration in the anterior portion of stomach. Case 16.—A family of four persons was seized, after partaking to- Arsenic. 611 gether of some broth, with acute pain, vomiting, and other symptoms of poisoning. They all recovered, though the dose was proved to have been very considerable. The causes assigned for the favorable termination were, that the Arsenic was administered in fragments, or coarse powder, and that it was enveloped by the greasy matter of the broth. (13. 46.) Case 17.—A lady in Paris took a considerable dose of Arsenic in the form of powder sprinkled on bread and butter. Three or four hours after this she took a cup of coffee, which immediately induced vomiting, and it continued to recur at intervals. Between six and seven o'clock in the evening of the same day, she was found suffer- ing with all the symptoms of arsenical poisoning, and the Hydrated Oxide of Magnesia was prescribed; it was followed by liquid evacu- ations, and the patient recovered. (13. 46.) Form 2d.—Acute Poisoning, with Collapse or Narcotism, without any remarkable symptoms of Gastro-enteritis. In some cases of poisoning, both in man and animals, the symptoms are those indicating dk . der of the cerebro-spinal and vascular sys- tems ; abdominal pain, vomiting and purging being either altogether ab- sent or very slight. The symptoms are usually faintness, or perhaps actual syncope, frequently convulsions or paralysis, and sometimes in- sensibility or delirium. This form of arsenical poisoning is very rare. In most of the recorded cases, the quantity of Arsenious-acid taken was very large ; for example, half an ounce or even more. (3. 54.) Dr. Pereira states that he has seen one case of this form of poison- ing. The individual (a gentleman about twenty years of age,) coarse- ly pounded a lump of Arsenious-acid and swallowed it. At a rough calculation it was supposed that he took about six or eight drachms of the Arsenic. The symptoms were pain, vomiting, great weakness, with extreme depression of the vascular system, faintness, collapse, and death in about four hours. (3. 54.) His intellect was clear until a very short time before death, when he sank into a doze. There were neither convulsions nor paralysis. Every attempt was made to remove the poison from the stomach; co- pious vomiting existed; large draughts of water were administered, and the stomach-pump applied. Notwithstanding these circumstan- ces, more than four drachms of solid Arsenious-acid in the form of lumps, was found in the stomach after death. Their weight had ap- parently prevented their removal during life. (3. 54.) This second variety of poisoning with Arsenic includes a few cases in which the signs of inflammation are far from violent, or even alto- gether wanting, and in which death ensues in from four to six hours, or a little more, at a period too early for inflammation to be always properly developed. The symptoms are then generally obscure, and are referrible chiefly to the mode of action, which is probably the cause of death in most cases—a powerful debilitating influence on the circulation or on the nervous system. (9. 46.) 612 Arsenicum-Album. These symptoms occasionally amount to absolute narcotism, as in some of the animals on which Sir Benjamin Brodie experimented. Thus, when he injected a solution of the Oxide of Arsenic into the stomach of a dog, the pulse was rendered slow and intermitting, the animal became palsied in the hind legs, lethargic, and in no longtime insensible, with dilated pupils; and soon afterwards it was seized with convulsions, amidst which it died, fifty minutes after the administration of the poison. In man the symptoms very seldom resemble so closely those of the narcotic poisons. In Mr. Stallard's case, however, the symptoms of irritation which appeared at first, speedily gave way to complete insensibility for two hours before death. A similar instance has been related in Hencke's Journal. A young man who got an ar- senical solution from ar^old woman to cure ague, was attacked after taking it with vomiting and loud cries, and afterwards with incoherent talking, then fell into a deep sleep, and finally perished in convulsions in five hours. (9. 46.) In some cases of the kind now under consideration, one or two at- tacks of vomiting occur at the usual interval after the taking of the poison; but it seldom continues. The most uniform and remarkable affection is extreme faintness, amounting at times to deliquium. Occa- sionally there is some stupor, or rather oppression, and often slight convulsions. Pain in the stomach is generally present, but it is slight and seldom accompanied with other signs of internal inflammation. Death commonly takes place in a few hours. Yet even when it is re- tarded till the beginning of the second day, the faintness and stupor are sometimes more striking features in the case than the symptoms of inflammation in the stomach. (9. 46.) This variety of poisoning has hitherto only been observed under the three following circumstances : when the dose of poison was large, when it was in little masses, or when it was in a state of solution. The mode in which the first and last cases operate is evident; they facilitate the absorption of a large quantity of Arsenic in a short space of time, so that its remote action begins before local action is fully developed. But it is not easy to see how any such effect can flow from the Arsenic being in little masses; it is also to be observed that none of the circumstances here mentioned is invariable in its operation. (9. 46.) On the whole, the present variety of poisoning is rather uncommon, and indeed, although the attention of the profession was pointedly called to it, it does not seem to be so generally known as it ought to be. (9. 46.) Cases.—A druggist swallowed an ounce of powdered Arsenic at once and died in eight hours, after two or three fits of vomiting, with slight pain and heat in the stomach. (9. 46.) A young woman died in a few hours after suffering from trivial di- arrhoea, pain in the stomach, and strangury; her death was immedi- ately preceded by slight convulsions and fits of suffocation; on dissec- Arsenic. 613 tion, the stomach and intestines were found quite healthy. Half an ounce of Arsenic was found in the stomach. (9. 46.) A girl fourteen years of age, took about ninety grains and died in five hours, having vomited once or twice; she complained of some little pain in the belly, and was affected towards the close with great faint- ness and weakness. The stomach and intestines were healthy. (9. 46.) Another case was that of a man so addicted to drinking that his daily allowance was a pint of brandy. When first seen, there was so much tranquillity that doubts were entertained whether Arsenic had been really swallowed; but at length he was discovered actually chewino- it. This state continued for nearly five hours, when some vomiting ensued; coldness of the extremities and spasmodic flexion of the legs soon followed, and in a few minutes more he expired. (9.46.) An individual having swallowed three drachms at eight o'clock in the morning, went about bidding adieu to his friends, and telling them what he had done. He was then prevailed on to take emetics and diluents, which caused free and easy vomiting. He suffered very lit- tle till one, when he became affected with constricting pain and burning in the stomach, feeble pulse, cold sweats, and cadaverous expression, under which symptoms he died four hours later. Orfila designates this the most extraordinary case of poisoning with Arsenic which has come under his notice. (9. 46.) In another case the symptoms were at first some vomiting, after- wards little else but faintness, sickness, a sullen expression, and a general appearance which led those around him to believe him intoxi- cated. Death took place in nine hours. (9. 46.) A stout, middle-aged man, swallowed a large quantity of Arsenic in fragments, and died in a few hours; he experienced nothing but fee- bleness and great tendency to fainting. The stomach and intestines were not in the slightest degree affected during life, and no morbid appearance could be discovered in them after death. (9. 46.) Another died with narcotic symptoms within only two hours after taking nearly a quarter of a pound of Arsenic. (9. 46.) Another case proved fatal in four hours, when the symptoms were vomiting under the use of emetics, great exhaustion, feeble hurried pulse, cold sweating, drowsiness, and finally stupor. The quantity ot Arsenic taken was about an ounce. (9.46.) A young woman was caught in the act of swallowing little frag- ments of Arsenic, and it afterwards appeared that she had been em- ployed most of the day in literally cracking and chewing lumps of it. Whenjhe physician first saw her, the countenance expressed chagrin and melancholy, but not suffering. After being forced to drink, she vomited a good deal, but without uneasiness. Two hours afterwards her countenance was anxious, but she did not make any complaint, and very soon resumed her tranquillity. Five hours after the last por- tions of the poison were taken, she became drowsy, then remained perfectly quiet for four hours more, and at length on trying to sit upm 614 Arsenicum-Album. bed, complained of slight pain in the stomach, and expired without agony. (9. 46.) The cases which have here been given, will be sufficient to correct the impression that Arsenic when it proves fatal always produces vio- lent and well-marked symptoms. (9. 46.) Case 1.—A girl, aged eighteen, took an ounce of Arsenic in pow- der; in two and a half hours she was vomiting violently much mucus and small pieces of Arsenic. The Hydrated Per-oxide of Iron was given, and she lay the whole day quietly in bed, praying with folded hands; her face did not express pain, and she distinctly stated, when- ever asked, that her back ached her, but she had no other pain; there were no other signs of poisoning; she would not take the antidote any more, and she died in twelve hours; the only symptoms were repeated vomitings, and several stools without pain: putrefaction commenced in twenty-four hours, and had made rapid advances the next day. (4. 11.) Case 2.—In this case the Arsenious-acid was swallowed by mis- take for flour, at 6 o'clock in the morning. He did not discover his mistake for half an hour, and then, though feeling no signs of illness, he walked slowly two miles to the surgeon's. He arrived there shortly after 8 o'clock, and very coolly said he wanted an emetic, but did not say, until asked, what he wanted it for. He complained of no sick- ness, faintness, burning or pricking sensation in the throat, nor of any symptom of poisoning—especially poison which had been swallowed two hours previously. He received an emetic of Sulphate of Zinc, which acted in a few minutes, and brought up some white powder tinged with bile. I then gave him large draughts of milk and lime- water, which were quickly ejected. After a short interval the stomach became quiet, and he expressed himself as quite well, and said he would return to his work; but he consented, on my advice, to remain at home for a few hours, and in the meantime to drink plentifully of lime-water. 1 desired him to send to me on finding himself at all ill, or if sickness should come on. (13. 46.) I felt very skeptical as to his having taken Arsenic, and unfortu- nately I was unable to decide the point, for during my absence for a moment, my surgery-boy had thrown away the contents of the basin which deceased had vomited. Hearing nothing of deceased for three hours after this time, I felt satisfied that Arsenic had not been taken, and believed the man had gone home. At 12 o'clock I was sent for, as diarrhoea had suddenly come on. He had vomited two or three times yellowish-colored fluid. On my arrival I found the patient sit- ting by the fire in a drowsy state, but easily roused. Countenance sunken and livid; pulse rapid, and extremely feeble; surface-of the body cold, and watery stools of a greenish hue passing involuntarily. He answered questions rationally, and complained of no pain, no ten- derness of the abdomen, no tenesmus, or any of the usual irritative symptoms of poisoning by Arsenic. He was ordered instantly to a warm bed, and to have hot water to his feet, &c, and a little brandy and water. He seemed to rally for a short time, and desired to get Arsenic. 615 out of bed. He was allowed to do so, contrary to orders, and then complaining of dimness of sight, lay down on the bed, and in a few minutes expired. A post-mortem was not held. (13. 46.) The remarkable features of this case are, the length of time before any symptom of poisoning occurred, and the total absence of the usual symptoms of poisoning by Arsenic. (13. 46.) Case 3.—A case analogous to this has been reported, where a young woman swallowed a considerable number of small fragments of Arsenious-acid. As she was seen swallowing the poison, a physician was sent for immediately—he forced her to drink, which caused vomiting without much uneasiness. In two hours afterwards her countenance expressed much anxiety, but she was tranquil. She gradually became drowsy, then remained calm for four or five hours, and finally on trying to sit up, complained of pain in her stomach, and expired without a groan. (13. 46.) Case 4.—On Sunday, at 5 o'clock in the afternoon, a woman re- quested me to visit her niece, who had taken a tea-spoonful of white Arsenic. The patient I found to be a heavy, stupid-looking girl, sit- ting in her chair more asleep than awake; on rousing her she reeled about the room in such a manner that I suspected poisoning by some narcotic. However, she acknowledged having swallowed " white Mercury," and a paper was brought to me which I immediately recog- nized by the aid of a pocket-lens to be Arsenious-acid. She vomited once after dinner, but there were no further symptoms until half an hour before she died, at noon the following day. She had no pain, no sickness, no acrid eructations, no burning taste in the mouth; her face was very pale, and she was faint and giddy. The Sulphate of Zinc, with mucilaginous drinks, was given her, and soon produced copious vomiting, which was kept up for half an hour. The Hydrated Per- oxide of Iron was then administered in large doses. At 9 o'clock at night she had experienced no pain, no unpleasant symptoms whatsoever. She was disposed to sleep quietly. At 10 o'clock the next morning, her aunt came to say that she was quite well, and wanted permission "to go a-gleaning" but at half-past 11 o'clock, while in a more than ordinarily cheerful mood, and engaged in preparing dinner, she sud- denly complained of an excruciating pain in the body with great pros- tration of strength. She went to her bedroom to lie down, and at 12 was found dead. (13. 46.) It is supposed that as the lower classes in Lincolnshire are exces- sively addicted to the use of Opium, this might have been the case here; and that the Opium may have suppressed and prevented the Arsenic-pains from making themselves felt. This, however, is not necessary, as it is by no means the first, or only case on record, where no pain whatever has been experienced. (46.) Pathology.—Stomach contained half a pint of a thin, dirty, green fluid ; mucous coat much corrugated, having a fungous appearance, very soft and so fragile that a touch of the finger tore it away. Three or four large reddish-brown patches were observed, extending into the 616 Arsenicum-Album. intestines considerably beyond the duodenum. The peritoneal coats of the stomach and bowels were not inflamed. The lungs and the heart were healthy; head not inspected. Arsenic was contained in the stomach-fluids. (13. 46.) Case 5.—Harriet T., aged nineteen, a robust and healthy girl, took on Tuesday night, Sept. 1st, about two ounces of fly-water, contain- ing two and a half grains of Arsenic. Li rendered her restless during the night, producing watchfulness and slight pain in the stomach. Next morning she became sick and very thirsty, and the tenderness and pain in the stomach had increased. In the course of the day the sickness became worse, she was repeatedly purged, her countenance looked pinched, and the extremities became cold. On Wednesday night she rallied and became more comfortable and cheerful, but was still thirsty. On Thursday morning she was worse, cold and drowsy, and she was sent to the London Hospital; her countenance was then pale and anxious, extremities cold and bedewed with a cold clammy sweat; pulse hardly perceptible, and she lay in a state of incipient coma. She then sank and died in about thirty-six hours after the administration of the poison. The body was examined twenty-one hours after death, and from the appearances present Dr. Letheby was led to conclude that death resulted purely from coma, as neither the symptoms during life, nor the state of the stomach after death would allow him to attribute it to the effects of gastro-enteritis. (13. 46.) Pathology.—The brain was much congested and the several ven- tricles filled with half-coagulated blood. Lungs natural; the heart flabby and distended with dark jelly-like blood; haemorrhagic spots were seen on the endocardial membrane, especially where it covers the auriculo-ventricular valves. The abdominal and pelvic vis- cera were congested ;—the stomach was pale and empty, and along the pylorus it had assumed a gamboge tint: Arsenic was found in its tissues. (13. 46.) This is a valuable addition to the comparatively small class of cases in which death is due solely to coma. Another case has re- cently occurred at the King's College Hospital, in which the poison was also taken in fly-water, when after the complete evacuation of the stomach and temporary relief of all the symptoms, the child was seized with fatal coma. The smallness of the dose is also unprece- dented. (13. 46.) Case 6.—An interesting case of poisoning by Arsenic, in which none of the usual symptoms were observed, is reported by Mr. Hough- ton. He was called to see Mrs. B., whom he found in a state of con- siderable mental excitement, but without any symptoms of cerebral affection. She told him very collectedly, that about three quarters of an hour previously she had taken half an ounce of Arsenic, which she had that morning procured from a druggist. She was free from the ordinary symptoms of irritant poisoning. She had no thirst, pain, heat, or constriction of the throat or fauces, epigastric tenderness, vomiting, tormina, abdominal pain, or discharge from the bowels. The Arsenic. 617 stomach-pump, albumen, Sulphate of Zinc, and the hydrated peroxide of Iron were used. She was then put to bed, where she became com- posed, almost free from pain, but had occasional gentle fits of vomiting of a bilious character, this being the only symptom. Her pulse was rather feeble, and she soon seemed disposed to doze, in which state she continued for an hour and a half, when her bowels were moved, accompanied by some tenesmus. In about an hour from this time she was found in a state of collapse, which was met by external sti- mulants. From this state of depression she never properly rallied, but remained quietly dozing from time to time, and died perfectly calm and collected, thirteen and a half hours from the time of taking the poison. (13. 46.) Throughout her illness she presented no gastric symptom, except occasional mild vomiting; but whatever the stomach received was soon rejected ; there were no tormina, no tenesmus or strangury; no cramp, and no cerebral or spinal symptom to the last. Arsenic was found in large quantities in the fluid discharged by the stomach-pump. (13. 46.) Pathology.—At the pyloric end of the stomach, on the posterior surface of the organ, there was a bright red patch, nearly the size of the palm of the hand; and on the posterior part of it there were se- veral streaks, about half an inch wide of a black color, and running from above downwards, slanting from the cardiac to the pyloric end of the stomach. The intervening mucous membrane had a natural appearance. On washing the black deposit away, which was effected with difficulty, the mucous membrane beneath was found to be con- siderably inflamed. This black deposit was left where the membrane was inflamed, excepting on the red patch near the pylorus, and no- where else. It was most copious also where the inflammation was most severe. There was no destruction of the mucous membrane. With the exception of the red patch at the pyloric extremity of the stomach, every part of the mucous membrane which had been acted on by the Arsenic, was thickly coated with iron, which it required some trouble to wash off with a sponge, as if the antidote had been attracted and firmly held by the poison, which indeed had become so completely combined with it as to be incapable of detection upon re- peated careful experiments. In testing the contents and coats of the stomach for the poison, the resulting liquid was filtered through char- coal, by which probably a part of the Arsenic was arrested. (13. 46.) Case 7.—A lad, aged seventeen, took three drachms of Arsenic on an empty stomach, not having eaten for seventeen hours; thirteen hours after he was sleepy, pulse 90, soft and rather weak, tongue coated, slight nausea, but little tenderness of abdomen ; he only vomit- ed after being obliged to drink freely; his pulse rose to 110, and hard; he drank and vomited five gallons of fluid; he was restless and became weaker, but had little pain; in fifty-five hours his stools became dark, bilious, and mixed with mucus, with constant urging ; he became weaker, extremities cold, cold sweats, complained of burn- 618 Arsenicum-Album. ing heat of the whole body, but his skin felt cold, great restlessness excessive thirst; he soon died. (4. 11.) Post mortem: Unusual rigidity of the body; livid color behind ears, on neck, scrotum, penis and nails ; great vascularity of the pleura especially the diaphragmatic portion, with but little fluid in its cavity; pericardium contained two ounces of reddish brown fluid; spasmo- dic contraction of heart; blood coagulated but slightly, and black; omentum very vascular; great vascularity of stomach and bowels; pylorus very much thickened and vascular ; liver paler than usual; gall-bladder filled with saffron-colored bile; much thick yellow fluid in bowels;—lower part of colon and rectum much contracted, not larger than a thumb, apparently thickened, and the ligamentous bands enormously contracted; kidneys congested; a small quantity of purulent fluid in the pelvis; bladder contracted and hard, not larger than a small pear, and its mucous coat very vascular. (4. 11.) Case 8.—The Duke of Praslin, as is well known, after the murder of his wife, took Arsenic, with the view of committing suicide. The amount taken could not be arrived at, but it was probably large; yet though the symptoms were severe, and the internal lesions very ex- tensive, he survived five days and eighteen hours. The first symp- toms appeared on the evening of the eighteenth; there was vomiting, accompanied by an extremely feeble pulse, and great debility; the vomiting ceased after a glass of Bordeaux and some ice. During the night and next day the vomiting returned ; on being placed in a bath he fainted : the fainting recurred on leaving it; and soon after he had an involuntary evacuation. At 3 o'clock in the afternoon of the 20th, being in bed, he stated in answer to a question that he was better. He spoke distinctly, his mind was clear, he did not complain of any pain in the abdomen on pressure, he breathed freely, the tongue was clean, but the pulse was extremely small and irregular, and the extremities icy cold. These symptoms led M. Andral, who had been called in to suspect the possibility of poisoning, and the evacuations were preserved. At 11 o'clock in the evening of the 20th he was somewhat stronger ; evacuations had ceased, pulse stronger and more regular, but too frequent; hands still cold. On the 21st he was re- moved from his residence to the prison of the Luxembourg. He suffered - merely from coldness of the extremities, and thirst. An hour after his arrival he was found with a calm appearance, a little more color than natural, a somewhat vacant look, the temperature of the body, with the exception of the hands, restored; the sufferings relieved, pulse tolerably full, from eighty to eighty-five in a minute, tongue clean, thirst excessive, stomach free from pain, no vomiting or nausea. In the evening the pulse was small, frequent and like a thread, and the extremities cold; there was a great sensation of tight- ness in the throat, and of great oppression ; the abdomen was tym- panitic and slightly painful; no evacuations of any kind since the re- moval to the Luxembourg. On the 22d all the symptoms were more intense ; there was extreme spasmodic constriction of the throat, very Arsenic. 619 painful deglutition, and ardent thirst; the tongue and mucous mem- brane of the mouth and pharynx of a deep red ; a sensation of burn- ing from the mouth to the anus; the abdomen inflated and tender to the touch ; a high state of fever, a frequent and irregular pulse, now strong, now weak; extreme oppression, no nausea, no vomiting; bow- els twice relieved by injections ; urine passed in small quantities, though diuretics had been employed. He passed a restless and sleep- less night, and was evidently growing weaker. On the 23d the symp- toms were aggravated, the features had undergone a great change; the complexion had assumed a reddish-brown cast; the intellect re- mained clear; there was constant thirst, extreme constriction of the throat, very painful deglution ; the tongue red and dry, the abdomen inflated and painful, the respiration much oppressed ; the pulse small and frequent, the extremities very cold ; no evacuation of the bowels, and no urine passed. At seven o'clock on the morning of the 24th, his sight had become dim, the respiration very difficult, the pulse very weak and frequent, but the mind still intact. At one o'clock the res- piration was more embarassed, the extremities icy-cold, the pulse very frequent and scarcely perceptible. He gradually sank and died at thirty-five minutes after four o'clock, having preserved his senses lo the last. (13. 46.) Pathology.— The post-mortem examination discovered nothing worthy of remark in any other part of the body, except the alimen- tary canal, unless the effusion of blood in spots under the pleura, arid under the lining membrane of the left ventricle of the heart be con- sidered as due to the action of the poison. In the stomach from the cardia to the pylorus, there were seven large eschars, from three- fourths of an inch to an inch, and a half in diameter, scattered over the length of the great curvature. These eschars were black, and completely circumscribed by a hard and thickened border of a faint yellow color. Round these eschars, for a short distance, the mucous membrane was somewhat softened, and of a deep red color. The eschars did not extend through the whole thickness of the walls of the stomach, and there was neither ulceration nor perforation. The rest of the mucous membrane was perfectly healthy ; the duodenum and the lower portion of the ileum were of a uniform dull-red color, but free from eschars and ulcers. The rest of the intestines, large and small, were perfectly healthy. (13.46.) Case 9.—A man of dissipated habits, three hours after an unusually full supper,took a large dose of powdered Arsenic, followed by copious draughts of water. He passed the night with great agony in the chest and bowels, but had no nausea, vomiting, or diarrhoea. At 11 A.M., the next day, M. Chammartin was sent for, and found the man in a state of great collapse, with his face pale, and his features haggard and pinched; he was agitated and spoke with a feeble voice; his res- piration was difficult, and he complained of a tearing sensation along the gullet, and at the epigastrium, and of thirst and dryness of the fauces. His tongue was moist, but red at the edges and point, his de- 620 Arsenicum-Album. glutition was easy, and there was no diarrhoea, though he suffered from colic and cramps in all his limbs. The hydrated oxide of Magnesia was then given, warmth was applied to the surface, and he was afterwards bled. He was then removed to the Hotel Dieu where all his symptoms improved. He finally recovered. The quantity of Magnesia given was about seventeen ounces ; and while in the Hotel Dieu some hydrated sesquioxide of Iron was also given. (13. 46.) Case 10.—A respectable young man fell in love with a girl of an abandoned character, quarrelled with his relations, and while under the conjoined excitement of this and liquor, persuaded the girl to join him in taking Arsenic. They purchased an ounce, which was entirely consumed by them after a hearty supper; it was mixed with flour in the form of a cake. This was in the evening. Soon after 11 o'clock they where found lying on the bed, apparently insensible. The man on being roused began to be sick, and confessed that he had taken Arsenic. A surgeon was summoned, and he was immediately removed to his home. The girl was not seen by a medical man until 1 A.M. She had then vomited two or three times. The vomited mauer ap- peared to consist of lumps of fish, cake, &c. in a semi-digested state. She complained of a severe burning pain in the stomach, throat and bowels. She appeared wild and excited, and from her manners had evidently been drinking freely. An emetic of Sulphate of Zinc was given, the fauces were tickled, and a quantity of albumen and water administered, which soon produced vomiting. The stomach; pump was used, and the common sesqui-oxide of Iron. Both patients convalesced. (13. 46.) This is probably the largest amount on record, from which a pa- tient has recovered. The recovery in this case is probably due to the hearty supper, the quantity of mucilaginous drinks, and to its having been mixed with flour, all of which would tend to envelop and entangle the particles of Arsenic and prevent their coming into injurious contact with the walls of the stomach. (13. 46.) It is a notable fact that in the above cases the two most constant symptoms of arsenical poisoning were absent, viz., vomiting and diarrhoea. (46.) 3d Class.—The third variety of poisoning places in a clear point or view its occasional action on the nervous system. This occurs chiefly in persons, who, from having taken but a small quantity, or from having vomited soon after, are eventually rescued from destruc- tion ; but it has also been met with in some cases, in which death has ensued after a protracted illness. (9. 46.) In such cases the progress of the poisoning may be divided into two stages. The first train of symptoms is exactly that of the first or inflammatory variety, and is commonly developed in a very perfect and violent form. In the second stage the symptoms are referrible to nervous irritation. (9. 46.) These generally come on when the former begin to recede, yet Arsenic. 621 they sometimes make their appearance earlier, when the signs of inflammation in the alimentary canal continue violent; and more rarely both classes of symptoms begin about the same period. The nervous (?) affection differs in different individuals; the most formi- dable is coma: the slightest, a peculiar imperfect palsy of the arms or legs, resembling that occasioned by the action of lead: and between these extremes have been noticed epileptic fits, or tetanus, or an affec- tion resembling hysteria or mania. (9. 46.) Case 1.—Epilepsy. A girl swallowed a drachm of Arsenic, and was in consequence attacked violently with the usual symptoms of irritation in the whole alimentary canal. After being ill about twenty- four hours she experienced several distinct remissions and had some repose, attended with fainting. In twelve hours she began to im- prove rapidly ; the pain subsided, her strength and spirits returned, and the stomach became capable of retaining liquids. So far the pa- tient labored under the common effects of Arsenic. But a new train of symptoms then gradually approached. Towards the close of the second day she was harrassed with frightful dreams, starting from Bleep, and tendency to faint; next morning with coldness along the spine, giddiness and intolerance of light; and on the fourth day with aching of the extremities and tingling of the whole skin. These symptoms continued till the close of the sixth day, when she was suddenly seized with convulsions of the left side, foaming at the mouth, and total insensibility. The convulsions lasted two hours; the in- sensibility throughout the night. Next evening she had another and a similar fit. A third but slighter fit occurred on the morning of the tenth; another, next day at noon; and they continued to return occa- sionally till the 19th day. For some time longer she was affected with tightness across the chest and stomach complaints, but she was eventually restored to perfect health. (9. 46.) Case 2.—Five individuals partook of a dish poisoned with Arsenic, and they were all violently seized with the usual inflammatory symp- toms. But, farther, one had an epileptic fit on the first day, which re- curred on the second; and he had besides frequent twitches of the muscles of the trunk, a feeling of numbness in one side, and heat and tingling of the feet and hands. Another had tremors of the right arm and legs on the first day, and several epileptic fits in the course of the night. During the next fifteen days he had a paroxysm every evening about the same hour; which returned after an intermission of eight days, and frequently for several months afterwards. (9. 46.) Symptoms of Acute Poisoning, with Gastroenteritis, followed by an Affection of the Cerebro-spinal System. In this form of poisoning we have at first the usual gastro-enteritic symptoms, which have been already described under the first form of poisoning. When from the smallness of the dose, or from other cir- cumstances the patient recovers from the gastro-enteritis, symptoms of a cerebro-spinal affection sometimes make their appearance. The 622 Arsenicum-Album. kind of disorder, however, varies considerably in different individuals, The most formidable, says Dr. Christison, is coma; the slightest a peculiar imperfect palsy of the arms or legs, resembling what is oc- casioned by the poison of lead; and between these extremes have been observed epileptic fits or tetanus, or an affection resembling hysteria or madness. (3. 54.) Case 1.—Two boys, aged thirteen, and ten, a girl, aged fourteen and an older person, partook of soup in which flour, prepared to poison rats, had been used by mistake. In a short time they all had violent pains in the bowels, and a painful sense of contraction in the stomach; they took milk freely, but without effect upon the pains, which in- creased to such an extent that the death of the patients was soon expected; five hours after, the Ferri-oxidat.-hydrat. was given in doses of from a half, to a whole tablespoonful every half hour; on the following day the children were quite well, but the older per- son still suffered with violent trembling of the limbs, and with pains in the head and stomach. Before two of the children took the antidote, they had had the most violent spasms, and lay exhausted, stiff and with their bodies bent backwards; their hands and faces were cold and covered with cold sweat. The other two were almost exhausted by constant retching and vomiting, and the most intense abdominal pains. (4. 11.) After taking the antidote the gastric pains subsided slowly, but the vomiting ceased immediately, was followed by frequent thin stools, after which the three children fell into a quiet sleep. (4. 11.) Case 2.—Three servant-girls took Arsenic by mistake. They had the usual gastric symptoms, vomited blood, and had discharge of blood from anus ; had much fever, followed by profuse sweats, pains in the teeth ; and their chests and necks were covered with purple spots; after a lull of the symptoms they all had returns of vomiting, purging, excessive pains in the stomach, inflammation and swelling about the root of the tongue ; two of them could not speak or swallow, and in twenty-four hours were seized with trismus and convulsions of the whole body; in forty hours one of them was in an apoplectic state, breathing with difficulty, with general convulsions, jaws locked, face pale and repulsive, pulse ninety, and weak; when aroused she had violent headache, with burning and pain in the throat; both the others became speechless and could not swallow ; with convulsive cramps of the body, locked jaws, frequent spasmodic smiling, bloating of the face; pulse 106, and strong. The next day two of them were attacked al- most simultaneously with headache, followed by violent delirium and unconsciousness, which were removed by cold affusions. (4. 11.) Case 3.—A girl, aged nineteen, took Arsenic in the morning at breakfast; remained comparatively well all day; had a slight convul- sion in the evening, then vomited food, froth and a little blood; her face was red in patches, and covered with sweat; her eyes were swollen and the edges of lids very red ; she had frightful pains in the stomach ; her pulse was small, irregular and very frequent; epigas- Arsenic. 623 trium and bowels exceedingly sensitive and painful; after drinking freely she vomited very often ; gradually became cold and collapsed, and died in eighteen hours. (4.11.) Case 4.—A girl, aged twenty-two, was poisoned by her seducer ; in twenty-four hours she lay unconscious, with large red spots over ber whole body, and distended abdomen; the vomiting ceased; she recovered gradually and was delivered at full time. (4. 11.) Case 5.—A boy, aged three years, took £ grains of Arsenic ; had the usual gastric symptoms, with scanty urine, high fever, quick pulse, white tongue, &c. He took Carbonate of Iron, and gradually re- covered by the fourth day, with the exception of diarrhoea, with dis- charge of greenish, coagulated and bloody mucus. (4. 11.) Case 6.—A man, aged thirty-five, took half an ounce of Arsenic, but vomited more than half of it quickly. His pulse was quick, irregu- lar, weak and spasmodic, his breathing difficultand look wild; his eyes projected from his head, and were bathed in tears, which exco- riated his cheeks ; he had twitchings in the muscles of his face, and his tongue was dry; he had burning pains in the bowels, excessive thirst; abdomen was tense and tender; he had involuntary discharges of much acrid burning water from the bowels; offensive sweat over the whole body; his. urine was suppressed, and his mind wandered from time to time. (4. 11.) Death, seemed unavoidable, but on the sixth day a profuse miliary eruption broke out all over his body, with much relief; the eruption repeated itself several times in fourteen days, and terminated, finally, in branny scales; ulcers broke out on both heels and discharged an icho- rous matter. He remained weak, had general tremblings for a long time, and frequent attacks of inflammation of the eyes. (4. 11.) Case 7.—A melancholic lad, aged eighteen, took a large quantity of Arsenic, and was soon attacked with great anxiety and a cold sweat; these disappeared in a quarter of an hour, and he remained well all day; in the evening a similar attack occurred and disappear- ed as quickly; during the night he was seized with severe colic pains, followed by vomiting and diarrhoea ; he had violent pains about the navel, his face was pale, sunken and covered with a cold sweat; pulse contracted, frequent and irregular. Convulsions and other nervous symptoms ensued, he gradually recovered, but for more than a year he suffered with spasms, which seemed to commence in the abdomen; with attacks of idiocy and melancholy, and various other nervous affections. (4. 11.) Case 8.—About two drachms of Arsenic was put by mistake in wine; five men drank of it from time to time ; they spat much, had heaviness in the head, stupefaction, nausea and violent vomiting; one had paralysis of the legs; another lay with loss of sensation and con- sciousness ; the vomiting ceased, but hiccough set in, their pulses and respirations were scarcely perceptible, their faces swollen, eyes dull, lips convulsively distorted as if from risus sardonicus, jaws closed, hypochondria tense, and shaken by convulsions. 624 Arsenicum-Album. These symptoms were followed by fainting fits, delirium, comatose stupefaction, burning heat in the bowels, intense thirst, full strong pulse, hot skin, red and inflamed face, anxiety, &c. Then very troublesome itching occurred, followed by an eruption of very small itch-like pustules, which desquamated. (4. 11.) Case 9.—H. P. P., physician and surgeon, aged thirty-five, tem- perate and of good constitution. On the 24th of July, at a quarter to five o'clock P.M., sent for a small quantity of Bi.-tart.-potassa, which he took in ice-water, with sugar and jvj of Tr. Gent. Comp. In about twenty minutes he was taken very ill, and continued to get worse, for an hour and a half. He was in great distress with ineffec- tual efforts to vomit and purge until a quarter past six o'clock, when he began to vomit every five or ten minutes, and purged fifteen times in twenty-one minutes. In a short time he began to vomit and purge blood, which continued until three o'clock A.M., Sunday morning, when this ceased. Very excruciating cramps now commenced, and he was attacked with great thirst for the first time. Being left alone by his own request, and having no water, his sufferings were almost in- supportable. At five o'clock he got water and sent for medical ad- vice ; the physician ascertained at eight o'clock, that he had taken 127 grs. of pure Arsenic, which had been given to him by mistake for Bi.-tart.-pot. They had no hopes of his ever recovering. He lived, however, and in five or six days he had gastritis, which lasted for several months; at the same time he had continued constipation of the bowels. He continued in this way for ten or twelve months. He suffered severely with cramps in the parts which became paralyzed; in a short time his cramps left him, and his gastritis began to get bet- ter. At this time, Aug. 1853, the cramp's left him, and he lost the entire use of his arms, hands, legs and feet by paralysis, and at this time he was attacked with severe neuralgic pains in the parts para- lyzed, in the thighs, legs, forearm and arms and hands, worst in feet and legs; cold was very distressing, could bear no warm food or drink, but external pain after eating, tenderness over liver and stomach. These neuralgic pains continued about two years and a half; they were then less frequent, and not quite so severe. They came on about four o'clock P.M., every day, and continued until about half past four or five o'clock in the morning. Nothing relieved him but very large doses of Morph.-Sulph.; the neuralgic pains began to de- crease in their duration; they diminished about one hour every day until he was nearly well. In Jan. 1856, he began to use his arms and hands a little; has not taken any Morph. since July, '56; about this time he began to improve in his general health, and he began to walk a little. Before he took the Arsenic his weight was one hundred and seventy-five pounds; forty-three hours after, it his weight was re- duced forty-two pounds. He is now, May 6, 1857, doing as well as he could expect. His feet are as yet partially paralyzed, and he suf- fers somewhat from neuralgia about three or four hours every other day or night. The pains come on at ten o'clock P.M. precisely, and Arsenic. 625 leave him at two o'clock, A.M., precisely. He is now in hopes that in a few months he will be entirely recovered. Sensation was not entirely destroyed. Boiling water poured on the parts that were paralyzed could not be felt, but ice-water gave him great pain, particularly when neuralgic pains were present. There was also a remarkable chilliness down the spine. No fever at any time, no chills, but cold sweats, with excessive thirst; chronic cold sweats about legs and arms for six weeks; would wet the sheets with the sweats. Excessive sensitiveness to cold ; when asleep, the slightest draught of air, even over his face would wake him; the opening and shutting of the door would chill him disagreeably. The cramps were worst in calves of legs and in thighs, but slight- ly in the arms and hands ; the muscles could be seen working; the pains of the cramps were so severe that he could not help screaming out. The cramps were most severe from 6 A.M. to 9 A.M.; then every half hour or hour during the afternoon; from 8 P. M. to next morning he would have no cramps. The neuralgia did not come on until the cramps ceased; were most severe in the same muscles in which the cramps had been. The paralysis did not set in until just before the cramps left him. The neuralgic pains did not leave him until the paralysis began to leave him. Under the use of the galvanic battery the pains would leave him one hour earlier, and commenced one hour later ; he could bear the shock so strong that it would knock a boy down ; there were four thousand plates in the battery, a Hartford University battery. The feet were entirely paralyzed, also the legs and hands ; could move some of the muscles of the thighs and hips; the upper arms could be moved ; could not feel a pin run into the flesh to the bone, but the slightest cold application would be felt. Could not stand or walk for thirty-eight months ; Strychnine did not benefit his paralysis; one-eighth grain doses Iodide of Potash as aduretic was the most useful remedy. Arsenic was detected m the urine. Commenced with two grains three times a day, and in- creased the Iodide one grain a day, until he took 120 grains a day; then diminished the doses; made seventy-five ounces of urine a day. When he commenced the Iodide was making thirty ounces per day; it in- creased to seventy-five ounces per day for months, and still makes two quarts per day; Iodide also caused perspiration; also acted on bowels ; rather it did not purge but removed the obstinate costiveness Case 10.—Peter Galpin, a laborer, aged twenty-seven, a powerful and robust youn<* man of intemperate habits, attempted suicide by taking Arsenic. °The quantity taken was not ascertained exactly, but it could not have been far from a scruple. Two hours had elapsed from the time it was taken, before treatment commenced. When the medical attendant arrived he had vomited twice freely, but without any relief. The family had given him copious draughts of a weak 40 626 Arsenicum-Album. infusion of tobacco, which produced no other effect than to»ag^ravate his sufferings. His pulse was 130 per minute, small and wiry. He complained of great constriction and dryness of the fauces, but chief. ly of a most agonizing pain and burning in the stomach ; it seeming as he expressed it, as if it were filled with burning coals. As the length of time that the poison had been retained, precluded the idea of emetics, the calcined Magnesia was selected as the antidote, and drachm doses were prepared, to be given every hour in milk and wa- ter. At this time the pulse was 150, the constriction and dryness of the fauces extreme; the whole surface bedewed with perspiration; the pain and burning sensation in the stomach seemed augmented to the highest possible degree and the right hand was entirely paralyzed; in short, every thing betokened a speedy dissolution. Visiting him the next morning, instead of finding him dead, we found him quietly dozing in an easy-chair. The lady stated that after taking the first dose of Magnesia, he said he felt much relieved, and before the time for the second dose, he had fallen into a doze. She stated that each successive dose had produced the most surprising and marked mitiga- tion of every symptom, and that long before morning he was entirely freed from suffering. (13. 46.) Case 11.—Three servant-girls in one of the Hebrides, ate a mix- ture of lard, sugar and Arsenic, which had been laid for destroying rats. The ordinary signs of irritation of the stomach ensued, but on the following morning were greatly mitigated. They were then or- dered twelve grains of Liver of Sulphur every other hour. Soon afterwards the inflammatory symptoms became more severe, the root of the tongue swelled and inflamed, and in the afternoon two of them lost the power of speech and swallowing, and were attacked with locked-jaw and general convulsions. The third had not locked-jaw, but was otherwise similarly affected. On the morning of the third day one of the two former was found comatose, with continuance of the locked-jaw, and occasional return of convulsions: and on being roused by venesection and cold effusion, she complained of headache and heat in the throat. The Sulphuret of Potass, which had been discon- tinued on account of the locked jaw, was then resumed. On the fourth day the headache increased, and the patient became delirious and unmanageable. The cold affusion, however, soon restored her again to her senses, and from that time her recovery was progressive. (13. 46.) Form 4th.—Paralytic Cases. A common nervous affection in the advanced stage of the more te- dious cases of poisoning with Arsenic is partial palsy. Palsy in the form of incomplete paraplegia, is a very common symptom, even of the early stage in animals, and has also been observed in man. The paralytic affection, however, is more frequent in the advanced stage, and in those animals who recover, an incomplete paralysis of one or Arsenic. 627 more of the extremities, resembling lead palsy, is often the last symp- tom which continues. (9.46.) Case 1.—Dehaen relates a distinct example of this disorder occur- ring in a female, who took a small quantity of Arsenic by mistake. The ordinary signs of inflammation were soon subdued, and for three days she did well, but on the fourth she was attacked with cramps, tenderness, and weakness of the feet, legs, and arms, increasing gra- dually till the whole extremities became at last almost completely pal- sied, at the same time the cuticle desquamated. But the other func- tions continued entire. The power of motion returned first in the hands, then in the arms, and she eventually recovered; but eleven months passed befofe she could quit the hospital. (9. 46.) Case 2.—Four persons were simultaneously affected about an hour after breakfast, with the primary symptoms of poisoning with Arse- nic, and some in a very violent degree. But besides these symptoms, in all of them the muscular debility was great, and in two it amounted to true partial palsy. One lost the power of the left arm, and six months after was unable to bend the arm at the elbow. The others had also great general debility, and long-continued numbness and pains of the legs. (9. 46.) Case 3.—A man, after taking Arsenic, was taken with vomiting, purging, and other symptoms of abdominal irritation, which were mis- taken for dysentery. Five days afterwards he began to suffer also from feebleness of the limbs, amounting almost to palsy. Subse- quently an improvement took place, but he continued to suffer under irritative fever, diarrhoea and faintness. Several weeks after the di- arrhoea abated, but he had great stiffness, numbness, and loss of power in the joints of the hands and feet. (9. 46.) Case 4.—Two persons took about half a grain in soup twice a day for two days, and were attacked with the usual primary symptoms. One of them died in two weeks, gradually worn out, but without any- particular nervous affection. The other was seized with convulsions, and afterwards with almost complete palsy of the limbs. Berndt re- lates a case arising from the Arseniate of Potash, in which the para- lytic affection consisted in the loss of sensation and motion in the hands, loss of motion in the feet, with contraction of the knee-joints. (9. 46.) Dr. Falconer observes in his essay on Palsy, that he has repeated- ly witnessed local palsy after poisoning with Arsenic, and alludes to one instance in which the hands only were paralyzed, and to two oth- ers in which the palsy spread gradually from the fingers upward, until the whole arm was affected. On the whole the local palsy is the most frequent of the secondary effects of Arsenic. (9. 46.) Occasionally, instead of being palsied, the limbs are rigidly bent, and cannot be extended. They were contracted as well as palsied in the case mentioned by Berndt. (9. 46.) Case 5.—A man took one-sixth grain doses of Arsenic for some time to cure a chronic eczema; he was attacked with jerks in the legs 628 Arsenicum-Album. and painful drawing proceeding from the back; general restlessness, formication, and trembling of the whole body; chilliness along the back and weakness of the muscles, especially of the legs, so that his walk became uncertain and stumbling. (4. 11.) Case 6.— Professor Malmsten reports two cases; in one, after the usual gastric symptoms, there was headache, inclination to delirium, followed by stupor for several days; then there were dull pains in the back, with painful fleeting stitches on the outside of the limbs, and numbness, first in the tips of the fingers, extending to hands and arms, and then to the toes, feet and legs. The power of motion and strength of the limbs diminished so much that he could scarcely hold anything in his hands, and his walk became uncertain and sttiimbling; he sweat much and passed a great deal of urine; the debility increased for several weeks, when the loss of sensation in his fingers was very great, in his hands less so, and natural above the wrist; there was also loss of sensation from the toes up to the knees; he could grasp objects, but could not hold them fast; his walk was staggering and stumbling, if he attempted to stand, he would fall, if not supported; it was also difficult for him to sit up; he could move his limbs with diffi- culty ; he had formication in his fingers and toes towards evening, but not during the day. He was cured with Arnica, followed by Nux- vomica. (4. 11.) Case 7.—A child, twenty months old, swallowed a quantity of paste in which Arsenic was mixed for the purpose of destroying rats. This was at 4 p.m. At 6 the child had vomited much, had had two natural motions without pain, and was sleeping calmly; countenance natural, pulse 130; respiration a little hurried. At half-past 9, still sleeping, but restless; skin hot, pulse 140; no expression of pain. Soon after 10 o'clock became worse, extremities and face became cold; lips livid, eyes sunk, pupils fixed and rather dilated, pulse scarcely perceptible; respiration feeble, accompanied with sighing. After lying about half an hour in this condition, he expired without a struggle at half-past 11, nearly eight hours after the accident. (13.46.) Post-mortem.—The stomach and intestines exhibited little deviation from a healthy appearance. The former contained a small amount of mucus and a few particles of paste. The villous surface manifested no signs of inflammation. Two or three vascular patches hardly dis- cernible only existed. (13.46.) Case 8.—M. W. poisoned himself with a tea-spoonful and a half of Arsenic, and after suffering all the symptoms of acute arsenical poisoning, they succeeded in evacuating a great part of the poison and saving life. The vomiting did not cease for eight and forty hours. The gums swelled much; the mouth became sore, with oedema of face and feet; paralysis of hands and feet, with peculiar suffering in the circulatory organs; remarkably small and indistinct pulse, with a spas- modic kind of catch in the breathing, and according to her statement, a sensation in the head as if a carpenter were at work with hammer and chisel; a gritty feeling in the eyes, which she was continually I Arsenic. 629 rubbing. After continuing in bed eight or nine days, she was able to get up, complaining only of boils in different parts, costiveness, con- junctivitis, lameness in walking, with loss of feeling in the hands and feet. (52.46.) J J *■ Two cases have been lately recorded in which paralysis has fol- lowed the medicinal use of Arsenic in three minim doses for seven weeks. (13. 46.) Case 9.—Charles Wilson, aged forty-one, Swede, seaman, entered N.-Y. Hospital, 1st Dec, 1849. He states that accidentally, about five months ago, he swallowed some Arsenic, which had been laid aside for the purpose of killing rats; that remedies were promptly used which counteracted the primary effects of the poison; felt per- fectly well for seven days afterwards; was then attacked at night with a violent cramp in index-finger of right hand, successively invad- ing the other fingers and lastly the thumb, then attacking the other hand in the same manner, and -finally the feet; the pain in the hands subsiding as the feet became affected; that the whole duration of the cramp was about thirty minutes, after which he fell into a sound sleep, which continued until morning; that when he awoke he felt free from pain, but on attempting to rise, was surprised to find that he had lost the use of the affected parts, and was in fact perfectly helpless; and that this paralysis has continued unchanged to the present time, ac- companied with a feeling of heat and numbness which invaded the upper extremities from tips of fingers to a point about three inches be- low the elbow, and the legs from the toes to a point a little below the knee. Has also had lancinating pains in these parts, regularly com- mencing about 5 P.M., and continuing until midnight. Present state.—Paralysis and nocturnal pains as above stated; can neither feed himself, nor stand alone when placed upon his feet. Has dryness of throat and great thirst; on 10th of January his urine was found to contain Arsenic estimated at l-170,000th part; traces of it were no longer detectable on the 18th of May. On the 14th of July, seven months and a half after his admission, he is reported as having slowly and steadily improved; had had no pain for some time save on the approach of stormy weather, when pe- culiar painful sensations were perceived in the fingers. He had taken Sulphate of Quinine, Strychnine and Electricity, and is finally re- ported as discharged relieved on the 15th of July. — [N. Am. Hom. Journal, 1851. Case 10.—Subject, H. P. Perkins, M.D., aged thirty-five years, and healthy; reported by Dr. Wetmore. On Saturday, July 24th, 1852, at a quarter to 5 o'clock, P.M., he sent for a small quantity of Potass.-bitart., and took the powder brought him in ice-water with sugar and a little Tr. Gent.-co. on an empty stomach. Twenty-five minutes after he was seized with giddiness and slight loss of vision, burning sensation in the stomach, great coldness of the surface of the body and profuse cold perspiration, inclination to vomit and purge, without ability to do either, and very severe cramp in the stomach and « 630 Arsenicum-Album. abdomen. Imagining that he had an attack of cholera, he took a large dose of Calomel, (40 grs.,) and a mixture composed of Peppermint, Rhu- barb, Opium, Lavender, and Cayenne-pepper, without relief. In about an hour and a half he began to vomit, with great difficulty, and some ten minutes after to purge, and, when this had continued fifteen or twenty minutes, to vomit and purge bloody matter. The latter did not cease till 3 o'clock, A.M., (Sunday, the 25th,) when he became quiet. At 3tJt o'clock, thirst commenced, for the first time. He drank up all the water, tea, &c, he had by him, but the thirst increased and be- came distressing. This led him to suspect that he was poisoned. From this time till a little after 5, being unable to walk or arouse any one, he lay in great agony from thirst, praying for death—at length he was able to make himself heard by a servant, who brought him a pint of ice-water, which he drank at once and immediately threw it up. He then sent for the hydrated peroxide of Iron and a physician, who ascertained about 8 o'clock, that instead of the Potass.-bitart., he had taken 127 grs. of pure Arsenic. At 12 o'clock he fell asleep, and slept fifteen minutes, but seemed in great distress. His physician had no hope of recovery, but. he thought himself that he should eventually get perfectly well. On Monday morning (26th)—forty-three hours after taking the Arsenic he was weighed, and was found to have lost in that time forty-two pounds. From this time he suffered severely from cramps, constipation and gastritis until May, 1854, when he began to be relieved of his cramps, and the constipation and gastritis were much improved. He now (in the course of about a fortnight) lost the entire use of his feet, legs, arms and hands—and severe neuralgic pains set in and continued for two and a half years. These were so violent that he could obtain relief only by very large doses of Morphine—he averaged daily, for eighteen months or more, 36 to 38 grs. Also, on one occasion he swallowed at once |viij. of Laudanum, without producing the slightest narcotism. He is now (April, 1857,) entirely free from his gastritis, crampsi and constipation. His breath has a peculiar, very offensive pungent odor. His feet are still partly paralyzed, so that it is difficult for him to walk any distance, and there is but little sensation as yet below the instep. There is some soreness on motion and pressure, in the arch of the right foot. The neuralgia is nearly gone, and he hopes in a few months to be entirely well. On inquiry, I was enabled to procure these few additional particu- lars: (11.) Amongst the first symptoms he noticed, after he suspected that he was poisoned, were a crimson line on the gums (which he had re- marked in other cases of arsenical poisoning) and injection of the con- junctiva, with symptoms of iritis. His mind was all the time perfectly clear, and, with all his senses rather morbidly acute. He was for a long time troubled with bad ( Arsenic. 631 dreams and night-mare, which would dwell on his mind and annoy him during the day. His appetite was usually inclined to be ravenous. The cramps appeared to affect all the muscles of the inferior extre- mities at once, and especially he thought the plantaris of the right leg. The neuralgic pains were confined to the arms, below the elbows, and to the legs below the hips, they did not seem to follow the course of the main nervous trunks. They were never darting in their character, but always steadily increasing to their climax and then gradually de- creasing. Cold air or water would always bring them on—they were worst between 9£ o'clock, A.M. and 8, P.M. The paralysis was of both motion and sensation—but he remained acutely sensitive in the paralyzed parts to cold. Arsenical paralysis always commences at the extremities. It may be confined to the feet, to the hands, or even to the fingers. It has been known to creep progressively from the hand over the whole arm. It appears to attack more frequently the nerves of motion than those of sensation. Both these forms are often found associated, however, or perhaps anaesthesia alone is present. It (arsenical paralysis) is pe- culiar almost exclusively to the third form of poisoning. When the effect of the poison is quickly fatal, within twenty-four hours, for ex- ample, paralysis, as might be supposed, is very exceptional. It might be asserted, however, that its principle is present, for we always find an extreme prostration and extraordinary feebleness. (73. 46.) The duration is variable. It may be four, six, seven, and ten months, or even years. Along with the paralysis, are pains of the extremities, frequently of an excruciating character. Hahnemann has insisted upon the burning pain, (brennende schmerzen.) They may accompany the paralysis or may exist alone, and although exhibiting a preference for the extremities, they may also invade the spinal column. Quarin says in his oldLatin, "I have had under treatment a patient, who,having taken Arsenic, was attacked with sharp pains in the joints, and with a slow fever; while upon his fingers and toes appeared tophaceous concretions." (73. 46.) ANOMALOUS CASES. Case 1.—Arsenic; Poisoning followed by Gangrene.—M. Forget, of Strasburg, has published the following case:—A man, sixty-three years of age, took two ounces of Arsenic; an hour afterwards vomit- ing came on, accompanied by colic and frequent alvine evacuations. Nine hours after the ingestion of the poison, the face was pale and haggard, the extremities cold, as well as the nose and ears; the pulse small and quick, the tongue moist and icy, and the weakness very great. There was much pain in the abdomen, the stools were very fluid, but the intelligence was clear, and the answers slow. (67 by 10.) The patient took the sesquioxide of Iron, and Ether, and had sina- pisms to the arms and legs. After this, vomiting recurred, and in two hours reaction was established; the extremities became warmer, and 632 Arsenicum-Album. the face was less pinched, and more animated. The reaction in- creased for a little while, but subsequently gave way, the symptoms became less marked, and two days afterwards the effects of the poison had entirely disappeared. Severe pain in the left leg was, however, complained of, and that limb was somewhat cold and tender on pres- sure. This pain went on increasing; the pulsations of the femoral artery became gradually weaker, and mortification set in. Amputation was performed ten days after the Arsenic had been taken, but the pa- tient rapidly sank; sphacelus occurred in the stump, and he died twenty days after the taking of the Arsenic, and ten after the amputation. Here the patient survived a dose of poison far larger than one com- monly looked upon as inevitably causing death. The next point of interest is the concomitance of the gangrene and poisoning, and it may be asked whether it were the age of the patient, or the Arsenic • which caused the gangrene. (67 by 10.) Case 2.—A young woman dissolved two ounces of white Arsenic < in a cup full of water, and drank it off, leaving about a table-spoonful of the powder at the bottom of the cup. In about an hour she was seen by the physician, who found her retching and sometimes vomiting, with violent spasms of the stomach and bowels, with a weak and quick pulse, affected frequently with a diarrhoea of a dark, bloody color, and often complaining of coldness of her extremities. She recovered in a few days, a result due doubtless to her early vomiting.—[Med. Re- pos., Vol. 5, p. 43. (67 by 10.) Case 3.—The family in which the fatal accident occurred consisted of six individuals and a maid-servant; the mother, Mrs. Gilton, three boys, and two girls. They all lived at home except the eldest son, who was away the greater part of the day. It appears that the manu- facture of certain mineral colors was carried on at the premises, and that Arsenic was employed as one of the ingredients in this manufac- ture. It further appears that there was a well in the color-house where the operations were conducted, and that this well furnished water not only to the works, but also by pipes communicated with the house, where the water was used for ordinary domestic purposes. A short time previous to the first person being taken ill, a quantity of Arsenic had been thrown down a drain, which was subsequently found obstructed, and it is probable that rain-water percolating through this had carried a portion into the well. All of the family partook of the water on the premises, as did also a cow belonging to them. The workmen employed in carrying on the business did not take their meals at the house, and therefore took little or none of the water. (12 by 10.) Mr. Bickersteth was first called to West Derby, where the family resided, on Monday, February 16, and found the mother in a dying state; unconscious; surface cold; the arms being in continued motion about her head. She died in a few hours, but before death conscious- ness returned for a short time. He was told that the youngest son had died a week previous, as it was supposed, from hydrocephalus. The symptoms, however, of both mother and child, appeared to have Arsenic. 633 been bilious vomiting and purging, with great thirst and head affec- tions. On this visit the rest of the family looked rather ill, but did not make any complaint. Two days after, viz., February 18, Mr. Bickersteth was again sent for. The eldest son and one of the daugh- ters were then suffering from bilious vomiting and purging, with great thirst, not, however, accompanied by pain or tenderness in any part. The daughter felt some curious sensations in her lower limbs ; in both the pulse was very quick. (12 by 10.) Mr. Bickersteth suspected that some poisonous substance had been taken, and finding the water which they used came from a well in the color-house, he thought it probable that Arsenic was present; he pro- hibited the use of the water, and took samples away, which were sub- sequently delivered to me for analysis by the brother of the deceased lady. Upon analysis the water was found to contain Arsenious-acid, or white Arsenic, in the proportion of four-tenths of a grain to the im- erialpint. (12 by 10.) The following day, February 19, the eldest son was better, and so was his uncle, who had only been there one day, and was seized after taking tea in the house. The two daughters and the youngest son were now suffering. The vomiting had ceased in the one first attacked under the administration of Prussic-acid,,and had given way to ner- vous symptoms. There was great restlessness, indisposition to an- swer questions, numbness of the lower extremities, whilst the arms were in continual motion in the air, as if picking at something above the head; the skin was hot but not dry, and did not exhibit any discolora- tion; the tongue was dry and brown, and there was great thirst; the throat seemed dry, and the breathing was quick and audible; the pulse was very quick, 125 or 130, but not hard; the heart acted forcibly, but without friction sound, or murmur. The girls did not complain of pain on pressing the abdomen, but the youngest son slightly moved when this was done, though he said it gave him no pain. They had all uncomfortable feelings, which they could not describe, but were at his time conscious. (12 by 10.) On the following day, the 20th, they were much worse. The breathing and pulse very rapid; the tongue and lips dry, cracked, and covered with blood and sordes. The eldest girl was unconscious, throwing her arms, legs, and body about in every manner. The other two exhibited the same symptoms as yesterday, only in an increased degree, and consciousness was fast departing. [There had been no purging or vomiting in the girls since Wednesday the 18th.] (12byl0.) On Saturday, the 21st, the youngest boy died at 4 P.M.; the pecu- liar movement of the arms continuing up to the time of his death. Between that period and Sunday night the two girls died. The ser- vant early at this period was taken ill and went home; at a later time the cow was affected. The workmen, with one exception, were not sufferers. A short time after the servant was admitted to the fever hospital with symptoms purely nervous, and after a few days was dis- charged cured. (12 by 10.) 634 Arsenicum-Album. Post-mortem examination of the youngest son twenty-four hours after death. (12 by 10.) There were no peculiar appearances noticed on the skin, and the muscles of the trunk were of their usual color. The lungs were adherent on both sides by old adhesions posterior- ly; both were congested with bloody serum, especially the right. The bronchi were red and injected, and covered with red mucus. The heart and pericardium were both healthy-looking; and the blood in the body was dark and fluid generally, though there were co- agula in the heart. (12 by 10.) The trachea and epiglottis presented marks of inflammation. The liver was slightly enlarged, presented exteriorly many yellow- ish green patches, and was internally of a uniform slate or ash color. Its consistence was normal; and the bile in the gall-bladder was co- pious and dark. The oesophagus was healthy-looking. The stomach was contracted, contained some greenish fluid and mucus, but, with the exception of punctiform and ramified redness at the splenic and pyloric ends, pre- sented no unusual appearance. The rugae were red and vascular; the mucous membrane was not softened or ulcerated. (12 by 10.) The commencement of the duodenum was red like the stomach. A few patches of redness existed in the jejunum, and the lower part of the ileum was discolored for about twelve inches, where the soli- tary glands appeared unusually large and numerous. The coecum was dark-colored and congested. The rectum and co- lon were also discolored here and there, but no ulceration or softening had occurred. The intestines contained a large amount of faeces. Spleen and kidneys were healthy. Head.—Sinuses and veins congested; about a table-spoonful of serum existed at the base of the brain, and the same quantity in the ventricles; no softening or formation of false membrane was observed. (12 by 10.) Case 4.—A man, aged thirty, addicted to drinking, and while under the influence of liquor, took two ounces of Arsenicum-album, from which he suffered no inconvenience except a slight and sour smelling diarrhoea, accompanied with pain in the stomach and bowels. The stomach-pump and vomits of Lime were successfully employed, and ten days after the occurrence the patient was well again. (81 by 20.) Case 5.—A woman took two ounces of Arsenic; had the usual gastric symptoms; her face was bloated, with a most frightful expres- sion of fear; the conjunctiva not very red, but the ciliary vessels around he cornea were so much dilated that they resembled the vascular zone which attends acute iritis; the hands and lower part of both fore-arms were as dark and livid as in malignant cholera. (4.11.) Post-mortem.—In this and many other cases, notwithstanding the tendency to lividity of some parts, the muscles were of a very bright red color, and very firm texture; great rigidity of the body; the left ventricle so hard from some contraction, that it resembled concentric hypertrophy; the ordinary vascular appearance of stomach and bowels. Arsenic. 635 OF LONG-CONTINUED SMALL DOSES, CAUSING SLOW OR CHRONIC POI- SONING. Hahneman has most graphically described the condition of slow poisoning by Arsenic, and his description is quoted by Christison in his valuable treatise on Poisoning, and yet the pigmies of the Allopa- thic profession of the present day characterize the learned German by the opprobrious epithet of "quack"!!! (54.) He calls it " a gradual sinking of the powers of life, without any violent symptom; a nameless feeling of illness, failure of the strength, an aversion to food and drink, and all the other enjoyments of life." According to Pereira, the following are the symptoms produced by the long-continued use of Arsenious-acid :—Disorder of the digestive functions, characterized by flatulence, sensation of warmth or actual pain in the stomach and bowels; loss of appetite, thirst, nausea and vomiting; purging, or at least a relaxed condition of the bowels, and griping; furred tongue, with dryness and tightness of the mouth and throat, or with salivation ; quick, small, and sometimes irregular pulse; oppressed respiration, with a dry cough. The body wastes, the sto- mach being frequently so irritable that no food can be retained in it. Headache, giddiness, and want of sleep, are frequently observed. The limbs become painful, feeble, trembling, subject to convulsions; occasionally benumbed and ultimately paralyzed. The cutaneous sys- tem is in some cases affected, an eruption makes its appearance, and now and then the hair and nails fall off. ffidema of the feet and face js not unfrequently observed; and under these symptoms the patient gradually sinks, in some cases retaining his consciousness to the last, but at other times delirium or stupor supervening. (54.) Case 1.—Dr. Jackson, of Edinburg, noted the symptoms of poi- soning in a lady who was subject to the action of small repeated doses for eight weeks. The Arsenic here was introduced so slowly and its effects so gradually increased that we may take many of the symp- toms as pathogenetic. Sickly look, small frequent pulse; frequent slight tickling cough, or rather hawking, without expectoration ; occa- sional discharge of mucus from bowels, often tinged with blood; te- nesmus and griping of some days'standing; flatulence; redness of eye-lids and lining membrane of nostrils ; loss of appetite and failure of strength; restlessness at night; increasing weakness; dryness or tightness of throat, hoarseness of voice ; later the stools assume a fatty appearance, owing to presence of pus, as proved by microscopical ex- amination; tongue red and fiery, mouth and lips excoriated, anxiety and restlessness very great; percussion reveals tubercular infiltration at summit of both lungs, most in right, indolent in both, symptoms re- sembling tuberculosis of abdomen and chest; conjunctiva much in- jected; anus excoriated; hiccough, restlessness, and general distress, pule 130, and feeble; urine scanty, high-colored, dense, albuminous, 636 Arsenicum-Album. depositing blood-discs and casts of uriniferous tubes of kidney. Died with tetanic spasms, with mental faculties perfect. (52 by 10.) Case 2.—Dr. Kelso observed the following symptoms from a small poisonous dose in a child:—Listlessness and indisposition to reply to questions; pulse 120, weak and unequal, occasionally fluttering; re- spiration regular, slow, and imperfectly performed; nausea, and incli- nation to vomit; heat and pain in stomach; pain in epigastric region, increased on pressure; alternate dilatations and contractions in rapid succession, and in extreme degree, of the pupil of either eye, espe- cially of the right, increased on the approach of light or of a moving body; eye-lids drooping languidly, concealing to some extent the eye- balls ; features generally relaxed, expressionless appearance of coun- tenance; epigastric region considerably distended, and acutely painful on pressure; no evacuation either from the bowels or the bladder. (52 by 10.) AQUA TOFFANA—ACQUETTA DI NAPOLI. In the present place it may not be amiss to advert to the supposed effects of the celebrated Aqua-Toffana, or Acquetta di Napoli, a slow poison, which in the sixteenth century was believed to possess the property of causing death at any determinate period, after months, for example, or even years of ill health, according to the will of the poi- soner. (9. 46.) The most authentic description of the Aqua-toffana, ascribes its properties to Arsenic. According to a letter addressed to Hoffman by Garelli, physician to Charles Sixth of Austria, that emperor told Ga- relli, that, being governor of Naples at the time the Aqua-toffana was the dread of every noble family in the city, and when the subject was investigated legally, he had an opportunity of examining all the docu- ments—and that he found the poison was a solution of Arsenic in Aqua-cymbalariae. The dose was said to be from four to six drops. It was colorless, transparent, and tasteless, like water. (9. 46.) Its alleged effects are thus eloquently described by Behrends, in Uden and Pyls Magazine:—" A certain indescribable change is felt in the whole body, which leads the person to complain to his physician. The physician examines and reflects, but finds no symptom either ex- ternal or internal—no constipation, no vomiting, no inflammation, no fever—in short, he can advise only patience, strict regimen, and laxa- tives. The malady, however, creeps on; and the physician is again sent for. Still he cannot detect any symptom of note. He infers that there is some stagnation or corruption of the humors, and again advises laxatives. Meanwhile the poison takes firmer hold of the system ; languor, wearisomeness, and loathing of food continue ; the nobler or- gans gradually become torpid, and the lungs in particular at length begin to suffer. In a word, the malady is from the first incurable; the unhappy victim pines away insensibly, even in the hands of his physician; and thus he is brought to a miserable end through months or years, according to his enemy's desire." (9. 46.) An equally vigorous and somewhat clearer account of the symptoms Arsenic. 637 is given by Hahnemann. "They are," he says, "a general sinking of the powers of life, without any violent symptom—a nameless feel- ing of illness, failure of the strength, slight feverishness, want of sleep, lividity of the countenance, and an aversion to food and drink, and all the other enjoyments of life. Dropsy closes the scene, along with black miliary eruptions, and convulsions, or colliquative perspiration and purging. (9. 46.) The la6t nervous affection to be mentioned is mania. The only instance Christison has found of it arising from Arsenic, is related by Amatus Lasitanus. He has not recorded the particulars, but merely says that the individual became so outrageously mad as to burst his fetters and jump out of the window of his apartment. According to Zacchias, Amatus was not very scrupulous in his adherence to facts in recording cases. (9. 46.) ARSENIC-EATING. A case in which a person was charged with poisoning, was tried at Cilli, in Styria. The victim was an old soldier, who died suddenly, and in whose stomach Arsenic was found. It is said that the court in submitting the case to the jury, asked the question, " Was the deceased an Arsenic-eater?" To which the jury replied, "Yes, he probably was." This question had reference to the fact, it is said, that in the provinces of Lower Austria and Styria, bordering on Hungary, it is quite common with men to chew Arsenic mixed with their bread, as the Chinese chew Opium. The absorption of the small quantity thus used, induces a fresh, clear complexion, and to a certain extent bright- ens the faculties; but with those who thus make a habit of eating it, there follows before long debility, and premature death. Females do not at all indulge in it, and the few men thus distinguished are known as eaters of poison. (39.46.) Dr. Tschudi states that the peasantry purchase it under the name of hedri, from wandering herbalists or peddlers, who obtain it from the Hungarian glass-workers, &c. These poison-eaters have a double aim; first they wish to give themselves, by this dangerous habit, a fresh and healthy appearance, and a certain degree of embonpoint. Many of the peasant girls, and even the men, have recourse to this expedient, from a desire to please and from coquetry; and it is re- markable what success they attain, for the young toxicophagi are dis- tinguished by the freshness of their complexions, and by their aspect of flourishing health. The following is one of many instances:-A girl who attended cows, in good health, but pale and thin, having a lover whom she wished to attract still more she had recourse to Ar- senic, and took it several times a week. The desired result was soon attained, and after some months she became fat and chubby-cheeked. To carry the effect further, she increased the dose, and fell a vietim to her coquetry-she died poisoned. 1 he number of deaths from the abuse of Arsenic is by no means inconsiderable especially among young people Dr. Tschudi states that so careful are they to conceal 638 Arsenicum-Album. the fact, that it often is only revealed on the death-bed. The second advantage obtained by the toxicophagi is, that they become more free in respiration, and are able to ascend high mountains with ease. Upon long excursions into the mountains they take a bit of Arsenic, which they allow to dissolve in the mouth. The effect is surprising; they ascend in this way heights which would be insurmountable without it. They commence with a piece of Arsenic the size of a lentil-seed, or half a grain. They keep to this dose, which they swallow several times a week, morning and evening, for a long period, to become ac- customed to it. Then they'increase the quantity insensibly, but with precaution, until the desired effect is produced. A countryman, a sexagenarian, in excellent health, was in the daily habit of taking four grains. He had followed the habit forty years, and had transmitted it to his son. There was no trace of arsenical cachexia in this indivi- dual, no symptoms of chronic poisoning. It is to be remarked, how- ever, that when the practice is dropped, emaciation generally ensues. The custom does not diminish the sexual passion, on the contrary, it increases it." (39. 46.) This is the substance of Dr. Tschudi's statements, but all of them it will be seen, are unsupported assertions. (46.) It may be as well to bring to mind a general use of Arsenic in Vi- enna, among the stablemen and coachmen of the great houses. They mix a good pinch of the powder with corn, put a piece the size of a pea in a linen bag and attach it to the bit of the horse; this produces a bright aspect of the skin, roundness and elegance of form, and foam at the mouth. The coachmen of the hills adopt the same practice before commencing a laborious journey; and horse-dealers carry with them small balls of Arsenic, to be given to those animals which they are leading to market. Should a horse thus treated fall into the hands of one who does not employ Arsenic, he gets thin, loses his freshness, becomes dull, and in spite of abundant food, does not recover his for- mer sleekness. (39. 46.) This last paragraph we take from Wharton and Stitle's Medical Ju- risprudence, they copying from the Medical Times and Gazette, of July, 1854—the article, however, originally appeared in the Gazette des Hopitaux, of May 16, 1854. (46.) A doctor, whose name at this moment escapes me, has given for a period of nine or eleven months, increasing doses of Arsenic to ani- mals ; beginning with xir °f a gra'n) he finally gave fifteen grains daily, with no diminution of their health or spirits. (46.) Christison, however, unequivocally says that the tendency of habit to modify the action of Arsenic is questionable. So far as authentic facts go, habit has no power of familiarizing the constitution to its use. One, no doubt, may hear now and then of mountebanks who swallow without injury entire scruples or drachms of Arsenic, and vague ac- counts have reached me of patients who took unusually large doses for medicinal purposes. But as to facts of the former kind it is clear that no importance can be attached to them; for it is impossible to Arsenic. 639 know how much of the feat is genuine, and how much legerdemain. With respect to the latter facts, I have never been able to ascertain any precise instance of the kind, and so far as my own experience goes, the habit of taking Arsenic in medicinal doses, has quite an op- posite effect from familiarizing the stomach to it. (9. 46.) 1st. M. Kesteren says that the evidence upon which these state- ments have been made is simply the loosest kind of hearsay evidence. Neither Dr. Von Tschudi, Mr. Boner, Dr. Johnston, Dr. Kaltenbrun- ner, nor Dr. Vitzhum, have personally observed or watched the Arse- nic-eater, although the two latter are residents in parts of Styria where it is alleged that Arsenic-eating prevails. All of them have received their information from other persons. (13. 46.) 2d. No chemical analysis of the excretions, nor any post-mortem, nor chemical examination has ever been had of the organs of those who have indulged in Arsenic-eating. 3d. No analysis has been had of the so-called Arsenic. (13. 46.) 4th. Its alleged effects are totally at variance with all other experi- ence of it as a remedy or poison, while its consequences, (which we always find following its administration and ceasing on its withdrawal,) are in the case of the Styrian peasants totally reversed—immunity at- tending its use, poisoning arising on its cessation. [It may be true in the case of such poisons as the system may become tolerant of, (Opium, &c.,) but it can hardly hold good of one of the most, essen- tially cumulative poison which we have. Its effects, so far from be- coming more tolerable to the system by use, seem to accumulate by its continuance, even in small doses, and finally burst suddenly out into all the symptoms of irritant poisoning; and these symptoms sub- side at once on the drug being discontinued.] (46.) 5th. No mention has been made of the effects of Arsenic upon the systems of those unaccustomed to its use, the beginners in the prac- tice ; and surely no one would be so bold as to assert that the Styrian peasant can do what no other human being is capable of, viz., take a grain or two of Arsenic for the first time, without any effect. There is a want of statistical information as to how many are killed by the habit, or in the process of initiation, a fact which of itself throws the gravest doubts upon the story, as the most trivial inquiry must have revealed a certain amount of mortality from this cause, more surely than from its occasional excess, or want of the poison. (13. 46.) 6th. No information is tendered as to how long this practice has obtained. It is quite certain that it could not have existed without having attracted the attention of the resident medical practitioners, since some of the accounts state that many have pursued the practice for twenty or thirty years. One man is reported by Dr. Von Tschudi to have eaten Arsenic for forty years, and to have inherited the prac- tice from his father. Where did it originate, and how is it that it has only just come to light? (13. 46.) 7th. In Cornwall, where Arsenic is prepared.no such practice pre- vails. Supposing the story true, the same might have been expected 640 Arsenicum-Album. of the Cornish peasantry; the absence of the practice among the lat- ter, augments the incredibility of the former. Again, the destruction to the lower animals and to vegetation by its inhalation, and of chronic skin disease by its external irritation, observed in the mining districts of Cornwall, has been altogether overlooked in the searching for the marvellous, among the Arsenic-eaters of Styria, where it is said to give health, vigor, and beauty. (13. 46.) The medico-legal importance of this question induced the author to examine its grounds—and it has been shown that the story wants verification —and as far as information has been procurable, the asser- tions are without any of the elements of proof. (13. 46.) Case 1.—Tschudi, in speaking of an Arsenic-eater, who from his twenty-seventh year, every month near full moon, for eight or ten days, took small portions of Arsenic, pure, gradually increasing the dose to three or four grains; on one occasion took a larger dose than usual, was seized with violent colic and burning in throat and oeso- phagus. A friend of his told him if he continued on in this course, that he would die of dropsy, and he was thus persuaded to leave off. Since then he has had frequent attacks of gastrodynia. This habit had continued thirty-five years, and he had taken in all about twenty- two ounces. A constant hoarseness of voice is peculiar to Arsenic- eaters. (81 by 26.) Case 2.—The director of an Arsenic mine had been in the habit of taking three to three and a half grains of powdered Arsenic every morning with his coffee; the same practice is pursued by his work- men. He considers this the best method of guarding those exposed in the mines against the ill effects of Arsenic, and indeed it is asserted that all the men so employed enjoy excellent health. (81 by 26.) TESTS FOR ARSENIC. As small a quantity as 100,000th part of an aqueous solution, aci- dulated by Hydrochloric-acid may be detected by boiling in it a slip of bright copper—a grey film of Arsenic being deposited upon the copper. (10.) The above is a slightly imperfect and partially incorrect account of Reinsch's well-known exceedingly simple and efficacious method of detecting Arsenic. If the copper is put into the acidulated fluid be- fore it is duly heated, i. e. to the boiling point, a stain will almost al- most always occur in the presence of organic matters. Supplemen- tary tests are also requisite, since solutions of various metals give a coating not unlike that of metallic Arsenic. Hence the copper being removed from the acidulated and heated fluid, after the deposit is formed, must be washed in distilled water, dried and introduced into a reduction tube. On the slow application of heat, Arsenious-acid will be sublimed and deposited on the sides of the tube in the form of minute octahedral crystals. These may be examined by a lens, and then dissolved in water and subjected to the liquid tests. (39. 11.) When powdered Arsenious-acid is boiled in distilled water, it is very Arsenic. 641 slowly dissolved, part of it floating on the surface of the liquid, or aggregating, in small lumps, at the bottom of the vessel. (3. 46.) A clear watery solution of Arsenic has a very feeble reaction on litmus. Its taste is feeble. By evaporation on a glass plate it yields octohedral crystals. It yields a white precipitate with Lime-water ; a yellow color, and, on the addition of Hydrochloric-acid, a yellow pre- cipitate with sulphuretted Hydrogen-water; a green precipitate with ammonio-sulphate of Copper; a yellow precipitate with ammonio- nitrate of Silver ; it evolves arseniuretted Hydrogen-gas when mixed with Zinc, and either Sulphuric or Hyd/ochloric-acid {Marsh's test) ; and, lastly, when boiled with Hydrochloric-acid and clean Copper foil, it gives a grey metallic coating to the latter, {Reinsch's test.) (3. 46.) Lime-Water.—The Lime-water test gives a white precipitate, soluble in most acids. The impediments to the operation of it are a large quantity of water and free acids, which hold it in solution, and gelatinous and oleaginous liquids which keep it suspended. The fallacies are carbonates, oxalates, tartrates, and phosphates, which also throw down white precipitates with Lime-water. (3. 46.) Ammonio-sulphate of Copper.—If a dilute solution of Sulphate of Copper be added to a solution of Arsenious-acid, a pale green precipitate, {Arsenite of Copper, called Scheels green), soluble both in Nitric-acid and Ammonia, is obtained, and Sulphate of Ammonia with excess of Ammonia remains in solution. It is done as follows: Add (cautiously) Liquor-ammoniae to a diluted solution of the Sulphate of Copper, so as to redissolve the Oxide of Copper, which is at first thrown down. Care must be taken not to employ too much Alkali, otherwise the test will not act. Moreover, the solution must not be concentrated, or the precipitate will not be obtained. The impediments are astringents, tea, infusion of galls, &c, which prevent the charac- teristic action. The fallacies are yellow-colored and other organic liquids, as decoction of onions, which give a green color and slight precipitate, (with the blue test), even though no Arsenic be present. (3. 46.) Ammonio-nitrate of Silver: {Hume's test.)—If a solution of Ammonio-nitrate of Silver, be added to a solution of Arsenious-acid, a yellow precipitate, Arsenite of Silver, takes place, and Nitrate of Ammonia, with excess of Ammonia, remains in solution. The pre- cipitate is soluble in liquid Nitric-acid, in solution of Ammonia and in solution of Nitrate of Ammonia. The mode of preparing this test is as follows: Add a few drops of Liquor-ammoniae to a solution of Nitrate of Silver, so that the Oxide of Silver, which the alkali at first throws down, may be nearly, but not quite redissolved. Great care is requisite to add neither too much nor too little ; for, if too much be employed, the solution will not occasion any precipitate with Ar- senious-acid, and, if too little, it will produce a precipitate with Phos- phate of Soda, similar to that produced with Arsenious-acid. The only proper way of knowing when the proper quantity has been employed is to test the solution. Arsenious-acid, but not Phosphate 642 Arsenicum-Album. of Soda, ought to occasion a precipitate with it. The impediments are free acids, chlorides, and organic matters. The acids may be readily neutralized by an alkali. If common salt or other metallic chloride be present, Ammonio-nitrate of Silver throws down a white precipitate, even though a considerable quantity of Arsenic be pre- sent. To obviate this, add a few drops of Nitric-acid, then an excess of solution of Nitrate of Silver. Filter, to get rid of the precipitated Chloride of Silver, and apply the Ammonio-nitrate of Silver. The presence of much organic matter impedes the action of the lest. Its fallacies can hardly be called such. Ammonio-nitrate of Silver, when properly prepared, does not occasion a yellow precipitate with any substance save Arsenious-acid; and hence it is not subject to any fallacy of that kind. If, however, it be not properly prepared, it may occasion a yellow precipitate {Phosphate of Silver) with Phosphate of Soda. There is an optical fallacy against which the student ought to be upon his guard; if Ammonio-nitrate of silver be added to certain yellow liquids containing common salt, a white precipitate {Chloride of Stiver) is produced, which seen through a yellow medium, might, by a careless observer, be mistaken for a yellow precipitate. (3. 46.) Hydro-sulphuric-acid.—This test may be employed either in the gaseous form or in the form of sulphuretted Hydrogen-water. The former is to be preferred. If sulphuretted Hydrogen-water be added to a solution of Arsenious-acid, the liquid is rendered yellow; and, on the addition of a few drops of a strong acid, like hydrochloric, a yellow precipitate falls. If the gas be passed though a solution of Arsenious-acid, the same yellow precipitate is produced. In order, however, that this may take place, the liquid must be slightly acidified by Hydrochloric-acid. If it be already acid, it should be neutralized by an alkali, and then acidified with Hydrochloric-acid. The pre- cipitate is yellow, insoluble in Hydrochloric-acid, readily soluble in Liquor-ammoniae, forming a colorless and very limpid fluid, and yields metallic Arsenic, when dried and heated with Soda-flux or Potash-flux. Hydro-sulphuric-acid gives with the Salt of Cadmium, a yellow precipitate, insoluble in Liquor-ammoniae, and soluble in Hydro- chloric-acid. Perchloride of Tin yields a yellow precipitate, soluble, though with difficulty, in Liquor-ammoniae, and soluble in concentrated Hydro- chloric-acid. A solution of Tartar-emetic yields, with Hydro-sulphuric-acid, an orange-red precipitate, which is soluble both in Liquor-ammoniae and Hydrochloric-acid. Dilute solutions of Tartar-emetic yield paler- colored precipitates. The Bi-hydrosulphate of Ammonia, has been employed as a sub- stitute, but is very fallacious. When fresh it turns solutions of Ar- senic yellow, Tartar-emetic red, and lead black ; but, after exposure to the air for a day or two, it forms a white precipitate with Arsenic, yellow with Tartar-emetic, and red with lead ! ! (3. 46.) Arsenic. 643 Marsh's Test: If Arsenious-acid be submitted to the action of Zinc or diluted Sulphuric-acid, arseniuretted Hydrogen-gas is evolved. Mix a small portion of the suspected liquid with some di- lute Sulphuric-acid (1 tot or 8) and pour the mixture over some pieces of Zinc, previously introduced into a proper apparatus ; bubbles of lit immediately make their appearance. If no Arsenious-acid be pre- sent, the gas evolved is Hydrogen, but if the liquor hold Arsenic in solution, arseniuretted Hydrogen-gas is formed. Care must be taken not to apply the flame to the gas jet before the air is expelled, or an explosion may be the result. The gas is recognized by, first, its having an alliaceous odor; second, it burns with a bluish white flame, and the evolution of a white smoke (Arsenious-acid) ; third, its flame deposits on a cold piece of mica-glass or porcelain, held in the upper part of it, a black spot or ring, surrounded by a larger white ring of Arsenious- acid ; fourth, if the gas be transmitted through a glass tube, heated to dull redness, it is decomposed into its constituents, the metallic Arsenic being deposited in the tube ; fifth, if arseniuretted Hydrogen be trans- mitted through a solution of Nitrate of Silver, free Nitric- and Ar- senious-acids are formed in solution, while metallic Silver is pre- cipitated. This reduction of Silver may be conveniently shown by wetting a piece of bibulous paper with a solution of Nitrate of Silver and exposing it to a current of the gas. (3. 46.) Reinsch's Test:—If an aqueous solution of Arsenious-acid be boiled with pure Hydrochloric-acid, and clean Copper foil, or fine Copper gauze, or Copper wire, the latter acquires an Iron-grey metallic coat- ing of metallic Arsenic. If the coated Copper be washed, dried, cut into small pieces, and then heated in a glass tube in the flame of a spirit-lamp, the metallic Arsenic is volatilized, and if the experiment be performed in a tube of very small diameter, it sometimes yields a metallic ring; but, in general, it becomes oxidized and yields a sub- limate of minute octohedral-crystals. If the coating be sufficiently thick, it may be scraped from the Copper and heated alone in the tube. The obtained Arsenious-acid should be dissolved in water, and tested with Ammonio-nitrate of Silver, and Hydro-sulphuric-acid. (3. 46.) Reduction Tests.—Formation of a metallic crust.—If Arsenious- acid be intimately mixed with freshly-ignited but cold Charcoal, or still better with a mixture of Charcoal and Carbonate of Soda (the residue obtained by incinerating in a covered crucible, tartrate or acetate of Soda), and heated in a glass tube, the acid is de-oxidized and yields metallic Arsenic, which is sublimed into a cooler portion of the tube, when it condenses and forms a metallic crust. A com- mon cylindrical test-tube answers very well, but the reduction tube of Berzelius is to be preferred. The characters of the Arsenical crust are the brilliancy of its outer surface, which is frequently equal to polished steel, or looking-glass ; the crystalline appearance and greyish-white color of its inner surface, its volatility, its conversion, by sublimation up and down the tube, into octohedral crystals of Ar- senious-acid, which may be dissolved in water, and tested by the liquid reagents. (3. 46.) 644 Arsenicum-Album. antidotal treatment. Sometimes from one-half to one and a half ounces of Arsenic may be given to horses, without bad effects during life, and no morbid appearance after death ; but two ounces will generally produce death in two or three days. Frank reports three horses killed with two-ounce doses, without any antidotal treatment. Then a number of horses, poisoned with two-ounce doses of Arsenic were treated with the hydrated per- oxide of Iron. (4. 11.) Case 1.—A nine year old horse took two ozs. of Arsenic, followed immediately by four lbs. of Ferri-oxydat-hydrat., in eight litres of water. No symptoms ensued, and it was killed at the end of nine days; a few erosions were found in the stomach. Case 2.—A seven year old horse was treated in the same way, with a two-oz. dose of Arsenic, followed at once by four lbs. of Ferri- oxydat.-hydrat. No symptoms followed and it was killed on the eighth day ; only very slight inflammation of duodenum was found. (4.11.) Case 3.—An old horse was experimented on, in the same way, without effect, and was killed on the nineteenth day. There was slight effusion into the abdomen, slight false membranes of new formation on the colon, with irritation, congestion, some inflammation and erosion of the stomach and bowels. (4. 11.) Cases 4 and 5.—Two horses took Arsenic as above, and one took the antidote two hours, and the other four hours afterwards. They both remained well, and were killed on the eighth and eleventh days; both showed slight traces of inflammation and erosion of the stomach and bowels; one had a copious effusion of yellowish serum into the cavity of the abdomen. (4. 11.) Case 6.—The antidote was not given until five hours after the poison had been taken ; the horse died in twenty-four hours, with all the signs of arsenical poisoning, both before and after death. (4. 11.) From other experiments it was proven that the hydrated Peroxide of Iron will not neutralize the Arseniate of Potash, but Arsenious- acid only. (4. 11.) Case 7.—A man, aged fifty, took 311J. of Arsenic ; six hours elapsed before he came under treatment. He had the usual gastric symptoms, for which Milk, Albumen, and Ipecac, were used; the hydrated- Oxide of Iron was not used until ten hours had elapsed, then it was taken, to the extent of ten ounces, with great improvement, up to the evening of the fifth day, when collapse sat in, with stupor and slight delirium, and death on the seventh day. (4. 11.) Our esteemed friend, Dr. Wilson, of this city, informs us that he has employed Tincture of Tobacco, in several cases of Arsenic-poisoning with entire success. This gentleman has given to dogs as much as three grains of Arsenous-acid at a dose, and entirely antidoted its effects with Tincture of Tobacco. In those instances where the antidote had not been administered until vomiting, purging, and red- Arsenic. 645 ness of the conjunctiva had made their appearance, one or two doses of the Tobacco sufficed to arrest all toxical phenomena, and speedily restored the health. Its homceopathicity to many of the physiological effects of arsenic render it peculiarly appropriate, after the hydrated Peroxide of Iron has exercised its antidotal chemical action. (10.) Of nineteen dogs, poisoned with Arsenic and bled, sixteen died ; of thirty treated with stimulants, eleven died; of nine without anything, eight died. Those treated with stimulants also recovered more quickly. (11.) external use. The symptoms arising from the external or topical application of Arsenic, are very similar to those produced when administered through the stomach, with the exception of the immediate local lesion. On man it has been known to act through an ulcer or wound, the inner membrane of the rectum, the membrane of the vagina, the membrane of the air tubes, the membrane of the nose, and even the sound skin. (9. 46.) Many persons have been poisoned by the application of Arsenic to surfaces deprived of the cuticle, such as blistered surfaces, eruptions, ulcers, or wounds. When applied in this manner it commonly induces both local inflammation and constitutional symptoms. Amatus Lusi- tantis relates the case of a young man, who, against the advice of his physician, annointed an itchy eruption of the skin, with an Arsenical ointment and next day was found dead in bed. A similar case, not so rapidly fatal, has been recorded by Wepfer. A girl, affected with psoriasis of the scalp, had it rubbed with an ointment of butter and Arsenic. In a short time she was seized with acute pain and swell- ing of the whole head, fainting fits, restlessness, fever, delirium, and she died within six days. Zitman has noticed the cases of two children, eight and ten years of age, who were killed by the applica- tion of an Arsenical solution to a similar eruption of the head; and Belloe relates the case of a woman who, trying to cure an inveterate itch with Arsenical lotion, was in consequence attacked with severe ery- sipelas of the whole affected part,succeeded by tremors and gradualex- haustionof the vital powers, ending fatally in two years. M. Erard has met with two cases, when in consequence of a freshly blistered surface being dressed with an ointment made of the stearine of arsenicated candles, local pain, nausea, pain in the stomach, urgent thirst, redness of the tongue, involuntary contractions of the muscles of the extre- mities, and weakness and irregularity of the pulse came on, and one person died within twenty-four hours, while the other recovered, chiefly because the dressing caused so much pain that the patient could not keep it on long. (9. 46.) Case 1.__Death from the external application of Arsenic.—In this case Arsenic was applied ignorantly, upon the recommendation of a friend, to the heads of three children suffering from porngo favosa. Two of them were found with their faces swollen and oedematous, par- 646 Arsenicum-Album. ticularly about the eyes, and the skin red and shining. The scalp was covered with a copious eruption of porrigo favosa; the Arsenic had been applied thirty-six hours previously. She had obtained six pence worth of Arsenic, had mixed it with a gill of gin and rubbed it well into the children's heads ; but not satisfied with this, she had ap- plied at a dispensary and obtained the Ung.-hydrarg.-oxyd.-rub., which had also been applied, some little time after the Arsenic. The youngest child, (about two years of age) was pale, and there was no sign of inflammation of the scalp, but it was suffering from diarrhoea and tenesmus, with great weakness of the lower extremities. The same night it died, its lower extremities having first become entirely para- lyzed. The mother stated that on one previous occasion, she had applied the Arsenic but it had been followed by no ill consequences, with the exception of some swelling; that this had soon subsided and the child had appeared better. No post-mortem was made, so ii was impossible to say if there were any internal lesions of .organs. (9. 46.) Next, as to ulcers. M. Roux has noticed the case of a girl, who was killed by an application of the Arsenical paste to an ulcer of the breast, and in whom the constitutional symptoms were strongly marked, although the quantity of the poison must have been very small. The preparation used, which contained only a twenty-fourth of its weight of Arsenic, was applied for a single night on a surface not ex- ceeding an inch and a half in diameter. Yet she complained next day of violent colic, and vomited frequently, the countenance soon became collapsed, and she died two days afterwards in great anguish. Another instance of the like kind is related in the "annates d'Hygiene" —and, in fact, they are too numerous to need citation. (9. 46.) There is a singular uncertainty in the effects of Arsenic, when ap- plied to ulcerated surfaces. Some persons, like Roux's patient, are obviously affected by a single application, while others have had it applied for a long time without any other consequences than the formation of an eschar at the part. Two causes have been assigned for these differences, and probably both are founded on fact. One, which was assigned by Mr. Blackadder, is the relative quantity of Arsenic applied. He says he never witnessed but one instance of its acting constitutionally, although he has often applied it to sores; and he imputes his success to his having always used a large quantity. For he considers that, by so doing, the organization of the part is de- stroyed, and absorption prevented, but that if the quantity be small,as in the mode practiced by Roux, it will cause little injury and readily enter the absorbing vessels. (9. 46.) Another unequivocal cause is pointed out by Harles. He remarks that it may be applied with safety to the abraded skin, to common ulcers, to wounded surfaces, and to malignant glandular ulcers, even when highly irritable, provided the part be not recently wounded so as to pour out blood. The reason is obvious;—the application of the poison to open-mouthed vessels, is the next thing to its direct intro- Arsenic. 647 duction into a vein. It is some confirmation of Harles' opinion, that Roux, whose patient was so easily affected, recommends that before Arsenic be applied to an ulcer, a fresh surface be made, by paring away the granulations. (9.46.) The symptoms vary in their nature. Sometimes the chief disorder is inflammation, spreading over and around the original sore, some- times inflammation of the alimentary canal, sometimes an affection of the nervous system. In general, the sufferings of the patient, both from the local inflammation and constitutional symptoms are very severe. But this rule has its exceptions. In Pyl's me- moirs there is the history of a child, who died four days after an itchy eruption of the whole body had been washed with an arsenical solution, and signs of vivid inflammation were found after death in many parts; yet she appears only to have complained of headache. Occasionally too, without exciting either inflammation of the part, or disorder of the stomach, or a general injury of the nervous system, it seems to give rise to partial palsy of the muscles adjoining the seat of its application. (9. 46.) / It has also been applied to the rectum and vagina, todere has noticed a case which happened in France. A lady died suddenly and it was discovered that her servant has administered Arsenic to her in enema. (9. 46.) Case 2.—A middle-aged female was seized with vomiting, diarr- hoea, swelling of the genitals, and uterine discharge, and soon ex- pired She told one of her neighbors, that her husband, after re- peated attempts, had succeeded in poisoning her, by introducing a powder into her vagina, while in the act of enjoying his nuptial rights. The vulva and vagina were gangrenous and the intestines inflamed. (9. 46.) Another case happened in Finland, where three woman were poison- ed in this way. The man was a farmer, near Copenhagen, and as soon as he tired of his wives he would introduce a powder of Arsenic and flour into the vagina on the point of the forefinger; soon after he would marry one of his maid-servants. On the third repetition of this it was discovered. (9. 46.) . . Case 4—Prof. Robertson, of Calcutta, while exhibiting Marsh s test to the class, inhaled some of the arseniuretted Hydrogen-gas He soon became aware of a sense of burning in the throat, and next day he had an intense acrid burning sensation, Irom the pharynx to he lower extremity of the alimentary canal, excessive irritability of .he stomach; vomiting, first of food, then of bile, ultimately of dark coffee- ground looking matter, consisting of broken-down blood-corpuscles, and desquamated epithelium of the stomach and lower parts of the oesophagus and obstinate constipation of the bowels There was severe deep-seated pain in the lumbar region ; he voided between three and four pints of bloody urine, which, on being analyzed, exhibited minute traces of Arsenic" Symptoms of great constitutional disturbance were present; considerable fever; full, hard, frequent, incompressible 618 Arsenicum-Album. pulse ; dry, hot, unperspiring skin ; intense restlessness, anxiety and general uneasiness ; a pale, anxious countenance, and considerable prostration of the vital powers. On the third day, the bowels not having been opened, and'there being a good deal of tenderness in the left iliac region, with a sense of weight and dragging in the fundament, a dose of Castor-oil and Laudanum produced a copious clay-colored evacua- tion, with a tubular, membranous-looking slough, somewhat ragged in appearance and about four inches long. It was a portion of the lining membrane of the rectum. The symptoms gradually improved from this time. (9. 46.) Case 5.—A farm-servant was affected with inflammation of the skin of the lower part of the abdomen, the penis, scrotum, and upper part of the thighs, running on in some places to ulceration, consequent on exposure for two hours to a solution of White Arsenic. He had been engaged in washing sheep, in a bath composed of Arsenic dissolved in boiling water. In the evening, he complained of pain and smarting, and the following morning the skin was red and inflamed. He had severe burning pain, and considerable constitutional de- rangement. It was a fortnight before he could return to work. The solution consisted of two pounds to fifty gallons of boiling water. (18. 46.) Case 6.—A man was poisoned during the manufacture of compo- sition candles, in which Arsenic was contained. He first complained of his hand being swollen on Wednesday, but was not seen by a medical man until Saturday morning. The left hand and forearm, and glands of the axilla were much swollen, and there was an abrasion at the back of the hand. The angry appearance of the limb, evidently showed poisoning, and saline draughts, fomentation, and poultices were ordered; but the patient got worse, purple patches appeared on the arm and side, and he died on Monday. From the evidence of his employer, it appears that two ounces of Arsenic per hundred weight only were used. No post-mortem was held, unfor- tunately, by which the extent of the internal lesions could be ascer- tained. (13. 46.) Case 7.—A man, in the habit of powdering Arsenic for apothe- caries, worked at this for two days, and pulverized three pounds of Ar- senic ; he worked with his cap pulled down over his eyes and a four- doubled towel over his mouth and nose. (4. 11.) On the second day, he was obliged to urinate frequently; then vomiting of mucus and blood set in ; he had burning pains in the nose, mouth, and eyes; his saliva was profuse and bloody ; swallowing was painful and difficult; on the third day his breathing was painful, and he felt hot stitches all over his body; on the fourth day there was swelling and insupportable burning of the penis, pain in urinating, vesicles on his hands, thumbs and forehead; painful swelling of the right arm and hands ;■ his fface was covered with pustules, his eyes were red, his eyelids swollen and red-streaked; his chest and stomach painful. On the fifth day, he had medical advice: his pulse Arsenic. 649 was weak and frequent, respiration oppressed, stomach painful, his kidneys, bladder, and penis caused him frightful pains, and there was retention of urine. (4. 11.) Case 8.—A boy, aged six years had Arsenic, mixed with Olive-oil, rubbed into his head, to kill lice. He went to bed bright and well, waked up with severe headache, had frequent vomitings, and was swollen all over his body. By the next evening, the whole body was swollen in an extraordinary degree, and covered with bluish vesicles ; his pulse was miserable ; he had cold and viscid sweats on his head and forehead ; frequent fainting fits and slight convulsions of the facial muscles; he died in twenty-four hours. (4. 11.) Case 9.—A hearty farmer, aged twenty-five, applied a strong solu- tion of Arsenic, to cure the itch, over his whole body, three times a day. Soon after the first application he experienced violent pains over the whole body, as if he lay upon a fire or upon needles; these pains increased, the skin raised in large vesicles, spontaneous vomiting oc- curred after every meal, and death ensued on the third day. (4. 11.) Post-mortem: Almost the whole body was stripped of its skin; there was inflammatory redness of the stomach and duodenum ; the hair came out very easily. (4. 11.) Case 10.—A man employed to grind and sift Arsenic, kept a cloth over his mouth and face ; but, soon after his work was finished, his scalp was found covered with several hard, isolated pustules; the whole face and both ears were extraordinarily swollen, and covered with a dark erysipelatous redness and large vesicles; the hands and other covered parts of the body were effected in a lesser degree, with the exception of the scrotum, which was greatly swollen and covered with bullae, which soon burst and assumed a perfectly gangrenous appearance. To these were added violent pains, drawings and throbbings in the head, vertigo, delirium, sleepless nights, violent pains and jerks in the limbs; trembling of the hands, great anxiety and oppression of the chest, dryness of the tongue, occasional vomiting, with violent fever, and a quick, Jaard pulse. He recovered in four weeks, but his hair fell out, and pains in his limbs lasted a long time. (4. 11.) Clinical Remarks.—Arsenic, in these cases, seemed to act like the poison of severe or malignant erysipelas. (11.) Case 11.—A drachm of Arsenic, in two ounces of Flaxseed, was applied to an old foot-ulcer. In two hours severe pains extended up the leg to the abdomen and sacrum; bilious vomiting, and three diar- rhoeic stools had occurred; the vomiting and diarrhoea lasted all day, the abdomen was distended and painful to touch, and the pulse febrile. On the third day, the diarrhoea had ceased,but the vomiting continued; there was also increased secretion from the irritated eyelids and nos- trils, which lasted for a long time, in connection with roaring in the ears. (4. 11.) Case 12.—By mistake, powdered Arsenic was sprinkled on a sore place in the bend of the thigh, in a child aged four years. Violent 650 Arsenicum-Album. inflammation ensued, spread quickly up to the navel, and changed to gangrene; vomiting, diarrhoea, and meteorism of the bowels occurred, and death on the seventh day. (4. 11.) SKIN. The cutaneous system is always more or less affected by the long- continued employment of small doses. Its pathogenetic action upon the skin is manifested in various forms, depending upon the size and mode of administration of the doses, and the constitution, dyscrasia, and idiosyncrasy of the prover. In most instances, it is probable that Arsenicum merely operates as the agent, in developing upon the surface some internal latent humor. This appears evident from the fact that, in almost every case the eruption, which is thrown out under the use of the acid, is but a re-appearance of one which had previ- ously existed. Hence, we have among the physiological effects,pus- tular, urticarious, miliary, scaly, (leprous and eczematous,) herpetic, scorbutic, and even psoric eruptions. From larger doses, the cellular tissue may become involved, and ulcers, or even gangrenous patches become developed. (10.) Arsenic seems to have special relations with the effete matters of the organism. Administered internally, or applied externally, it pos- sesses the power of decomposing and destroying cancerous and other malignant degenerations of the tissues. In producing this effect, its action is almost entirely limited to the diseased parts. So, also, when administered in minute and repeated doses, it excites into activity latent morbid humors in the blood, or effete matters from the meta- morphoses of the tissues, which are not eliminated by the pores of the skin. (10.) Its operation appears to be two-fold; first, by a direct contact of its atoms, in a crude form, with either healthy or diseased parts, and pro- ducing actual disorganization and destruction; or, secondly, in very minute doses, acting upon the retained products of the changed tissues of the organism, in obedience to the law of catalysis. Crude or allo- pathic doses, with their physiological phenomena, mayibe placed in the first category; while infinitesimal doses, with their pathogenetic results, may be ranked in the latter class. (10.) ARSENICAL ERUPTIONS. Boerhaave notices, among other symptoms, yellowish vesicles appear- ing upon the breast, for several days. (73. 46.) Case 1.—A man, aged thirty-five, was poisoned with two drachms of Arsenic. On the sixteenth day, an abundant miliary eruption made its appearance over the whole body, and two ulcers, which made their appearance upon the heels, discharged an ichorous matter. The eruption, after several exacerbations, disappeared after fifteen days, leaving a dry, furfuraceous, scaly surface. (73. 46.) Case 2.—Belisle, fifty-seven years of age, apothecary's assistant, powdered, in two days, three hundred weight of Arsenic. The second Arsenic. 651 day he was seized with various alarming symptoms; the fourth day he had pimples on his hands, on his knuckles, and also on his fore- head; also, a painful tumefaction of the right arm and hand. His face became covered with pustules. (73. 46.) Case 3.—A cavalry officer was poisoned with Arsenic in soup. During his convalescence, there appeared upon his face, his neck, and the interior aspect of the fore-arm, an eruption of little pustules of a miliary character. (73. 46.) Case 4.— Five men were poisoned with an Arsenical solution in wine. In a few days, there appeared a complete want of appetite, followed by an eruption of little pustules, resembling the itch. The desquamation was prompt. (73. 46.) Cask 5.—A chambermaid rubbed her head, for some trivial affection, with a pomade containing Arsenic. In six or seven days, the whole head was swelled, the ears, doubled in volume, were covered with crusts. The ninth day, the body was covered with a considerable eruption of little pimples with white points, above all the hands and feet. In less than forty-eight hours, the eruption disappeared, followed by desquamation. (73. 46.) Case 6.—Eva Truszka and Anna Malkowska powdered their heads, by accident, with Arsenic. The two following days they had riolent headache, and enormous swelling of the scalp and of the face. Their hair was cut off. On the 26th, twelve days after the accident, Eva's head and face were enormously tumefied, and spots and bluish streaks covered her face; and there were many ulcers, the size of a penny, upon the hairy scalp. With Anna, there was less tumefaction, and some ulcers upon the head. On the 14th of the succeeding month, the ulcers, which had penetrated to the pericranium, were rapidly healing. (73. 46.) Case 7.__Three young men powdered their heads with Arsenic. The same symptoms as above. One of them died. At the autopsy of the latter, there were found large blue-black spots upon the thorax, the abdomen, the scrotum, the hypochondrium and back. The scro- tum was inflamed. (73. 46.) Case 8.—Kelly, in experimenting with Arsenic in chronic rheuma- tism, developed an erysipelas upon the eyelids and face, lasting six days. (73.46.) , , ., # „ Case 9 —Three young women poisoned themselves accidentally with Arsenic, mistaken for candy. The next day there were purple spots upon the breast and back of the neck. (73. 46.) Case 10—Bachman gives the history of a lady poisoned with Ar- senic by a servant. In the midst of a train of grave symptoms, it was discovered, towards the fifth day, that the anus and genital organs were ^C^sTriT— In a young man, who had committed suicide with Ar- senic, in fourteen hours there was found, at the autopsy, traces of gan- grene upon the scrotum and prepuce. (73. 46.) Case 12.—A man of forty-five, was induced to apply Arsenic to an 652 Arsenicum-Album. ulcer upon the leg. The day but one after, among other symptoms of Arsenical poisoning, the body was covered with red spots. The fifth day, the ecchymoses were almost black. (73. 46.) Case 13.—A young woman poisoned herself with Arsenic on the 17th of October. After divers symptoms, on the 19th there appeared a miliary eruption, especially upon the abdomen, and vesicles upon the tongue, which disappeared at the end of a few days. (73. 46.) Case 14.—A man, aged thirty-two, poisoned himself, on the 3d of May, with " Becoeur's Arsenical Soap." On the morning of the 5th, the neck and the breast were covered with a confluent pruriginous erup- tion, something like urticaria. The eruption spread, during the day, to the hairy scalp, to the back of the neck and the shoulders, and disap- peared during the night. (73. 46.) Case 15.—Two young men poisoned themselves with a bottle of wine, containing half an ounce of Arsenic in solution. With both, between the fourth and fifth day, there was desquamation of the greater part of the body, most marked upon the fore-arms. (73. 46.) Case 16.—In the case of M. Blandy, five days after the appear- ance of the first symptoms of poisoning, there was a pustular eruption about the lips, and the anus was excoriated and surrounded with ulce- rations, accompanied with an insupportable burning. (73. 46.) Case 17.—Dr. Schindler, whose brother, a chemist, was poisoned by the fumes of arseniuretted hydrogen, notes, among the other symp- toms, that in the course of the third week, during his convalescence, the prepuce and glans were covered with purulent vesicles, which later became small, round, superficial ulcerations. He counted sixty- five upon the prepuce. The eruption passed off in ten or twelve days. (73. 46.) Case 18.—In the case of two little girls, of three and five years, who died, poisoned by Arsenic, it was noticed that there was intense scarlatinous redness of the skin of the abdomen, and especially of the internal surface of the thighs. They died, respectively, in twenty-seven and eighty-five hours. (73. 46.) Case 19.—In a case mentioned by Orfila, on the fifth day there was remarked upon the forehead, around the eyes, upon the cheek- bones, the upper part of the arms, the shoulders, the upper part of the chest, an eruption of white pustules, not very numerous, and which became analogous, as to form and course, to the small-pox eruption. The pustules, of which some were isolated, the greater part confluent and easily broken, were replaced by scabby crusts, which fell, leaving very perceptible cicatrices. (73. 46.) Case 20.—N., occupied in pulverizing Arsenic, although pro- tected by a cloth {mouchoir) over his head and face, still was attacked by the following symptoms: The hairy scalp was covered with a great number of hard and isolated pustules. The face and ears were enormously swollen, red, and erysipelatous, and covered with vesicles, which degenerated rapidly, and took on a gangrenous aspect. He was completely cured at the end of four weeks. (73. 46.) Arsenic. 653 Case 21.—A man, aged forty-five, poisoned himself with Arsenic, and died the next day. The scrotum was livid and excoriated. (73. 46.) Case 22.—On the 10th of February, 1846, twelve persons were poisoned, at Thaun, with Arsenic. The fourth day, the greater part of them were attacked with an eruption of little blisters, similar to those produced by the nettle, or little pimples, as in miliary affections. (73. 46.) Case 23.—On the 13th of May, 1847, J. M. poisoned himself with a coffee-cup of an Arsenical solution. The usual symptoms were rapidly developed. On the 17th, dysphagia, and ulcerations of the throat, increased the next day. On the 19th, in the parotid region of the left side, appeared an erysipelatous tumor. On the 20th, it was covered with numberless vesicles, full of yellowish serosity, and the tumor extended to the nose and mouth. On the 21st, the tumor was enlarged and covered with fresh vesicles. On the 23d, the erysipelas became crusted over, and desquamation was going on, and five super- ficial ulcerations had appeared upon the border of the tongue. On the 25th, new vesicles upon the left ear. He slowly recovered. (73. 46.) Case 24.—Mrs. Wooler was poisoned, by her husband administer- ing Arsenical injections, about the 1st of May. On the 30th, the mouth and lips were excoriated. On the 8th of June, these excoria- tions were notably increased, and were very painful. On the 13th, the face and the arms were covered with an eruption, which took, lit- tle by little, the character of an eczema. On the 23d, the back of the tongue was ulcerated, and the palate covered with papules or pustules. (73. 46.) Case 25.—Marie Lassalas, sixteen years of age, a domestic, en- tered the 10th day of October, 1854, at the Hotel Dieu de Clermont. She was young, fresh, and well-looking, offering only slight traces of chlorosis. From the first day of her entrance, she took four-drop doses of Fowler's solution, four times daily. On the 16th, the fol- lowing symptoms were noted: Slight lacrymation; catarrhal stop- page of the head, with nasal voice; rery marked fluent coryza; has had a little bleeding at the nose during the night. 17th.—Catarrhal symptoms very marked, {fortemcnt enrhumee); has sneezed all night; the throat and tonsils red. 20th.—There has appeared, during the night, all over the leit lore- arm, a confluent eruption of little, red, papulous pimples, of the size ol a pin's head. Two days before, according to the patient, the same eruption had appeared and disappeared. ,<-.-. 21st— The same eruption, accompanied with great loss of appetite, and the same " cold in the head," and lacrymation. 22d -The eruption of the fore-arm was much more considerable. The intensity of the eruption induced me to suspend the Fowlers so- U 23d —The fore-arm is quite red, covered with very small and very confluent papules, similar to what is called "goose flesh. 654 Arsenicum-Album. ' fljiTr.—- The same redness of the fore-arm, with considerable pain- ful swelling. 25th.—For some days past, there has been the same eruption about the lips, upon the hand and right knuckle, with intense itching. These eruptions disappeared, little by little. There followed a slight desquamation. The coryza obstinately remained to the last. Discharged on the 4th of November without a trace of the eruption (73. 46.) Case 26.—Desgranges relates the case of a woman who anointed her head with an Arsenical ointment, to kill lice, and, after using it several days, was attacked with erysipelas of the head and face, at- tended with ulceration of the scalp, swelling of the salivary and cer- vical glands, and inflammation of the eyes. Ther^ were, likewise, violent constitutional symptoms, much fever, fainting, giddiness, vomiting and pain in the stomach, tenesmus and ardor urinae, tremors of the limbs, and even occasional delirium. Afterwards the whole body became covered with an eruption of white papulae, which dried and dropped off in forty-eight hours. She recovered gradually. (73.46.) Case 27.—A schoolboy, having found in the street a parcel of Ar- senic, his mother mistook it for hair powder; and, as he had to deliver a valedictory at school the next day, she advised him to powder his head well with it in the morning, which he accordingly did. In the middle of his speech, he was attacked with acute pain of his face, and a fertile crop of pustules soon broke out upon it. The head after- wards swelled much, and the pustules spread all around it. He was tormented with intolerable heat in the scalp, and the hair became matted with the discharge into a thick scabby crust. This crust separated in a few weeks, and he soon recovered completely. (73. 46.) Pathology.—In a similar case to the above, which proved fatal, be- sides other morbid appearances, the scalp was found gangrenous and infiltrated with blood, and the stomach much inflamed. (73. 46.) Henckel speaks of miliary eruptions as preceding and disposing to pulmonary phthisis, so frequent among the miners of Freyburg. (73. 46.) Schepfler, who put forth, during the last century, a treatise upon the hygiene of miners, notices, among other Arsenical symptoms, vesicles and ulcerations of the mouth and tongue, ulcerations of the axilla and genital organs, and even carcinomatous ulcerations of the latter region. (73. 46.) Klinge, another physician of the arseniferous mines, affirms that the workmen who constantly handle the ore, rich in Arsenic, are habitu- ally subject to ulcerations of the arm-pits and thighs. (73. 46.) Brockmann has recently published a work, (" Die Metallurgischen Krankheiten in Oberharze,") which, doubtless, will throw much light on the subject of chronic poisoning. (73. 46.) Christison says that in Arsenical poisoning, divers eruptions have been remarked, above all, those which last many days in succession; that they are more frequent in those who survive the poisoning a week Arsenic. 655 or more; that they are of different natures; petechial, morbilliform, (measly) red, miliary, or vesicular. (73. 46.) Bramer says, that among the workmen employed in the different arts, in using Arsenic, (principally in pulverizing it,) there appears an eruption of vesicles of the size of a pin's head, or even of the size of a pea, similar to the common itch. These eruptions are exceedingly itching, and by the action of scratching the pustules, are soon de- stroyed, and give place to a fine crust. (73. 46.) The Arsenical eruptions are thus classed: A. Petechial eruptions, or ecchymoses.—They affect, by preference, the trunk and genital organs. (73. 46.) B. Papulous eruptions.—These papules, which some authors have compared to the eruption of measles, often resemble those syphilides so well known, which attack the face. They are often of a hue some- what less coppery. Their place of election seems to be the neck and face; they have been seen upon the hands. They are, in general, few in number, and discrete. They sometimes arise by groups of red papules, the size of a pin's head; these papules run together, later, to form the large papules the size of a bean. They do not disappear under six or eight days, and fade away successively, with a light fur- furacious desquamation. Large, red spots, diffuse and disseminated, have been seen also upon the neck and limbs. (73. 46.) C. Nettle rash—Urticarious eruptions.—This is one of the most frequent forms of Arsenical exanthem. Genyard has often seen pa- tients, under the use of Arsenic, troubled with pimples upon the face, the neck and limbs, soon disappearing. A young girl, whom Genyard treated with the Arseniate of Iron, showed for two consecutive days, throughout the length of both legs and arms, a confluent, urticarious eruption. The wheals and pimples were white, slightly rosy, round about, and of the uniform size of beans. They were accompanied with considerable itching. (7. 46.) D. Vesicular eruptions.—These have been compared to the itch, white and red miliary eruptions, and of eczema—a form very frequent, and which Genyard himself had frequently seen. E. Erysipelatous eruptions.—The Arsenical erysipelas is often vesi- cular. It is developed, with equal readiness, by the internal adminis- tration of Arsenic. Genyard has lately confined himself to the em- ployment of Arsenic internally, and often sees partial erysipelas of the face, often confined to the eyelids. (7. 46.) F. Pustular eruptions.—These have been compared to those ot small-pox. They terminate in crusts, or ulceration, and leave "cica- trices." (7. 46.) ., . G. Ulcerations.—These ulcerations have been met with upon the head, limbs, scrotum, tongue, lips, and in the throat; they appear-to arise as pustules, which burst, leaving an ulcerated surface. (7d. 4o.) H. Gangrene.-These last three forms of Arsenical eruptions, ap- pear to be most peculiar to those cases where Arsenic has been ad- ministered in toxical doses. (73. 46.) 656 Arsenicum-Album. Arsenic appears to have an elective preference for the genital or- gans. Stahl has remarked the same fact. " Deinde accedit fere in viris specialissima repentina sphacelatio, et post-mortem preceps putrido in genetalibus." "Hence, we find a peculiar tendency to sphacelation and putridity of the genitals, particularly after death." (73. 46.) Clinical Remarks.—Arsenic is very important in many chronic affections of the skin, particularly the scaly forms, (lepra psoriasis and pityriasis); also in eczema and impetigo. Icthyosis and elephantia- sis are also said to have been benefited by its use. (3. 54.) Useful in chronic indurations of the cellular tissue. Thomas Hunt, of London, has cured with Fowler's solution, several forms of inveterate cutaneous disease, prurigo of the anus, scrotum and pudendum, lepra, psoriasis, urticaria, impetigo, eczema, acne, sy- cosis, lupus exedens, and naevus matemus—some most obstinate cases yielding to its power. (11.) He advises full doses, five drops, three times a day, at once, and then that the doses should be diminished—the time for lowering the dose is indicated by the supervention of conjunctivitis, when a prickling sensation is experienced in the tarsi, the eyes suffused with tears, and the conjunctiva inflamed. The skin of the trunk is apt to take on a slight inflammatory action, and subsequently the skin of the limbs. This inflammation appears as a faint pityriasis, and all those parts of the skin, protected from the light, acquire a brownish, dingy, unwashed appearance. If this state be kept up, the other disease of the skin will vanish just as rapidly as if the conjunctiva were kept sore. (11.) Arsenic is much less apt to affect the stomach and bowels, if taken during a meal. One patient was cured by one-fourth of a drop of Fowler's solution, three times a day, or only -j-hr of a grain of White Oxide of Arsenic, of a psoriasis guttata. In several cases, it acted as a vigorous tonic. (11.) Todd's inflammatory gastric dyspepsia is apt to be attended with a papular and scaly condition of skin, something between lichen and psoriasis. (11.) Eczema, in its acute stage, will be infallibly greatly increased in severity by the employment of Arsenic, even in the most minute doses, (Hunt)—but it cures the chronic stage. (11.) All the diseases of the skin which Arsenic cures, agree in this one important respect, that they are characterized by the presence of scales or scurf—even when they do not belong to the order squamae, they are usually but little benefited by Arsenic, until they arrive at that stage in which they assume a furfuraceous or scaly condition. (Hunt 11.) In the earlier stages of eczema it is injurious, or useless, but when once this disease has fallen into that condition in which there is no longer any distinct evolution of vesicles, but, in their place, a serous fluid, which exudes, at times, and dries rapidly into thin furfuraceous Arsenic. 657 scales or laminae, the subjacent skin being red, glazed, dry, and more or less fissured and cracked, it will often be productive of the most decidedly beneficial results. (Hunt. 11.) Urticaria-luberosa is the only exanthem which requires Arsenic. (Hunt. 11.) Lichen is the only papular disease which requires it—in its most chronic and rebellious forms, especially in those varieties of lichen circumseriptus that are confined to the face, or to the margins of the anus and genitals, in which the skin becomes red, excoriated, chapped and furfuraceous. (Hunt. 11.) Or in chronic fluent form of lichen, where the whole body is covered with papulae, capped with thin, flimsy scales, having a close resem- blance to ptyriasis—the irritation and consequent insomnia being most distressing. (Hunt. 11.) Chronic eczema is the only vesicular eruption which demands its use—seldom yields but to Arsenic. (Hunt. 11.) No pustular diseases require it, except very chronic and rebellious forms of impetigo. (Hunt. 11.) It is, however, incontestibly of the greatest service in lepra, and inveterate psoriasis. After obstinately resisting all other treatment, it will yield, in the course of a few weeks, to Arsenic. (Hunt. 11.) When it is about to exercise a beneficial influence, it will be ob- served that increased action appears to take place in the diseased cutis, which becomes irritable, red, and inflamed. The scaly patches then appear to heal up, either from the centre or circumference, ac- cording as it is lepra or psoriasis, and eventually fall off, leaving the skin red, smooth, shining, and covered with a thin epidermic exfolia- tion. After this, nothing comes off, but a red stain will be left. This will soon disappear, if the remedy be continued, for, until this blotch be entirely and effectually removed, the disease is liable to return. (Hunt. 11.) In furunculus, Dr. Schweich has prescribed Arsenic, with great success, for some time past, and has found the cure very durable. He begins with four drops of Fowler's solution, twice a day. Acne yields to Arsenic with the same readiness. (13. 46.) In regard to the treatment of skin-diseases by Arsenic, the follow- ing are Mr. Hunt's views, and he has probably given more attention to it than any other writer. The author's object, in his work, is not so much to present a general treatise on skin-diseases, as to point out a more promising mode of treatment of those skin-affections which are particularly marked by their intractibility. He describes these dis- eases as, first, not of limited duration, but they may afflict a whole life-time. This excludes, at once, nearly the whole class of the exan- themata. Second, they are not necessarily connected with or sympto- matic of other disorders ; thus excluding strophulus, aphthae, phymea, and syphilitic eruptions. Third, they neither originate in, nor are protracted by local causes. Scabies, porrigo, and certain local forms of psoriasis, pityriasis, prurigo, eczema, and impetigo are thus excluded 42 658 Arsenicum-Album. Fourth, they are not specially allied to debility. This puts aside pemphigus, pompholix, rupia, and some varieties of purpura and ec- thyma. We have thus the subject much narrowed, and the diseases in which Arsenic will probably be most useful, he asserts to be certain varieties of lichen, lepra, psoriasis, impetigo, eczema, ecthyma, chronic urticaria, acne, sycosis, lupus, and rare congenital nairvus. He states that the first inquiry should be as to whether they are of a syphilitic origin, or if a febrile state exists. Its numerous failures in the treat- ment of cutaneous diseases, he thinks, depends upon five causes: First, in the syphilitic character of the eruptions, Arsenic being given whereMercury is wanted ; second, its inflammatory condition, atwhich period it does no good; third, it is often given on an empty stomach, and the irritation thus induced prevents its continuance; fourth, it is given in too large doses, and at too distant intervals; and fifth, it should be given in decreasing doses. He regards it, when these precautions are observed, as little short of a specific in the skin-diseases mentioned. He also regards it, in small doses, as curative of diarrhoea, and relates cases where ob- stinate purging ceased, together with an eruption, under its use. In persons very susceptible of its effects, Mr. Hunt states that a remark- ably small dose, such as the fourth of a minim, will be sufficient to cure the disease for which it is given ; and that its curative effects reside in doses too small to be hurtful. An effect of Arsenic, which has also been observed by others, (M. Duvergie for instance, and in the case, reported in the present article, of the Due de Praslin), he comments upon, viz., the production of a dirty-brown discoloration of the skin. (13.46). pathology. Dr. Geoghegan has investigated the morbid anatomy of a series of cases of arsenical poisoning,,and gives the following as the result of his observations. The inquiry was chiefly confined to the appearances in the stomach. In the examination of sixteen fatal cases, all (save one, in which the parts were altered by maceration) exhibited either vascular injection, ecchymosis, or coloration, singly or combined. The mucous membrane was engorged in fifteen, the submucous also in five, the peritoneal in two, and the venous plexus of the splenic end in one. The ramiform vascularity he has found confined to the submu- cous coat. Of the vascular injections which implicate the mucous membrane, the punctiform. or closely stellate, he has found by much the most common, and the striated the least. Diffuse redness, which is the alteration he has most frequently met with, Dr. Geoghegan views as the result of translation or imbibition, influencing a previously- formed vascular injection. It may exist either alone or otherwise. Ecchymosis presented itself, either first as blackish, scarcely elevated patches, or streaks of variable size and figure, readily removable by the nail, and, when thus treated, leaving behind them the ordinary ap- pearances of erosion, or, second, petechial, florid-red blotches, of small Arsenic. 659 size and trivial thickness. He does not accede to the view, that either of these is produced by the lodgment of undissolved particles of Arsenic, but considers them to result either from the general stimu- lation of the mucous surface, (as occurs in the case of fluid poisons), orlas a consequence of the remote action of Arsenic. The local contact and adhesion of the latter sometimes gives rise to great and fungous thickening, confined to the mucous membrane, which, in one instance, was accompanied by a copious effusion of tough, coriacious fibrin. Erosion of the mucous membrane has been met with by the author, under the form of either circular patches, with undefined edges, and without surrounding coloration or hardening, or of long, sinuous streaks. He considers erosion as the result of the removal of the mucous coat, where occupied by the blackish ecchymoses, in which parts the membrane is much softened, although elsewhere of natural consistence. (13. 46.) He has never met with true ulceration of the stomach in arsenical poisoning, although he has seen it invade the buccal mucous mem- brane. Softening of the mucous membrane, he views as pseudo-mor- bid as also extensive blackish-brown staining, which resulted, in one case from the action of the gastric acid on the blood of a violently irritated surface. Attention is drawn to the importance of a careful inspection of the stomachic and intestinal contents, which, in many cases the author has found to hold important and unexpected relations to the other evidence; and, in one case, afforded means of identifying the body, which could not otherwise have been effected. (13. 46.) In regard to inspections after variable periods of inhumation, he thinks that care should be taken in coming to conclusions, since chemical changes take place which may completely deceive the eye. He has observed the deposition of crystalline, gritty, and whitish grains on and in the mucous surface, which he has found to consist of ammonio-phosphate of Magnesia; and also a white granular substance on the peritoneal coat of the concave surface of the liver supposed by the inspector to have been Arsenic, deposited by transudation, which proved to be sulphate of lime. (13.46.) Case 1 —In a case of poisoning, where there was much vomiting and diarrhoea, the heart was relaxed, soft and easily torn; m the right cavities, fluid, livid blood, without fibrinous clots; in the lelt cavities, the same kind of blood, with small clots; in the inferior vena cava blood of the color of wine-sediment; mucous membrane of the stomach not softened, but covered with much ye low mucus; injected, red, brown, or livid appearance of portions of the stomach and bowels; much nlargement of Brunner's glands, especially in ^*e duodenum and about the ileo-colic valve ; congestion of bladder, enlargement of liver, and coniestion of the nerv. sympath. magn. Case 2 -In two cases, besides the ordinary symptoms, there were numerous"aphth« in the mouth; much paralysis of sensation of the hands and feet and a paroxysm of fever every evening. Besides in- fl mmaUon othe stomach and bowels, there was considerable enlarge- 660 Arsenicum-Album. ment of Peyer's glands, in the lower part of the jejunum, with tendency to ulceration, and a pretty large number of miliary vesicles in the colon. 1st. Dr. Quaglio made four autopsies of cats, poisoned with the arsenite of Potash. In the first, most of the internal organs were sound, with three exceptions. The heart was indurated, hypertro- phied, red, and contained a fibrinous clot, though the blood was cherry- red and liquid. The stomach was distended by gas, and immediately in front of the pylorus there was a perfectly circumscribed spot, the size of a penny—brownish red, evidently the commencement of a per- forating ulcer ; and all around evidences of chronic catarrh of the stomach. The peritoneal coat of the large intestine was here and there injected, and the ileum was much contracted, throughout its length. (73.46.) In the bladder was a little greenish-yellow urine, containing a large amount of albumen, fat-globules, and debris of the epithelium of the urinary tubes. Reaction neutral, Urea, Uric-acid, and chloride of Soda notably less. The kidneys, at least double their volume, were greatly congested—above all in the cortical portion, which was brown-red, hard, and augmented in diameter. The surface of the section exuded a red and viscid liquid. The Malpighian bodies were streaked with red, and congested ; the glandules were full of blood; the tubes of Bellini filled with fibrinous clots, flecked with sanguineous globules. (Commencement of the second stage of Bright's disease?) (73. 46.) 2d. Left lung healthy; right lung much hepatized throughout its extent, and from its section there flowed a frothy, sanguinolent serum, (serous pneumonia). The quantity of serum in the pericardium was double its normal amount, the left ventricle enlarged and hypertrophic, and the muscular substance pale. The stomach was tumefied, in stripes resembling tape-worms. The liver was discolored, its border fringed, and filled with liquid, dark-colored blood; it was unequally congested, as if from commencing putrefaction, and the gall-bladder filled with fluid, black-green bile. The coils of intestine wero ad- herent to the abdominal parietes by exudations of coagulable lymph; the coecum, covered by still stronger exudations, formed one mass with the ileum and neighboring mesenteric glands. The mucous membrane of |the ileum presented, near the appendix vermiformis, a gangrenous patch. The urine contained cylinders of fibrine, fat-glo- bules, and diminished albumen and urates. The kidneys, though much tumefied and enlarged, are less congested than in the previous case. The capsule was slightly adherent, and the cortical substance yellow and friable; fibrinous exudations poured out with fat-globules from the openings of the canaliculi. The epithelium of these was, in part, altered and filled with fat. (73. 46.) 3d. In this case, for a week past, the cats' eyes had been closed, and, on opening them, there poured out a quantity of thick, yellow pus. The conjunctiva, however, was only injected and softened; neither pustules nor ulcers upon the cornea, nor conjunctiva, but the crystalline Arsenic. 661 lenses were both hardened and opaque {troubles). Heart altered, the left ventricle presenting commencing hypertrophy. Stomach natural. Kidneys enlarged, slightly hardened, but with a surface still smooth and glossy; the pyramids of Malpighi containing many tubes filled with fibrin. (73. 46.) 4th. The exterior of the nose was covered with a viscid, tenacious matter, fetid, as in ozena; the cartilages of the alae of the nose were ulcerated and perforated. The mucous membrane of the left nostril was, in particular, converted into an ichorous mass. There was no pus upon the cornea of the right eye, but the lens was obscured. The mucous membrane of the larynx was red, and injected upon the right side. In the upper and lower lobes of the left lung were two spots of hepatization, giving exit to a sanguinolent liquid on section. The heart was indurated, and the left ventricle hypertrophied and globulous, from the encroachments of the interventricular parietes upon the right ventricle. The stomach, distended with gas, was covered, in the neighborhood of the pylorus, with a tenacious layer of a shining black substance, resembling India ink. The duodenum, and all the rest of the alimentary canal was contracted and empty. The small intestines were injected upon the exterior, and contained several lumbrici, and the folds of the mucous membrane of the colon were tumefied. In the ccecum was a deposit of ochre-colored pigment, and similar to the fibrinous appearance of an old apoplectic deposit. In the bladder was a little, clear, yellow urine, containing fat-globules, crystals of uric-acid and oxalates, and the debris of epithelium of Bel- lini's tubules. In the kidneys, of which the capsule was easily de- tached, showing the same fatty degeneration of the epithelium, and other tubes deprived of their epithelium, the greater part of the ca- naliculi were enlarged, in such a manner as to form granulations upon the surface of the kidneys. (73. 46.) The doses, in the cases of these four preceding animals, was one- eighth of a grain of arsenite of Potash daily, for twenty days, then increased to one-fourth of a grain, for eighteen days more. On the 8th of December, these four cats had succumbed. During the ad- ministration of the poison, save the greatest indifference to its ad- ministration, great thirst, great tendency to lick the lips and the orifice of the urethra, and, before their death great immobility and fixity of look, but little remarkable was observed. (73. 46.) The morbid appearances produced by Arsenic differ very much, according to the length of time before death supervenes. In the first place, there are some cases in which little or no morbid appearance is to be seen at all. These all belong to the second variety of poison- ing, which is characterized by the absence of all local inflammation, and the presence of symptoms indicating an action on the heart, or some other remote organ. In such circumstances, death takes place before sufficient time has elapsed for the development of local inflam- mation. (9. 46.) This, however, is not invariable, as many cases are on record in 662 Arsenicum-Album. which, though death took place within two, three and a half, five, six, eight, or nine hours, strongly marked symptoms of gastritis were present. In the ordinary cases, in which death is delayed until the second day, or later, a considerable variety of diseased appearances have been observed. They are the different changes of structure, arising from inflammation in the alimentary canal, in the organs of the chest, and in the organs of generation, together with certain alterations in the state of the blood, and of the system generally. (9. 46.) The first set of appearances to be mentioned are those indicating inflammation of the alimentary canal, viz., redness of the throat and gullet, redness of the villous and peritoneal coats of the stomach; black- ness of its villous coat, from the extravasation of blood into it; soften- ing of the villous coat; ulceration of that as well as of the other coats; effusion of coagulable lymph on the inner surface of the stomach; ex- travasation of blood among its contents; finally, redness and ulcera- tion of the duodenum and other parts of the intestinal canal, and more particularly of the rectum. (9. 46.) Redness of throat and gullet does not appear to be common, at least it is not often reported ; but there appears to be reason to suppose that if it were more frequently looked for it would be found. (9. 46.) Redness of the inner coat of the stomach is a pretty constant effect of Arsenic, when the case is not very rapid ; all the varieties of red- ness, produced by irritant poisons, may be produced by Arsenic. There is nothing, however, in the redness caused by this poison, by whichit is to be distinguished from the pseudo-morbid varieties. (9.46.) It is singular, that however severe may be the inflammation of the inner membrane of the stomach, inflammatory redness of the peritoneal coat of the stomach is rarely found. Yet inflammatory vascularity does sometimes occur there. A common appearance, when the inter- nal inflammation is well marked, and one often unwarily put down as inflammation of the peritoneum, is turgesence of the external veins— sometimes so great as to make the stomach look livid. (9. 46.) Blackness of the villous coat, from effusion of altered blood into its texture, is sometimes met with. When its color is brownish-black, or greyish-black, and not merely reddish-black, where the inner mem- brane is elevated into firm knots or ridges, by the effusion, and the black spots are surrounded by vascularity or other signs of reaction, the appearances strongly indicate violent irritation. I have already said that such appearances are never imitated by a pseudo-morbid phenomenon. (9. 46.) One of the most remarkable appearances occasionally observed, where the body has been buried at least some weeks before examina- tion, is the presence of bright-yellow patches, of various sizes, which appear as if painted with gamboge, and obviously arise from the oxide of Arsenic diffused throughout the tissues, having been decomposed and converted into sulphuret of Arsenic, by the sulphuretted hydrogen disengaged during the process of putrefaction. Christison has wit- nessed this appearance in several cases. It is an extremely important Arsenic. 663 part of the pathological evidence. I doubt whether natural causes can occasion any appearances similar to it. It is the effect of a chemical test, applied to the poison by nature. (9. 46.) The next appearance is unnatural softness of the villous coat of the stomach. It has certainly been found, after death from Arsenic, un- usually soft, brittle, and easily separable with the nail. But the same state occurs so often in dead bodies, unconnected with the occurrence of irritation in the stomach, that it cannot, with any certainty, be as- sumed as the effect of irritation, when it is found subsequent to such a symptom. So far from softening and brittleness being a necessary effect of the irritation produced by Arsenic, it is a fact that a condition precisely the reverse has also been noticed. In a case in which Christison examined the villous coat—except where it had been disin- tegrated by ulceration and effused blood—it was strong and firm, and the rugae were thickened, raised and corrugated, as if seared with a hot iron. Metzger once found the mucous membrane thickened, dense, and the rugae like thick cords. (9. 46.) Sometimes the villous, and, more rarely, the outer coats of the sto- mach are found actually destroyed, and removed in scattered spots and patches. The loss of substance is occasionally owing to the same action which causes brittleness and softening of the villous coat; the action having been, however, so intense as to cause gelatinization. That such is the nature of the process, appears from the breach in the membrane being surrounded by gelatinized tissue, and not by an areola of inflammatory redness. But, in ordinary cases, the loss of substance is owing to a process of ordinary ulceration, as is proved by the little cavities having a notched, irregular shape, and being sur- rounded by a red areola, and a margin of firm tissue. Destruction of the coats of the stomach by ulceration is not a very common conse- quence of poisoning with Arsenic, as death frequently takes place before that process can be established. It does not often occur, un- less the patient survive two days. Cases have been known in less time however. In many works on medical jurisprudence, it is stated that it may cause complete perforation; but this is exceedingly rare, though it has been known. (9. 46.) Another species of destruction of the coats of the stomach is gan- grene or sloughing. This appearance occurs frequently in the narratives of the older writers, but its existence as one of the effects of Arsenic is problematical. Christison says it has not been witnessed, so far as he knows, by any recent good authority. Those who have mentioned it, have probably been misled by the appearance put on by the black, extravasated patches, when they are accompanied by disintegration of the villous coat, and effusion of clots of black blood on its surface— an appearance which resembles gangrene closely, in everything but fetor. (9. 46.) Destruction of the coats of the stomach, as produced by Arsenic, has been variously described by authors, under the terms erosion, cor- rosion, dissolution, and ulceration. But the.correct mode of describing Arsenicum-Album. it appears to me to be by the terms gelatinization, or ulceration, ac- cording to the nature of the diseased action by which it is induced. At all events it is necessary to beware of being misled by the terms erosion, corrosion and the like, which all convey the idea of chemical action, whilst it is well ascertained that a chemical action either does not exist between Arsenic and the animal tissues; or, if it has exis- tence, it tends to harden and condense, rather than to dissolve or cor- rode them. Arsenic is not a corrosive. (9. 46.) Various secretions have been found on the inner surface of the sto- mach. The mucous secretion of the inner membrane is generally increased in quantity. Frequently, it is thin, but viscid, as in its natural state, but sometimes it is both abundant and solid, as if coagu- lated ; and then it forms either a uniform attached pellicle, or loose shreds floating among the contents. In both forms it has been mis- taken for the mucous membrane itself. I believe this increased secre- tion and preternatural firmness of the gastric mucus cannot take place without some irritating agent being applied to the stomach. Both may occur without any other sign of inflammation of the mucous mem- brane. Mucus, abundant in the stomach, has been known to put on the appearance of curdled milk, owing to the presence of the very large quantity of finely-powdered Arsenic. Sometimes the matter effused is true coagulable lymph; this, of course, is quite decisive of the presence of inflammation. (9. 46.) Another very common appearance is the presence of a sanguinolent fluid, or even actual blood in the cavity of the stomach. The fluids which are generally the subject of analysis, are thick, dirty, brownish- red, evidently containing a large proportion of blood ; actual clots have been found, and, it is said, even half a pound of coagulated blood, in one case ; and, in another case, three pounds of black ichor, mixed with clots of blood. A good deal of reliance has been placed on the presence of bloody effusion, in proof of the administration of Arsenic or of some other irritant. It is of some importance, as it appears not to be an effect of that irritation which accompanies cholera. (9. 46.) Redness of the mucous membrane of the intestines is often present, when the stomach is much inflamed. Dissolution of the mucous coat is much less frequent than in the stomach. Ulceration occasionally occurs in lingering cases. The signs of inflammation are seldom distinct lower down in the small intestines than the extremity of the duodenum. But the rectum is sometimes much inflamed, though the colon, and, more particularly, the small intestines, are not. Dr. Male found the rectum abraded, ulcerated and even redder than the stomach itself, and Dr. Baillie also notices two cases in which the lower end of the rectum was ulcerated. A common appearance in lingering cases is excoriation of the anus and even gangrene. (9.46.) Contraction of the colon is also mentioned. In the cavity of the chest will be met with, redness of the pleura, redness and congestion of the lungs, redness of the inner surface of the heart, and redness of the lining membrane of the windpipe. (9.46. Arsenic. 665 Redness of the diaphragmatic part of the pleura, or even of the whole of that membrane, has been at times observed—as one would, indeed, expect, from the pectoral symptoms which at times prevail, during life. Inflammation of the lungs themselves has also been noticed. Dr. Campbell found great congestion of blood, in the lungs of animals poisoned by the application of Arsenic outwardly. Sproegel likewise found the pleura, pericardium, and whole lungs inflamed, in animals. A distinct example of advanced pneumonia is related in Pyl's Magazine: The lungs were found in the highest state of in- flammation, and so congested as to resemble a lump of clotted blood. Another case is related in Hencke's Journal: This patient had obvi- ous pneumonic symptoms during life, and, after death, the lungs were so gorged that, on cutting into them, nothing but clotted blood could be seen in their cellular structure. In a case where it was applied outwardly, for scirrhus, both lungs were found completely gorged with blood, and presenting all the characters of pulmonary apoplexy. (9. 46.) It is alleged that the inner surface of the heart has been found red from inflammation. In a case examined officially, by Orfila, the left cavities were of a mottled red appearance, and in the left ventricle were seen many small crimson specks, which penetrated into the mus- cular part of the parietes. The right cavities had a deep reddish- black tint, and the ventricle of that side contained specks like the other, but more faint. These observations are not satisfactory; there is no evidence that the observer drew the distinction between inflam- mation and the dyeing of the membrane with blood after death. (9.46.) The inner membrane of the windpipe is said to be sometimes af- fected with inflammatory redness. Jaeger found it so in animals, and the symptoms referable to the windpipe during life would lead us to expect the same thing in man. The organs of generation are occasionally affected. The penis, in the male, and the labia, in the female, have been found distended and black. In an interesting' paper by Bachmann, the external (female) parts of generation were surrounded by gangrene ; and in a case re- lated in " Pyl's Collection," the inside of the uterus and fallopian tubes was inflamed. It is probable that signs of inflammation in the internal organs of generation will be found, if there have been corres- ponding symptoms during life. (9. 46.) To complete this account of the morbid appearances of the mucous membranes, it may be that the conjunctiva of the eyes frequently pre- sents vascularity and spots of extravasation. (9. 46.) With regard to the state of the blood, Sir B. Brodie states that in animals it is commonly liquid. Harles, on the authority of Wepfer, Sproegel, and Jaeger, states that it is black, semi-gelatinous, and sometimes pultaceous. Novati alleges that the blood, after -death, is, without exception, black and liquid, as after cholera ; of a blackish- purple tint, that colors linen reddish brown ; viscid, opaque, and with- out any trace of coagulation. In a fatal case, related by Wildberg, 666 Arsenicum-Album. the blood was everywhere fluid. This condition is not uniform, for Dr. Campbell found it coagulated in the heart of a rabbit, and Wepfer in a dog. (9. 46.) general remarks. It is now generally admitted that Arsenic produces, in the living body, two classes of phenomena, or that, like the narcotico-acrids, it has a two-fold action. One action is purely irritant, by virtue of which it induces inflammation in the alimentary canal and elsewhere. The other, although it seldom occasions symptoms of narcotism, properly so-called, yet obviously consists in a disorder of parts or organs re- mote from the seat of its application. (9. 46.) It is also the general opinion of toxicologists that Arsenic occasions death more frequently through means, of its remote effects than in con- sequence of the local inflammation it excites. In some cases, indeed, no symptoms of inflammation occur at all; and in many, although in- flammation is obviously produced, death takes place long before it has had time to cause material organic injury. Nevertheless, in some, though certainly in comparatively few instances, the local action, it must be admitted, predominates so much that the morbid changes of the parts primarily acted on are alone adequate to account for death. (9- 46-> ' ..... Its chief action being on organs remote from the part to which it is supplied, a natural object of inquiry is, whether this action results from the poison entering the blood, and so passing to the remote or- gans acted on, or simply arises from the organ remotely affected, sympathizing, through the medium of the nerves, with the impression made on the organ which is affected primarily. On this question precise experiments are still wanted. The general opinion has for some time been that it acts through the blood; and this view has of late been strengthened by indisputable evidence, that the poison does enter the blood, and is diffused by it throughout the body. For a long period, chemists sought in vain for Arsenic in tissues and se- cretions remote from the alimentary canal; but this most important discovery, pregnant alike with interesting physiological deductions and valuable medico-legal applications, was announced by Orfila to the Paris Academy of Medicine, in January, 1839, when he stated that Arsenic is absorbed in such quantities, in cases of poisoning, as to admit of being discovered, by an improved process of analysis, in various parts of the system, such as the liver, spleen, kidneys, muscles, blood, and urine. The situations where Arsenic is met with in largest quantity are the liver, the spleen, and the urine, but above all in the liver. The precise circumstances in which it may be found, in one or another of these quarters, has not yet been determined. But, in most cases of acute arsenical poisoning, where the search has been made at all, it has proved successful in the liver. In two late instances, Pereira has succeeded in finding Arsenic in the liver, after four months inter- ment, by Reinsch's or Marsh's test. Since Arsenic, then, is clearly Arsenic. 667 absorbed into the blood, it becomes an interesting question whether the organization of the blood is thereby changed. This question can- not be answered with confidence. But, in all probability, the blood undergoes some change in its crasis; for, in most cases of acute poi- soning, that fluid is found, after death, in a remarkable state of fluidity. And Mr. James observed, that if venous or arterial blood be received into a solution of Arsenic, instead of coagulating in the usual way, a viscous jelly first forms, and lumpy clots separate afterwards. (9. 46.) On page 598 of the Materia Medica, I stated that Arsenic had oc- casionally been detected in human bones, in the form of Arseniate of Lime. And, notwithstanding the pretended trials of Lehmann and others, it has again been detected by Professor Doremus in the bones of Mrs. Simpson, who was supposed to have been poisoned by her husband. See Prof. Doremus' elaborate report. (10.) Our knowledge of the affections produced by the remote action of Arsenic is in some respects vague. Toxicologists have, for the most part, been satisfied with calling it a disorder of the general nervous system. When employed to designate the state of collapse, which accompanies or forms the chief feature of acute cases of arsenical poisoning, this term is misapplied. The whole train of symptoms is not that of a general nervous disorder, but simply of depressed action of the heart. That this is the chief organ remotely acted on, in such cases, appears probable from certain physiological experiments, in which it has been remarked that immediately after rapid death from Arsenic, the irritability of the heart was exhausted, or nearly so, while that of the intestines, gullet, and voluntary muscles continued as usual. (9. 46.) Arsenic belongs to those poisons which act with nearly or quite the same energy, whatever be the organ or texture to which they are supplied. Experiments leave no doubt that when applied to a fresh wound it acts with at least equal rapidity as when swallowed. Al- though, in such circumstances, the signs of irritation are often distinct, yet the symptoms, on the other hand, are sometimes more purely nar- cotic than by any other mode of administering it; Sir B. Brodie, in particular, having observed loss of sense and motion to be induced, along with occasional convulsions. Arsenic likewise acts with energy when applied to the conjunctiva of the eye, as was proved by Dr. Campbell. It acts, too, with great energy when inhaled into the lungs, or in the form of arseniuretted hydrogen. It further acts with violence through the mucous membrane of the vagina, producing local inflam- mation, and the usual constitutional collapse ; also when injected into the rectum and when applied to ulcers. Its power of acting through the sound skin is limited ; if applied for a sufficiently long period for absorption to take place, poisoning ensues. It is most active when injected into a vein, or applied to a fresh wound, or introduced into the cavity of the peritoneum; it is quite inert when applied directly to the nerves. (9. 46.) It is a striking fact that, no matter what the tissue be to which the poison be applied, if death is delayed, it almost always produces in- 668 Arsenicum-Album. flammation of the stomach; and, on inspection of it after death, traces of inflammation are found. In some instances of death by its out- ward application, the inflammation has been greater than where it has been swallowed. Sproegel says, in a dog killed by its application to wounds, the whole stomach and intestines, outwardly and inwardly, were of a deep red color, blood was extravasated between the mem- branes, and clots found in the stomach. (9. 46.) Of the different preparations of Arsenic, those which are the most soluble are the most active. The metal itself is inert, in accordance with what appears to be a general law in toxicology. This state- ment, however, must be qualified in so far as this, that if the metal be given in a coarsely-powdered or pulverized state, a sufficient amount almost always becomes oxidized to give rise to symptoms of poison- ing. The most active preparations are probably the arseniuretted hydrogen, the black oxide, or fly-powder, and the white oxide. (9.46.) The white oxide, however, is the most important, as with this we have most often to deal, and it is the power of this which it is desir- able to fix with some degree of precision. (9. 46.) It has been stated, by various systematic authors, that the white oxide will prove fatal to man in the dose of two grains. Hahnemann, according to Christison, says, in more special terms, that in circum- stances favorable to its action, four grains may cause death in twenty- four hours, and one or two grains in a few days. But neither he nor any of the other authors alluded to have mentioned actual cases. Fodere knew half a grain to cause colic and dysenteric flux, which continued obstinately for eight days; and Christison has related an instance where six persons, after taking each a grain in wine, during dinner, were seriously and violently affected for twelve hours. Mr. Alfred Taylor mentions three similar cases, occasioned by taking Ar- senic in port wine—one, an infant about sixteen months old, who got about one-third of a grain, a lady, who took a grain and a-half, and a gentleman, who got two grains and a-half—in all of which, violent vomiting and prostration, without pain, occurred for three or four hours, and the gentleman of the party did not recover for several days. M. Lachese mentions his having met with a number of cases of poison- ing from small doses in bread or soup, whence he concludes that even one-eighth of a grain, taken in food, may cause vomiting; that a quarter, or twice as much, taken once only, causes vomiting, colic and prostra- tion; that the same quantity, repeated the next day, renews these symptoms in such force as to render the individual unfit for work for several days, and that four such doses, taken at intervals during two days, that is between one and one-half and two grains in all, excite acute gastro-enteritis, and may prove fatal, since two individuals who had taken this much died—one in seven weeks, and the other three weeks later. The smallest fatal dose I (Christison) have found recorded elsewhere, is four grains and a half, and death ensued in six hours only; but the subject was a child four years old, and the poison was taken in solution. Alberti mentions the case of a man who died from Arsenic. 669 taking six grains. Two children died, the one in two days, the other a day later, after taking rather less than sixteen grains; their ages were four and a half and seven. Valentine alludes to a case where thirty grains of the oxide, in powder, killed an adult in six days. The effects of even small medicinal doses, and the fatal effects of comparatively small doses on animals (Renault having found that a single grain in solution killed a large dog in four hours) must convince every one that the general statement of Hahnemann cannot be very wide of the truth. (9. 46.) The activity of oxide of Arsenic is impaired by admixture with other insoluble powders. Bertrand, under the impression that charcoal was a complete antidote, took five grains of Arsenic mixed with that sub- stance, with impunity; but Orfila afterwards showed that other insoluble powders had the same effect, as clay, &c, and act simply by envelop- ing the poison, and therefore must be introduced along with it. A singular recovery from a dose of sixty grains, mixed with powdered Cinchona-bark, probably arose from this circumstance. In this case, however, the symptoms were severe for three days. (9. 46.) Dr. Geoghegan regards the influence of Arsenic on the process of decomposition, to be rather of a catalytic or disposing nature than due to chemical action. In the course of his researches, he has found an organ comparatively well preserved, from the tissue of which the poison has been completely discharged, while in another organ of the same individual, in a less complete state of preservation, it was readily detected; it thus looking as if the retention of the Arsenic in the tissue favored its more rapid decomposition. As to its entering into complete chemical union, as a general thing, he doubts; but he is con- vinced that it does so combine with the structure of the liver. But he assigns various reasons which lead him to reject the hypothesis of Lie- big, that it is by this chemical reunion that Arsenic is enabled to act as a poison ; on the contrary, he thinks that it would favor its allocation in situations where it is least productive of disturbance to the system at large, and most favorable to its elimination from the blood. (13. 46.) He has witnessed, on the one hand, preservation of the stomach and intestines, the body decaying as usual, and, in others precisely the opposite conditions. In the latter case, he has found that the ra- pidity of decomposition is not equal throughout the alimentary tract. He describes a peculiar form of decay of the alimentary canal, which he calls rancid putrefaction. It is characterized by a peculiar odor, like that of fatty matter altered by exposure to the air, and by a persis- tent and strongly-marked acid reaction, which, in one instance, con- tinued undiminished after the lapse of four years. (13. 46.) In some instances, during the slow decay of the partially dried or- gans of persons poisoned by Arsenic, the alliacious odor was distinctly perceptible. It was singular that such organs, kept in closed vessels, were greedily attacked by small insects, which maintained a vigorous existence, although, moreover, immersed in an atmosphere impregnated with arseniuretted hydrogen, perhaps with the exception of the cyanide of cacodyl, the deadliest of the arsenical compounds. (13. 46.) 670 Arsenicum* Album. The most common effects from long-continued smaller doses, like one-sixteenth to one-sixth of a grain, are, a gradual sinking of the vital powers, general feeling of malaise, disordered stomach, loss of appetite, tongue dry and furred, thirst or adypsia, nausea, vomiting, purging, pain in the stomach and bowels, heat, flatulence and disten- tion of the stomach and bowels, constriction of the mouth and throat, with dryness or with salivation; tenderness of the mouth; pulse fre- quent, feeble, and sometimes irregular; breathing short and oppressed; faintness, debility, headache, vertigo, sleeplessness, inflammation of the conjunctiva, swelling and stiffness of the palpebrae and face, heat, swelling and itching of the tarsi, numbness, irritation of the skin, dropsical swellings of the face and limbs, general wasting of flesh. (10.) When taken in doses of from a twentieth to a sixteenth of a grain, it is said to increase the appetite, and to act as an alterative and a general tonic. If swallowed, or applied to a denuded surface, it is absorbed into the system, and may be detected in the blood, the bones, the urine, the liver, kidneys, spleen, stomach, and the muscles. Waring quotes the following synopsis of twenty-five cases, from Dr. Guy's " Principles of Forensic Med.," p. 466: "Vomiting in twenty-three; in one not until artificially induced; in one or two it has been absent. The vomited matters consisted, in three cases, of blood; in one, of mucus only; in one, of water containing Arsenic; in one, of bile; and in one, of bile and faeces. Diarrhoea was present in eleven, excessive in seven, absent in four. The matters passed by stool consisted, in three cases, of blood; and in two, of matter resem- bling green paint. Pain present in nineteen, absent in one; in two, it subsided after a short time. The tongue and throat constricted, hot, painful and tense in nine cases. Thirst—of seventeen cases, it was present in fifteen, absent in two; and in thirteen it is described as intense. Countenance flushed and swollen in seven cases, and pale and anxious in five. Eyes inflamed, swollen, or smarting, in seven cases. Skin hot and dry in six cases; covered with cold perspiration in four; profuse perspiration, with petechiae, in three; universal des- quamation in one; eczematous eruption in one. Headache in nine cases, absent in one; described as intense in four. Pulse generally very frequent, but variable, ranging from 90 to 140, or more; in one from 30 to 49. Violent palpitations in two. Extreme restlessness in five. Extreme debility in ten. Coma in three, and delirium in three. Mind unimpaired in six. Cramps of the legs in nine cases; in four, extending to the arms. Convulsions in six. Paralysis of the tongue and gullet in three. Tetanus in two. Chorea in one. Hysteria in one. Epilepsy in two. Death took place in three cases, in the midst of convulsions; and, in one, after a horrid fit of convulsive laughter, followed by a rigid spasm of the whole body." Some cases, like number five, for example, afford us examples of its action upon the brain and nervous system. Although vomiting, purg- ing, intense thirst, and arterial excitement were present in each of these cases, yet there was an almost entire absence of pain, abdomi- Arsenic. 671 nal tenderness on pressure, and other indications of local inflamma- tion, and most of the symptoms were referable to the brain and nervous system, especially those which occurred near the close of life. (10.) Hahnemann, in his first essay on the homoeopathic principle, asserts, "that it has a great tendency to excite that spasm in the blood-vessels, and the shock in the nervous system, called febrile rigor. If it be given in a pretty large dose (one-sixth or one-fifth of a grain) to an adult, this rigor becomes very evident. This tendency makes it a powerful remedy as a similarly acting medicine in intermittent fever; and this all the more, as it possesses the power, observed by me, of exciting a daily-recurring, although always weaker paroxysm, even although its use be discontinued. In typical diseases of all kinds, (in periodical headache, &c.,) this type-exciting property of Arsenic in small doses (one-tenth to, at most, one-sixth of a grain in solution) becomes valuable, and will, I venture to guess, become invaluable to our perhaps bolder, more observant, and more cautious posterity. ":* * • * The continued use of Arsenic, in large doses, causes gradually an almost constant febrile state; it will thus, as indeed experience has to a certain extent taught us, prove useful in hectic and remittent fevers, as a similarly acting remedy, in small doses, (about one-twelfth of a grain)." "It possesses a great disposition to diminish the vital heat and the tone of the muscular fibre. Hence paralysis, from a strong dose, or a long-continued and incautious employment of it." "It diminishes the tone of the muscular fibre, by diminishing the tone and cohesion of the coagulable lymph of the blood, as I have convinced myself by drawing blood from persons suffering from the effects of Arsenic, more especially such as had a too inspissated blood before the use of this metallic acid." " It also diminishes the sensibility of the nerves. Thus, it gene- rally seems to kill more by extinguishing the vital power and sensi- bility, than by its corrosive and inflammatory power, which is only local and circumscribed." "It weakens the absorbent system." "I would direct particular attention to its peculiar power of in- creasing the irritability of the fibre, especially of the system of the vital functions. Hence cough, and hence the above-mentioned febrile actions." 44 When used for a length of time, and in pretty large doses, it sel- dom fails to cause some chronic cutaneous disease, (at least, desqua- mation of the skin)." " It produces acute, continued pains in the joints, as I have seen." The following remarks were compiled many years ago, from autho- rities now not recollected; (11.) The earliest poisonous (!) effects are, diminished (?) action of heart and intense inflammation of stomach. Given medicinally! the first and earliest sign of its action, is an increased strength and frequency of the pulse; next follows the well-known fullness of the palpebrae, and 672 Arsenicum-Album. itching of the alae nasi. If its use be continued, the irritation of the mucous membranes extends to the fauces, inducing redness and cough. and along with these symptoms the tongue begins to be covered with a white fur, which, gradually increasing in thickness, gives its surface the appearance of having been rubbed over with chalk; the action of the heart continues to increase in force and frequency—the pulse be- comes full and hard, and, at last, a general anasarcous state is set up. Again, the symptoms induced by an overdose are of an inflammatory or pyretic character. Bouillaud says it acts poisonously on the sys- tem in two different ways : 1st. By exerting a specific influence on the blood, thus giving rise to adynamia. 2d. By exciting an inflamed or sthenic condition in the parts to which it is applied. Emery says, whenever unpleasant symptoms arise from doses of one-fourth of a grain, they are always of a more or less inflammatory character; such as a quickened and strong pulse, sharp pains in the region of the heart, and general feverish heat. Along with these symptoms, he has occasionally observed a partial paralysis of the ex- tensor muscles of the hand. The prostration of the nervous and cir- culating systems are often fatally great, coupled with severe structural disorganization of the stomach and bowels. (11.) Brodie, in his experiments, always found the action of the heart excessively feeble, although the muscular parts, including the intes- tines, nearly retained their usual irritability; hence it would seem to exert a specific paralyzing power upon the heart. It seems also to have almost a specific tendency to irritate and inflame the gastric sur- faces, as appears from the fact, in several cases of fatal poisoning from its external application, that the mucous membrane of the stomach and bowels has, on dissection, been found highly inflamed. (11.) Jaeger compares the action of Arsenic to that of the poison of snakes, which acts primarily upon the blood. Sproegel sprinkled it upon a wound in a dog's back, and he found that the stomach and bowels be- came inflamed. Coagulated blood was effused into the cavities of the stomach and bowels. The pleura, pericardium, and lungs were also very much inflamed. (46.) Lachaise of Angers, says that one-eighth'of a grain has no other effect than that of inducing speedy vomiting. One-fourth to one-half of a grain produces more decided symptoms—stomach seriously affected, also the bowels. Hence there was pain in the abdomen, nausea, vomiting, with acrid sensation in the throat. Repetition of the dose, same symptoms, with vertigo and great prostration of strength. (46.) A. S. Taylor gave one-third of a grain to a child of sixteen months. In about twenty minutes, it became sick and vomited severely for three hours, and thus recovered. It did not complain of pain. (46.) A lady at fifty-two, took one-half of a grain. In thirty to forty mi- nutes, complained of general uneasiness. She had no pain, but vo- mited violently for four hours. She then recovered. Arsenic. 673 A gentleman, aged forty, took two and one-half grains. In twenty minutes, felt unwell, and vomited for three hours. He did not recover entirely for several days. In these four cases there was no pain, but violent vomiting and pros- tration of strength. A full stomach probably saved them all. (46.) CHARACTERISTIC PECULIARITIES. Arsenic exhausts the powers of life, either of single organs, or of the whole organism. It produces decomposition of the organic sub- stance, a cachectic condition, colliquation, which the following symp- toms clearly show : Yellow, pale, death-like color of the face, sunken eyes, haemorrhage, per rectum, &c.; foul, destructive, easily bleeding, cancerous ulcers; eruptions, like scorbutis ; black pustules; emacia- tion; dropsy; phthisis, &c. Among the pains produced by Arsenic, burning pain is the most characteristic and constant, although there are other remedies, such as Carbo-anim. and vegetabilis, Euphorbium, Mezereum, Pulsatilla, Secale-cornutum, &c, which produce this kind of pain, but none in such a marked degree as Arsenic. A very cha- racteristic effect of Arsenic is the periodicity of its physiological phe- nomena, although there are other remedial agents, such as China, Ipecac, Natrum-mur., Nux-vom , Pulsatilla, Rhus-tox., Veratrum, which possess this intermittent character. All morbid conditions produced by Arsenic are characterized by extreme restlessness, uneasi- ness, and almost causing frenzy in some instances. Arsenic-pain is relieved, although only temporarily, by the application of external heat. The Arsenic-pain appears mostly during rest, and is generally relieved on motion. Roaring in the ears, during a paroxysm of pain, as in China, is a characteristic symptom of Arsenic. Arsenic-nausea and vomiting is accompanied by extreme prostration and anguish, pe- riodical, and worse during rest. The cardiac symptoms point strongly to Arsenic, as a remedy or palliative in morbid conditions of the heart, also its specific action on the external skin is very strongly marked. (26.) GENERAL SPHERE OF ACTION. EMPIRICAL OPINIONS. Alterative, febrifuge, anti-periodic, tonic, anti-spasmodic. Arsenious-acid appears to exert a specific influence on several parts of the body, especially the alimentary canal, the heart, and the nervous system. That the alimentary canal is specifically affected, is shown by the inflammation of the stomach, produced by the application of Arsenic to wounds, and which, according to Sir B. Brodie, is more violent and more immediate than when this poison is taken into the stomach itself. That the heart is also specifically acted on by Arse- nious-acid, is proved by the symptoms, (the anxiety at the precordia, the quick, irregular pulse, &c.,) and by the post-mortem appearances, [red spots in the substance of this viscus,) and by the diminished sus- 43 674 Arsenicum-Album. ceptibility to the galvanic influence. The specific affection of the nervous system, is inferred from the symptoms; namely, the headache, giddiness, wandering pains, impaired sensibility of the extremities, delirium, coma, feebleness, lassitude, trembling of the limbs, and the paralysis, or tetanic symptoms. (54.) The alimentary canal, heart, and nervous system are not the only parts on which this acid appears to exert a specific influence; the lungs, the skin, the salivary glands, &c, are also specifically affected. The disorder of the lungs is inferred from the local pain, cough, and occasional inflammatory appearances after death. The eruptions and other altered appearances of the skin, and the falling off of the hair and nails, sometimes noticed, have led to the idea of the specific influence of Arsenious-acid on the cutaneous system ; an opinion which seems further supported by the fact of the remarkable influence it exercises in some cutaneous diseases, especially lepra. The salivation noticed by Marcus, Ferriar, McFarley, Cazenave, and others, shows lhat the salivary glands are specifically influenced. The swelling of the face, and the irritation and redness of the eye-lids also deserve notice, in connection with the specific effects of this poison. (3. 54.) PHYSIOLOGICAL EFFECTS. On Vegetables.—The effects of Arsenious-acid on plants, have been studied by Jaeger, Marcet, Macaire, and by others, and, from their observations, we learn that it is poisonous to all the higher, and most of the lower families of plants. It appears that seeds which have been soaked in a solution of Arsenious-acid are incapable of germi- nating, and that buds which have been plunged in it are no longer capable of expanding. If roots or stems be immersed in this solution, the plants perish—death being preceded by drooping of the leaves and petals, and the appearance of brownish patches on the leaves, the veins and midribs of which are discolored. If the stem of the common Barberry (Herberis-Vulgaris) be placed in a solution of Arsenious- acid, the plant dies; but the stamens, according to Macaire, become stiff, hard, and retracted, and, on any attempts being made to alter their position, they readily break. On repeating the experiment, however, I did not observe this condition of the stamens; I found them not at all brittle, but quite flexible, and difficult to break by the point of a knife. The leaves, when burnt, evolved a garlic odor. (3. 54.) Jaeger also found that Arsenic is absorbed by plants; for, on burning vegetables destroyed by this poison, he experienced an allia- ceous odor. On some cryptogamic plants, Arsenious-acid appears to have no injurious influence. Jaeger has seen a small plant (supposed by De Candolle to be Mucor-imperceptibilis) growing in water, which contained -fa of its weight of Arsenic. More recently, Gilgenbrants says he has seen an algaceous plant, of the genus either Leptomitus or Hygrocrocis, develop itself in a solution of Arsenic. Dr. Pereira confirms this statement, and states that, at the time of writing, he has before him an abundant vegetation (Hygrocrocis) in a solution of Ar- Arsenic. 675 senious-acid, the vegetable filaments being intermixed with octohedral crystals of Arsenic. (54.) On Animals generally.—Arsenious-acid is poisonous to all classes of animals. Dr. Pereira thinks there are no exceptions to this state- ment known. The most extensive series of experiments are those performed by Jaeger. From them we learn that in all animals, from the infusoria up to man, death from Arsenic is invariably preceded by inordinate actions, and increased evacuations, especially from the mucous membranes. In most animals, the stools were frequent and fluid, and in those in which mucus is secreted on the surface, it was remarkably increased. The power of voluntary motion and suscepti- bility of external stimuli were decreased, and, after death, the muscles soon ceased to be influenced by the galvanic agency. In animals which breathe by lungs, respiration became difficult and laborious; and in warm-blooded animals, great thirst was experienced. In birds and mammals, convulsions came on, preceded by vomiting, except in those animals (as rabbits) which cannot vomit. Enormous quantities of Arsenious-acid have been sometimes administered to horses with impunity. Berthe gave two, and afterwards three drachms to a mare, for the cure of an obstinate skin disease, without any injurious effects. Beissenhirts gave successively, on different days, one, four, three, two, and eight drachms of Arsenious-acid to a horse; the animal did not die until the ninth day after taking the last mentioned dose. Yet, notwithstanding these and some other analogous facts, which seem to prove that Arsenic has comparatively little, effect on horses, the best informed veterinarians agree in considering it an energetic poison to those animals. (3. 54.) In Mr. Hunt's inquiry into the properties of Arsenic, addressed to some two thousand practitioners, their conjoined testimony went to show that its action varies more than that of any other mineral; this has been noticed in poisonous as well as in medicinal doses. Second, that its powers are chiefly manifested in chronic, non-contagious skin- diseases; next to these come intermittent and neuralgic maladies. Third, that, in many cases, Quinine increases its efficacy. Fourth, that Arsenic should not be given when another medicine will answer the purpose, and that a passive slate of the system is preferable for its ad- ministration. (13. 46.) Girdlestone says Arsenic should never be given in doses of more than five or six drops, three times a day, to adults; two or three drops, one or two times a day, to children. (11.) Other authorities, viz., Bateman, Thompson, Rayer, Biett, never give more than fifteen or eighteen drops a day. (11.) When given in medicinal doses, one of the earliest constitutional symptoms is acceleration of the heart's action—sometimes it becomes quickened, in the course of a few days, by ten, twenty or even thirty beats more in a minute; pulse, at the same time, hard and wiry In some cases, before, but generally after the increase of pulse, signs of irritation of the stomach arise ; the tongue becomes coated, toward us centre and 676 Arsenicum-Album. root, with red sides and tip; loss of appetite, sense of weight in the epi- gastrium; at the same time, heaviness and pricking sensations about the eye-lids, with flashes of light before the eyes when they are closed; after a time, the eyelids will become puffed and droop, giving the countenance a peculiarly melancholic and care-worn appearance. More or less head- ache, chiefly over the eye-brows and lower part of the forehead; this pain in the head is frequently one of the first symptoms ; the patient commonly has confused and horrible dreams, especially the case with children .(11.) Girdlestone has remarked that, in some cases, a uniform lobster-red color of the skin came on, (hence homceoepathic to scarlet fever); that erysipelas sets in, or that phlyctenae and pustules appear when Arsenic disagrees. (11.) Erichsen has frequently observed the disease of the skin for which it was given, more particularly chronic eczema, evince a decided in- creased action—the patches becoming red and irritable; if its use then be continued, which it should never be, great irritation of the stomach and throat will ensue; there will be nausea, vomiting, total loss of ap- petite ; headache, which increases in severity; urine becomes high colored; the countenance, which has become pale and sallow, will assume a remarkably sorrowful and anxious cast; tremors of the limbs come on, with an occasional feeling of faintness. Sometimes the first symptom is a degree of thirst, feeling of oppression about the epigas- trium; in others, pricking sensations about eye-lids, and flashes of light; in others, and very commonly headache, with disturbed dreams. Quickness of the pulse is usually antecedent, or at least coincident to all those. (11.) In a nervous female, who took it in excess, it caused extensive de- rangementof the stomach, which was followed by a violent neuralgic at- tack ; at a subsequent period, a distressing train of hysterical symptoms set in, which terminated in dementia, which has lasted four years. (11.) Arsenic is badly borne by plethoric persons, or those of a highly san- guine, or sanguineo-nervous temperament. In persons of a ruddy complexion, blue eyes, light or fine hair, thin, delicate skins, excita- ble pulse and nerves, whose hearts beat and cheeks flush from slight emotions, it quickly irritates the digestive organs, and causes a sense of weight or tension in forehead. (11.) ON THE VASCULAR SYSTEM. Blood.—Hahnemann asserts that it diminishes the proportion and cohesion of the coagulable lymph in the blood, and thus diminishes the tone of the muscular fibre. He also supposes that it has a tendency to excite spasms of the blood-vessels. (10.) It is often found in the blood, and probably exercises a direct influ- ence in decomposing it, and holding it in a fluid state. The blood of persons who have been poisoned with Arsenic is said to re- semble that of patients who have died of yellow fever, cholera, and certain typhoid maladies. All the blood-vessels are found to contain blood, in a fluid, black, and sometimes papescent condition. Thecavi- Arsenic. 677 ties of the heart are also found to contain more or less thick, black, decomposed blood. (10.) Heart and Arteries.—Spasm of the blood-vessels, according to Hahne- mann, is an effect of Arsenic. This effect is produced by the direct actionofthe poison upon the arterial vessels, and the influence is de- pressing from the commencement, as is evident from the rapid, feeble, and irregular pulsations, the diminution of animal heat and vitality, and, finally, the complete paralysis of the vascular system. (10.) Morbid appearances of the vascular system. The blood is some- times, though not invariably fluid, after death, and dark colored. The heart is mostly flabby, and it is said that on its inner side, (especially the carneae columnae and valves, particularly of the left side,) is ob- served redness, sometimes diffused, sometimes in the form of spots, which penetrate a line in depth into the substance of the heart. The pericardium usually contains serum. (3. 54.) Clinical Remarks.—Hypertrophy.—Dr. Wurmb, of Vienna, an ex- cellent authority, says: "We think we do not err, if, relying upon our own experience at the sick-bed, we maintain that the respiratory symptoms of arsenical poisoning must be ascribed to the baneful effects of the poison on the heart. Symptoms indicative of an affection of the heart generally appear, in a very violent degree, at the commence- ment of poisoning with Arsenic, and are rarely absent, and its homceo- pathicity is as strongly marked as its clinical success would lead us to expect." Dr. Black says: " In organic affections of the heart, especially where there is dilatation or valvular disease, it is the best remedy; and it is worthy of note that, under its use, the various pains, the distressing palpitations, the dyspnoea, are relieved in a marked manner, and that while the organic disease may remain unchanged." Dr. Russell says : " As far as my experience goes, I fully concur in all that is said of the value of Arsenic in organic diseases of the heart; not only do the pains frequently subside by the use of this medicine, but the most formidable symptom we have to contend with, anasarca, is often arrested by a persevering administration of this remedy. (12. 46.) Pericarditis.—Arsenicum is a most important remedy in this affec- tion, and, as a rule, it may be selected in preference to all others, in that form of pericarditis attended with effusions of serum into the cavity, while Aconite is preferable for cases characterized by the pre- ponderance of fibrinous depositions. Venous System.—The general diffusion of blue or black spots over the bodies of individuals who have been poisoned with Arsenic, indi- cate its tendency to produce venous congestions. Such results would be naturally expected from a substance which weakens and paralyzes almost every tissue with which it comes in contact. As the tone of these vessels gradually becomes impaired, and the blood becomes de- composed, congestions, which sometimes extend to the capillaries, occur, paralysis supervenes, and the patient expires. The appearance of the bodies of those who have died from the poison is very similar to that of cholera and yellow fever cadavers. (10.) 678 Arsenicum-Album. ON THE TISSUES. Muscular Tissue.—We have already observed that Hahnemann sup- posed that it impaired the tone of the muscular fibre, by diminishing the proportion and cohesion of the coagulable lymph of the blood. The power of muscles is dependent, to a considerable extent, upon the integrity of the nerves which supply them; and, as Arsenic ope- rates as a depressor upon the entire cerebro-spinal system, it is evident that it acts specifically to diminish the vitality, tone, and strength of the muscular tissue. It is homoeopathic to general and rapid failure of strength, great sense of prostration, tremulous condition of the limbs, and inability to make even slight muscular efforts. (10.) Fibrous Tissues.—Its action upon the fibrous tissues is similar to that upon the muscular tissues—depressing and paralyzing. (10.) Serous Tissues.—It probably exercises a specific action upon all of the serous membranes. It gives rise to inflammation, redness, and effusions of lymph or serum in the pleura, the pericardium, the arach- noid, and the peritoneum. It operates upon these tissues, firstly, by direct contact, and secondly, by impairing the integrity of the nerves which supply them. Lassaigne found it in the infiltrated pleura of a horse. Its action upon the pericardium is indicated by palpitations, and rapid and irregular action of the heart, anxious and oppressed res- piration, sudden attacks of faintness, sharp pains in the cardiac region, great debility and sense of suffocation after ascending a stairs, walking rapidly, or lying down. Upon the pleura its influence is manifested by short, difficult, and painful respiration; short, dry cough; very rapid, but regular pulse; burning pains, and pleuritic stitches in the chest. Upon the arachnoid and the peritoneum it also exerts a specific action, although the manifestations are less apparent than upon the other membranes alluded to. (10.) MUCOUS Tissue.—Arsenious-acid exerts a marked influence over the mucous membranes of the organism. This influence is manifested promptly, as many physiologists have demonstrated, whether it be introduced into the stomach, the blood, or applied to a denuded sur- face. Among its first and most important effects is gastro-enteritis, manifested by nausea, vomiting, purging, distention, hardness, and pain of the abdomen on pressure; heat, dryness, and constriction of the throat; intense thirst; tenesmus; rapid, feeble, and irregular pulse ; cold, clammy sweats; and sympathetic irritation of the urino- genital apparatus. Many observers have noticed that it produces upon the gastro-intestinal mucous membrane a peculiar inflammatory action, which is accompanied with exudation, softening and ulceration of Peyer's plates. Hence its applicability in typhoid fevers and many affections of the mucous membrane of the stomach and intestines, especially when accompanied with inflammation, or ulceration, or softening. (10 ) Its action upon the mucous membrane of the respiratory apparatus Arsenic. 679 is much less constant and strongly marked than upon that of the gas- tro-intestinal canal. It produces effects which correspond closely with ordinary epidemic influenza, asthma, and certain anginose affec- tions of the throat and larynx. A very uniform effect of large and repeated doses, and we have sometimes observed it from attenuated doses, is redness of the conjunctiva, and puffiness and smarting of the eye-lids. (10.) The mucous membrane of the urethra occasionally gives evidence of inflammation, from repeated doses of the acid; but this effect is, in part, attributable to the contiguity of this part with the rectum, which is so actively impressed by the drug. The lining membrane of the uterus and vagina are likewise sometimes affected in a similar man- ner. (10.) Glandular System.—Pereira has observed salivation from the use of Idiopathic doses of Arsenic. But, more frequently, it affects the sali- vary glands in such a manner as to suspend their secretion. It has been detected in the liver, kidneys, and spleen, and produces physio- logical and pathological phenomena, in each of these organs, which will be recorded under the appropriate heads. (10.) EFFECTS ON THE CEREBRO-SPINAL SYSTEM. Brain.—Delirium, coma, epilepsy, impaired memory, headache and sleeplessness, are among the physiological effects of this substance. Post-mortem examinations, of persons who have died from poisonous doses, have detected congestions of the veins and sinuses of the brain, inflammation of the membranes, serous effusion into the ventricles, inflammation of the substance of the brain, extravasation of blood in the occiput. (10.) From the above physiological and pathological data, it is evident that it produces an impression upon the brain. Formerly we were of opinion that these cerebral symptoms and pathological appearances were produced by the violent vomitings of patients poisoned with the drug; but its marked specific action upon the spinal and ganglionic systems renders it almost conclusive that it has specific relations with. the brain. (10.) It acts primarily upon the encephalon, as an irritant, giving rise to sleeplessness, anxiety, general irritability, and mental and physical uneasiness, and succeeded by a semi-paralytic condition of the organ, just before death, indicated by obscuration of sight, stupefaction, and general paralysis of the mental powers. (10.) Nerves of Motion.—The specific action of Arsenicum upon, the ante- rior portion of the spinal column is strongly pronounced. Although it excites in the motor nerves a morbid irritability, which often persists until actual paralysis occurs, yet its actual effect is to iinpaijE the tone of this system of nerves. It is true that the Styrian peasant some- times takes it, even in large doses, as a stomachic and general tonic, with the impression that under its influence he can exert aa unusual, 680 Arsenicum Album. amount of muscular power, but the idea is fallacious. Whenever the Arsenic-eater takes his dose, the entire nervous system becomes mor- bidly sensitive, for the time being, and there will, apparently, be an exaltation of muscular force, but he, in reality, loses vitality and strength from the beginning. As the Opium-eater, or Haschish toper often mistakes the intoxicating effects of these substances for augmented mental power, so does the Styrian Arsenic-eater mistake a transient excitability of his nervous and muscular systems for an actual increase of strength. (10.) Its depressing influence upon the nerves of motion is manifest, from the following general pathogenetic phenomena: Trembling of the limbs; rapid sinking of muscular strength, when not under the influ- ence of the drug; stiffness and immobility of the limbs; heaviness, coldness, numbness, and dropsical swellings of the limbs. (10.) The observations of Dr. Tschudi, with regard to the endurance and wonderful performances of these poison-eaters, in ascending moun- tains, and in other feats of agility, are to be taken with many "grains of salt." While the men take it to acquire strength and bottom, the peasant girls employ it to gain embonpoint, and fresh, rosy cheeks. But such strength and beauty, with their concomitant dangers, are dearly purchased. (10.) Nerves Of Sensation.—It acts specifically upon the entire spinal cord, impairing the tone of the nerves of sensation, as well as those of mo- tion. It produces in the sentient nerves a morbid irritability, which often continues until death, while their vitality gradually diminishes. Pains, sensation of weakness, irritability, intolerable uneasiness, and, finally, numbness in the parts supplied by these nerves, are character- istic physiological effects of this substance. In the paralytic affec- tions arising from its use, the sentient as well as the motor nerves are usually involved. (10.) Among the nervous disorders in which it has been employed by both schools, with more or less success, may be cited nervous head- aches, chorea, epilepsy, spasmodic asthma, whooping cough, sympa- thetic affections of the heart, and various other neuralgia). Under the appropriate heads, pertinent clinical facts will be recorded. (10.) Ganglionic Nerves.—According to Hahnemann, one of the most im- portant effects of Arsenicum is excessive irritation, and, finally, gene- ral paralysis and death of the ganglionic system of nerves. Thus, gradual failure of strength, diminution of animal heat, extreme nervous irritation and uneasiness, great tendency to decomposition of the fluids of the body, feeble and oppressed respiration, palpitation, weak and irregular action of the heart, spasmodic movements of various parts, and faintness, all point toward disorder of the ganglionic system of nerves. It is, therefore, homoeopathic to morbid conditions, charac- terized by diminished vitality, and impending paralysis of this system. Arsenic. 681 ON THE NERVOUS SYSTEM. Its effects upon the nervous system, and through it upon the vascular system and heart, are its chief and most important charac- teristics. In all the cases of poisoning, we find the most marked de- pression of the nervous system, and coldness of the skin ; great feeble- ness of the heart's action, cold perspiration, oppressed respiration, sensation of approaching death and faintness, feeble, imperceptible, and intermitting pulse, and dimness of sight. Here we have a per- fect and complete picture of the paroxysms of organic disease of the heart, and an almost perfect picture of a paroxysm of angina pectoris, from spasm or organic disease, with the exception of the pain in the chest, and, in some cases of poisoning, even this is not wanting. This fact should not be overlooked in the treatment of organic diseases of the heart. (46.) Also in fevers, " where the skin is dusky, and the impulse and sys- tolic sound of the heart both fail, (Latham's softening of the heart,) and death is imminent and threatening;" especially if there be icy coldness of the extremities, creeping upward to the trunk, im- perceptible pulse, rapid failing of the powers of life, and gradual sinking and exhaustion, Arsenic is, most clearly, homceopathically in- dicated. (46.) Clinical Remarks.—Dr. Johnson says, " Let our readers not forget the decided efficacy of many old remedies, in even the worst cases of neuralgia; perhaps, on the whole, none deserves our confidence bet- ter than Arsenic, internally." (11.) Emotive and Sentient Sphere.—Excessive anxiety and restlessness, driving one to and fro in the daytime, and out of bed at night. Dread of being alone. Excessive fear of death, or mania of suicide. Great indifference and apathy to everything. (32.) The head feels confused and heavy, while in the room, but is better on going into the open air. Vertigo. (32.) Mind and Disposition.—Excessive anxiety and restlessness. Dread of being alone. Excessive fear of death, or suicidal mania. Melan- choly sadness. Religious melancholy and reserve. Crying and weep- ing, with a few incoherent sentences. Scruples of conscience. Great indifference and apathy. Vexed at trifles. Crazy. Imbecility. Fits of anguish, of the most violent kind. He talks little, complains^of anguish. Weakness of body and mind, without talking. (32. 26.) Clinical Remarks.—The mental conditions especially character- istic of Arsenic are: Great anguish, anxiety, restlessness, general un- easiness, impatience, and apprehension of impending evil. We are informed by Dr. Leon that, in certain stages of yellow-fever when this mental condition obtains, this medicine is peculiarly beneficial. In all maladies, these mental phenomena are of much importance in guiding us in the selection of remedies. The following cases are in point. (10.) Case 1.—Mr. P., aged 32 years, of good constitution, consulted Dr. Weber (Arch. f. H., viii. 56) for the following condition of me- 682 Arsenicum-Album. lancholy : Whenever a fit of melancholy occurred, he was not at all able to sleep any night; had no rest in bed, but constantly tossing about; gets into a profuse perspiration ; finally, he could not stay in bed any longer, was obliged to walk about; feeling, during such times, an inde- scribable anguish about the chest, continuing for six or eight nights; even during the day the anguish continued, making him feel as though he had committed murder. This condition of things pursues him from place to place ; unable to remain in the same place for more than fif- teen minutes. Sometimes tears were streaming down his cheeks, fancying, on meeting any of his friends, having offended them in some way, he wants to beg their pardon ; even to his wife, who, in reality, always has been treated kindly by him, he would fall on his knees, begging her not to be angry, &c, &c. This condition was always accompanied with great heat of the head and face. For several years such fits of melancholy, &c, would befall him; at first, every six months only, then about every three months. He was treated allopa- thically, at first, by venesections and foot-baths, which had the effect of alleviating the duration of the attack by one-half, but instead of that, the paroxysms occurred much oftener. He took one dose of Ars. 30 ; the next morning, he joyfully reported that he had slept per- fectly sound all night, and felt well otherwise. After the expiration of a month from that time he had another attack, for which he re- ceived a dose of the same medicine as before, which not only relieved him, but effected a permanent cure. (26.) Case 2.—A blacksmith, aged thirty-six, of strong constitution, took a severe cold, after having had an attack of measles, and suffered from fits of melancholy in consequence of it, with the following symp- toms: His looks betrayed great internal anguish and restlessness, and possessed with the idea that he could not be happy in his own house, which idea chased him, as it were, from one place to another, night and day; during such a paroxysm, his face became hot and red, and he was afraid to be alone for fear he might commit suicide. Bel- ladonna was given without success, and Arsenic, 24, effected a cure in a few days. (Annal I., 66., Ruckert.) (26.) Case 3.—A woman, aged sixty-five, had been suffering, for a whole year, from periodical fits of melancholy, with the following symptoms : Great anguish, burning in the stomach, and retraction of the abdomen. The degree of anguish so great at night as to oblige he^ to rise from the bed and walk about the room ; towards evening she feels timid, with palpitation of the heart, accompanied with heat and a feeling of constriction in the precordial region, a similar feeling of constriction of the head ; face bloated, red, and hot; pulse eighty per minute, and rather weak. Twinging, gnawing pain in the pit of the stomach, with water-brash, urging to urinate, with but little discharge of urine at the time. Dr. Neumann (Pr. Beitr., 2., 145,) cured this case in one week, with Arsenic, 30. (26.) Sensorium.—Diminished memory. Stupid, and weak feeling of the head. Muddled condition of the senses. Weakness of the mind. Arsenic. 683 Dullness and weakness of the mind, of long duration. Loss of sensa- tion, loss of consciousness and speech. Delirium. In the room, the head feels confused and heavy, feels better in the open air. Vertigo, with throbbing in the head when raising it. When closing the eyes, in the evening, one is affected with vertigo, so that one has to hold on to something. (32.26.) Clinical Remarks.—Delirium, loss of consciousness, loss of speech, coma, vertigo, dizziness, and weakness of the head, are all strongly- marked pathogenetic effects of Arsenicum. But it must not be for- gotten that those symptoms, and all others pertaining to the sensorium, may be entirely absent. Arsenical groups are of constant occurrence, in which the disposition and sensorial faculties are in a normal con- dition. (10.) Head.—Trembling of the head. Falling out of the hair. Distention of the veins. Great swelling of the head. Vertigo on closing the eyes, returning every night. Vertigo—everything turning black be- fore the eyes—with nausea while lying down ; with confusion of the mind, stupefaction. Feeling of extreme heaviness of the head, with roaring in the ears. Aching, stupefying pain in the head, with heavi- ness in the forehead. Beating pain in the forehead, with inclination to vomit. Hemicrania. (19.) Feeling in the head of tightness, heaviness, confusion, dullness, loss of memory. Headache, press- ing, pressing-benumbing, pressing-drawing, pressing-sticking pain, throbbing, tightness. (1. 26.) Periodical headaches ; semilateral head- aches. (32.) Pathology.—Inflammation of the membranes of the brain. Tur- gescence of the vessels of the brain ; the vessels of the brain are con- gested with blood. Thick, black, viscid blood in the vessels. Serous effusion into the ventricles. Inflammation of the substance of the brain. Extravasation of blood in the occiput. (1.) Redness of the brain and the membranes. Effusion of serum upon the brain. (3.) Clinical Remarks.—We have carefully examined the symptoms of forty-three cases of poisoning by Arsenic, recorded by different ob- servers, and find that headache had been present in thirty-two cases. The general character of these headaches has been pressing, beating, heavy, stupefying, and tearing. In eleven cases, the pains were in- tense. These effects were produced by poisonous doses of the crude drug. The dynamic phenomena which have been observed by ho- moeopathic provers, from imponderable doses, are similar to these, but far more extensive and vital. Among them we find periodical head- ache, relieved by cold applications ; semilateral headache, increased by eating ; paroxysms of excessively painful hemicrania, with great weakness; coldness of the extremities, and viscid perspiration; icy coldness of the scalp, with severe itching after the paroxysm ; vertigo, even to falling, and when sitting, or on rising from a sitting posture; heaviness in the forehead, or in the whole head ; falling out of the hair of the head, and swelling of the head and face. (10.) Teste asserts that " the symptoms caused by Arsenic seem to as- 684 Arsenicum-Album. sume a nervous form, the higher the attenuations with which the prov- ings were instituted. Thence it follows that the lower attenuations are more particularly adapted to organic affections, and especially to the very acute affections of the bowels. We know, indeed, from expe- rience, that the twelfth dilution of Arsenic was much more efficacious in cholera than the thirtieth. Having had an attack of cholera, in 1849, I have very accurately observed the differences on my own person." (Mat. Med., page 219.) (10.) In the treatment of head-symptoms, to which Arsenicum is homoeo- pathic, experience has taught us to prefer from the sixth to the twelfth dilutions, repeated at long intervals. While in the allopathic school, we have occasionally cured severe cranial neuralgiae with Fowler's solution—pushing the doses according to the allopathic routine, until the poisonous influence of the drug became manifest, in the form of swellings of the head, face, and neck, nausea, griping, &c. But per- nicious effects, in these instances, were observed, like a general de- pression of the nervous and vascular systems, and tendency to drop- sies, dyspepsia, and bowel affections. The effects of dynamic doses, when properly selected, are far more prompt and reliable than the crude poisonous doses, and, under all circumstances, free from danger. (10.) Allopathic physicians do, undoubtedly, cure different forms of head- ache with Arsenite of Potassae, but their enormous doses always en- tail more ultimate suffering and danger upon their patients, than if the original malady had remained untreated. (10.) Scalp.—The hairy scalp is painful, as if ecchymosed, especially when touched. Swelling of the head and face. Scald-head. Burn- ing pustules on the head. Corrosive burning-itching of the hairy scalp. Pimples, covered with scurf, and painful when touched. Pus- tules, with burning pain. Tinea capitis, with swelling of the cervical glands. (32. 26.) Ulceration of the hairy scalp. Falling out of the hair and beard. Red tetters on the forehead and cheeks. (1) Re- appearance of an eruption like porrigo, which had been suppressed many years before by external applicatious, from repeated doses of the sixth attenuation. Reappearance of a previously suppressed itch- ing, papular eruption, from repeated doses of the thirtieth decimal dilution. Intense aggravation of an eczematous eruption upon the forehead, from a few doses of the thirtieth decimal dilution. In three instances, reappearance of suddenly suppressed crusta lactea, from a few doses of the sixth dilution. (10.) Pathology.—OEdematous condition of the scalp. Dark, livid, or greenish patches upon the scalp. (2.) Clinical Remarks.—As an eliminator of latent chronic miasms, and of retained effete matters, resulting from metamorphoses of the tissues, Arsenicum is an agent of great value. In the dead body, it appears to neutralize the influence of the ever-present oxygen, as a decom- posing agent, and thus to prevent the natural decay of the tissues. (10.) In the living organism, it exerts a singular influence upon all poison- ous and effete matters, exciting them into activity, and causing their Arsenic. 685 development, through the pores, upon the skin. We imagine there are but few homoeopathic physicians who have not observed the pecu- liar power of this substance, in aggravating existing eruptions, and in developing those which were latent. (10.) Upon this hypothesis, we can readily understand why it has cured such a variety of cutaneous affections. Numerous reported cases are extant, of tinea capitis, porrigo, eczema, lichen, crusta lactea, acne, lepra,psoriasis, impetigo, and other chronic affections of the skin. (10.) Many other medicines effect cures of cutaneous maladies by a di- rect action upon the poison in the blood and in the tissues. Thus, Mercury neutralizes the syphilitic poison by direct contact in the blood and in the tissues. Sulphur cures psora by actual contact with the acari. Thuja destroys the sycosic miasm by acting upon it within the organism. (10.) Our experience with Rhus-tox. has been similar to that with Ar- senicum. In nearly all cases, it has, in the first instance, increased the eruption upon the surface and developed it in new localities. We infer, therefore, that it operates as an eliminator, rather than as a direct neutralizer of morbid humors. (10.) With regard to Arsenic, Trousseau and Pidoux (" Therap. et Mat. Med.," p. 322,) observe : "Arsenical preparations, administered in dis- eases of the skin, have uniform and easily appreciable effects. Thus, in squamous maladies, at the end of a few days, we observe an in- crease of activity in the eruption, the pimples and pustules becoming hot and irritable. After a time, they begin to heal in the centre, the edges contract little by little, and often, at the expiration of two months, sometimes sooner, we see a malady which had existed for many years disappear." (10.) It has been considered most homoeopathic in dry cutaneous dis- eases, and it unquestionably cures such cases more promptly than it does moist eruptions, like eczema, impetigo, &c. But its patho- genesy proves it to be strictly homoeopathic in the latter maladies, and repeated, though sometimes tedious cures have confirmed the accu- racy of these provings. (10.) In tinea capitis, Hering advises Arsenicum, after Rhus, Sulphur and Staphisagria have been given and failed to cure. He recommends it particularly when there is a corrosive discharge, or when ulcers have formed upon the scalp. We have often prescribed it in this affection, in both high and low attenuations, but without any material benefit. (10.) We have occasionally employed it, with decided advantage, in ma- lignant cases of erysipelas of the face and scalp, with extensive sup- puration of the cellular substance, a tendency to gangrene, and a general prostration of the forces of the system. In such cases, we prefer from the sixth to the twelfth attenuations. (10.) Porrigo and eczema of the scalp, forehead, and eyebrows have some- times disappeared under the protracted use of Arsenicum, 30th, re- peated at intervals of six or eight days. Lepra, psoriasis, and other scaly eruptions of the scalp, have also been apparently cured by the same dilutions. (10.) 686 Arsenicum-Album. Allopathic physicians likewise report numerous cures of these af- fections of the scalp, by large doses of the crude drug; but, as their treatment is almost invariably accompanied by powerful external appli- cations to the affected parts, no reliance can be placed upon these reports. (10.) Among its physiological effects, are repeated slight desquamations of the skin. The inference is, therefore, that it may prove useful in removing that condition of the scalp which causes dandruff. (10.) It has been employed with much benefit, in the dry and parchment- like state of the entire surface, which is so often present in gouty subjects. In these cases, it operates by facilitating the sluggish, natural desquamations, and thus enabling the pores to throw off the re- tained effete and noxious matters. Under the use of rarely-repeated doses of a high dilution, the insensible perspiration becomesmore abundant, and the skin gradually assumes its normal condition. (10.) ' Fever.—Chills and heat, without sweat. Chills followed by sweat. Chills without either heat or sweat. Chills every evening, also fever- chill through the whole body, with hot forehead, warm face, and cold hands—without thirst or fever. Nightly fever, without thirst and sweat. Sweat, three nights in succession. Chills, mostly in the evening, afternoon, or noon, never at night—induced either by drink- ing, or while in the open air; either a general chill or local, either long-lasting or in alternation with fever. External coldness with in- ternal heat, at the same time, or vice versa. During the chill, dis- tressing uneasiness, ill-humored ; distress and gnawing in precordial region, with nausea and tearing pain in the lower extremities. Fever, always in the evening and at night, of different degrees of intensity, as if the blood in the arteries were too hot, or burning, accompanied with distress and redness of the body, followed by nausea. Sweat at the termination of the fever, and on going to sleep. Sweat in the morning or forenoon. Sweat, either local or general, warm or clam- my, cold sweat. Roaring in the ears, with tremor of the body during sweat, in the forenoon. Pulse, small, quick, weak, very quick, inter- mittent, wiry pulse. No thirst during the chill, but following the same. Thirst during the sweat j violent, burning thirst, but the pa- tient can drink but little at a time. (21. 26.) Nightly, burning heat all over, with burning in all the veins, without thirst or sweat. (32.26.) Clinical Remarks.—Intermittent Fever.—It corresponds to this malady when the symptoms manifest themselves without much regu- larity, when the different stages are not strongly marked, and when the chills and hot sensations are prone to alternate, and to become mixed together. Thus, "Alternation or mingling of chilliness and heat; or heat, without any previous chilliness, followed by. sweat. Chill, particularly after drinking, or after a meal, or after walking in the open air, or in the afternoon or evening, with inability to get warm, followed by dry heat, and, lastly, sweat at the termination of the fever. Heat, without any previous chilliness, followed by svveat." During the chill, "Absence of thirst, stretching of the limbs, yawn- Arsenic. 687 ng, general feeling of malaise, headache, great weakness and desire to lie down ; pains in the back, limbs, stomach, and bowels; anxiety, irritability, and confusion of ideas; bitter taste in the mouth, nausea, vomiting, difficulty of breathing, general coldness of the surface." During the fever, " Great thirst; oppressive headache in the fore- head and temples ; pain, oppression, and burnings in the stomach ; great languor and debility ; trembling of the limbs ; surface dry, hot, and burning; restlessness, anxiety, delirium; sallow countenance, white fur upon the tongue, or tongue dry and red ; bitter taste, nausea, heat and chilliness in alternation; palpitation, vertigo, humming in the ears, rapid pulse. Symptoms worse in the evening and at night." During the sweat, " After the fever there are drowsiness and in- clination to vomit, and very soon the sweating stage commences. We now have a diminution of the pains which accompanied the fever; cold perspiration, thirst, humming in the ears, great weakness, rapid, feeble, intermittent pulse, faintness and languor." During the apyrexia, " Lassitude, bruised feeling in the limbs, con- fused feeling in the head, weakness, gastric irritation, and general malaise." By the old school, Arsenical preparations have been empirically employed, as a remedy in intermittent fevers, for centuries. A know- ledge, however, of its therapeutical properties was confined to the eastern nations, until a recent period, when Dr. Fowler, of England, brought it forward, and established it as a valuable medicine against this disease—next in value to Quinine. In France, Boudin, Tessier, Maillot, Neret, and Bernier have confirmed the observations of Fow- ler. (10.) It is a singular fact that the two most valuable homoeopathic reme- dies in intermittent fever, Arsenicum and China, should have been empirically seized upon by allopathists, as their chief remedies m the same disease! The usual doses of the old school are from one-twelfth to one-eighth of a grain. But much better results have been obtained by Dr Boudin, late Physician General of the French troops in Algeria, from doses of one one-hundredth part of a grain, triturated with sugar of milk. (10.) This gentleman declares, (" Waring's Hier., p. 7b) "that Arsenous-acid, properly prepared—triturated with sugar of milk -preserves, in the somewhat microscopical doses of the one-hun- dredth of a grain, all its medicinal energy, not only in marsh fevers, but also in a multitude of other diseases. * \ a™™." able, in a great number of cases, and by very small doses of Arsenious- acid to put an end, in a short time, to quotidian, tertian, and quartan fevers-contracted in latitudes the most various, often complicated with chronic enlargements of the abdominal viscera and which were incurable by the sulphate of Quinine Out of three hundred^ and twenty-three cases, he cured two hundred and thirty-eight many of which had resisted Quinine. He administers it about six hours be- fore the expected paroxysms." (10.) Unfortunately for suffering humanity, these allopathic gentlemen 688 Arsenicum-Album. have not given us any data with reference to the pernicious after- effects of these large doses. No allusion is ever made to the arseni- cal dropsies, and the arsenical cachexies which so often follow this treatment. (10.) M. Boudin has reduced the ordinary dose of this school from one- eighth to one-hundredth of a grain, and has witnessed greatly increased curative effects from the reduction. Why does not this eminent medical gentleman continue to reduce his doses still more ? By so doing, might he not find that the imponderable doses of the homceopathist are all-sufficient to grapple with the malady, and thus save patients from the deleterious influence of toxical quantities of the drug? We commend to M. Boudin, and to all other medical men, infinitesimal doses, if they would cure cito, tuto, etjucunde. (10.) Abdominal Typhus.—Under "Abdomen,"' we have already referred to its applicability in this malady. In this place, therefore, we shall only enumerate the prominent indications of the remedy. They are as follows: Irritation and ulceration of Peyer's glands, and of the fol- licles of Brunner; tenderness, or sharp pain in the right iliac fossa, upon pressure ; tendency to, or actual decomposition of the blood, and therefore, occasional nasal and intestinal haemorrhages. Derange- ment of the cerebral and nervous apparatus.. Tongue dry, dark in the centre, and red on the borders ; petechial eruptions and suda- minse ; tympanitic distention of the coecum and colon; urine scanty and dark. Pale and sunken face. Constipation, followed by diar- rhoea. Universal prostration ; general collapse. For other arsenical phenomena, in connection with this disease, we refer the reader to the symptomatology. (10.) Yellow Fever.—After the active symptoms have been subdued by Aconite and Belladonna—and the patient remains very weak, thirsty, anxious, or stupid ; excessively restless, particularly at night; with constant jactitation ; sunken countenance ; rapid and feeble pulse; nausea, diarrhoea ; dry and red, or pale and moist tongue ; scanty and red urine ; hot, pungent, and dry, or cold and clammy skin ; haemorr- hages from the gums, nose, and intestines, and an evident tendency to decomposition of the blood—Arsenicum is an invaluable remedy. Our friend, Dr. A. Leon, has often employed this drug for the above group of symptoms, with satisfactory results. (10.) It is an important remedy in malignant forms of scarlatina, variola, and erysipelas. In the two first maladies, autopsical examinations have sometimes revealed irritation of the follicles of Brunner, and ulceration of the Peyerian patches. In certain stages of each of these affections the blood is also altered and decomposed—losing its red color and fibrinous consistency. When this general condition ob- tains, and other symptoms correspond, it will often prove an efficient remedy. (10.) Case 1.—G. W., aged thirty-five years, of strong constitution, was taken, in May, with a tertian intermittent fever. The chills were severe, lasting for several hours, with alternate burning heat, weak- Arsenic. 689 ness and prostration, heaviness of the lower extremities, depressed mental condition, violent headache and stitches in the temples, nausea, very bad taste in the mouth, aversion to all kinds of food during the paroxysm, bowels constipated, lips swollen and covered with crusts. Dr. Seidel prescribed three doses of Arsenic—one to be taken in the evening, one the next morning, and one the following evening ; after which there was no recurrence of the disease. [Allg. Hom. Z., 1.46.] (26.) Case 2.— Mr. E., aged forty years, formerly healthy and strong, but, for nine months past, suffering from intermittent fever, which ap- peared first as a quartan, then changing to tertian, and afterwards to the quotidian type, for which he received allopathic treatment, with Chinine-sulph., China-regia, Ammon-mur., &c, without being cured. He now consulted a homcepathic physician, Dr.Gaspary, for the fol- lowing condition of things : Vertigo, with great weakness, and stupe- fying headache before the chill. During the fever, his head felt heavy and confused ; he lay in bed as if stupefied, with violent pain and vertigo on rising ; obscuration of sight from debility; buzzing and roaring in the ears during the fever,- but not at any other time ; dry- ness of the mouth without thirst, little or no appetite, with natural taste; during the apyrexia, rising of food, pressure in the stomach with nausea, stool regular. Fever-paroxysm occurred every fourth day, in the forenoon, with yawning, stretching of the limbs, and a feeling of the greatest discomfort; gradually changing into severe shaking thills, with headache, tightness of the chest, coldness of the abdo- men, without thirst. He was obliged to go to bed, and, two hours afterwards, a violent burning fever set in ; the skin became very red, all over the body, his mouth was parched and slimy, without thirst. The heat continued until evening, when he fell asleep, awaking about midnight with great anguish and violent sweat, which continued until noon of the next day, followed by a feeling of great languor, uneasi- ness, irritable mood, &c. He received Arsenic, but afterwards had two more paroxysms, which were, however, much lighter than the two previous ones, and his general health improved from day to day. About a month later, he had a recurrence of the disease, but was promptly and effectually cured by a few doses of Arsenic. [Annal, iv., 427.] (26.) Case 3.—A case of Febris Intermittens Quotidiana Duplex, in a boy aged two years, of feeble constitution—has had the fever and ague for the past three weeks. At three o'clock, A.M., he gets icy coldness of the whole body ; finger and toe-nails and lips turn blue; he lies on the bed, with sunken face, closed eyes, looking like a corpse; after the lapse of an hour, he gets into a burning heat, asking hastily for water to drink ; after which a profuse sweat sets in, a*id continues until about four o'clock, P. M. The second paroxysm be- gins at eight o'clock, P. M., the same day, but is of shorter duration, and less intense. During the apyrexia, the child is ill-humored, eats little or nothing, but is thirsty, and complains of pain in the abdomen ; 44 690 Arsenicum-Album. his sleep is restless, and his body emaciated. Dr. Y. {Horn. Be- kehrungsepisteln, 1837, p. 37) gave the little patient Arsenic, 3, in the evening. The following attack was much lighter, and, after a few more doses of the same medicine, he recovered perfectly, in the course of a few days. (26.) Sleep.—Irresistible inclination to sleep. Great uneasiness, and sleepless tossing about in bed. Starting of the limbs when on the point of falling asleep, or during sleep. Nightly restlessness, anguish about the heart, and violent burning under the skin, as if hot water was flowing through the veins. Anxious dreams. (32. 26.) Start- ing, as if frightened, during sleep. Suffocative fits on lying down, and after sleeping. Symptoms worse atnight in bed, and in the morning. (1.) Clinical Remarks.—It is applicable in the restless, anxious, and sleepless condition, which sometimes accompanies maladies of a ty- phoid and nervous type. It is indicated in stupid, drowsy, and indif- ferent states of mind, as well as for extreme uneasiness, sleeplessness, and nightly jactitation. It is likewise homceopathically related to ty- phoid conditions, with more or less tendency to coma. (10.) Skin.—Burning, and burning itching. Dry, parchment-like, or else blue and cold skin. Rash, especially white. Itch-like pimples. Va- rioloid. Urticaria. Blood blisters covering the whole body. Pe- techiae, with putrid fever. Black pock, as if gangrenous. Suppurating herp<«, with violent burning pain. Ichorous ulcers, with raised edge,s or thin crusts. Gangrenous or cancerous ulcers. Insensible or ex- tremely painful ulcers, with stinging and burning, especially when the parts become cold. Discolored nails. Warts. Chilblains. Varices, ■General anasarca. (32. 26.) Repeated bran-like desquamations, which leave ihe skin dry, like parchment. Appearance upon the thighs, legs, and arms of an itching eruption, like lichen, from re- peated doses of the thirtieth decimal dilution. [?] Intense itching of the skin, without any appearance of eruption, from the same dilution. (10.) Pathology.—In persons who have died from long-continued small doses, the following appearances have been observed upon the skin: Face and extremities swollen ; slight desquamation over the entire surface of the body; patches upon different parts of the skin, of a brown or mahogany color; eruptions of various kinds, which have been driven to the surface by the poison ; dry and parchment-like ap- pearance of the skin; dry, scaly, and glossy skin, which appears to lie loosely over the muscles; indurated, dry, and scorbutic state of the skin; blue or black spots over the body, from very large doses. These pathological appearances have been observed by Hahnemann, Noack and Trinks, Hunt, Orfila, Von Tschudi, and Guy. Our own suppositions induce us to suppose that very large doses operate upon the skin in such a manner as to produce actual decomposition, followed by gangrenous spots, and sometimes ulcerations ; while long-continued small doses act upon any latent miasm which may be present in the blood, and upon -effete matters arising from metamorphoses of the Arsenic 691 tissues, which are not eliminated by their natural outlets. Therefore, we are presented with eruptions of various kinds, and other morbid cuta- neous appearances. (10.) Clinical Remarks.—We have conjectured that minute doses of the drug possess the power of exciting into activity certain internal latent humors, and of determining their development upon the skin. This is without doubt the most natural and safe mode of eliminating these morbid poisons. In cases where no chronic humor exists in the or- ganism, the medicine excites into activity all retained effete products of the changed tissues, and throws them off from the surface in the form of slight desquamations. These desquamations are especially prone to occur after the use of high dilutions. (10.) [?] The cutaneous affections over which it seems to have a special in- fluence, are chronic eczema, urticaria, lepra, the different varieties of acne, chronic lichen, psoriasis, herpetic eruptions, impetigo, scurvy, mi- liaria, and scaly eruptions generally. (10.) Our experience with this remedy, in this class of maladies, has been somewhat extensive. In numerous instances, during our professional career, we have tested its effects, from allopathic doses of Fowler's solution up to the highest attenuation of the homceopathist, and we are perfectly convinced of the vast superiority of rarely-repeated doses of the higher dilutions in effecting cures. Frequently-repeated doses of the stronger preparations have almost invariably aggravated every variety of cutaneous disease in our hands, while doses of the thirtieth dilution, repeated at intervals of one or two weeks, have generally been productive of benefit, and occasionally of permanent cures. We can call to mind several cases of obstinate chronic eczema, acne, and lepra, which had, for months, and even years, resisted the action of often-repeated low dilutions of this and other cutaneous remedies, and which were speedily cured by a few doses of the thirtieth dilution, given at long intervals. (10.) In the allopathic school, Arsenic has been employed as a remedy in chronic cutaneous diseases for several centuries, and it is still held in very high estimation. Teste, in his "Materia Medica," page. 200, re- marks: "If we had no other authorities to consult than modern allo- pathic physicians, their practice, except the doses, accords so per- fectly with our own, that we might almost feel tempted to regard their mode of treating cutaneous diseases internally, with Arsenious-acid, as copied from Hahnemann." But I really believe this is not the case. For, as early as 1789, Adair published the happy results which he had obtained with Arsenious-acid, taken internally, in obstinate tetters. Rush, of Philadelphia, confirmed Adair's observations about the same period. Lastly, in 1806, Girdlestone, but especially Willan and Pear- son, in England, had popularized this use of Arsenic by a number of successful cases; and Bielt was one of the first who tried it in France. Cazenave expresses himself as follows, concerning the use of Arse- nious-acid in cutaneous diseases: "It is proven, now-a-days, that wonderful results are obtained with Arsenious-acid in the treatment of 692 Arsenicum-Album. cutaneous diseases, both in the dry forms and in the chronic eczema and intertrigo. This remedy is less successful in papulous eruptions, &c, and, in general, it has almost always failed in the various forms of porrigo, acne, sycosis, &c. It may be very useful in the elephan- tiasis of the Greeks; to the treatment of acute exanthemata, it is not applicable, as a general rule. Homoeopathy can add but little to these statements." (10.) We have no doubt that certain cutaneous eruptions have frequently disappeared under the long-continued allopathic use of Liquor Potasses Arsenitis. We concede, when this active poison is administered ac- cording to the method of Dr. Hunt, of Margate, in doses of five drops and upwards, three or four times daily, for many months, and, after the disappearance of the eruption, to still persevere in its use, for as many months as the disease had existed years, that the chronic humor or miasm which had caused the eruption may, in some instances, be neu- tralized and destroyed. But we as firmly believe that the drug, in accomplishing this object, always inflicts permanent injury upon the organism, in the form of dropsical affections, derangement of the di- gestive and nervous systems, and a general loss of vital force. (10.) By this method, the action of the drug is chemical and mechanical— decomposing and destroying the morbid cause, and, at the same time, impairing the integrity and strength of the tissues with which its crude atoms come in contact. In these instances, the action of the medicine is chemical and tissue-destroying. But, when administered in these maladies in imponderable doses, especially at the thirtieth attenuation and upwards, it acts dynamically, or perhaps catalytically, and produces such an effect upon the internal morbid molecules as to determine them to the surface, and thus cause their elimination through the skin. The smaller atoms possess another important advantage over crude ones, in being able, from their minuteness, to penetrate the capillaries, and thus to exercise an influence upon these important vessels, and upon the sentient extremities of the nerves. It is upon these minute structures that the infinitesimal atoms of malarial-mias- matic contagions and epidemic poisons exercise their principal influ- ence. (10.) Case 1.—M., aged forty-three years, a blacksmith, of strong con- stitution, was suffering for three months from ill-conditional ulcers over the face, forehead, neck, chest, fore-arms, and hands, with terrible burning pain. They at first appeared as small red blotches, which would soon fill with a straw-colored fluid, and then burst and discharge an acrid humor, which would porrode the surrounding skin and form large crusts, beneath which the process of ulceration continued, &c. He now and then felt a sense of shivering in the affected parts. No sleep, on account of the continued terrible burning pain. Yellow diar- rhoeic stools, turbid yellow urine, general malaise, and ill-humored. Dr. Schubert (Arch. f. hom. H., II., 104) gave him Ars , 30, in frac- tional doses, and in two weeks effected a complete cure. (26.) Case 2.—A woman, aged about sixty years, had suffered for several Arsenic. 693 months w ith small ill-conditioned ulcers, extending over the whole body, except the face, accompanied with burning pain and intense itching, which caused her to scratch violently but without relief, and always feeling better in a warm temperature. When one crop of ulcers had apparently healed up, another crop would appear—the patient losing flesh very rapidly. Digestion very much disturbed, each mouthful of food or drink causing pressure in the oesophagus, as though it had lodged there Very great languor and prostration; very restless and interrupted sleep. The fever, which occurred every day, beginning with chills, caused an increased burning in the eruption, followed by heat, and finally sweat. Dr. Gross (Arch. f. hom. H., I., 105) ordered Ars., 30, in repeated doses, which effected a cure in three weeks. (26.) Case 3.—A case of "scabies herpetica cucm superveniente febri inter- mittente" in a man aged about twenty-three years. Patient said he had been troubled for six weeks past with a quartan intermittent fever. His face is pale and oedematous, his eye.s sunken and surrounded with blue circles; the muscles of the face flabby, vacant expression of the eyes, and a dragging motion of the body on walking. The arms, thighs, and knees were covered with thick brown crusts, from under which thick, greenish, foul-smelling matter exuded; between the fingers, bend of the elbows, and popliteal spaces were scattered yel- low, broad pustules, some containing pus and others covered with brownish crusts, causing a painful itching and burning, especially towards evening, after exercise, and when the body became heated, from which he had been suffering for several years. Dr. Gross pre- scribed Ars., 30, one dose every evening, for about six weeks, at the expiration of which the patient reported himself as being cured. (21. 26.) Case 4.—Herpes, in the case of a student, reported by Dr. Kretsch- mar, (Arch. f. hom., H. viii., 1, 69,) of the size of a dollar piece, situated between the shoulder-blades, accompanied with intense burn- ing, especially at night, so as to prevent sleep; the integument very red, and covered with minute blisters, often scratched open in conse- quence of intolerable itching and burning. Not being well versed in the selection of drugs at that time, Dr. K. gave Sulphur for five days, without any benefit, while the patient noticed another spot making its appearance in the praecordial region, causing as much burning as if it had been touched with Oil of Vitriol. He now received fractional doses of Ars , 30, and, in the course of ten days, was completely cured. (26.) Case 5.—A male child, three weeks old, was afflicted with furun- culi all over the body, from the size of a pea to the size of a filbert, which, after'twelve or twenty-four hours, filled with blood and some matter, causing apparently much pain. Every day new pustules made their appearance. Dr. Tietze ordered Ars., 30, to be taken in frac- tional doses for eight days, a» the expiration of which a oure was effected. JAllg. Horn. Z., iii., 1, 15.J (26.) 6&i Arsenicum-Albttm. as an escharotic and in cancer. Clinical Remarks.—Though employed as a caustic, yet the nature of its chemical influence on the animal tissues is unknown. Hence it is termed by some a dynamical caustic, in opposition to those caus- tics acting by known chemical agencies. Mr. Blackadder asserts that the danger of employing Arsenic consists in not employing a sufficient quantity. A small quantity, he says, becomes absorbed, whereas a large quantity quickly destroys the organization of the part and stops absorption. (9. 46.) In estimating its action as an escharotic, particular attention should be paid to the following facts, viz.: that it is an irritant, and not a corrosive poison. Its effects upon the surfaces with which it comes in contact are radically different from those of Nitrate of Silver, or the strong acids, or other tissue-destroying corrosives Nitrate of Silver acts indifferently upon the sound skin, the mucous surfaces, or an open sore. Arsenic, on the contrary, acts with great reluctance upon the sound skin. Nitrate of Silver chemically destroys the tissues with which it comes in contact—burns them up; Arsenic, on the contrary, kills the tissues with which it comes in contact, by poisoning them, and thus, causing them to die. Nitrate of Silver enters into chemical union with the chlorides and albuminates of the flesh, and presents an impassable wall to the absorption of the salt; Arsenic, on the con- trary, only has its absorption limited by the incapacity of the dying tissues to carry on the process; each fresh portion of tissue with which it is brought into contact in its progress is capable of taking up and repeating the process of absorption until its death. (46.) Therefore, in using it as an escharotic, we must bear these matters in mind, and allow for its alterative action upon the surrounding tissues through absorption, as well as its escharotic effects upon the part it- self. (46.) M. Manoc has been engaged in investigating the action of Friar Cosme's Arsenical Paste, in more than one hundred and fifty instances, and he has come to the conclusion that the paste penetrates the can- cerous tissues by a sort of special action which is limited to it. This action is not simply escharotic, for, beneath the superficial blackish layer which the caustic has immediately disorganized, the subjacent morbid tissue seems struck with death, though it may retain its proper Jexture and almost its ordinary appearance. Later, the cancerous mass is separated by eliininatory inflammation, which is set up around its limits. The same paste, which extends its influence more than six centimetres deep in a cancer of close texture, when applied to super- ficial gnawing ulcers, usually only destroys the morbid texture, how- ever superficial this may be, and respects the sound parts. (17. 46.) That this is not always the case, is clearly shown by those many cases of poisoning on record, from the local outward application of Arsenic to sores and ulcers, when acute internal lesions have ensued, attribu- table to the absorption of the Arsenic. «(46.) Arsenic. 695 He also thinks that the absorption of Arsenic is proportionate to the amount of surface involved, and that a sore of small dimensions need never cause any uneasiness, but that, in a large cancerous ulceration, it should only be attacked in portions at a time. (17. 46.) Case 1.—Mrs. A. suffered from uterine haemorrhage, and the specu- lum revealed a fungous growth, the size of a walnut, pouring forth blood on the slightest touch, which rapidly filled the speculum. The practitioner, (a homoeopathic one.) after vainly applying lunar caustic, besides the usual internal remedies for cancer, was dismissed, and another physician called. He being also unsuccessful, she returned to the first, begging him to save her life. She was at this time, July 9, reduced to a pale and marble-like skeleton, and it appeared to me wonderful that she could have retained the spark of life so long. I decided upon Arsenic, topically applied. I used very finely-powdered white oxide of Arsenic; it was cautiously applied to the fungus, through the speculum, by means of the sponge of a probang, previously moistened with water. The bleeding ceased that day. 1 repeated the application on the twenty-third and twenty-fifth, and, on the twenty- eighth, the tumor was expelled. My patient progressed favorably, and at the end of a month was strong enough to enjoy a drive into the country. She lived five years after the treatment, and suffered but little from the absorption of the Arsenic into the system. (12. 46.) Case 2.—J. B., aged thirty-five, had a large cartilaginous tumor, re- sembling cancer, growing from the right side of the inferior maxillary bone. Had been operated upon, by cutting, at the North Devon In- firmary; the tumor, since the operation, has increased rapidly. She cannot close her mouth, consequently cannot masticate; the growth extends to the pharynx, rendering the respiration noisy and deglutition difficult. Without removing the entire half of the lower jaw, there ap- peared no hope of cure. I proposed the operation, but no persuasion of mine could induce her to submit to it; as a last resource, I used Arsenic. To apply it on the surface of the mucous membrane would, no doubt, have proved fatal. I therefore made an incision into the substance, by means of a narrow bistoury, filled a grooved director with Arsenious-acid, and armed a probe with cotton-wool; the probe was placed on the director, and the whole introduced into the wound; the director was then withdrawn, leaving the Arsenic to work its way. The application produced violent pain and great constitutional dis- turbance, but the woman is now alive and healthy, and the mother of a large family. (12. 46.) Case 3.:—A. C, aged seventeen, a farm-servant, consulted me in March, 1834. He had an ulcer on the scrotum, over the right testicle. Having seen cases of chimney-sweeps'cancer in London, I recognized the disease, and I removed a piece of the scrotum the size of a half crown. The part healed by granulation, and for six months the pa- tient was free, but at the end of that time the disease reappeared. I then decided on applying Arsenic, and the part sloughed off, leaving the tunica-vaginalis more cleanly dissected than it could possibly have 696 Arsenicum-Album. been by the knife of the most skilful operator. Granulation and cica- trization followed rapidly, and the cure was permanent. Case 4.—R. P., a farmer, was afflicted with a cauliflower excres- cence growing from the internal malleolus; it was nearly three inches in diameter, of a circular form, and had the appearance of consolidated jelly. It rendered locomotion impossible, for it projected an inch or more from the surface of the skin, and was very painful. We first passed a double ligature around and through the tumor, and tied it; it was tightened daily until the part fell off. and the surface was then dusted liberally with Arsenic. It produced very serious effects, exciting great alarm for the patient's safety; however, the remainder of the mass sloughed away, and left the external lateral ligament uninjured. The wound healed in a short time, and, for a period of six years, the patient was a hale and hearty man, but eventually died of cancer, ap- pearing in the same place. (12. 46.) Case 5.—Miss S. presented herself for treatment in April, 1842. The right side of the dorsum of the nose, from the origin of the eye- brow downward, for an inch, and from the centre of the dorsum of the nose to the internal canthus of the eye, was occupied with an ulcer of a greyish-white color, with irregular flattened borders and uneven sur- face. At the upper and lower part of this ulcer were two small warts, round and shining, and at their apices showing a ramification of ves- sels. The deepest part of the ulcer was at its centre, yet the bone was not exposed, and close beside this excavated part there l«y a spongy, elevated mass. The lower punctum-lachrymalis was im- bedded in a similar mass. The whole bled easily on the slightest touch, especially the spongy parts, upon which a brown scab often appeared, which was soon thrown off again. The purulent discharge was not considerable; the surrounding skin was normal, except that upon the forehead and cheeks were three warts, similar to those above described but not injected. It was of fourteen years' standing. The patient had used purgatives, Mercury, Iodide of Potassium, in enor- mous doses, and tincture of Iodine, outwardly. The ulcer had also been cauterized with Nitrate of Silver. All was in vain, so that, at last, the patient left off all medicine, and only dressed the ulcer with some mild salve. The history and symptoms clearly indicated the cancerous nature of the malady. The homoeopathic treatment con- sisted of Arsenic, 8, six drops every two days, for internal use, and for external use an ointment made with about two grains of the first decimal trituration of Arsenic, and a sufficient quantity of fresh lard. This was spread on a piece of lint, and fastened on the ulcer with sticking-plaster. The dressing was at first renewed twice a day, afterwards more irregularly. After it had been applied for a few days, the warts reddened, became gradually reddish-brown, and, in the course of ten days, they, as well as the ulcer, formed a very hard brown scab, when the eyelids, forehead, and one cheek became slightly inflamed and oedematous. The scab was softened and detached, by means of water-compresses, in a few days, when the oedema disap- Arsenic. 697 peared, and the raw surface of the ulcer was treated as before. The oedema never returned again to any extent. In a short time the greater part of the ulcer became clean, the suspicious-looking spots were fur- ther cauterized with the Arsenic, the trituration of which was applied, either dry or moistened. The healt hy-looking parts were not touched. They healed rapidly. In six weeks a cicatrix was produced, which had a glazed appearance, and was only half the size of the original ulcer; at lower punctum only, there still remained a suspicious-look- ing spot. This it was resolved to cauterize with the Arsenic, but the patient was obliged to go away before it could be done. She returned in February, 1853, in consequence of the spot at the lachrymal point having enlarged, and a small ulcerated point having begun in the centre of the cicatrix. The former treatment was commenced and carried out with success; but she eventually died of cancer of the stomach. (12. 46.) Attomyr affirms that he has cured a case of cancer of the lip. A. L., six years old, had lost the left half of the upper lip, and the soft parts extending to the zygoma, and also a considerable portion about the angle of the mouth, by a cancerous ulcer. Arsenic, sixth dilution, brought about the healing of the ulcer in six weeks. (12. 46.) Eyes.—Christison says, under the use of Arsenic, the conjunctiva is often so injected as to seem inflamed; eyes red and sparkling, red- ness of the eyes, giddiness, and intolerance of light, eyes bloodshot, with burning pain. (11.) Wood and Bache say that it causes oedema, especially of the face and eyelids, with a feeling of stiffness of these parts ; livid circle around the eyelids. (11.) Hunt says, in a few days, or possibly weeks, while using Arsenic, a pricking sensation is felt in the tarsi, and the conjunctiva becomes slightly inflamed; a slight degree of conjuncti- vitis, in forty-nine cases out of fifty, takes precedence of the more grave affections which indicate an overdose. Five-drop doses, three times a day, for thirty-five days, caused inflammation of both con- junctiva, which lasted seven weeks. Same doses caused tenderness of the tarsi, but no redness, in five days ; in fifteen days, conjunctiva were slightly and partially inflamed ; in five days, slight partial red- ness of conjunctiva, eyelids stiff and itchy, stiffness and pricking in the eyelids almost every evening, after taking three doses of five drops. (11.) In a fortnight, conjunctiva inflamed, and eyelids puffy. (11.) In a fortnight, in another case, the eyes were exceedingly weak, lower eyelids pufied and swollen, conjunctiva reddened, and tears ready to start. (11.) In another case, in twenty-six days, the conjunctiva became in- flamed, the lower eyelids swollen and puffy, the eyes itched and.were weak, conjunctiva much inflamed, with pain in the orbits. (11.) In a fourth case, in eighteen days, the conjunctiva were slightly inflamed, and eyes weak. (11.) 698 Arsenicum-Album. In another case, five drops were taken, three times a day. In three days, the patient complained of excessive weakness of the eyes, sen- sations of smarting, itching, and pricking in the eyelids, and a copious secretion of tears. In a sixth case, in seven days, from two and a half drops, three times a day, conjunctivitis ; one drop, three times a day, for five days more, conjunctivitis no better, rather worse. In half-drop doses, con- junctiva still very troublesome; dimness of sight; left eye became so singularly affected that she could only see the half of an object with it. (11.) In the eighth case, five drops were given, three times a day, for three weeks, when the conjunctiva became very red, sore, and injected. (11.) In the ninth case, the conjunctiva became inflamed, and eyelids tumefied. While taking Arsenicum for six weeks, the conjunctiva became inflamed; the right eye became better, but the left eye re- mained considerably inflamed". In two weeks more, while continuing the medicine, both eyes became inflamed and painful—but the right eye, though inflamed, looked more natural; eyes much inflamed,with copious fluid discharge from the nose. (11.) Vogt says'Arsenic causes warmth of the body, especially felt in the forehead and eyebrows. Blue circles about the eyes. Itching and prickling around the eyes and temples. Sunken eyes, with yellowish countenance. Swell- ing of the eyelids. Painless soft swelling under the eyes. Twitching of the eyelids, and drawing pain in the eyes. Constant twitching of the lids, with discharge of tears from the eyes. Burning pain and dryness of the eyelids. Violent inflammation of the eyelids. Dis- charge of corrosive tears from the eyes. Eyes and lids inflamed. Chemosis. Blue spots in the white of the eye. Violent pain in the eyes. Burning and tearing pain in the eyes. Photophobia. Sparks before the eyes. Specks on the cornea. Dreadful distortion of the eyes, fixed wild look. Protrusion of the eyes; glistening of the eyes. Obscuration of sight. Amblyopia. Total blindness. (19. 26.) Oph- thalmia, with violent burning pain. Arthritic, scrofulous, and rheumatic ophthalmia. Lachrymation and nightly agglutination. Dim and yellow eyes. (32. 26.) Redness of the conjunctiva. (3.) Swelling and stiffness of the palpebrae. Heat, tenderness, and itching of the tarsi. (44.) Burning coryza. (1.) Clinical Remarks.—Dr. Dudgeon states that Arsenicum exerts a most extensive action upon the eyes; the conjunctiva is not alone the seat of its action, but the sclerotic and choroid membranes also. It is homoeopathic to some stages or varieties of catarrhal, scrofulous, rheumatic, arthritic, and scorbutic ophthalmia; also in some stages of Egyptian and gonorrhoeal, and more especially when the pains are extremely violent and burning, and the secretions of an acrid, serous nature. He has also found it very useful in exanthematic ophthalmia; in that following measles, especially when the lachrymation is exces- sive, and the tears produce corrosion of the cheeks, and doubts not Arsenic. 699 that it will be equally serviceable in some cases occurring during, or after scarlet-fever or varioloid. It seems to be the only remedy from which we may expect any advantage in the ophthalmia from uterine phlebitis. From its producing swelling of the eyes, and a beating like that of a pulse in the eyes, each throb being attended with a stitch; and from its well-known influence upon the haemorrhoidal vessels, and the typical character of some of its effects, it would seem that it must prove homoeopathic and useful against haemorrhoidal and menstrual ophthalmia. (12. 54.) Riichert furnishes the following clinical indications for the use of Arsenicum in inflammation of the eye: (11. 54.) "Swelling and spasmodic closure of the eyelids, which cannot be opened on account of the inexpressible pains. Adhesion of the eye- lashes. Injection of the conjunctiva, which is covered with red blood- vessels, and forms a wall around the cornea, (chemosis); redness and granular appearance near the cornea. Bluish redness of some of the blood-vessels. Violent pains from opening the eye, especially at night, when the sufferings are most severe. Violent burning in the eye, which prevents the patient from eating or sleeping; burning and piercing pains in the eye. Profuse discharge of corrosive tears on opening the eye ; hot tears ; small ulcers on the cornea ; dirnness of sight; contraction of the pupils. Excessive intolerance of light; feeling as if the eyes had not room enough in the orbit, and were being pushed or pulled "out. Redness of the white of the eye, and dimness of the cornea. Intermittent inflammation of the eye, commencing in ihe morning or afternoon, and diminishing by ten o'clock at night. Aching and throbbing pains. Annoying pulsation in the ball of the eye and its neighborhood. Dimness of vision, cannot see small objects, even when quite near, and large objects only at the distance of ten feet." (11. 54.) Dr. Peters, in his work on diseases of the eye, con- cisely gives the indications for the use of Arsenic in diseases of the eye. (54.) Pustules on the conjunctiva have recovered while using Arsenicum. Hering advises it in scrofulous ophthalmia, " when the pains are of a burning character, as if produced by red-hot coals, and when spots have already made their appearance upon the eye." We have occa- sionally prescribed it with success in scrofulous ulcerations of the cornea, with swelling and redness of the eyelids and the puncta- lachrymalis, profuse and piercing, burning, stitching pains in the eyes ; secretion from the meibomian glands, copious lachryinat.on, alter Sul- phur, Euphrasia, Graphite, and Calcerea had failed to afford relief. (10.) Many diseases, especially pustular ophthalmia, will come to an end at some time; when twenty remedies have failed, the last one will seem to cure. (11.) „. , ,< * • u Helmuth ("Practice of Surgery," p. 460) observes: "Arsenic, be- sides exercising a powerful action upon the sclerotic and choroid coats, is very beneficial in inflammation of the conjunctiva The symptoms which require its use are, violent and intense redness of 700 Arsenicum-Album. the membrane, with congestion of the vessels; swelling of the eye- lids ; a profuse flow of acrid tears; nightly agglutination; great photophobia; aggravation of pain from exposure to light, and a feeling as if sand were lodged in the eyes." (10.) The same author has employed it advantageously in purulent op- thalmia, when the pains are very violent and burning, and there is an acrid, serous secretion, with pains of an intermittent character. (10.) Dr. Dudgeon prescribes it in gonorrhoeal opthalmia, when the pains are severe, occurring in paroxysms; when there are violent stabbings in the eye, the eyeball feeling like a coal of fire. In these cases, Dr. Dudgeon also advises topical applications of Arsenicum, Argentum-nitricum, Euphrasia, Rhus, and Mercurius. He mixes a drop of the dilution prescribed internally, with a teacupful of water, and applies it to the eye, two or three times a day, by means of a soft rag. (12. 10.) In syphilitic ulcerations of the cornea, Arsenicum often follows Mercurius with advantage. Patients who have become much emaciated and exhausted from the severity and obstinate continuence of the disease, notwithstanding the use of Mercurius, Nitric-acid, Thuja, Hepar-sulphur, and Calcarea. (10.) Helmuth has cured, in fourteen "days, a violent inflammation of the eye, with effusion of pus into the anterior chamber, with Arsenicum, fourth dilution, every four hours. (10.) Professor Kitchen, of Philadelphia, considers Arsenicum, 3, and Conium, 3, in alternation—every four hours, in acute cases, and night and morning, in chronic cases—the best remedies in scrofulous oph- thalmia. He has been uniformly successful with them. (10.) Arsenicum has been successfully employed after Sulphur in hy- dropthalmia. (10.) Ruckert gives the following pertinent cases: Case 1.—A girl, aged six years, subject from the slightest cause to violent inflammation of the lids, with photophobia, received much treatment with no benefit. The little patient was then put under the care of Dr. Hermann, in the following condition : On removing the green shade, which she wore over her eyes, the lids presented a swollen and inflamed appearance; ciliae agglutinated; discharge of corroding tears; conjunctiva-selerotica injected, and cornea had marks of healed ulcers, and a few open ones. She complained of biting, stinging, burning pain in the eyes, with photophobia. Ars., 30, ef- fected a cure in ten days. (21. 26.) Case 2.—A man, aged twenty-eight years, of delicate and cachectic habitus, was cured of the following affection by a few doses of Ars., 30, prescribed by Dr. Stapf: Conjunctiva-bulbosa of the left eye, which was much injected; photophobia; vision impaired; violent throbbing in the affected eye, returning as it were every other day, after a good night's rest; the pressure and throbbing in the eye began at five o'clock, A. M.: gradually increasing in intensity until five o'clock, P. M., and then decreasing by degrees, until ten o'clock in tike evening, at which time she was freed from the above. (21. 26.) Arsenic. 701 Case 3.—Two cases of ophthalmia-scrofulosa. One case of scrofu- lous inflammation of the left eye, with two ulcers on the cornea, with shooting pains and lachrymation, was cured by Ars., 3, in twenty- three days; and another similar case, in a woman aged twenty-seven, was also cured by Ars., 3, in sixteen days. (12. 26.) Case 4.—A case of carcinoma of the inner canthus of the right eye, in a young lady who had been affected with it for some years, in the shape of little warts, easily bleeding on being touched, and for which she had received very active treatment without benefit. Being disgusted with this empirical procedure, she dropped all treatment for some considerable time, and kept the diseased parts covered with simple lard, spread on a little piece of linen. After a lapse of time, she was induced to consult Dr. Bahr, who treated the case with Ars., 8, six drops every third day, and an external application of the first trituration of Arsenic, mixed with lard. This he continued for about eight months, making the intervals in the administration of doses gradually longer. Accompanying the above, she had occasionally oedematous swelling of the lids, forehead, and cheeks, sleeplessness at night, a feeling of constriction in the chest, pressure in the stomach, increased thirst, and flashes of heat. At the expiration of the eight months, the disease had disappeared; but, some time afterwards, she was suddenly taken with continued terrible vomiting, accompanied with the greatest anguish, &c, &c, and, in the course of thirty-six hours, was a corpse. Autopsy revealed cancer of the stomach. (12. 26.) One of our Allopathic brethren, Dr. Mackenzie, {London Journal of Medicine, July, 1851,) recommends it highly in catarrhal ophthalmia. Was this gentleman aware that one of its pathogenetic effects is red- ness and inflammation of the conjunctiva ? The same writer also commends it in some forms of catarrh, coryza, and hay-fever. Of course he has never heard of homoeopathy! Dr. Mackenzie must be considered a great medical wag. (10.) VVurmb recommends Arsenic in those inflammatory affections of the eyes and lids which are situated more particularly in the con- junctiva. He thinks it is more specially indicated when there is strong injection of the conjunctiva, tendency to ulceration, violent pains, increased flow of tears, great photophobia, and weakness of vision. (12. 46.) Case 5. —A girl, aged six, had suffered for several years from re- peatedly recurring attacks of ophthalmia, which were so obstinate under ordinary treatment that she usually remained several months in succession without being able to leave off the local and internal remedies; and latterly there remained, after one of these attacks, so much irritability of the eyes that the slightest exciting cause brought on photophobia and inflammation for several days, so that the child could hardly ever be without a green shade. I was requested to treat the child. She could scarcely open the eyes, even under the large green shade, which shut out almost every ray of light. I found the 702 A rse n icum ~A Ibum. eyelids swollen, red at the edges ; the few remaining ciliae matted together with pus. On opening the eyes, the tears flowed out copi- ouslv, arid were of an irritating quality, as was shown by the exco- riated state of the cheek ; the conjunctiva-sclerotica was intersected with enlarged single vessels, and both corneae displayed cicatrices and ulcers still open. The patient complained of smarting and burn- ing pains, much aggravated by the light, which she dreaded exceed- ingly, and all objects appeared as if seen through a veil. Dr. Her- mann gave Arsenic, and the eyes were well in eight or ten days. Since that time, adds the report, ten months have passed without any return of the disorder, and the patient has not once been obliged to use her shade. (12. 46) Case 6.—Mr. M., aged twenty-eight, was attacked with ophthalmia. There was injection of the conjunctiva and severe aching of the eye. The symptoms then shifted to the left eye, with intense photophobia. Pulsation extended all about the eye, and the patient described the pain as intense. It went on, with no diminution, until Arsenic was given, when the symptoms immediately yielded. (12. 46.) According to Gross, as quoted by Ruckert, Arsenic has been used with success in obstinate inflammation of the eyes, following an attack of grippe, (influenza,) with subsequent ulcers or obscurations of the cornea, with severe photophobia; and Dr. Hartung praises its use, in cases where the palpebral conjunctiva is very much inflamed, with violent burning pain, and inability to open the eyes. (26 ) Case 7.—A girl, aged fourteen years, of delicate constitution, has been suffering for forty-eight hours with violent inflammation of the conjunctivae ; was cured by Arsenic, 24. [Arch.. 8, 2, 75, Ng.] (26.) Case 8.—A girl, aged twenty-two years, a frequent sufferer from erysipelatous inflammations, whose family is subject to phlebitis and varicose veins, had been affected for eight days with inflammation of the conjunctivee-palpebrarum, and severe swelling of the lids. Dr. Schelling ordered Arsenic, a dose to be taken every two hours, and effected a cure in forty-eight hours. [Allg. Hom. Ztg.,'6S, 148.] (26.J Case 9.—A case of sclerotitis, with severe photophobia, in a servant-girl, who, in consequence of having taken a severe cold, had been surlering thus for several weeks ; treatment had afforded no relief. Dr. Hermann (Arch., 12. 3, iii.) effected a cure in a few days by Arsenic, 30. ('Hi.) Case 10.— A man, aged twenty-eight years, of delicate, cachectic constitution, had been suffering from an intermittent (periodical) in- flammation of the eyes. Aconite and Bellad. were given without benefit; but Arsenic, 30, effected a cure in three days. [Arch., 18, 2, 43, Stapf.] (26.) Cask 11.— Mrs. B , aged thirty-two, of delicate constitution, was troubled with an inflammation of the conjunctiva, returning every after- noon at four o'clock, which Dr. Lorbacher cured by two doses of Arsenic, 30, one dose at night, and the other was given in the morn- ing. [Vierty, 1,2,257.] (26.) Arsenic. 703 Case 12.—A lady, fifty-four years of age, already suffering for five weeks from coryza, and, for eight days past, troubled with ophthalmia, as follows : Swelling of the lids, and inflammation of the sclerotica, with darting pain through the ball of the eye on motion. Dr. Haustein prescribed Ars., 6, one dose to be taken at night, and one in the morn- ing, which effected a cure in five days. [ Altg. Horn. Ztg.,o9. 36 ] (26.) The indications for its employment in scrofulous ophthalmia, accord- ing to Ruckert, are as follows : Eyelids swollen, with inflamed edges; profuse secretion from the meibomian glands, causing agglutination of the lids in the morning, accompanied with spasmodic contraction of the same, causing sharp pain on attempting to open the same. Conjunctiva-bulbosum filled with inflamed blood-vessels; cellular tissues degenerated, inflamed with a diffusion of congested venous capillaries. Appearance of cornea smoky, opaque, with small ulcers, and blue- greyish spots; iris and pupil entirely obscured. Curuncul Simple mucous flux of the bowels is often attended by a quick almost involuntary discharge of food and drink, intermixed with much mucus. -., .,.,,, 3. Undigested stools, in which the food, at first, passes off but little 764 Asarum-Eur opceum. changed,but afterwards, as the ejected food becomes black, discolored, bad-smelling, or mixed with bile, mucus, or also with blood, and at- tended with weakness and fever—points to softening, ulceration, or degeneration of the gastro-intestinal mucous membrane, or of the intestinal or mesenteric glands, or of the liver, spleen, or pancreas. 4 An habitual discharge, consisting in part, at least, of indigested food, and occurring more quickly than natural, may depend upon dilatation of the pylorus or a direct communication between the stomach and colon. 5. Undigested stools, still not following very quickly after each repast, and intermixed with actual faeces, may depend upon simple weakness of the digestive organs, or thinness of the bile or gastric juice, or weakness induced by long-continued diarrhoeas, &c, or by excesses in eating or drinking, or by profuse suppuration, even in distant parts. 6. In adults, the more undigested the food, especially when mixed with a gelatinous whitish mucus, the more unfavorable the prognosis. 7. Undigested stools, in aged persons, is a sign of great debility of the digestive organs. 8. In children, on account of their slender powers of digestion, it is not an uncommon phenomenon, and may follow every profuse and persistent diarrhoea ; hence, it is not often of much importance. It is frequent during teething, and also in confluent and descending aphthae. 9. Inflammations of the chest, bowels, and mesenteric glands may be attended by it; 10. And it is common in rhachitic children. Jahr mentions China and Ferrum, also Arsenicum, Bryonia, and Nux, as the principal remedies against lientery; also Arn., Asarum, Calc, Cham., Con., Lach., Merc, Nit.-ac, Nux-mos., Oleander, Phos., Phos.-ac, Squills, and Sulph. (11.) China is thought most indicated when there are undigested stools, especially at night, or immediately after eating, with evacuation of everything eaten. It has cured lientery, but old-school doctors say that it is only indicated in lientery from debility. (11.) Ferrum is thought useful against undigested stools, which it has cured. It is almost specific in ascarides and against some kinds of slimy stools; is said to be best suited when lientery is brought on by the debility caused by a blenorrhoea of the bowels, induced by ascarides. The old school give it as a tonic. (11.) Arsenicum is recommended when there are undigested stools, with masses resembling undigested tallow, intermixed with tendinous parts. It is homoeopathic to lientery from violent irritation, inflammation, or ulceration of the bowels. The old school say it acts as a tonic or alterative. (11.) Bryonia is suggested when there are undigested stools. It is a drastic cathartic, and is homoeopathic to those lienteries which arise from excessive irritation of the bowels. (11.) Nux-vomica has also been used against undigested stools, and is Asardbacca. 765 thought to be homoeopathic to lientery arising from too rapid peris- taltic action of the stomach and bowels. (11.) Arnica is thought to be a remedy for some cases of undigested stools. Dierbach says Arnica quickly attacks the prima-viae, causing eructations, stomach-ache, retching, nausea, vomiting, cutting pains in the abdomen, tenesmus, also diarrhoea, but more frequently consti- pation ; hence, it is most homoeopathic in lientery from irritation. Calcarea is recommended against lientery and undigested stools, both when they are hard and costive, or thin and diarrhoeic, and when there are pap-like stools, with undigested food, in the evening after eating, preceded by griping, as if wind or loose faeces would pass; gruel-hke stools with undigested food. (11.) Chamomilla has also some reputation in correcting undigested stools. Conium has been used when there is a discharge of undigested particles with the stools; discharges of undigested food, with griping in the stomach and bowels. (11.) Nitric-acid has cured some forms of indigestion when there were undigested faeces. Nutmeg has also been suggested as a remedy. Pereira says it is a carminative, useful in mild diarrhoeas, and often uses it as a substitute for Opium. It is a narcotic, as two drachms have produced stupor. Oleander has been used against undigested discharges of food which was eaten the evening before. Phosphorus, the old school say, acts as a stimulant in lientery from debility. . Scilla-marit. is said to cause offensive stools, with hot urine and discharge of undigested food. Purging is not unfrequently produced by it and, when given in excessive doses, purging, pain, griping, and inflammation of the bowels have occurred. As Squills is more of an emetic or stomach-remedy than a purgative or bowel-remedy, it may be best in those cases which depend upon an affection of the stomach. Urinary Organs.—Asarum sometimes causes irritation of these parts, which may be almost as severe as that caused by Cantharides; it may induce pressure on the bladder, with constant desire to urinate; raging, intense pains in the groins, darting through the urethra into the glans, and persisting there for a long time. (11.) Female Sexual Organs.-As before stated, it has been used to cause miscarriage and abortion. It seems to excite menorrhagia in which the menses come on too soon, last too long, with the blood very black It has some reputation against the removal of intense lumbar- pains'at the time of the menses, even when they are so severe that the patient can haidly get her breath. (11.) Larynx and Trachea.-Noack suggests its use in some affections of the chest and air-tubes, in many catarrhal and asthmatic affections, ', a few most troublesome coughs, even whooping-cough, more es- pecially when frequent attacks of coughing are excited by mucus in 766 Asarum-Eur op ceum. the chest, which rises into the throat, causes difficulty of breathing, and is expelled with difficulty; also when the throat feels constricted, and the patient is frequently attacked with oppressed breathing, and a short, hacking cough, which may be excited by simple inspiration, the throat and air-tubes being excessively sensitive. (11) Chest.—It has been recommended, and should be used more fre- quently in rheumatic and pleuritic pains about the chest, in chronic inflammatory affections of the lungs, and, perhaps, in petechia? and spasmodic asthma. The chest-symptoms caused by it are well- marked and very peculiar. It is indicated when there are sharp or dull stitches in one or both lungs, for eight days or more, increased by inspiration, rendering the breathing short and jerking, with a dry, hacking cough ; burning and constrictive sensations, not only in the chest, but in the lungs themselves, as if a sharp wire was twisted around them, and was cutting them through. (11.) It should be used in hectic fevers and chronic pleuropneumonias more frequently than it is," and should do away with much of the routine-treatment of pleuritic pains with the everlasting Bryonia, and hardly less hackneyed Arnica, Cannabis, Sulphur, and Ranunculus. Back.—It may be thought of in some muscular pains of the back, especially when there are burning pains in the small of the back, or across the loins, from the brim of one pelvis to the other, as if the flesh were torn or pulled; or when there is a painful lameness in the back, as if bruised, both in the small of the back and about the shoulder-blades ; when there is pain in the back and nape of the neck, as if a bundle of muscular fibres had been strained by violent exertions, extending over the trapezius muscle to the head and shoulders ; or, painful lameness of the muscles of the nape, as if bruised. It has also been suggested in stiff-neck, when there is a feeling in the muscles of the neck as if a cravat were tied around them too tightly; or, spasmodic contraction of the cervical muscles, with evident flexion of the head to one side. It may prove useful in someof the muscular affections so graphically described by Inman. (11.) Superior Extremities.—It does not seem adapted to many affections of these parts. It may be thought of when there is pain in the shoul- der, when moving it, as from a sprain ; also pain in the deltoid muscle, with lameness of the arm, some pains in the wrists, &c. It may be kept in mind when the hands and feet are very cold, and the head, face, and ears quite hot. (11.) Inferior Extremities.—It may be thought of in some of the accom- panying affections of hip-disease ; also in the pains in the left side, and in one or other of the joints, especially ihe knee-joints, which occur so frequently and persist so obstinately in many nervous and hysterical females, giving rise to fears of consumption or pleurisy, conjoined with joint-disease. It may be used when there is pain, Asclepias-Curassavica et Incarnata. 767 either dull or pressing, or drawing in the hip-joint, with tenderness on pressure, and increase of pain from walking or moving; when there is such a violent pain in the hip-joint from walking that the patient cannot put his foot to the ground. (11.) It has also been suggested against the languor, weariness, and pains in the legs and back, such as are felt in the beginning of fever and ague. (11.) It has some claims to consideration in chorea, when there are spasmodic contractions of the muscles of the neck and of the thighs, with visible twitchings and jactitations of the gastrionemic muscles, arid twitchings of the eyelids. Also against that excessive sensitiveness of the nerves which attends chorea and other nervous affections, so that the slightest noise or scratching produces the most disagree- able sensations. (11.) ASCLEPIAS-CURASSAVICA. Bastard Ipecacuanha. Red-head. Blood Weed. Authorities.—Wood and Bache (7). Watson, of Utica (54). GENERAL REMARKS. This is a very pretty species of Asclepias, from one to three feet high, and bearing hundreds of bright red flowers. It is a native of the West Indies, abounding especially in the islands of Nevis and St. Kitts where it is considerably used as a medicine. Both the root and the expressed juice are emetic; the former in the dose of one or two scruples, the latter in that of a fluid-ounce or more. They are also cathartic in somewhat smaller doses, and the expressed juice, made into a syrup with sugar, has been strongly recommended as a remedy for worms ; the medicine, however, is somewhat uncertain in its operation. According to Dr. W. Hamilton it may also be usefully employed in arresting haemorrhages, and in the treatment of obstinate gonorrhoea, in which it has been found very efficient by Dr. Bacham. ASCLEPIAS-INCARNATA. Swamp Milkweed. AuTHORiTiKS.-Kings Dispensatory (100). Watson, of Utica (54.) GENERAL REMARKS. Reported to be emetic, cathartic, and anthelmintic For the last „ufPose, the powder of the root has been employed, ,„ doses of ten to wenty grains per day. Dr. Tully, of New-Haven, has found it 768 Asclepias-Syriaca et Tuberosa. useful in catarrh, asthma, syphilis, rheumatism, and worms. Dr. Fowler, of New-York, speaks in the most unequivocal terms of its virtues in amenorrhoea, and says that it is capable qf producing abortion in comparatively small doses, i.e., from two to three drops twice a day. He states that it is in common use, among women of a certain class, for this purpose; and, in a case which came under his own observation, it had been used seven times with this view, and each time with success. Dr. Fowler had given it in one case of pregnancy, in a woman with deformed pelvis, with complete success; he gave it in three-drop doses, and, in twelve or sixteen hours, labor- pains were induced, which resulted in a satisfactory expulsion of the uterine contents within forty-eight hours, without subsequent ill con- sequences. He has also prescribed Asclepias in many cases of amenorrhoea, with uniform success. Dr. A. C. Jones, of Philadel- phia, has given it in several cases of suppressed menstruation, without benefit. Dr. Hale, of Michigan, thinks it is the Asclepias-syriaca which is so useful in amenorrhoea, and not the Asclepias-incarnata. ASCLEPIAS-SYRIACA. Common Milkweed. Authorities.—King's Dispensatory (100). Watson, of Utica (54.) GENERAL REMARKS. It is crudely decreed to be anodyne, emmenagogue, diuretic, and alterative, and thought useful in amenorrhoea, dropsy, retention of urine, dyspepsia, asthma, cough, dyspnoea; also in scrofulous and rheumatic disorders. (54.) Asclepione, obtained from the above, and doubtless possessing the same properties, is white, tasteless, and inodorous. ASCLEPIAS-TUBEROSA. Butterfly Weed. Pleurisy Root. White Root, cf c. Authorities.—King's Dispensatory (100). Watson, of Utica (54.) GENERAL REMARKS. It is said to be diaphoretic and expectorant, without being stimulant; in large doses, often cathartic. It is thought, by the botanic doctors, to be a valuable article, acting prominently on the cutaneous system, stimulating the capillary circulation, promoting diaphoresis, expec- <*t9*jrr*-*-. ttli