C«8t
1871
> i
■ i
THERAPEUTICS
OF
DIPHTHERITIS.
A COMPILATION AND CRITICAL REVIEW
OF THE
GERMAN AND AMERICAN HOMCEOPATHIC LITERATURE
BY
F. GUST. OEHME, M.D.,
STATEN ISLAND, N. Y.
SECOND, ENLARGED EDITION.
        BOERICKE & TAFEL,

   NEW. YORK:            PHILADELPHIA :

145 GRAND STREET.        635 ARCH STREET.

             1877. 
WC 320 028t 1877

34811390R
NLfl  DSlbabl?  5
NATIONAL LIBRARY OF MEDICINE
atiiSK?
ARMY MEDICAL LIBRARY
   I ✓ ^, FOUNDED 1836
*x/
WASHINGTON, D.C
NLM051686175 
I 
 
THERAPEUTICS
OF
DIPHTHERITIS
A COMPILATION AND CRITICAL REVIEW
GERMAN AND AMERICAN HOMCEOPATHIC LITERATURE

             by/
      F. GUST. OEHME, M.D.,
          STATEN ISLAND, N. Y.
SECOND, ENLARGED EDITION.
        BOERICKE & TAFEL,
   NE W YORK:             PHIL ABEL PHI A :
145 GRAND STREET.        635 ARCH STREET.
             1877. 
wc 
THERAPEUTICS  OF DIPHTHERITIS.
   The following pages contain a compilation* and critical review
 of the therapeutics of diphtheritis, collected from the German
 and American homoeopathic literature, and translations.  We
 have  arranged the material in a similar way as in Ruckert's
 Klinischen Erfahrungen (clinical experiences), and have men-
 tioned all clinical cases and  general remarksf  regarding  a
 remedy which  seemed of interest,  but omitted all cures with
 medicines in alternation, or by the use of one drug internally
 and another externally (locally).  Although such a mixed treat-
 ment  may be justified  in  many cases, yet, as there  can  be
 nothing learned from them, it seemed useless to mention such.
   Before enumerating the different remedies, which have been
 used or recommended, we wish to bring first a few general re-
 marks on diphtheritis.
   1. The genuine diphtheritis belongs to that class of epidemic
 and contagious diseases, in  which specific vegetable germs in-
 vade the human body, and cause pathological changes (inflam-
 mation and gangrene) in the primary affected membranes, and
 also cause a general  infection and considerable  disturbance  in
 remoter organs and tissues, by entering into the circulation of
 the blood.  {Internat. Horn.  Presse, 6, 577; Balogh.)
   2.   [Nature of diphtheritis and its difference from croup.
  a. Diphtheria prevails during winds
 with a damp atmosphere; in this sec-
 tion of the country, sea winds.
  Diphtheria has a stadium prodro-
 morum, with  angina,  and general
 collapsus and asthenia.
 t Diphtheria commences in the fau-
ces, and may extend to portions of
the adjacent mucous membrane.
  Croup, on the contrary, during dry
winds; in this section, northwest and
west winds.
  Croup commences  suddenly, with
signs of turgor and synocha.

  Croup localizes itself in the respira-
tory membrane.
  *Up to the 1st of March. 1877.
  •(•By general remark, in contrast to clinical case, we understand the indications for the selection
of a remedy, such as we find in works on therapeutics.
>~J -J «■-. -A. T 
4
THERAPEUTICS OF  DIPHTHERITIS.
  The  diphtheritic  exudate grows
out of the submucous tissue, piercing
the mucous membrane, which bleeds
if  the  exudate  be  removed;  the
exudate,  after  passing  through a
stage of low organization, dissolves,
finally, in gangrenous mortification.
  The  fcetor  oris in diphtheria  is
strong and specific.
  The product of croup  is exuded
upon the mucous membrane, which,
if the exudate be removed, appears
injected or cedematous;  it is amorph-
ous, and gradually dissolves in pus.
  In diphtheria neuroparalysis is the
result of an intoxication of the blood,
which attacks the central life of the
nerves.  The amount of the exudate  _
does not seem  to have any  influence i membrane
Upon its development, as there are
cases on record in which this exuda-
tion  was  very  trifling and  even
wanting, and yet paretic symptoms,
even death, in consequence of paraly-
sis of the heart, have been observed
to take place.

  Ztschr.f. horn. Klin.,  18, 57,1869;  Villers.
1,147.
  It is in croup, for a dull smell, in-
different, and only to a finer smell
appears empyreumatical.
  In croup neuroparalysis is the re-
sult of an exhaustion of local inner-
vation, in consequence of excessive
secretion of  the  diseased mucous
Raue's Record,
  b. In diphtheritis the submucous
tissue is affected, besides the mucous
membrane.
  In diphtheritis the surface looks
gangrenous and  ulcerated after the
removal of the exudate.
  Diphtheritis is a destructive, gan-
grenous disease.
  Diphtheritis is mostly epidemic.
  Diphtheritis attacks adults  as well
as. children.
  Diphtheritis is favored by unclean-
liness, squalor, crowded dwellings, in
short, by everything which promotes
the origin or growth of fungi or spores.
  Diphtheritis is the local expression
of a general disease, of an intoxica-
tion of the blood, caused by miasma-
tic influences, and may produce death
as well by local as by general causes.
  Diphtheritis is contagious.

  Ztschr.f.  horn. Klin., 18, 153
  In croup only the mucous mem-
brane.

  In croup, on the contrary, the mu-
cous membrane remains smooth and
whole.
  Croup is a plastic disease.

  Croup is mostly sporadic.
  Croup mostly children.

  Croup is occasioned more by cli-
matic influences.
  Croup is a local disease, which may
kill by paralysis of the nerves of the
larynx or by asphyxia.
 Croup is not.

Hirschel.
  3. Often the local affection is not in proportion, at least appar-
ently, to the general disease; now  the former, now the latter,
is much more violent than one would expect.  Seemingly very
slight cases  prove fatal, or  are succeeded  by severe or  long-
lasting after-diseases.

  4. When  the diphtheritic process reaches  the  larynx, the 
BY F. G. OEHME,  M.D.
5
cough will assume the croup tone, hence the name " diphtheri-
tic croup;" but as a wrong name may lead to a wrong under-
standing of the disease, and possibly, to a wrong treatment, it
is best to  abandon the name "croup" entirely, and call the
disease "laryngitis diphtheritica."  Croup and diphtheritis are
so entirely different in their nature, that they cannot exist to-
gether in one patient.  Croup could never come to diphtheritis,
as a plastic disease  cannot attack an asthenic  patient;  but
diphtheritis may, possibly, come  to croup, but if so the diph-
theritic fungi would find  such  favorable conditions  for their
growth,  that  very  few hours  would suffice to have  croup
entirely changed into diphtheritis.
  5. We may suspect diphtheritis, although we see no exudate,
when a patient, with sore throat, feels  very sick generally
and unusually weak.  The fever may be very slight, even in
dangerous cases.  Foetor oris is not always present.
  6. Our main object should always be to treat with internal,
specific remedies the general disease, the  intoxication  of the
blood, of which the exudation in the throat is merely the local
expression and  consequence, not its cause; the external treat-
ment should be of secondary consideration.   {Allg. h. Ztg., 89,
46 ; Lorbacher.)
  7. In our opinion the genetic difference of  cases and the
complications, caused by different constitutions, are too little,
frequently not at all, taken into account in selecting the remedy.
{Allg. h.  Ztg.,  91, 125 ; Goullon).   Many  do not even attempt
to  individualize, although this  is strictly required in  homoe-
opathy.
  8. Local cauterization,  with  Argent,  nitr. and other  like
substances, is, happily, condemned even  by many  allopathic
physicians as useless and even dangerous; likewise the frocible
removal  of the exudate has been abandoned as a torturous and
injurious process.  On the  other hand, nobody should neglect a
gentle cleansing of the affected parts, or  the  local application
of the internal remedy, provided it is used in such a diluted
form that only its dynamical, not its chemical, action is called
in requisition.
  9. Diptheritic patients should  be  made to take a sufficient 
6
THERAPEUTICS OF DIPHTHERITIS.
amount of nourishing, easily digested food ; often, also, alco-
holic drinks, to prevent exhaustion and paralysis.
  10. When in a case, several remedies have been given succes-
sively and unsuccessfully before the right one, we have always
mentioned them in order to give the treatment as complete as
possible, and to show that drugs considered infallible, proved
ineffectual.
  11. There is not one single remedy which has been highly praised,
but  what some one has found utterly useless.  We must mention
this, because we have left out entirely all negative results; therefore
the reader will please keep this in mind when reading any of
the following  excerpts.  For example, we will note only  the
following.  Payr,  in Wiirzburg, Bavaria,  writes:   " Merc.
hydrocyan., Brom., Sulph. acid., Nitr. acid., Muriat. acid., Iod.,
and  Kal. bichrom. were of avail  not until  the  epidemic had
begun to decrease, eight patients dying out often.   {Allg. h. Ztg.,
80,  73).  The  same may be  said even of the  inhalations of
Carbol. acidum.  {Allg. h. Ztg., 91, 124.)"

  The following  are the  remedies used and recommended
in diphtheritis, followed by a  General Resume:


                     I. Aconitum Nap.

  12. Aeon, is recommended by T. Nichol in laryngitis diphthe-
ritica—a true pathological similitude between the effect of  the
drug and the elementary morbid state, which lies at the root of
the disease. I always used Lodge's  thick, one or two drops to
half a glass of water, one  spoon full every half hour.  (Amer-
Horn. Obs. 9, 449.)

                 II. Ailanthus  glandulosa.

  13. Ailanth. has many well marked symptoms indicating its
use  in diphtheritis {see Allen's Encyclop.):  thick oedematous.
and dry choky feeling in the throat; throat dry, rough,  and
scrapy ; throat tender and sore on swallowing ; the fauces and
tonsils are inflamed, with  spots of incipient ulceration, etc., etc. 
by f.  g. oehme, m.d.
.
   14.  The throat is livid and swollen, the tonsils studded with
 numerous deep, angry-looking ulcerations, from which a scanty
 fetid discharge exudes; the neck is very tender and swollen;
 the tonsils are prominent and  studded with ulcerated points.
 In scarlet fever.  {Ibidem; Chalmers.)
   15.  The patient had some fever and vomiting; on the fourth
 day not a sign of the eruption; extensive diphtheritic exudate
 in the throat.  Ailanth. thick three drops every half hour.
 Two days later a faint eruption on the lower part of the body.
 On the third day after using Ail. all danger past.   Rapid and
 complete  recovery.  A similar, previous case, where Ail. was
 not used, died on the eighth day of the disease and third day
 of the treatment.   {N. E. Med. Gaz., 11, 228; Bryce.)

                       III.  Alcohol.

   16.  Grauvogl recommends the external  use  of  brandy, or
 equal parts of alcohol and water, in order to destroy the fungi.
 If the gargling is too painful the patient may take a mouthful
 hourly, afterwards less frequently, and hold the head backward
 for a few minutes.   Should the oesophagus be  affected small
 quantities may be  slowly swallowed.   The alcohol should be
 kept in the mouth till it causes smarting.  The most extensive
 fungous growth is often diminished  one-half in a few hours.
 This treatment should be continued till the last vestige of the
 fungi  has disappeared.   In very severe cases, however, this
 mode of application is insufficient, especially when hoarseness
 is present; then inhalations of alcohol must be used, diluted
 with  water or not, according to circumstances.  They should
 be prolonged each time until smarting is produced—a sign of
 their effect.  After every inhalation the pain in  the  larynx,
 the hoarseness, and the  dyspnoea are diminished.  The same
 treatment is required when the fungous growth has spread into
 the choanse or nose.   With children the alcohol may be applied
 by means of a small water-color brush.  Gargling with diluted
alcohol is the best prophylacticum. {Allg. h. Ztg., 74, 202; Raue's
 Therap., 122.)
   17.  We order at once to touch  up hourly most spots in the 
8
therapeutics of diphtheritis.
 throat with alcohol by means of a small brush.  If the patient
 is able, we let him gargle with a liquid, composed of one large
 spoonful of water and'5 drops  of alcohol.  Internally we give
 Merc, sol., 3 (1: 99), 0.05 in 3 ounces of water; one spooonful
 every two hours.  As prophylaticum I order after every meal a
 little brandy or claret.   Pursuing this treatment I have not
 lost a case, whilst the allopathic physicians lost a great many.
 {Allg. h. Ztg., 77, 1; Zwingenberg.)
   18. We use in connection with the medicine hourly gargling
 with diluted alcohol;  it shortens the disease materially.  {Allg.
 h. Ztg.,  78, 81;  Sybel.   See So. 24.)
   19. It has proven  an excellent adjuvant to gargle  with
 diluted  alcohol; with small children to touch  up the diphthe-
 retic spots with it, and  where the  larynx was affected  to use
 inhalations.  This is  easily accomplished by a cup of diluted
alcohol  heated to boiling, over  which the child  is held for ten
minutes every two hours.   Light cases of diphtheritis in grown
people are cured quickly  without medicine by merely gargling
 with diluted alcohol.  {Allg. h.  Ztg., 79, 15 ; Heinrich.)
   20. Two cases of severe diphtheritis had a very satisfactory
 course under the internal use  of Mercury and the external
 application of alcohol by means of a brush.  As, however, the
benefit  from  the former seemed  very doubtful  the next  light
 case was treated only with gargling with diluted alcohol;  it
 run equally as favorably.   Three other cases which came after-
 wards under treatment recovered under the exclusive use  of
 gargling.   {Ztschr.f. h. Klinik. 18, 53; K)
   21. Bolle has seen the same happy results from the external
 use of alcohol.   {Pojnd. h. Ztg.,  1868. !No. 12.)
   22. Delicate  girl, ten years old, subject  to throat affections,
and always quickly prostrated ;  diphtheritis.  Aeon., Bry., Kal.
 bichr. unsuccessful.  On  the fourth day, patient rapidly grow-
 ing worse, pulse 140; prostration extreme; somnolence^; and
 occasional  starting up and trying to leave the bed; the mem-
 brane has  invaded every visible part of the throat; the case
 looks very unfavorable.   Arsen. 2, and gargling with diluted
 brandy  (15 drops to a tablespoonful of water), both every hour.
 In five  and a half hours decided improvement.  The patient 
by f.  g. oehme, m.d.
9
 was delighted with the gargle, as it gave her great relief every
 time she used it.   She had begun to expectorate bloody mucus
 and  shreds of lymph in  considerable quantities.  Four days
 later the patient was well.  (N. E. Med. Gaz., 4,69; Hoffendahl).
   23. Boy of six years.   After several days of sickness with
 fever the patient appeared very sick and prostrated.  One mass
 of membrane extended over both tonsils, the uvula, and visible
 part  of the pharynx.  Ars. 2, and gargling with diluted brandy
 every hour.   After a  few hours the membrane began to loosen.
 Recovery four days later.  {Ibidem, page 73.)
   24. "We have applied the same treatment in a case of scarlatina,
 accompanied  by severe sore  throat, with  gray-colored, ashy
 deposits covering both tonsils.  The sore throat begun on the
 second day of the eruption, and there was considerable glandu-
 lar swelling and great prostration ; and as the patient, a boy of
 eight years, was of highly scrofulous diathesis, the symptoms
 were altogether alarming.   Weak brandy and water were used
 as the gargle, and proved very grateful to him.   The relief was
 immediate, and his improvement rapid.  The swelling of the
 glands diminished, and in two days the deposit was entirely
 removed  from  the tonsils.  This method  is well worthy of
 trial.  {Ibidem, page 74; I. T.  Talbot.)

                          Resume.

   In  the above we  have the testimony of nine physicians (see
 No. 29) in favor of the external use of diluted alcohol or brandy.
 We ourselves  have used alcohol with the same good result, also
 whiskey or rum, whichever happened to be at hand ; we dilute
 so  that  the  mixture  still causes a bearable smarting.   Mild
 cases  are  materially shortened by the use of diluted alcohol
 alone without any medicine (see -No. 19.)
  Alcohol has this advantage over all other substances, recom-
 mended externally against diphtheritis, that, being non-medic-
 inal, it allows  the use of any homoeopathic remedy, high or low,
 and is still one of the most powerful destroyers of any fungous
growth.  Besides, where it is desirable, the internal remedy can be
 dissolved in it for external use.   It can be used as a gargle or in 
10
therapeutics of diphtheritis.
 the form  of spray by means of a toilet spray-producer, or as
 steam, or  applied with a brush.
   A simple, but very effective atomizer may be extemporized
 from  the  common Indian rubber syringe, possessed by most
 families.  After unscrewing the injecting tube, connect  the
 syringe with the short tube of a glass atomizer, by means of  a
 short piece of rubber pipe and place the long tube in a vial con-
 taining the diluted alcohol  or medicine.  Hold the  atomizer
 about one foot from the patient's mouth and contract  the bulb,
 whenever  the patient  draws breath.  If an unruly child will
 not open  the mouth,  let the  spray be  taken in  through  the
 nose.   [These glass atomizers are made by Hagerty, 214 Pearl
 St., N. Y. City, at 75 Cts. a doz.]

                      IV.  Alumen.

  25. A weak solution of Alum, is recommended externally by
 Houard.  {Bahnem. Monthly, 10, 359.)

                     V. Ammon. carb.

  26.  Obstruction of the nose; the moment he  falls asleep, he
 is aroused by want of breath.  (Raue's  Therap., 120.)

                VI. Ammonium causticum.
                      Caustic ammonia.
  27.  The second form of diphtheritis commences with a very
 little swelling, but a good deal of fever and pain in the limbs,
 back, and  head.  A few small, white spots on  the tonsils ; they
 continue to spread and become confluent, till the whole throat
 is covered. Sometimes the throat is nearly filled on account
 of the thickness of the membrane.  I have had cases where the
membrane has  extended down the throat at least two and one-
half inches; one of that length I removed from the throat of a
 12 year old girl.   In this  form I use Ammon. caust 1 dec  in
ternally, 15 dr. to two-third glass of water, one spoonful e'verv
half hour; as gargle 30 dr. to a glass of water, every half hour
 The  fever leaves the second day, but  the throat  feels a little 
by f.  g. oehme, m.d.
11
sorer  than on the first day and the exudate has generally ex-
tended somewhat more, but the third day the patient is better
every way and soon recovers.  {Amer. Horn. Obs., 1, 60 ; Brown).
  28. Among many cases, successfully treated with  this medi-
cine,  I shall mention but one.   Girl  of 20 years, corpulent,
plethoric  constitution.   Croupous cough,  which  threatened
suffocation every  moment.   The  lower  part of the pharynx
covered with a white exudate extending down as far as could
be seen.   Patient in the greatest agony, frequently jumping
out of bed and gasping for breath.  Six o'clock, p.m., Ammon.
caust. 15  dr. to a glass of water,  one-half spoonful  every half
hour.  The first few doses nearly strangulated her, deglutition
being so  difficult.   Soon afterwards  she was easier.   Next
morning she was sitting up in bed, breathing freely; has taken
some broth, deglutition very easy, exudate nearly gone; cured
next  day.  In  less severe cases I  put 5 dr. to a glass of water.
{Amer. Horn. Obs., 1, 91,1864; Spranger.)

                          Resume.
   Passing over No. 27 as not absolutely convincing (see Note
to internal treatment in General Resume-), we wish to pay more
attention to the unquestionable  and  remarkably fast  cure  of
laryngitis diphtheritica,  a disease,  which is not  very often
cured, certainly not so rapidly.
   Although there is  but one cure on record, yet we are forced
to consider Ammon. caust. a great remedy in diphtheritis for
the following reasons:
   1.  It is the chemical antidote to  Chlor., Brom. and Jod.,
with which none but very unsatisfactory results have been ob-
tained in this disease.  (See Re'sume' to Brom.)
   2.  Injected into a vein it has  been  used with great success
against the  poisoning by snakes, Prussic acid and even hydro-
phobic dogs.   In  these poisonings (except that by Prussic acid,
with which however diphtheritis has in common the paralytic
symptoms) we have a ferment in  the blood and a constitutional
disease, as in diphtheritis.
   3.  All  who have once smelt too strongly of Ammonia, know
how  quickly it effects the mucus membrane and what violent 
12
therapeutics of  diphtheritis.
suffocation, with  cough, hoarseness,  and whistling breathing,
it produces.  From Allen we quote  the following  symptoms:
Deep redness of the velum, its pillars, the tonsils, and the pos-
terior wall of the pharynx ; the posterior wall of the pharynx,
and the epiglottis, wTere deeply reddened, and like the mouth,
with most intense pain in the throat; great difficulty in swal-
lowing.   Great  weakness.   Great  prostation.  Remarkable
exhaustion; his muscular strenght is diminished to a degree
not proportioned  to the duration of the  disease, etc., etc.
  Its stimulating power can  not  be valued too  highly just in
this disease.
                   VII. Apis mellifica.

  29. During a malignant, very infectious, epidemic Ap. 3 was
sufficient  in most cases;  in  severe  ones,  however, Ars. and
Chin. ars. was necessary; moreover inhalations of diluted alco-
hol, as recommended by Grauvogl, were used in all  cases with
good results.   Under this treatment only six children  under
three years died out  of forty patients, and with  these the
disease  had  spread to  the larynx.  The disease had its crisis
generally on the fifth day ; severe cases, however, not until the
fourteenth day.  Apis, in connection with gargling or inhala-
tions, operated  as a phrophylacticum.  {Allg. h. Ztg., 78, 103;
Neuschafer.)
  30. With Apis 4-6, better  results  were  obtained  than with
Arsen.  and  Brom., as long as the diphtheritis was not of a
septic nature, nor had extended  to the  larynx.  {Allg. h. Ztg.,
78, 75 ;  Sybel).   Since we use externally diluted alcohol every
hour the disease is materially shortened.  {Ibidem, page 81.)
  31.  Apis has proved useful in several light, cases, when the
diphtheritic exudation was preceded by violent fever, headache,
especially pain in the back of the head and neck, and a cutting
pain in the abdomen.  A sign of  its favorable operation is a
light perspiration  after twenty-four hours' administration
{Allg. h. Ztg., 89,  44; Lorbacher.)
  32. Great debility   from  the   beginning; the  membrane
assumes at once a dirty, grayish color; there is puffiness around
the eyes;  pain in the ears when swallowing; an itchy, stinging 
by f.  g. okhme, m.d.
13
eruption on the skin ;  a sensation of weakness in the larynx ;
numbness of the  feet and hands, and even paralysis.  (Never
does good either before or after Rhus tox.) (Raue's Therap., 119.)
  33. Great dibility characterizes the case even from the onset;
absence of thirst;  scantiness  of urine;  the  membrane  has a
dirty-gray color;  the pulse is very quick, at least 140; puffiness
about  the eyes;  an  eruption appears upon  the skin,  which
itches and stings.  (Guernsey's Obstetrics, 945.)
  34. The first diphtheritic patches generally appear on  the
arches of the palate and on the uvula.  The uvula is cedematous
and elongated; the urinary secretions are entirely suppressed, or
there is  excessive albuminous urine; deglutition is very pain-
ful ;  heat is very  unpleasant to the patient.  Great  restlessness
with an uncontrolable tossing about and trying to get off  the
bed.  This form is frequently  found in combination with scar-
let fever.   {World's Horn. Convention; Lippe.)
  35. Boy of fifteen  years.   The whole of the fauces covered
with  diphtheritic exudate,  and  already one-half of the  uvula
destroyed.  Ap. 3 every two hours ; painting with a solution
of one part alcohol and two  parts water three times a day.
Recovery in four days.   {Allg. h. Ztg., 78, 103 ; Neuschafer.)
  36. Boy of ten years.   Both tonsils almost entirely covered
with  exudate. Apis  every two  hours, and diluted  alcohol
externally every hour.  The  superficial exudate  removed in
twenty-four hours; the more imbedded in  three  days.  Two
other cases in the same family recovered  equally as  quick.
{Allg. h. Ztg.,  78,81;  Sybel.)
  37. A girl of four years suffered several days since from sore
throat, fever, and general indisposition at a time, when several
malignant and fatal  cases of  diphtheritis happened.  During
the following two days the whole fauces were filled up with
diphtheritic exudate,  some membranes also showed themselves
in the mouth, and especially on the lips and corners  of  the
mouth; easily bleeding of the affected parts;  violent fcetor oris;
a yellowish, very offensive-smelling secretion from both nostrils;
considerable swelling  of the submaxillar and lymphatic glands
of the neck; the  general condition becoming worse and worse;
not much complaint  in swallowing.  Ap. 3,  every two hours, 
14
therapeutics  of  diphtheritis.
3 drops; injections of diluted claret; externally warm  poul-
tices.   Recovery in about fourteen days.   {Allg. h. Ztg., 79, 19;
Polle.)
  38.  Boy of nine years.  Diphtheritis after  the  eruption  ot
scarlatina; slight bleeding of the affected parts; offensive smell
from mouth and nose ; yellowish and offensive-smelling  secre-
tion from the nose ; glands of the neck much swollen; swallow-
ing comparatively little painful; general  condition  of the
patient very serious; violent  fever; very great' thirst; constant
delirium.   Ap. 3, every  two hours, 3 drops;  externally warm
poultices; painting of the  exudate with diluted alcohol (1: 4),
and injections of it in the nose.  Two days later the favorable
effect of the treatment apparent,  and five days later  the re-
moval of the exudate;  after which the affected parts  showed
deep cavities.   {Ibidem.)
  39. Three mild cases of  diphtheritis were cured  in five days
under the same treatment.   {Ibidem.)

                          Resume.

  Apis has been used or recommeded:  1, in lighter cases, es-
pecially when proceeded by much  fever, headache, pain in back
of head and neck (29, 31, 39); 2, in severe cases, as  long as they
are not of a decidedly septic character (30, 35, 36, 38);  3, when
present great  debility from the onset, puffiness about the eyes;
itchy eruptions, etc. (32, 33); high fever  (31, 33).
  In  No. 37 the recovery was too  slow to be convincing.
  Apis  may  be  particularly  serviceable,  when  diphtheritis
appears during scarlet fever  (34, 38).
  Apis should be left  off, when  the disease  spreads  to  the
larynx (30.)
   There seems to be a greater discrepancy in the quality of the
different preparations of Apis than of any other medicine.   Phy-
sicians have often found one preparation useless,  but  another
very effective, and have  drawn attention to this fact.
   Indications  for the  selection of  Apis are  the following*
 symptoms: "Violent inflammation of the throat; much dryness,
* The following quotations are taken from Allen's Encyclopedia of Pure Materia Medica. 
BY F.  G. 0EHME,  M.D.
15
burning, stinging, roughness ;  sensation of fulness; contraction
and suffocation in the throat; difficult swallowing; tonsils very
much swollen; throat swollen inward and outward;  marked
prostration  and depression ; nervous restlessness; itchy erup-
tions of the skin ; oversensitiveness of the skin to touch ;  much
fever."
  Because one physician  has found  Apis of  no benefit  in
diphtheritis of the  larynx, it  does not follow, that  it will  be
thus in all cases, as we cannot expect one drug to be the only
remedy for this disease.  If we take into account the following
symptoms:  "Voice  grew  hoarse ; breathing and swallowing
very difficult;  difficulty of swallowing not  caused by the swell-
ing of the throat, but by the  irritation  of the epiglottis; sen-
sation as  of a  rapid swelling of the lining membrane of the
air-passages; rough  voice;  speaking painful;  hoarse cough ;
intense sensation of suffocation, could bear nothing  about the
throat; hurried, difficult respiration ; labored inspiration as in
croup, etc.;" we see no reason why  it should be neglected in
such cases.
  Although there is  no case on record where Apis  has cured
a paralysis, yet  it has the  following paralytic symptoms:
"Crawling as if  going to sleep in  both arms;  very  distinct
sensation of numbness in the fingers; lower limbs feel  paralyzed;
weakness of sight, etc."  This we mention, because a true remedy
against diphtheritis should also have a paralytic effect'upon the
system to correspond to the totality of the disease.

                     VIII. Arsen. alb.

  40. In several, not very, severe cases Merc. sol. did not stop the
inflammation of palate and fauces, and a rather thick grayish
white exudate would not disappear;  no foetor oris, no swelling of
the submaxilliary glands, no salivation;  the fever threatened to
become adynamic.  In such cases repeated doses of Ars., 2d trit.
(1: 9), proved beneficial. Perhaps  it might be used successfully
also in severe cases, where gangrene of the mucous  membrane
threatens, and  there is salivation,  adynamic fever, and prostra-
tion.   (Hirsch. Ztschr.f. h. Klin.,  13, 142;  Trinks.) 
16
therapeutics OF  DIPHTHERITIS.
   41. Arsen. 6 (1: 9), four to five drops hourly, is—besides the
 external use of alcohol—the chief remedy against gangrene of
 the affected parts; frequently it has to be used  from  eight to
 ten days.  The use of alcohol alone is not sufficient to  prevent
 the gangrenous destruction; neither is the sole  use of Arsen.
 sufficient to destroy the mould.  Both have to be used together.
 {Allg. h. Ztg., 74, 202 and Raue's Therap., 123; Grauvogl.)
   42. Arsen. 3d or 4th dil. (1: 9), every two or three hours, is
 specific against diphtheritis; with a stronger solution  I paint
 the throat (internally), after having it swabbed with cold water.
 Diphtheritis of the larynx is mostly fatal, and requires other
 remedies.  (Ilirsch. Ztschr.f. h. Klin., 17, 5; Sorge.)
   43. In the non-malignant diphtheritis Arsen. 3 and frequent
 wabbing with fresh water  have always rendered  good services.
 (Kafka's Therap., 1, 433.)
   44. Great restlessness; constant desire for cold drink, taking
 but little at a  time;  or better  by drinking  hot water;  all
 symptoms worse about midnight.   (Raue's Therap., 120.)
   45. Pale  face, seldom red; feeble, quick pulse ; sensation of
 internal  heat;  intense thirst; difficult deglutition ; extreme
 lassitude, with  desire to remain  lying down ; pain  in limbs
 with weariness; tongue brownish; sickening,  fetid, putrid
 odor from the mouth; tonsils and soft palate partially or fully
 covered with a grayish-white deposit; sometimes bleedino- from
 the  nose with acrid discharge; nausea and vomitino-.   After
 the  use  of Arsen. 1 dec. (!), 10 gr. to half pint  of water, in-
 ternally and  as  a gargle, from 24 to 48 hours, the deposit loos-
 ens and  separates  from the tonsils and palate in touo-h mem-
 braneous pieces, leaving the mucous membrane dark red, swol-
 len and sore, for which condition I usually give Bell, or Merc.
 This treatment  has been satisfactory in every case  for the last
four years.  {Trans, of the H. M. S. of N. Y., 7, 262  1869 • J
Barrows).
  46. The  membrane  is dry-looking and wrinkled,  and may
cover the entire fauces; very fetid breath;  great  dysphagia •
very  great prostration;  the  child  wants water  often  but in
small quantities; great restlessness, particulary after midnight-
warm drinks are sometimes desired instead of cold.   (Guern'
sey's  Obstetr., 945.) 
BY F.  G. 0EHME,  M.D.
17
   47. When the advanced septic form appears.  Great fetor
from the diphtheritic deposits and oozing of blood from under
the elevated portions of the thickened deposits.   Great thirst;
inclination to be warmly covered.  Restlessness ; although very
weak, the  patient desires to have his position, and  even  the
bed or room, frequently changed.  (World's Horn. Convention ;
Lippe.)
   48. Bakody  used  Arsen. 3-6 with  such  excellent  result in
the genuine and scarlatinous diphtheritis, that he lost none out
of twenty-two cases.  {Internal. Homoeop. Presse, 6, 585.)
   49. Boy of 12 years.   Bell., Merc,  Apis, ineffectual.  Very
violent fcetor oris; in the throat a thick, dirty-looking exudate,
between whose cracks a discolored liquid oozed out; dysphagia;
violent thirst;  weak, small pulse; sunken face; sticky perspi-
ration ; abdomen extended; constipation.  Arsen. 8, afterwards
in alternation  with Nux, removed the danger in four days.
{Allg. h. Ztg., 64, 108 ; Fielitz.)
   50. Two girls of 14 and 29 years.  Diphtheritis; all remedies
which  had been used, ineffectual.  On  the fourth  day  the
burning pain extended into the stomach.  They live and sleep
in a moist kitchen.   Very painful swallowing;  rapid collapse. '
Arsen. 30 every two hours.  The next night sleep, the follow-
ing day no fever, and the burning pain only trifling.  Quick
recovery.   {Allg. h. Ztg., 78, 14; A. R.).
   51. A one-year old girl had pneumonia crouposa of the  left
lower lobe, which terminated in an abscess.   A cavern the  size
of a  goose's egg could be proved.  There was  present very
great anaemia,  great prostration, and obstinate exchausting
diarrhoea.  Finally diphtheritis appeared.  The  entire fauces
were  covered  with a  thick  web-like  exudate; swallowing
became impossible on account  of paralysis  of the muscles of
the throat; drink came out through the nose and caused violent
coughing.  The child could breathe only with the mouth wide
open.  Its mother succeeded in its taking, during six  or eight
days, small quantities of milk, while lying on its back with the
mouth wide open and the tongue  perfectly still.  The throat was
swabbed every  hour with fresh water.  Ars. 3, two teaspoon-
fuls every two hours.  This child, though given Up by every con-
     2 
18
THERAPEUTICS OF DIPHTHERITIS.
suiting physician, recovered completely.   (Kafka's Therap., 1,
433.)
                         Resume.

  Arsen. is recommended und used, when the fever becomes
adynamic (40, 45, 49), when there is great prostration or col-
lapse (22, 23, 40,45,46,49, 50, 51), great restlessness (44, 46, 47),
great thirst, constant desire for small quantities of drink (44,
45,46,47, 49), gangrene (40,41,47), fetid breath (45,46,47, 49),
dysphagia (45, 46, 49, 50, 51).   Besides  these symptoms, the
following are mentioned  in the cases: perspiration sticky and
abdomen  extended  (49);  burning  pain  extended  into the
stomach  (50); exhausting  diarrhoea and  great  anaemia (51);
somnolence and occasional starting up and trying to  leave the
bed (22).   (The dysphagia seems to be caused more by paralysis
than by swelling of the affected parts.)
  We wish to draw attention to the following:  1. Almost all
the general remarks (40-45) and the  cases (49, 51) belong to the
earlier literature on diphtheritis (till 1869); there is nothing of
any consequence since then, regarding this remedy.   2. Trinks
(40) speaks of its use only in not very severe cases, Kafka (43)
in non-malignant, and they use  it, even then, quite low.
3. Grauvogl  (41)  recommends Arsen. not without the external
use of alcohol, Arsen. alone being insufficient.   4. Sorge (42)
considers Arsen., low, specific in diphtheritis, but not without
a still  lower  dilution  externally.   These physicians seem  to
depend as much on  the fungus-destroying as on the  dynamic
power  of Arsen.   Trinks does not  speak of applying it  ex-
ternally, but he gives it so strong (^ gr.) that  the mere
swallowing cannot help having a local effect.
  It follows  from all this:  1. That Arsen. is not the remedy
for diphtheritis with a severe inflammation of the throat and
its accompanying symptoms.  2. That the dynamical influence
of Arsen., even on  the gangrene of the  throat, is very  insuf-
ficient, as all physicians lay great stress on the  external treat-
ment, i. e., on the direct destruction of the fungi.  3. That its
sphere of action is only in a laier stage of the disease, especially
when the above mentioned  group of  symptoms prevails.  It is 
BY F.  G. 0EHME, M.D.
19
therefore, not a principal diphtheritis remedy, and has not been
used much, since the attention  has  been drawn to such as
Mercur. hydroc, Carbol.  ac, and Salicyl. acidum.
  Arsen. is not the remedy for diphtheritis of the larynx (42).

                     IX. Arsen. jodat.
  52. Girl, aet. 5, scrofulous.  Sickly from birth; asthmatic;
croupy symptoms prominent;  hoarse cough ;  diphtheritic  de-
posit covering mouth from fauces to outer edge of lips, and also
covering external auditory canal; short, difficult respiration;
pulse weak, slow ; great prostration ;  bad odor  from patient.
Arsen. jod., 1st trit., cured {Hahnemannian Monthly,  February,
1874, p. 297 ;  Raue's Record, 6, 86 ; F. Bigelow.)
  N. B.—Arsen. hydrobrom. has also been used.

                      X.  Arum triph.

  53. Constitutional symptoms of diphtheria with  congested
throat;  it will often cut short  the disease.  {Hahnemannian
Monthly, March, 1874, p.  358;  Raue's Record,  6, 86; W. R.
Childs.)
  54. The discharges from the nose and  mouth are very acrid,
and excoriate  the skin whenever they come in contact with it.
The lips become very sore and swollen, and the  skin peels off;
the  patient continually  picks at these peelings, trying to pull
them off, and  thereby makes the lips bleed.  Drink is refused
on account of the great soreness of the mouth; the breath is
verv fetid, and the cavity of the mouth is covered with  diph-
theritic deposits and ulcers.  There is very great restlessness,
the patient crying and throwing himself into all sorts of posi-
tions.  (World's Horn. Convent. ;  Lippe.)

                  XL Baptisia Tinctoria.

  55. Oppressed breathing unto suffocation, because  of pulmo-
nary congestion.  Rising in bed  does not relieve ; the patient
must go to the window for fresh air.   (Raue's Therap., 120.)
  56. The cases in which Baptisia  is  indicated seem to  be 
20
THERAPEUTICS OF DIPHTHERITIS.
those where  there is little pain.   Sensation  of great fulness,
oedematous swelling of the affected parts, especially affection
of the posterior opening of the nose, little pain or soreness of
the fauces,  characterize  the  most  dangerous form of diph-
theritis.   {Ohio Med. and Surg. Reporter, 1, 144.)
  57. Baptis. is indicated, when  the following symptoms are
present:  prostration, chilliness of the lower  limbs and back,
with  fever at night; burning heat of the face, with flushed
cheeks; pulse accelerated  or slower than in health; headache,
bruised feeling in the occiput;  tonsils and  soft palate swollen,
with constant inclination to swallow, not accompanied with pain ;
aphonia ;  the tongue is coated white, yellow or yellowish-brown,
and feels as if burnt or scalded ; the root, especially, is swollen
and feels numb; constipation  or diarrhoea, the stools dark and
blood streaked.   Occasionally delirium, with  confusion of sight
and  almost complete  deafness.  {Amer.  Horn.  Observ., 5, 233;
Hoyne.)
                     XII. Belladonna.

  58. Belladonna is only in its place, if the diphtheritis com-
mences with high fever and severe inflammation of the tonsils
and fauces, but  not  after the  exudate has appeared.  {Baehr's
Therap., 1, 328.)
  59.  In  an  institution  for  orphan girls, diphtheritic  sore
throat prevailed with  and without exudation.   The  disease
distinguished itself by high fever, headache, debility, bright-red
swelling of the  fauces, often thin, yellowish exudate.  Bellad.
30, cured  quickly.   {Ztschr. f. h.  Klin., 14, 155 ;  C.  Wessel-
hceft.)
  60.  The patient is restless, complains of sore  throat-  the
fauces look highly inflamed;  the pupils are enlarged;  he feels
drowsy, and  yet unable to fall asleep;  starts suddenly out of
sleep.  (Raue's Therap., 119.)
  61.  Hughes affirms that Belladonna is frequently the specific
remedy even in severe cases, and  that the treatment  can  be
always commenced with it, but that it should not be continued
if there is no decided  improvement after  twenty-four hours
or if the symptoms return after they have left.  {Allg  h Ztq
84,152.)  '                                            '   y'" 
BY F.  G. 0EHME, M.D.
21
   62. When the  patient finds the disease coming on  quickly,
is afraid she will choke to death, and  knows she will not get
well, will not lie down for fear  of choking, Belladonna will
relieve promptly, but will not complete the cure alone.  {Hah-
nem. Monthly, Aug. 1872, p. 16. and  Raue's  Record, 3, 119;
W. McGeorge.)
   63. The inflammation of the tonsils and fauces might induce
one  to select Belladonna in the very beginning of the disease,
but  it would not have the least  influence upon the course of
the diphtheritis.  {Allg. h. Ztg., 89, 44;  Lorbacher.)
   64. The throat has a highly inflamed appearance;  is very red
and shining; drowsiness;  the eyes are very much injected ; the
face  is flushed; there is throbbing of the carotids; the pulse is
very rapid;  the child complains occasionally of  chilliness;
great difficulty in swallowing, with pain running up  into the
ear.   (Guernsey's Obstet., 946.)
   65. The patient complains, from the onset, of much dryness
in the throat and great pain on swallowing.   The glands of the
neck swell at once, the throat looks red, the neck becomes stiff.
The  patient is very drowsy, his head is hot and painful.  Under
such circumstances the disease may be entirely prevented from
further development, even though there may be diphtheritic
cases in the same house.   ( World's Horn. Convention ; Lippe.)

                          ResumS.

   Belladonna is  in its place only in  the beginning of the
disease, when there is very severe  inflammation, or in very mild
cases;  but it is inferior in every  respect to Apis, which takes
here its place. (See Resume to Apis.)

                      XIII. Bromium.

   66. Bromium is recommended  by Black against  the malig-
nant forms.   Great weakness and  lassitude after all other symp-
toms have passed off is  a symptom of Bromium, and also a
characteristic one of diphtheritis.  (Bsehr's Therap., 1, 329.)
   67. The beneficial influence of  Brom. 1 (1: 9), 12 drops to 6
ounces of water  every one or  two hours, one tablespoonful, 
22            THERAPEUTICS OF DIPHTHERITIS.

shows itself in this wise, that the salivation becomes  less and
the exudate decreases.   But as there may be cases where the
disease may spread to the larynx, although  there  is not much
exudate in the fauces, we  use  Brom. 1  (1: 9), 20 drops  to 1
ounce  of  Glycerine, also externally.  In order  to keep the
larynx free from the disease we blow 1 or 2 grs. of Kal. hydro-
brom. 1 in  the mouth during an inspiration.   (Hirsch, Ztschr-
f. Klin., 11, 189;  Mayhoffer.)
  68. The nature  and character  of diphtheritis and croup are so
completely and entirely different that the remedies of one disease can-
not be those of the other (see 2, a and b). {Ztschr. f. h. Klin., 18,
57; Villers.)
  69. Brom. and Chlor. have the power to destroy miasm. With
their vapor the air can be purified and  epidemics prevented.
A few  drops of a solution of either will prevent infection from
diphtheritis, and  we have saved whole families from  it by or-
dering each member to take Brom. water (daily 10 to 12 drops in
sugar water).  A whole boarding-school, close to a diphtheritic
hospital, was  saved  by fumigations with  Brom.  A  remedy
which destroys the origin of a disease, must be important also
in its treatment.  {Allg. h. Ztg., 79, 8 ; Ozanan.)
  70. Brom. water is made by dissolving 1 drop of Brom. in
25-50 gram, of water, and is given in drop-doses every hour, so
that |-2 gram,  of the  solution are consumed in twenty-four
hours.   Or one may use fumigations or  inhalations of Brom.
Brom.  water is poured into boiling water; a funnel of paper or
glass is inverted over it, and the  whole put before the patient
for inhalation.  Only four or five cases of croup died out of 150
cases of croup and diphtheritis treated in this way.  {Allg. h-
Ztg., 79, 14; Ozanan.)
  71. The  field for  Brom. is the pseudo-membrane, and it
operates in most cases favorably, but has no influence on the gan-
grenous process.  {Ibid., 79, 28; Ozanan.)
  72. Diphtheritis begins in the larynx and  comes upwards,
with hoarse and croupy cough, fearful pulse; all the symptoms
dangerous.  (Raue's Record, 2,  73.)
  73. In cases where the membrane forms back, almost over
the  larynx.  I have found it very serviceable in  my own case, 
BY F.  G. 0EHME, M.D.
23'
removing husky tone of voice in a few hours.  Brom. has pref-
erence for the left side of throat also, and  stiffness of neck
sometimes accompanies it.  {Ibid., 4. 85.)
   74.  When the disease commences in the larynx and comes up
into the  fauces, and in some cases in which it runs down  into
the larynx and produces a croupy cough, with much rattling of
mucus.  In either case there is rattling of mucus in the larynx
on coughing, and the cough has a croupy sound.  (Guernsey's
Obstet., 946.)
   75.  We  have treated successfully 21  cases of  diphtheritis
with Brom.   Of these 4 were light, 2 complicated with scarla-
tina ; in one the disease had spread to the larynx, and the rest
were mostly malignant.   We poured 2-3 drops of the 2d or 3d
dil. (1:9) in half a glass of water, and gave  one tablespoonful
every one, two, or three hours.  No external  treatment.   The
operation of the medicine was even  in neglected  cases quick,
and the convalscence required only a  few days after the removal
of the exudate.   Brom. is indicated in all cases where a croup-
ous  inflammation is formed  by the exuberant growth of  the
fungi.  It  is the  only  remedy  in diphtheritis of the larynx.
{Internat. h. Presse, 6, 591; Balogh.)
   76. Funkel (allopath) used Brom. only externally in  three
cases of diphtheritis.  After the first application the foetor oris
disappeared.   On  the following day the ulcers were  perfectly
clear, and healed quickly by the external use of Arg. nitr. (!).
{Ibid., 6, 592.)
   77. Man of 28 years.   Violent diphtheritis these two days.
The tonsils and the back part of the fauces completely covered
with firm, thick exudate ; pulse 120 ; weakness.   Cauterizing
with Arg. nitr. for three days useless.  Lemon juice externally
for one day useless.  Faintings ; face ashy-gray ; cheeks sunken ;
pulse very soft.  Brom., 3 drops to 200 gram, in water; every
hour one tablespoonful; improvement already by evening ; a
quieter night.  The next day freer expectoration.  Three days
later the membrane came  off in large pieces and  formed again,
but thinner and smaller ;  pulse 110.   Recovery from the diph-
theritis five days later.  The subsequent  paralysis  removed in
four months.  {Allg. h. Ztg., 59, 14;  Ozanan ) 
* 24           THERAPEUTICS OF DIPHTHERITIS.
   78. Stout girl of 5 years.  Diphtheritis since yesterday.  Both
tonsils completely covered by exudate ;  face red; skin burning
hot; pulse 148 ; 5 drops Brom. water (see 70) to 150 gram, wa-
ter, and 30 gram, sugar syrup; hourly one tablespoonful.  The
next night better;  pulse 122.  On  the fifth  day only little
exudate.  Relapse on account of mistake in diet.  Recovery
on the ninth day.  {Ibid., 79, 21;  Ozanan.)
   79. Girl of  13 years.  Diphtheritis since  yesterday ;  pulse
140.  Right  tonsil completely covered with  thick exudate,
Feeling of suffocation; skin hot; vomiting twice.  Brom. water
one dr. every two  hours.  The next day worse; then slow
improvement.   The  sixth  day cough, with  croup-tone  and
hoarseness; pulse 120.  Expectoration  of much thick mucus,
and of a piece of membrane one centimetre broad and one and
a half centimetres long.  Still larger pieces thrown out during
the next two days.  Diphtheritis removed on the twelfth day.
Complete  recovery several days later.  {Ibid.)
   80.  Boy of 5 years.  Scarlatina, and  on the ninth day diph-
theritis.   On the third day of the diphtheritis  Brom. water 20
dr. to 150 gram, sugar water.  The next two days no change-
On the eighth  day removal  of the exudate.   {Ibid.)
   81.  Boy of 3 years; diphtheritis since yesterday;  Brom.
water; cured in four days.  {Ibidem.)
   82.  Man of  25 years;  diphtheritis; Brom. water; the next
day worse; faintings and vomiting; pulse small, 60; the exu-
date more extended;  Brom. continued; the following  day
better.   Cured two days later.  {Allg. h. Ztg., 79, 28 ; Ozanan).
   83.  The wife and two children of a diphtheritis patient took
Brom. water as a prophylacticum.  The children had a  slight
attack of  it, the mother not.  (Ibidem.)
   84.  Man of  65 years; middling severe case of diphtheritis ;
Brom. water from the beginning of the disease.  Cured in seven
days.   {Allg. h. Ztg., 79, 38 ; Ozanan.)
   85. Man of  37  years; on the third day very  violent diph-
theritis; pulse 120;  Brom. and Bell.; the two following days
the same  condition.   On the seventh  day  the  right  tonsil
swollen very  much; pain very severe;  Brom.  continued.  On
the eleventh day the abscess opened.  On the sixteenth day no 
BY F.  G. 0EHME, M.D.
25
 more exudate visible.   In the same house eleven other persons,
 adults and children, taken  with diphtheritis and  cured  by
 Brom.; but a child of 16 months died of diphtheritis of the
 larynx.  {Ibidem.)
   86.  Man of 48 years.  In spite of Aeon., Bellad.,  Apis, and
 Laches., each taken one  day,  the diphtheritis made rapid
 progress.   A large part of the  velum, the whole uvula, and
 both tonsils, covered with exudate;  foetor oris;  hoarseness;
 rough, dry cough;  dyspnoea; quick, weaker-growing  pulse.
 Brom., 3,4 dr. to half a glass of water, one spoonful every two
 hours.  Decided improvement by  evening, which continued
 during the following  days, but  the exudate  remained un-
 changed.   1 dr.  undiluted Carbol. acid, to 1 glass of  water, for
 gargling every hour, removed the exudate in about ten hours.
 {Allg.  h.  Ztg., 85, 4;  Hirsch.)

                          Resume.

   Ozanan, the strongest advocate of Brom., does not seem to
 be clear in his own mind, because, without giving  any special
 indications for this medicine, he considers it  the sole remedy
 against diphtheritis, and at the same time  says in another
 place (71): " The field for Brom. is the pseudo-membrane, but
 it has no influence on  the gangrenous process," which means,
 in other words,  " The field for Brom.  is croup, but  it has no
 influence on diphtheritis" (see 2 b, diphtheritis is a destructive,
 gangrenous disease).  It is, therefore, not strange that his cases
 are not remarkable recoveries, viz., in the 1st case (77) (the best
 recovery of all), it required eight days to remove the exudate;
 in the 2d, the exudate not quite removed in five days; in 3d
 (79), the  next day after Brom., patient worse, then  slow im-
 provement, exudate removed not until the twelfth day of treat-
 ment;  in  4th  (80), no change for two days after Brom.; 5th
 case insufficiently related; in 6th (82), worse the next days after
 Brom.; in  7th (84), Brom. from the beginning of a medium case,
cured in seven days; in the 8th (85), the next two  day  after
Brom., no change.  Such cases are no proof in favor of Brom.,
but just the opposite. They are not worth the printing, because, 
26
THERAPEUTICS OF DIPHTHERITIS.
when a medicine is the right one, it operates at once, and the
recovery is quick, no " next day worse," or " no change for two
days."  In No. 86 Brom., not answering to the totality of the
disease, was unable to remove the  exudate, but Carb. acid, did
it  in  ten hours; on the contrary, Brom. removed the exudate
quickly in No. 76, because it was given in  the  former case in
the 3d dil. internally (dynamically insufficient); in the  latter,
used quite strong externally (chemical action).
  Ozanan's reasoning, that  Brom.  must  cure  diphtheritis,
because it destroys  all fungous growth, is absurd ; the reasons
are obvious.
  Balogh (75) does not mention a most important item, {. e.,
the number of days it required to remove  the exudate.  His
statement  is not of much weight, because the requirements of
a medicine by some physicians (like Ozanan) are very moderate.
The same may be said of Mayhoffer (67), but as he used the
remedy also externally, he secured the chemical (fungus-de-
stroying) power of Brom., and may have thus obtained a better
success.
  Nos.  72 and 73 are very indefinite.  Brom. is here recom-
mended when the disease commences on the very lowest part
of the fauces, spreading upwards, which is contrary to the usual
beginning.
  Guernsey (74) might just as well  have expressed himself
briefly, thus, in diphtheritis of the larynx with much rattling.
Ozanan and Balogh also consider Brom. the remedy for diph-
theritis of the larynx.
  When B?ehr wrote his  Therapia, very little had been written
on  the  treatment  of  diphtheritis;  this explains his meagre
remark {66).
  Ozanan's misgivings that Brom. is a remedy  for croup, but
not for diphtheritis, is fully affirmed by Villers (68).
  In No. 83 Brom., as a prophylacticum, proved useless in two
cases out of three.
  The use of Brom. in diphtheritis rests on these three points:
1, that it destroys fungous growth; 2, that diphtheritis, when
spreading  to  the larynx, produces symptoms similar to  croup
(croupy cough, hoarseness, difficult,  croupy  breathing);  and 3, 
BY F.  G. 0EHME, M.D.
27
that Brom. is an  important croup remedy.  To reason  from
this that it is also a great remedy against diphtheritis of the
fauces or larynx, is a wrong conclusion.   If diphtheritis and
croup are two entirely different diseases in their nature and
character (2 a and b), Brom., being a chief croup remedy, cannot
at  the  same time be a  great diphtheritis remedy, because
a drug has not only to cover the symptoms, but must likewise
correspond to the character of the disease.  How can one and
the same remedy answer to a sthenic and an asthenic disease,
to a plastic disease and one whose tendency from the onset  is
decay, exhaustion, paralysis ? Do we give Bellad. for headache
in the full-blooded and robust, and  also in the bloodless and
feeble ?
  We shall speak of the fungus-destroying power of a medicine
in the General Re'sume' after the remedies, as we cannot repeat
in the Resume" of each drug, of a like nature, what we have  to
say on this point.

                   XIV.  Bryonia  alba.

  87. We  have used Bryon. tinct., 1 dr.  every  two hours,  in
two cases of diphtheritis, in which  the fever was  slight, the
throat complaints insignificant, and the general condition  of
the patient little disturbed.   The recovery required in one case
ten, in the other fourteen days (!). (Hirsch., Ztschr.f. h. Klin.,
11,189; Mayhoffer.)
  88. The patient is quickly prostrated, shuns  all motion, and
complains  on moving, or when being moved, of pain every-
where ; white tongue; feeling of dryness in the mouth, without
particular thirst or desire for large quantities of water.  (Raue's
Therap., 119.)

                XV.  Calcarea chlorata.
                       Chloride of lime.
  89.   R. Hughes in his account of fifty cases, after canvassing
the claims of the  various remedies, finally comes to the con-
clusion  that our most hopeful outlook is in  the direction  of
such antiseptics  as the Permanganate of potash and Chloride  of 
28
THERAPEUTICS OF DIPHTHERITIS.
lime.  We have defended the employment of this remedy on
a higher ground than as a mere antiseptic.  We have prescribed
it frequently, because  it  best answered the whole pathological
state as well as the symptomatology of these cases.   During
five years not  a single case  of diphtheritis was lost, although
some of the cases were of the most dangerous character.  Chlo-
ride  of lime was used both internally and locally.   Internally
I dissolved from 8-20  dr. in half a glass of water, one spoonful
every half to two hours.   Previous to giving this  solution
internally, I used  a gargle  containing  1 teaspoonful  of Liq.
calc. chlorin. to two-thirds  of a  glass of water.  I only used
the gargle where there was a  great amount of diphtheritic
deposit.   It removed the  membrane rapidly.   The  disease
commenced with a feeling of general indisposition, soreness  of
the throat, throat and fauces highly inflamed, tonsils swollen?
loss  of appetite,  fever,  and restlessness at  night.   These
symptoms after twenty-four  or thirty-six hours, were followed
by complete prostration;  the throat  and fauces covered by a
rapidly spreading membrane, extending  up into the nose, caus-
ing complete obstruction, discharging a sanious ichor; exces-
sive  foetor oris ; the  glands of  the  neck enormously swollen;
complete loss of appetite; great pallor ; nausea ; vomiting;  more
or less diarrhoea.  Under the action of Chlor. of lime, the dan-
gerous symptoms would disappear sometimes  in two or three
days, though sometimes they would  last from  ten  or  twenty
days before convalescence.  Out  of nearly one hundred cases I
lost only two, and these were diphtheritis of the larynx.  {Am.
Journ. of Horn. M.  M., 7,452; C. Neidhard.)   (A shorter, simi-
lar notice by the same physician is found, N. E. Med. Gaz., 2,
280.)

                         Resume.
  As Brom. and Iod. are chief remedies in croup, and as Chlo-
rine  is very intimately allied to both, it follows that it likewise
is an important croup medicine, and  will have,  though not  as
yet  used, a like definite place  assigned as  Iod., Brom., and
Spong.  But as croup and diphtheritis are entirely different in
their nature and character,  it further  follows that Chlorine 
by f.  g. oehme,  m.d.
29
 like Brom. and Iod., cannot be a homoeopathic remedy against
 diphtheritis.  The result obtained is  not  due to its dynamic
 effect, but to its fungus-destroying power;  (see  Re'sume- to
 Brom. and General Re'sume.)

                      XVI. Camphora.
   90. Camph. has been used by some allopathic and  undoubt-
 edly also by homoeopathic physicians, but it is strange that no
 mention is made of  it in  homoeopathic literature, especially as
 a disease like diphtheritis would offer  frequent occasion for its
 use.  The  following symptoms call strongly for its administra-
 tion: Great prostration  and weakness, almost to faintness;
 great exhaustion; faintness, shivering, and numbness;  fainting;
 collapse, etc.
   It may  be  given either in the usual way, or, still  better, as
 spray from the 1st  or 2d dil., by means of a common  toilet
 atomizer.

                     XVII. Cantharis.
   91. Too  copious or difficult  urination;  the urine contains
 shreds or coats of uriniferous tubuli; extreme prostation, sink-
 ing, death-like turns ; irritable-looking rash upon the skin or
 shining through the epidermis.   (Raue's Therap., 120.)
   92. There is marked disturbance of  the urinar};- organs;  fre-
 quent desire to urinate, with  burning and cutting pain;  the
 membrane  appears in patches  upon the posterior wall of  the
 throat, with burning in the throat.   (Guernsey's Obstet, 946.)
   93. Diphtheritis, with great  burning in throat, accompanied
 by a scraping sensation, so that, when  expectorating, blood was
 brought  up.  {Hahnem. Monthly, March, 1874, p. 358; Raue's
 Record, 6,  86.)
  N.B.—The  principal sensation in the throat is burning pain,
 burning soreness.

                     XVIII. Capsicum.
  94.  When,  if a description can be given, the throat smarts
as if from  cayenne pepper; the diphtheritic deposit covers a 
30
THERAPEUTICS OF DIPHTHERITIS.
considerable portion of the fauces.   There is  a sensation  of
constriction on swallowing.  (Guernsey's Obstet, 946.)
  95. The throat smarts as from cayenne pepper; diphtheritic
deposits cover a considerable portion of the fauces.  There is a
sensation of constriction, accompanied by soreness on swallow-
ing.   (World's Horn. Convention ; Lippe.)

                XIX. Carbolicum acidum.
  96. Carbol. acid has not yet failed as a prophylactic.  Carbol.
acid, 1 grain to 1 ounce of water, every two hours, half a tea-
spoonful, has a favorable influence on  the fungous growth, less
upon the fever and the other complaints.  {Aflg. h. Ztg. 80, 83;
Lutz.)
  97. Carbol. acid  has not yet failed,  even in malignant cases,
but Apis, Arsen., Brom., and Merc, hydrocyan. have.  In light
cases I give Carbol.  acid, 3(1: 99), 12 dr. to 120 gram, water,
every two hours one spoonful, and  for little children, who
can  not gargle,  I order the mouth and fauces to  be  painted
several times a day with a solution of 8-10 drops of the tincture
to one glass of water.  Those who can, should  gargle  with  it
every hour.  Under this treatment the difficulty and  pain  in
swallowing are removed within forty-eight hours in most cases,
and after some days the exudation commences to come  off, and
the whole process is finished in eight  or nine days.  In malig-
nant cases I give a  lower dilution  with greater  frequency
(every half to one hour).   I also order  inhalations with  SiegeTs
apparatus three  or four times a day, and well  covered  cold
water-pack around  the neck.   I have received  cases from the
allopathic treatment, which were  near death  on  account  of
threatened asphyxia, yet,  out of danger after three  or  four
inhalations.  {Allg.  h. Ztg., 89, 202 ; Davidson.)
  98. Carbol. acid 6 was a sure prophylacticum.  If the remedy
is administered in the 3d dil., as soon  as the disease breaks out,
recovery takes  place in  three days.  {Allg.  h.  Ztg.,  91, 44-
Gigliano.)
  99. My experience in the last years regarding the  use  of
Carbol. acid is very favorable.  The severer the case, the more 
by f. g. oehme,  m.d.
31
satisfactory have been the results.   I use  it only externally,
therefore difficult swallowing is no contraindication.  My
atomizer is the usual toilet spray-producer.  I fill the bottle
with a solution of Carbol. acid (2 grains to 6 ounces of water,
for children weaker), and rinse with it the whole affected part
every one or half  an hour.  There is enough of it absorbed to
secure the dynamical effect of this  great remedy.  It is un-
necessary to relate any case, as they resemble each other more
or less.  Since I used this  drug, the after diseases  have been
much less frequent.   Whether the fungi are the cause or the
consequence, Carbol. acid proves its disinfecting power.   Weak
solutions operate better than strong ones.   Sometimes seventy-two
hours pass by  before improvement commences,  but I continue
the treatment as long as the patient  is no worse, and just this
perseverance has obtained success, where even collapse  threat-
ened.  {Allg. h. Ztg., 91, 93 ; S. Lilienthal.)   I confess that I
lost my cases  where the larynx was  affected.  {Hahn.  Month.,
11, 267; Lilienthal.)
  100. Bsehr has used the last two years nothing but  Carbol.
acid; out of twenty-eight cases he lost none.   He has counted
here only such cases where the exudate was imbedded in the
mucous  membrane, and foetor oris present.   He gave  Carbol.
acid, 1-3, 2-3 dr.  in water every two or three hours, and before
each dose he swabbed the affected parts with diluted alcohol. {Internal.
Horn. Presse, 6, 581, and Allg. h. Ztg., 87,140.)
  101. See No. 86.  All symptoms were improved  by  Brom.,
only the exudate remained unchanged, but disappeared in about
ten hours after the external use of Carbol. acid.  {Allg.  h. Ztg.,
85,4; Hirsch.)
  102. Girl, living in  a very small and bad tenement.   On the
second day of the disease the entire fauces covered with exudate,
glands of the neck swollen, aphony, croup-like cough, fetid dis-
charge from the nose, violent fever, pulse 130.  Carbol. acid ;
improvement not  until four days later, and  recovery nine days
later.  {Allg. h. Ztg., 87,  140;  Baehr.)
  103. Child.   For  twenty-four hours diphtheritis; ulcer of
about half inch  in diameter on  the left side of  the  throat.
Carbol. acid.  Worse on the second day.  On the third day the 
32
THERAPEUTICS OF DIPHTHERITIS.
whole throat filled up with membranes; on the fourth  day
ichor run out of mouth and nose in lying ; the exudate reached
forward to the teeth.  On fifth day the exudate  was thrown
out, but formed again as a thin coat;  on seventh day only a
little of it was left, on the eighth day only a little reddish ulcer;
on the ninth day child went out doors.  {Ibidem.)
  104.  Girl.  Very large swelling outside on the neck.  Carbol.
acid.  Also in this case the disease grew worse till the fifth,
and  had subsided  on the seventh  day so far  that  the  ulcers
were clean.   On ninth  day child went  outdoors.  {Ibidem.)
Another severer case had a very similar course.
  105.  Child.   Merc, hydrocyan. unsuccessful  for three days.
Carbol.  acid. 1, 2 dr. to one glass  of water, every  two hours
one dose.  The next day better in  every respect, recovery  two
days later.   {Allg. h. Ztg., 91, 44;  Gigliano.)  In many other
cases, also in malignant ones, the same result.
  106.  A pregnant, syphilitic  woman.  Violent  fever, tonsils
very much  swollen, fauces  intensely red,  tongue coated white.
Belladonna.  Scarlatina.  Inflammation  of  the throat worse.
Tonsils and fauces covered with thick membranes.  Mucous
membrane  of the  nose severely affected ;  submaxillary glands
very much swollen, and hard ;  very profuse salivation; tongue
very much swollen ; scarcely able to open the jaws; swallowing,
even of liquids,  almost  impossible.   Nitr. acid, ineffectual.
Carbol. acid. 2, 2 dr., in water every two hours;  for gargling
or rinsing, a 2°- solution of Carbol.  acid.   Improvement; re-
covery.  {Ztschr. f. h. Klin., 24, 135 ; Mossa.)

                          Resume.

   After reading the above regarding this drug, one might think
it the panacea for diphtheritis, and that there could be no more
death from  this disease, but—remember what has been said in
No. 11.
   We  have very  little to sum up, because  97, 98, 99 and 100
are  sweeping  assertions without any special indications for the
selection of the remedy, as homoeopathy requires.   We shall
speak of this one remedy—doctoring in the General Re'sume*, as 
BY F.  G. OEHME,  M.D.
33
 we cannot repeat our remarks on this subject in the Resume" ot
 each remedy thus abused.
   Regarding Nos. 102,103 and 104, we refer the reader to what
 has already been said of the cases 77-85, in the Re'sume' under
 Bromium.  They are not remarkable cures, especially,  when
 we take into account that Alcohol was also used externally.
   We will not  consider case 106, as there is no  mention how
 soon the improvement begun, nor how many days the recovery
 required.
   In No. 105, no symptom is given to  furnish any indication
 for the selection of the drug:.
   Consequently, out of all the above material, only 96 and 101,
 about four lines in all, are of any practical use.  It is this :  1.
 Carbol. acid, has a favorable influence on the fungous growth,
 less upon the fever and other complaints.  This hits the truth
 quite near.  2.  It removed the  exudate  very  quickly after
 Brom. had improved the other symptoms, the fungi excepted.
   Carbol. acid,  has  the  power of destroying all  fungous and
 parasitic growth, and also of causing paralysis, but it does not
 produce a highly inflammatory state of the throat; even  the
 pain is not severe, especially if  we exclude those symptoms
 which appear immediately after taking the drug, caused by its
 local (chemical)  effect.  Consequently it is not homoeopathic to
 a diphtheritis with severe inflammation and pain in the throat,
 accompanied by high  fever (beginning  of many  cases), but is
 indicated after the inflammation and pain have partly subsided,
 and the exudate been deposited, especially when the following
 symptoms  are present: great languor ; weakness ; great prostra-
 tion ; general soreness;  drowsiness;  chilliness;  cold perspira-
 tion ;  dizziness;  headache;  especially  in the  forehead, or
 through  the temples, as if from a tight  band around the fore-
 head ;  affection of the  mucous membrane of the  nose;  face
 pale; loss of appetite; nausea; weak pulse, etc.
  Experience must decide, if it  is particularly adapted, when
the exudate is very soft and diffluent, in contrast to Kal. bichr.
which  is recommended,  where the exudate is more fibrinous
and  securely attached to the subjacent integument (see 130).
  Some have found it useful in diphtheritis of the larynx, others
     3 
34
THERAPEUTICS OF DIPHTHERITIS.
 not.  We  wish to draw particular attention to Lilienthal's
 remark, that weak solutions operate better than strong ones.

                        XX. China.
   107. As soon as the diphtheritic process is ended, it is advis-
 able to order at once a strengthening diet and the use of China
 3 ; as the great loss of strength, and the anaemia require  imme-
 diate restoration.  (Kafka's Therap., 1, 434.)

                XXL Chininum  arsenicosum.

   108. We have seen surprising  results from Chinin. ars. 3, in
the malignant angina during scarlatina.  The rapidly develop-
ing paleness of the skin, the  quick  exhaustion, and the fast
destruction of the mucous membrane of the fauces  drew our
attention  to this remedy.    We  gave it every two  or three
hours, and swabbed the fauces every hour with fresh  water.
(Kafka's Therap., 1, 433.)
   109. Since I use Chinin. ars., I have not lost another case of
diphtheritis, although I have treated several hundred  patients.
The favorable results I had with it in diphtheritis during
scarlatina,  induced me to prescribe it also in the genuine diph-
theritis, of which we had an epidemic of a year's duration.  I
have  often treated from three to five members  of  the same
family, simultaneously or successively, and  always with rapid
success.  In all cases there were present foetor oris, swelling of
the submaxillary glands, frequently also  of  the parotides  vio-
lent fever, and great prostration, besides the characteristic signs
on the tonsils and  palate.   I gave mostly the 1st centesimal
trit., 1 grain every two hours, seldom the 2d trit.; the 1st trit.
was decidedly more effective than the 2d trit., which was suffi-
cient only in milder cases and with little children.  It required
generally twenty-four hours to  see an evident improvement of
the accompanying symptoms, but not of the exudate, which
remained the same.   In several cases improvement took place
not until  after forty-eight hours or even after a longer  use of
Chin. ars.  In two  cases of malignant scarlatina of  young
people, the diphtheritis  was  cured not until after a fourteen 
BY F.  G. 0EHME, M.D.
35
days' use of Chin, ars., 1st trit.  During the administration of
this  remedy the diphtheritis very seldom spread to the larynx,
still  no case was cured by  it after the larynx had already been
affected.   I had two such cases.  {Allg. h. Ztg.,  87, 113, and
196; Findeisen.)
  110.  A slender girl of 20 years.  Blackish exudate, very ex-
tended ; hoarseness ; febris putrida ; great weakness;  head con-
fused ;  anxiety ; delirium  at night; difficult swallowing; very
strong  foetor oris; tongue and skin dry ;  pulse 130.  Apis,
painting  with  and inhalations  of alcohol ineffectual.  Chin.
ars.  improved soon.  Recovery.  {Allg. h.  i%., 78,103; Neu-
schafer.)
  111.  A stout girl of 10  years.  Severe diphtheritis.  On  the
third day, Chin. ars.  1  (1 : 99), 1 gr. every two  hours.  Two
days later there was the following condition: strong foetor oris;
the submaxillary glands very much swollen and painful; breath-
ing through the mouth because the  nose was stopped up with
purulent and bloody substance ;  corners of the nose excoriated ;
tongue coated thick and  brown; both tonsils  covered with a
gray exudate; on the right tonsil a bloody ulcer  with uneven
edges,  which  corresponded to the size of a membrane just
retched out; the lower half of the uvula gangrenous, the upper
half covered with exudate; the entire posterior wall of the
fauces completely covered with exudate; swallowing of liquids
very difficult; great weakness ; sleeplessness; pulse small, very
frequent.   Chin, ars., 1st  decimal trit. (1 : 9), 2 centigr. every
hour.  Two days later the condition much the same, no worse;
exudate a trifle less.  The same prescription continued.  Two
days later, considerable improvement; same prescription con-
tinued.   Two days later, recovery.   {Allg. h. Ztg.,  87, 204;
Findeisen.)
                          Resume.

  Only three physicians have used Chin, ars., and two of them
recommend it, when the following symptoms are  present: pale-
ness  (anasmia),  rapid  exhaustion,  quick destruction of  the
mucous membrane (108); foetor oris, swelling of the submax-
illary glands  and parotides, violent fever, great prostration
(109). 
36
THERAPEUTICS OF DIPHTHERITIS.
  As we have no proving of this drug (except a short and in-
sufficient one) to guide us in its selection, its use has been only
empirically.  It is, however, impossible to conjecture correctly
the operations of Chin. ars. from those of Chinin. sulph. and
Arsen., as we know from chemistry  that the  properties of a
combination (salt) are different from those of its constituents.
Still experience in the homoeopathic practice has taught us that
the properties of the base vastly predominate over those of the
acid.   For instance, Calc. carb., acet., and phosph. are  not so
different from each  other in their operations, but what we can
give frequently one in place  of the  other.   While  between
Phosphate of Lime, Iron, Mercur., Quinine, etc., there is such
an entire difference, that not even the thought of giving one in
place of the other would ever  enter our mind.   According to
this experience the operations of Chinin. would excessively pre-
dominate over those of Arsen.
  Chinin. and Arsen.  have great  power  of destroying fungi,
and Chin. ars. 1st decimal trit. (1 : 9) every hour, is such an im-
mense  dose that it could not help acting locally (111).  As the
2d  trit. was useless, and as, after giving the 1st trit., the im-
provement begun by a slight decrease of the  exudate, we are
inclined  to think that the recovery  was due  more to its in-
voluntary local  application (swallowing) than  to its  dynamic
influence.  Most homoeopathic physicians would have rather
changed  the  remedy than gone still lower in the scale, as the
2d trit. is low enough, especially of a drug poisonous as this.
  Chin. ars. did not  always prevent the disease from spreading
to the  larynx, and never cured after it had spread.
  We  do not think much of any case where the writer neglects
to state how soon the improvement commenced, and how many
days the recovery required.  This part of the history of a case
is of as much consequence as  the  symptoms, or any other im-
portant part (110).
                      XXII. Chlorum.

  112.  Aqua chlori, as undiluted as possible,  has a favorable
effect upon the diphtheritic process, but is very  disagreeable on
account of its bad taste.  {Allg. h. Ztg., 80, 83 ;  Lutz.) 
BY F.  G. 0EHME,  M.D.
37
                 XXIII. Chromicum acidum.
   113.  Ozanan considers Chromic, acid, a great specific against
 diphtheritis  of  the fauces  and larynx, even when the parts
 become  gangrenous, as it  produces a very similar disease.
 (Hirsch., Ztschr.f. h. Klin.,  19,144.)
   114.  Chrom. acid. (1 to 4 parts of water), externally, could
 not  stop the local process  in three severe cases, and did not
 prevent death.  {Allg. h. Ztg., 80, 83; Lutz.)

                 XXIV. ClMICIFUGA RACEM.
   115.  Cimicif. is an important remedy in those cases in which
 the patient complains of considerable pain in the back, relieved
 by rest and increased by motion.   There is a constant desire to
 swallow, but the act is attended with difficulty;  the mouth and
 often the throat is filled with a thick saliva, which it is difficult
 to remove;  the  patient  perspires greatly  during  the night.
 {Amer.  Horn. Obs., 5, 233; Hoyne.)

                 XXV. CONIUM MACULATUM.
   116.  Five  cases were cured by Conium, three  of which were
 after scarlatina.   In one of the latter cases (a girl of 4 years)
 the urine turbid, after standing dirty gray with  a little yellow-
 ish tint; condition worse nights, somnolence,  with constant
 waking and change of position; sawing, snoring breathing ;
 exudation dirty-grayish.  Con. 30 every three hours.  Recovery
 in five days.   {Allg. h. Ztg., 82, 4; Kunkel.)

                  XXVI. Croton tiglium.
   117.  Croton tigl., as indicated in cases of diphtheritis charac-
 terized  by  not much, if any hoarseness, not much difficulty in
 swallowing,  excessive  exhaustion, perhaps  coming  on with
 alarming suddenness.   {Med. Invest,  10,  149; Williamson.
 Raue's Record, 5, 112.)

             XXVII.  Ferrum sesquichloratum.
  118. Ferr.  sesquichl.  is used externally by some, merely to
destroy the fungi;  no special indications. 
38
THERAPEUTICS of diphtheritis.
             XXVIII. Gelseminum sempervir.
  119. Local  tingling of parts  during  the  fever;  incipient
paralysis or anesthesia;  defective or  impaired vision;  objects
appear a long way  off,  are seen double or inverted.  (Raue's
Therap., 120.)

                XXIX. GUAJACUM OFFICIN.
  120. A. S. Cough, after quoting the pathogenetic symptoms,
which indicate its use, says, that where it was at all indicated,
it has proved more  satisfactory than  any other single remedy
exhibited by him in this disease.  {Amer. Horn. Obs., 1, 77.)

               XXX. Hydrastis canadensis.
  121. In diphtheria  the Hydrast. has been found  of benefit.
It corresponds to the debility which results from that disease,
and to the local condition of the throat, when ulceration occurs.
I am accustomed to use it as a gargle in all cases where ulcer-
ation is noticed.  Dr. Logan says: " I have used Hydr. in ulcera-
tion  of the mucous membrane with very  satisfactory results.
Three years ago I  treated over two hundred cases of diph-
theria, using Hydr. as a gargle with good results." C. C. Smith
reports the following  case:  The disease  came on  in  the usual
way.  Under  the use of Nitr. acid., Bellad., and Capsic, the
throat was cured in  a  very short time, the  false  membrane
clearing off nicely.   But about the period when I was looking
for  the time to arrive when  the patient (a  girl of fourteen)
should be well on the road to health, I was  not a  little sur-
prised to discover the diphtheritic membrane forming in the
left nostril and in  the vagina, the  former being  completely
plugged up.   I at once administered this drug both externally
and internally, in  the 1st decimal dilution, 6 dr. to one-half
tumbler of water, one spoonful every hour.  Very soon the false
membrane began to shrink up, and soon came awa}'; the cure
was rapid and complete.  (Hale's New Rem., 2d edit., 574.)
  122. Hydrast. is  indicated, when  the patient  complains  of
chilliness, although well covered ; the headache is of a beatino-
or darting character, and not confined to any one locality ; the 
BY F.  G. 0EHME,  M.D.
39
stools consist entirely of blood;  epistaxis is a prominent symp-
tom.  The other symptoms do not differ essentially from those
given under Phytol. and Bapt.  {Amer. Horn.  Obs., 5, 233;
Hoyne.)

                   XXXI. Ignatia amara.
  123. The disease  commences  on the right side; high fever;
delirium is characterized by a fearfulness or dread;  the sore-
ness of the throat is greatest between the acts of deglutition;
pains in the back of the head, nuchae, and sometimes in the
ears.  We give Ign. 200 or 1000, three or four  doses in inter-
vals of three or four hours, then wait one or two  days.  A
repetition  of the  medicine will rarely be necessary.  {Hahn.
Monthly, 12, 157 ; H. N. Guernsey.)  Low dilutionists  must
here exercise faith!

                      XXXII. Iodium.

   124.  Iod. rendered excellent service in a case of diphtheritis.
The velum palatinum and tonsils covered  with thick, grayish-
white exudate; much pain in throat, painful swallowing; sali-
vation ; strong foetor oris.  The patient, a girl of 10 years, was
scrofulous, and had had swollen submaxillary glands for several
months.   Iod. 3,  every three hours.   Three days later decided
improvement.   Recovery on the sixth day.  {Ztschr. f  horn.
Klin., 4, 180 and 187 ; Hirsch.)
   125  Boy of 4 years.   Diphtheritis; Mercur.;  cough with
croup' tone.  Hep.  and  Iod. 3 ineffectual.  Iod. 1, recovery.
{Allg. h. Ztg., 69,  180 ;  Goldman.)               *,.,.,  ...
   126.  Jod. is best indicated in the early stage of diphtheritis,
 when much glandular irritation is present, and when the dis-
 ease threatens to  attack the larynx.  When, in addition to the
 formation of specks or patches of exudate of greater or less ex-
 tent  with sore throat, enlargement of the tonsils or glands of
 the neck, disinclination for  food, difficulty of breathing, cough,
 and alteration of the voice, supervene, the administration of Jod.
 should  be at once resorted to.   {Amer. Horn.  Obs.,  9,  451;

   -^ 33*__See what has been said  in the Resume" under Brom. 
40
THERAPEUTICS OF DIPHTHERITIS.
               XXXIII. Kali  bichromicum.
  127. Kal. bichr. is indicated  in  cases similar to Sulphur.
acid., but the disease  is deeper seated, commences in the fauces,
and spreads to the larynx.  The increased redness, and consider-
able sensitiveness of the still healthy  parts  of the mucous
membrane of the  mouth and fauces, is a characteristic indica-
tion for Kali bichrom., while a purplish paleness of the mucous
membrane, and a moderate swelling of the affected parts, points
to Nitri acidum.  When the disease spreads to the larynx in
cases where Kali bichr. is indicated, we soon observe hoarseness
with cough, which is at first rough and dry, but becomes loose
after a few hours, and causes fits of choking in consequence of
the  tough  expectoration.  Although   this  remedy is very
specific in such cases, still improvement takes place gradually,
which proves the deep affection of the mucous membrane.  Kal.
bichrom. 6, 3 to 4 dr. to one-half glass of water, one spoonful
every three to four hours.   {Ztschr.f. h. Klin.,  17, 53 ; Hirsch.)
  128. The discharge  from the  nose is tough and  stringy;
pain in the left ear; swelling of the parotid glands; croupy
cough; measle-like eruption; red, raw,  shining  tongue;  deep-
eating ulcers in the fauces.  (Raue's  Therap., 120.)
  129. The disease extends into the throat (and bronchia), pro-
ducing a  croupy  cough, in paroxysms,  with expectoration of
viscid, tough mucus, which may be drawn out into long strings;
tough and stringy discharge from the nostrils ; pain in the left
ear; swelling of the parotid and submaxillary glands ; eruption
upon the skin, which looks like  that of measles; the tongue is
red, raw, and shining.  (Guernsey's Obstet, 946.)
  130. This  remedy seems especially  appropriate  to  pseudo-
membranous lesions of a diphtheritic nature,  affecting the re-
spiratory mucous surfaces, from the nares  down to the ulti-
mate ramifications of the bronchial tubes.  It is indicated in
diphtheritis, (1) when the deposit is of  a firmer texture, more
apt to be developed into casts which are cartilaginous, or pearly
in appearance, elastic, fibrinous,  and  more securely attached to
the subjacent integument; (2) when a transfer of the local dis-
order to the  larynx  or trachea impends, as shown by the sore- 
BY F.  G. 0EHME, M.D.
41
ness of the larynx, when pressed upon from before backwards,
aphony, croupy inspiration or  cough, and a desire on the part
of the patient to lie with the head thrown far backwards in
order to open the glottis; (3) when the tonsils are almost or
quite enveloped by a thick or well organized deposit, and when
at the same time the patient  has an almost incessant cough ;
(4) when there is an evident tendency to ulceration and deposit
upon remote  mucous  membranes as, for example, those of the
uterine system.  In my own experience this remedy is almost
a specific to diphtheritic formations upon the free uterine, and
to those found upon the  respiratory epithelial surfaces.  Since
in all these cases the putrid symptoms are less marked than in
the pharyngeal and alimentary  diphtheritis, you  should take
the hint to cease the use of Kal. bichr., when these symptoms
ensue.  Ars.  jod., Nitr.  ac. and Carb.  veg., are much more
decidedly indicated for such  a condition.  {Amer. Horn. Obs.,
9, 450; Ludlam.)
  131. Kal. bichr. was found useful by Bryce, when the char-
acteristic yellow-brown fur on the tongue was present.  {N. E.
Med. Gaz., 11, 224.)
  132. The patient is in an  almost  unconscious condition;
when aroused from it or when  awaking from apparent sleep, he
complains most, or feels worse (same as Lachesis).   He often
awakens with a desire to  cough, or to hawk up detached  por-
tions of  the diphtheritic deposit; while making this attempt
he throws off tough, ropy, yellow, discolored mucus.   The fetor
is very great; the deposit covers the throat, uvula, tonsils and
even roof of the mouth, and are  of yellow-greyish color.   The
patient becomes hoarse, indicating the extension of the disease
into the  larynx and air-passages.   The tongue is either quite
red, or is covered with a thick, yellow substance.   The (right)
parotid gland is much smaller and, upon deglutition, the pain
shoots up to  the ear and down the neck of the affected side,
Kali bichr. will correspond to the form of disease in which the
vegetable parasite, found in the diphtheritic deposit, resembles
the spirobacteria.   {Worlds Horn. Convention; Lippe.) 
42
THERAPEUTICS OF DIPHTHERITIS.
                          Resume.
  If the reader will delay its use till the often mentioned indi-
cation for Kal. bichr. appears, viz., stringy, tough mucus, which
may be drawn out into strings, he will lose many chances for
using this drug succesfully.  It is indicated, where  the mucous
membrane is  deeply affected, and there  is much ulceration; the
mucus is frequently streaked with blood; pain  in  the throat;
painful, difficult swallowing; spasmodic cough with or without
hoarseness;  great  weakness; cachectic look; swollen glands.
The disease  spreading to the larynx.   Frequently the nose also
affected.
  According to Ludlam (130), whose indications are very ex-
tensive, this  remedy is indicated, when the exudate is  of  a
firmer texture and more securely attached, and when there is
a tendency to diphtheritic deposits upon remote mucous mem-
branes.  According to  Bryce (131),  when the tongue has  a
yellow-brown fur.
  As no cures with this important medicine have been  pub-
lished, it seems, that it has not received sufficient attention.

                XXXIV. Kali chloricum,
       Kali hydrochloricum, Chlorate of Potassium. (KO,C106).
  133. Girl  of 11 years.   In spite of Bell. 3, Nitr. ac. 6, and
gargling with diluted alcohol, the diphtheritis made rapid pro-
gress, and presented a  severe case.   On the fourth day, pulse
120, bad sleep, little  appetite;  the  entire fauces filled  with
exudate; violent pain in the throat; strong foetor oris ; in the
morning a fainting fit,   Kal. chlor. 1 (1: 99), one teaspoonful
every  hour;  the  same  preparation  for gargling every  three
hours.  Improvement of the general condition and the appetite
in a few hours ; also the exudate a little less.   Recovery  soon.
{Internat horn. Presse, 3, 575 ; Goullon, Jr.)  In Allg. horn. Ztg.,
78,  126, he  recommends Kal.  chlor. \ to 1  gramme to 50
grammes water, one teaspoonful  every two to three hours.
  134. The  chlorate of potash  I have found  most  effective,
when the breath  of the patient is fetid, indicating the decom-
position of the febrin  and albumen and the formation, out of 
Br F.  G. 0EHME,  M.D.
43
their ultimate elements, of carburetted  and sulphuretted hy-
drogen  gases (!), etc., etc.  {Trans. Horn. Med. Soc. of N.  Y., 2,
28,1864; D.D.Smith.)
  135.  Kal. chlor. I have used only in certain cases attended
with offensive effluvia.  When this symptom is relieved,  I dis-
continue its use.   {Worlds Horn. Convention; B. F. Joslin.)

                         Resume.
  Smith thinks (134), as it appears from the subsequent re-
marks, which we  left out, that  this salt is decomposed in the
body and that the Chlorine  neutralizes the obnoxious gases by
forming new  combinations.  In originating this  theory two
important  facts have been  overlooked, viz.: 1. That Woehler
and Gustin have  proved, that this salt  is quickly eliminated
undecomposed by the kidneys and lachrymal glands;  2, That the
homoeopathic practice has demonstrated  again and again, that
in every salt the base, but not the acid, is by far the predomi-
nating agent in its operations  (see Resume to Chin. ars.).
  As Chrom. acid, has  not  been of much use in diphtheritis,
but Kali bichrom.  mentioned  for a great remedy ; furthermore
as Chlorine, in the form of Aqua chlori, has scarcely been em-
ployed and  acid, chloricum  (CI 05)  not at all, while Kali chlo-
ricum has had, at  least, some effect; finally as Ammon.  caust.
cured very  quickly a laryngitis diphtheritica, we  are of the
opinion, that  the  Alkalies  (KO, Na 0, NH3)  have been alto-
gether too  much  neglected and that Kali caust.  will be far
superior to Kali chloric, perhaps also to Kal. bichromicum.
  The pathogenetic symptoms of Kal. chloric, indicate its use in
diphtheritis no more than those  of a host of other remedies.
  If physicians had not theorized so much and  worried  their
brain so persistently about  the diphtheritic fungi, our thera-
peutics would be better and  truer homoeopathic, than they are.
               XXXV.  Kali hydrobromicum.
            Kalium bromatum,  Bromide of  Potassium.
  136. Bromide of Pot. and Argent., in cases in which there is
an anaesthesia of the roof of the mouth and fauces.   (Raue's
Therap., 120.) 
44
THERAPEUTICS OF DIPHTHERITIS.
   137. Lymphatic child of 8 years, disposed to frequent sore
throats; Bell. 2, and Merc. subl. corr. 3, useless.   On the third
day, pulse 150, face very red, throat swollen; impossibility  to
move the head; the submaxillary glands, especially on the right
side, very much swollen and painful; tonsils still more swollen,
purple ; tonsils and uvula covered with very thick exudate ; a
distinct, crooked line of demarcation between the healthy and
affected part; mouth dry, hot; anxiety; excitement, alternating,
with  comatose somnolence.  Kali  hydrobrom., 75 centigr.  to
250 grammes of water, one spoonful every hour.   Improvement
by evening; a better night.  The exudate removed  in nine (!)
days.   {Allg. horn. Ztg.,  73, 85 ;  Noack).
   138. Diphtheritis with quick pulse; fever; dry tongue; offen-
sive breath; highly injected and dusky red fauces; with patches
of wash-leather exudation on tonsils or pharynx.   (Trans. Horn.
Med.  Soc. ofN. Y., 8, 273, 1870; Snelling.)

               XXXVI. Kali hydrojodicum.
              Kalium jodatum, Iodide of Potassium.
   139. Man of 38 years. Diphtheritis.   On the second day of
the disease, headache; general indisposition; languor and fever;
fauces very red; uvula swollen and elongated; tonsils covered
with exudate.   Kal. hydrojod. 0.05 in  150 grammes water, to
be used in twenty-four  hours by the spoonful.  Recovery  in
five or six days. (Allg.  horn. Ztg., 79, 62 ;  Ozanan.)
   140. A female.   Rather light case of diphtheritis.  Kal.
hydrojod.  Slow recovery.  (Ibidem.)
   141. Girl of 10 years.  Diphtheritis.   Chills; fever; pain in
throat; pulse 135; skin hot; exudate  on both  tonsils.  Kal.
hydrojod., 0.25 to 1 glass of sugar-water, one spoonful every
hour.   On the next day, the exudate thicker,  skin less hot*
the next two  days, throat  symptoms  and exudate worse.
Kal. hydroj. 0.75.  Improvement two days later; recovery on
the ninth day.  (Ibidem).
  N.B.—These three cases, certainly, do not encourage the use
of this drug in diphtheritis. 
BY F.  G. OEHME, M.D.
45
              XXXVII. Kali permanganicum.
                  Permanganate of Potassium.
   142. Useful in diphtheria with ulceration, and gangrenous
 suppuration with fetid odor.  Dose, 1 gr. to 1 oz. of water;
 two teaspoonful  doses.  (Hahneman. Monthly, March  1874, p.
 357;  W. R. Childs; Raue's Record,  6, 86.)
   143. Having tried all  the recommended local applications, I
 call attention to Permang. of Pot., 1 dec.  trit., 5 gr. to 1 ounce
 of water.  I have found it  principally indicated when under-
 neath a fetid scab-like membrane there was considerable era-
 sion of the mucus membrane; it is  not indicated  in the tena-
 cious "kid-leather" membrane.   (Amer. Horn.  Obs., 3, 205; J.
 Nichol.)
                    XXXVIII. Kaolin.
   144. Kaolin  has been used by a few physicians, but always
 in alternation with other medicines.  (American Observer, 1871,
 page 129, and Raue's Record, 3, 101.)

                   XXXIX. Kreosotum.
   145. An eight-year old girl, whose two sisters were sick with
 a  violent diphtheritis, was seized with  fever, vomiting, loss of
 appetite, restless sleep, general languor, swelling of the glands;
 three days later, suddenly, very much exudate in  the fauces.
 Nitr. ac. 2, internally, and 1 dil., externally.  All symptoms
 much worse during the next three days; foetor oris.  Kreos. 3,
 internally  and  externally;  Improvement in twelve hours.
 Recovery.   (Allg. horn. Ztg., 78, 83 ;  Sybel.)

                      XL.  Lachesis.
   146. During  an epidemical diphtheritis there were a great
 many cases, where the general symptoms were much  severer,
 in comparison to the local symptoms than one would suppose.
 Frequently the prostration was  quite violent  before any local
 symptoms could be discovered.  The pulse slow, weak, small;
perspiration cold, clammy; foetor oris.  Here Laches, helped
quickly.   (Allg. horn. Ztg., 70, 16 ; Dunham.) 
46
THERAPEUTICS OF DIPHTHERITIS.
   147. The following pathogenetic symptoms of Laches, speak
for its selection in diphtheritis: lassitude, weakness, extremely
painful swallowing,  difficult speaking, ulcerated appearance of
the mucous membrane of the fauces; pale redness of the fauces,
white or yellowish  exudate.  Experience  afterwards  proved
these symptoms to be indications for this drug. (Hirsch., Ztschr.
f.  h. Klinik, 14, 155 ; C. Wesselhoeft.)
   148. In two cases the following symptoms were present: the
subjective symptoms were much more prominent than the objec-
tive; the complaints,  especially the swallowing, were much
more violent than one  would suppose from the extent of the
disease;  sensation as if a foreign body was in the throat, with
stinging  extending into the ear; urgency to  swallow, and de-
sire  to hawk  up something,  with attacks  of choking; voice
weak and hoarse; cough caused pain in the throat, therefore, in
the endeavor to restrain  it, it sounded short  and suppressed;
fever.  After ineffectual use of Aeon., Merc, sol., and Kal.
bichr., Laches. 9, every three hours, improved  very much in
twenty-four hours, and cured in six to seven days.   (Hirsch.,
Ztschr.f.  horn. Klin., 17, 53; Hirsch.)
   149. When, after Bellad., by next evening, there is no mark-
ed change  for the better, or when the patient is even worse in
the morning  after some sleep, with a decided development of
those skinny patches on the tonsils, worse on the left side ;  or
when croupy  symptoms appear, and the patient cannot bear
anything touching his neck and throat.  (Raue's Therap., 119.)
   150. Begins on the left side, with a tendency to extend to the
right; pulse 140 or 150 ; give one dose and  wait; in  twelve
hours  there will be slight improvement, more in thirty-six
hours, and much more in forty-eight hours.   In one case where
the left  tonsil was one complete black slough, the disease
passing to  the right, one dose cured.   (Raue's Record, 2, 72;
and Hahnem. Monthly, 5, 286 ; H. N. Guernsey.)
   151. Sore throat, hurting patient to swallow, with great diffi-
culty in  swallowing; in bad  cases, fluid swallowed  runs out
through the nose;  dislike to have throat touched or examined •
flushed face;  quick  pulse;  breathing oppressed;  membrane
commences on left tonsil and pharynx, extending to uvula and 
BY F.  G. 0EHME, M.D.
47
right side.   Laches, will remove the membrane in from twenty-
four to thirty-six hours less time than Lycop.  In cases where
the membrane is just forming, will  remove it  in forty-eight
hours.   (Raue's Record, 4, 85, and  Hahnem. Monthly, 1872, p.
16; W. McGeorge.)
  152.  When the disease first makes  its appearance in the left
side of the throat, and there remains or extends from thence to
the right side, the  throat very sensitive to touch or pressure.
(Guernsey's Obstet,  946.)
  153.  Boy of 8 years, brother of a two-year's old girl, violent-
ly sick with diphtheritis (see No. 213;  cured  by Sulph. ac.;
Hirsch, 14, 142).  Violent pain in throat, swollen tonsils, fever,
heat. Bell.  6. for three days, ineffectual.  Considerable exudate
in the choanse; in sneezing a tough, skinny substance is blown
out  of the nose.  Lach. 30, every three hours; slow recovery.
(Hirsch., Zeitschr.fi horn. Klin., 14, 142; C. Wesselhoeft.)
  154. A young, tall, active  man, with  dark eyes and  hair.
Diphtheritis, two days;  face sickly, pale ;  dark' rings around
the eyes ; swallowing exceedingly painful; speaking difficult;
weakness extraordinary ; mucous membrane of the fauces pale
red ; white exudate on the tonsils and velum.   The singular
grouping of the exudate causes the affected parts to look like
ulcers  of the mucus  membrane  with white edges.  Mind de-
pressed.  Several remedies ineffectual.  Lach. 30, every three
hours; improved by next day, and cured in three days. (Hirsch.,
Zeitschr. f horn. Klin., 14, 142; C. Wesselhoeft.)
  155. A girl of 9  months ; diphtheritis; Bell., 30 ;  worse two
days later.  Very difficult swallowing ; complete aphonia; a
wheezing, hissing sound, in place of the natural crying.   Exces-
sive weakness ; lets the head  hang ; scarcely lifts the limbs.
Fauces pale, covered with white exudate.   Laches. 30, every
three hours.   Improved in twenty-four hours, and cured in five
days.  (Ibid., p. 149 ;  C. Wesselhoeft.)
  156. Girl of 6 years ; velum, tonsils, and  posterior wall of
fauces pale-red ; on the left tonsil tough, yellowish-white exu-
date.  Lach.  30,  every  three hours; cured in three days.
(Ibid., p. 155;  C. W.)                  . ,    , •  , t.  ^    ,
  157.  A  boy of  6  years;  epileptic,  with  thick head,  pale, 
48
THERAPEUTICS OF DIPHTHERITIS.
 bloated  look, and delicate constitution.  For the last fourteen
 days the following condition:  on  the left side of the throat
 several white, exudate spots ; the mucous membrane pale-red ;
 not much difficulty in swallowing; both parotids considerably
 swollen; pulse very frequent, hard;  great apathy; somnolency,
 drooping eyelids.  Several  remedies ineffectual.  Lach.  30,
 every three hours.  Improved in twenty-four hours, and almost
 cured in forty-eight hours.  (Ibid.; C. W.)
   158. An  Irish family of eight children was attacked with
 malignant diphtheritis; three died under allopathic treatment.
 I was called to see three others who had been under the same
 treatment several days; found them as follows: 1. Girl of 8
 years, throat greatly  swollen internally and externally ; dis-
 charge from the nose and mouth of an intensely fetid  and ex-
 coriating fluid; fauces covered with diphtheritic membrane ;
 pulse 110, small; extremities mottled and livid (scarlatina);
 swallowing  almost impossible.   2.  Girl of  6  years,  similar
 symptoms, but not so aggravated ; fever considerable.   3. Boy
 of 4 years, with similar symptoms, has a dark rash on the body
 (scarlatina).  The fetor from the patients was overpowering, as
 they were all in one room.  Small hopes of recovery, owing to
 the  filthy  surroundings, insufficient  food, and  want of care.
 Laches. 10, every three hours.  In three days the three children
 were out of danger.   The oldest girl commenced  improving
 the next day.  On the third day an abscess in the cellular tissue
 of the neck opened. A few days afterwards the two remaining
 children  were attacked ; they died on the third day under all(>
 pathic care.   (Amer. Jour,  of Horn.  Mat. Med., 2, 184- E  M
 Hale.)
  159. Boy  of 8 years; sick five  days; constant delirium,
 which changes rapidly from one subject to another; talks, sings^
 or  whistles  constantly;  throat  filled with membrane  of a
 dark color, which was developed from left to right; has not slept
 for seventy-two hours, but during last twelve hours has occa-
 sionally fallen into a light sleep, which was followed by aggrava-
 tion of all symptoms; badly smelling stools ; urine high  colored
and of strong smell; body covered  with bluish-red eruption
which is  round and elevated.  Laches. 4m, one dose cured in a 
BY F.  G. 0EHME,  M.D.
49
 few days.   (Amer. Jour, of Horn. Mat. Med., 3, 40, Goodno; and
 Raue's Record, 2, 73.)
   160.  Girl of 26  years;  pulse 130; skin hot and dry;  face
 very red;  drowsy;  muttering delirium;  grayish  membrane
 developed from left to right.  Laches.  5C; cured in forty-eight
 hours.   (Ibid., p. 139.)
   161.  The diphtheritic deposits first show themselves on the
 left  tonsil,  from there extending to the right side, and then
 spreading further.   The neck is stiff, or the external  throat
 sore and quite tender  to  the touch.  The patient coughs, and
 feels worse, when  awakening from sleep; expectoration very
 difficult and scanty.  Great loquacity is only kept in check by
 the hoarseness.  (World's  Horn. Convention; Lippe.)


                          Resume.

   None of the one-remedy doctors have used Lachesis.  Others
 that have administered it, have  found it indicated, when the
 following symptoms were  present:
   The subjective symptoms much severer than the objective ; violent
 pain in throat; extremely painful and difficult swallowing ; diffi-
 cult speaking ; sensation of a foreign body in  the throat, with
 stinging extending into  the  ear;  urgency to  swallow, and
 desire to hawk up something, with choking spells ; dislike to
 have the throat touched; pale redness of the fauces; exudate
 begins or is worse on left side ; voice weak and hoarse; aphonia ;
 cough causes pain; foetor oris;  fetid discharge from mouth and
 nose ; violent prostration even before the exudation ; lassitude ;
 weakness;  pulse  weak,  small;   perspiration  cold, clammy;
 somnolency; delirium ; symptoms worse after sleep.
  In several cases the disease appeared during scarlatina.   No.
 157 is more  of a subacute,  slow nature.


                    XLI. Lachnanthes.

  162. If the child has a  very stiff and painful neck, drawn to
one side, with diphtheria.   (Guernsey's  Obstet, 946.)
4 
50             THERAPEUTICS OF DIPHTHERITIS.
                    XLII.  LYC0P0DIUM.
  163. When the aspect of the fauces is rather of a brownish
redness, worse on right side, and worse from swallowing  warm
drinks; when the nose is stopped up, and the patient cannot
breathe with his mouth shut; he keeps his mouth constantly
open, slightly projecting his tongue which gives him a silly
expression ;  the nostrils are widely dilated with every inspira-
tion ; on awakening out of a short nap  he  is awfully  cross,
kicks, and behaves naughty, or he jumps up in bed, stares  about
and knows  nobody, seemingly dreaming  with open  eyes; fre-
quent jerking of the lower limbs, mostly with a groan, awake
or slumbering; great fear of being left alone.   (Raue's Therap.,
119.)
  164. Boy of 7 years;  membrane of a grayish color, developed
from  right  to left.- stoppage of nose, with excoriating coryza ; is
unable to breathe through nose; lies with mouth open and tongue
protruded;  headache in right  side;  constipation;  fever; all
symptoms worse about  4 o'clock  p.m.  Lye. 2C, one dose cured.
(Am.  Jour,  of Horn. Mat. Med., 3, 140; Goodno, and Raue's
Record, 2, 73.)
  165. Girl of 10 years; patches of membrane on right  tonsil,
of a  dirty-white color; stoppage of nose, is unable to  breathe
through it; headache;  high fever; aching of the whole  body.
Lye. 6m, one dose cured.  (Ibid.)
  166. Patient of 29 years; has had inflammation of the tonsils
and fauces for four  days; much swelling and pain, amounting to
spasm on swallowing; white diphtheritic patches on the tonsils;
constant desire to swallow, accompanied  by spasm, and  violent,
stinging pain;  rigors;  rapid pulse;  swelling  and pain  most
marked on  the right side ; fcetor oris.  Lycop. 200;  two doses,
night and  morning.  Improvement after a few hours, and re-
covery without formation of pus or abscess. (Transact, of Amer.
Instit, 1870, sec. 2, p. 252;  C. Wesselhoeft, and Raue's Record,
3,101.)
  167. Girl of 20 years. Lach., Merc. sol. and  bijod. useless.
Diphtheritic membrane on tonsils and fauces much  increased •
fauces are red and covered with whitish patches;  ticklino-  irri- 
BY F.  G. 0EHME, M.D.
51
tation, and stinging in the throat on going to sleep; followed,
after coughing, by smarting, burning, and throbbing; worse on
the right side of throat and fauces ;  nausea ;  loss of appetite;
great weakness and depression; pulse 90, hard ; considerable
foetor oris.   Lycop. 200 ; two doses produced an immediate im-
provement and recovery.   (Ibid.)
   168. Membrane comes first on the right side, and if the forma-
tion is not stopped, goes to the left side; difficulty in breath-
ing ; in bad  cases, fan-like motion of alae nasi; speech indis-
tinct, in some cases when the formation of membrane had gone
on for some  time; soporous condition and indifference to ex-
ternal surroundings, and impatience on awakening.  Given in
cases where the membrane  is just forming, Lycop. will remove
it in seventy-two hours "(! !)."   When  fully formed it will
sometimes  take  five days.  The membrane is not so likely to
form a second time on the right as on the left side.  In one
very severe case the membrane came  twice on  the right side
and three  times on the  left.   (Hahnemannian Monthly, 1872,
August, p. 16 ; W.  McGeorge, and Raue's Record, 4, 85.)
   169. When it appears first on the right side, and from thence
inclines to  spread to the  left, or it begins in the nose and ex-
tends down into the throat. (Guernsey's Obstet, 946.)
   170. The diphtheritic deposits begin on the right tonsil and
from there extend  further.  Swelling of all the glands of the
neck; perfect stupor, diminished secretion of urine.   Grinding
of teeth as  well during the heavy stupor, as when fully awake.
(World's Horn. Convention; Lippe.)
   171. Severe case  of diphtheritis,  affecting  the  throat and
nares ; worse on the right side;  the nose is stopped up, and the
patient  cannot breath with her mouth  shut; she keeps  her
mouth constantly open,  slightly projecting her  tongue, which
gives her a silly expression.   Lye. 30 acted like magic.  (Hahn.
Monthly, 12, 129 ; E. C. Price.)

                          ResumS.

   The most prominent indications for Lycop. are the follow-
in <>•:  worse or beginning on right  side;  stoppage of nose  with 
52
THERAPEUTICS OF DIPHTHERITIS.
excoriating  coryza, and inability of breathing through  the nose;
much swelling and pain in throat, with spasms on swallowing,
etc.
  Price considers " projecting tongue and silly expression," the
most characteristic symptoms (171).

                    XLIII. Mercurius.
                     Various preparations.
  172. The  mercurial preparations  answer only to the compli-
cation with scarlatina, because they have no  true relation to
the diphtheritic process.  (Allg. h. Ztg., 84, 152; Hughes.)
  173. As Iodium has a specific influence  upon the croupous
process, so has Mercurius upon  the diphtheritic.   We  may
succeed in curing  non-malignant  diphtheritis with Bellad.,
Apis, Muriat. acid., but it is done the quickest and surest with
Mercurius.   Merc, solub. 2 suffices in the non-malignant form,
but the malignant requires  Sublim., Prsecip.  rub.,  Merc. jod.
flav.,  Merc, hydrocyan.   Sublim.  and Brom. in alternation
when the larynx  is affected.   (Allg. h. Ztg., 79, 15 ;  Heinrich.)

                 XLIV.  Mercur. bijod.  rub.

  174. Merc, bijod., two grains of the  salt dissolved  in  one
ounce  of alcohol, every two hours, a small  dose on  pellets or
sugar of milk, is my chief remedy  in ordinary cases.   In the
more malignant forms, where there is considerable fetor of the
breath, and the symptoms decidedly adynamic, Merc, corrosiv.
will be found preferable.  (Amer. Jour,  of Horn. Mat. Med., 9,
175; Joseph Hobson.)

               XLV. Mercur. jodat. flavus.
                   Protoioduretum Mercurii.
  175. Great difficulty in swallowing, with great pain in the
throat; the salivary glands are very much swollen and painful;
very offensive smell from the mouth, and fetid discharge from
the fauces and nares; swelling of the cervical glands.   (Guern-
sey's Obstet, 946.) 
by f.  g. oehme,  m.d.
53
   176. Girl of 3J years.  Merc, and Arsen. ineffectual; the dis-
 ease  has spread  to  the larynx.  Calc. sulphurata and Iod. for
 three  days ineffectual;  the disease worse.   Aphonia; breath-
 ing very much impeded ; the nostrils dilated with every respira-
 tion ;  the  pit of the stomach  drawn  in at every inspiration;
 very  weak murmur of respiration heard all  over  the  chest,
 sometimes none  at  all; frequent violent spells of suffocation.
 Merc. jod. flav. 2 (1  : 9), five grains every hour, afterward less
 frequently.  The next night better, steady improvement, re-
 covery.  (Hirsch., Ztschr.f. h. Klin., 17,190; Sorge.)
   177. The diphtheritic deposits begin on the arches  of the
 palate ; glands of the neck swell very rapidly; there is a gen-
 eral condition of oedema of the throat and neck.  (Worlds Horn.
 Convention ; Lippe.)

                 XLVI. Mercur.  bromatus.

   178. I have used Bromide of Mercury in a few cases of diph-
 theria, with great painfulness of the inner throat, white deposit,
 and a  dusky redness of the fauces  and tonsils.  It acts very
 satisfactorily in 3 dec. trit.  (Hale's Therapeutics, 82).

              XLVII.  Mercur. hydrocyanicus.

   179.  The indication for its use is the presence of the exudate,
 which  may be  white, yellow, gray,  or any shade  between.
 The accompanying fever has the adynamic character, and the
 collapse shows itself in the commencement of the disease, there-
 fore this drug should be used even before the exudation.   Fre-
 quently the exudate is in places which cannot be seen.  When
 an epidemic of diphtheritis prevails, administer it in  every in-
 flammation of the throat.   Higher dilutions operate better than
 lower; I begun at the 6th and have arrived at the 30th dil.
 (Hirsch., Ztschr.f. h. Klin., 17, 162; Villers).
   180. Villers treated, during ten years, over a hundred cases
under  three different latitudes (Dresden, St. Petersburg, and
another city in Russia), and found that the disease was always
the same, and that  Merc,  hydroc. was the  only  suitable and
quickly operating drug.  He did not lose a single case, but in- 
54
therapeutics of diphtheritis.
sists on using the 30th dil.   It certainly should not be admin-
istered below  the 6th (1 : 99) dil.  After using this drug the
further extent and degeneration of the exudate  is stopped at
once, the  improvement is  very  striking  even  after  twelve
hours, after twenty-four hours no vestige of exudate is generally
to be seen, and after two or three days the  disease is so far re-
moved, that the remedy is no longer necessary, as the  patient
is well.  With the improvement of the  local symptoms that
of the others keeps pace;  refreshing sleep and appetite appear
already after a few hours, and strength comes rapidly.  If the
remedy is given in the stage of invasion, i. e., before the exudate
is deposited, it will not appear  at all.  As  a prophylactic it is
equally effective.   Paralysis and other after-diseases have not
been observed  after the use of this drug.  Several  physicians
have never seen any result from Merc, hydrocyan., because they
gave the 2d  and  3d trit. or dil., which is much too strong, or
rather not sufficiently developed.  (Allg. h. Ztg., 88, 92, and
Internal,  h. Presse, 6, 425, 431, and 439.)
   181. A scrofulous boy of 7 years, in Dresden, Saxony.  Merc.
s*ol. ineffectual.   Beginning of exhaustion.  Arsen.  On fifth
day cough with croup tone; torpid character of the  disease.
Iod. As the collapse grows worse and worse, again Arsen.  On
the seventh  day, extreme exhaustion; sawing breathing ; ady-
namic fever;  spasmodic  cough  when  examining the fauces.
On the left  side  of the velum, close to  the  uvula, loss  of sub-
stance of about half an inch in diameter, surrounded by a nar-
row, intensely red rim, the  color of which contrasts with the
purple tint  of the neighboring membrane; the deficiency is
filled with a slate-gray, soft  substance, which hangs below the
edge  of   the  velum.  A  hopeless  case.   Merc,  hydrocvan. 6
(1: 99), one  drop  to half glass of water, one spoonful every two
hours, three doses, afterwards  three doses of Iod., then again
three doses of Merc, hydr., etc., in alternation.  The next night
quiet sleep,  with diminishing attacks of  coughing; no sawing
breathing.  On the next morning appetite and not the least
vestige of the gangrene;  general  condition  correspondingly
better.  Extraordinary quick recovery.   (Hirsch., Ztschr. f. h
Klin., 17,146; Beck and  Villers).  We  did not hesitate'to
translate this  case although two remedies  had been given
in 
by f.  g. oehme, m.d.
55
alternation ; as Iod. was ineffectual before the last administra-
tion of Arsen., in is unlikely that it had any effect afterwards;
therefore the cure was due entirely to Merc, hydrocyan.
  182. Boy of 4 years, in Dresden. Lives in a bad cellar-tene-
ment.  One brother and sister have just died of diphtheritis
without any treatment.  Tonsils, velum palatinum, and fauces
much swollen, dark red,  and thickly covered with exudate;
great difficulty in swallowing; hoarse voice; rough, dry cough
with anxiety; skin hot and dry ; pulse 130, small; great weak-
ness, apathy, emaciation.  Merc, hydrocyan. 6 (1: 99\ one drop
to half glass of water, one spoonful every two hours ; twenty-
four hours later the swelling of the velum and fauces diminished
one-half; the color of  the mucous membrane  almost natural;
only a trifling vestige of the exudate ;  pulse 90  ; skin almost
normal.  The second night quiet  sleep and appetite.  On  the
third day his mother washed the floor,  and on the fourth day
the  patient, poorly clad, sat  on the window-stool of a frosty
window.  No relapse of diphtheritis, but laryngitis catarrhalis
with violent fever, which  Phosph. 30 cured.  (Ibidem, p. 156 ;
Villers.)
  183. A man in the last stages of consumption, in St. Peters-
burg, Russia.   Extreme emaciation and weakness, so that he
can  scarcely speak.   For  the last six days diphtheritis,  for
which an allopathic  physician  had prescribed, daily, several
doses of Chin, sulphuricum.  Skin like parchment, dry;  ex-
tremities cool; liquid stools ; the entire mouth and fauces cov-
ered with one mass of soft, grayish-green exudate, of which
some portions could be easily removed, leaving an easily bleed-
ino-  surface.   Merc, hydroc. every two hours.  After the first
dose the diarrhoea checked; after  the  second dose quiet and
refreshing sleep.  After twenty-four hours the swallowing bet-
ter •  he feels better and looks better ;  mouth and fauces almost
free from exudate.  The usual tuberculose expectoration, which
had stopped for several days, commenced again.  One day later
the mouth and fauces  perfectly healthy; strength is gaining.
Ten  days later he died of tuberculosis.   (Ibidem; Villers.)
  184. A 3-year old, very sickly, scrofulous girl,  of a scrofulous
mother and an old, syphilitic father.  On the fourth day of the 
56
therapeutics of diphtheritis.
diphtheritis the following condition:  the child lay on its back,
with hanging under jaw and half-closed eyes; sopor, but when
spoken to, easily roused ; mouth and fauces completely covered
with whitish-gray exudate; the dry lips bleed a little on open-
ing the mouth ;  nose stopped up ;  swallowing impossible ; the
patient  can utter only a few croaking sounds; emaciation and
flabbiness of  muscles; extreme weakness; skin hot and dry;
pulse excessively weak, and so fast that it cannot  be counted ;
urine scant,and darker than usual,without sediment;  no stool
for the last two days.  Prognosis very unfavorable.  Aeon, and
Bell, ineffectual.  Merc, hydrocyan.  30, three globules every
two hours.  Improvement begun  after the fourth dose, in the
night; complete recovery on the fourth day, with the exception
of weakness.  (Hirsch., Ztschr.f. h. Klin., 17,162; Villers.)
   185.  A week,  irritable, anaemic, 11-years' old boy, living in
a narrow, damp  cellar-kitchen, also used  as a wash-room.  On
the second day  the entire mucous membrane  of the mouth
and fauces dark red  and considerably swollen.  On the left side
of the  velum palatinum a deep diphtheritic ulcer, with sharp-
cut edges, surrounded by a ring of exudate; on the mucous
membrane many very  small exudate patches;  the tip of the
tongue  dark  red;  the papillae filiformes  much swollen; the
middle and back part of the tongue covered with a dirty-yellow
coating; swallowing exceedingly  difficult; face has an apathe-
tic, anxious expression ; on the upper  half of the body a profuse,
viscous perspiration,  which is cold  on forehead  and cheek.
Radial pulse on the  right arm scarcely perceptible ; on the left,
thread-like, 140.  Extreme  prostration;  no  appetite.   Merc.
hydrocyan. 30, 1 dr. to a glass of  water;  every two hours one
spoonful.  Quiet sleep in  the second half  of the following
night;  next day in forenoon, good appetite  ; in the afternoon
no vestige of the exudate and of the coat  on  the tongue;  natu-
ral color of mucous  membrane of the mouth  and fauces; pulse
80, strong; he feels well.  (Allg. h. Ztg., 79, 102 ; Villers).
   186.  During an  epidemic diphtheritis in a small  city  in
France,  thirty-two  patients died  out of forty under allopathic
treatment.  Under  the treatment  with  Brom., Spong., and
Tart, em., several cases also were lost, but after Merc, "hydro- 
BY F.  G.  0EHME, M.D.
57
cyan, arrived from Paris, no more fatal cases.  (Allg. h. Ztg.,
88, 70;  Roguin.)
  187. A 4-year old girl; light case.   Merc, hydroc; recovery-
{Allg. h. Ztg., 79, 136;  Ganz).
  188. A lady of 24 years, suffering since morning with severe
sore throat; feels  very weak; pulse  120;  skin hot and dry;
deglutition very painful; frequent pains, darting  from throat
to ear and head ;  tonsils greatly inflamed  and enlarged.  Ac.
and Bell. 3.   The next day fever  somewhat  diminished ;  ton-
sils less acutely inflamed, but much ulcerated ;  the ulcers deep,
and many of them filled with a greenish-yellow pus.  Mercur.
cyanuret., 2  gr. to  half a tumbler of water;  two small spoonfuls
every two hours.  Next day much better in every respect; the
following day recovery.  (N.  E.  Med. Gaz., 6, 115;  G.  W.
Richards.)
  189. A 10-year old boy had for several years chronic enlarge-
ment of tonsils; sore  throat, with  much  febrile  excitement;
headache; restlessness  ; some pain in swallowing ; tonsils very
red, swollen and covered with small, superficial ulcers.  Merc.
cyan. 1,1 gr. to  half a  tumbler of water; one teaspoonful every
two hours.  Decidedly improved the next  day, and cured  the
second.   (Ibidem.)

                          Resume.

   AVhen Viller's son  (No. 181)  was  hopelessly sick,  Beck re-
commended Merc, hydroc. as the only remedy which  might be
of  use,  because it had  produced  gangrene of the velum palati-
num and fauces on five persons poisened with this drug.  The
astonishing  result led Villers to use it again and again,  always
with the same gratifying success;  and we  must admit that his
are marvellous cures, but must add  that others did not find it
such a universal remedy (see No. 11).  We have also  practiced
under three different latitudes, and neither lost a patient,  but
were obliged to use various remedies ; probably others  have had
equally as good results.
   We have no proving of this drug, can therefore not give any
indications  for its selection. 
58
THERAPEUTICS OF DIPHTHERITIS.
             XLVIII. Mercur. solub.  Hahnem.
  190. The success with Mercur. has  not been very great, and
could not  be otherwise, as Mercur. lacks the excessive  quick
prostration and the  entirely suspended  action of the skin.
(Bohr's Therap., 1, 328.)
  191. Profuse  salivation;  profuse  perspiration;   offensive
breath;  swelling  of the  submaxillary glands.  (Guernsey's
Obstet, 946.)
  192. With a  very few exceptions, we have experienced the
best results with Mercurius sol.  (Allg. h. Zlg., 79, 177; Gceze.)
  193. An 8-year old boy.   Headache ;  fever; vomiting; con-
vulsions ; unconsciousness, with somnolency;  swelling  of the
right tonsil, with some whitish-gray, soft exudate.  Merc, sol.,
3d trit.   Improvement the next morning, and  return of con-
sciousness.  Recovery in a  few days.  (Allg.  h. Ztg., 79, 177;
Goeze.)
  See No. 17.

              XLIX. Mercur.  sublim. corros.
  194. Merc. subl. com, 2d or 3d trit., is  the  right  medicine,
when the exudate covers the entire fauces and extends into the
nose,  from which a profuse discharge  flows.  (Allg. h. Ztg., 85,
86; Dittrich.)

                   L. Muriatis acidum.

  195. Mur.  acid,  is scarcely  indicated in quick and violent
cases, but will  suit where there is not  much fever, but great
lassitude and weakness.   It is necessary not to use the remedy
too weak, but in the 1st or 2d dilution (Baehr's Therap., 1, 329).
  196. The use of Muriat. acid, is founded more on its anti-
septic property than on its  pathogenetic symptoms.   (Hirsch.
Ztschr.f. horn. Klin., 13, 141; Trinks.)
  197. Hughes asserts that our only remedy is Muriat. acid.
wherever intoxication of the blood evidently exists  but that  it
is by no means particularly effective;  that our most hopeful
outlook is in  the direction of such antiseptics as  Kal. permano-.
and Calc. chloricum.   (Allg. h. Ztg., 84,152.) 
by f.  g. oeiime,  m.d.
59
  198. A boy of 15 years.  After a five days' use of Bell, and
Merc, the following symptoms: the patient hawks  out  con-
tinually tough, fetid phlegm ; the voice hoarse,  nasal ; rattling
of mucus ; submaxillary glands swollen as large as hens' eggs ;
the head bent forward, because, when holding it erect, or when
lying down, the phlegm in the fauces causes difficult breathing
and chocking  spells.  The entire back  part of the  fauces a
gangrenous ulcer, covered with tough mucus, which draws out
in strings ; foetor oris; swallowing of water very difficult, pro-
ducing cough; pulse small, very fast; face  pale, with  a  very
anxious expression ; spirits depressed.  Mur. acid. 1  (1: 9), 4 dr.
in  water every hour;  externally,  Mur. acid, dilut.,  half a
drachm,  to 1 ounce of  Mel.  rosar.  Improvement in  twelve
hours ; fcetor oris removed in twenty-four hours, the exudate in
four  days.  Complete recovery in eight days.  (Ztschr. f.  h.
Klin., 16, 92; Hirsch.; Pemerl.)
   199. A young man of 17  years;  scarlatina.   On the third
day tonsils and fauces covered with exudate ; the submaxillary
glands swollen as large  as pigeons' eggs; can only  hold the
head bent forward; continual desire  to  hawk, with difficult
spitting  out of tough mucus;  swallowing almost impossible.
Bellad. ineffectual. Muriat. acid. 2, and externally  the  diluted
acid.  Improvement on the fifth day ;  the diphtheritis removed
on the ninth day;  the scarlatina in the stage of desquamation.
(Hirsch., Ztschr. f h. Klin., 16, 101; Pemerl.)
   200. Of eight other cases, the mild  ones were treated inter-
nally with Mur. acid. 1;  the severe ones internally and exter-
nally ; also warm, wet compresses.   In all cases improvement
began after twelve hours ;  at the latest after twenty-four hours.
The violent fever subsided;  a general, alleviating perspiration
appeared ; sleep ;  the violent, congestive headache  in the fore-
head diminished; the submaxillary glands became less painful;
the swallowing better; the thirst lessened; appetite; the exu-
date disappeared at the latest in four days.   Only in  one  case,
a strong man of 40 years, the disease lasted  almost fourteen
days. (Ibidem, Pemerl.)
   Pemerl used Mur. acid., because he once, when an allopathist,
cured with it quickly a stomatitis with very similar symp- 
 60             therapeutics of diphtheritis.

 toms.  In another case Mur. acid. 1, internally and externally,
 proved ineffectual, and it was  given alternately with  Chin.
 ars. 3.  (Ibidem, p. 131.)
  201. Child of 8 years; on the fifth day after Bell, and  Merc.
 protojod.; patient  worse, the disease tending toward the putrid
 type; trembling of the hands; bleeding of nose, the blood dark
 and putrid ; great prostration ; restless  with slight  delirium ;
 very little rash  and the peculiar smell, which always attends
 this disease in its worst form.   Mur. acid. 5 dr. to one-quarter
 glass  of  water, every hour one spoonful;  improved next day
 and cured in a few days.  (Trans, of Horn. Med. Soc. of N. Y.,
 3,182,1865; Swift.)
  202. Man of  45 years;  his child just died of diphtheritis
 under allopathic treatment. On third day :  slight fever, pulse
 slow  and weak;  little thirst, tongue  coated thick,  yellow,
 white ; uvula and tonsils swollen, red and covered with a thick,
 whitish false membrane ; putrid smelling breath with sordes on
 the teeth; a complete sore or  scabby condition of the lips, en-
 closing the mouth; more or less rash on body and limbs ; nose
 bleeds every few hours, blood dark and fetid.   Mur. acid.  1
 every hour.   Next day the same, following day  better,  three
 days later cured.   (Ibidem.)
  203. Boy of 12 years in  the same family and sick at the same
 time.  Considerable fever; red and  swollen uvula and tonsils,
 with slight membranous deposit; pulse weak and rather quick;
 bloated face ; pain in lower limbs ; feet swollen and painful; no
 rash.  Merc,  protojod.,  Bell., Rhus.  Two  days  later: breath
 putrid, bleeding of  nose, the blood dark and fetid ; dark crust
 upon the lips and a slight  scarlet rash upon the  whole body;
 great  prostration and slight thirst.  Mur.  ac. 1  every  hour.
Next day much better, cured three days later.  (Ibidem.)

                          ResumS.
  Three  physicians speak  discouragingly of the use of Mur.
acid, in diphtheritis; only two physicians used  it in several
cases; this was in  1865  and 1867.   Since then we do not find
this drug mentioned in  our literature, and Nitr. acid, seems to
have taken its place. 
by f.  g. oehme, m.d.
61
   Pemerl used the acid so strong externally that it had a local
 effect upon  the fungous growth; whether it had, at  the same
 time, a dynamical  influence is difficult to tell.   We may call
 No. 198 a fair cure, while No. 199 is not at all convincing.
   In No. 201-3 " bleeding from the nose, the blood  dark and
 putrid," seems to be the leading and only characteristic symptom,
 common to all  three  cases.   Rash, though  also found in the
 three cases, is no symptom of Mur. acid.
   The provings of the drug show no more similarity to diph-
 theritis than a hundred other remedies.  We cannot find but
 one or two of the prominent symptoms, mentioned in the cases
 among the symptoms of Mur. acid, in Jahr's German Symptomen
 Codex, and should never think of selecting thi3 drug  for such a
 group of symptoms.

                  LI.  Natrum muriaticum.

   204. Swelling of the submaxillary glands and  lymphatics;
 map tongue; burning in the throat; after application of caustics,
 especially Nitrate of Silver.  (In different regions of Pennsyl-
 vania, a  weak solution of table salt was  used during the last
 epidemic as a gargle with  great success).  (Raue's Therap., 120.)

                    LIT. Nitri ACIDUM.

   205. The  local symptoms of Nitri  acid,  resemble those of
 diphtheritis much more than those  of Muriat. acid., and we see
 no reason why the latter has been preferred.   (Baehr's Therap.,
 1, 330.)
   206. Ulcers in the  mouth;  corroding discharge  from the
 nose ; intermitting pulse.  (Raue's  Therap., 120.)
   207. Nitr. acid. 2 or 3, three to four drops to  half  a glass of
water, one spoonful every one or  two hours, was of benefit,
especially in those cases where  yellowish-white or grayish spots
showed  themselves frequently, to a  great  extent  in the fauces,
and occasionally on the inside of the cheeks.  Often these spots
became  confluent, and  formed a dirty, pearl-colored,  dull-look-
ing, pseudo-membranous  coating  of  the mucous  membrane.
Swallowing very difficult.   If the exudate spreads to the larynx 
62
THERAPEUTICS OF DIPHTHERITIS.
the respiration is difficult, and voice and cough hoarse ; great
thirst; the lips mostly pale, occasionally a little bloated.  Fre-
quently tough mucus flows  from the corner of the mouth.
This drug  should  receive particular attention, when children
are attacked whose parents are syphilitic, or have taken much
allopathic medicine.   (Ztschr. f.  h. Klinik, 17, 52 ; Hirsch).
  208. Nitr.  acid, is  suitable only in sporadic cases of diph-
theritis when the following symptoms are present: the raucous
membrane  is  covered with a thin, opaque, milky-white coat, as
if it had been cauterized with nitrate of silver.  The continuity
of this exudate distinguishes it from that of the epidemic diph-
theritis.  The swallowing is very difficult and  painful.   In
such cases Nitr. acid, removed quickly the local symptoms, after
which one could reach better the severe affections of other
organs, caused frequently by the  overdosing with  Calomel.
(Hirsch., Ztschr. f. h.  Klin., 17,162, and Allg. h. Ztg., 79, 47 ;
Villers.)
  209.  In Weimar and neighborhood, a form of diphtheritis
is not uncommon  where there  are superficial round  ulcers.
After the cream-like exudate has disappeared one sees  a thin
hoop-like ring, which  is the edge of the diphtheritic ulcer ; the
surface of the latter has also a different color from the surround-
ing membrane.  This kind  of ulcer is  very characteristic for
Nitr.  acid.  3 to 6, but  where the ulceration is deep, Hep., Merc.
sol., and other preparations of Mercur. are indicated.  (Allg. h.
Ztg., 85, 84 ;  Goullon, Jr.)
  210. Nitr. acid, was of use  only in the 1st and 2d dil.  (Allg.
h. Ztg., 89, 44; Lorbacher.)
  211. Much  pain when  swallowing;  stoppage of  the nose
with discharge of acrid fluid and hoarseness.  (World's Horn.
Convention; Lippe.)
  212. A scrofulous, chlorotic girl of 12 years.  Bell. Mercur
6.  The patient grows steadily worse.  On the third day :   the
last night a bad one ;  great uneasiness and violent fever •  fauces
red and swollen;  excessive salivation ; swallowing exceedino;lv
painful;  foetor oris.  Nitr. acid.  3, four dr. to one ounce and  a
half of water, one dose ever}- half hour, improved already bv
the middle of the afternoon ;  the next night good sleep ; quick
recovery.   (Allg. h. Ztg., 74,195 ; Goullon, Jr.) 
BY f. g. oehme, m.d.
63
  213. A boy of 10 years, frequently subject to bleeding of the
nose.  The diphtheritis began with epistaxis.  Apis ineffectual.
Apis  in  alternation with Kreos. 3, externally diluted alcohol,
removed the foetor oris, and improved the general condition
within  five days, but the  exudate spread still more.  Nitr.
acid. 2, internally, and 1st dil., externally, improved in twenty-
four hours ; after forty-eight hours the whole exudate came off
at once,  and left a deep sore ; loss of a portion of the  velum
palatinum.  Appetite and strength better.  Partial paralysis
of velum palatinum and nervus opticus.   The former difficult
hearing much better.   (Allg. h. Ztg., 78, 82; Sybel.)
  214. A 4 year old sister of a  brother, violently sick with
diphtheritis, received Apis as a prophylacticum in alternation
with  Aeon, on account  of  fever; notwithstanding this treat-
ment diphtheritis three days later.  Nitr. acid. 2 internally,
1st dil. externally.  Although  the disease was not severe, yet
it required from eight to fourteen days to remove the exudate.
(Allg. h.  Ztg.,  78, 83;  Sybel.)
  215. Female, just recovered from a very severe  influenza of
six weeks' duration.  After a violent chill, sore throat; severe,
pressing headache ; great dulness, sleeplessness, general feeling
of sickness;  pain when swallowing; dryness in  the throat;
exudate; pulse  115.   Scarcely  twenty-four hours  after the
commencement of  the disease violent attacks of dyspnoea and
suffocation, during which blood and  pus is thrown out.  De-
spondency ; pulse too slow and weak.  Nitr. acid. 6, every two
hours; four days later, removal of the local symptoms ; appe-
tite.  (Hirsch., Ztschr.f. h. Klin., 24, 84; Goullon, Jr.)
  216. Two girls.  Ac. 2, Bell. 2, Merc. sol. 5, Merc. sol. 3, in-
effectual.  On the sixth  day, the exudate very extended, dirty,
discolored ; excessive foetor oris, profuse salivation, swollen sub-
maxillary glands; drinks run out of the nose;  bad nights;
great despondency.  Nitr.  acid.  2, six drops to  half glass of
water, one spoonful every two hours.  During the next twenty-
four hours the disease neither better nor worse.  The same pre-
scription continued; the same medicine  and preparation  also
externally as a gargle, every two hours.   Decided improvement
the next morning.   Two days later the disease removed.  (In-
terna*, horn. Presse, 5,19 ; Billig.) 
64
THERAPEUTICS OF DIPHTHERITIS.
   217. Girl of 9 years.  Nausea, vomiting three times, twelve
 hours later feverish, with red face and  pain in the head.   The
 inside of the mouth, tonsils and nearly the whole fauces covered
 with  a deposit, varying in apparent thickness from a  mere
 mucous coating to that of ordinary buckskin;  the thicker and
 earlier patches were yellowish, the glands on either side swollen,
 and the surface, not covered, was of a bright red.  Beating in
 the throat;  pain in swallowing.  Vomiting of a ropy, greenish
 yellow mucus.  Nitr. acid., three dr. to a  glass of water, one
 spoonful hourly, arrested within six hours the progress of  the
 disease; six hours still later the patches disappearing, less pain
 in the throat, pulse softened, patient better in ewery respect.
 Twenty-four hours later a few doses of Laches. 12, to complete
 the cure (why another medicine?).  (Transact, of the Horn. Med.
' JSoc. ofN. Y, 2, 225 ;  G. B. Palmer.)
   218. Lady of 20 years sick in a family, where four had just
 died of diphtheritis under allopathic care; high fever, pain  in
 head, nausea, vomiting, tonsils very much swollen, with a heavy
 deposit upon them, also on the back part of the throat, which
 was almost closed.  The coating white at the margin, yellowish
 in the  thicker portions and turning  black  at  some points.
 Nitr.  acid, as in  last case; hot water compresses externally.
 In twenty-four hours the  pain mostly gone,  skin moist, the
 patches in the throat showed the line of demarcation.  Recov-
 ered soon.   (Ibidem).
   219. Woman of 33 years.  Most severe form of diphtheritis.
 The case had yielded to the remedies  until we arrived at this
 stage:  the  exudate had disappeared, but there still remained
 symptoms  of  adynamia  of a  rather  marked character, and
 locally, the surfaces,  late the seat  of the exudate,  presented
 that dark hue—verging on mahogany—which sometimes as we
 recall some of the features of that  awful epidemic, preceded
 death by only a few hours,  being the forerunner of that event.
 A passive congestion, if the term is allowable,  of the vessels of
 the part takes place, and  rapid disintegration of the tissues
 seizes upon them  in a few hours.   She had had Bell. Merc.
 protojod., Chin.,  Ars.;  Nitr. acid., three or  four  dr. every
 three  hours, changed this  color to  a flesh tint, and the ady- 
BY F.  G. 0EHME,  M.D.
65
 namia to a reasonable degree of strength.  (Am. Horn. Obs., 4,
 399 ; J. F. Merritt.)

                           Resume.

   Little  harmony is between the general remarks 206 to 209.
   Nitr. acid, is recommended by Villers (208) against sporadic
 diphtheritis, where the mucous membrane has  the appearance
 of having been cauterized  with Arg.  nitr.; by Goullon (209)
 against superficial  round ulcers; by  Hirsch (207), and Villers
 (208), after syphilis or overdosing  with Quicksilver, either  in
 the patient or his parents.
   The most  prominent symptoms  for which  Nitr.  acid, has
 been used are the following: swallowing very difficult and exe-
 dingly painful; excessive salivation; fauces and glands swollen;
 fcetor oris; great uneasiness ; violent  fever.
   No.  213 proves that the drug is also beneficial where the
 local etfection is deepseated.  No. 219 is a peculiar case.

                     LIU. Phosphorus.

   220. Phosphorus deserves consideration in the  treatment  of
 diphtheritis,  especially where  the  adynamic character shows
 itself early, the strength fails rapidly, and paralysis of the heart
 threatens. (Hirsch., Ztschr.f. h. Klin., 13, 142; Trinks.)

          LIV. Phytolacca decandra and octandra.

   221. Phytol is indicated in a large  number  of cases.   The
 general symptoms are  pain in the forehead, of a dull, aching
 character, increased by motion, head hot, face livid, skin  dry
 and harsh, great prostration, weakness of the upper extremi-
 ties especially with  drowsiness, nausea,  vomiting  and  fre-
 quently diarrhoea.  The characteristic  symptoms are stiffness
 of the neck;  redness and swelling of  the  soft  palate, tonsils,
oesophagus and frequently the roof of the mouth, with constant
inclination to swallow,  accompanied with more or less pain;  the
taste metallic or lost, the tongue is raw, with  blisters  on  the
 'de and feels rough ; the appetite lost; the saliva increased and
     5 
66
THERAPEUTICS OF DIPHTHERITIS.
the breath offensive.   At a late stage of the disease the vision
is impaired and the hearing dull.   (Am. Horn.  Obs., 5, 232 ; P.
S. Hoyne.)
  222. Dr. Burt says he has succeeded with Phytol. decand. in
thirty-two  out of thirty-four  cases  of diphtheria  treated.
(Hale's New. Rem., second edit., 782.)
  223. Phytol. octandra, growing in great abundance all around
this city (Sidney,  Australia), but  not indigenous.  This is a
most valuable plant, used either internally or externally.  It is
specific in diphtheria, given in decoction or infusion, applied
very assiduously to the fauces as a gargle  and used  hot, and
frequently repeated as a poultice to the throat; all stiffness dis-
appears ;  the  membranaceous  formation is  thrown off, and is
not reproduced ; perspiration follows ; fever subsides ; all ach-
ing, general  pains, and headache  disappear, and the  patient
eagerly seeks for food.  (Ibidem, 783, and  British Hum. Rev.,
1866; Sherwin.)
  224. Miss B., set. 20.  Had a severe chill at night, with great
pain in back of head, back and limbs, followed with fever and
sore throat.   Two days  later, found her suffering very much,
with great headache; worse in the back part;  back and limbs
aching fearfully;  both tonsils very much swollen, and covered
with a grayish pseudo-membrane;  tongue very red at the tip,
coated white; great prostration ; cannot stand  ; if she rises up
in bed, she  immediately faints away; prognosis  unfavorable.
Phytol. decand., 4 dr. every hour and a gargle  of the  same be-
tween.  Morning, decided change  for the better.  Continued
the same treatment for  three days, when the  false membrane
came off, and  the fifth day discharged her cured.   The fever
abated remarkable quickly.  (Ibidem, 779 ;  Burt.)
  225. Mrs. B., aet.  31.  November 16th,  throat  commenced
to feel sore in the morning, followed by high fever  all  dav *
right  tonsil very much swollen.   At noon commenced to see
white substance forming on the tonsil.   I was called at 10 p.m.
found the right tonsil covered  completely with a white pseud-
membrane; fauces and soft palate very much inflamed • degluti-
tion almost impossible; loss of appetite ; great frontal headache •
bowels moved every two hours, with severe pain  in the umbilical 
BY F.  G. 0EHME, M.D.                 67
region; great prostration ;  vertigo is so great that  she cannot
walk; pulse 127, soft.  Phytol. decand., 4 dr. every hour, and a
gargle of the same every hour, consisting of 50 dr. in a tumbler
of water.   18th. Very much better, pulse 100 ; throat does not
feel near as sore; false membrane beginning to come off; back
and limbs ache but slightly; headache nearly gone ; continued
the same treatment three days; discharged her cured; the di-
arrhoea stopped the second day.  (Ibidem.)
  226. Miss H., aet. 25. December 3d, had a severe chill in the
night, followed by high fever and sore throat. Aeon, and Bell.,
all  day,  but continued to  get worse.  Midnight, I discovered
patches of pseudo-membrane on  the tonsils; she  complained
most bitterly of the back of her head and neck; back and limbs
aching; pulse 120;  bowels  costive; loss of appetite.  Phytol.,
3 dr. every hour, with a gargle of the same between. 4th, noon.
Feeling better; continued the same treatment.  5th. No fever;
feeling quite well, but thinks her throat is more sore; both
tonsils are swollen, and covered in patches with false membrane;
continued the same treatment—giving 6 drops at a dose.  6th.
Feeling a great deal better; pseudo-membrane is off from the
tonsils; continued the same remedy every two hours for two
days, when I discharged her cured.  (Ibidem.)
  227. Snyder, aet. 39.  November 10th.   Throat commenced
to feel sore, with severe headache; back and  limbs aching se-
verely.  11th. Throat  very  sore;  both tonsils covered with
grayish pseudo-membrane, soft and swollen ;  palate and fauces
violently  inflamed;  deglutition  impossible;  severe  frontal
headache ;  back and limbs aching severely ; high fever;  pulse
128 ; delirious at times; bowels costive; has not slept through
the night.  Fat salt pork around the neck, beef tea every two
hours, and  Phytol. every half  hour, 4 drops  at  a dose, with a
gargle  of the  same.   12th. Decided change for  the better;
pulse 98 ; head, back, and limbs do  not ache as hard  as they
did yesterday ;  throat feeling very sore, but the false membrane
does not seem to be spreading.   Phytol., every hour.   13th.
Feelino- much  better; pseudo-membrane commencing to  fall
off  leavino- great holes in the tonsils that bleed a  little; con-
tinued the same  treatment.  14th. Pseudo-membrane all off; 
68            THERAPEUTICS OF DIPHTHERITIS.
 tonsils very  much  swollen, very red and  ragged ; continued
 Phytol., for three days every two hours when I discharged him
 cured.  I have given Phytol. in two cases of children and two
 in adults, where the pseudo-membrane was well formed (but
 there was not so much fever), with  the same gratifying result.
 (Ibidem.)
  228. Man, aet. 26.  January 4th, 10 p.m.  Slight pain in the
 left tonsil when swallowing; rested well till 2 am.; awoke with
 severe frontal headache;  back and legs aching very hard, with
 high fever and sore throat; could not sleep any more.  8 a.m. :
 Pulse 120, very soft;  head, back, and legs  aching violently ;
 throat very sore; left  tonsil very much  swollen, and covered
 with a grayish false membrane;  right tonsil has patches of the
 pseudo-membrane on it; deglutition is almost impossible ; great
 prostration;  can stand up  only a few moments  at a time, it
 makes him so faint and  dizzy.  Phytol., 4  doses every hour,
 with a gargle of the same, consisting of 50 drops  in a tumbler
 water. 5th. Feeling very much better; fever nearly gone; head
 back, and legs do not ache half  as much as they did yesterday;
 pulse 100; throat is feeling very sore; left tonsil is very much
 swollen and still covered  with the pseudo-membrane; the right
 one looks very red,  with  small patches of membrane on it; de-
 glutition almost impossible ; continued treatment.  6th. Feel-
 ing much better; pseudo-membrane is off from both tonsils; they
 look very red, and  the left  is still  swollen; no fever;  slight
 appetite; continued the  treatment.  7th. Feeling quite well,
 but throat pains when swallowing; discharged cured. (Ibidem,
 780, and  Amer. Horn. Obs., 1, 35.)
  229. Mrs. G., set.  21, nursing a babe.  January 11th.  Throat
 commenced to feel sore ; had a very restless night.  12th. Slight
 headache, with a severe pain in back and legs; very chilly all
 the time; throat very  sore; both tonsils very much swollen
 and covered in patches with a dark-colored pseudo-membrane;
 deglutition very difficult; face very much flushed  ; great pros-
 tration ;  cannot sit up any, she is so faint and weak.  Phytol.,
4 drops every half  hour, with a gargle  of the same.  13th.
Feeling very much better;  back and legs do not ache any;
throat is  feeling very  sore; tonsils very red and  swollen, and 
BY F.  G. 0EHME, M.D.
69
covered in patches with pseudo-membrane ; deglutition is very
painful.  Continued same  treatment once  an hour.  14th.
Feeling quite well; pseudo-membrane is off from both tonsils;
there are large holes eaten into the tonsils ; can swallow quite
well; discharged her cured the next day.  She nursed the babe
all the while, but it did not take the disease.  (Ibidem.,  781.)
  230. Miss K., aet. 9.   December 12th. For the last two days
has had a fever, with chills all the while; throat has been very
sore, and is getting worse all the time; head, back, and legs
are aching constantly;  pulse 130; very  weak  and soft; soft
palate  and tonsils are violently inflamed and. swollen;  both
tonsils are covered with  grayish  pseudo-membrane;  cannot
swallow anything;  ver}T weak; cannot sit up; has not eaten
anything for two days;  will not take any nourishment.  Phy-
tol., 2  drops every  hour.   Morning.  Feeling a little  better;
pseudo-membrane about  the same; continued treatment.  Morn-
ing. Feeling quite well;  false membrane is all off, but the throat
is feeling very sore; discharged cured the next day.  (Ibidem.)
  231. Henry, set. 4.  For two days has  had a  little fever and
sore throat; feels cold all the time; refuses to take food ;  both
tonsils twice as large as they ought to be, covered in  patches
with a whitish false membrane ; pulse 118, very weak; he lies
on the lounge all the time.  Phytol., 10 drops  in a half tum-
bler of water.   Cured in two days.  (Ibidem.)
  232. A young lad was taken with diphtheria, and treated by
an old-school physician,  and died.  His sister, 28 years of age,
was taken with it three days after, and treated by an eclectic,
and died the fourth day.  A young lady, who waited on them,
was taken down with it four days after the death of the sister.
Found her with a very sore throat, and the tonsils and soft
palate  covered  with the false membrane, of a greenish color;
both tonsils were twice as  large as  they ought to be;  neck
was very stiff; pulse 128 ;  she was very much frightened, was
sure she would die ; hands and  limbs trembled constantly.   I
tried to quiet her, and gave her Bellad. and Iod. of Merc, every
hour in alternation.  Morning.  Found her very much  worse;
fever the same, and still trembling.   I gave one dose of Aeon.,
and then a gargle of a tincture from the  green root of Phytol. 
70
THERAPEUTICS OF DIPHTHERITIS.
every half hour, and gave internally about  6 drops of the
same, every hour.  Remained with her through the day and all
night.   Morning. She was not so nervous, and  the disease had
not made any progress ; continued the same treatment.   Next
day about the same; continued  same medicine, but made it a
little stronger.   Morning. Decidedly better ; pseudo-membrane
looks as if it would soon drop off; continued the same  treat-
ment.  Morning.  Feeling quite  free from fever; about a quar-
ter of the membrane has come off;  she  has  a  fine, scarlet
eruption all over the body and limbs, but more on the legs than
on the body; urine is albuminous; continued the same  treat-
ment every two hours.  Morning.  The right tonsil is free from
the membrane, but looks very raw, and burns a good deal; con-
tinued the same.  Next  morning, false membrane  all gone '■>
swelling has disappeared, excepting the left tonsil.   Continued
Phytol.; the case cured in a few days.   (Ibidem, 782.)
  233. The patient, in the room with a scarlatina patient, was
taken sick.  High fever, headache, etc.; not  complaining  of
throat for two days, when the child's mother told me she com-
plained of her throat; both sides covered with the membrane,
with a rash on the body.  Stopped Aeon, and Bell., and gave
Phytol. decand. (tincture from root), 15 dr.  in one-third glass of
water, two teaspoonfuls at a dose every hour;  with a gargle of
the same, 3 dr. to a glass of water.  It was the quickest cure
of the disease I ever made.  (Ibidem; G. F. Foster.)
  234. Miss  A.  Tonsils very much swollen, covered wholly by
the false membrane ; she was  panting for breath ; eyes staring,
and her condition dangerous and distressing.  Phytol. decand.,
4 dr. of tincture of the root, every hour.  Next  mornino-, found
her much better, and in a  few days  she  was convalescent.
Several cases occurred in  the  same neighborhood, and were all
cured by Phytol.  (Ibidem, 783 ; J. Doy.)  Boyce, Stearns, and
others, used  Phytol. also succesfully.  (Ibidem.)
  235. Great headache; violent  aching in the back and limbs •
great prostration; cannot stand; when rising up in bed gets
faint and dizzy.  (Raue's Therap., 120.)
  236. Phytolac. decand. is suitable when the following symp-
toms are present: Fever, pulse 120  to  130 ; geueral and quick 
BY F.  G. 0EHME, M.D.
71
prostration;  nervous symptoms  with  subsequent paralysis;
vomiting ;  dyspnoea ; headache ; enlarged glands, and especially
a false membrane on the tonsils and in the fauces;  the exudate
is very tough and dirty brown.   Palmer considers it a great
remedy, where the exudate in the fauces comes off hard.  Ac-
cording to Boyce, many cases, which were treated with Phytol.
dec, distinguished themselves by a strongly marked adymanic
condition,  and in many  cases a  partial  paralysis remained.
40 dr. of the tincture to one pint of water makes a good gargle.
(Allg. horn.  Ztg., 84, 134, and  Horn.  World.)
  237. Hughes asserts  on the strength of forty-seven cases,
treated in the course of ten years, that Phytol. dec. is incapable
of subduing the malignant form of diphtheritis, but that it is
specific where there is violent fever, pains in the head and back.
(Allg. h. Ztg., 84, 152, and Brit Journ. of Horn.)
  238. A.  E.  Small had opportunity to observe the effect of
Phytol. dec. in a number of cases, and obtained always good
results where there was chilliness during the evening and night,
and dryness and  soreness in the throat during the morning.
In several cases, where the evening chill was followed by sore-
ness in the throat the next morning, he found a bluish-red exu-
date on the tonsils and fauces, difficult swallowing, and  very
great  sensitiveness of  the  tonsils, with  considerable fever.
Phytol. dec. 3 cured almost  always.  He  says further: When
my patients  complain  of a  choking sensation in  the throat,
caused by the swelling  of the tonsils and  soft palate, and the
soft palate  looks fiery-red, I am on my guard, and give Phytol.
dec.  3, usually with success.  I also give  this drug when the
patient complains of rawness in the throat, and the neck is so
sensitive that he cannot bear the least touch of solid food, and
gets almost frantic with pain when swallowing liquids. (U. S.
Med. and Surg. Journ., vol. 7, 26, and Internal, h. Presse, 3, 405.)
   239 Phytol. dec. cured a sore throat with tonsils swollen and
covered  with grayish  patches; dizziness; backache.  (Horn.
Monthly, March, 1874, p. 358, and Raue's Record, 6, 87.) 
72
THERAPEUTICS OF DIPHTHERITIS.
                          Resume.
   The most important symptoms of the above cases and remarks
 are the following:  Chills usher in the disease, appearing irregu-
 larly the first days ;  violent pain in the front or back part of the
 head, in the back and limbs ; great prostration, with fainting or
 vertigo when rising, preventing the patient  from  sitting up ;
 loss of appetite; high fever;  dilirium-; tonsils, soft palate, and
fauces  highly inflamed, very much swollen, sore, and sensitive;
 deglutition almost impossible ; choking sensation; dyspnoea ; the
 exudate mostly of a grayish color.
   Besides the above mentioned throat symptoms the following
 are  the most frequent  among the pathogenetic symptoms of
 Phytol.: sensation, as if from a lump in the throat; fulness in
 the throat; roughness and rawness in the pharynx; dryness in
 the fauces; disposition to hawk up mucus.
   In case  232 a scarlet eruption appeared, and in case  233 a
 rash.  Hughes  (237) considers  the drug insufficient  in the
 malignant  form.
   The doses were from 2 to 6  drops of the tincture in frequent
 repetition; a preparation of the same strength was used also for
 a gargle.   At times the tincture from the green root, gathered
 early in spring, was used.  If a certain dose did not  have an
 effect, it was increased in strength and frequency.

                       LV. Plumbum.

   240.  Schiissler considers the gangrene  of  the exudate and
 mucous membrane of the throat the principal and characteristic
 symptom of diphtheritis, and for this reason Plumb. 4-30 for a
 specific against  it.   He has cured many cases with it.  (Allg. h.
 Ztg., 78, 62.)
   241.  I have the best success with Plumb, jod. 9-12.  (Allg. h.
 Ztg., 80, 91; Schiissler.)  Since I  use Plumb, jod.  I have not
 lost a single patient, although I have treated several hundred.
 (Ibidem, page 145.)

                 LVI.  Rhus  toxicodendron.

   242.  When the child is restless, wants  to be carried about
 wakes up every now and then complaining of pain in the throat • 
BY F.  G. 0EHME, M.D.
73
 when a bloody saliva runs out of the mouth during sleep ; when
 the parotid glands are a good deal  swollen ;  when there are
 transparent, jelly-like discharges from the bowels at  stool or
 afterwards. (Raue's  Therap., 119.)
   243. When a  typhoid condition sets in, give Rhus tox,  if
 there is thirst; if not, Apis.  (Am. Horn. Obs., 6, 556 ; II. N.
 Martin.)

                  LVII. Salicyl. acidum.
   244. Dr. Hauon in Uckermiinde  has used internally Salicyl.
 acid,  for the last months, and obtained astonishing results.  He
 gives an adult Salic, ac.  0.5 to  150.00 colatur (in  a solution of
 Natr. phosph. 5.0: 150.0, in order to  dissolve it more readily,)
 every hour 1 spoonful; for children a weaker solution.   A girl
 of seven years.   Diphtheritis commenced four  days ago ;  very
 violent fever; the entire fauces covered with  white exudate;
 Salicyl. acid.;  the next night sleep; removal of  almost the
 whole exudate and of the fever  in eighteen hours ; cured in two
 days.  Woman of thirty-eight  years,  man of twenty-one years,
 three girls of eight, ten, and twelve years—diphtheritis.  After
 the third  or fourth  dose of Salic, ac. the exudate came off so
 fast that it  was thrown  out with violent retching.  With the
 disappearance of  the exudate  the fever  subsided, and  after
 twelve hours convalescence commenced. (Allg. Med. Central Ztg.,
 May  22d, 1875, and Allg. h. Ztg., 91, 125; Boston Journal of
 Chem., 10, 46.)
  245. Wagner has treated internally and externally fifteen
 cases, some of them very severe, with Salic, acid., and not  lost
 one case.   Light  cases were cured in three to five days, and
 severe ones, where the local and general symptoms allowed but
an unfavorable prognosis, required only about eight days to have
all signs of  the disease removed. In  two cases hoarseness  and
barking cough (affection pf  the larynx) were present, still  they
were cured.   It made no difference, regarding the course of the
disease, whether he used a gargle or not.   Children who could
not o-argle took every two hours Sal. ac. 0.15-0.3 in water or
wine ; larger  children used at the same  time  a gargle every
hour (Salic,  ac. 1.5 ; solve in Spirit, vin. 15.0; Aq. dest. 150.0.) 
74
THERAPEUTICS OF DIPHTHERITIS.
If crystals should form, warm the solution.  (Ztschr. f. h. Klin.,
24,143.)
  246. Frontheim reports thirty-one cases  treated with Salic.
ac.; the severest were cured in eight days, the milder ones in
two, three, and four days.  There occurred no cases of diph-
theritic inflammation of the kidneys, nor were there  any cases
of paralysis of the palate.  He used Salic, acid., 2 gram, to 200
gram, water, and a sufficient quantity of alcohol, externally and
internally, every three hours. (Boston Journ. of Chem., 10, 46.)

                         Resume.
  The above reports come from allopathic quarters, and it  is
singular that no homoeopathic physician has published any of
his experience with this remedy.   As Salic, ac, on account of
its similarity of operation, takes the place of Carbol. ac in so
many respects, it could be no false supposition that it would be
also useful in the treatment of diphtheritis.  Although we have
no proving of this  drug, the above results are so satisfactory
that we are justified in using it, at least where Carb. ac. fails.
We hope some one will soon publish a proving of this acid so
that we may know just when to select it.
  We have seen improvement within a few hours and a speedy
recovery after Salic, acid., when there was not much or any
fever, but great weakness, difficult deglutition, much inflam-
mation, and  the exudate soft.   Internally a few drops of fi^t
dil. (centes.) to a half glass of water, one teaspoonful every half
or one hour and the same as a gargle; with those who cannot
gargle, we  use the spray of the first dil., reduced with about
half water.

              LVIII.  Sanguinaria canadensis.

  247. Boy of five  years.  Found  him with a hoarse, muffled
cough; complete  aphonia; pulse 132; soft  palate and fauces
covered with a continuous coating of pearly fibrinous exuda-
tion ;  on a uscultating the  larynx the characteristic hissino- sound
was  heard;  difficulty of breathing very  great;  the  child
stretched back his head and grasped his throat in ao-ony, while 
BY F.  G. 0EHME, M.D.
75
the dark and swollen features added to the gloom of the prog-
nosis.  Sanguin., an acetous preparation, made by steeping one
gr. of Sanguin. in two ounces of vinegar.  In fifteen hours the
symptoms had undergone a notable modification, and in forty-
eight hours the patient was  out of danger.  No other remedy
was used, except an occasional dose of triturated  Aconitum.
(Hale's New Rem., 2d edit., 926.)
  248. When the membrane is diffluent; not, when it is tough
and closely adherent.   (Amer. Horn.  Obs.,  9, 455 ; J. Nichol.)

                      LIX. Sulphur.

  249. Sulphur  possesses an astonishingly quick and sure in-
fluence in diphtheritis. (Allg. h. Ztg., 80, 89; Lutz.)   The mem-
branes become soft and come off without loss of substance, the
inflammation subsides, the swelling  of  the  glands  lessens, the
fever disappears, appetite and  sleep return.  Among the fun-
gus-destroying  substances Sulphur, used locally, is the  surest,
quickest,  and most pleasant (Ibidem.)  The flour  of Sulphur
may be blown on the diseased part, or applied with a small
brush, and at the same time the flour of Sulphur may be taken
internally, or an emulsion used as a gargle.  The main  object
is to bring continually  the affected part in contact with Sulphur
as much as possible, till  the exudate has  entirely disappeared.
(Ibidem, page 90 ; Lutz.)  Payr  asserts that it is necessary to
blow in  the  Sulphur  but three times; besides this he gives
against the fever Chininum,  8 gr. to 4 ounces  of water, one
spoonful every two hours, afterwards Chininum, 2d trit.  Since
he has adopted  this treatment he has  had  better results than
with all other remedies.
  250. Large, yellowish  deposit all around the  posterior wall of
the pharynx,  all posterior to the uvula and isthmus faucium.
(Raue's Record,  2, 73.)
  251. The whole back part of the throat, posterior to the pa-
latine  arch,  appears  to  be  in a condition  of ulceration  and
sloughing; very quick pulse;  flashes of heat;  frequent sinking
spells.   (Guernsey's Obstet, 947.) 
76
therapeutics of diphtheritis.
                         Resume.
  In No. 249 only the fungus-destroying  property of Sulph. is
taken into account; in Nos. 250 and 251  the remedy is recom-
mended, when the  seat of the disease  is  principally  on the
posterior wall of the pharynx.
  Symptoms which  indicate Sulph. are particularly the follow-
ing :  The pain and soreness may be quite severe and even extend
into the ear;  pain as if from a lump  in the throat; empty swal-
lowing  more painful than even that of liquids;  the inflamed
parts  not  bright-red, but  purple; dryness in  the  throat.
Especially in cases which have a slow, sluggish course.  Where
the indicated medicine does not have the desired effect, inter-
pose a few doses of Sulphur.

                  LX.  SULPHURIS  ACIDUM.
  252.  The  following pathogenetic  symptoms point  to Sulph.
acid.: apathy; white color of the softened and swollen mucous
membrane of the mouth and fauces; pulse 108; softening  and
swelling of the mucous membrane of the palate and pharynx,
with white spots, which cannot be removed ;  difficult swallowing ;
over the entire  cavity of the  mouth  a  thick, white coating.
After six weeks a large, painful swelling of the left parotis.
Excessive paleness.  Weakness, languor; severe sopor.  (Hirsch.,
Ztschr., f h. Klin., 14, 156;  C. Wesselhoeft.)
  253.  The symptoms of Sulph. acid, have not much similarity
with those of a severe diphtheritic process, if we, as a matter of
course, except the corroding, destroying effect of the undiluted
acid.  But this drug has a great relation to  the aphthae of little
children.  Likewise we do not perceive that Sulph. acid, affects
deeply the mucous  membrane of the larynx, but we observe,
especially in little children, that a light diphtheritic process of
the mouth spreads to  the larynx, and  produces thereby a very
dangerous condition,  which we have  several  times quickly
removed with  Sulph. acid. 3. (Hirsch., Ztschr. f.  h.  Klin.
17,52;  Hirsch.)
  254.  In South Australia,  Sulph.  ac, 4 dr. to three-fourths
glass of water, as a  gargle, is used as a quick and sure remedy
against  diphtheritis.  (Allg. h. Ztg.,  90,120.) 
BY F. G.  0EHME, M.D.
77
   255.  Girl of 2 years.  On the bright red, swollen tonsils, a
 white coating soon  appeared, which  changed after a few days
 into a thick, grayish, or yellowish-white substance, which was
 observed  also on the hard palate and the inside of the cheeks.
 When  pressing the tongue down, a  quantity of this exudate
 was squeezed out of the fauces.   It feels like paste, and is so
 tenacious, that it  can scarcely be  crushed between the fingers.
 Very difficult swallowing, all liquids run out of the nose.  No
 appetite.  Apathy, somnolency; the child whines when being
 lifted.  Pulse frequent, small.  Excessive fcetor oris.  Bell. 6,
 Laches. 30, Merc. sol. 30, Ap. 30 ; each for two days, the patient
 growing worse all the while.  Sulph.  acid. 6; every two or
 three hours; decided improvement in twenty-four hours, and
 after forty-eight hours, only a vestige of the exudate ; recovery
 three days later.   (Hirsch., Ztschr.f. h. Klin., 14,142; C. Wes-
 selhoeft.)
   256.  Girl of 3  years.  Inflammation of  the throat, Bell.;
 patient  worse.  On  the fourth day teeth, lips, and  inside of
 cheeks  covered with a thick, yellow, membranous substance,
 which can be removed only with the  greatest difficulty, and is
 very sticky.  The tonsils  cannot  be seen.  Speech  thick, in-
 distinct ; swallowing almost impossible; frequent loose cough;
 both parotid glands swollen, and very hard;  great apathy;
 sopor, Ap., 10 ; every three hours; worse the next day.  Very
 fetid breath; pulse frequent, and weak;  breathing difficult on
 account of the accumulation of exudate.  Sulph. ac 6,  every
 three hours; distinct improvement in  twenty-four hours; in
 forty-eight hours  no foetor oris,  and only a  little  exudate;
 recovery  soon.   (Hirsch., Ztschr. f.  h. Klin.,  14,  149;  C.
 Wesselhoeft.)
  257. A woman.   Very  violent  inflammation  of the tonsils
 with great difficulty in swallowing; very difficult  speaking;
very obstructed breathing; violent fever;  intense redness of
the fauces ;  left tonsil as large as a walnut, and covered with a
streak of 'gray  exudate of 3 cm.  length, and 1  cm. breadth.
Fetid breath;  violent salivation.  Aeon. 3, every hour, and
every hour gargling  with Sulph. ac, 4 dr. to 6 ounces of water.
The next  morning, exudate,  foetor oris, salivation, and violent 
78
THERAPEUTICS OF DIPHTHERITIS.
inflammation removed.  In the place of the exudate a  small
ulcer with clean edge and  surface.  (Allg. h. Ztg., 90, 181;
Kafka.)  (Although two remedies have  been  used simultane-
ously, still we have reported the case, because we do not think
that Aeon, had any influence  on the disease.)

                         Re'sume.

   Wesselhoeft (252) and Hirsch (253), disagree widely regarding
the use of this drug in diphtheritis.
   The  three cases are very similar, having in common most of
the following symptoms: throat inflamed ;  tonsils bright-red,
swollen;  exudate  thick, grayish,  or yellowish-white,  sticky,
tenacious;  swallowing very  difficult, liquids  run out of the
nose; swallowing  almost impossible;  breathing  difficult  on
account of the accumulation of the exudate in the fauces; ob-
structed  breathing;  speech  thick,  indistinct, very  difficult;
violent salivation ; excessive fcetor oris ; pulse frequent, small,
weak; apathy; somnolency.  Excessive  paleness, weakness,
and languor (252).
   This remedy should receive more attention.

                 LXI.  Tartarus emeticus.

   258.  Difficult  breathing, gasping for  air;  rattling  in the
chest; retching; vomiting of tenacious mucus; small circular
patches, like small-pox pustules, in and upon  the  mouth and
tongue; oedema of the lungs.  (Raue's Therap., 120.)

                LXII.  Thuja occidentals.

   259.  Ortleb  has used Thuj.  with very good success in diph-
theritis.  (Allg. h.  Ztg., 91,125.)
   260.  Ortleb  knew  of  no surer remedy than Thuj. even  in
malignant diphtheritis.   May it not be, that  diphtheritis  at-
tacks especially sycotic persons, as croup scrofulous ones   (Alia
92,123.)                                                 y' 
BY F. G. 0EHME,  M.D.
79
                       APPENDIX.

                    LXIII. BORAC. ACID.

  261. W. -Vogel in Germany (allopath) recommends highly
the external application (with brush) of 4-6 parts of Borac. acid.
to 180 parts of water.  (Hirsch., Ztschr.f. h. Klin., 26, 16.)

              LXIV. Natr. sulpho-carbolicum.
                   (Sulpho-carbolate of Soda.)
  262. Beebe found, that Carbol. acidum, administered inter-
nally,  was effective as an antiseptic, but the objection to it
was, that it could not be diffused in sufficient quantities to in-
sure success without risking its poisonous effects.  Sulphite of
Soda was found to be diffusive enough, but to lack energy.  It
was  finally in a combination  of the two—Sulpho-carbolate of
Soda—that the desired agency was discovered, and its use this
winter during the present epidemic of  scarlet fever and diph-
theritis, has  in a large number of cases demonstrated its effi-
ciency.  (N. E.  Med. Gaz., 12, 89.)
  N.B.—The doctor seems to  think, that there is no difference
between Carb. acid and a salt of this acid, and overlooks en-
tirely that in the effects of a salt, the base predominates over the v
acid.  (See Resume to Chin, ars.)  If he was in distress merely
for a  fungus- or  spore-destroyer, disregarding all pathogenetic
symptoms, he would have found in Salic, ac. all he could wish,
as it can be fed in 10 grain doses without killing the patient.
It offers in this respect great advantage  over Carbol. acidum.

                   GENERAL RESUME-

  In order to overlook the therapeutical material  more readily,
we have  attempted to classify the drugs, and  added  a few
therapeutical hints  to each  remedy  of the first two classes.
For  fuller indications see Re'sume' at the end of  each remedy.
  1. As Adjuvant alcohol, either as gargle or spray.
  2.  Chief remedies:
  ^•5._Severe inflammation of  throat and fever. 
80
therapeutics of diphtheritis.
   Carbolic acid.—So high local inflammation ; no severe pain ;
the fever, if any, adynamic ; much exudate.
   Kal. bichrom.—Deep seated affection and ulceration of mucous
membrane;  bloody discharge.
   Laches.—Subjective symptoms, especially those  of throat,
much severer than objective; left side worse ; great prostration
even before exudation.
   Mercur. hydrocyan.—According to Villers in all cases of epi-
demic diphtheritis; indications wanting.
   Nitric acid.—After  syphilis, or overdosing with  Mercury ;
swallowing very difficult and exceedingly  painful; excessive
salivation.
   Phytolac. decan.—Chilly; violent pain in the head, back, and
limbs; great prostration, with  fainting or vertigo; high fever;
severe inflammation of throat.
   Salicyl. acid.—Indications wanting; probably similar to Car-
bol. acid.
   Sulph. acid.—Accumulation  of sticky, tenacious exudate  in
the fauces; salivation ; apathy ;  sopor.
   3. Remedies second in importance : Ailanth.  (during  scarla-
tina), Arsen. (later stage, collapse);  Bellad. (much  the same
symptoms as Apis);  Camphor  (prostration, collapse);  Chin.
(during convalescence);  Lycop. (worse on right side, stoppage
of nose); Sulph. (affection of the posterior wall of the pharynx ;
purple color of the affected mucous membrane ; slow, sluggish
course).
   4. Remedies not much used,  or having received only  a
passing notice ;  some of them may never be used  again ;  some
may yet become  more important: Aconit., Alum, (externally),
Ammon. carb., Ammon. caust, Arsen. jod., Arsen. brom., Arum
triph.,  Bapt. tinct., Borac acid.,  Bryon., Calc chlor.,  Canth.,
Capsic, Chlorum,  Chrom.  acid., Cimicif, Con., Croton,  Ferri
sesquichl., Gelsem., Guajac, Hydrast., Ignak, Kal.  chloric, Kal.
hydrob., Kal. hydrojod., Kal. permang., Kaolin, Kreos., Lach-
nan., Merc, bijod. rub., Merc. jod. flav., Merc, bromat.  Merc.
solub., Merc, sublim. corr., Muriat. acid., Natr. mur., Natr. sul-
pho-carbol., Phosph.,  Plumb., Rhus tox., Sanguin., Tart. em.
Thuj. 
BY P.  (}. OEHME,  M.D.
81
   We wish to draw particular attention to the alkalies, Am. caust,
Kal. caust,  and Natr. caust.  (See Re'sume" to Ammon. caust.,
and Kali chloricum.)  Will physicians please publish results.
  5.  Remedies used or recommended against diphtheritis of
the larynx: Ammon. caust., Brom., Carbol. acid., Kal. bichrom.,
Merc jod. flav., Merc, hydrocyan., Nitr. acid., Salic, acid., San-
guin.
  6.  Doubtful remedies : Brom., Chin, ars., Chlor., Iod.
  After this general abstract  of the remedies, we must speak
of several other points.
  1.  The internal treatment—Altough diphtheritis appears as
varied as many other diseases, yet most physicians have entirely
neglected to individualize.  Many have chosen some one parti-
cular remedy, administered it  in all cases without distinction,
and justified themselves by their success.   If their success has
been so satisfactory with one remedy for all cases, it would have
been much  better still,  if  they  had individualized  and used
various medicines, just as the}^ would have done in  the treat-
ment of any other disease.  Nature nor homoeopathy has made
an exception in diphtheritis. The evil effects of this one-remedy-
doctoring is seen in the  quality of our Therapia  on diph-
theritis, which is very inferior to that of any other disease in
the whole homoeopathic literature.  The general remarks are
often nothing but sweeping assertions, how this or that drug
cured all cases.  Frequently is  added, with the greatest naivete,
that, nothwithstanding in some instances the administration of
this one remedy had to  be persisted in for several days before
any improvement was perceived.  Now we say, that just these
cases should have been treated with some other  medicine,  be-
cause if a remedy is the right one it acts at once, and the  recovery
is quick.   The majority of the clinical cases are insufficiently and
incompletely described and the cures not convincing.  We do
not wish to be misunderstood ; we do not demand perfection;
but when we see so generally not the least inclination  to indi-
vidualize and read so many worthless clinical cases, it  is time
to reprove.  The modus operandi and results of a physician in
his practice is one thing, and  his publications another; with
the first we wish to  be  as lenient as possible; with  the other 
82
therapeutics of diphtheritis.
we reserve the right to exercise a severe but just criticism.  If
physicians had individualized in their practice, and published
only such cases wherein the influence of the medicine was quick
and unquestionable,* our Therapia on diphtheritis would  have
a much higher standing and be of more practical use.   Hand-
in-hand with the lack of individualizing is the almost universal
practice of using unusually low attenuations, with a tendency of
going still lower, if the previous  seems insufficient.  Both de-
viations  from the  usual method of homozopathic practice  have
been  unmistakably caused  by  the  presence of the  fungous
growth, which  has been  altogether too much of a  bugbear to
most physicians.
   We consider a  physician a  low  dilutionist,  when he uses
externally a low attenuation, though he may give internally a
much higher dilution.   No one will deny that absorption takes
place during local application while the drug is in contact  with
the mucous membrane.
   2.  The external treatment.—Although it has been practically
proved (see Nos. 157,166,167, 181,182, 183, etc.) that external
treatment is not an absolute necessity, yet most physicians have
thus  used various  substances for the destruction of the fungi.
Some have even made it the only object, others the main part
of their treatment, and selected the remedy with sole regard to
this effect.   But as the internal treatment has always been justly
  * We cannot express too strongly our opinion on this point. We are not
satisfied with cases where the operation of a drug is only probable, or
nearly so.  There can be no other reason for publishing a clinical case
otherwise than to show the effect of a medicine;  and the writer should
bear in mind that the reader does not see the case.  Therefore its history
should be given as completely as possibly, the language concise and clear,
symptoms well arranged, and, above all, the effect of the medicine so de-
cided that there can be no shadow of a doubt.  Many drugs may influence
a case, but only one will cause a rapid and indisputable improvement or
cure.  Before estimating the effect of  a medicine we should first ask, how
soon most likely, would the case have improved or recovered without any
medicine.
  Those symptoms, which decide the selection of a remedy, ought to be
particularly emphasized, as there should always be a diagnosis of the remedy,
while those symptoms, which are common to most cases of diphtheritis are
of importance only for the diagnosis of the disease. 
BY F. G. 0EHME,  M.D.
83
considered in homoeopathy the most important part in the treat-
ment of all diseases, we see no reason why diphtheritis should
be an exception.  Alcohol destroys the fungi as quickly as any
of the substances used for this purpose.  But as its external use
allows at the same  time a strictly homoeopathic treatment, it
has the advantage over  all other drugs (see  Re'sume",  under
Alcohol).
   3.  The influence of the external treatment upon the  internal
disease.—The  destruction of the fungous growth has indirectly
a  favorable effect  also on the general  or internal disease, even
if the drug  has no dynamical effect.  It certainly  gives the
system a  better chance to recover by  its own vitality, than if
it had to overcome also the local injury of the fungi.   Many of
the supposed  cures are merely the result of this chemical, local
action of the drug.  If a physician wishes to know whether the
improvement is due  to the chemical or dynamical effect, let him
use this same  medicine above the 6 decim. dil., and he will  see
the difference.  The mere swallowing of a very low (1 and 2
decim.) dilution or trituration, cannot help having also a local,
chemical influence.  There have been more recoveries, not cures,
than many physicians have been aware of.
   4.  The character (severity) of diphtheritis.—With the excep-
tion of cases in certain localities, and when it prevails as a ma-
lignant epidemic, we do Dot consider diphtheritis such  a danger-
ous  disease as it is  frequently viewed ; on the contrary, it is
very  manageable and  accessible to treatment.   We have seen
much severer  cases—sometimes formidable ones—during  our
ten years' practice in Concord, N.  H., than we have during six
and a half years in Plymouth, Mass., or four and a half years
on Staten  Island, N. Y.  In either of the two latter places a
homoeopathic physician never need lose  a patient, though he fre-
quently may have quite a violent case.  Similar differences are
probably found between other localities, also between different
epidemics, and this should be taken into account in estimating
our success and the effect of our remedies.  The unfavorable
result of allopathic physicians should not mislead us to consider
the disease naturally as severe and fatal as with them, since the
m0re heroic  the external treatment the worse the result; on 
84
THERAPEUTICS  OF  DIPHTHERITIS.
account of this treatment their success is more unfortunate and
murderous in this disease  than in any other;  it is  they, who
make the disease severe and fatal.
  5. Diphtheritis  of the  larynx has  proved  in the  greater
number of cases  a  fatal disease.  Some physicians  have not
hesitated  to say,  they never cured a case.  No special  indica-
tions have been given for the selection of the remedies.
  6. The diet should receive particular attention even after re-
covery, as improper food may cause death, especially with chil-
dren.  A child of 3 years,  after complete recovery, was given
two hard-boiled eggs for breakfast, against the strictest  orders.
I chanced, about an hour after, to be present, when it vomited
them up;  three hours later it was dead.  I learned afterwards
that it had been given other  improper food the day before
(see No. 9). 
 
 
JUL 1   1946 
WC 320 028t 1877



34811390R
NLfl  DSlbflbl?  S
NATIONAL LIBRARY OF MEDICINE
B^y::-' ■•
aK.x.'L:::.-
t«s: :::■■'•-• •
E33P-
Pe"
[&*«>"
NLM051686175