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NATIONAL LIBRARY OF MEDICINE
        Bethesda, Maryland


             Gift of
 The National Center for Homeopathy
 
 
 
     1 < -n?  HART MANN'S


                THEORY

                    OF


CHRONIC   DISEASES

                 AND THEIR


    HOMCEOPATHIC  TREATMENT.



         THIRD GERMAN EDITION.


     REVISED AND CONSIDERABLY ENLARGED BY THE AUTHOR.


         TRANSLATED, WITH ADDITIONS,

 AND ADAPTED TO THE USE OF THE AMERICAN PROFESSION,

                    BY

      CHARLES J. HEMPEL, M.D.



               VOLUME IV.


               NE W-YOR K:
    WILLIAM  RADDE, 322 BROADWAY.
      PHILADELPHIA:—C. L. RADEMACHEtt, 239 ARCH-ST.
          BOSTON:—OTIS CLAPP, 12 SCHOOL-ST.
        ST. LOUIS:—FRANKSEN & WESSELHOEFT.
                   1849. 
                        ENTERED
      According to Act of Congress, in the year 1849, by
                  WILLIAM  RADDE,
In the Clerk's Office of the District Court of the United States
           for the Southern District of New-York.
OJtJ*)

H. LUDWIO AND CO., PRINTERS, N. T. 
31383
     Public Library.
     WASHINGTON, D.O,

     JAN 14  190a
             THE
TRANSLATOR'S  PREFACE.
   This volume completes Hartmann's work on  the treatment
of Acute and  Chronic  Diseases.   I commend it to the careful
attention of all those who are anxious to possess a systematic
expose' of the homoeopathic treatment of acute and chronic dis-
eases.   It is the only complete work of  its kind in existence,
and will be found a most acceptable guide of practice, not only
to beginners, but also to older practitioners.
   I ought to state, here, that Hartmann generally prefers the
attenuations from the 30th downward, especially in the treat-
ment of syphilis and chlorosis, where, he contends, large  doses
of low  attenuations  are  absolutely necessary  to  a  prompt,
safe and thorough cure.
   In this, I  believe,  all wise observers  agree.  On the other
hand,  the so-called high potencies are, in  certain cases, valuable
in practice, Hartmann's opinions to the contrary, notwithstand-
ing.   Of course, if we wish to see effects from the high poten-
cies, we must in the first place be sure to select the proper, that
is, the specific remedy.  I have seen effects from the high po- 
 iv               translator's PKIFACE.
 tencies, a denial of which, would infallibly and necessarily lead
 to the rejection of all  evidence of any action of our medicines
 whatsoever.   Hartmann contends, and I fully agree with him
 in this, that  the  successful treatment of syphilis and chlorosis
 requires large doses of the  specific remedial agent.   To  this I
 would add, that another numerous  class of diseases  requires,
 in a large number of cases,  the exhibition of large  doses  of
 the  specific  medicine, viz :  hysteria, neuralgia  (with  a few
 exceptions),  the numerous ailments arising from nervous irrita-
 tion, and intermittent diseases, especially fever and ague.   The
 specific remedy for  neuralgia,  nervous irritation, and  hysteria,
 is Aconite, as will  be demonstrated in the Organon to which
 allusion has   been made in  former volumes ;  the  principal
 specifics  for  fever  and ague  in  our  country are :  Cinchona
 and  Arsenic, the former of which has sometimes to be  given
in five drop doses, at repeated intervals,  to  effect a  permanent
and reliable  cure.
                             CHARLES  J.  HEMPEL.
  New-York, 1849. 
SEVENTEENTH CLASS.
5 178.  Apoplexia  cerebralis,  Apoplexia  sanguined,
                  encephalorragia.

  By apoplexy, we understand a more or less sudden,
entire or partial loss of consciousness,  accompanied
with  loss of sensation and motion; the latter (sensa-
tion and motion) are sometimes still existing, but very
feebly;  the vital functions, circulation and respiration,
continue, sometimes a little slower and more laboured;
at others even with more vigour. In almost all cases ap-
oplexy is preceded by precursory symptoms, which are,
properly speaking, symptoms of general plethora, such
as: dulness and heaviness of the head, derangement
of the  sensual  functions, obscuration  of  sight as if
through gauze, buzzing in the ears, hardness of hear-
ing, indisposition to perform mental labour, great desire
to sleep, the sleep being unrefreshing and disturbed by
dreams  ; injected state of the eyes, increased redness
and temperature of the scalp, throbbing of the  caro-
tids and temporal arteries,  cold hands and feet,  the
extremities go  to sleep, they feel numb, as if the pa-
tient were  walking on velvet; the  cerebral nerves feel
irritated, with  hard aching pain  through  the  brain.
The abdominal organs are frequently very torpid, the
pulse is  slow, full and intermittent, the patient has fre-
quent nightmare, etc.
  In sudden and total sanguineous apoplexy the  brain
feels as if torn, the cerebral functions cease suddenly,
the patient falls down without  consciousness or sensa-
tion,  totally  or partially  paralyzed; stool and  urine
pass off involuntarily, the patient is comatose, breath-
ing stertorous, slow, pulse hard, full and slow, the eye-
lids hang down as if paralyzed, the mouth is drawn to
  vot., iv.—1 
2
APOFLEXIA CEREBRAL!*, ETC.
the side not paralyzed, the eyes are staring and protru-
ded,  the  pupils insensible   and  frequently dilated;
speech is difficult or entirely lost, etc.  In many cases
the patient vomits, the face looks livid and turgescent.
  If the cerebral functions cease totally or partially, in
consequence of the pressure of the extravasated blood
upon the brain, the symptoms of nervous apoplexy  or
paralysis of the brain make their appearance,  resem-
bling very closel)r those of a violent concussion of the
brain ; the patients, totally  paralyzed, look pale  as
death, they seem to be in a deep swoon,  their pulse is
feeble and irregular, vomiting and nausea are present.
In some cases, after this condition has existed for a cou-
ple of hours, the pulse becomes  fuller, the face looks
red, and all the other symptoms of hyperemia make
their appearance, precisely as after concussion of the
brain.
  In other cases the patients complain of a sudden vio-
lent headache, become  pale and vomit;  sometimes
they are able to walk a  few steps, the seated pain  in
the head and the vomiting continuing all the time ; the
face looks pale as after death, the pulse is soft, the pa-
tient is conscious but  stupified ;  little by  little the red-
ness of the face and  the stupor increase,  the patient
answers slowly and with difficulty ; coma finally sets
in, from which the  patient cannot be roused.  These
cases are probably induced by the bursting of a cere-
bral vessel, and the gradual extravasation of blood  in
the brain.
   In most cases partial paralysis remains ; sometimes
one side remains paralyzed (hemiplegia), in other ca-
ses an extremity, or the patient may remain paralyzed
crosswise; in some cases one half of the face, or the
tongue and larynx, remain paralyzed, without loss of
consciousness.
   Serous apoplexy is said to be characterized by pale-
ness and bloatedness of the face, cachectic  appear-
ance, leucophlegmasia, gradual setting in of complete
or partial paralysis, vomiting, fits of nausea ; it is  oc-
casioned by debilitating causes, metastasis, suppression 
APOPLEXIA CEREBRALIS, ETC.
3
of the secretions, cerebral diseases,  terminating in se-
rous effusions.  Post mortem examinations have, how-
ever, shown that an extravasation of blood had taken
place in supposed serous apoplexy, and a simple  effu-
sion of serum in apoplexy which was characterized by
all the symptoms of an extravasation of blood, show-
ing that, in practice, it is of scarcely any use to distin-
guish serous and sanguineous apoplexy.   (Canstatt).
  Gastric, bilious  or abdominal apoplexy, is induced
by   constitutional   predisposition,  excesses,  chagrin,
over-eating, constipation ; it is characterized by a coat-
ed  tongue,  eructations, disposition  to vomit, bilious
vomiting, yellow tinge  of the eyes and shrivelling of
the skin ; the precordial region is distended, sensitive,
the patieiit sometimes grasps at these parts.
  §  179. Causes.   Apoplexy is more frequent among
old than young people, and likewise among males than
females ; in many families it is hereditary.   A consti-
tutional predisposition for sanguineous apoplexy is in-
dicated by a stout  and short body, a disproportionately
large head, a short and big neck, with the head set upon
broad  shoulders,  corpulence, dark-red, livid counte-
nance, distention of the frontal  and temporal veins.
This predisposition is increased by a plethoric consti-
tution, piles, rich  living, sedentary habits; it exists
most frequently among literary men, and persons given
to idleness and luxurious living.
  External causes.  Traumatic, dry and cold weather,
excessive heat, stroke  of the sun,  sudden transition
from cold to warm, and vice versa ; apoplexy is very
apt to take place at the time of the spring equinox, or
in consequence of the abuse of spirituous drinks,  or of
narcotic substances, scurvy, etc.  It is occasioned by
metastasis, sudden suppression of haemorrhage, sweat
on the feet,  closing of ulcers, etc.   It is likewise occa-
sioned by tight cravats, which prevent the proper re-
flux of the blood from the brain, by tumours of the neck,
goitre, angina, impeded circulation of the blood in the
lungs, occasioning a repletion of the cerebral vessels ;
by asthma, whooping-cough,  emphysema of the lungs, 
4
APOPLEXIA CEREBRALIS, ETC.
or by organic affections of the heart and the large ves-
sels, hypertrophy of the left heart, contraction of the
aorta ; or by disorganizations of the cerebral  vessels.
  Prognosis:  Apoplexy is the  more  dangerous  the
mere frequently the attacks occur ; the danger is  par-
ticularly great in the case of old people with  an  apo-
plectic habit.  Apoplexy is more especially dangerous
when the respiratory and circulatory apparatus is pa-
ralyzed, when the breathing becomes laboured, sterto-
rous, slow, superficial, irregular ; when the cheeks puff
up and then collapse again at every expiration in  con-
sequence of a paralysis of the muscles of the cheeks
and lips;  when  the pulse becomes slow, small, inter-
mitting, and deglutition difficult; when the sphincters
become relaxed  and urine and faeces are passed invol-
untarily.  Bad symptoms are :  coldness of the extremi-
ties,  clammy sweat on the upper parts of the body,
continued or even  increased  paralysis; mechanical
grasping of the patient, without consciousness, at one
and the same spot of the head.
  The homoeopathic treatment of apoplexy  is much
more favourable than the allceopathic ; even in cases
which seemed almost hopeless, I have succeeded in
effecting a cure.  We know,  from  experience,  that
sanguineous and nervous apoplexy is much more easi-
ly cured than the nervous and serous varieties, which
frequently leave important secondary diseases.
  § 180.  In treating  apoplexy, the  exciting causes
should, if possible, be removed, as the first step :  tight
dresses, for instance, should be taken off before  any
other treatment can be thought of. The patient is  car-
ried to a cool place, and everything that has a tendency
to vitiate the air is removed from his presence.  Head
and trunk are raised.  If the attack  is owing to poi-
son, this has, in  the first place, to be antidoted, after
which the other  medicines required by the symptoms
are administered.   Strong coffee by  the  mouth  and
anus is the best antidote for opium, accompanied with
friction.   If the irritability of the muscular fibre should
have been destroyed, if the body should already be icy- 
APOPLEXIA CEREBRALIS, ETC.
5
 cold and insensible, it will be advisable to cause  the
 patient  to smell repeatedly of a saturated solution of
 camphior, to rub the temples and knuckles  with it, and
 to put the patient into a warm bath.  After the resto-
 ration of the vital action, frequent small doses of Ipe-
 cacuanfia may be given.   If Belladonna  should  have
 occasioned the apoplexy, strong coffee should likewise
 be given to  restore the lost irritability,  after which
 Opium and Hyoscyamus will complete  the cure.   For
 the after  diseases,  slight  electric shocks, Mercurius
 vivus, and other remedies, will prove useful.
   The  Hyoscyamus apoplexy is  best  antidoted  by
 smelling of a saturated solution of Camphior.  The spas-
 modic effects of spirituous drinks are removed by Nux
 vom.  Arnica, internally and externally, is indispensa-
 ble in apoplexy depending upon mechanical  injuries.
 A surgical operation may likewise be necessary in this
 case.
   In most  cases we  are undoubtedly called  upon  to
 treat nervous apoplexy, since  sanguineous apoplexy
 generally depends upon nervous debility, or some oth-
 er nervous affection, except when it is  occasioned  by
 organic  diseases of the circulatory or respiratory  or-
 gans.  The symptoms of plethora are  generally only
 apparent, or  the causes which we suppose brought on
 the attack, are too transitory to effect that  result.
   The best medicines for the precursory symptoms, or
 even for  the  incipient stage of apoplexy, especially in
 the gastric variety, are Aconite, Nux vom.,  Coffea, Bel-
 lad., Ipecac, Am., Bryon., Ignat., etc.  Aconite, Nux v.,
 Ipcc, Coff., Bellad. and Merc, are the best medicines
 for the precursory symptoms of sanguineous apoplexy.
 It is impossible to say which of those remedies should
 be given first, as the symptoms differ in almost every
 attack.   I will report a case from my own practice, to
 illustrate my own mode of selecting a remedy for such
 a disease.
  The patient was a short, feeble, emaciated female of
80 years.   For some time past she had  been suffering
with oedema  of the  lower extremities, and had been
confined  to her  bed for  about  a week,  during which 
6
APOPLEXIA CEREBRAI.IS, ETC.
time the swelling had reached the pit of the stomach.
The animal functions remained pretty  regular, until
one evening, at supper, the arms  suddenly sank,  the
head inclined forward, the mouth  was  drawn  to  one
side, and speech became extinct.  The patient was sit-
ting in her bed, with the head bent forward, the breath-
ing was short, rattling, skin cold, pulse small,  feeble,
scarcely perceptible ;  the secretions were suppressed ;
she seemed to be  very little conscious or sensible,  for,
on being spoken to, she  remained perfectly silent,  and
listless ; all the functions of irritability, sensibility  and
reproduction seemed to be quite low.  She did not de-
sire anything, nor did  she refuse anything, but she was
unable  to swallow;  if some liquid  was poured into
her mouth it flowed out again at the corners.  I gave
her a few pellets  of Belladonna, 30.  This seems to be
the principal remedy, shortly after an attack charac-
terized by speechlessness, loss of motion and sensation,
diminution of the sensual  functions, stupor, paralysis,
convulsive movements of single muscles, or extremities,
dysphagia, flow of saliva from the  mouth.  On the fol-
lowing morning she was able to swallow some liquid,
and she continued to improve until the fourth day.
All the  symptoms decreased except  the oedema,  and
the general paralysis.   On the fourth day a violent or-
gasm of the circulation  supervened, with a full, quick
pulse, and a general restlessness.   I gave a few doses
of Aconite, which quieted the circulation, but left short-
ness of breathing  and  rattling,  aggravated by motion.
Chiamomilla was  given without success,  but Arsenic
seemed to relieve her very much.  The  patient  had
now been sick a fortnight.   She was able to raise  her
head, and to utter a few sounds, without articulating.
The breast seemed to  be free ;  the patient was able to
take some more substantial food, stool and sleep were
regular ; she passed,  however,  iess urine than  before,
and the oedema and paralysis of the lower extremities
and right  arm seemed to have increased, rather than
otherwise.  The swelling yielded  to Helleborus niger,
followed in six days by Ferrum, and then, in four days, 
APOPLEXIA CEREURALIS, ETC.
7
China.  For the remaining paralysis I first gave Stan-
num., and a fortnight afterwards, Causticum, highest
potency.  A fortnight after taking this medicine, the
patient was able to walk across the room by means of
a cane,  and to articulate a few words.  She remained
the same for about four or  five weeks.  Stannum was
now given.  This seemed to strengthen her lower ex-
tremities, and  to enable her  to  utter a few  coherent
words.  Baryta carbonica, 30, two pellets, did more good
than any of the above-mentioned remedies.   The im-
provement was particularly  visible in  her speech.
Baryta  seems to be the  principal remedy in paralysis
of old people,  particularly when remaining after  an
apoplectic fit.
  Other remedies  for apoplexy  are : Ipecacuanha in
frequent small doses, particularly  when  the patient
moans a good deal, and the breathing is  very short
and deep.  It is an excellent remedy for sanguineous
apoplexy, but  may likewise, be  of service in gastric
and serous apoplexy.   In  the two  latter kinds, Nux
vom. and Digitalis are principal remedies.   Carbo veg.
has been found very useful in sanguineous apoplexy.
  Aconite is a remedy for  every variety of  apoplexy,
particularly, however, when plethora and an excited
circulation are striking  phenomena,  or when the ner-
vous system is very much irritated.
  A few doses of Coffea may be given when the pa-
tient is very sensitive,  and, after return of conscious-
ness, complains a good deal of intolerable pain.
  The principal remedies for  nervous  apoplexy are:
Belladonna, Arnica, Coffea, Hyoscyamus, Stramonium,
Iodium, etc.;  for sanguineous apoplexy: Aconite, Ipec,
Nux vom.,  Bellad.,  Mercur., Lauroc, Opium, etc.:  for
gastric apoplexy :  Nux v., Bryon., Ignat., Ipec, Ant. cr.,
Tart.emel., Puis., etc.; for serous apoplexy : Am., Ipec,
Merc, Opium, etc.
  Belladonna  is useful  in  almost every form of apo-
plexy,  except, perhaps, the gastric  variety.  It anti-
dotes the apoplectic effects of Merc, Opium,  Valerian,
Sec corn., and other substances.   It deserves attention 
8
APOPLEXIA CEREBRALIS, ETC.
when-congestion of the chest and head is present.   Il
is indicated by redness and congestion of the conjunc-
tiva,  by glistening eyes,  dilated pupils, muscce voli-
tantes, diplopia, restlessness and tremour of the extrem-
ities,  indisposition  to  move, lethargy, excessive ner-
vousness and sensibility,  sopor, stertorous  breathing,
jumping out of bed from  anxiety, tendency to start,
fearful, peevish, whining mood, insensibility,  loss of
consciousness, illusions of the  senses and fancy, dul-
ness of the head, vertigo, heaviness of the head, aching
pain in the forehead as if the head would burst open,
drawing, tearing and heat in the head, etc.
   The symptoms of Aconite have been so  frequently
mentioned in this work, that it seems superfluous to
reiterate them here.
   Coffea is suitable for apoplexy of nervous individu-
als, caused by violent  emotions.  In sanguineous apo-
plexy it acts as a palliative, and requires to be succeed-
ed very shortly by some other remedy of a more last-
ing effect.  Its principal sphere is the nervous variety,
in individuals affected with the following symptoms,
in their healthy state :  great nervousness, sad and whi-
ning  mood, sleeplessness from  excessive  bodily and
mental  excitement, frequent flushes of heat in the face,
dizziness  and heaviness of the head, anxious restless-
ness in  the whole body, tightness of the head with pain
as if bruised, sensitiveness of hearing.
   Opium corresponds to the symptoms which charac-
terize the apoplexy of drunkards.  It is a  valuable
medicine in apoplexy, for this reason: that the reac-
tive power of the organism frequently sinks to such an
extent, that the proper remedy cannot act upon the dis-
ease, on account of this apparent  extinction of irrita-
bility.   A single dose of Opium is frequently sufficient
to restore  the reactive power  of the organism.  It is
indicated  by the following symptoms : stupor,  coma,
with stertorous breathing and depressed lower jaw, the
patient is  roused with  difficulty; on waking, he looks
about senseless,  and  is unable  to answer a  single
question;  red, bloated face, moaning,  constant mo- 
AfOPLEXIA  CEREBBAL1S, ETC.
g
 tion of the lips as if to talk; full, slow pulse, with op-
 pressed, anxious breathing, and frequent breaking out
 of copious sweat, which is cold in the face ; on trying
 to raise the head, it falls back again immediately ; the
 temporal arteries throb visibly.  All these  are symp-
 toms of sanguineous  apoplexy, and it would seem as
 though Opium must  be indicated  by them.   This is,
 however, not the case: for the same symptoms make
 their appearance, if the cerebral irritation and the pres-
 sure on the brain last a sufficient  length of time ; in
 this way the physician is frequently led into error.
   Laurocerasus is useful in apoplexy when the patient
 falls down suddenly without any precursory symptoms.
 It is a species of intoxication, as is sometimes  observ-
 ed after taking large doses of prussic acid.   If a cure
 be possible in such a  case, a few doses of Laurocerasus
 are frequently sufficient to restore the vital  action.
 The improvement is indicated by  a deep sleep, with
 stertorous breathing.  The medicine has to be contin-
 ued until the patient seems to slumber quietly.  On
 waking from this slumber, the patient is sometimes not
 quite conscious of himself.
   Hyoscyamus.  The  patient falls down suddenly, with
 a violent shriek, convulsive motions, followed by ster-
 torous breathing.   This  attack is  frequently charac-
 terized by precursory symptoms: languor and lassi-
 tude all over, transitory loss of consciousness, frequent
 disposition to sleep, which, if the patient should yield
 to it, ends in a continuous deep sleep, from which the
 patient frequently starts as if in affright; during this
 sleep  the pulse becomes remarkably small and feeble,
 and the whole body is covered with a profuse and cool
 sweat.  The patient complains of frequent attacks of
 violent vertigo,  as if  he would fall down, illusions of
sight, concussive jerks in the brain ; the patient's fea-
tures  are distorted; his face looks livid, and he has a
sad and peevish mood.
  Stramonium corresponds rather  to the precursory
stage, and to the after symptoms, which I do not deem
it necessary to describe in this place.
                        1* 
10
APOPLEXIA  CEREBRALIS,  ETC.
  Arnica is useful in apoplexy from mechanical inju-
ries.  It is now employed by even the  most celebrated
alloeopathic surgeons  for injuries of the head, without
any one  acknowledging  his indebtedness to Hahne-
mann for this valuable medicine.   Arnica corresponds
principally to serous and sanguineous apoplexy, even
if not of a traumatic nature.   Persons  with a sanguine
temperament, red face, plethoric, and liable to flushes
of heat, are more particularly benefited by Arnica.
  The principal  remedy for gastric apoplexy is Ipeca-
cuanha, particularly when the stomach had been over-
loaded with pork and fat pastry, and the patient had
indulged in nightly  revelry.  Precursory symptoms
are : restless sleep, disturbed by frequent  starting, irri-
table mood, ineffectual urging to vomit, and other gas-
tric symptoms.   After Ipecac, Pulsatilla, Nux vom., Ig-
nat., and the antimonial preparations are frequently in-
dicated.  The various forms of apoplexy  being related
to each other, Ipec may therefore  be employed in any
of them.
  Merc. sol. corresponds to every form  of apoplexy.
The excessive use of coffee and wine produces, besides
many  ailments which yield to Nux  v., Arsen., etc. a
variety of symptoms, very much resembling  those of
apoplexy ;  particularly congestions of the head, char-
acterized by a distensive pain  in the head, as if the
head  would be  pressed open, or as if it  would burst,
accompanied with orgasmus, sanguinis, and throbbing,
a condition which is frequently  observed in plethoric
persons; constant uneasiness and heaviness  of the
limbs, languor and lassitude, even  from the least exer-
tion ;  turgor of the vessels of the eye,  with sudden and
frequently  recurring paroxysms of loss of sight,  or
blackness of sight with vertigo,  obliging one to lie
down ; buzzing  in the ears.  Belladonna may be giv-
en before Mercury.
   Plumbum acet. or  metallicum seems to be an excel-
lent remedy in apoplexy.  I would recommend, how-
ever, to give first a dose of Opium, Bellad., Hyoscya-
mus, or some other remedy, before administering Plum- 
PARALYSIS.
11
bum.   This remedy corresponds to the following pre-
cursory symptoms : languor, lassitude and drowsiness,
indolence, frequent attacks of loss  of consciousness,
feeble and slow pulse ; at other times, a throbbing is
perceived in the whole body, particularly in the neck
and abdomen, with heat in the  face, sensitiveness of
the organs of sense, vertigo, dulness of the head.
   Veratrum corresponds to coldness of the whole body
sudden prostration and collapse of the body, distorted
and protruded  eyes, as in suffocated individuals, con-
stant flow of saliva, loss  of consciousness, disfigured
and cold countenance, as of dead persons, flabby mus-
cles, locked jaws, imperceptible breathing.   Formerly
I employed large quantities  of Coffea by the  mouth
and anus, for such symptoms, and frequently succeed-
ed in curing  the patient; but I think Veratrum would
have  been more suitable.  If these  symptoms  should
have been produced by poisoning with veratrum, warm
coffee, by the mouth and anus, would be the best anti-
dote.
  Iodium would prove the best remedy for orgasm of
the blood, violent pulsations  in the  whole  body, par-
ticularly in the larger vessels, disposition to haemor-
rhage from various organs, quick, strong and full pulse,
anguish and  oppression, great nervousness, and phleg-
matic temperament, etc.
  The various forms of paralysis  which sometimes re-
main after apoplexy, will be treated of in the  following
chapter.
  In using the above mentioned remedies, it is perfect-
ly proper to resort to mesmerism, for the purpose  of
calming the patient; local distress may sometimes be
removed by laying on the hands, or by touching the
place with the tips of one's fingers, supporting the mes-
meric action by a strong and pure will.

  § 181.  Paralysis.
  Paralysis consists in a cessation or  diminution of the
two fundamental functions of the nervous system, sen-
sation and motion, or of either of them.  Paralysis may 
19
PARALYSIS,
be caused by real debility, or by  some other external
cause suppressing the nervous action, such as :  fulness
of the vessels, extravasation, foreign bodies, tumours,
dislocation,  ligatures ; spasmodic affections may like-
wise lead to paralysis.  Paralysis may alternate with
spasms, or be accompanied with  spasms  and pain.   It
may proceed both from the peripheral and the  central
nervous system.
  What  apoplexy  is to  the brain, paralysis is  to
single branches of the nervous system.  In  paralysis
the cerebral functions remain, in themselves, undisturb-
ed.  It is easy to diagnose paralysis of an external or-
gan.  Paralysis of internal organs is inferred from the
complete inability of the organ to  perform its functions.
Paralysis  cannot take place suddenly, except  during
the incipient stage of apoplexy.   Paralysis which sets
in gradually, is preceded by precursory symptoms, such
as: spasms, convulsions, pains in the affected parts;
frequent precursory symptoms are :  creeping and ting-
ling sensation,  formication, going to sleep  of the part,
numbness, weakness and coldness,  or sensation as  if
drops of cold water were flowing through the diseased
part.
  The setting-in of paralysis is characterized by a com-
plete loss of motion and sensation  (complete  paraly-
sis) ; or one only of the nervous functions, most fre-
quently motion, is lost, (incomplete  paralysis, paresis).
Paralysis of one side of the body  is  called hemiplegia.
In paraplegia the upper or lower, most frequently the
lower extremities,  are  paralyzed.   In  transverse  or
cross-paralysis, one upper, and the opposite lower ex-
tremity, are paralyzed.  Beside the above-mentioned
precursory symptoms, which continue during  the at-
tack, we may mention a slow, feeble, small, soft pulse,
discoloration of the affected part,  diminution of animal
heat, want of nutrition,  gradual  emaciation;  tabes,  or
oedema.
  Universal paralysis frequently sets in in apoplexy,
and many other diseases,  shortly before  death.  Par-
tial paralysis derives its particular  name from the or- 
PARALYSIS.
13
gan which is the seat of the disease.  Hemiplegia, for
instance, is characterized by a sunken countenance on
the side affected, by  stuttering  speech,  deafness and
blindness  on one side, oppression and heaviness in the
chest on the  affected  side, constant rattling.
  Paraplegia of the lower extremities is frequently ac-
companied with involuntary  stool and  discharges of
urine, less frequently with the contrary condition.
  Blepharoplegia, or paralysis of the eyelids, is either
a paralysis of the upper eyelid (blepharoptosis), in
which case the upper eyelid hangs down over the eye,
and the patient is unable to raise it without assistance ;
or else  the eye remains uncovered all  the time, (la-
gophthalmus, oculus leporinus); the consequences  of
this par alysis  are constant lachrymation, photopho-
bia, frequent ophthalmia, occasioned by dust getting
into the eyes.
  Glossoplegia (paralysis of the tongue) is frequently
a symptom and consequence  of apoplexy, character-
ized by stuttering,  inarticulate sounds, difficulty of mo-
ving the tongue, inability to  chew, involuntary  flow
from the mouth of the saliva, and of the liquid which
is introduced into the mouth.
  Dysphagia paralytica  (paralysis of  the pharynx)
frequently accompanies  the  former paralysis.  The
patient  is  unable to  swallow, principally liquids; in
attempting it, he is frequently exposed to the danger of
suffocation.
  Enuresis paralytica, and paralysis ani, have been
mentioned under paraplegia.
  § 182. Post-mortem examinations do not reveal any
great changes in the structure of the nerves ;  they ve-
ry rarely appear decayed, dissolved or desiccated ; in
(he neighbourhood of the nerves, various disorganiza-
1 ions, such as swollen and indurated glands, steatoma-
ta, indurations, scirrhus, etc., are  frequently discovered.
  Etiology.  What has been said of the predisposition
for apoplexy, that  is likewise  applicable to paralysis.
Exciting  causes are: strong  emotions  and passions,
continuous violent pains,  convulsions, nervous fevers, 
H
PARALYSIS.
poisoning by narcotic substances, lightning, disorgan-
izations and injuries of the brain, spine and spinal mar-
row, dislocations, curvatures, ruptures and caries of the
vertebral column, contusion, tearing and compression
of single nerves by a ligature, or by  some other me-
chanical cause, such  as  hard bodies  situated in the
neighbourhood of the nerve, suppression of exanthems,
arthritis, rheuma, hysteria, pregnancy, gastric  causes,
worms.
  Prognosis.  This depends upon the exciting cause,
and the facility of removing it.  It is very unfavoura-
ble when the disease is caused by organic diseases of
the  brain and nerves ; more favourable, on the  contra-
ry, when succeeding typhus or dysentery.  It likewise
depends upon the importance of the paralyzed organ ;
upon the duration  of the malady; upon the constitu-
tion and age of the patient; upon the  intensity and
extent of the disease.
  § 183. The remedies which have been proposed for
apoplexy, are likewise useful in the treatment of pa-
ralysis.   I shall therefore omit repeating them  here in
detail,  and  shall confine myself to  those  remedies
which were not mentioned in the chapter on apoplexy.
  The  success  of the  treatment depends a good deal
upon the exciting cause, which the homoeopathic phy-
sician should therefore endeavour to find out, particu-
larly in recent  cases,  where the disease was caused,
for instance, by the abuse of narcotic substances. For
as long as they  remain in the stomach or intestinal ca-
nal, they ought, in the first place, to  be removed by
vomiting, or an artificial  evacuation.  This  end is
most speedily and safely attained by large quantities of
coffee, taken by the mouth and anus: the fauces may,
at the  same time,  be tickled with a feather.  Coffee
antidotes a great many narcotic substances.  If some
of the effects of the narcotic poison should still remain,
Camphor should be given as the next best antidote, the
doses to be repeated at short intervals.  I propose Cam-
phor in case no more  specific antidote should be indi-
cated. 
PARALYSIS.
15
  A paralysis which is occasioned by the inhalation of
mercurial vapours* and is accompanied with tremour of
the paralyzed part, is best met  by Stramonium, which
requires  to be repeated very  frequently during the
treatment.   Next to Stramonium we have Hep. sulph.,
Sulph., Nitr. ac, Argent.,  Cicut., China and  Staphys.
These remedies are generally sufficient to effect a cure.
Other remedies may, however, be necessary.
  Paralysis occasioned by the  inhalation of the va-
pours of Arsenic, has likewise to be first  treated with
the antidotes of that poison.  This kind of paralysis is
accompanied with  occasional paroxysms resembling
fever and ague, which occur principally at night, and
are very often accompanied with general prostration.
The first remedy  for that paralysis is Chiina, to be re-
peated at suitable intervals.  Next to China we  have
Veratrum, which is  even preferable when the frequent
paroxysms  of  debility  and  the general  and sudden
prostrations are exceedingly troublesome.   China and
Verat. are likewise suitable when  the above symp-
toms are not present.   In  this case Ipecac, may per-
haps deserve a preference ; Ferrum, Nux v., Sambuc,
Graphiit. and Hepar. are likewise useful remedies.
  If* paralysis should have been  occasioned  by any
other causes than the above named, the physician will
have  to prescribe  in accordance with the symptoms.
I  will offer a few  more observations about several  re-
medies.
  Rhus tox.  It is well known that this remedy is one
of our  most valuable medicines for paralysis ; but it
is perhaps  less well known that Rhus is the best re-
medy for paralysis caused by nervous  fevers  and
typhus.
  Stannum  is the  principal  remedy for paralysis of
one side, particularly the left, if the patient complain
of a heavy weight  in the arm and side of the chest,
and suffer with night-sweats.  This remedy may  have
to be succeeded by  others, if the paralysis should not
entirely disappear under its influence ; afterwards it
* At occurs frequently among looking-glass makers 
1G                   Paralysis.
may occasionally be  resorted  to  again during  the
treatment.
  Causticum, when the affected part trembles on  ris-
ing from one's seat, the  trembling  ceasing again on
sitting down.
  Cicuta  is likewise  indicated  by  those  symptoms,
particularly when the  lower extremities are periodi-
cally attacked with paroxysms of crampy pains, leav-
ing a trembling behind.
  Oleander is recommended for painless paralysis.
  In paralysis arising  from suppressed discharges of
blood,  the action  of the proper  remedies should be
supported by foot-baths of salt  and ashes, tepid sitz-
baths,  warm oat-meal,  or flaxseed-poultices to  the
soles of the feet.
  Paralysis occasioned by the suppression of habitual
sweat  on the feet by exposing them to humidity, is
best met by Rhus t., Colch.,  Mercur., Zinc.;  Nux v.,
Dulc,  Bryon.,  are  the best remedies  for paralysis
arising from a general  cold.  Paralysis arising from
external  injuries  yields to Arnica, Calendula, Cicut.,
Con., Plat.
  § 181.   In this  paragraph  I will  endeavour to  de-
scribe  the symptoms of various particular  forms of
paralysis which have yielded to specific remedies.
  Rhius t.  has been successfully administered for para-
lysis of the lower extremities characterized  by a sen-
sation  of numbness and insensibility.   This  remedy
is likewise indicated by cramp and a sensation as if
single  tendons were shortened,  symptoms which evi-
dently  depend upon a diminution of the nervous ac-
tion ;  likewise by a sensation as if bruised and sprain-
ed, on  one side ; by a distressing uneasiness wander-
ing about in single limbs during  rest,  and  relieved
only on increased motion.  This  distress leaves a kind
of lameness in the part, increasing with that distress,
and distinctly  pointing to ultimate paralysis.  The
principal symptoms of Rhus are : lameness in all  the
extremities and joints,  with stiffness,  worse on  rising 
PARALYSIS.                  17
after having been  seated a long time ; paralysis  of
one  side or of the lower extremities,  with dragging,
slow, difficult walking.  Rhus t. is therefore an excel-
lent remedy for hemiplegia and paraplegia,  for enu-
resis paralytica, and paralysis of the rectum, provided
the other symptoms correspond, and, in such a case,
likewise for blepharoplegia and dysphagia paraty-
tica.
  I have cured,  with Cocculus, several cases of para-
lysis of the lower extremities, proceeding from the
small of the back, and  arising from cold.  Some  of
the  patients complained of great itching of the  skin
at night, with small red pimples on  the  skin in the
day-time ; most  of the patients had cedomatous feet
and  an  irritable  nervous  system.   Cocculus corre-
sponds likewise to hemiplegia,  particularly of the left
side, with a sensation of coldness in the affected part;
and  to paralysis of the right upper and lower extrem-
ity, with numbness as if gone to sleep; also to dyspha-
gia paralytica, provided  the symptoms correspond.
  Causticum has been rejected by a number of ho-
moeopathic physicians, who declare it a useless agent.
I have used it successfully in partial paralysis  occa-
sioned  by  a cold current of air, and  in  hemiplegia
from suppressed itch  or some other cutaneous erup-
tion, with  numbness,  deadness, and  coldness  of the
affected part, especially the head  and foot.  It is  a
valuable remedy  for  paralysis remaining after apo-
plexy and characterized  by weakness of the arms and
a dragging, vacillating  gait, sometimes accompanied
with  frequent rush  of blood to the head and anxiety,
also vertigo,  dulness,  and  tightness  of the  head.   I
have used Causticum with success in paralysis of one
side  of the face from cold, extending from the fore-
head to the chin.  I have never been able  to cure pa-
ralysis of the tongue  with stuttering, hissing, indis-
tinct speech,  with  Causticum alone, but had always
to resort to Stramonium,  Dulcam.,  and  Acid. mur.  It
renders good service in enuresis paralytica.
  Oleander.  All I can say about this agent is, that it 
18                   PARALYSIS.

has removed several cases of painless paralysis of the
upper  and lower extremities,  with  coldness  of the
former.  The  paralytic  attack was  preceded for a
long time by frequent attacks of violent vertigo.
  Secalc cornutum.   It is well known  that paroxysms
of cramps, when frequently recurring in  the  same
limb, leave lameness and  even  complete paralysis.
Secale corresponds to this condition.  If the lower ex-
tremities  are attacked, stool and urine are frequently
passed  involuntarily, and the  paralyzed limbs ema-
ciate rapidly.
  Cuprum is  useful for paralysis  remaining after an
attack of Asiatic cholera, nervous  or typhus-fever, or
apoplexy, particularly when the following  symptoms
are present: sensation as if  the blood were rushing to
the  chest, accompanied, when lasting a  long time,
with violent palpitation of the heart,  and with a slow,
feeble,  and small pulse : the eyelids  close frequently
and twitch; on opening the lids, the eyeballs seem to
wander, as is observed soon after the removal of apo-
plexy ;  the faculty to  open  the eyes returns after the
return of consciousness.
  Plumbum corresponds to  paralysis remaining after
apoplex}', and very particularly  to paralysis charac-
terized by loss  of sensation, and  great  and sudden
emaciation of the  paralyzed part; also  to paralysis
of the arms,  with pain, dryness and death-like pale-
ness of the skin, which is constantly cold ; also to he-
miplegia and to periodical paroxysms of paralysis.
  Zincum.  I have employed it empirically in paraly-
sis  of single parts, hemiplegia, paralysis of the lower
limbs, feet, upper eyelids.
  Stan num.  This remedy is valuable only in cases of
paralysis complicated  with psora.  I have used it suc-
cessfully in paralysis  of the left arm and foot  caused
by  fright.  It  is useful only in paralysis of single ex-
tremities.
  Kali carbonicum is useful when  the paralysis came
on  gradually and was caused by taking cold without
the  patient knowing  it, particularly when  the pa- 
PARALYSIS.
19
tient's skin inclines to perspiration,  though he  com-
plains of dryness.  I used this remedy  in  the case of
a patient  who had complained for a long time pre-
vious of frequent paroxysms of vertigo in the open air,
accompanied with  a tottering gait  as  if  intoxicated,
which, afterwards, lasted much longer than the attack
of vertigo, and finally terminated in complete paralysis
of the lower limbs;  two or three years after, the up-
per limbs became likewise paralyzed.  In  this case  I
employed Kali, but without success,  nor was the pa-
tient  cured by other remedies.*
  Natrum muriaticum  corresponds to paralysis caused
by  sexual debauchery and onanism, and proceeding
from  the cauda equina; also to paralysis caused by
violent passion, anger  or chagrin.   This agent is valu-
able  for  nocturnal pains  which,  though depending
upon some apparently insignificant  cutaneous  irrita-
tion,  arrest the  free  use of the affected part leading
to momentary paralysis  and even hemiplegia,  which
becomes  permanent after several paroxysms, and oc-
casions involuntary  discharges of  stool  and  urine.
The symptoms of Natrum  pointing to  paralysis, are :
sensation  as  if the extremities would go to  sleep;
stiffness  and  cracking  in  the  joints ;  shortening  of
tendons ;  indolence, indisposition to work ; languor;
incipient  amaurosis;  lameness of  the small  of the
back, with tightness and sensation as  if bruised;
lameness and heaviness of the extremities, with numb-
ness  and  deadness.
  Sulpliur corresponds  to  paralysis of the lower ex-
tremities,  and to  paralysis  arising from suppressed
eruptions.  Sometimes we  are unable to ascertain the
cause of paralysis ; in this  case  we may commence
the  treatment with Sulpliur, which frequently repro-
duces old pains  that  the patient had forgot, and will
prove of essential  service to  the practitioner  in the

  * Did Dr.  Hartmann make use of Aconite, not one or two doses,  but
systematically for  weeks 1 How strange it is that Aconite, which is the
sovereign remedy for almost  every species of paralysis,  should be so little
used by physicians \—Hempel. 
20
PARALYSIS.
selection of adequate remedies.  It may be occasion-
ally repeated during the treatment for the purpose of
restoring  the  susceptibility  of the organism to other
agents.
  Strontian is  said to have been successfully used in
paralysis of the lower limbs and right side.
  Argilla  has  been found useful  in paralysis of the
arm and hand.
  Anacardium has rendered some service in paralysis
of the lower limbs remaining after apoplexy-
  Baryta carbonica. is one of the most  valuable reme-
dies for paralysis after apoplexy, and particularly for
paralysis of old people, preceded for a long time by  a
feeling of instability in the whole body, sudden giving
way of the knees  and pain  in the  lumbar-vertebra'.
Glossoplegia can scarcely ever be cured without Ba-
ryta, which is considered a panacea tor old people.
  Dulcamara, alternated with Sulpliur, is an excellent
remedy for paralysis arising  from a cold,  or from
dampness,  and from  suppressed itch  and terpes.  It
cures paralysis of the arm with icy coldness, as if oc-
casioned by apoplexy;  paralysis  of  the upper and
lower extremities, tongue, urinary bladder.
  Colc/ticum autumnale  corresponds to paralysis from
exposure to wet, or from  sudden suppression  of the
perspiration on the skin,  or of habitual foot-sweat.
The Colchicum-symptoms  pointing to paralysis,  are :
drawing-jerking, sf.itching-tearing pains in single mus-
cles and in the periosteum, with lameness or paraly-
sis;  painful lameness of the knee-joints, with sudden
prostration, &c.
  All the  remedies recommended for apoplexy,  may
likewise prove useful in paralysis, beside the follow-
ing : Phwsphwrus, Verat., Staphiys.,  Silic, Sep.,  Curb.
veg., August.,  Arsen.
  Guaco proved useful  in  two cases of paralysis of
the lower extremities from cold.
  For  incontinence of urine we may use :  JMagnes.
ausi., Bellad.,  Aeon., Dulc,  Lauroc,  Cauthi., Stann., 
NEURALGIC  AFFECTIONS.
21
Lycop., Magnes. carb.,  Natrum  mur. ;*—for paralysis
of the feet:  Sulph., Nux vom., Zinc, Cocculus, Tlierm.
Tepliz ;—for paralysis of the eyelids : Stramon.,  Cha-
mom., Spigel.,  Verat., Bellad., Sepia, Zinc;—for para-
lysis of diseased parts : Plumb., Colch., Natr. mur.;
—for  paralysis  of  the tongue:  Stramon.,  Dulcam.,
Opium, Acid, mur., Baryt. carb.
                EIGHTEENTH CLASS.

   § 185. Neuralgic affections.
   They are affections  of the  sensitive sphere.   The
old physicians called them spasmodic affections. Their
physiological  character is made  up of the following
facts:
   1.  They are  seated  in  the  peripheral  system  of
nerves; we have cerebral, spinal and ganglionic neu-
ralgias.   2. Every neuralgia consists of a series of par-
oxysms of different durations, separated by irregular
intervals of ease.  3. The pain varies: it is tearing,
stitching, burning, etc.   In  neuralgiae of the  central
nerves the pain is directed from within, outwards ;  in
those of the ganglionic nerves it runs from the periphe-
ry towards the centre.   4. The volume of the affected
organ decreases.   5. The temperature of  the organ
decreases.  6. Discoloration takes place, the affected
part becomes paler.  The urine becomes paler, losing
its characteristic  pigment.   Another  characteristic
phenomenon is the spastic pulse ;  the artery becomes

  * Also Sulphur.  I used it in the case of a boy, who had to urinate
every half hour during the day, and wetted his bed every  night; he had
to sleep  on  a hard board and in a sitting posture;  on  urinating, the
urethra swelled up to a bag of the size of a walnut, blue-coloured; be-
fore the bag appeared, the urine seemed to be arrested in its  course by
a valve, which caused  great pain.  The patient  had been  treated alloeo-
pathically for months, getting worse all the time.  After the first dose of
Sulphur 1st., the patient ceased to wet his bed ; the whole  cure was com-
pleted by means of eight doses of Sulphur. The patient has  been perfectly
well for more than a year past.—Hempel. 
22
NEIRALGIC  AFFECTIONS.
thinner, and contracted, in proportion as the volume
of the affected part decreases ; the current of blood  is
much smaller, it rushes along with much less force,
though not always with less rapidity.
  Etiology : Prosopalgia is more frequent among peo-
ple  of a certain age, than previous to pubescence : ab-
dominal spasms  appear at every  age, but of different
forms.   Females are  more liable to  neuralgia  than
males.  One attack predisposes for other similar at-
tacks, and other forms of neuralgia.
  The principal causes of neuralgia  are:  change  of
temperature, sudden  transition from warmth to cold,
causing a rheumatic or inflammatory affection, which,
though apparently not neuralgic, yet shows a remark-
able tendency to periodicity;  irritation of the nerve
by some mechanical cause, a foreign body, ball, splin-
ter, exostosis, etc. ;  calcined metals, lead, copper, etc.
  The violence of the  attack seems to depend in some
measure upon the time of day, or the period of the year,
when it takes place.
  Prognosis.  Neuralgic affections are not always ve-
ry dangerous, though  they require a proper  apprecia-
tion on the part  of the practitioner.  If an important
vital organ should  be affected, the prognosis is much
less dangerous than in the opposite case: acute neu-
ralgias are more dangerous, though also  more curable,
than chronic ; the most dangerous neuralgiae are those
that depend upon internal irritating -auses, which can-
not be removed; those that depend upon atmospheric
causes,  are much more  easily cured;  neuralgiae com-
plicated with other  pathological states,  are not  so
easily cured; recent  neuralgiae are much more easily
cured than neuralgiae of long duration, where symp-
toms of paralysis have already supervened ;  the more
violent and frequent the  paroxysms,  the  more unfa-
vourable the prognosis ( Schcenlein).
  Before describing the treatment of neuralgic affec-
tions, it may be proper to speak more in detail of the
causes which occasion the attack, and of the diet to  be
pursued during the treatment.   Neuralgia?  are very 
NEURALGIC AFFECTIONS.
23
frequently incidental to particular seasons, appear at
a time when  epidemic fevers generally prevail, and
therefore require to be guarded against in the same
manner as the fevers,  such as: avoiding to take cold,
to be wet through, to lie on the cold floor, or to expose
the bare body, or single parts only,  to the cold night
air ; or to drink much cold, bad or marshy water, or to
eat sour fruit containing a good deal of water.  Sim-
ple, easily digested food, is the best nourishment.
  Some attacks yield  to dietetic measures.   Neural-
giae, depending upon a mechanical cause, demand sur-
gical aid, though Arnica, Calendula, Conium,  Platina,
Dulcam., Ruta,  etc., may likewise be  employed.  If
caused by a cold, or by getting wet through,.etc., the
attack is sometimes arrested in its incipiency by  the
use of Dulcamara, Colchicum, Rhus t., Chiamom., Colo-
cynt., Ignat., etc.  If caused by some gastric derange-
ment, the proper remedies will be found  in the para-
graph on gastroataxia;  likewise, the remedies  for
fright, (especially Sec.  corn., Stram.,) chagrin,  fear, in-
dignation.   If the  attack should  have occurred fre-
quently, and should come on again by simply touching
the diseased part, the following remedies will remove it,
and  if properly and carefully administered,  will fre-
quently cure the whole disease :  China, Stram., Arsen.,
Coccul, Bellad., etc. If the affection is easily excited by
touching an ulcer on the finger, Cocculus is the best rem-
edy to remove the pain.  If caused by swallowing a li-
quid,  Hyoscyamus,  Bellad., Stramon., Canthar, are the
best remedies; if caused by noise, or tepid water, Angus-
tura should be resorted to ; if caused by moving  or using
the diseased part, try Cocculus; and if the  glare of
the light have excited the attack, give Bellad.  or Stra-
monium.   Camphora antidotes the neuralgic effects of
the grains of  Cocculus, and  Stramonium those of the
vapours of Mercury. Neuralgiae, caused by worms, re-
quire Ignat., Marum. verum, Mercur., Valeriana, Hyos-
cyam., Cicuta, etc. 
24                  PROSOPALGIA.
                CEREBRAL NEURALGI.E.

  § 186. Prosopalgia, dolor faciei Fathergilli, neural-
gia facialis.
  The disease occurs in paroxysms, at irregular inter-
vals ; the attack is sometimes preceded by oppressive
anxiety, itching or feeling of coldness in the part to be
attacked, formication and  trembling of the eyelids,
tension in the palate and nose, numbness of the tongue,
etc.   At first the pain is inconsiderable,  like a mere
prick, or a common toothache, but  gradually  it be-
comes more violent and piercing;  the pain is lancina-
ting or tearing, dragging or pressing, beating,boring,
frequently accompanied with a sensation as if the face
would be cut or sawed to  pieces.   The  pains  either
follow the course of the different branches of one side
of the trigeminus  (more frequently on the right than
left side  of the face ), or exclusively one or the other
branch of the nerve.  If the pain be seated in the su-
praorbital branch, it generally commences at the fora-
men supraorbitale, shooting to the eyebrows, forehead,
eyelids, and frequently, deep into the orbits; if the in-
fraorbital branch should be the seat of the affection,
the pain spreads over the cheek, upper lip, lower eye-
lid, radiating to the teeth, palate, and tongue.  A neu-
ralgia of the inframaxillary branch extends to the lips,
alveolar processes, teeth, to the soft parts under the
chin,  and the side of the tongue.  Frequently the pain
seems to follow the ramifications of the pes anserinus,
spreading even to the temporal region ; least  frequent-
ly the pain is seated in the lingual branch,  and most
frequently in the superior maxillary and frontal nerves.
  Reflex phenomena, in the motor nerves, are scarcely
ever wanting;  for instance : the muscles of the affect-
ed side of the face twitch  involuntarily, the eyebrows
are knit, and the eyelids close spasmodically, the cor-
ner of the mouth is drawn  towards the  ear, and the
spasm extends even to the respiratory muscles ; the
contractions exhibit the forms of oscillating movements, 
PROSOPALGIA,
25
 or of clonic spasms, or theyare tonic, and of the nature
 of trismus; the jaws are locked, as in tetanus, during
 the attack.  The vasomotoric nervous fibres  are like-
 wise affected ; this is to be inferred from the redness,
 puffiness, and sometimes from the paleness and blue-
 ness of the affected side of the  face, during the parox-
 ysms ; sometimes the cheek becomes oedematous and
 collapses again afterwards; the arteries of the affect-
 ed side pulsate more strongly, and the veins swell.  If
 the ophthalmic branch be the seat of the affection, the
 conjunctiva  becomes red, and a profuse  lachrymation
 takes place during the paroxysm ; in neuralgia of the
 maxillary branches, a more copious secretion of saliva
 takes place.
  The attack ends either gradually or suddenly; the
 more violent the attack, the shorter its duration, some-
 times only a few minutes, rarely longer than a quarter
 of an hour.   The intervals between the paroxysms may
 last  for hours, days, weeks, months, and  even longer;
 during these intervals the pains generally cease entire-
 ly; but if the affection  should  have  lasted for years,
 indications of pain are always present.  At  first the
 paroxysms are rare, but become more and more fre-
 quent the longer they last.   Paroxysms occur very sel-
 dom at night,  hence sleep remains  generally undis-
 turbed.
  The affected nerves are  sometimes so sensitive that
 the paroxysm is excited by the least emotion, contact,
 pressure,  exposure to  cold air, motion of the facial
 muscles  by talking, chewing,  yawning,  sneezing,  or
 even by merely thinking of the attack.   Amusement
 sometimes keeps the paroxysm off for a time (Cann-
 statt).
  Etiology:  Prosopalgia  is hereditary the  same  as
 any other species of neurosis.  This  affection is most
 frequent among females of the age  of 40; it occurs
 rarely among  younger persons,  and never among
 children.*)   Constitutional  nervous irritation predis-
  * This is a mistake. I have treated a girl of 10 years for prosopalgia;  the
paroxysms occurred at night, and were truly dreadful.—Hempel.
  VOL. IV.---2 
26
PROSOPALGIA.
 poses for neuralgia; this kind of irritation is met with
 among unmarried persons, or married persons without
 children, or  it may be  the  consequence of chlorosis,
 hysteria, hypochondria, loss  of animal fluids, frequent
 emotions, chagrin, grief, care, etc.
   Local hurtful  influences  are: wounds, contusions,
 splinters, foreign  bodies, abuse  of washes and other
 substances for beautifying the face, ulcers  and  disor-
 ganizations,  affections of the teeth  and  abdominal
 organs, metastasis, suppressed chronic eruptions, itch,
 herpes,  suppression of habitual  discharges of blood,
 arthritis, carcinomatous dyscrasia, psoric or syphilitic
 dyscrasia, etc.
   The disease is not very dangerous, but the cure is
 generally very slow.  It depends upon the age of  the
 patient  and  upon the duration  of the disease, upon
 the  manner  in which it originated  ; rheumatic and
 intermittent  prosopalgia is more  easily cured than
 gastric, and this more  easily than impetiginous, arthri-
 tic and cachectic  prosopalgia; prosopalgia occasioned
 by organic alterations of the nerves, brain, bones, is
 exceedingly doubtful; likewise when the attacks suc-
 ceed each other very rapidly.  The prognosis depends
 likewise upon the circumstances  of the patient: tran-
 quillity of mind,  absence  of care,  a  confident,  quiet
 mood ; intellectual amusements facilitate the cure very
 much.
   §  187. Treatment.  The homoeopathic treatment of
 prosopalgia, in order to be successful, has to be based
 upon an accurate  knowledge  of  the  physiological
 nature of the disease,  and, if this  knowledge cannot
 be obtained, then the treatment must  be  instituted in
 accordance with the symptoms.
  For  inflammatory prosopalgia (of the fifth nerve)
 Aconite is the best remedy;  the  pain is continuously
 throbbing and stitching, not only  in the nerve, but
 also in the surrounding muscular  parts, with swelling,
alternate heat and chilliness, etc.  Rheumatic proso-
palgia with  swelling, always requires Aconite; the
pain  is  intolerable, burning, tingling-stitching,  ap- 
PROSOPALGIA,
27
pearing in  paroxysms, accompanied with  great  ner-
vousness,  as if occasioned  by some internal ulcer.
The medicine has to be repeated.
  Belladonna is indicated  in  inflammatory and  ner-
vous prosopalgia by paroxysms of long duration, com-
mencing with  a troublesome itching and titillation in
the affected part, which changes to a violent lanci-
nating pain, or to an  aching, crampy, tearing, draw-
ing pain in the malar and nasal bones; the pain is
always seated on one side; frequently the pain fol-
lows  the  course  of the  infra-orbital nerve, when it
changes to an intolerable violent cutting  pain;  it is
frequently  accompanied  with an increased secretion
of tears and saliva.  Belladonna is likewise useful for
stitching  and  tensive pains,  accompanied  with a
spasmodic closing of the jaws and painful stiffness of
the neck.
  One of  the  most valuable  remedies for stitching
pains with pressure, or for fine-beating pains in the right
malar bone and right side  of the nose, is China, par-
ticularly when  the  pain is  aggravated by contact, or
when the pain is excited  by touching the diseased
part and then increases to  a frightful degree.   The
nervous and rheumatic neuralgic pains,  the stitching
pains in the malar bone which disappear by pressure,
the tearing with pressure and the  cutting burning in
the upper jaw, belong  to the curative sphere of China.
  Veratrum is  closely related to China;  the  pain is
drawing and tensive, spreading over the right half of
the face as if the parts  would be  compressed or
pressed into, recurrirg in paroxysms ; the patient is
slightly delirious, and the part swells after the cessa-
tion of the paroxysm.
  Arsenic did me good service when the pain,  only on
one  side,  was seated  around the eyes,  more below
than  above, sometimes extending  over the temporal
region;'the pain was burning or  drawing-stitching,
as from a multitude of red-hot needles ; the  whole face
assumed an expression approaching to the hippocratic
countenance, disappearing  with the attack.   Arsenic 
28
PROSOPALGIA.
is likewise useful for intermittent prosopalgia, char-
acterized by a violent stitching pain deep in the right
eye. aggravated by motion ; also for prosopalgia com-
mencing with  a tearing-darting  pain in  the  teeth
which rouses the patient from sleep before midnight,
extending to the right  temple and right side of the
face  and driving the  patient to despair; the  pain
abates in a few hours and sometimes only towards
morning.
   I have used Capsicum when the patient was unable
to state whether the pain was seated  in  the bones,
muscles, or nerves, or in all these parts together : the
pains were excited by  contact, they were  fine pains
penetrating the nerves, or a tearing-burning stitching
in the right malar bone; the pains were particularly
acute  on going  to  sleep,  and were aggravated by
contact.
   I have frequently cured prosopalgia with verbascum,
1st att., when all other remedies  failed.  The pain is
an intensely painful aching, sometimes interrupted by
a violent stitching.
   Digitalis purpurea is indicated by a crampy, or
laming-drawing pain in the malar bone, preceded by a
corrosive itching of the cheek ; the crampy  pain is
characteristic.
   Mezereum is indicated by  a  crampy,  stupifying
pressure in the malar bone, spreading over  ihe neigh-
bouring parts  and frequently terminating in tearing.
The  attacks are  almost  always accompanied by
chilliness  and shuddering.
   Staphysagria was found useful in  a case of 15
years' standing ;  flashing stitches darted through- the
affected side of the face, leaving behind a dull aching
pain.  The nightly  sleep became quite good.   It is
absolutely  necessary to repeat the dose,  and to alter-
nate with some other remedy.
   Aurum  is suitable for a syphilitic  dyscrasia ;  the
senses are morbidly  sensitive ; the patient  dreads the
pain, and excites it by merely thinking of it. The pain 
PROSOPALGIA.
29
is tearing and stitching, in the soft parts and the malar
bones ;  it is sometimes accompanied  with tension.
  Spigelia is a valuable  remedy for  intermittent and
nervous prosopalgia, and for prosopalgia seated deep
in the orbits, imparting to the eyeball a  sensation as
if it were too large;  this  sensation  is  especially  felt
during  a motion of the eyeball and the facial muscles,
and is accompanied with an intensely painful pressure
and a digging-stitching in the ball.  The prosopalgia,
properly so-called, is characterized  by pressure and
burning,  particularly in  the  malar  bones ; the pain
does not bear the least motion  or contact, is always
felt on one side only, and is accompanied with anguish
about the heart and  great uneasiness.
  Stannum is indicated by aching-drawing  pains  in
the malar bone and along the orbital margin  of  the
right eye  ; they commence very slight, increase and
decrease  again gradually, disappear during  walking,
but re-appear again during rest if the paroxysm should
not  yet have  run its natural  course.    An  aching-
gnawing  or  cutting  pain on  the  left side  is  almost
always  accompanied with swelling of the cheek.
  He par  sulphuris is useful  for a  drawing-tearing
pain  extending  from the cheeks to the ears  and
temples,  aggravated by  contact, caused  by  former
severe  affections, in cachectic individuals.
  Colocynth  removes prosopalgia caused by internal
mortification and chagrin  ; the pain is tear'ng and ten-
sive, or burning and  stitching,  in the left side of the
face, with swelling, redness and heat  of the cheek.*
  Conium is valuable for a  flashing-tearing pain  in
the right half of the  face, recurring every two to five
minutes ;  or  for  a stitching  pain in the right cheek,
in front of the ear, sometimes accompanied with tear-
ing.   These pains are sometimes preceded by a corro-
sive itching on the part to be attacked.
  Kali  carbonicum  corresponds  to a drawing-tearing,
the drawing being sometimes accompanied with pres-
* See the valuable clinical remarks in Hempel's Jahr. 
30
PROSOPALGIA.
sure in the cheek; the tearing, almost always seated
in the left malar bone, generally appears at night,  is
accompanied with swelling of the cheek, sleeplessness,
and extorts tears from the patient.
  Thuja  is suitable for females  at  the  critical age,
and  corresponds to crampy pains in the right cheek
during rest ; darting and  stitching pains in the malar
muscles,  only  while walking  in the open air; boring
pain in  left malar bone  diminished by contact,  or
digging and jerking pains ; gnawing and boring pain
in the left upper jaw,  or  tearing pain striking in the
direction  of the eye ; all these  pains  leave  behind
them a stiffness in the muscles  of deglutition  and a
pain in the articulation of the jaws.
  Beside the  above-mentioned  remedies,  we may
mention  Arnica, Ferrum,  Nux v. Bryon., Ruta, Phos-
jhor.,  Sepia, Lycop.,  Ledum,  Clematis,  Baryt. carb.,
Calc, and above all, Sulphur  and Causticum.
  §  188.   I take  the  liberty  of here offering  a  few
remarks on
  CANCER OF THE FACE, LIPS, CHEEKS,  NOSE AND TONGUE.

  Generally it is the lower lip that is attacked, whence
the disease  spreads ; but it may likewise first break
out in any  other of the above-mentioned parts, and
thence extends farther.  It  develops itself  out of a
scurfy or ulcerated spot,  which gradually spreads and
gives rise to fungous excrescences, etc. ; or a portion
of the lip becomes hard and swollen, assuming an ill-
shapen  form,  which enlarges, pains violently, and
breaks.   The  cancer gradually involves the skin of
the chin,  the  mucous membrane of the mouth,  the
gums and submaxillary glands, destroying the whole lip
and  the bones.   Ulcers of the lips frequently become
malignant without being cancerous,  especially syphi-
litic ulcers.
   Cancer of the  tongue generally commences with a
hard, circumscribed  swelling on one  or the other side 
PROSOPALGIA.
31
of the tongue ; lancinating pains are experienced ; the
swelling breaks, spreading rapidly.   Ulcers in t h 3
spongy tissue of the tongue frequently become obstinate,
or are rendered obstinate by being constantly moisten-
ed  with saliva, or irritated by pointed and decayed
teeth.—The papillae frequently become hypertrophied,
forming spongy excrescences.—Syphilitic  ulcere  of
the  tongue frequently degenerate to cancerous ulcers.
  Every cancer, including cancer of the tongue, de-
pends upon a peculiar, specific disposition of the or-
ganism, which may be hereditary.   Cancer may be
caused  by a blow or contusion ; by treating an ulcer,
an  induration or excrescence of the face, lips or nose
with irrita-ting substances externally ; by scrofula and
syphilis ; suppression of habitual secretions, etc.
  Prognosis:  This is not  very favourable,  although
many cases are said to have been cured.   The more
extensive the  cancer  and the more enfeebled the con-
stitution, the more unfavourable the prognosis ; this is
likewise the  case  when the cancer re-appears again
after an operation.  The knife should never be resort-
ed  to in the treatment of cancer ;  an operation  is not
only useless, but inflicts unnecessary tortures upon the
patient, and, generally speaking, hastens his end.
  § 189.   For cancers of the face, the first remedy is
Arsenic;  not Fowler's solution, but the pure Arsenic.
The pathogenetic effects of Arsenic which point to can-
cer, are : Burning swelling in the nose, with pain  to
contact; tumour in the nose: ulceration of the nostrils,
high up, with discharge of fetid ichor;—ulcers in the
whole  face ; wart-shaped ulcer  on  the cheek ;  dry,
cracked lips, brown  streak in the lips, as if burnt ;
bleeding of the lower lip; ulcerated eruption around
the lips; cancer-like eruption on the lower lip, with
thick crust, hard, pad-shaped edges, with burning pain,
particularly when the parts become cold,  and with a
lardaceous bottom ; spreading ulcer on the lip,  pain-
ful in  the evening,  when in bed, with tearing and
smarting in  the  day-time during motion,  which is
worst when touching the ulcer and  in the open air, 
32
PROSOPALGIA,
disturbing the night's rest;—corrosion of the edge of
the tongue,  in front, with  smarting; the tongue is
blackish,  cracked.—Arsenic may  sometimes require
some other medicine with it, but it is undoubtedly  the
most valuable agent when  the cancerous dyscrasia
has tainted the organism ; it is the sovereign remedy
for cancer of the nose,  tongue and alveolae.
   Clematis being a remedy for the effects from abuse
of mercury,  such as  indurations,  even  when of a
schirrous nature, it  will be  found useful  for syphili-
tico-mercurial ulcers on the lips when becoming carci-
nomatous ; it may likewise  prove useful in alveolar
cancer when characterized by,a drawing-jerking and
burning-stitching in the edges of the ulcer on touching
the affec ed  part;  these  sensations spread over  the
whole side of the face as far as the eye and ear.
   Aurum met. is preferable to clematis when the can-
cer of the lip, nose or alveolae, grows out of a  sy-
philitic  or syphilitico-mercurial  soil; the scrofulous
diathesis  is  not excluded  from  the sphere of this
agent.   Aurum may likewise prove useful for cancer
generally.   It is preferable to many other remedies
when not  only the soft parts, but  also the  bones,
are affected.  In this  case  Aurum muriaticum is pre-
ferable  to the metallic gold ; for  the  muriatic acid
is not without its use in the treatment of cancer of
the face, especially of the tongue, where I have em-
ployed it in alternation with Arsenic, guided by these
symptoms: the  tongue  feels heavy and elongated,
so that  he is unable to move it, with great dryness
in  the  mouth  and fauces;  painful  blister  on  the
tongue, with burning ; deep ulcer on the tongue, with
black bottom and inverted edges.—Mercurius may be
of service  if the bones have already become affected ;
likewise Nitric acid, particularly when the ulcers bleed
profusely, with stinging and burning; even Asa. may
be serviceable when the edges of the  ulcer are hard,
bluish, and sensitive to contact.
   Conium has been  employed with success in carci-
nomatous affections arising  from contusion op shocks; 
PROSOPALGIA.
33
it is indicated by a scrofulous diathesis and spreading
ulcers in the face and on the lips, which look blackish
and discharge a bloody,  fetid  ichor.
  As regards  Carbo anim., I am unable to state what
symptoms have led homoeopathic physicians to its use
in cancer of the face; it must have  been employed
empirically.
  Calcarea carbon, occasions polypi in the nose, which
easily degenerate into carcinoma, particularly  when
an  inherent  dyscrasia  pre-exists.   Pimples,  scurfs,
ulcers  highp^gxjr^ tfce }F8£#Vis' accompanied  with
swelling, ma^A^,(^^5^01^juration, lead to cancer,
which  would jffoer^iarevrequire Calcarea.   The same
remarks apply to the lips.
  Silicea. H||!A?NxiAi  I9§$ that the silex contained
in mineral waters,  is the curative  principle in the
treatment of chronic  diseases,  and therefore took the
trouble of proving it  upon the healthy.   The results
of his  provings  were exceedingly rich.   The symp-
toms which point to the use  of Silicea in carcinoma
of the  face, are : erysipelatous  blotches, lymphatic
and suppurating glandular  swellings, scirrhous  in-
durations, putrid, spreading ulcers, particularly when
arising from  abuse   of Mercury,  with penetrating
odour; ulcers with  boring and  stitching pains  and
pains as if  from concealed pus; fungus  haematodes
in the eyes (in conjunction with  Calc, Sepia, Lycop.,
Thuja), scurfs and ulcers  in   the nose,  the cracked
skin and schirrous  indurations  in  the face and on
the upper lip; smarting scurfs on the margin of the
upper  lip; painful, spongy and carcinomatous ulcers
on the  lower lip.
  Sulphur  is  considered  by some an excellent  re-
medy for cancer of  the face.  It is  certainly useful
as an  intermediate remedy,  and revives  the recep-
tivity of the organism when  this seems unwilling to
accept the  influence of the  proper specific  agent.
Even when  carcinoma of the face seems to  have
arisen from suppression of some  cutaneous eruption,
I  would use Sulphur  only in the  manner suggested. 
34
PROSOPALGIA.
   Sepia may be  given in  cancer of the nose, when
the  patient  complains  of a  violent burning pain
in  the large  scurfs;  beneath  the  scurfs,   which
keep spreading and thickening all  the  time,  a  cor-
rosive ichor  is  constantly  oozing out,  essentially
favouring the spreading of the cancer.  The general
organism soon suffers sympathetically;  we may  in-
fer this  from the paroxysms of feverish  heat  and
chilliness which recur several times during the day.
The disposition of the patient is  likewise  to be con-
sidered ;  Sepia is indicated by sad fancies, apprehen-
sions about one's health,  fearfulness inducing  a hur-
ried pulse and hurried breathing,  as if the   breath
would give out.
   Anlimonium  crudum may  be  considered of value
in cancer of the face.  I used it successfully,  until a
cure  was completed, for a horny excrescence under
the lower lip; the horn fell off every eighth day, after
which it grew again ; after falling off, the  surface
of the stump, which kept increasing, looked raw  like
raw flesh;  the fleshy papillae looked like the papillae
on the tongue ; a viscid humour oozed  out of every
single papilla.  If the scurf to which  the  thickening
of the humour gave rise, remained for more than eight
days, the humour then oozed out between the scurf
and the horn  which now developed itself in breadth.
The horn was painless, except when knocked against,
in which case it bled.   I  gave one dose of the third
trituration  every day, and  covered  it moreover with
a  little plaster of antimonial butter.
  A similar horny excrescence was cured by means
of Ranunculus  bulb.  The excrescence  was   seated
on the forehead, somewhat painful; the patient com-
plained frequently of  a burning itching in  the  ex-
crescence ;  the scurf formed more rapidly than in the
former. After falling off, the stump resembled a deep-
eating ulcer with sharp edges.  I used Ant. crud. for
several weeks without  success.   Ranunc, 6th att.,
morning and  evening, and applying the first  exter-
nally, effected  a cure in  a  few weeks. 
NOMA, CANCER AaUATICUS.
35
   Acidum nitri  has been employed by me  not  only
in carcinomatous ulcers  arising from  a syphilitico-
mercimal  origin, but also in strawberry-shaped or
other fleshy growths in  the face,  spreading rapidly.
The remedy was used internally high, and  exter-
nally low.   Not in  every case had the excrescence
a  syphilitic  origin.

   §  190.  Noma, cancer aquaticus.
   This  morbid process in the mucous membrane of
the mouth is similar to  the  pustula  maligna on the
skin.  Symptoms of constitutional illness are not at
first perceived;   a whitish,  reddish  and  frequently
blackish pustule or  blister shoots suddenly up in the
mouth,  forming  a scurf; the  surrounding cellular
tissue is swollen, hard, though painless, not red nor
very white either; cheeks, lips  and eyelids are ge-
nerally oedematous; the  skin is pale, livid,  feels like
wax, shines like grease; the  parotid  and  cervical
glands soon become affected. The blister soon breaks,
discharging a blackish ichor and  assuming a livid
colour ;  the parts around, to a considerable extent,
change very rapidly to a  gray, ash-coloured, or black
papescent  scurf, or to a putrid discoloured papescent
mass, in which the mucous membrane and other soft
parts are contained in a state of dissolution.  The de-
struction generally  commences in the middle of the
cheek or at the corners of the mouth, attacks not only
the soft parts, but also the bones and teeth, and extends
even to the orbits and forehead, neck and chest.   The
ulcer is irregular,  shaggy, insensible, and discharges
a thin, bloody ichor with a cadaverous odour; the edges
of the ulcer are hard, indented,  black as coal,  sur-
rounded by  a dark shining redness; the parts  which
slough off do not bleed.   In from three to eight days
the cheeks, lips and eyelids may become transformed
to a soft, putrid mass.—Afterwards fever and symp-
toms of constitutional  suffering set in;  the breathing
becomes oppressed, the pulse small and  frequent, col-
liquative diarrho&a sets in, etc.—If we succeed in ar- 
36
NOMA, CA>CER AQUATICUS.
resting the destruction, the gangrenous parts are se-
parate from the sound parts by a border of an intense,
vivid rtdness, the odour disappears, laudable pus is
secreted instead of the ichor, and healthy granulations
shoot up from the ulcerated surface.
  Noma affects almost exclusively children  from the
second to the tenth year, rarely full-grown people, and
infants  at the breast very  rarely.  The patients are
generally unhealthy,  scrofulous,  delicate  children
with blond hair,  brought  up on bad food, in bad air,
in foundling or almshouses, orphan asylums, etc.  Some-
times the disease sets in as a  sequel to measles, scar-
latina, smallpox, whooping-cough, dysentery, typhoid
or intermittent fevers.  The disease is not epidemic,
and is very rare.
  Generally speaking, the disease  terminates fatally.
  I have never treated a case of this disease, and what
I offer about the treatment is  therefore purely theo-
retical.
  I recommend Secale cornutum as the specific for this
disease.  Its destructive  action seems to  be similar
to that of noma.  We know from post-mortem exami-
nations that it produces  gangrene of the  stomach,
lungs and other viscera; that the  heart and lungs are
generally pale, flabby and  deprived of blood.  Gross
recommended Anthracin  in case  Secale should have
proved fruitless.  Others recommend Corrosive  subli-
mate, and  some  again Helleborus niger, though the
eruption which this substance produces in the mouth,
seems to be  aphthous rather than any thing else.
  lodium has the following symptoms: Ulcer on the
left cheek with hard tubercle, and swelling of the sur-
rounding glands; vesicles in the mouth with increased
secretion of  fetid saliva and swelling of the  gums,
small elevations on the inner side of the right cheek,
with inflammation of the surrounding  parts :  putrid
smell from the mouth ;  sudden emaciation down to a
skeleton, with hectic fever.—This  remedy acts slowly,
but the  slowness  may be overcome by repeating the
dcse the more frequently ; I would likewise state "that, 
HEMICRANIA, CLAVUS, MEGRIM.
37
in such diseases, I never use the high or highest poten-
cies.   Kali  hydriodicum  may likewise be mentioned
along with Iodium. Acid, mur., Tart, emet., Carboveg.,
Chlore, Kreasot., have likewise been proposed.
   After this short deviation,  I  return again  to the
treatment of neuralgic affections.

   §. 191.  Hemicrania,  Clavus, Megrim.
   The attacks are periodical.  The patients complain
of a boring  pain at a  circumscribed spot near the sa-
gittal  suture  in  the  outer parts of the head ; or the
pain  occupies  one side of  the  head, the foiehead,
supra-orbital and temporal region,  extends into the
orbits, and is sometimes relieved by pressing the head
together ; whereas, at other times, the affected part is
extremely sensitive to the least pressure.  When the
paroxysm is at its height, the patient feels sick at the
stomach, vomits up water and mucus, after which the
patient feels somewhat relieved.  The attack is some-
times  excited quite suddenly, by chagrin, fright, sud-
den joy, a  cold, indigestion,  etc.  During the attack
the  patients are extremely  sensitive  to  light, noise,
change of temperature, even  to the  smell  of food ;
they endeavour to keep  mind and body as quiet as
possible.  The paroxysm generally commences  with
sun-rise, on waking,  and ceases at night; sometimes,
however, it  lasts longer.  Next day the patient is  well
again, after a refreshing sleep.   The left  side of the
head is  more  frequently  attacked  than the right.
The attacks generally  occur periodically, either  at
regular or  irregular  intervals.  Among females,  the
menses are  sometimes retarded by the pain.   The at-
tack is frequently  preceded by vertigo, cheerful and
loquacious mood, or sadness, nausea, loss of appetite,
sour eructations, vomiting, etc.   It is more  or less
mild or violent; generally it increases gradually, com-
mencing wilh a slight pressure or a sensation of cold-
ness in the part to be attacked, and then  changing to
a throbbing, boring pain,  or  to  a stitching, burning,
tearing pain, etc. 
38          HEMICRANIA,  CLAVCS, MEGRIM.
   The  characteristic  symptoms of hemicrania are :
 the characteristic neuralgic character of the pain, its
 periodical recurrence, the  absence of  any derange-
 ment of the cerebral functions between the paroxysms,
 the absence of all febrile symptoms during the  attack;
 these may, however,  set in  after  years of suffering,
 and then  the patient is  never entirely free from pain,
 particularly in the region of the sagittal  suture ; sleep-
 lessness supervenes, and  the affected  spot is  swollen
 externally and sensitive to the least pressure.
   Causes: Persons with irritable nerves, hysteric, hy-
 pochondriac, chlorotic individuals, females who have
 become enfeebled by hard labours and  haemorrhages,
 individuals  leading  a sedentary life,  literary people,
 etc., are most liable to the disease.   It is occasioned
 by bad digestion, obstructions  in  the portal  system,
 arthritis,  mercurial dyscrasia, etc., by menstrual sup-
 pressions, excessive intellectual labour, excitement of
 the fancy.
   §. 192.  Treatment.   Coffee should be avoided very
 particularly, otherwise  a cure  is impossible.  The
 disease is sometimes  caused by coffee, particularly
 when the  patient complains of a violent drawing-ach-
 ing pain in one side  of the head, with a sensation as
 if a  nail were  driven  into the parietal bone ;  the
 aversion  which  patients experience  against coffee
 during the attack, likewise shows  that  coffee  is food
 for such a megrim.  The brain sometimes  feels as if
 torn or smashed to  pieces.  For this  headache, Nux
 vom. is the first remedy, which may be given in re-
 peated doses; or Ignatia, Pulsatilla or Chamomilla may
 be required after the first dose of Nux, and this medi-
 cine may then be  repeated  afterwards.  Nux v. is
 likewise indicated when the stitching-aching  pain in
 one side of the  head  commences early  in the morning,
 increases  gradually, and finally becomes so  violent
that  the  patient is almost  frantic.   This attack is
rarely  accompanied with congestion  of blood to the
brain ; generally the face is pale, and the features dis-
torted.  Nux v. is one  of the principal  remedies. 
HEMICRANIA, CLAVUS, MEGRIM.
39
   Dr. Tietzer furnishes the following indications for
 Nux in megrim :  " It is  more suitable  to men,  when
 the disease proceeds from the ganglionic system, and
 the hemicrania is sympathetic, particularly among
 haemorrhoidal subjects who complain of pain  in the
 small of the back,  pressure on the  rectum, difficult
 stool  and gastric ailments ; or to persons with a cho-
 leric temperament, to drunkards, and literary persons
 leading a sedentary life.—The pain is most frequently
 drawing-aching;  there is frequently  a sensation as if
 a nail  were  driven into one  side of  the  head; on
 one side the brain feels as if dashed to pieces.—Among
 females, the menses occur prematurely and are too
 profuse.—The pain sets generally in early in the morn-
 ing, or after a meal,  or on exerting the mind."
   '• Ignatia.   It is suitable to sensitive, hysteric indi-
 viduals  with  a sanguine nervous  temperament, and
 soft, insinuating manners, with a  disposition to re-
 verie, silent  grief,  fright,  mortification and  clonic
 spasms after some emotion.—The pain is chiefly press-
 ing, sometimes stitching,  from  within  outwards, in the
 forehead and root of the  nose."  The pressing pain is
 predominant;  when  there is a sensation as though a
 nail were bored  into the brain, the pressing is felt
 from without inwards; a  peevish mood  likewise indi-
 cates Ignatia.
   Chamomilla.  is  indicated by drawing-beating pains
 in the  right half of the head, recurring in paroxysms
 and excited by emotions ; by a quarrelsome and vexed
 mood,  hypochondriac, whims, etc.
   Pulsatilla is suitable to chlorotic, hysteric persons,
 with a phlegmatic, good-natured and  roguish disposi-
 tion ; it suits a scrofulous diathesis and abilioso-gastric
 state.  It corresponds to stitching-tearing pains, worse
 in the  evening and most  violent at night; to a  sad,
 whining mood.
   Belladonna  should  be used when  the  pain extends
to the orbit and nasal bones; the pain is pressing, un-
dulating, as if the  brain would  be dashed to pieces or
as if it were  shaking to and fro.   (PleUina might like- 
40
HEMICRANIA, CLAVL'tf, MEGRIM.
wise be tried for an undulating pain.)  Belladonna is
particularly indicated when the pain is aggravated by
the least  motion of the body, and especially of the
eyes, by exposure of the eyes  to  the  light,  by noise,
by people walking about in the sick-room, and gene-
rally by every least concussion ; the  arteries pulsate
audibly.—Belladonna is likewise suitable for the ar-
thritic  hemicrania,  with shooting, deeply penetrating,
intense pains, sometimes  commencing  at one spot as
with a breath, changing to a long,  extremely painful
stitch,  which pierces the whole hemisphere of the brain,
and deprives the patient of consciousness.  This attack
yields  to  one  or two doses of Belladonna in 36 hours,
and  frequently remains  suppressed for a  long  time,
though Sepia seems more adapted to a cure, inasmuch
as stitching and pricking pains are  among the patho-
genetic effects of that, medicine.  Sepia  is particularly
indicated  by  stitching pains  in one of the  frontal or
occipital  protuberances ; the  stitches are like flashes
from without inwards, and reverberate deep in  the
brain for  a long time ; the more frequently they recur,
the more  the patients complain of heat in  the head,
which  gradually becomes more and more troublesome
and  is accompanied with great tightness of the head,
and painfullness  of the head to contact.  In arthritic
hemicrania it is frequently observed that the scalp is
very painful to contact, with a sensation of tightness.
In some cases I have removed this last  symptom with
Acid, nitr., or Zincum or Petroleum, being guided by the
accompanying symptoms in the selection of the remedy.
  Though Sepia and Belladonna are necessary to effect
a  radical cure, yet Aconite is  absolutely required for
the  following symptoms: a tearing-drawing  and
jerking-s:itching pain in the head, with fulness and
weight in the forehead,   throbbing in the temples,
bloated and red countenance, the headache gradually
increasing to such an extent,  that the patient almost
becomes frantic; the, patient moans aloud,  complains
of great anguish, with shortness of breathing and pal-
pitation of the heart, etc.   I give the patient Aconite. 
HEMICRANIA, CLAVUS, MEGRIM.
41
 to  smell  of every 5 or 10 minutes;  in  a short while
 the patient goes to sleep, and feels relieved.
   Coffea  corresponds to a pressing pain on one side of
 the head, as  from a nail being driven into the brain,
 or  as if the brain were smashed to pieces; the pain is
 generally excited by mental exertions, and occurs even
 in persons who had never used coffee.  In some cases
 Nux v. and  Bryon. are required after Coffea.  The
 symptoms for Bryonia are : Pressing pain in the left
 frontal eminence from within outwards, as if the part
 would  burst  open, aggravated by  moving  the eyes,
 accompanied  by tearing with pressure  in the affected
 hemisphere of the brain, likewise with dizziness and
 heaviness in the same, sleeplessness, and a vexed, irri-
 table mood.
   Colocynthis corresponds to  a pressing or drawing-
 crampy hemicrania when aggravated by lying on the
 back  or by stooping, accompanied with  nausea and
 vomiting, appearing  every  afternoon or evening, ex-
 torting cries  and tears,  and inducing an increasing
 shortness  of breathing.  It is easily excited by emotion,
 indignation and mortification.
  This kind  of hemicrania  is frequently cured by
 China.  I have used it principally for a pressure with
 tearing, or for a tearing with pressure at some spot of
 the head,  with great mental  excitement,  restlessness,
 excessive  activity of the fancy ; the pain is aggravated
 by movement  in the open air, or by pressure.
  Hemicrania, and headache generally,  are frequently
 accompanied with vomiting and nausea. Ipecacuanha
 is suitable for many of such cases,  likewise Pulsatilla,
 particularly when the pain is boring,  stitching, con-
 tractive, or as if the head were screwed in.
  Hemicrania  is seldom cured with  one remedy only.
 Among those that require to be mentioned is Veratrum
 album, when the pain is throbbing with  pressure, with
 sensation  as  if the brain were bruised, rush of blood
to  the head, pains in  the stomach,  obstinate consti-
 pation,  etc.
  Arsenic corresponds to a  throbbing-stupifying pain 
42
HEMICRANIA, CLAVL'S, MEGRIM.
in the forehead, particularly over the root of the nose,
or over the left eye, the pain almost always  leaving
a weakness of the head with qualmishness and weak-
ness in  the pit  of the slomach.  The arsenic-hemi-
crania is  characterized by  symptoms like the follow-
ing : it occurs regularly after dinner,  decreases by
applying cold water to the head,  and increases again
on removing it ;  it is most violent in the evening and
at night,  is relieved by walking about, by external
warmth and compression of the head: it is sometimes
accompanied by excessive prostration, etc.
  Arnica  is suitable for paroxysms of stitching pain in
the forehead and temple, with  heat  in  the lace and
thirst, nausea and qualmishness in the  pit of the sto-
mach,  particularly on  stooping.  Arnica  is suitable
for  arthritic  hemicrania, likewise Guujacum.   The
pressing pain, which frequently changes to a stitching,
occurs most frequently in the right frontal eminence,
or on the vertex, and  ascending  from the nape of the
neck, shortly after  rising in the morning.   Guajacum
is also indicated by a drawing-tearing pain from the
left parietal bone to the frontal protuberance;  it is
generally  accompanied with  a  sensation as if the
scalp were swollen, and as  if a  throbbing were felt
in  it.
  The principal indications  for Hyoscyamus are : stu-
pifying pressure, changing  to stitches  or tearing and
shifting about.
  Cicuta  corresponds  to a  pressing heaviness, or a
stitching-compressive pain, generally in the right side
of the head, from the nose and eye to the occiput.  It
occurs most  frequently among  hysteric individuals,
with a sad and anxious temper.
  Ruta removes a stupil'ying pressure in the right half
of the forehead, and above  the root of  the nose, with
nausea, decreased by motion.
  Manganum aceticum is indicated when the pains
occur  at  night,  are aggravated  by  stooping ; some-
times they occur during a  walk in the open air, and
are  relieved in the room, or they get worse or better 
HEMICRANIA, CLAVUS,  MEGRIM.          43
with a change in the weather.  The principal symp-
tom is a tearing-stitching  pain  in the left side of the
head ; the  pressing pain from the occiput across the
vertex to the forehead is less frequent.
  Capsicum annuum is an  excellent remedy for ar-
thritic headache and  hemicrania,  particularly when
the pain is throbbing  or stitching with pressure, ag-
gravated by moving  the eyes and head,  and by in-
clining the latter  forward;  in  hysteric megrim  it
deserves a  preference over many other remedies.
  Thuja renders good  service  in  old hemicrania ;  in
hemicrania arising from former sycosis, which, after
being apparently  cured, leaves behind  it rheumatic
affections of other organs, which disappear again with
the setting-in of the hemicrania.   Thuja is character-
istically indicated by a pressing-aching pain in one side
of the head, as  if  a nail were driven in, in the right
hemisphere of the brain ; the pain generally becomes
worse in bed, during rest and in warmth, and is re-
lieved by motion, coldness and sweat.
  Spigelia,  Sabina, Aurum, Rfius  tox., deserve to be
ranked  next to Thuja.
  Nitri acidum: Indicated by oppressive heaviness
which passes into a  drawing-stitching  and darting-
cutting  pain, with tightness of the head and nausea ;
the drawing-stitching pain, generally in  the  left side,
in the occiput and parietal bone, is the most painful
symptom ;  it obliges  one to lie  down, and  prevents
sleep ; the   darting cutting strikes from before back-
wards.  This kind of hemicrania occurs in scrofulous,
hysteric, syphilitic  subjects, and is accompanied with
vascular excitement; it is excited by little exercise,
a walk in the open air,  by a slight cold, etc.
  Tinct.ura acris sine kali.  Hahnemann has mixed up
the symptoms of this agent with those  of Causticum.
I have used the former remedy when  the patients
complained of the brain feeling as if torn or smashed
to pieces on one side, which was aggravated by shak-
ing  the  head.  The  pains became worse  towards 
44
NEURALGLE OF THE  SPINAL NERVES.
evening  and in the open air ;  the  aching pains are
excited by a current of air. and set in with chilliness.
  Conii/ni has been given for drawing-tearing-stitch-
ing pains;  for a sensation as if a large foreign body
were lodged in the right hemisphere  of the  brain,
which can  be dislodged by  external  friction.  It  is
suitable for old people and females, and for hypochon-
driac, hvsteric, scrofulous and syphilitic individuals.
  Calccaea  carbonica  is suitable for  scrofulous sub-
jects, and  is  principally indicated  by  a stupefying-
aching pain on one side, with empty eructations, ex-
cited by reading  and writing; by an oppressive sen-
sation of fulness, with heat in the head, and aggrava-
tion on raising and moving the head ;  by a pressure
from within,  relieved  by  counter-pressure;  by  an
aching-drawing, tearing, stitching pain.
  Petroleum,  Lycop.,  Zinc.   Phosphor., Silic, Kali
carb.,  should  not   be  forgotten.  The latter remedv
relieves headaches caused by riding in a carriage.
          NEURALGIA  OF THE SriNAL  NERVES.

  § 193.  Neuralgia  of the spinal marrow,  spinal ir-
ritation, rhachialgia, notalgia.
  Spinal irritation  is  a disease  of the spinal marrow
which scarcely ever leaves a trace of material altera-
tion  of that  organ in the dead body.  The principal
symptom  is: pain  in the  back, accompanied  with
pain, disagreeable sensation and convulsive paroxysms
in the internal body, or in  the organ which is in rela-
tion with  the  affected portion of the spinal marrow.
The  pain extends  through  the whole or part of the
spine.   The  pain in  the marrow  is sometimes more
deep-seated than the origin of the nerves  of the
secondarily affected organ.  When the upper cervical
portion  (especially the 2d  and 3d)  is  affected, the
patients complain of  pain in the head, forehead, face,
illusions of the senses, hemeralopia, vertigo, amauro-
sis, buzzing  in  the ears, deafness, delirium, stiffness 
           NEURALGIA OF THE SPINAL  NERVES.        45

 of the neck or altered inclination of the head.  A pain
 in the lower cervical portion  is accompanied with :
 pain in the region of the clavicles, shoulders, breasts,
 sternum, arms  and fingers, spasm of the fauces or
 larynx, singultus ; spasmodic movements or paralysis,
 sensation of oppression or palpitation of the heart.   If
 the upper dorsal portion be affected, we  have : constric-
 tion of the thorax, orthopnoea, spasmodic cough, palpi-
 tation of the heart, fainting fits,  moaning; pains in the
 hypochondria, below the false ribs.  If the lower dorsal
 portion be affected, the patient complains of pain in the
 stomach, cardialgia, pain in the  pit of the  stomach, de-
 rangement of the digestive functions, vomiting, eructa-
 tions ; sometimes pains in urinating, with frequent urg-
 ing to urinate. An affection of the lumbar portion is in-
 dicated by sensitiveness of the abdominal integuments,
 colic, pains and impeded motion of the lower limbs;
 ischuria, drawing in the testicles.—The most important
 Bymptoms  sometimes run  a more or less  regular
 course.—The  irritation is most frequently seated in
 the  region of the 7th to  the 9th,  and  of the  first to
 the second dorsal vertebra.
   Causes:  The disease  is  more  frequent  among
 •women than men, and principally among  hysteric and
 hypochondriac individuals ; it is caused by menstrual
 irregularities, confinement,  digestive  derangement,
 affections  of the dental nerves, foreign bodies which
 irritate the spinal marrow.  The blood, when infected
 with  the miasma of typhus  and  intermittent  fever,
 appears to cause a secondary spinal irritation, which
 many consider as the essence of the, disease.   In this
 case  the irritation  is  principally  seated  in the first
 and the adjoining dorsal vertebrae. '(Canstatt).
   §  194.   I shall not attempt to construct a complete
 special therapei'a upon the subject of spinal irritation.
 Many of the diseases  arising from  spinal  irritation,
have already  been treated  in former chapters, such
as : intermittent diseases, ar hritis, rheumatism, para-
lysis, prosopalgia, etc.; many others will be mentioned
hereafter.  I will add a few general indications, which, 
46        NEURALGIA OF THE SPINAL NERVES.

though of little  practical value  in themselves, may
serve to suggest a useful remedy in particular cases.
  Pain of "the cervical  vertebrae.—For pressure  in
the same:  Guajacum.:  tension  and pressure:  Bis-
muthum ; cracking  in  the same on shaking the head :
Stannum; cracking or crackling,  on moving the head,
also stiffness in the  same : Magncs. arct. ;  pain as if
sprained :  Cinnabaris ; soreness of  the lower cervical
vertebrae: Conium.—Intermittent  stitches  in the cla-
vicles :  Subina;  tearing in the  clavicular region:
Lycop.; muscular jactitation  around the  clavicles:
Asa.—Pressure on the shoulders:  Kali karb.; tearing
pain  with  pressure in the  shoulders, striking down
the arm  very rapidly, particularly at night, relieved
by pressure, excited by motion :  Belladonna; tearing
stitching in both shoulders: Asa;  tearing in  the
shoulders, with  stiffness of the lower  limbs and dif-
ficulty of moving them :  Thermce  Tepl.;  tearing in
the  shoulders with  pressure  from  without inwards:
Laurocerasus ; rumbling and gurgling in the shoulders
and scapulae,  with chilliness over the whole  body:
Taraxacum;  rheumatic  tearing in  the  shoulders:
Rhodod.;  tearing between the shoulders, aggravated
by  cold, relieved by warmth : Rlius tox.; stitching
with burning and  pain  as if bruised between the
shoulders:  Magnes.   mur.;  stitching  pain in  the
shoulder on raising and moving the arm : Ledum ;
drawing, tension and tearing from the shoulders across
the nape of the neck through  the whole arm: Man-
ganum ; dull  stitching pain  betw. < n  the shoulders
from above downwards: Mezereum; sore  feeling be-
tween the shoulders, with stitching tightness when
walking:  Colocynth; tearing, throbbing,  ulcerative
pain from the shoulder to the fingers, also  pain  as if
sprained with cracking: Thuja;  tearing  and burning
in the shoulder with lameness of the arm, particularly
during the  cold season, during rest and in the warm
bed : Rhus tox.—Pain at the lower end of the sternum
as  from  a shock or  sore:  Cicuta ;  stitches  in  that
region: Angustura;  stitching  with  pressure  in the 
           KEURALGIjE OP THE  SPINAL NERVE*.        47

 sternum and  sides of the chest: Argilla; fine stitch-
 ing in  the  middle of the sternum without disturbing
 the expirations or inspirations: Bismulhium ;  stitching
 with  pressure on  the sternum : Eupliorbium; aching
 pain in the  sternum aggravated by contact:  Sassupa-
 rilla ;  itching, fine, sharp stitches  at the upper end of
 the sternum, close below the throat-pit, obliging one to
 rub, with pain as if sore  and  ulcerated  behind  the
 part when coughing :  Staphys.; aching and crampy
 pain in  the region of the sternum, particularly after
 eating and drinking :  Veratrum; tearing and stitching
 in the  sternum:  Cyclamen;  sharp  stitches in  the
 sternum and  near the right chest:  China;  tensive
 pain on the sternum : Acid,  mur, dull cutting-stitch-
 ing pain near  the sternum  below the  last true rib,
 also as from a plug below the first three costal car-
 tilages : Aurum;  pressure  in the  sternum and  side:
. Cantharid.; pinching under  the sternum : Cannabis.
 The pain in the dorsal vertebrae has likewise different
 forms,  such as: crampy pain  in the  same,  early  in
 the, morning when in bed, in a recumbent posture :
 Euphorbium;  tearing with  pressure  in the  lower
 dorsal: Sabina ; cutting in the region where the first
 dorsal unites with the last cervical vertebra : Digita-
 lis ; aching pain as from stooping or straining, pass-
 ing off during motion : Acid. mur.;  tearing pains with
 pressure : Aurum ; rheumatic pains in the same as if
 bruised, when  stooping and raising one's-self again:
 Veratrum ;  burning-tearing pains : Nux  vom__For
 drawing  in  the lumbar  vertebrae: Conium; violent
 tearing  pain in the same, extending from both sides
 to the renal region, aggravated by moving the  trunk:
 Stannum; bruised  pain, where the last  lumbar joins
 the os sacrum : Aconite; tearing with pressure in the
same exfending forward as far as the iliac bones;  it
seems  as though  the  vertebrae would be  broken  to
pieces,  only  when bending forward and  backward.
(C/ielidon). 
48      NEURALGT.E  OP  THE ABDOMINAL nerves.
        NEURALGIA OF THE ABDOMINAL  NERVES.

  § 195.  Neuralgia coeliaca.
  Formerly this disease was  confounded  with colic
and cardiaigia, until Autenrieth succeeded in establish-
ing the  correct diagnosis of  each of those  affections.
  The paroxysms are preceded by a precursory stage
lasting  from a few minutes to several hours, during
which the patients are very  uneasy and apprehensive
of the coming  attack, which  sets in in the following
manner: The patient feels a violent pain  in  the pit
of the stomach, below the ensiform process ; the pain
is  burning, tearing, stitching,  aching, as if a hot  coal
were  lodged there ; or as if  the part were violently
torn asunder; the pain is frequently so piercing  that
it  sets robust persons frantic, and causes feeble indi-
viduals  to faint.  After the pain has lasted for a while
at this  spot, say from five minutes to half an hour, it
leaves there and shoots under the sternum towards the
neck  like  a flame, or  it divides into  two currents,
which, following the course  of the sympathetic nerve,
ascend  towards the neck on  both sides of the verte-
bral column ;  or else  the pain suddenly branches off
in every  direction,  particularly towards  the hypo-
chondria, following the course of the  plexus lienalis
and hepaticus.  Towards the end of the paroxysm the
patient  is  troubled with eructations or accumulation
of water in the mouth ;  after the paroxysm the patient
complains  of  great emptiness in the  abdomen  and
languor and lassitude  in the whole body;  the tongue
is  clean and the appetite and digestion are good.  It
is very  rare that several paroxysms take place in one
day ;  but if they continue long, scarcely a day passes
without a paroxysm.  The paroxysms are most violent
in spring  and  fall ;  much  less so in summer and
winter; they are  most frequent at  night and in the
morning.
  Etiology:  The disease  is  much  more  frequent
among  men than women, in the proportion of 3 to 1. 
         NEURALGLE  OF  THE ABDOMINAL NERVES.      49

 It is most frequent between the years of 20 and 35 ;
 afterwards it occurs less frequently.  Hereditary abdo-
 minal weakness and a  sedentary life  predispose for the
 disease;  it may be occasioned by  an  imperfect ap-
 pearance of haemorrhoids, by suppression of itch, mis-
 managed gonorrhoea, etc.
    The prognosis is  almost always more or less favour-
 able under homoeopathic treatment, except if the sto-
 mach  should  have become  disorganized in conse-
 quence of the long  duration of  the disease.
    §. 196.  Nux v. and  Arsenic  are the best remedies
 for this disease.
   Nux is indicated by the following symptoms: Sanguine
 choleric  temperament, malicious  character, venous
 haemorrhoidal  constitution, the haemorrhoids being im-
 perfectly developed;   the  pain makes  the patient
 frantic;  sedentary  life with  intellectual  exertions.
 Arsenic is more suitable to persons with melancholy,
 nervous  temperaments;  the pain  causes  them  to
 swoon.  Nux v. is preferable when the pain sets in in
 the morning and the patient falls into a heavy sleep
 after the paroxysm,  from which he wakes more tired
 than he was the previous evening; the pain is relieved
 by lying down.  Arsenic  is more suitable  when the
 paroxysms set in about  midnight, rousing the patient
 from the  soundest  sleep ;  they can  be  relieved by
 walking about.  The  burning  pain  corresponds to
 Arsenic, the  tearing, stitching,  hard-aching pain to
 Nux; anguish is always present; a very high degree
 of anguish may however point  to  Arsenic.  For the
 gastric symptoms which set in towards the end of, or
 after the paroxysm, I give Nux; for the nervous symp-
 toms, Arsenic.
  Sabadilla helped me  out in some cases where the
 burning pain, soon after its appearance in the pit of
 the  stomach, flashed upwards in the chest, towards
the throat-pit,  accompanied with intolerable oppres-
sion of breathing, almost unto suffocation,  which the
patient  felt immediately after waking ; sometimes a
constrictive sensation deep in the fauces was present;
      vol. iv.—3 
50
COLICA, ETC.
after  the paroxysm the patient complained of empty
eructations and a feeling of emptiness in the abdomen;
languor of the wh.ole, body, and sensation  as if he had
been lying on wood the whole night.
   Veratrum may be tried in the place of Nux if this
should fail, and Phosphorus in the place of Arsenic.
   Cicuta virosa  suits nervous, irritable females : the
pain  in  the  pit of the stomach is burning-stitching-
throbbing, accompanied with loud singultus.
   Bryonia, Conium and Sulphur deserve to be named,
the two  latter especially when the disease is supposed
to have  arisen from the suppression of some  cutane-
ous eruption.   Other remedies will be found mention-
ed in the chapter on cardialgia.*

   §. 197.  Colica, enteralgia, enterodynia, colic.
   Colic is characterized by pressing, constrictive, cut-
ting,  pinching, tearing, wandering or  seated  pains,
principally in the umbilical region, or along the course
of the colon: they abate or cease, and recur again,
alternately ; the abdomen is not distended, hot or sen-
sitive to pressure.   The duration of the  attack varies.
The  pains  may become  so  violent  that the patient
writhes  like  a worm, tosses  about the bed in anguish
and despair, rolls about the floor; the abdomen is so
sensitive to  the touch that  one might be led to sup-
pose  a violent inflammation  must  have  developed it-
self.  By increasing  the pressure,  the pain  is some-
times diminished,  which  is  not  the case  when in-
flammation is present.  After the attack, the sensitive-
ness of  the abdomen ceases.—The  colic may be  ac-
companied with pain in the stomach,  bladder, uterus,
calves.—During the paroxysms the abdominal muscles
and integuments are spasmodically drawn to the spi-
nal column.   The contraction of the bowels frequent-
ly leads to obstinate constipation ; the reflex action on
the stomach causes  vomiting,  and  upon the biliary

  * If physicians will try the tincture of Aconite for this disease, they
will soon find out what is the true specific for it.  In most cases card algia
is a simple state of venous congestion which yields to Aconite, and the appli-
cation of warm flannel to the stomach.—Hempel. 
FLATULENT COLIC.
51
ducts  icterus.  The  sympathetic  suffering  of the
nerves  of the diaphragm and  of the  nervi vagi ex-
plains the oppression, anguish, the  moaning and  ir-
regular breathing, the singultus,  etc.—The  pulse  is
contracted, small, the extremities  are cold, face pale,
the features exhibit an expression  of pain ; after the
attack, the urine is watery, pale-yellow; fainting fits
and convulsions sometimes set in.
  Etiology:   Colic may be excited  by  every unusual
irritation  of the intestinal mucous membrane : indi-
gestion, a cold drink  while the body is hot, crude ve-
getables,  unripe fruit, excessive use  of ripe fruit, im-
proper use of emetics and cathartics, acrid  and me-
tallic substances, poisons, foreign  bodies,  retained or
indurated faeces, worms, excessive or morbid secretion
of  bile,  flatulence, mechanical dragging of  the in-
testine  by hernia or other alterations  of place, etc.
According to the  origin,  we distinguish rheumatic,
bilious, gastric, stercoral, verminous,  metastatic, ar-
thritic, haemorrhoidal, menstrual,  flatulent, hysteric,
hypochondriac colic.
  The prognosis is not unfavourable.

  § 198.  Flatulent colic.
  Flatulent colic  depends upon an  accumulation of
air  induced by flatulent and fermenting  food, etc., du-
ring a weak state of  the bowels, or it may be caused
by  a  cold, disturbing emotions, such as:  anger and
chagrin, inducing  a spastic state of the  bowels, which
prevents the discharge of the accumulating gas.  The
pain is distensive, stitching, drawing, cutting, and is
somewhat, relieved  by  pressure   on  the abdomen.
Frequently the  pain wanders about, with rumbling,
following the  course of the intestines, particularly the
colon, and affecting even the stomach and chest.  The
abdomen  is  irregularly distended  in   some  places,
without  hardness, or great  sensitiveness; here and
there  a hard elastic swelling starts up yielding a tym-
panitic sound.  The pain is relieved  by the discharge
and shifting  of the  flatulence.   The same relief is
procured  by  eructations, and rubbing  the abdomen. 
52
FLATULENT COLIC.
Sometimes the flatulence wanders only  as  far as the
region of the left hip, where it causes a horrible pain,
and then leaves again  with a  noise.   Violent colic is
sometimes accompanied with ischuria, spasmodic erec-
tion of the penis, and coldness of the extremities ;  the
pulse is generally small,  intermittent;  costiveness,
anguish in the praecordial region, straining, etc.,  are
likewise present.   This kind of colic frequently befals
infants that are brought up without the breast, hypo-
chondriac,  hysteric persons, and individuals leading a
sedentary life.  The colic  is generally of short dura-
tion, disappears  after the  emission  of flatulence,  but
is apt to re-appear, and, finally, to become  habitual.
  §.  199.  Nux vom. is one of the  first remedies for
this disease.   It causes difficulty  of  digestion, disten-
tion  of the epigastric region, pressure and fulness in
the stomach,  particularly  after dinner, disposition to
flatulence, and even a  real flatulent  colic.  It removes
colic which is deep-seated  in the  abdomen,  and is ac-
companied by a sensation as  if a cutting or sticking
instrument were operating upon the bladder, the neck
of the bladder, the commencement of the urethra, the
perinaeum, the rectum and anus, as if cutting  flatu-
lence would press out  everywhere ;  the pains become
intolerable by stepping about, so  that the  patient is
obliged to walk bent double, whereas they disappear
rapidly during rest, when sitting  or  lying.  This colic
is frequently  accompanied  with the most violent head-
ache, and pains in the  small of the back.
  Cocculus is indicated by a constrictive pain in  the
abdomen, with qualmishness, and pressing towards the
sexual parts; by discharge  of  flatulence without relief,
constantly  followed by other flatulence which becomes
incarcerated  here and there,  and causes a pressing,
tearing, and burning pain;  sometimes the  flatulence
distends the  whole  abdomen,  affects the  stomach,
causing a  crampy and griping-tearing  pain in  the
same, and  creates a feeling of anguish, with pressure
in the subcostal region; these symptoms abate or  dis-
appear by  eructations. The attack generally sets in
after midnight. 
FLATULENT COLIC
53
   Chamomilla removes the following symptoms, which
are sometimes caused by a cold:  sensation as if the
flatulence would press through in various places; dis-
tention in the praecordial region and hypochondria ;
indescribable  anguish, restlessness, clammy sweat.  A
violent attack is  sometimes accompanied  with an
urging to stool and rumbling, which disappears again
after the discharge of some slimy water.  This kind
of colic frequently occurs among infants, and readily
yields to Chamomilla.
   Belladonna  removes a flatulent colic, "which is re-
lieved  by bending  forward and by pressure ; the trans-
verse colon protrudes like, a  pad.   This colic is fre-
quently accompanied by a pinching  and pulling from
above  downwards in the affected parts, which in-
creases in proportion as the, patient endeavours to re-
main up ; in this case  he feels as  if the bowels were
loose and had settled lower down.   The colic is some-
times accompanied by discharges of pus, which  seem
to point to the presence of an ulcer in the bowels ;  in.
such a case Mercurius may be given after Belladonna.
Mercury is very frequently indicated after Belladonna
in abdominal  affections.
   Belladonna,  is likewise useful in those kinds of coli-
codynia flatulenta,  which bring on  fainting fits,  cold
sweats, or a violent congestion  of blood to the head,
with redness  of the face and swelling of the veins;
the pains arc. so violent that the patients behave like
frantic madmen.
   Belladonna likewise removes the grasping and grip-
ing as  if with nails, under the umbilicus, particularly
when accompanied with pain in  the back and small
of the  back.
   Flatulent colic deep  in the abdomen, with sensation
as if the lower bowels were constricted, incarceration
of flatulence,  with pressing and tensive pains, a tight
and anxious feeling under the short ribs, is most speed-
ily relieved  by China.
  Hysteric persons are frequently roused from sleep
at night by an attack of flatulent colic, characterized 
54
FLATULENT COLIC.
by stitches  in the  sides and towards the chest:  the
pain  is relieved bv  emission of flatulence, but the
emission being incomplete, the pain lasts a long while.
This kind of colic is most certainly relieved  by  Igna-
tia amara.   The  colic is sometimes accompanied  by
an aching pain  at a small spot of ihe head, peculiar
to hysteric females; this pain is a sensation as if a
blunt body were driven into  the brain.
  Pulsatilla is more  suitable for women than men,
and is especially indicated when the headache arises
from  nervousness  rather than from  hysteria;  also,
when  the  aching colicky pains recur periodically in
the evening or after midnight, and when the flatulence
which is  incarcerated  in the epigastric region,  and
causes pinching and gurgling, passes off with a violent
cutting colicky pain,  and frequently even with nausea
and vomiting.
  Zincum seems to  help  when the  flatulent  pains,
which  afterwards  increased to real aching  colicky
pains, get worse from drinking a glass  of wine, or ap-
pear  towards  evening, during  rest;  the,  pains are
generally  accompanied with constipation, with loud
rumbling, fermenting sensation, and retraction of the
abdomen ;  hot,  humid  winds are frequently  passed
without relief.
   Veratrum  is  suitable to flatulent colic preceded by
anguish,  despair as if beside one's-self,  particularly
when the flatulence  shifts  about and finally attacks
the whole abdomen; the emission  of flatulence is  so
much more difficult,  the longer it remains incarcera-
ted ; the abdomen is distended and hard.
   Phosphorus relieves  flatulent  colic  which is deep-
seated in the distended abdomen,  aggravated in a re-
cumbent posture, and accompanied with loud, painful
rumbling.
   Hyoscyamus is useful for pressing  flatulent colic, in
the evening when  in bed, with distention  of the abdo-
men,  and pain  on  touching it; also  for flatulent, colic
 which sets in after rising in the morning, and is  ac-
 companied with meteoristic distention of the abdo- 
COLICA GASTRICA.
55
men,  rumbling,   pinching in  the  abdomen, with
pressure from above downwards, nausea,  and bruised
pain in the back.
  Capsicum may be tried for  a painful tension from
the abdomen to the chest, as if from distention of the
parts, also with pressure, particularly in  the epigas-
trium, worse during motion; the patient complains of
an oppressive tightness in the lumbar region ; the hard-
ness and distention of the abdomen  make the contact
of the clothes intolerable.
  Aurum.  Nightly incarceration of flatulence under
the left  ribs, with stitching ;  the attack  sets in even
after the most moderate meal.
  Asafoztida. Suitable for hysteric and hypochondriac
individuals, or persons suffering with congestion of the
portal system and abdominal pulsations.   The pain is
great,  abdomen  distended,  great  rumbling in the
bowels.
  Carbo veg. Flatulent and haemorrhoidal colic.  The
former is aggravated, or renewed  by taking the least
nourishment. The  pain is crampy,  -with  pressure,
particularly  in the  left  epigastrium, under the ribs,
and in  the  region of the bladder.   The attack is fre-
quently  induced  by a cold;  emission of flatulence
procures some relief.
  §. 200.  Flatulent colic  is sometimes accompanied
with a sensation  as  if hernia would protrude through
the abdominal ring.  There is indeed danger of hernia,
if the sensation should have been experienced repeat-
edly.   The proper remedies  for  this symptom are:
Chamomilla,  Nux vom., Cocculus,  Veratrum, Magnes.
arct., Capsic, Aurum, Mezer., Acid,  sulphur., Sulphur,
Phosphor., Carbo anim.  Hereditary disposition, con-
stitution,  temperament, previous diseases, etc., some-
times point  to one  or the other  of those  remedies.
I  have frequently removed that condition of the ring
with Nux vom., Cocc,  Verat., Magnes., Chamomilla.

  §. 201.  Colica gastrica.
  This colic  is  induced by crudities, bile, mucus, un-
digested or decayed remnants of food, noxious articles 
56
COLIC A  GASTRICA.
of diet, worms, etc.  The colicky pain  is more or less
violent,  accompanied with  a sensation of tightness,
heaviness, repletion;  pains in the back extending to
the  loins, thighs, knees; deranged stool.  The abdo-
men  is  not  hot, the  pulse somewhat irritated,  but
neither hard nor tight; fever may, however, supervene.
The pain is relieved by the, discharge of the foreign
substances.
  Bilious colic is induced by the presence of acrid bile
which is secreted, to excess, into the stomach and in-
testinal  canal : the colic is generally felt in the epi-
gastrium; it is  generally accompanied with vomiting
of greenish  matter, from  which  we  may infer the
presence of bile in the stomach. This kind of colic is
sporadic, caused by violent  anger or chagrin ; it is
endemic in hot countries, where bilious fever and he-
patitis are common diseases ; it is frequently epidemic,
even in our climate, in hot summers, with cool nights;
then  it  prevails in company with bilious fevers and
bilious  dysentery,  or other  bilious diseases,  is fre-
quently  combined with  these  diseases, and is caused
by a cold,  indigestion,  carousing  in the evening,  or
night-air.  Bilious colic does not always set in sudden-
ly ; sometimes it is preceded  by  bilious phenomena,
such as loss  of appetite, bitter taste, yellowish-slimy
coating on the tongue, tightness in the praecordia. The
colicky pains are generally violent, acute, cutting, con-
tractive, frequently emanating from the right side.wherc
they are most violent; accompanied with great inter-
nal heat, thirst, restlessness.   The  patient is relieved
by discharges of bile from the stomach or rectum.
Violent attacks easily lead to hepatitis or enteritis,  or
leave, at any rate,  a great sensitiveness of the intesti-
nal canal, predisposing the patient to new attacks.
  §.  202.  If we can ascertain  the  cause of the colic,
we should endeavour to  remove it, or to select our re-
medy accordingly.   Chamomilla, for instance, should
be given when the attack was brought on by violent
passion or chagrin.  It is indicated  by a painful dis-
tention and tightness in the  subcostal region, particu- 
COLICA  GASTRICA.
57
larly in the right hypochondrium,  whence  colicky
pains spread to the umbilicus,  causing a pressure and
griping in  the  stomach, which lead to nausea and
bilious  vomiting, and  leave the tongue coated with
yellowish  slime,  and a  bitter,  bilious taste in the
mouth.
  Nux  vom. is  preferable to Chiamom., if the attack
took place after a copious meal, or some time elapsed
before medical aid was required ; it suits patients with
a robust, plethoric constitution, or persons accustomed
to rich living.
  Ignatia  corresponds to colic  from silent grief, and
Pulsatilla should be given when Chamomilla relieves
but  does  not stop the  recurrence of an attack.   See
the chapter on Gastroataria, vol. I.
  Ipec, Bryon.,  Verat., Arsen., Dulc, Sulph.,  are like-
wise indicated for bilious colic.
  Hahnemann cured a case of  colicodynia with  large
doses  of  Veratrum (see Hufeland's Journal,  vol. III.,
No.  3, year 1797.)  Four  or  five  hours after eating
fruit, particularly pears,  the  patient  experienced  a
certain movement about the umbilicus ;* suddenly he
felt,  at the same spot, a pinching as if with pincers,
accompanied with excruciating pains ;  this continued
for half a minute or a whole minute, and disappeared
suddenly after some rumbling extending down to the
groin or coecum.   If the attack was  very  bad, the
pinching and rumbling occurred more frequently until
they  remained  altogether.  This  sensation  was ac-
companied with a feeling of constriction from above
downwards, so that no flatulence could be discharged
either above or  below.   The  anguish  and  pain in-
creased from hour to  hour,  the  abdomen  became
swollen and painful to the touch. The anguish, which
resembled a fever, was attended with a frequent urg-
ing to vomit, the chest became oppressed, the breath-

  * The patient had complained of  a dull, disagreeable sensation
in the left hypochondrium for a year past, after  having had  an at-
tack of colic.
           3* 
58
COLICA  GASTRICA.
 ing short and difficult, cold sweat broke out,  and the
 patient felt stupified and prostrated.  In this condition
 he was unable to swallow  liquids, much less  solids.
 During the  stupefaction the face was bloated, with
 protruded  eyes,  and no sleep.  Gradually flatulence
 was emitted above  and below, and the attack dis-
 appeared after 16 or 24 hr.urs.  The  patient remained
 weak for three or four days, but the  seated dull pain,
 general  feebleness  and the sickly  appearance re-
 mained.
   Colocynthis is  a  principal remedy for bilious colic
 from chagrin.  I  used it with success in a species of
 colic arising from sudden flatulence  which could not
 be discharged ; the  attack  set  in at midnight.   This
 remedy is particularly useful  when the most violent
 pains continue unabated, except with very slight inter-
 missions, and, on ceasing, leave a bruised pain  in the
 whole  abdomen, which,  on stepping,  produces a sen-
 sation  as if the bowels were suspended by easily torn
 threads, on which  account  the patient has  to walk
 slowly and cautiously.   This symptom continues even
 a  long  time after the cessation of the attack.  Colo-
 cynth is likewise  indicated  by an intense pain at a
 small spot in the umbilical region,  appears periodi-
 cally every 10 or 15 minutes,  or even less frequently,
 commences with  a slight drawing from the sides to
the centre,  which gradually  increases to a  crampy,
pressing, digging, tearing and griping pain, and be-
comes  so violent that the patient utters loud shrieks,
bites on every thing which  is near him,  and writhes
in his anguish  like  a worm.  The above-mentioned
bruised pain remains after such an attack.
   Worm-colic belongs under this  head.   The  pains
shift about, with  long intermissions, and are frequent-
ly most  violent before breakfast; they  can be  ap-
peased by sugar-water or milk, and are excited by salt
food ; the pains are gnawing, boring, creeping, the pa-
tient feels something living move about in his abdomen.
— Mucous colic  exhibits symptoms  of mucous  de-
rangement  and colic ; the pains are aching, boring, at- 
COLICA  SATURNINA, ETC.
59
tended  with flatulence.—Colic from indurated faces,
to which old people, hypochondriacs, pregnant females
and individuals with  old herniae,  are  subject.  The
lumps  of faeces  may be  displaced and  felt with
the hands, etc.  The remedies are  the same as those
that have been indicated  in the last paragraphs, and
in the first volume.

   §. 203.  Colica saturnina, pictorum, rhachialgia me-
tallica.
   This kind of  colic  arises from the introduction  of
metallic oxyds, especially lead, in various forms and
Ways, into the human body.  This may take place by
mixing it  up with food and drink, wine for instance, or
by administering it as a medicine  in the form of an
acetate, or by inhaling metallic vapours, as is the case
among miners, potters, painters, type-founders, or by
using badly glazed leaden vessels.  This colic is cha-
racterized by an excessive retraction of the abdominal
muscles  towards the spine,  sympathetic  vomiting,
strangury, slow  and hard pulse, obstinate constipation,
and dryness of the faeces.
   The colicky pains are at first dull, intermitting;  as
the  disease increases, they  become twisting, con-
strictive, boring ; they  become concentrated in the pit
of the stomach  and  umbilical region, when they
radiate to the  chest, back, hips, arms and feet; at last
the intermissions disappear, the pain becomes conti-
nuous, and is frequently so violent that the patients
toss   about,  moan, writhe in  agony; the pain  is
sometimes relieved by  compressing  the  abdomen.
The abdominal muscles are frequently contracted  to
such an extent that the vertebrae can be felt through
them.  The alvine evacuations cease; sometimes a
scanty discharge of hard  lumps like sheep-dung does
not take  place  till a  week or  a fortnight after the
commencement  of the  attack.
  Reflex-symptoms are:   loss of  appetite, nausea.
retching,  vomiting of a  dark-green  matter,  or like
verdigris :  strangury or ischury ; retraction  and con- 
60
COLIC A  SATURNINA, ETC.
traction of the sphincter ani ; the testicles are drawn
spasmodically to the abdominal ring ; the breathing is
anxious and even  asthmatic,  particularly during the
attack,  the voice  is hollow and dull; sometimes sin-
gultus is present.
  The following  symptoms are likewise frequently
observed in the course of an attack : tearing pains in
the limbs, sometimes  alternating with the colic, parti-
cularly at night; these  pains, if lasting, increase to
weakness, tremor and paralysis ; the extensor muscles
are paralyzed, the flexor muscles remain active ; this
is strikingly  noticed in  the muscles of the hands,
which are then  bent inwards towards the  forearm;
the  pain  in  the limbs  frequently continues  with the
paralysis.  Other nervous  symptoms  are:   epileptic
spasms, delirium, amaurosis, apoplexy.—The patients
emaciate rapidly, the skin  becomes dry, cracked, yel-
lowish.
   The  attacks generally  last  from eight days to a
fortnight.  They  are readily cured by homoeopathic
means, but  the cause  remaining, relapses  are very
frequent.  In  this case the constipation becomes ha-
bitual, the patients retain a pale complexion, they be-
come thin, feeble, paralytic and dropsical.—Termina-
tion in enteritis and ileus is not very frequent.*
   § 204.  The specific remedy for lead-colic is Opium.
It removes the attack by opening the bowels.   None
of the allceopathic adjuncts, such as alum, cathartics,
oleosis, hyoscyamus, etc., are required with  Opium.
   Platina is recommended by some as  a superior re-
 medy for lead-colic.
   After the removal of the attack,  various symptoms
 sometimes remain,  such as the  paralysis.   The con-
 stipation,  spasms in the  chest, amaurotic weakness,
 can  be met by Stramonium; Bell/donna deserves  a
 preference  if the amaurosis and  deafness should be
 very great, and may be followed by Hyoscyamus.  In

   • For a beautiful description of the lead cachexia, see Hempeft 
           COLICA ^ERUGINALIS,  COPPER-COLIC.        61

some  cases slight electric shocks will be found use-
ful.
  Alumina is likewise a good remedy for many  after-
diseases.

  §. 205. Colica aruginalis, copper-colic.
  This colic attacks workers in copper,  coppersmiths,
etc., or persons who eat food prepared in badly tinned
copper  vessels.  It differs from lead-colic  in many re-
spects.
  The abdomen is distended, hard, painful to contact;
the spasms, which  are sometimes accompanied with
cutting and  tearing  in the bowels, are very violent,
and attack even the extremities, accompanied with
piercing shrieks ;  anxiety and pressure in the  pit of
the  stomach,  spasmodic  constriction  of the  chest,
white-coated tongue, with red tip and edges ; difficult
speech, diarrhoea, sometimes resulting in the discharge
of a thin, green, or bloody mucus, with tenesmus ; the
urinary secretions are frequently totally suppressed;
sympathetic vomiting as consensual  symptom.
   § 20G. Treatment.  This must be  antidotal.   Bella-
donna  is the  best  remedy when the above-named
symptoms  occur :  erethism, distention,  hardness and
sensitiveness  of the  abdomen,  spasmodic  tenesmus,
colicky griping, particularly  in the umbilical region,
the above-described  stools, stuttering speech, etc.
  After Belladonna, we  may  give  Mercurius, when
the erethic symptoms are subdued, and purely gastric
symptoms  exist in  the lower part  of the  intestinal
canal, the stomach being  quiet.
   Ipec. and Verat. may likewise be  indicated  by the
symptoms.
   Nux vom.  is related to Mercurius, and is  to be pre-
ferred  when the reflex-action  towards the stomach
continues.
   China, Hep. sulp ,  Cocc, Calc c, may likewise be
mentioned  as useful remedies for  the  after-effects,
after the colic is subdued. 
fi2  COLtCA SANGUINEA. PLETHORICA,  H.r.MORRllOIDAI.I*.


  § 207.   Colica  sanguinea,  plethorica,   hcemorrhoi-
dalis.
  This colic is excited by congestion of the abdominal
organs, haemorrhoidal or menstrual suppression.  The
symptoms  are  various, and are  apt to recur period-
ically, especially when  the  moon  is on the increase.
Fever is  present  only when the colic is very violent.
The colic, which  is  apt to assume an inflammatory
character, is extremely violent,  continuous, seated,
stitching,  cutting,  oppressive, increasing  by contact;
if the spasmodic character prevails, the pains are pa-
roxysmal  like  labour-pains, and  the  abdomen is at
times  distended and  sensitive,  at others  spasmodic-
ally  contracted;  a  sensation of  coldness in  the
abdomen  is  experienced when a paralytic state  is
present.  These colicky pains are accompaned with
drawing,  tensive,  stitching  pains  in the small of the
back,  back and loins,  which suddenly shoot through
the pelvis or extend to the thighs ; all sorts of conges-
tions  and spasms,  such as: spasms of the bladder,
stomach, and uterus,  pressing on the rectum, distress
in the chest, headache, buzzing in the ears, vertigo,
fainting fits, palpitation of the  heart,  anxiety, etc.
These symptoms frequently  continue for months until
the blood  is discharged; the symptoms decrease with
every new paroxysm, they are most violent when the
first  discharge of blood takes place.   If this  should
not take place, the symptoms increase to  the utmost
violence.
  § 208.  Nux vom. is  an excellent  remedy for  this
disease.   In haemorrhoidal colic the bladder is more
or  less affected, which makes the pain very distress-
ing.  The external sexual parts and the region of the
bladder are  spasmodically  drawn inwards, the abdo-
men  becomes  more and  more sensitive,  denoting an
inflammatory state ;  there is  a  constant urging  to
urinate, without ability ; great anguish and restless-
ness, leading to a sinking  of the  \itnl forces,  parti- 
          COLIC DEPENDING UPON LOCAL  CAUSES.       63

 Cularly  among old people, unless speedily relieved.
 These  symptoms  are  frequently relieved  by a  few
 small doses of Nux.
   If the  prostration should increase  from minute to
 minute, Arsenic must be substituted for Nux, provided
 help is not too late.
   If the  colic should  have lasted until an inflamma-
 tory state is developed, Aconite is required, which will
 remove the whole trouble.*
   Belladonna corresponds to a constrictive, spasmodic
 sensation  deep in the abdomen, with a hot,  burning
 sensation, and  a pressing sensation  close  above the
 pubic  bones  and the sacral region, becoming intole-
 rable by motion, and inducing a sensation of extreme
 weakness, sensitiveness, loss  of consciousness, even
 fainting.
   Sulphur is suitable for a colic which sets in slowly,
 from day to day, particularly when the spasmodic co-
 licky pains  are  accompanied with  a sensation  as
 though the inside of the abdomen were all raw, and
 the  least  touch causes great pain.   The  spasmodic
 contractions extend to the chest, pelvis, sexual organs,
 frequently alternate with  cutting and stitching, and
 are at the same time accompanied with violent pains
 in the  small of the back, which  sometimes extend
 along  the back as far as between the shoulders, in
 the shape of drawing and tensive-aching  pains.
   Useful  remedies  are:  Capsicum,  Ferrum,  Thuja,
 Puis.,  Ignat., Colocynth.,  Carb. veg.,  Phwsphior., and
 others.

   § 209. Colic depending upon local causes.
   Under this head belong those kinds  of  colic which
 attack old people,  or  are caused by sedentary habits,
 dry food,  tight lacing, accumulation of faeces.  This
 accumulation generally  takes place in the colon  or

 * Aconite should  be given from the commencement.  Hartmann com-
mits the same mistake as most other physicians, to suppose that spasms
and inflammation are two dilfcrent conditions. See my Organon.—Hem- 
64
COLICA  HERNIOSA.
rectum, occasions congestions of blood, and is known
by a troublesome pressure  and tightness deep  in  the
abdomen, spasmodic contraction  of  the  abdominal
muscles, and the  colicky pains which have already
been  described.   It is  true,  the  patient  frequently
experiences peristaltic motions in  the intestines as it
they would overcome the difficulty, but these  lead only
to antiperistaltic  movements reaching up to the  sto-
mach, and giving rise  to putrid  or sour eructations,
loathing, vomiting, and even vomiting of fax-es.
  Good diet and daily exercise in an open, pure air
will,  with Nux,  overcome  this complaint,  provided
the other svmptoms correspond; very often 1<ratrum,
Bryon.,  Staph;/*.,  Pla'ina,  China, Bellad.,  Cocculu*,
or some other medicine, may prove more useful  than
Nux.  If faecal vomiting (ileus) should already have
set in, Opium is  the  principal  remedy,  unless the
symptoms should indicate Plumbum.
  If the disease should have become very obstinate,
the medicines will have to be repeated very frequent-
ly, and a great many even may have to be used. It
will be difficult  to cure such an  obstinate complaint
without the use  of the antipsorics,  Sulphur, Calcar.,
Silic, Lycop., Alum., and  Zincum.

   §  210.  Colica  herniosa.  This colic is not easily
diagnosed.  It is caused by the incarceration or stran-
gulation of recent, or old hernia, and  the pain, which
at first is  felt only  in the region of the hernia, gradu-
ally  spreads  over the whole abdomen.  It  is  always
accompanied with  obstinate constipation,  except in
the case of incomplete hernia or  hernia of the omen-
tum ; sometimes,  however,  the faeces which are  con-
 tained in the bowels below the incarceration, are still
 passed. The abdomen swells;   the hernia,  which
 could  be  replaced previously, becomes  immovable,
 painful, swollen,  tense, hot, red, and retains  white
 pits  from the pressure  of the finger.   Retching, vom-
 iting, at last  vomiting of faeces : fever, with small,
 spasmodic pulse,  singultus, cold sweats, and the  like, 
COLICA  HERNIOSA.
65
 accompany the incarceration.   If the swelling  be-
 comes rose-coloured or livid, gangrene is  imminent;
 gangrene  has actually set in  if the swelling retreats
 with a noise under the pressure of the finger; the de-
 nuded intestine is black, relaxed, or hard and liver-co-
 loured.  Incarceration may take place with every form
 of hernia, even  internal  hernia, particularly at  fie
 abdominal  ring, and  with intestinal  hernia.  It fre-
 quently  exists even  if no external trace of hernia is
 visible.
   We may class here the  involution  of the intestines
 termed  volvulus,  intussusceptio.  This   is a  very
 dangerous and acute affection.   It  is characterized
 by a continuous, violent vomiting, with obstinate con-
 stipation, no  flatulence  even being passed. The pa-
 tient complains of violent,  boring pains in the distend-
 ed region, and a sensation as if the bowels were fre-
 quently tumbling amongst  each other.  The  pain is fre-
 quently concentrated about the umbilicus,  it is a sen-
 sation as if a string were  tied round the umbilicus, or
 a violent tension.   The pain finally spreads over the
 whole abdomen, with meteorism and  excessive sensi-
 tiveness.   There is painful rumbling above the incar-
 ceration, eructations, singultus, thirst,  anguish, sudden
 prostration, quick  and  contracted pulse,  sometimes
 urinary difficulties.  Fever sets in on the supervention
 of enteritis.
  § 211.   A specific remedy for this affection is  Nux
 torn., which should be  given in a small dose, and, of
 course, before gangrene sets in.   It is  not advisable to
 try the, taxis previous to the exhibition of Nux, be-
 cause it increases  the constriction of the  muscular
 fibres of the intestinal canal and abdominal ring, ren-
 dering the trouble more obstinate.  The medicine has
to be repeated frequently,  unless an improvement sets
in in the  first half  hour.  The symptoms indicating
Nux, have been described  before.
  For ileus, Nux may likewise be  tried.   Belladonna
is useful for spasm from volvulus, intussusception and 
66           PROCTALGIA ANI)  TENESMUS.

incarceration, even when faecal vomiting is about set-
ting in.   It is preferable  to Nux and Opium when the
abdomen  is meteoristically distended,  with  anguish
and restlessness,  spasmodic and griping pains in the
abdomen  and region of the bladder, and constant  in-
voluntary discharge of urine.  Plumbum  should not
be forgotten for these symptoms.

  § 212. Proctalgia and  tenesmus.
  These affections  are, generally speaking, symptoms
of some more  general disorder, but  they are some-
times so acute that the patient fancies  he has  no  other
disease,  and wishes to  be freed  from  the local dis-
tress.
  The distress must be very painful, if we  consider
the multitude of nerves which are ramified over the
mucous membrane of the rectum.   Neuralgic or  other
painful affections  of the mucous membrane covering
the sphincter ani, such as : fissures, even  haemorrhoi-
dal tumours, are  sometimes accompanied with a  spas-
modic contraction  of the muscle, which, at first, con-
sists of short paroxysms of painful constriction, but, if
recurring frequently,  may increase  to a permanent
contraction,  and constitute a painful  affection lhat
may exercise a very pernicious influence on the  gene-
ral health of the patient.
  Tenesmus—a  constrictive  pain at the anus,  with
sensation of urging to stool—may  be  excited  by  acrid
faecal matter (in various forms of diarrhoea, dysenters,
blennorrhoea of the rectum) by an irritation produced
by  ascarides, by a reflex-action from the bladder  or
uterus;  it may be present in catarrh of the bladder,
vesical calculi, etc.  Violent  tenesmus  may  occasion
prolapsus of the  rectum.
  § 213.  The  treatment of these complaints  is  prin-
cipally symptomatic.  Among the following medicines
the beginner will find  perhaps some that not only cor-
respond to the particular distress, but the general state
of  the patient. 
              PROCTALGIA AND TENESMUS.            67

  Burning pain  in the anus:  The  simple burning  is
frequently relieved by Capsic and Alum. ; when oc-
curring at night, Iodium ; during stool:  Terebinth ; af-
ter stool :  An!im. tart.,  Stront.;—burning-itching  and
smarting  in the anus  are  frequently relieved by  An-
tim. crud.; burning tingling,  as if from worms, by Te-
rebinth. ;  burning-cutting,  pressure, and constriction
during  stool,  by Staphys.; burning, itching, and ting-
ling,  by Colchic ; burning before, after and between
stool, by Oleander;—itching, smarting, soreness, burn-
ing sensation, pressure in the anus, as if tumours
would form, by Acid. nitr.;  smarting and soreness in
the tumours, by Puhat.;—frequent creeping, with te-
nesmus in the anus, as if  diarrhoea would  set in, in
the evening before going to sleep, Platina;  for press-
ing,  contractive sensation, with swelling  of the tu-
mours,  burning-gnawing pain in the anus during soft
stool, Angustura. is frequently suitable ;  whereas Acid.
mur.  or Ant. crud. suit for swollen tumours  with burn-
ing soreness,  and  Magnes. artif. for a smarting hae-
morrhoidal  soreness after stool, with constriction  of
the rectum.—Kali carb. relieves a stitching, tearing,
and cutting, also a smarting and burning in the anus;
Plumbum  relieves a  stitching and burning, also con-
traction, constriction, and retraction of  the anus.  Ig-
natia relieves the contractive sore pain in the anus
as from blind piles, a few hours after stool; Mezereum
the constriction of the anus above the  protruded rec-
tum, after stool.
  For the itching  of the anus, also from worms, see
Vol. I., Worm fever.
  For protrusion of the haemorrhoidal tumours during
stool, with burning pain, give Calc carb., unless Colo-
cynth. should  be indicated by the previously swollen,
painful tumours.—Sulphur,  Lycop., Nux com., Ars.,
Nnlr. mur.,  deserve  great  attention  in these affec-
tions. 
68     GASTRALGIA, GASTRODYNIA, CARDIALGIA. ETC.

  Prolapsus  of the rectum, occasioned by these neu-
ralgic affections, may be treated with Ars<».. Sulph.,
Mercur.. Sep.. Dulcam., Catch.. Ruta, Magnet., Ignat.
and Magnes. mur.

  §. 214.  Gastralgia, gastrolynia, cardialgia, colica
vcntriculi.
  This disease depends  upon  an increased irritation
of the nerves of the  stomach, inducing an abnormal
contraction of the muscular fibres of that organ.
  General  diagnostic  symptoms of cardialgia  are :  (a)
Neuralgic  phenomena.   The region be low the xiphoid
cartilage, the epigastrium, and partly even the hypo-
chondria, are the seat of the pains of various character
and intensity, the paroxysms  alternating with inter-
missions.   Generally  the pains are  violently constric-
tive, twist ing, turning, cutting, tearing, boring, gnawing,
beating, etc.; at  times dull, as if a band were strung
round the  body ;  at times so violent, that the patients
bend double.   The extent of the pain varies;  fre-
quently it  occupies the  epigastrium or  only  a small
portion of the same, or it extends to the back, breast
and scapulae.   Pressure from  without frequently  re-
lieves the  pain ;  this is the reason  why  the patient
presses the region of the stomach against hard bodies;
at other times the patient  is  afraid of slight contact,
whereas hard pressure is always easily borne.  The
attacks generally last from a quarter of an hour to a
full hour ; sometimes a whole day; the paroxysm is the
shorter the more acute it is.  As the disease progress-
es, the paroxysms increase in intensity and frequency;
sometimes  they are  caused by eating light  food, by
fatigue, emotions, a change of weather; the intermis-
sions gradually become so short that the patient feels
a pain all the time.  The exacerbations generally take
place in the  afternoon,  less at night; sometimes at
certain hours of the day, and even when the stomach
is empty, before breakfast.
  (b) Sympathetic symptoms : By sympathy the patient
frequently  experiences a  pain in the spine in the region 
      GASTRALGIA, GASTRODYNIA, CARDIALGIA, ETC.    69

of the last  dorsal vertebrae, extending as far as the
scapulae.   The  motor nerves are frequently affected
svmpathetically:  we have  distressing  vomiting, not
always of food, eructations, yawning, spasmodic con-
traction of the abdominal muscles, diaphragm, the pit
of the stomach sometimes is drawn in to the  vertebral
column,  singultus,  obstinate constipation, feeling of
anguish, palpitation of the  heart, constriction of the
fauces, aphony,  urging to  urinate.  The stomach is
sometimes distended by flatulence ; towards the end of
the paroxysm the patient is relieved by the vomiting of
grass-green bile, or of an acrid-sour,  sometimes slimy
secretion from the mucous membrane of the  stomach.
This vomiting  frequently terminates the paroxysm.
The pulse is contracted and  small, the skin  cold.
Sweat breaks out as the pains abate, the  pulse rises.
  Violent cardialgia may lead to sympathetic fainting,
tremor, delirium, general debility, convulsions and te-
tanus.   Cardialgia is generally without fever; appe-
tite frequently undisturbed,  the patient frequently de-
sires salt, sour, spiced, bitter food.  (Canstatt.)

              VARIETIES  OF  CARDIALGIA:

  Pyrosis, soda, ardor ventriculi,  which  not only oc-
curs in the higher degrees of cardialgia, but sometimes
indicates that it is about setting in.  This  is a burning
sensation  from the stomach to the mouth along the
whole of the oesophagus ; it  is frequently accompanied
with accumulation of water in the mouth, which has
at times an acrid, at times a sour, corrosive taste, is
frequently accompanied with nausea and discharged
with vomiting.   The spasm  is sometimes diminished
by the  secretion of such a watery fluid.
  A second  variety is  flatulent cardialgia.   The  gas
which  is accumulated in the stomach  may not only oc-
casion  the attack, but be produced by  the reflex-action
instituted by cardialgia.  The cardialgia is then ac-
companied with flatulence,  meteorism of the epigas-
trium and hypochondria, tympanitic percussion sound 
70    GASTRALGIA, GASTRODYNIA,  CARDIALGIA.  ETC

of the swelling, difficult breathing, great  anguish,
small pulse, rising of air, emission of flatulence  with
relief.  The flatulence  may  be  caused by  indulging
in flatulent, fermenting food, fruit, cider, grapes,  etc.
  A third variety is. according to Canstatt,  neuralgia
coeliaca, of which mention has been made above.
  § 215.   Many  authors designate by  the  term gas-
trodynia  a rather aching, continuous pain (Hufeland),
by the term cardialgia a constrictive pain in  the  sto-
mach causing anxiety; by  pyrosis  is understood a
lighter degree, or rather a mere symptom of the dis-
ease.   This  division has no practical  value.   It  is
more useful to distinguish an idiopathic and sympto-
matic cardialgia; by the former we mean a primary
affection of the  stomach, and by the latter  we under-
stand an affection depending upon other pathological
states, such as:  indurations of the liver, affections of
the spleen, kidneys, etc.
  A predisposition for this disease is  frequently here-
ditary.   It is more frequent  among women than men,
and is principally met among individuals with irritable
nerves, weakly, hysteric, chlorotic subjects, and individ-
uals disposed to spasms, particularly  at the menstrual
period, at the critical age, by weak  digestion,  abuse
of cathartics, improper use  of  the hydropathic treat-
ment, abuse of coffee and tea.   The, reason  why the
excessive use of  coffee predisposes women  to this dis-
ease  more  than men, is this,  thai  -omen are more
confined to their houses and  have no; r he same oppor-
tunities that men have to dispel the pernicious effects
of  coffee by active  business, and exercise in  the open
air.  Literary men who lead a sedentary life and use
much coffee, are, for the same reason, likewise subject
to that disease.   It occurs most frequently between the
ages of 20 and 50, rarely before  the age of pubescence.
  Exciting causes:  Emotions,  a cold,  suppression of
foot-sweat and habitual discharges of blood, and par-
ticularly suppression of cutaneous eruptions.  Taking
cold on  the  stomach while the  body is headed, is one
of  the  principal causes of  cardialgia,  particularly 
      r;A!«>TK.\I.GIA, GASTRODYNIA,  CARDIALGIA, ETC.     71

among debilitated,  irritable, individuals, in whom the
disease can easily be excited by sour food, sour wine,
beer,  fruit, fat pastry, meat.   The  disease may like-
wise  depend upon  organic  affections  of the stomach
and of neighbouring organs.
  Prognosis:  Cardialgia depending upon organic dis-
eases, is scarcely ever curable; relief is all that the
patient can hope for.
  § 216.  The  following remedies  have been found
particularly useful: Nux vom., Cham.,  Bellad.,  Cocc,
Ipecac, Stann., Staphys., Plat., Con., Bryon.,  Pulsat.,
Arg.  nit., Ignat., Chin , Hyoscyam.,  Bismuth.,  Arsen.,
Plumb., Argilla, Carb. veg. and  anim., Calc carb.,
Caust., Natr. carb. and mur., Sep., Baryt. carb., Lycop.,
Phosphor., Nilrum.
  Nux vom. and Chamomilla are specifics for cardial-
gia caused by the abuse of coffee.*   Nux is likewise
useful for cardialgia  caused by suppressed eruptions,
even  after years,  and by long  abuse  of spirituous
drinks.   This cardialgia of drunkards  is at first fre-
quently a mere vomiting, known as vomitus potato-
rum.   If is indicated  for heart-burn, for sanguineous
and hysteric cardialgia.
  The principal symptoms for which Nux is indicated
are: Contraction, pressure, crampy sensation, griping,
spasm, sensation as if the clothes oppressed the region
of the stomach, or as if flatulence were incarcerated
in the region of the hypochondria; this sensation, and
the pain  in  the stomach, are  generally increased by
taking food or coffee, and is very often accompanied
with an oppression  and constriction of the chest which
spreads  even as far  as the inter-scapular region and
small of the back, or  causes a  sensation as if a  band
were tied round the chest.  Early pains  which rouse
the  patient  from  sleep,  are  characteristic  of  Nux.
It is likewise indicated by the following sympathetic
symptoms:  Nausea, particularly  during the  attack,

  * S.c my pamphlet on the use of Nux. vom. in the treatment of disease,
I.cipsic. 
 12     GASTRALGIA, GASTRODYNIA,  CARDIALGIA, ETC.

 accumulation of water in the  mouth, gulping up of
 a sour, bitter fluid, with or without heart-burn, vomit-
 ing of mucus or of the ingesta, empty retching, palpi-
 tation of the heart with anxiety, sour, putrid taste in
 the mouth, constipation, flatulent distention of the ab-
 domen, hemicrania or aching pain in the forehead.
 Nux is likewise indicated when the  attack sets in at
 the time of the catamenia, in females who  menstru-
 ate profusely.
  The more delicate the patient, the smaller the dose ;
 and vice versa, the more robust the patient, the larger
 the dose.   I  have never given  lower than the third
 attenuation, and never hesitate to repeat the  dose.
  Chamomilla is  suitable  for persons  with irritable
 nerves and easily excited by anger.   It is indicated by
 a hard pain in the pit of the stomach as from a stone,
 also under the  left  short ribs.   This pain is always
 attended with shortness of breath and anxiety, is worse
 at night, so that the patient has to toss about his  bed
 in agony; it is frequently accompanied with  a throb-
 bing pain on  the vertex which the patient supposes
 can be relieved  by  getting  up from bed.  He feels
 relieved during rest, and by bending double. The pain
 is generally relieved by coffee,  whereas  it is  aggra-
 vated  when  Nux is  to be given.  Chamomilla will
 therefore be  found useful  for cardialgia induced by
 abuse  of coffee, for which Nux alone would not be
 sufficient.  Cardialgia caused by abuse of chamomile-
 tea, can  be relieved by Ignatia,  Pulsat.  and Coffea
 cruda, the latter medicine when the pains seem to be
 intolerable  and the patient is very nervous.  Cardial-
 gia caused  by the abuse  of both chamomile tea and
 coffee, yields  to Nux,  though Ignat. or Pulsat. may
sometimes be required in conjunction with Nux.
  The dose of Chamomilla is from the first to the sixth
att., and to be repeated.
  Belladonna may be  tried in  cases for which Chamo-
milla seemed  to be indicated,  but had no effect. Bel-
ladonna can scarcely ever be given at the  commence-
ment of an attack ; it is suitable for females with irri- 
       (SAM'KAI.GIA, GASTRODYNIA, CARDIALGIA, ETC     73

table nerves, and is particularly indicated by the fol-
lowing symptoms.  Gnawing pressure, spasmodic ten-
sive pain in the pit and region of the stomach, obliging
the  patient to  bend backwards  for relief or to arrest
the breath ; the violent pain induces loss of conscious-
ness or even fainting, or it recurs during dinner.  Hy-
osciamus and viola odorata deserve consideration when
these symptoms occur,  particularly  in cardialgia hys-
terica.   Bellad.  is  somewhat more indicated by slow
stool, sleeplessness, increased thirst, with aggravation
of the pain afterwards.
   Cocculus: I never gave it at the commencement of
a paroxysm, but always after Nux when this medicine
relieved  the attack, but did not prevent its recurrence.
Cocculus acts well when constipation or costiveness
is  present,  never when there  is diarrhoea.   It  suits
persons with taciturn, peevish dispositions, and is cha-
racteristically indicated  when the  attack is accom-
panied by a pressing constrictive pain over the whole
abdomen relieved  by  emission of flatulence, or by
nausea and accumulation  of water in  the mouth;
heartburn is never  present.
   Ipecacuanha is  indicated by nausea, retching, vomit-
ing of quantities  of mucus attended with  dull stitches
in  the, pit of the stomach and great distress in that
organ.
  Pulsatilla suits individuals  with quiet,   sensitive,
kindly dispositions,  and is indicated by stitching pains
in  the stomach  aggravated by making a wrong step
and attended with nausea ;  also by liquid stools, vom-
iting during the attack, absence of thirst except when
the pains are very violent; violent tension  and crampy
pain in the pit. and  region of the  stomach ; throbbing
and  sensation of anxiety in these  parts, or griping
and pinching which is relieved by eating. Pulsatilla
is likewise indicated by the opposite symptom,  when
the pains are aggravated by eating  and  change to a
pressure  and pinching, or  are excited by the use of
pastry and fat meat.
  Ignatia is sometimes useful after or alternately with
  VOL. IV.   4 
7t     GASTRALGIA. GASTRODYNIA. (.'ARM ALGi'A. ETC.-

Pulsatilla.   It is more suitable, however, when then
is less  vomiting  and costiveness rather than diarrluea
The stitching sensation is a characteristic indication
for Ignatia,  though it is not counter-indicated by a
sensation of pressure in the region of the pyloric ori-
fice, aggravated or excited by eating.   It is an excel-
lent remedy when  the disease  was  brought on  by
starvation, care, grief,
  These three last-named medicines relieve cardialgia
caused by the  abuse  of chamomile-tea. or by anger,
particularly when Chamomilla  is  found insufficient.
In this case Colocynthis is  likewise useful, particularly,
however, when the attack was caused by indignation,
or inward mortification on account of insulting treat-
ment ; the distress is a hard pressure as from a stone,
particularly  after eating, with sensation  of hunger,
and pain in the  pit of  the stomach when touching it;
frequently attended  with vomiting of the ingesta,
without previous nausea, small,  diarrhoeic greenish-
yellow stools and colicky pains.
   Hyoscyamus.   The attack occurs at any time during
the day ;  it does not depend upon eating or drinking ;
it  is a vague distress in the pit of the stomach, which
is  painful  to the touch ;  it frequently  sets in during
the night,  with  violent sweat, and occurs  every time
the  patient, takes cold by placing the hands in cold
water.
   Bismuth.  Mild form of cardialgia, pressure shortly
after a  meal, with nausea as if the  patient would
vomit.   I use the second  to fourth att.
   Platina.  Especially suitable  to females when  the
attack occurs at the  time of the profusely flowing
menses.  It is a pressure  in  the pit of the stomach
after a meal, with  sensitiveness  to  contact and con
strictive  sensation ; these symptoms  are   generally
attended   with   qualmishness,  succeeded   by  great
languor.
   China.  The  cardialgia is occasioned  by debility
induced by great loss of animal fluids.   It is useful
far flatulent cardialgia and pyrosis caused by abuse 
      GASTRALGIA, GASTRODYNIA, CARDIALGIA, ETC.     76

of cathartics  and emetics, by bloodletting,  haemor-
rhage, excessive loss of the seminal fluid, galactirrhoea,
exhausting sweats; these causes induce debility,  bad
digestion, a bilious, acrid or sour state of the intestinal
canal, with soreness in the  stomach, bloatedness and
pressure after every meal,  etc., so that the patient
feels  much better during rest and without food than
with it.  China corresponds particularly to the con-
tinuous violent attacks of  cardialgia  attended  with
repletion, oppression and anxiety, aching pain, heart-
burn, accumulation of water in the mouth, and empty
retching.
  Staphysagria : Painful pressure with  tension  and
crampy feeling in the pit of the stomach, taking away
the breath when increasing, relieved by  bending for-
ward ; it  is sometimes accompanied with a digging
pain.
  Stannum.  This  remedy  cured  cardialgia  which
would not yield to  any  of the above-mentioned re-
medies ; I used repeated doses of the sixth trituration.
The pain  was a griping and kneading pain, extending
to the umbilical region; the region of the stomach
was very  sensitive to  the  touch;  tension,  pressure,
shortness of breath, anxiety and nausea were present.
Stannum  acted particularly  well,  when a chronic
diarrhoea,  frequent and bitter eructations, a sensation
of fulness and distention, with hunger, were present.
  Argentum nitricum chrystallisatum  is an  excellent
remedy for violent cardialgia.  I have only used it for
females with  irregular  menses, generally  too early
and  too  profuse, with debilitated bodies  and very
irritable nerves; the violent  spasmodic  pains  in the
stomach, obliging the patients to bend double, had no
regular intermissions; they appeared at any period of
the day,  early, afternoon,  evening or night, always
attended  with violent  retching and discharge  of an
acrid, sour yellow-greenish  tenacious mucus, bitter as
bile.  This group  of symptoms was removed very
speedily.
  Cases which required  a  longer use  of Argent, nitr. 
70     GASTRALGIA, GASTRODYNIA,  CARDIALGIA, KIT.

were likewise more or less depending upon irregular
menses, but likewise  upon more or less  flowing piles,
particularly among females  that had borne children :
the pain was a burning, heat, uneasiness in the pit  of
the stomach, contractive rising  from the pit of the
stomach to the throat, nausea, eructations,  loss of ap-
petite, whereas the appetite  remained  unchanged  in
the former variety.  Stool was  generally regular, but
irregular stool was no counter-indication to Argentum
nitr.
  I  used  the  first to  third tritur.,  decimal scale.
The lighter attacks  yielded to  five or six doses, three
a day, in water ;  the  latter variety required  a longer
use of the medicine.
  Bryonia is  useful in the lighter cases of cardialgia
characterized  by  pressure in the pit of the  stomach
during or after a meal, and by a sensation of swelling
in the pit and region  of the  stomach.  This  pressure
sometimes increases to a contractive  pinching or cut-
ting,  and is relieved  or even removed by pressure on
the stomach, which brings on frequent eructations.
  In describing the symptoms which  indicate the par-
ticular remedies for cardialgia, I have confined myself
to those that are characteristic of the primary disease,
leaving out  the  secondary  symptoms  as  being too
various to admit of a minute description.  But if the
disease be really cardialgia, one  of the above-men-
tioned remedies will most probably be found indicated
by the secondary or sympathetic symptoms, for which
I refer the reader  to the Materia Medica Pura.   Bry-
onia, for instance, is indicated  when the symptoms  of
cardialgia  are accompanied by a pressing, aching
pain in the temples or in the  forehead  or even in the
occiput, as if the skull  would  be pressed asunder ;
this pain can be relieved by external counter-pressure ;
also by costiveness, or  by  aggravation  of the pains
during motion and amelioration  during rest.
  Alloeopathic physicians frequently reproach the ho-
moeopaths  with  not being able  to cure disorganiza-
tions  of single organs.   These   reproaches  are  un- 
SCIRRHUS.
77
founded, for such disorganizations can be and have
been cured, provided  the general debility of the par-
ticular  organ  and  the  general organism had not
become  excessive.   For  the  homoeopathic   agent,
having  a  specific  curative  relation to the affected
organ, must necessarily reduce and finally  remove
the disorganization in proportion as the pain  is dimi-
nished.  I am confident that the  many cases of gastro-
malacia and cancer of the stomach which occur now-
a-days,  would  not have developed themselves,  if the
primitive affection, a simple cardialgia  perhaps, had
been  met  from the commencement  by  appropriate
specific remedies instead of the round-about destruc-
tive alloeopathic  drugs.  But  even  where homoeo-
pathy is unable to cure, it is almost always  able to
procure relief.

   §. 217.  Scirrhus  et carcinoma ventriculi;  gastro-
stenosis eardiaca et pylorica.  Induration and cancer
of the stomach.
   Precursory  symptoms  of cancer   of  the stomach:
They frequently exist for years ; the digestion is ex-
ceedingly difficult, the nourishment which the patient
takes troubles  him  during  the  whole  period  of the
digestion ;  he  complains of a  dull pain, heaviness,
tension  in  the  epigastrium, flatulence; sometimes of
heartburn, desire to vomit,  vomiting of water; gene-
rally early in the morning before breakfast  a watery,
slimy, thready fluid rises into the mouth, sometimes in
considerable quantity, after which the remainder of
the day is passed in tolerable ease.  At  last vomiting
takes place one, two or several hours  after a meal,
which, however, can be avoided, provided the patient
takes such food as agrees with him ; the vomiting re-
turns, however, after the  least excess,  though this
likewise takes  place  when  the degeneration  of the
stomach is pretty far advanced.
   Symptoms of fully developed scirrhus of the stomach :
Hardness and swelling in the epigastrium, in the right
hypochondrium, or at some place which corresponds 
78
SCIRRIM'S.
to the situation of the disorganized stomach : this dis-
organization can be  felt, sometimes even seen ; it is
circumscribed,  and its  extent  varies.  The swelling
has various forms, is at times movable,  at  others im-
movable,   and  interwoven  with  the neighbouring
parts.  Gradually the vomiting becomes habitual, it
takes place two, three or four hours after a meal, or
at last even before breakfast; the latter  vomiting is
characteristic of cancer of the stomach, the substance
which is thrown up being blackish, chocolate-coloured,
or like soot or the sediment of coffee,  or even pure
blood.
  The difficulty of digestion now reaches  the highest
pitch.   The patient, at last dreads taking  the least
nourishment, because it induces vomiting preceded by
dreadful  distress, anguish  even  unto  fainting, and
agonizing pains  in the stomach.  A constant distress
frequently deprives the patient of all rest.   Obstinate
constipation; appetite  feeble or quite extinct; great
thirst; scanty secretion of urine ; skin dry, like parch-
ment.—The patient  is reduced to  a mere  skeleton;
dropsical symptoms set in ;  an expression of pain is
visible in  the sunken, emaciated countenance ;  the
eyes  are dull  and sunken ; the formerly livid com-
plexion changes to a  dingy-yellow, yellow-green (car-
cinomatous  habit).   The changes  in  the vascular
system frequently are not perceived until shortly be-
fore death, the pulse becomes feeble, small  and irre-
gular.  The patient feels sad and desponding.
  These symptoms may vary  more  or  less, as in all
other diseases: the swelling,  for instance, is not per-
ceptible when the schirrous degeneration is  seated in
the cavity  of the stomach, or in the lesser curvature
of that organ.  The vomiting varies likewise in regard
to time, quality and quantity of the  substance which
is thrown up; the same remark  applies  to  the stool,
digestive derangement and the pain. (Canstatt.)
   § 218.  Cancer of  the  stomach generally  runs  a
course of several years, and terminates fatally, unless 
SC1RR11LS.
79
the disease should  have been  arrested in the per-
cursory stage.
  Etiology: The disease occurs most frequently be-
tween the ages of 60 and 70, and between 40 and 50 ;
it is met more frequently among  men  than women,
probably because, among the latter, the mammae and
uterus are  chiefly invaded by carcinoma.  An heredi-
tary disposition is  supposed to exist  by  some , it is
likewise occasioned by endemic  influences, by a parti-
cular mode of life ; the excessive use of green cider, for
instance, or of sour wine, cider, etc., is a great predis-
posing  cause  for cancer.  Inveterate drunkards are
subject to  cancer ;  the  excessive use of spirits before
breakfast,  accompanied with depressing  emotions,
grief, care, occasion the disease.  It may likewise be
occasioned by abuse of acids, heating drinks, coffee,
tea, emotions of various kinds, sedentary habits, long
fasting, misery,  bad food, abuse  of cathartics and
emetics, various poisons,  lead,  abuse of  salt, sup-
pression of fever  and  ague,  haemorrhage,  chronic
cutaneous  eruptions, etc.
   Prognosis: very unfavourable.
   § 219. If we should suspect the existence of cancer,
the patient must avoid all abuse of spirits, and must
not be allowed to indulge in tonics, etc., for which he
frequently manifests a  great desire and  which  ag-
gravate the disease  even in the first period; the pa-
tient  must likewise be kept in good spirits,  and must
have proper food and drink.  In regard to medicine, I
will  first mention Nux vom.  and Arsenic.   The parti-
cular indications for  Nux  have been furnished  in
§ 216,  and I  have  only to add, that it is a valuable
remedy in callositas ventriculi, provided the symptoms
correspond.
   The  burning, corrosive and gnawing pain in the pit
and region of the stomach, which is generally present
in  cancer  of  that organ, points to Arsenic.   This me-
dicine  is  indicated by the following symptoms: Op-
pressive anguish, tightness  and distention in the pit
of the  stomach  and under the left short  ribs, cutting 
80
SC1RRIR 3.
 and tearing pain alternating with the above-mention-
 ed burning and corrosive  pain,  aggravation of the
 pain after  a  meal and  after midnight attended with
 extreme  prostration,  vomiting of  food  and mucus,
 which  is  frequently  so distressing that  it  induces
 fainting.   Mezereum and Plumbum  are likewise indi-
 cated by this  group of symptoms.
   Mezereum  is indicated by a burning-corrosive pain
 in the stomach, and as if  the internal surface of the
 stomach were sore ; sensation as  if the food remained
 for a long time undigested  in the  stomach, and oc-
 casioned a pressure ; bloody vomiting frequently takes
 place, and the patient is very sad.   These symptoms
 may likewise characterize a chronic gastritis.
   Plumbum is  an admirable medicine for cancer of
 the stomach.   It has: vomiting  without  relief, obsti-
 nate constipation;  the  substance which is vomited  '
 up is like verdigris, blackish, bilious,  bitter,  and the
 paroxysms  of burning  constrictive  pains  in  the sto-
 mach are excessively violent, and attended with prae-
 cordial anguish, anxious and cold sweat.
   Latterly  Verat., Carb. anim.,  Con.,  and  Lycopod.
 have been employed for cancer of the stomach.  The
 last-named is particularly useful, especially in indura-
 tion of the stomach.   Carbo animalis is likewise use-
 ful in this disease, as  well as in very obstinate car-
 dialgia characterized by griping in the stomach, and
 flatulent distention of the abdomen.  Veratrum is in-
 dicated by occasional  turns of blackish  vomiting, as
 of black bile and blood.
  In two cases occasioned  by  a violent  kick on the
 region of the stomach,  I have seen good effects from
 Conium.
  Phosphorus, from 6 to  8 doses, cures a species of in-
 duration or constriction of the cardiac  orifice, with
 twisting,  constrictive  pains  in  the  region  of the sto-
 mach, and vomiting of a clear,  sourish fluid towards
 evening and sometimes at night, sour eructations with
regurgitation of the ingesta. 
SC1PRHUS.
81
  § 220.  Continuation of the  homoeopathic treatment
of cardialgia.
  Since the  discovery of the  antipsorics. we cure a
great many  cases of cardialgia  that  could not be
cured before.   Carbo  animalis and veget. frequently
complete a cure when Nux vom. had but a temporary
effect.  Carbo veg. is indicated  by a burning sensation
in the stomach, (hence it may be of use in the treat-
ment of the above-mentioned disorganizations of the
stomach), by a continuous,  painful  pressure in the
region of the stomach with  anxiety, aggravated by
contact; by a contractive, spasmodic sensation in the
stomach obliging the patient to bend double, arresting
the breathing, and worse when lying down, attended
with a kind of heartburn, nausea, loathing even when
merely thinking of food, constipation. Carbo animalis
is indicated  when the patient, after a slight meal,
complains  of fulness,  malaise, feeling  of coldness in
the stomach, the  latter  symptom being  relieved by
laying the hand on the stomach, after which the other
symptoms  get likewise  better.  I  have always em-
ployed Nitrum  with  success when the patient  com-
plained of a burning pain in the stomach with violent
stitches ; after the paroxysm was over,  the  patient
complained of a sensation as if ice were in the stomach,
the pit of the stomach being at the same  time sensi-
tive to the  touch.   Carbo anim.  cures  a  state  of
debility of the stomach where every thing the patient
eats, distresses him.
   Calcarea carbonica : Indicated by cutting, compres-
sive, or spasmodic, or pinching-choking pains, attended
with a sensation of anxiety.   It is likewise excellent
for weak digestion, together with Graphites.
   Graphites is  likewise  suitable for a wrenching and
griping in the stomach, disappearing  after a meal,
and generally attended  with nausea, and accumula-
tion of water in  the mouth.
  Nitric acid is  suitable  for cardialgia accompanied
with  diarrhoea, or when the patients had been syphi-
litic and had been treated with Mercury.  Principal 
S2
GASTROMALACI A
symptom: spasmodic wrenching in the stomach and
pit  of the stomach, which ascends into the chest and
oppresses the breathing.
  Castoreum: bitter-sour regurgitations with loathing,
after  a meal ;  sickness at the stomach, with ptyalism,
tightness and weight in the stomach, with contractive
pain under the sternum and  ulcerative pain in the pit
of the stomach,  flatulent distention of the abdomen,
urgings to stool  are  generally  present:   the stool is
hard.
  Baryta carb. suits  scrofulous subjects.   It is indi-
cated by the following symptoms: the patient  is easily
satiated, great fulness  after a  slight meal,  pressure
and weight in the stomach, with externally perceptible
hardness close under the stomach.   It may be used
for disorganizations of  that organ.
  Sepia suits delicate, nervous females with fine skin
and liable  to get angry, or who have deranged their
nervous  system by onanism.  Symptoms : oppression
and weight, with cramp in the stomach ;  sour eructa-
tions, indifference  to  life, frequent turns of nausea,
ineffectual urging to stool, or hard stool.
  Lobelia inflata  may be tried for a pressing constrict-
ive sensation  in  the stomach and pit of the  stomach
after  a meal,  particularly  after  supper, extending to
the back and inter-scapular region, and attended with
bilious vomiting,  oppression  and anguish in the chest
and pain in  the small of the back.
  Natrum carb. and muriatum.  The latter for  a con-
tractive  cramp  in the  stomach, commencing  after
dinner and  continuing until evening, attended with
feeling of coldness in the back and stomach.
  Alumina is  useful when the cardialgia is attended
with  constipation.

  §221. Gastromalacia ; malanis ventriculi, gastrobro-
sis (Alibert), perforatio  ventriculi spontanea (Gerard) ;
softening of the stomach.
  Though  no neuralgic disease, yet  I mention  this
disease here, in order not to separate it from the affec- 
GASTROMALACIA.
83
 tions  of the  stomach generally.  A greater or lesser
 softening  of the membranes of the stomach  always
 precedes the formation of ulcers and the suppurative
 process such as take place in the stomach in tuber-
 culous and  carcinomatous formations.   This is  an-
 other  reason why I should be excused for treating of
 this affection in this place.
   The disease is principally observed among children
 of from a  few weeks to two years old.  Omitting the
 anatomical characteristics, I at  once  proceed to de-
 scribe the
   Symptoms.   The  disease  scarcely ever  appears
 under  the  same form.  At times it is like cholera, at
 times  like a gastritis of full-grown  persons, at others
 again  like a hydrocephalatous fever,  or  like  a slow
 nervous typhus.   Sometimes  the disease breaks  out
 suddenly without  any precursory  symptoms, with
 violent fever, the children are restless, scream  a good
 deal, the pulse  is  quick and their thirst can scarcely
 be quenched; the abdomen is distended, the region ol
 the stomach is  hot  to the touch, painful to pressure
 which may be inferred from the fact that the children
 draw the  lower  limbs up to the abdomen; repeated
 and frequently continual vomiting of a greenish-slimy,
 sour-smelling fluid,  accompanied with frequent dis-
 charges of watery, green, acrid, sour-smelling stools ;
 breathing oppressed, dry cough ;  breath and skin are
 cool; extremely  rapid collapse of the features,  and
 emaciation; the  screams  gradually change to mere
 moaning;  stupor sets in, convulsions and death.—If
 the affection should be less acute, it has the following
 symptoms: The children lose their  appetite, they are
 peevish, low-spirited, suffer frequently with eructa-
 tions, aphthae, obstinate diarrhoea,  vomiting; their
 sleep is restless  and they look  pale  and suffering.
 When  the fever appears, the diarrhoea and fever be-
 come more obstinate and frequent, the  discharges
consisting  of a watery mucus, with  putrid odor, and
sometimes  mixed up with  gray-green  filaments and
flocks;  the abdomen becomes  distended, the head 
84
GASTROMALACIA.
and extremities become cold, whilst the remainder o
the body is hot, and the abdomen even burning-hot u.
the touch ; rapid  emaciation, particularly about  th«
neck.  The head-symptoms  are  very striking,  the
children are  in a constant sopor, half stupified,  but
can easily be roused (agrypnocoma).
   Etiology:  infantile  age,  dentition,  atmospheric
causes, late-summer and spring when gastric diseases
and intermittent fevers prevail, swallowing corrosive
saliva as is secreted instomacace, angina gangraenosa
or  aphthae.  According to Rokitansky, the disease is
frequently traceable to a  disease of the brain, par-
ticularly hypertrophy of the brain or hydrocephalus.
   Prognosis: More favourable than  would  at first
sight appear ;  only the physician must not be scared
by the idea of  gastromalacia, and boldly prescribe his
remedies in accordance with the symptoms.
   § 222.  Treatment.  Many  symptoms character-
izing the precursory stage of this disease, and being
very frequently underrated by physicians, are so much
like a gastric disease, that the remedies indicated for
 gastric  affections  may be used here (see vol. I.).  A
 few remedies which seem to have a more specific re-
 lation  to  the  disease, will, however,  be mentioned.
 If the disease  should  commence with a diarrhoea, as
 is  frequently the  case, and if this should threaten to
 become habitual, a few drops of Calc. acet. daily, will
 be found eminently useful, being at the same time an
excellent  remedy for  troublesome dentition and scro-
phulosis ;  Calc. carb.,does not seem to have the same
penetrating effect in this disease.  Acidum phosphori-
cum  is  preferable  to Calc. acet., when the diarrhoea
has become habitual  and the central  organ  of the
 abdominal system of nerves seems to be  more deeply
 invaded.
   If the first symptoms should point to a  febris hydro-
cephalica, the  ineffectual  exhibition  of  Belladonna,
Aeon., Bi yon.,  will soon reveal the mistake.
   If the disease should resemble cholera, suitable  re-
medies have to be administered. 
SPASMUS VES10.F..
4
   Tartarus emeticus  is an excellent  remedy  for this
disease, particularly when the above described agryp-
nocoma sets in.   It surpasses both Arsen. and Vera-
trum.  These  last  named  remedies may. however,
likewise be very  useful  in gastromalacia ;   perhaps
they  were  never  given  in adequate doses, an error
which is  committed by all  who believe that the  do-e
is the only saving  principle  in homoeopathy.
   According to Dr. Arnold,  Kreasotum is the principal
remedy for gastromalacia; he uses it  in the  first
tritur.; some use it in the sixth att.  He says  that the
symptoms soon  abate and  finally  disappear,  except
the emaciation, which requires a longer time.

   § 223.  Spasmus vesicae,  cystodynia, cystalgia, cys-
tospasmus, spasm of the bladder.
   Spasm of the  bladder is very frequently a symptom
belonging to some more general affection;  but it like-
wise  occurs as  a primary  functional  derangement.
It is  with the latter that we  shall occupy ourselves
here.
   Symptoms of a  spasm of the bladder are :  Violent
constrictive  pain commencing at the neck of the blad-
der, extending along the dorsum of the penis towards
the forepart, with more  or less perfect painful erec-
tion, sometimes  radiating to the groins, testicles and
thighs,  and even  along  the  perinaeum towards  the
anus, attended with a pain  like tenesmus.  This  pain
generally lasts  a  few minutes, at most a quarter of
an hour, or  half an hour, after which it subsides en-
tirely.  It is accompanied with a  painful, ineffectual
urging to  urinate.  If the spasm invades the  neck of
the bladder, it, is attended with spastic ischuria;  if it
should become  seated in the  detrusor urinae  muscle,
the urine is  sometimes expelled with force, or it flows
out in drops ; in the latter case enuresis spastica takes
place.  When the spasm subsides, a full stream is
sometimes emitted, the urine  being clear, and even
paler than  usual.   In feeble  nervous  individuals a
violent  spasm is attended with anguish, restlessness, 
sf»
.-TASMl'S NF.slC.fi.
trembling, nervous paroxysms, cold sweat, small, con-
tracted pulse, vomiting.
  Etiology.   The disease may attack  either sex, and
every age ;  it is most  frequent among middle-aged
persons.  Nervous,  hypochondriac, hysteric individu-
als  are subject to  the disease.   Exciting  causes:
emotions, anger, chagrin, mental  efforts, irritation of
the  uropoetic or genital system by cantharides, diure-
tics, new wine, beer, excessive embraces, sitting on a
damp, cold floor, etc.
  § 224.  Treatment.  If possible, the exciting cause
should be removed  or counteracted.  If the spasm be
caused by cantharides or by the linseed-emulsions which
are so frequently used in gonorrhoea, Camphor is the
proper remedy.  I always use  this medicine when the
pain is so great that the patient is  unable  to  explain
himself.
  Cantharides may  be  given  when the spasm is at-
tended with enuresis spastica.   Of course, the disease
must  not  have  been caused by that agent.  The pa-
tient wanders from one place to another, complaining
of cutting, and a contractive pressing  pain along the
ureters  toward  the lower part of the bladder; some-
times there is a fleeting-tearing pain in the neck of
the  bladder, all of which painful sensations the patient
endeavours  to moderate by compressing the glans;
sometimes, after the urine  ceases to be discharged in
drops, a full stream of  urine flows out with relief or
even  an entire  abatement  of the  spasm; the urine
was,  in such cases, scarcely  ever found by me of a
purely spastic  nature ; generally turbid,  or with a
white-slimy sediment, particularly at night.
  Sassaparilla is, according to my experience, useful
only when  the  spasm  depends upon  the presence of
urinary calculi; the patient complains of a painful
pressing burning, and a quantity of pale urine is dis-
charged.
  Pulsatilla suits females  rather than men : the dis-
ease occurs  after the use  of  sulphur-water, or from 
NEUROSES.
S7
taking cold by exposing the  feet: the pain is intense,
continuous, the urine is discharged in drops.
  Colchicum and Dulcamara  are likewise useful when
the spasm is caused by a cold.   1 am unable to indi-
cate the particular symptoms.
  I will also mention Lycopod.,  Acid, phosphor., Sepia
and  Terebinthina.*
                NINETEENTH CLASS.

   §  225.   Neuroses.
   Their physiological character according to Schoen-
lein : 1. The morbid process always takes place in the
peripheral  nerves.  2. Every neurosis consists of a
series of irregular paroxysms, without  regular inter-
missions ;  the moon has a  great  influence on these
affections, the paroxysms of many forms  of  neurosis
are  more violent at certain quarters of  the moon.   3.
The  irritation in the  peripheral system of nerves  is
continued, during the paroxysms, to the central  organ,
particularly the spinal marrow and brain, though the
continuation is sometimes perceived only at the ex-
tremities  of the  affected nerve ; it is distinctly per-
ceptible in an  attack of peripheral epilepsy, at first
slight spasms,  afterwards convulsions, finally  the
brain is affected and loss of conciousness takes  place.
The sensation indicating the continuation, varies ; for
instance, sensation of a passing wind, of formication, of
an electric stroke, of a flame, etc.; in an hysteric attack,
the  patient  feels as  though a ball were  rolling up
from the  uterus with  a  constrictive  sensation; in
other cases the distress is  felt only at the commence-
ment and end  of the  time, in  the uterus and  in the
head (clavus hystericus).   The central portions  of the

 * And Aconite, the grand antispasmodic of homoeopathy ? Why
omit Aconite /—Hempel. 
.SS
NEUROSE*
nervous svstem  being not always invaded, this lead*
to a classification  of neurosis  in higher and  lower
forms ; to the former belongs  epilepsy, to the  latter
tussis convulsiva.  4. The single paroxysms arc char-
acterized by spasms and  convulsions.  5. During the
attack the'normal  function  of the irritated nerve  is
either  altered or suppressed, in hysteria  for instance,
where the smell of burnt feathers, of Assa foetida, etc.
appears agreeable, that of a rose,  on  the  contrary,
disagreeable.
  No decisive  anatomical change is observed  either
in the peripheral or central  portions of the nervous
system ; I therefore omit making  any particular men-
tion of those changes.
  Etiology: Age; abdominal epilepsy, for inslance,
attacks youth, and is not observed among old people :
asthma affects  generally people of a certain  age,
hysteria takes place at, the age of pubescence, etc.—
Sex.—External causes : Emotions, gout, irritants such
as splinters, contusions, sore fingers, worms.  Nervous
diseases  may likewise  be transmitted by the eye or
ear ;  epilepsy, for  instance, is frequently communi-
cated by  seeing an  epileptic  attack, or by hearing
epilepsy  or mania  spoken of with warmth.  A  ma-
terial  contagium exists only in  whooping-cough, if
anywhere.
  Prognosis: Some forms of neurosis, such as hysteria,
are not dangerous ;  eclampsia  is very dangerous.  If
the attack depend upon a material cause which can be
removed, the prognosis is more favourable ; or if the
attack should  have  been caused by  a momentary
noxious influence,  the  prognosis is likewise  more
favourable ; the prognosis depends likewise upon the
manner in which the disease  develops itself, and upon
the importance of the irritated portion of the nervous
system, upon the  frequency  and  violence  of the
paroxysms, upon the supervention of other dangerous
symptoms and the termination  in some other disease.
   Treatment:  We will speak of the treatment of each
species of neurosis in particular. 
NEUROSES OF THE NERVES.
89
   §. 226.  Neuroses of the nerves  of the thorax.

    TUSSIS CONVULSIVA, PERTUSSIS, WHOOPING-COUGH.

   Every epidemic disease is, properly speaking, acute;
 we call it chronic when it divests itself of the febrile
 symptoms, runs a long course, calls up ailments which
 had so far remained latent in the organism and unites
 itself  with them; whooping-cough  belongs  to  this
 class of diseases.
   In  whooping-cough  we distinguish  three  stages:
 the precursory or catarrhal stage, the convulsive or
 nervous, and  the critical or secretive stage.
   First stage.  It commences with catarrhal symptoms.
 sometimes catarrhal-gastric; these symptoms frequently
 resemble the precursory symptoms of an exanthematic
 fever.  The patients complain of tickling in the trachea,
 particularly under the sternum, occasioning a dry, pe-
 culiarly hollow cough with a metallic sound, charac-
 terized even  at this stage by  more or  less periodical
 paroxysms. It is frequently accompanied with angina,
 slight inflammation of the organs of deglutition, hoarse-
 ness,   sneezing,  lachrymation, sensitiveness  of  the
 eyes to light, chilliness, languor ; the child is peevish,
 restless, feverish ; the, fever is erethic, comes on towards
 evening, with coated tongue,  hurried pulse, hot and
 dry skin ; towards morning  the patient perspires,  the
 urine exhibits a sediment,  and the symptoms intermit,
 sometimes completely.   If the fever  should increase
 to a  synocha,  the  chest frequently exhibits inflamma-
 tory symptoms to be diagnosed by percussion and
 auscultation and by the blood-streaked expectoration.
 This stage having lasted from 3 to 21 days, it gradually
 passes over into the
  Second stage.   This  stage is  characterized  by  the
 paroxysmal cough, which one need but hear once to
 recognise  it  again immediately.  Previous  to  a  pa-
 roxysm the patient generally becomes restless, and en-
deavours to support himself by holding on  to  some-
thing,  impelled by anguish, dull pain,  pressure under 
90
NEUROSBS OF THE NERVES.
the sternum in the region where the diaphragm is in-
serted, in the pit of the stomach ; children breathe
more rapidly, anxiously, irregularly, weep, or start up
from sleep, seat themselves suddenly in an erect  pos-
ture,  stooping forward.  The cough consists of short,
irregular, violent expirations in rapid succession, inter
rupted by short or long,  imperfect attempts at inspi-
ration, accompanied with  a  peculiar whizzing sound
resembling the bray of an  ass; during this time the
glottis is spasmodically closed, which may be easily
inferred from the fact that, on applying the ear to the
chest, no respiratory murmur is heard, but a sonorous
whizzing which is formed in  the half-closed glottis
and extends down to the bifurcation of the trachea ;
shortly before and after the paroxysm the respiration
is frequently puerile.   During these  phenomena all
the muscles of the respiratory organs are spasmodi-
cally convulsed, the face becomes purple-red or  blue,
swollen, the eyes become red and seem to start  from
their sockets, the veins of the neck swell up ; blood is
frequently discharged from the nose, mouth, ears and
bronchi, and ecchymosed  blood  is seen in the  con-
junctiva ; face and neck are covered with a cold sweat.
the pulse is suppressed.  In from three to ten minutes
the paroxysm generally terminates with  vomiting  a
quantity of colourless, viscid mucus being discharged
together with the contents of the  stomach.  After a
violent paroxysm, the patient sometimes falls asleep
from  exhaustion.   Generally, however, he feels  well
again immediately after the cessation of the paroxysm,
wants to eat, or returns to his play ; physical changes
in  the respiratory  organs are seldom  seen, except
sometimes a puerile respiration with  rhonchus.   The
paroxysms are not regular ; they amount from 3  or 4
to 40 or  50  within the 24 hours.  They gradually de-
crease in number and  intensity.  This second stage
lasts from 4 to 8 weeks.
   In the third stage the paroxysms decrease more and
more, the convulsive phenomena disappear, the respi-
ration ceases to be whizzing, the  cough  becomes 
NEUROSES OF THE NERVES.
91
moist, and the patients, at the termination of the short
paroxysms, discharge a viscid,  thick, greenish sputa.
with noise in the bronchi, and affording great relief.—
Relapses may occur in this stage, which scarcely ever
lasts more than  from 3 to 4 weeks.
  Whooping-cough is liable to complications with
other diseases, particularly with bronchitis and pneu-
monia, also with congestion of the  brain and cerebral
membranes,  gastric and   intestinal  irritations with
remittent fever,  pleuritis, pericarditis, croup, angina.
  Etiology : Whooping-cough occurs most frequently
before  the seventh year, less frequently between the
7th and 14th, and least frequently among adults; it is
sometimes epidemic, but may occur in every season ;
it  is rather  contagious than miasmatic ; it likewise
occurs sporadically.
  Prognosis:  Not unfavourable ; whooping-cough is
a slow and distressing, but not  dangerous complaint.
The prognosis depends upon age, constitution, com-
plications, duration of the convulsive stage, etc.
   § 227.   Treatment:  It is quite  easy  when the
patients are perfectly free  from all  scrofulous taint.
Scrofulous children require  to be treated  with the
antipsorics.  Drosera is ineffectual in the case of scro-
fulous  patients.  In epidemic whooping-cough  I have
found Drosera sufficient in most cases.  Different  re-
medies, however, may be required by different forms
of whooping-cough.  The great point is  to notice the
characteristic symptoms of  the cough  and to pre-
scribe  a remedy in accordance with the symptoms.
This accounts for  the fact that epidemic whooping-
cough  has  been successfully  treated with different
remedies by  different  practitioners.
  The  catarrhal stage may require one of the  re-
medies mentioned vol. i. §§29, etc.  and §§ 194, etc.
The patient should be kept in the room, in the same
temperature ;  he should be protected  from changes of
weather, cold,  etc.,  and  should  use  slimy drinks,
gruel, slippery elm, etc.  If the  catarrhal stage  should
have been  induced by a  cold, and the cough  should 
92            NEUROSES OF THE NERVES.

be moist and loose, with slight hoarseness,  Dulca-
mara will be found useful.  Pulsatilla  likewise  cor-
responds to these  symptoms, particularly when vo-
miting is apt to set in,  in which  case  Ipecacuanha
should not be left  out of consideration.
  Aconite should be given when febrile motions are
present and  the dry cough is excited by a burning-
stinging pain in the larynx increased by coughing
(the  child grasps at that spot with the hand).   The
remaining  cough  may then be treated  with alter-
nate  doses  of China and Belladonna,  which  may
even  be followed by Ledum.  By this treatment the
cough is not always stopped, but rendered loose and
mild.
  In  many cases the catarrhal  stage is removed by
Chamomilla,  particularly when  the  constant irrita-
tion  in the  region  of the  larynx,  inducing a  dry
cough,  is accompanied  by  a  crampy sensation, or
when  the cough is excited by a titillation under the
sternum in the upper part of the chest; Chamomilla
is  not counter-indicated  by a  burning  sensation in
the larynx and a  painful soreness at the spot where
a little phlegm is detached after a long paroxysm
of distressing cough.  The dry,  spasmodic cough is
sometimes  accompanied  with retching and vomiting
impeding  the breathing;  the  patient's  face turns
blue,  and he  is tortured with  anguish;  Nux  vom.
relieves the  vomiting, and generally requires Pulsa-
tilla  after it.  If the cough should remain dry  and
spasmodic, without the wheezing,  Ignat.,  Ipec,  Hy-
osciam., Bellad.,  Conium,  are excellent remedies.
  In the second stage, Drosera  is a specific remedy,
particularly in epidemic whooping-cough.  Symptoms-
Rapid succession of single  turns of cough during  a
paroxysm, causing  danger of suffocation ; titillation
in  the larynx which rouses the  child from sleep  par-
ticularly after midnight, and causes  a  rapid  succes-
sion  of paroxysms ;  discharge  of blood  from mouth
and nose ;  the cough is  easily excited  by laughing,
singing, weeping, and emotions. 
              NEUROSES OF THE NERVES.            93

   Cina is  likewise  an excellent remedy  in the se-
cond  stage, particularly  when  the cough is  compli-
cated  with gastric symptoms and the child had been
troubled with phlegm in  the stomach and intestinal
canal, weak digestion, anorexia,  worms,  etc.  some
time  before the outbreak of the disease ;  it is like-
wise  suitable to scrofulous  children, or  when the
paroxysm  is caused by  a  sudden  spasmodic  con-
traction  of the larynx, accompanied with  a  general
rigidity of  the whole body, loss of consciousness and
staring look.
   Belladonna will seldom be found useful  in the con-
vulsive stage,  when the  periodical intermissions of
the inspirations during the  paroxysms  are present.
Belladonna is counter-indicated  by the phenomena
characterizing the  second stage;  it is otherwise in-
dicated  by a dry cough   accompanied with  a spas-
modic contraction  of the larynx,  and preceded by
weeping and a disagreable  sensation in  the  region
of the stomach.  Belladonna and Cina,  in alternate
doses, are  said to be  very useful in this cough.
   Cuprum  acet. is eminently useful when the  patient
is suffocated during the paroxysm,  and when he vo-
mits and is slowly restored to vitality after  the cessa-
tion of the  paroxysm ; even between the  paroxysms
the respiration  is accompanied with a rattling noise
in the bronchi,  as  if  they were filled with  mucus.
I have since used this remedy even in the commence-
ment  of the disease, and have found it more useful
than  Drosera, the wheezing  and whooping being re-
moved  in  a few days.    The remaining  catarrhal
cough yields to repeated  doses of Ipecacuanha.  This
agent  is frequently sufficient to remove  whooping-
cough, provided it  is repeated every 2 or 3 hours; it
is indicated when  the turns  of cough succeed each
other  so rapidly that the   respiration is  cut off and
every inspiration seems to excite a new paroxysm  ;
retching  is  generally present.
  Cortex ulmi is said to be a  very useful remedy.
  Conium suits nightly attacks of whooping-cough  ; 
i)4       ASTHMA, MALI M CADLC1M PULMoNUM

the patients have  a scrofulous  and chlorotic consti-
tution, the cough is exceedingly violent,  suffocative,
attended with flushes of redness in the face and bloody
expectoration.
  Lactuca virosa is said to remove  the anguish with
which many children are  troubled previous to an  at-
tack,  and to be  useful for violent paroxysms of dry,
spasmodic cough.
  Ambra has been  found  useful when the cough  is
accompanied with eructations and  hoarseness.  Also
Hyoscyam., Arsen., and Laurocer.   Arnica is suitable
when the paroxysms set in with weeping.
  It has been proposed to give a dose of Aconite every
day.  This  proceeding  is  well worthy  of  a careful
trial.
  If chronic ailments should have been roused by the
whooping-cough, the antipsorics are  then indispen-
sable, particularly  Tinct. sulph. and Sepia.  I  have
frequently given Sepia at  once, at the commencement
of the second  stage,  when the  spasmodic cough  set
in at  night,  so suddenly that the patients came  near
being suffocated and  the  chest  was constricted,  with
shrieks and retching.
  Whooping-cough  is sometimes  complicated  with
dentition and worm-fever ; I have even seen a compli-
cation of whooping-cough and intermittent fever,  for
which I  gave Silicea, this being the specific  for the
then  prevailing  fever.  The  whooping-cough disap-
peared with the  fever. I tried afterwards to prescribe
Silicea for  whooping-cough  without  the fever, but
found myself obliged to recur to the usual remedies.

  § 228.  Asthma,  malum caducum pulmonum, dys-
pnoea, orthopnaea.
  The general  character  of  asthma  is:  Periodical
spasm of the respiratory organ,  paroxysmal difficulty
of breathing, accompanied with a  sensation  of con-
striction of the chest  and violent exertions of all  the
auxiliary organs of respiration.
  The paroxysms generally take place in the evening, 
         ASTHMA, MALUM CADUCUM PULMoNUM.       i)!/

or between sunset until 2 o'clock at night.  Generally
the patients start from sleep with a sudden feeling of
suffocation; a feeling of stricture across the chest, or
as of a tight  belt or  a heavy  weight on the chest,
stops their breath and obliges them to raise themselves
suddenly in order not to suffocate ; the patients have
not air enough in the closed room, and the  windows
have to be opened.  The breathing, particularly the
inspirations, is carried  on  with great difficulty,  and
the wheezing, metallic-sounding, rough, rattling inspi-
rations are even heard at a distance.  The  thorax  is
not raised as  in its natural condition; it  heaves up-
wards and downwards, or  is  even quite immovable,
whilst the cervical,  intercostal, dorsal and abdominal
muscles, and the diaphragm, work violently, and the
patient, in his anxiety, is  endeavouring to  support
himself in any way he can  by holding on to any thing
in his neighbourhood ; the shoulders are raised like a
pair of wings, and the praecordial region is drawn in-
wards along the  region where the diaphragm is in-
serted.  The patients are unable  to speak, swallow,
cough; all these movements increase the spasm.
   The  features express anguish, fear, fright;  the
wings of the nose  are  widely distended, the face  is
blue-red,  the  eyes  protruded  from their sockets, the
vessels of the conjunctiva  are very  much  congested,
the jugular  veins  are  swollen.  The extremities are
cold, forehead and neck are covered  with  sweat as
from anxiety.  The beats of the heart and the pulse fre-
quently remain natural ; frequently however, particu-
larly when the heart is organically diseased, its beats
intermit, the pulse becomes small; irregular, violent
paroxysms may  cause  vomiting, convulsive  move-
ments of various parts of the body, even epilepsy.
During the paroxysm  we hear in various parts of the
chest,  by means  of  the  stethoscope,  a wheezing,
rattling, rumbling, and generally a very feeble and
sometimes even a  puerile  respiratory murmur; the
percussion sound is rarely altered.  Relief commences
when the patient begins to cough  up with ease  a 
96       ASTHMA. MAL1M CADUdM  TULMONIM.
tenacious mucus ; the breathing  becomes  freer,  and
the anxiety disappears;  sometimes sweat  breaks out
and the bowels are moved, or the patient is refreshed
bv a sound sleep.                   .               ,
 'The paroxysms last from a few minutes to several
days,  with remissions in the day-time and  exacer-
bations in the evening.  During the  remissions the
breathing is oppressed,  but  the anxiety is  less.   1 he
paroxysms occur very  irregularly,  sometimes every
week, month, in the fall or  spring, and at other times
they intermit several years.
   §229. Anatomical changes: We know of no organic
alteration of the thoracic organs, heart, large vessels,
pleura, lungs, mediastinum, that has not been met  in
The bodies of asthmatic  subjects ; disorganizations  in
the brain, spinal marrow, pneumogastnc  and phrenic
nerves, larynx and  abdominal organs.  On the other
hand, there are many subjects in whom no anatomical
alteration whatsoever  has  been  discovered.   lhis
shows that  those alterations are not necessarily the
cause  of the  asthma,  inasmuch as  they frequently
 exist without asthma, and  asthma  frequently occurs
 without them.  Various anatomical alterations,  such
 as • hyperaemia of  the bronchial mucous membrane,
 emphysema  of the lungs, dilatation and hypertrophy
 of the heart,  dropsy of the chest,  etc. are very  often
 products of the frequently  repeated asthmatic parox-
 ysms.  (Canstatt).
   Diagnosis and etiology:   The disease can be con-
 founded with angina pectoris, with asthma induced
 by affections of the larynx, or  with night-mare.   In
 angina pectoris the patient experiences a  piercing,
 crushing pain in the region of the heart, under the
 sternum, extending to the left arm  and shoulder ; the
 pain obliges the patient to stand still, but the breath-
 ing  remains tolerably  free; the patient's  anxiety is
 not caused  by want of air, but by  an indescribable
 agony as of death ; the paroxysms frequently  occur
 in the day-time and during motion ; the expectoration
 which affords relief in asthma, is likewise wanting.— 
AOTHMA, MALUM CADUCUM FULMONTTM.       &7
In asthma caused  by an affection  of the larynx, this
local  disease is easily recognised between the parox-
ysms ; the spasm, by the pa :e it's  own statement,
commences at the larynx, the patients look as if stran-
gulated, they are unable to speak a word, and they
press  the  air with a strong wheezing croupy  sound
through  the half-closed rima  glottidis.—Asthma is
easily distinguished from nightmare : for, although it
occurs likewise at night only, yet it is a state of half-
waking, during which the patient remains in a recum-
bent posture, all unpleasant  sensations disappearing
as soon as the patient wakes; during the attack the
patient feels as if his chest were oppressed by a load;
but this does not prevent a paroxysm of real asthma.
  Asthma is  sometimes hereditary; men are more
liable to  the disease than women ; asthma generally
affects persons  somewhat  advanced in  age ; among
young people  we  meet the asthma Millari,  and the
asthma thymicum of Kopp.  We distinguish asthma
plethoricum, organicum, cardiacum,  metastaticum,
arthriticum,  podagricum,  impetiginosum,  urinosum
(from anuria  of old people), humidum, etc.   These
names are of use only in so far as they point to the more
or less specific medicine  in every case.
  Prognosis:  It is favourable for a single paroxysm,
but unfavourable for the disease itself,  since it gene-
rally  lasts during the patient's life-time.  It is general-
ly favourable when the exciting cause can be  re-
moved ; it is unfavourable when an organic disease is
the cause of the paroxysms. In old people the prognosis
is much  less favourable  than in young subjects, inas-
much as the former  generally labour under some  or-
ganic disease.  Hereditary asthma is generally incu-
rable.  Death is imminent when the patient  becomes
weaker  and weaker, when hydrothorax, paralysis of
the upper extremities, hectic fever with irregular,  in-
termitting pulse, swelling of the extremities, continual
palpitation of the heart,  set in.
   § 230.  Treatment: This is facilitated a good deal
by a  knowledge of the cause of the disease.  The re-
       vol. iv.—a 
•  98       ASTHMA, MALUM CADUCI VI Fl'LMU.N L »l ■

  medies which we  employ must  not only  be direcied!
  against the actual paroxysm, but likewise  against the
  disease itself.  If we do not know of such a remedy,
  then it is our duty first to relieve  the paroxysm, and
  then to act  against the disease.
    I have frequently stopped, or at least relieved, a
  paroxysm of asthma which had been caused by sudden
  chagrin, by means of  a few doses of Chamomilla.   It
  is of great use when the constrictive oppression across
  the chest  sets in in the evening,  and had got worse
  until that time from the moment it had been  excited
  in the  day-time  by a fit of chagrin.  It is likewise
  useful when the asthma  had been caused by a fre-
  quent incarceration of flatulence; we see this incar-
  ceration very frequently  take  place in  children, in
  whom it causes asthma, and suffocative fits.  This in-
  carceration frequently takes  place in the praecordial
  and subcostal regions,  even in perfectly healthy  chil-
  dren (livergrown) ; these regions are swollen so that it
  is impossible to make  an impression in these  parts;
  the children are restless, toss  about,  cry, draw up
  their  legs,  are anxious and short-breathed, and  fre-
  quently the breathing  intermits entirely.
    If the paroxysm  depends upon congestions  of the
  chest,  as are frequently observed  in plethoric  young
  subjects in  consequence of menstrual, lochial and hae-
  morrhoidal  congestions  caused  by a sedentary life
  and constant thinking,  spirituous and heating drinks,
  and giving  rise to habitual spasms  of the chest  cha-
  racterized by palpitation  of the heart, short, panting
  breathing, oppressions, anxiety, sensation  of pressure,
  fulness, tightness,  constriction of the chest:  Nux V.
  will be found  the best remedy not only for  the pa-
  roxysm, but for the whole disease.   It is particularly
  indicated when the paroxysm is characterized by the
  following phenomena:  the  paroxysm is diminished
  by turning the body to the opposite side or to the back,
  or by sitting up in bed, or by rising or lying down.
  Nux is likewise suitable to persons  in whom  the pa-
  roxysm  is  excited by  heavy,  anxious, distressing 
         ASTHMA, MALUM CADUCUM  PULMONUM.       99

dreams,  such as attack persons who suffer with irre-
gular  beating of the heart,  abdominal  pulsations,
hypertrophy  of the  liver and spleen.  It suits melan-
choly  and hypochondriac subjects with  atrabilious
temperament; it is  likewise adapted to those kinds of
asthma where the patients  complain of the clothes
being  too  tight, and chest  and abdomen being  op-
pressed by them; nevertheless, putting off one's clothes
makes the asthma worse  instead of better.  Asthma,
when depending upon cardialgia, is so frequently  re-
lieved by Nux for this  reason,  that Nux removes so
many kinds of cardialgia.
  Arsenicum is a specific for  asthma when it depends
upon a dilatation  of the heart, hypertrophy, emphy-
sema or oedema of the  lungs,  hydrothorax, chronic
bronchitis, hyperaemia of the bronchial mucous mem-
brane, tuberculosis  (scrophulosis),  abuse of China or
Iodium.  Ars. is more particularly indicated by the
following symptoms: frequent  cough  during motion
as if caused by the  vapour of Sulphur, particularly at
night, attended with constriction in the trachea and
suffocative fits ;  or  even  without  cough this suffoca-
tive oppression of the chest and arrest of breathing
set  in in full-grown persons, a real spasmodic asthma,
accompanied with anguish and restlessness, as if the
whole chest would be constricted ; the patient cannot
speak  a word without  making the asthma worse,
which sets in particularly in  the evening.
  The asthma caused by copper  and arenious  va-
pours, is relieved by several  remedies, the paroxysm
itself  by Ipecac,  then Nux vom.,  Hep.  sulph. and
sometimes Merc. sol.  The proper antidotes should
be administered between the paroxysms, to eradicate
the constitutional ailments which  had been occasion-
ed by those poisons.
  If an asthmatic spasm  be caused by  the vapour of
Sulphur, Pulsatilla  is the best remedy to stop it; it is
likewise,  the best  remedy for  asthma caused by the
abuse of sulphur-water.  I have frequently been led
to give Pulsatilla by the  good-natured, mild counte- 
 100       APTHMA, MALUM CADUCUM  PULMONUM.

 nance of the patient, thnt ser-med to invite  pity, a
 reflex  of the  patient's character in his healthy days ;
 it  is likewise useful  when the asthma depends upon
 hypertrophy of the  pulmonary mucous  membranes;
 this  condition is recognised by the fact, that after the
 aba'ement  of the paroxysm, the patient is  relieved
 b\   raising  large  quantities  of  disorganized  mu-
 cus, after the discharge of which a physical examina-
 tion reveals in many places the bronchial respiration,
 as in  partial  emphysema  of the  lungs ;  this  kind of
 asthma might be termed asthma humidum.   Pulsat.
 is  likewise useful in the asthma senile and urinosum
 of old  people, where the audible vesicular breathing
 points distinctly to oedema of the lungs and scattered
 interstitial tubercles.  It is  highly recommended in
 the  asthma  menstruale and cardiacum  of chlorotic
 and  hysteric subjects.
  In the above-mentioned varieties of asthma, Stannum
 ranks  with Pulsatilla when the  constrictive  oppres-
 sion of the chest sets in  in ihe evening, causes an ex-
 treme  anguish,  and  obliges the patient  to loosen his
 clothes;  recovery does not always take place by rais-
 ing large quantities  of mucus at once, but by mucus
 being coughed up gradually.
   Colchicum may be tried  in asthma cardiacum with
 dilatation of  the heart  occasioned by acute rheuma-
 tism ;  also  when the heart is hypertrophied and the
 paroxysm is raised  to the highest pitch  by the least
 change in the weather, with icy-cold  extremities, ex-
 cessive restlessness,  anguish, and sudden prostration
 of strength.   Colchic is likewise useful in asthma at-
 tended  with  oedema of the lower extremities (this
 being  a  characteristic  symptom  of affection of  the
 heart, according to Kreyssig), or with constant urging
 on the bladder, like spasm  of the bladder, and  painful
discharge of a small quantity of urine.
  I  have used  Amman, carbon,  in a few  cases of
asthma, with repeated palpitation of the heart, con-
siderable  oedema of the feet, and an  asthmatic state
every evening  which continued  until  midnight  and 
          ASTHMA, MALUM CADUCUM  PULMONUM.      101

was  relieved by the  admission  of open  air.  The
symptoms were relieved,  except the  palpitation.—
Ammon. carb. is known as  an excellent remedy in
hydrothorax.
   Belladonna is excellent in asthma plethoricum, car-
diacum,  metastaticum,  haemorrhoidale, laryngeum,
not only for the paroxysm,  but for  the  disease itself.
I  do  not consider  it necessary to describe the symp-
toms more particularly.
   I have found Ambra,  second or  third trit., an useful
remedy  in  asthma siccum  and  senile,  particularly
when the oppression was  principally  felt in  the left
chest, extending from  the  heart  to the back and be-
tween the shoulders, attended with palpitation, an-
guish, arrest of breathing ;  it likewise  proved useful
in asthmatic ailments  of scrofulous subjects.
   Cannabis is suitable when the  patient can only
breathe  in  a sitting posture with the neck stretched
forward, attended with wheezing  in the trachea; the
abdominal muscles have to  be  put violently on the
stretch during every inspiration ; the  patient is ex-
ceedingly restless  and  tortured  by anguish.   These
symptoms always  occurred before  midnight,  in bed.
The patient was suffering with organic disease of the
heart (hypertrophy) and hydrothorax thence arising.
The effect of Cannabis  was  very striking.
   Tartarus emeticus: The suffocative distress depends
upon constriction of the air-passages;  it,  increases
gradually  from  evening till morning,  and then de-
creases again as gradually ; during the paroxysm the
anguish is sometimes increased by  sudden violent beats
of the heart as if the heart would start out of its place.
In the present case, though there  was occasional pal-
pitation between the paroxysms, yet no organic  disease
could be discovered, showing that Tart. emet. suits
asthma with or without organic affections of the heart.
Plethoric asthma  is perhaps the  more immediate
sphere of action for that agent.
  Moschus is  suitable  to hysteric or  hypochondriac
subjects,  when the  attack was developed by the body 
102      APTHMA, MALUM CADUCUM  IU LMONUM.

getting cold.   The  paroxysm  commences  with diffi-
culty  of breathing, increases  to  constriction  of  the
chest, and finally becomes a suffocative spasm of  the
lungs which  drives the  patient  to  despair : there is
no cough, perhaps a slight irritation at the commence-
ment.
  Oleum animate.  The asthma is occasioned  periodi-
cally by  a  flatulent distention of the whole abdomen.
particularly of the subcostal regions, or it is caused by
a spasmodic  contraction of the  larynx.  Kali carb.
may be tried under similar circumstances, and parti-
cularly in the dynamic asthma, or when the lungs are
partially destroyed.
  Nitri acidum  is an  excellent remedy to eradicate
the asthmatic disposition.  It is particularly  useful
to delicate constitutions, persons with sensitive nerves
and irritable temperaments, particularly when the or-
ganism had been weakened by mercurial treatment,
or by syphilitic,  scrofulous or  herpetic diseases.  The
patient  complains of fluent coryza, roughness of the
throat,  husky voice ;  as the  coryza diminishes, the
chest feels oppressed ;  if the coryza disappear entirely,
the oppression increases  to  complete loss of  breath,
attended with palpitation of the heart and anxiety on
ascending  an eminence ; or the  patient complains of
constant dyspnoea, he is scarcely able to breathe,
worse on leaning backward ;  sometimes the dyspnoea
is attended with anxiety, particularly when walking
fast;  when reaching the most violent degree,  the dis-
ease increases to a spasmodic oppression of the chest,
with  rush  of blood to  the heart, languor,  anguish,
which is excited by the least emotion.
  Lobelia inflata.  This remedy seems to be  princi-
pally adapted to asthma depending upon degeneration
of the  bronchial  mucous membrane occasioned by
chronic inflammation of the air-passages.   The cha-
racteristic  symptoms for Lobelia  are : Dyspnoea,  also
with oppressed, hurried respiration,  frequent desire to
take  a  deep  breath,  oppressive asthma, sometimes
after the least exertion and after exposure to the least 
         ASTHMA, MALUM CADUCUM PULM0NUM.      103

draught of air, and after eating heavy food ; periodical
spasmodic asthma of full-grown persons.
  Lactuca virosa  relieves spasmodic asthma occasion-
ed by  organic  diseases  of  the  heart, hydrothorax:
great tightness of the chest, which  rouses one  from
sleep at night and obliges one to sit up suddenly as if
in anguish, with heaviness on the chest which increases
to stricture.
  . Digitalis.  This medicine  is useful in asthma  com-
plicated with thoracic disorganizations. It is supposed
that Digitalis is indicated by a disturbed  action of the
heart and slow pulse ;  but I have always employed it
with success when  the disturbed action  of the heart
manifested itself equally in the pulse.  The increased
action  of  the heart depended upon incipient disor-
ganization of that  organ  and its  vessels, and the
asthma caused by that disorganization was  charac-
terized by the following symptoms : Roughness in the
trachea which had existed for some time previous, ac-
companied with a short, hacking cough, and gradual-
ly leading to laboured breathing which increases to a
spasmodic constriction of the larynx and chest, with
suffocative anguish which is particularly troublesome
early in the morning, on waking, and obliges one to
sit up.  Digitalis  is therefore an excellent remedy for
asthma cardiacum, organicum, metastaticum, hydro-
thoracicum.
  Sulphur is a most  universal  remedy for  asthma.
There  is scarcely a case  of asthma where Sulphur is
not used.   It suits almost every constitution and tem-
perament, and antidotes the bad effects of a  number
of  metallic poisons.   Sulphur is particularly useful
for the following conditions : Rough and deep  voice
when the weather  is cold and damp; accumulation
of mucus in the throat and chest,  exciting  a cough
which causes a spasmodic contraction of the  chest;
difficulty of breathing, more when sitting than when
walking; he  is unable  to take deep brea.th, because
the chest then feels contracted, the breathing  is sibi-
lant :  excessive  dyspnoea after  a  walk, continuing 
 104      ASTHMA,  MALUM CADUCCM PULMOKUM.

 for hours;  spasmodic asthma  of full-grown persons ;
 mucous asthma, after having made a few steps, her
 chest feels constricted, and she  has  to  stop  a little
 while to take breath ; this difficulty seems to be caused
 by an impediment in  the pit of the stomach where an
 adhesion seems to exist; oppression on the chest, ex-
 ternally, with anxiety, relieved when lying and sweat-
 ing ;  periodical arrests  of breathing,  in every po-
 sition and at every hour of the day ; suffocative at-
 tacks, particularly at night, during sleep, the patient
 starts up with a loud cry and is unable to recover hid
 breath ; towards morning the heart begins to palpi-
 tate and some sweat breaks out; tension in the chest,
 anxiety and weight on the chest, pressure as from a
 lump:  contractive   pain  about the  chest,  painful
 screwing together in  the chest; periodical constrictive
 spasms in the chest, with blue face  and  short breath,
 particularly in the evening, in a warm room,  attended
 with violent  palpitation of the heart,  worse during
 motion, passing off when lying in bed, occasioned by
 congestion of blood to the chest and orgasmus sanguinis
 in the chest, shocks in the region of the heart, with ar-
 rest of breathing and  anxious palpitation of the heart.
   §  231.   Phosphorus, Sepia,  Acid, phosph. are like-
 wise useful remedies  in some cases of asthma.  Arg.
 nitr. cryst. may prove useful in asthma caused by va-
 rious disturbances of the circulation.
   As palliatives for the relief of the patient  during a
 paroxysm, I recommend
   1) The  use of animal magnetism in the following
 fashion : Apply one hand flat on the pit of the stomach,
 the other on the larynx, or, if this should cause anxiety,
 on the forehead of the patient; sometimes I employ a
 light pass with both hands  and closed thumbs,  from
the larynx down  to the pit of the stomach, a  little
below that region.  The homoeopathic specific reme-
dy may be continued at the same time.
  2) Coffee, pretty strong, a large lablespoonful every
five  or ten minutes.  If the patient be  not  relieved
after the third dose, other means have to be resorted to. 
\6THMA MILLARI.
105
  3)  Camphor is likewise a  palliative, but only  in
certain cases.  1 use it in asthma humidum with very
irritable nerves, and particularly when the  larynx and
bronchial tubes are so filled with mucus that the pa-
tient is almost suffocated, which is easily  inferred by
the movement of the patient's hands and by the spas-
modic contortion of the facial  muscles.
  4)  Tabacum, first  or second att.,  or  the smoke  of
tobacco if the patients are not, used to it;  it relieves
the anguish in asthma organicum, cardiacum,  when
depending upon stenosis of the left heart.
  Other palliative remedies are : Ipec,  Puis., Ignat.,
Nux vom., Ambr.,  Colchi., Digit., Arsen., Tart. slib.

  §. 232.  Asthma Millari, Asthma laryngeum, spasm
of the glottis.
  The two latter names belong more properly  to the
asthma thymicum of Kopp ; I have classed  both va-
rieties under the same head,  because the treatment is
the same.
  The pathognomonic symptom of asthma  laryngeurn
is a sudden and violent interruption  of breathing for a
few minutes, after  which  the children resume their
respiration with a crowing noise.
  The lowest degree  of spasm of  the  glottis is fre-
quently observed in children with a vehement tempera-
ment, when they get out  of breath in consequence  of
a violent fit of anger or violent cries.   If the disease
be more violent, the spasm sets in suddenly, generally
on waking from sleep,  or, after fright, anger, in  con-
sequence of crying, laughing, a cold, or a drop of  li-
quid getting into the larynx while drinking, or without
any perceptible cause  ; the  spasm commences with a
whizzing,  exceedingly  fine,  almost crowing  inspi-
ration,  which  is several  times repeated  with  great
forca until the breathing stops entirely; the children
gasp for air with the most violent exertions, they turn
pale and  blue, the eyes protrude liom  their sockets,
cold swenf appears on the forehead, and the pulse be-
         i* 
106
ASTHMA M1LLARI.
comes small;  this lasts from one to ten minutes, after
which the breathing is resumed with a shrill, crowing
expiration attended with crying ; the  child soon goes
to sleep and wakes quite well, except some languor.
There are scarcely ever any other morbid symptoms
present,  except in very few cases a little cough  and
difficulty of breathing;  the appetite generally remains
good ; in a  few cases the digestion is deranged, the
abdomen distended and diarrhoea  is present.  At first
the  paroxysms occur rarely, at night,  during the  first
hours of sleep ; gradually they become more frequent,
and may even take place from 40 to 50 times a day.
   In the  second  or  convulsive stage the following
symptoms supervene : Rigidity of the muscles,  bend-
ing inwards of the  carpal  and tarsal joints, clench-
ing  of the thumbs, bending backwards of the  spine,
staring eyeballs turned upwards, involuntary stool and
emission of urine, the  tongue  is hanging out at the
mouth, irregular,  intermitting beating of the  heart,
cold extremities, distorted countenance. Even between
the paroxysms the child remains unwell, it looks pale,
languid,  drowsy, is peevish  and prostrate, the sleep is
restless and interrupted by starting,  pulse and respi-
ration are constantly hurried, the cheeks are covered
with a circumscribed  redness, the  strength  of the
patient is sinking more and more, and  hectic fever
sets in.
   Some physicians assert they have observed premon-
itory symptoms,  such as disposition to get something
into the windpipe  when swallowing, immediately be-
fore the setting in  of the paroxysm, screams with long
inspirations, paroxysms of laboured breathing which
sometimes  intermit  for days, nervousness ; or:  rest-
lessness,  disposition  to  start,  flatulence,  slight tonic
spasms, rattling in the trachea, etc.
   §  233.   Distinguishing  characteristics  of this^ dis-
ease : Many physicians pretend the disease is a variety
of croup ; but  there is no fever between the paroxysms,
there is neiiher cough  nor  local pain in  the 1  irynx,
the intermissions are  well marked and ro itinue  fre- 
XBTHMA MILLARI.
107
quently for days, the paroxysms may set in in all their
violence from the very commencement, the symptoms
do  not  increase as in croup,  there are no catarrhal
symptoms either previous to the disease nor during the
intermissions, the children are quite well between the
paroxysms, there is no  hoarseness, the disease  lasts
much longer than croup, etc.  The disease  is easily
distinguished from  whooping-cough;  the  similarity
extends only to the  wheezing  breathing;  the violent
cough which terminates in retching and vomiting and
is always present in whooping-cough, never exists  in
asthma millari; the paroxysms of whooping-cough oc-
cur at night as well as in the day-time, and a catarrhal
stage is always  present, quantities of tenacious mu-
cus are likewise  thrown up; all  these symptoms are
wanting in asthma millari.  Cyanosis always depends
upon congenital organic defects of the circulatory ap-
paratus, which can  be diagnosed by means of the
stethoscope through the continual irregularities of the
beats of the heart; the symptoms of suffocation show
themselves even a few days after birth, whereas the
asthma sets in in the first period  of dentition, or  even
afterwards;  cyanosis is attended with a  peculiar
rattling or wheezing, accompanied with violent cough.
  Etiology:  The disease generally  occurs between
the 6th and 18th month, seldom later; boys are more
liable to it than girls; it is sometimes hereditary, and
it happens that all the children of a family are visited
by it. Such children are generally of a delicate  con-
stitution,  pale, lymphatic, scrofulous, the  scrofulous
habit manifesting itself by eruptions on the head and
face, otorrhoea,  glandular  swellings.  Many physi-
cians consider this asthma as a disease inherent to the
period of development; more frequently,  however,
the  disease is excited by catarrh, bronchitis, croup,
whooping-cough, measles, hydrocephalous fevers,  cold,
particularly in the cold, damp  season.
  Prognosis: It  depends  upon  the  age and consti-
tution of the patient; the older  and  more robust the
patient, the less  dangerous the disease; the prognosis 
108
ASTHMA MILLARI.
 is likewise  depending upon the causes and compli-
 cations  of  the  disease, and upon its  duration  and
 course;  the convulsive stage and the termination in
 hydrocephalus are very dangerous.  (Canstatt).
   §. 234.   Treatment: One of the principal  remedies
 for the spasm which is the characteristic pathogno-
 monic symptom in asthma millari, is Sambucus.  The
 indications  are the  following:  The patient wakes
 from his slumber with his  eyes  and mouth half open,
 and has to sit up suddenly on account of want of
 breath;  the inspirations are short  and sibilant,  with
 occasional suffocative fits,  during which he throws his
 hands about,  face and hands are  swollen and bluish,
 with dry heat all  over, without thirst,  and irregular,
 small, intermittent pulse ;  the patient cries when the
 paroxysm  is setting in ; there is  no cough, and  the
 paroxysm generally sets in about midnight.
   Arsenicum.   The paroxysm is preceded for several
 days by slight catarrhal symptoms ;  the little one goes
 to sleep quietly, and the   spasm develops itself gra-
 dually and visibly ;  the breathing becomes  shorter,
 sibilant,  until the spasm sets in in all its violence  with
 a loud whizzing cry and sudden suffocation  as if the
 patient would die.
   Menya.nth.es trifoliata ranks with Sambucus, except
 that the spasm is lighter, though it comes on  sudden-
 ly and the  breathing is exceedingly laboured.
   Mnschus is  useful  for  sudden constriction  of the
 larynx, with desire to take a deep breath.
   Vera'rum.  Suffocative  constriction of the larynx,
 with imperceptible breathing,  contracted pupils, or
 protruded  eyes;  laboured  breathing  between the
 paroxysms.
  The following remedies may be given for paroxysms
 of nocturnal anguish : Ignat., Ipec, Bellad., Puls.,Liu-
roces., Nux  v., Aionit., August., Slranvm., Calcar., Ly-
co. ., Phosph r.
> 
INCUBUS, NIGHTMARE.
109
  §. 235.  Incubus, nightmare.
  It occurs  only to  plethoric subjects,  during sleep,
in a recumbent posture, and when the stomach is full.
One who is attacked with nightmare is in a sort  of
half-sleep,  and is sufficiently conscious to know  that
his sufferings are not real, but imaginary ; nevertheless,
this  condition  cannot be  removed by the  mere  force
of the will ; he is unable to stir, raise himself or cry
out.  Generally nightmare takes place in the first  part
of the night, after previous dreams, the patient ima-
gining that he is seized by some wild beast or phantom
which  oppresses his chest and causes anguish  and a
feeling of suffocation.  The attack lasts only a  short
while,  sometimes however a  few  hours,  and occurs
even several times in the night. The patient general-
ly wakes suddenly, with a sensation of languor, some-
times sweat on the upper extremities, trembling  of
the whole  body, palpitation  of the heart, headache;
all these symptoms disappear very soon, and no further
unpleasant consequence is perceived.
  In many cases the  disturbance  may be left to na-
ture ; but, if it should recur very frequently and if the
frequent congestion of blood to the chest should ex-
pose the patient to  the danger of some organic  dis-
ease, it is proper for the physician  to interfere.   The
patient should avoid coffee, and, if  the disease should
have been occasioned by  the abuse of heating, spi-
rituous drinks, or by overloading the stomach,  Nux  v.
will be found a specific remedy.
  If the  attack should be preceded for some  days by
orgasmus sanguinis, flushes of heat in the face,  fre-
quent palpitation of the heart with anxiety and rest-
lessness, oppressed  breathing,  heat, increased thirst,
Aconite,  in repeated doses, not too weak, is the  best
remedy.
  Opium is indicated by  the following  symptoms:
Sopor,  stertorous breathing with the eyes and mouth
half open,  he  cannot he roused, the face is  covered
with cold sweat and the  features express anguish ; 
no
■ i FFOCATIVE CATARRH.
the breathing is spasmodic, paroxysmal, and the limbs
twitch at times.
  Silicea corresponds to great anguish; sensation ns if
a heavy rough beast were lying on him,  so that he is
unable to utter a sound ;  dreams after  midnight:, iff a
state  of half-waking,  as if he would be seized by a
thousand phantoms;  after waking  he is unable to stir,
he is covered with sweat, experience's great- anguish
with palpitation of the heart,  afterwards great fear-
fulness.
  Puis., Bryon.. Bellad.,  Con., Guajac,  Ignat., Nitr.,
Sulph.,  Ammon carb., are. also useful in nightmare,
the last named particularly when the  attack takes
place while going  to sleep ; Guajacum, when  the  at-
tack occurs in a recumbent posture ;  Cinnabaris is re-
commended when the attack takes place after mid-
night.

  § 236.  Suffocative, catarrh.
  This disease is, properly speaking,  a variety of
acute  capillary bronchitis or of  pneumonia notha.
From various  reasons I have  classed  it in the  cate-
gory of asthmatic diseases.   Bronchitis  can only be
termed suffocative catarrh when the excessive accu-
mulation of mucus in the bronchi  induces an anguish
of suffocation  which finally leads to acute cyanosis,
until the patient is actually suffocated by the mucus
in the  bronchi, the   rattling  of which  is heard  far
off.  Such  a  condition sometimes  sets in  suddenly,
without any considerable precursory  symptoms except
some  coryza and bronchial  catarrh.  Suffocative  ca-
tarrh cannot take place unless the mucus is  accom-
panied with a spasmodic  irritation of the respiratory
apparatus.   During this spasm the patient sometimes
succeeds, after a paroxysm of excessive orthopnoea,
to raise an enormous  quantity of serous, transparent,
albuminous or slimy matter,  after which the respi-
ration  and   circulation are  more  easy.  Suffocation
takes  place very easily.  The stethoscope reveals an
enormous accumulation of fluid in all the bronchial 
SUFFOCATIVE CfATARRH.
Ill
 ramifications, over the greatest portion  of the chest.
 Fever is frequently wanting  entirely.   The attacks
 recur  at longer or shorter intervals ; if oedema of the
 lungs  should supervene, death is pretty certain.   The
 disease sometimes  runs its course in a few days or
 hours.                          •'•'•■■;
   § 237. Treatment: Ipecac, Coffea., Cam ph., Sambuc,
 Chamom.,  Pulsat. are the best remedies  at the com-
 mencement of the disease, and sometimes prevent its
 further development.   Chamom. is suitable  to chil-
 dren when the suffocative paroxysm announces- itself
 with  titillation  in the throat, rattling in th# .lai^yJaS!
 and chest,  violent cough, also with  convulsions,  colic,
 etc.   A sudden,  suffocative  oppression of the  chest,
 similar to suffocative  catarrh, attended with excessive
 accumulation of mucus in the air-passages,  and pant-
 ing breathing, is best met by Champhora, from  the
 first to third att.,  in the case of children.  Ipecac,
 not too high, and frequently repeated, is excellent for
 ineffectual  urging  to vomit, in  cases where catarrh
 with  increased  secretion  of mucus had existed  for
 some time previous,  after which the suffocative  ca-
 tarrh had set in with rigidity of the body and blueness
 of the face.
  If the disease cannot  by arrested by any of  the
 afore-mentioned remedies, or the suffocative  paroxysm
 sets  in  suddenly, Arsenic is the best remedy, except
 in a few cases, Belladonna, China, or Veratrum.
  If, during an  inspiration, a mucous rattle  should be
 distinctly perceptible  deep  in  the chest,  with  an
 anxious heaving of the chest in order  to  get  rid of
 the torturing irritation ; if the cough should have a
 dull, hollow, rattling sound, and if the patient should
 not have strength enough to diminish  the  irritation
 by coughing up the mucus which accumulates deep
 in the lungs: then we may infer  that paralysis of the
 lungs is imminent.  This  termination of  the  disease
occurs principally  among children and  old  people,
and is to be met by repeated doses of the first and
second trituration of Tart emet.  To old people,  how- 
1 12       ANGINA PECTORIS, NEURALGIA, ETC.

ever,  I first  give the spirits of Camph.  in drop-doses,
every 5 or 10 minutes, and afterwards Baryt. carb.

  § 238. Angina pectoris, neuralgia of the heart.
  Pathognomonic symptoms of angina pectoris : Horrid
pain in the region  of the heart, under  the  sternum,
setting in suddenly,  paroxysmally, extending over the
chest,  neck,  arms,  diaphragm, accompanied  with  a
sensation of fainting  and internal annihilation ;  the
patient has to stand still  and hold fast  to some fixed
object.
  Course of the  disease : The paroxysm frequently  sets
in without  any precursory symptoms,  which is cha-
racteristic of the disease ; low-spiritedness, indescrib-
able restlessness, stretching of the extremities, cloudi-
ness  of sight,  are  sometimes felt  previous  to  the
paroxysm.
  The neuralgic pain is characterized by a feeling of
approaching syncope,  anguish as of death ; the pain
itself varies, pressing, constriction or distention of the
heart, as if it  would break;  or sensation  as if the
heart  remained standing still; or the pain  is cutting
as if the chest would be cut  to pieces.  The pain  is
relieved by  quiet  and  by pressing the chest against
something hard. The breathing is apparently arrest-
ed, the patient thinks he will suffocate,  is speechless.
Palpitation  is not  always present;  the beats of the
heart  are rather  fluttering,  irregular;  the pulse  is
generally small, feeble,  somewhat  accelerated,  fre-
quently irregular; sometimes, however, it is hard,  full,
unaltered,  even slower than usual,  symptoms which
point  to organic disease of the heart.  During the
paroxysm the face  and extremities are  cold, covered
with  cold sweat; the features  are spasmodically dis-
torted,  and the senses  vanish ; generally,  however,
the  patients  retain  their  consciousness during the
paroxysm.
  At the commencement of  the disease  the  paroxysm
lasts  only a few minutes, afterwards it lasts  a  little
longer, but is  then  le^s violent:  the spism abates 
           ANGINA PECTORIS, NEURALGIA,  ETC.       113

 when eructations and sweat take place ; sometimes it
 terminates in vomiting  or discharge  of flatulence ;
 sometimes in cough with expectoration of mucus.  At
 first the paroxysms recur at long intervals, even after
 the lapse of years, afterwards they become more fre-
 quent,  and are  excited  by the least cause, such as:
 exertions, ascension of eminences, walking against
 the wind, dietelic transgressions, emotions, mental ex-
 ertions, etc. ; also coughing,, talking, yawning,  sneez-
 ing, or any kind  of motion.
   §  239.  Anatomical  clianges:  Those who  die  of
 angina pectoris  have  generally been  affected  with
 considerable struc'ural alterations of the  heart, or of
 the larger  vessels,  particularly the aorta,  such as:
 dilatation or ossification of the aorta, cartilaginous or
 ossified condition of the coronary arteries,  ossification
 of the valves, hypertrophy and dilatation of the  heart,
 inflammation and swelling of the mediastinum,  accu-
 mulation of fat  around the heart,  ossification  of the
 costal  cartilages, adhesion of  the  heart  and  peri-
 cardium, varicose state of the veins of the heart, pul-
 monary disease, hydrothorax, etc.
   Causes: Severe cases occur rarely before the fiftieth
 year ; lighter cases occur among young people.   Men
 are more liable  to this disease  than women.   Other
 causes are : anomalous gout, hysteria,  hypochondria,
 excesses  in  diet, drunkenness,  want of  exercise,
 chronic dyspepsia, care, emotions, etc.
  Angina pectoris, however, may exist without any
 organic alterations being present.  It  is a neuralgia
 of the cardiac nerves, a purely  dynamic  disease,  in
 spite  of  the  modern anatomico-pathological school,
 which rejects this theory  because no structural  alter-
 ations of the nerves can be discovered.
  The disease can last twenty and more  years, and
may.  on the other hand, terminate fatally after a few
attacks.   Sometimes it ceases entirely after a few
paroxysms.   Perfect  recovery is very rare.  In some
cases  the  disease alternates  with other arthritic com-
plaints, the feet swell, or evacuations by the skin and 
114       ANGINA PECTORIS, NEURALGIA, ETC.

bladder take place :  sometimes  erysipelas breaks out
on the  feet, relieving  the  chest.   The  disease  has
likewise been known to alternate with other nervous
diseases, gastralgia,  ischias. headache, etc.,  or to ter-
minate  in  organic  disease  of the  heart, cachexia,
dropsy.   Generally,  however, the patient dies during
a paroxysm, previous  to these  disorganizations  set-
ting in.
  Prognosis: It is generally unfavourable, particular-
ly when the cases are old, or  complicated  with  dis-
organizations,  when the paroxysms are violent,  and
follow each other rapidly in  consequence of trivial
causes, and when the intermissions  are  not entirely
free from pain.  The  prognosis is less unfavourable
when the disease depends upon gout, hysteria, spinal
irritation, when the  paroxysms  arc  rare and not too
vehement, and the patient is young in years.  (Can-
statt.)
  § 240. Treatment: During the paroxysm the patient
should be relieved of every pressure, even that of his
clothes,  and he should keep  perfectly  quiet,  in an
erect posture ;  a recumbent posture is intolerable.  It
is of great use  to  bathe the hands and feet  in warm
water,  to rub  the skin  with woollen cloths,  to apply
warm cataplasms and animal  magnetism.   Cold af-
fusions, applications of cold water to the chest,  may
likewise prove useful;  experience  will have to decide
on this point.
  Arsenicum  is  a  specific remedy  for  this disease,
provided  the structural disorganizations  of the heart
or larger vessels are not too considerable.  It is  indi-
cated  when the patient is unable  to breathe except
with his chest  bent  forward,  and then  only very im-
perceptibly ; when  the least motion causes a loss of
breath ; when  an oppressive  stitching in the region
of  the  heart  is attended with fainting and  anguish ;
when  even getting into bed  causes a  loss of breath,
and the  patient requires a long time to recover  him-
self; when the attack is renewed  by merely turning
round in bed.   Arsenic is certainly  a truly  excellent 
          NEUROSES OF THE  GENITAL SYSTEM.       115

remedy when the disease is purely dynamic ; though
it can only palliate the pain  when  extensive disorga-
nizations are present, in which case  the least cause
may provoke a new paroxysm.
  Digitalis is indicated when the action of the heart
is more vigorous than the pulse ; or when the disease
sets in suddenly, and drawing-tensive spasmodic pains
in the left chest and sternum, towards the nape of the
neck  and upper  arm, and  an  indescribable deathly
anguish are present.
  Sambucus may likewise prove  useful in angina pec-
toris (see Asthma millari).
  Angustura  may be tried in the lighter cases, when
the chest is in constant motion, and this is aggravated
by the  least  exercise, going up stairs, etc., attended
with  anxiety and  palpitation of the  heart, cutting
shocks in the sternum and back, or painful shocks in
the region of the heart.
  Lactuca  virosa   deserves  consideration,  when  a
crampy stitching  in  the  left chest, extending to the
left scapula, and  an indescribable tightness of the
whole chest,  are experienced.
  Veratrum album : periodical attacks of contractive
crampy pain in  the  left chest, or cutting pain with
excessive agony,  arresting the breathing, and extend-
ing  even to the shoulder.
  Asa fcetida and Sepia are likewise to be considered.
  I have frequently arrested or  moderated  an attack
by repeated  doses of Aconite.   Ipecac, may be tried,
when the patient frequently experiences an urging to
vomit during the paroxysm.
  Bellad.,  China,  Spongia, lodium, Mercur., etc., are
suitable intercurrent  remedies.

  § 241.  Neuroses of the genital system.
HYSTERIA,  ASTHMA  UTERI, SUFFOCATIO  UTERINA,  PASSIO
                     HYSTERICA.
  In describing the treatment of this disease, or rather
of this multitude  of diseases,  I  shall follow the ar-
rangement ol Schcenlein and Canstatt. 
116       NEUROSIS  OF THE GENITAL SYSTEM.
  Hysteria  is the name for a vast number of female
diseases.  It occurs in the most varied forms, which
makes the treatment  of hysteria rather diflicult.  A
sudden change of the phenomena of disease is  cha-
racteristic of hysteria.   Vehement symptoms frequent-
ly set in without  any  apparent  cause,  and then dis-
appear  again as  suddenly, or change to some other
form  of disease, or give place to perfect health and
cheerful spirits.
  The psychical phenomena are very  characteristic.
Hysteric females  are  capricious, their  emotions and
feelings  are  very  changeable ; from  deep grief  they
sometimes  pass  over   to  the liveliest  mood;  they
always  consider themselves  very sick  and want to
be pitied ; they affect to be very sick, in various ways,
sometimes  only to excite interest ; their  eyes  are
humid, languishing, half closed;  the nerves are very
sensitive, idiosyncrasies are more strikingly developed.
  Symptoms of hysteria : General  malaise, sadness or
excessive cheerfulness, loquacity, restlessness, anguish,
slight convulsions and pains in all the limbs, moaning
and yawning, urging to urinate,  discharge of watery
urine; sensation as if a ball were rising with a  rum-
bling noise from  the  left side of the abdomen to the
epigastrium, where it causes a retching and  vomiting,
or it rises in the  throat and  causes  a constriction in
that part.   This  is  followed by convulsions:  the
patients  strike their breasts  with their fists, and are
tossed up in  the  air,  in consequence of  which they
have to be watched with great care,  lest they should
hurt themselves.  In this condition they generally re-
main conscious; they  scream, howl,  laugh, sob spas-
modically.   During the remission the  patients  are
exhausted, delirious, soporous, or they are in ecstasy,
or in a  state of somnambulism ; soon, however, the
convulsions  return and  the same scenes recur some-
times every  three or four minutes.  Such a paroxysm
may last, for several days, after which  it frequently "ter-
minates in asphyxia, coma, rising of air, or in weeping,
sobbing, laughing, increased secretion of mucus  from 
LOCAL FORMS OF HYSTBRIA.
117
the genital organs, or increased discharge  of  watery
urine.   At first the pulse is small, contracted, the face
pale, ihe extremities cold ; afterwards  the patients
feel  exhausted,  the  pulse  gradually  becomes fuller,
and  the temperature  of the skin returns.
  This is the usual character of hysteric convulsions;
in a higher  degree  the  convulsions increase  to  St.
Vitus' dance,  tetanus, catalepsy,  even epilepsy with
loss  of consciousness.  Sometimes  the paroxysm  sets
in without any known cause ; sometimes they  are  ex-
cited by emotions, cold, dietetic transgressions.   Some-
times they are inconsiderable, and recur every week
or month ; as the patients grow older, the paroxysms
become more frequent and more intense ; the patients,
however, always look well, and remain fleshy.

  § 242.  Local forms of hysteria.
  1) Hysteric  headache  (encephalopathia  hysterica,
hysteria cephalica) :  hemicrania,  clavus, sensation of
coldness at the occiput, sopor and coma,  symptoms of
threatening  phrenitis, delirium,  obstinate  sleepless-
ness.  It is characteristic  of these ailments, to cease
suddenly, and to alternate rapidly with other ailments;
pale face, watery urine, small pulse, etc., are likewise
characteristic.
  2) Hysteric states of the mind:  To these  belong  the
frequent repetition of certain syllables, words, sen-
tences, tunes; nymphomania.
  3) Hysteria spinalis,  myelopathia hysterica.   This
spinal irritation is  generally sympathetic.   The pain
is generally a drawing through the whole  of the ver-
tebral column, accompanied with pains in the extre-
mities, formication, contraction of the muscles, cramps
in the calves, paralytic states, neuralgic  affections of
the thoracic and intercostal nerves, joints.   This pain
is randy seated, generally fleeting, and erratic.
  4) Hysteria uterina, neurosis uterina, spasmus hystc
ralgicus.  The patients complain of pain, tightness in
the hypogastric  and pubic regions, frequently attended
with drawing pains in the loins ana small of the back, 
118
LOCAL FORM* oF  HYSTERIA.
following the course  of the  round  and  broad liga-
ments of the womb; they  feel as if the  uterus were
forcibly drawn up  from the small to the large pelvis.
At times these pains are  colicky, at others they are
attended with a sensation as if a ball were ascending.
The sexual instinct  is  sometimes  violently  excited.
The menses are generally disturbed :  at times they
are scanty,  at others profuse, they are always irregu-
lar, and come on by fits and starts;  they  are  accom-
panied  with leucorrhoea.  The  paroxysms are most
violent  at the time of the menses, first periodically;
if the menses  have become irregular, the  paroxysms
occur at irregular periods.
  5)  Hysteria  vesicalis, nephro  et  cystopathia  hys-
terica.   The patients are attacked with violent, con-
tractive, and frequently burning pains in the lumbar
region,  along the  course  of  the  ureters, through the
whole  pelvis, in  the  region  of the bladder,  without
sensitiveness to hard external  pressure,  which distin-
guishes the disease from nephritis and cystitis ; violent
desire to urinate, no urine being passed,  or but very
little and with violent pains  (ischuria and stranguria
hysterica) ; the urine is clear, sometimes like water.
  6) Hysteria intestinalis, colica hysterica.  The spasm
generally commences in the region of the  coecum or
of the sygmoid flexure, with a sensation as  if a  ball
were lodged in these parts which is  constantly  in-
creasing in size.   The  pain  is  like a  violent colic,
burning, tearing, as if the bowel were  torn to pieces
with knives.  The patient screams when one merely
attempts to touch her,  whereas  she bears hard pres-
sure, provided her attention  is directed to something
else in the   meanwhile.   Borborygmi,  tympanitis,
sometimes  enormous distention  of  the  transverse
colon, with anxiety, shortness of breath, vomiting, etc.
No trace of fever.
  7) Hysteria gastrica,  gastropathia  hysterica,  car-
dialgia hysterica,pyrosis hysterica.  The patients com-
plain of a constrictive, or burning, or spasmodic pain
in the stomach, with  oppression, nausea,  vomiting; 
LOCAL FORMS OF HYSTERIA.           H9
 dread of  contact,  and  yet  they bear  the hardest
 pressure.  The patients  bear very  little medicine.
   8)  Hysteria pulmonalis, asthma hystericum. Hysteric
 females sometimes suffer with violent  oppression of
 breathing, suffocative anguish, stitching pains  in the
 chest, yet they are  able to  take deep  inspirations.
 Sometimes cough is present, at others there is not any :
 it is  dry,  barking, sometimes like whooping-cough.
 In many cases the patients breathe  only with the. ab-
 dominal muscles, in other cases the breathing is pant-
 ing, anxious,  or the patients  breathe only while sit-
 ting up in  bed.  Percussion and  auscultation do  not
 reveal any changes in the lungs,  no fever.
   9)  Hysteria laryngea, laryngopat.hia hysterica. The
 patients complain  of a loud, dry, almost barking cough,
 in paroxysms, occasioned by emotions and nervous ex-
 citement, sometimes attended with spasm of the rima
 glottis, and  croupy respiration.   Another form  is
 hoarseness and aphonia.   It comes on  suddenly, lasts
 for months and years, and then disappears again sud-
 denly ; sometimes, after  a violent mental excitement,
 the patient talks with her usual voice, whereas a few
 moments previous she was only able to speak in a very
 low tone.  Hysteric females  sometimes utter sounds
 like those of certain animals, dogs, etc., paroxysmally.
   10)  Hysteria cardiaca  et vascularis, cardio- et an-
gwpat/na hysterica.  Hysteric patients complain very
frequently of palpitation  of the heart  and anxiety  in
the region of the heart; the former is sometimes visible ;
sometimes it  occurs periodically, and becomes  so vi-
olent  that one would think the heart would burst out
of the chest.   The pulse is frequently  irregular, slow
and then again quick.
   11)  Globus  hystericus,  pharyngopathia  hysterica.
Sensation of constriction in  the  throat,  as if a ball
had lodged in it, sometimes  relieved  by eructations.
Sometimes a spasm occurs when the patients attempt
to drink. (Hydrophobia hysterica.)
  There are other local forms  of hysteria, which it  is
unnecessary to mention. 
120
local Forms oF hysteria.
  § 243.  The anatomical changes which have been
discovered in the  bodies of hysteric females,  are not
causes, but effects of the disease.  The essence of the
disease is very little known, the effect being generally
mistaken for  the cause.
  Causes: Canstatt considers hysteria  the hypochon-
dria of females, and  hypochondria the  hysteria of
males.  Hysteria,  however,  is much  more frequent
than hypochondria: even girls of 12 and 13 years  are
suffering  with hysteric  symptoms.   Feeble  persons
are principally  attacked with hysteria,  though ple-
thoric girls and women are likewise liable to that  dis-
ease.  The more sensitive the female, the more liable
is she to the disease.  The modern systems  of edu-
cation, reading  of novels, premature  sexual excite-
ment, sedentary habits, want of exercise, etc.  favour
the development of hysteria.  Hysteria  most frequent-
ly proceeds from the sexual organs : sterile  females
and young widows are most liable to it; painful, ir-
regular menses are likewise an exciting cause ; preg-
nancy frequently arrests and even cures the disease ;
vain longing, disappointed love, impotence of the hus-
band, sudden privation of long-enjoyed sexual inter-
course, etc., may lead to the disease; it may likewise
be excited by a rapid succession of confinements, hae-
morrhage, long-lasting leucorrhaea, long nursing, abuse
of depletions and cathartics.
  Exciting causes are likewise:  bad digestion, con-
stipation, dietetic transgressions,  excessive use of tea,
coffee,  exhausting  diseases,  particularly fever  and
ague  and abdominal typhus, violent emotions, anger,
jealousy, etc.
  Hysteria  sometimes terminates  in  epilepsy, som-
nambulism, mental diseases, and partial paralysis.
  Prognosis: It is unfavourable in this respect  that
hysteria is one  of the most lingering  and  protracted
diseases known  to physicians.  It is particularly  diffi-
cult to treat  when the disease was caused by emotions
or by scanty  menses which had been  treated in vain
for a  long time previous.  Bad symptoms are :  Long 
LOCAL FORMS OF HYSTERIA.
121
 paroxysms of syncope, excessive dyspnoea, loss of the
 senses and of consciousness, foam at the mouth during
 the paroxysm ; these symptoms precede the termination
 of the disease in epilepsy.  Hysteric paroxysms during
 pregnancy are  dangerous,  inasmuch  as they easily
 cause miscarriage;  and likewise during confinement,
 because,  by a process of metastasis, they may lead to
 mania puerperarum, exhaustion, etc.
   §  244.   Before describing the treatment of hysteria,
 I will transcribe the excellent advice of Schoenlein to
 the practitioner : " The treatment of hysteria is a very
 difficult task for the physician, not only because the
 diagnosis is difficult, and the disease runs along course,
 but because there are spiritual obstacles.  The  phy-
 sician's patience is sometimes tried to the utmost: for,
 though persuaded that the disease is of very little  con-
 sequence, yet he is constantly obliged to listen to the
 patient's  lamentations, and to  hear the same  com-
 plaint repeated for the hundredth time, without getting
 impatient; for if he should excite the least suspicion
 in the patient's mind that he underrates her sufferings,
 her confidence  is irretrievably  lost.  If  a physician
 wants to treat  hysteric females, he  must show them
the greatest sympathy, must patiently  listen to their
complaints, must not appear vexed  or indifferent, un-
less he cares to be dismissed."
  There are  few remedies in the homoeopathic  Mat.
Med.  which have not been employed in the treatment
of hysteria.  Almost every organ and system has been
visited by this disease, every function  has been dis-
turbed by it.   And yet, the phenomena of hysteria are
so evanescent that it seems impossible  to indicate po-
sitive remedies for them.   Nevertheless, guided by
the nervous symptoms and  the  physical distresses of
the patient, I will try to point  out some of the prin-
cipal  remedies to the beginning practitioner.
  For the hysteric paroxysm mentioned in § 241, one
of the principal remedies is Nux moschaia, which is
particularly adapted to hysteric spasms and paroxysms
of debility.  It is indicated by a changeable disposition,
  VOL. TV.—6 
122
LOCAL FORMS OF HYSTERIA.
from excessive sadness to extreme mirth ;  by great
languor  after  the  least  exertion;  previous to the
paroxysm,  violent tearing in the body, and  sensation
as if she would faint.   It is likewise useful when the
disease came on after fever and ague, and abdominal
typhus occasioned by  spinal irritation, or when it was
caused by disturbances of the sexual system, retarded
and scanty  menses preceded by pain in the small of the
back as if a transverse piece of wood  would be press-
ed out,  attended with headache, languor, cardialgia
with waterbrash, pain in the liver; the menstrual
blood is thicker and  darker, whereas at the time of
the menses mere leucorrhoea took place.
   Valeriana is indicated by a morbid irritation of the
nervous system, sensation of languor, excessive  sen-
sitiveness of all the senses;  there is no changeable
mood,  but  a disposition to fear  and despondency.
The patient does not complain of a rising ball, but of
sudden  ascension of warmth from  the  epigastrium,
with oppression of breathing, nausea as if she would
vomit, first felt in the umbilicus and  then  extending
to the pharynx, with sensation as if a  thread were
hanging down  from  the pharynx,  ptyalism  and
vomiting.
   Viola odorata has been recommended by some, pro-^
bably because some hysteric patients prefer  the smell
of burnt feathers to the odour of a violet.   Viola is per-
haps  indicated by  much  weeping without  knowing
why,  by nervousness, constant distress in the chest,
painful dyspnoea, laboured and painful breathing, with
anxiety and occasional strong beats of the heart.
   Secale cornutum is indicated by the peculiar spasms,
the clonic  and tonic  convulsions,  the phenomena of
the mind and  sensorium which we observe  in hys-
teric patients.
   Aurum.  The chief indications are : excessive irri-
tation of all the  senses, great susceptibility to  pain
even when merely thinking of it, with inability to bear
anything or anybody,  religious  melancholy, grief 
LOCAL FORMS OF HYSTERIA.
123
about one's own-deserved fate, great anguish  about
the heart,  dread of men, etc.
   Pulsatilla ranks with Aurum, except that Aurum
suits every  constitution  and temperament, whereas
Pulsat. is principally  adapted to females, and can
scarcely ever be exhibited in the hypochondria of male
subjects.   Schoenlein recommends Pulsatilla in hys-
teria uterina as one of the most powerful remedies,
particularly when  the  menses are  scanty and at-
tended with nervous paroxysms.  He proposes  very
small  doses, forgets, however, to state that he owes
this piece of wisdom to Hahnemann and homoeopathy.
   Moschus  is an excellent  remedy in hysteria,  when
the  following symptoms  exist:  Hysteric patients fre-
quently complain  of a feeling of pain in the whole
body without being able to indicate the precise spot;
the  pains  are felt  more intensely,  when  inquired
into; they shed tears while complaining of a general
languor, with a feeling of malaise  which increases
to fainting ; various kinds  of spasms, to  which hys-
teric females are  subject,  are  relieved by Moschus,
such as:   sudden  rush of  blood to  the  head,  with
staring eyes and  spasm  in the mouth,  followed by
rapid, confused talking, after  which cadaverous pale-
ness with  profuse  sweat over the whole head ; or:
sudden paroxysm characterized by staring eyes with
paleness of the face, heaviness of the head, pressure
in the nape of the neck, coldness of the body, nausea,
afterwards  obscuration of  sight, contraction of the
pupils, loss of equilibrium,  rigidity and extension  of
the  right  hand and fingers; sudden  vanishing  of
sight from a slight pressure on the vertex, with  great
anxiety,  palpitation of  the  heart  and  stupifying
headache,  or pain  as if from a nail driven into the
skull; oppression across  the stomach and pit of the
stomach,  with  anxiety;  violent  excitement of the
sexual organs with intolerable titillation; suffocative
constriction in the larynx, etc.
  Conium suits unmarried females, particularly when
the symptoms seem  to proceed  from  the  sexual sys- 
124
LOCAL FORMS OF HYSTERIA.
tem;  the  patient  complains of violent itching about
and in the sexual organs, with  pressing-down pain
in the uterine region,  and  stitches in the  vagina;
the menses are suppressed, or too scanty ; a smarting
leucorrhoea which  renders  the parts sore,  is almost
always present,  with  frequently  recurring,  labour-
like  contractive pain  in  the  abdomen.   A  charac-
teristic symptom  is a  pressure in the pharynx,  as-
cending from  the  pit  of the stomach, as if a round
body would ascend; the patient  is sad  and melan-
choly, dissatisfied  with herself and every body near
her ; nervous paroxysms ; when alone, the patient is
disposed  to weep, sob ; this  is followed  by scintil-
lations before the eyes and indistinct sight, so that
the patient has to hold on  to something,  after which
she feels languid and  complains of a dull headache ;
or : weariness and chilliness, obliging her to lie down,
with headache and violent palpitation of the heart,
pain at every pulsation as if a knife  were driven
through the occiput,  the  beat  of the heart being
either strong,  quick or fluttering.
  I gave  Cocculus with  success for  the following
symptoms: frequently  recurring  hiccough,  choking
constriction in the upper part of the  fauces,  with
dyspnoea and  irritation as if  cough  would  set  in ;
retarded menses, which afterwards appear  with ab-
dominal spasms,  anguish,  oppression of breathing,
spasms in the chest,  attacks  of  nausea even  unto
fainting,  and jactitation of the limbs.
  I am obliged to confess, that the remedies which
have been mentioned in the above paragraphs, by no
means cure an hysteric paroxysm unless they are  at
the same time adapted to the  disease itself.   Instead
of pointing  out  more remedies  which  relieve   the
paroxysm,  I will mention a few medicines that are
more  adapted  to the general hysteric disease.
  Natrum muriaticum:  I have frequently been tempted
to believe that hysteric females are able, in a state
of somnambulism  or clairvoyance,  to  prescribe  for
themselves the remedies which are specifically adapted 
              LOCAL FORMS  OF  HYSTERIA.          125

to their condition, and that it  is owing to this power
of divination, of which the patients are not  conscious,
that they will swallow a quantity of salt,  quantities
of the  chemically prepared vinegar (containing  sul-
phuric  acid), chalk, lime,  etc.   The  same  remark
probably applies to the so-called idiosyncrasies, which
impels  them to  desire Asafcetida as well as Moschus.
May this appear hypothetic or otherwise, it is a fact
that  these  strange  desires and idiosyncrasies some-
times reveal the  means by the employment of which
the  disease  can be cured.   I have frequently pre-
scribed Natrum  mur. with great success,  when  the
particular taste of the patient for salt  was the prin-
cipal curative  indication.  Of course,  Natrum mur.
possesses among its pathogenetic symptoms far more
certain and valuable therapeutic indications than the
uncertain idiosyncracies of tlie patients ; the principal
of these indications  are :  frequent recurrence of  the
paroxysms  in the day-time  ; speedy disappearance of
the hysteric symptoms after sweat sets in ;.cadaverous
paleness of the  face and  general debility during  the
paroxysm ;  drawing sensation from the left shoulder
to the  head, with pressing in the  temples  as if  the
head would  burst, pain in  the brain  as if sore and
bruised, constant nausea as if proceeding  from  the
stomach, desire to lie down, and chilliness  with heat
in the face.   Other indications are : general  debility
and frequent paroxysms of fainting ; frequent sensation
in various parts of the  body as if they had gone  to
sleep ; vivid, fanciful dreams  during a light  sleep ;
somnambulistic rising and walking in the room ; sad-
ness, grief, whining and melancholy mood, irresolute-
ness, great  absence of mind ;  sudden  disappearance
of the headache with nausea ;  clavus in the left side
of the head ; and  lastly the menses,  which  delay and
decrease more and more.
  Calcar. carb. is a good remedy for hysteria, parti-
cularly  when the sexual system is unusually  excited
and the hysteric  spasms show  a tendency to  assume
the epileptic form. 
126
LOCAL FORMS OF HYSTERIA.
  Asafcetida corresponds to the following  symptoms :
pressure in the oesophagus, contraction of the throat,
sometimes  occasioned  by a  sensation  as  if a  body
were rising in the throat, which obliges the patient to
swallow frequently ; this pressure generally proceeds
from the stomach, ascending along the oesophagus and
producing the sensation as if a foreign  body  were
rising in the throat, attended with nausea and a feel-
ing of  fulness in the pit of the stomach, compressive
sensation in the abdomen.
  Sepia is suitable to feeble females with a fine, de-
licate skin.  Sepia corresponds to the following parox-
ysm :  sensation as  of  an icy-cold hand between the
shoulder-blades,  followed by coldness over the whole
body, suffocative spasm in the chest for several mi-
nutes,  followed  by  clonic convulsions of  the  right
limb, and twitching of the right limb and  arm, when
the limb is  held ;  lastly, tremor of the lower extrem-
ities; the  nightly sleep is  disturbed by frequent at-
tacks of anxiety, sudden fainting with  profuse sweats
and undisturbed  consciousness, without,  however,
being able to speak or stir.  Sepia is more suitable to
sad than cheerful dispositions.  For further symptoms,
I refer  the reader to the Mat. Med.
  Magnesia muriatica   corresponds to  the  following
symptoms: liability to take cold, frequent  attacks of
a bruising pain throughout the whole body, sick feel-
ing, fainting fits  at table, with anxiety, nausea, pale
face, photopsia  (green and red colours.) trembling of
the whole body,  relieved by eructations;  uterine
spasms, pain in the small of the back, leucorrhoea ;
these  last-named symptoms become more violent as
the menses diminish,  they appear periodically, and
the spasms finally extend down the  thighs and up-
wards, involving the whole abdomen, causing a pain-
ful  hardness of that part.
  Nitri acidum:  Drawing sensation in the back, every
day once or twice, changing to a griping in the sides,
whence it passes along under  the ribs to the pit of the
stomach, where  the patient   experiences  a twisting 
            TREATMENT OF LOCAL HYSTERIA.         127

 sensation, and feels relieved after  eructations; this
 attack  is most violent towards evening, particularly
 when the weather  is changeable ;  the patient  con-
 stantly complains of a feeling of illness, and fainting,
 slight tremor  through the whole body,  sad, whining
 and melancholy mood.  The  globus  hystericus, the
 many symptoms of abdominal hysteria, menstrua] ir-
 regularities, spasms in the chest, etc., should likewise
 be present,  if nitric acid is to do the  patient any good.

   § 245.  Treatment of Local hysteria.
   1)  Hysteria cephalica.   The remedies used for local
 hysteric pains, must of course correspond to the ge-
 neral malady.   Valeriana  may be given for hysteric
 headache, when the pain is stitching or pressing, ex-
 tending from the forehead  to the orbits, with or with-
 out stupefaction  and dulness, or  alternating with
 these latter symptoms.  If the pain should arise from
 an erethic state of the brain, or should be a paroxysm
 of a periodical nervous headache, Belladonna  will be
 found preferable.  Mercurius is adapted to a stitching-
 boring  or tearing nightly pain, and  Phosphorus re-
 moves such a pain when preceded by evening-nausea.
   For  the  nightly  headache  of hysteric females  I
 will name
   Hepar  sulph., when a pain sets in,  on moving the
 eyes, as if the forehead would be torn out;  and
   China, when  the pain is  pressing and  accom-
 panied  with sleeplessness.
   For  hemicrania  I refer  to Chamom., Cicut., Colo-
 cynih.,  Nux vom., Puis., Sepia, Cali carb.,  etc.,  also
 Sulphur,  when the headache is  periodical,  returns
 every  eight days, the pain  is aching-tearing, stupe-
 fying.
   For  clavus   I  mention Coffea,  Bryonia,   Ignat.,
 Aurum, Platina.  Aurum is particularly indicated for
 a roaring in the head, attended with palpitation of the
 heart, buzzing in the ears,  swelling  of the  abdomen
close above  the pubic bones,  spasms in that  region,
sexual excitement, changeable mood, excessive loath- 
 128        TREATMENT  OF LOCAL HYSTERIA.

 ing of life alternating with bright spirits. If the patient
 should be delirious, I give Aconite and  Belladonna.  If
 the head be cold, I give Calcar., Veratrum, Agaricus.
   If the hysteric headache  be accompanied  with  ob-
 stinate  sleeplessness and nightly canine hunger. China
 is  indicated:  Silicea, when there is much heat in the
 head, and rush of blood to the head; and Hepar sulph.,
 when these symptoms are accompanied with a crowd-
 ing of ideas upon the mind.   When sopor is present,
 Opium is excellent,  particularly for stertorous breath-
 ing with open mouth and distorted, open eyes : Anti-
 monium  tartar,  for  an  irresistible drowsiness even in
 the open air, in the day-time and evening; the patient
 cannot even keep herself awake by pulling the eyelids
 apart;  Magnes. art if,  (Northpole), Veratr., Caust.,
 Bellad.,  Sepia, Acid, phiosph., Puis., etc.
   § 246.  2) Hysteric states of the mind.
   For the  frequent repetition  of certain  syllables,
 words,  sentences, tunes, I do not know of a single
 remedy which I could recommend,  since  such a state
 has never occurred in my practice. For the  loquacity
 of hysteric females  I have  used with  advantage Ar-
 senic, Belladonna, Hcpar  sulphi. ; for  a difficulty of
 speech, either from want of words or voice, Cannabis;
 for a feeble, imperceptible, heavy, stuttering speech,
 Secale corn.;  for difficulty of speech, with jerks of the
 head and arms when uttering  the words, Cicu/a virosa.
 A melancholy mood in  hysteric females requires, ac-
 cording  to  the characteristic symptoms,  Viratrum,
 Hyosciam., Stramon.,  Bellad.,  Hellebor.,   Anacard.,
 Opium,  Aurum,  Platin.
  Nymphomania belongs to these disordered states of
 the mind.  It occurs very seldom, and is only seen in
 its  most violent form  during confinement.  It may
 likewise occur as a local hysteria. Such an unnatural
 excitemei t of the sexual instinct, attended with affec-
 tion of the brain and consequent delirium,  voluptu-
 ous titillation  in the sexual organs, anxious oppression
 and palpitation,  is  frequently  removed  by  Platina,
without the help of any other  medicine. It may like- 
            TREATMENT OF LOCAL HYSTERIA.        129

wise be used during confinement,  though Bellad. and
China may likewise be indicated, particularly  when
a thin, fetid ichor  is secreted  instead of the regular
lochia.   Veratrum  is indicated when the lochia are
suppressed  or very scanty  during the nymphomania,
attended with delirium.  If the lochia should be sup-
pressed,  and the secretion of milk in the breasts de-
crease, attended with a painful sensitiveness  of the
external  and internal sexual parts, Zincum is the best
remedy;  this is likewise  the case when the  disease
had been occasioned by onanism,  and when the men-
ses, after having been suppressed  for a certain length
of time,  reappeared suddenly with alternate paleness
and  redness of  the  face,  and violent cutting and
pressing  in the  abdomen and  small  of the back.
  If  nymphomania should  arise from some  of the
many abdominal ailments to which  hysteric females
are subject, Gratiola might perhaps prove efficacious.
  For nymphomania caused by sexual excesses, onan-
ism,  or   by  an  unsatisfied sexual  desire,   China,
Conium,  Anacardium, Staphysagria, or perhaps Aurum,
Thuja, Mercur., Ignat., Nux  vom.,  Hyoscyam., etc.,
may prove useful.
  § 247.   3) Hysteria spinalis.  This is generally,  as
I remarked in § 242,  a drawing  pain  along the
spinal column, upwards or downwards; but  it may
change to some  other pain, or be a different pain from
the commencement.  For hysteria spinalis I recom-
mend Bell id., Dulcam., Digit., Capnc, Tliuja, Mer-
cur., Sulphur, Carbo veg.—If the pain should be ac-
companied with  spasmodic contractions of thcmuscles,
cramps in the calves, Ipec, Cuprum and Secale  should
be considered.   If  the pain  should be attended with
paralytic conditions, neuralgic affections of the tho-
racic and  intercostal nerves,  nerves  of the  articu-
lations, Dulc, Rhus L, Plumb., Stann., Squiila, etc.,  or
Puis., Ignat., Ars., Moschius, Caust., Cicut., deserve  to
be mentioned.
  § 248.   4) Uterine  hysteria.  To the remedies men-
tioned in § 244 I will add the following:
           6* 
180        TREATMENT OF LOCAL HYSTERIA.

  Cocculus,  for suppressed or scanty menses, with op-
pressive abdominal spasms,  flatulent distention of the
abdomen, laming weakness of the uterine region, an-
guish, oppressed breathing, spasms of the chest, etc.
  Causticum, when the menses are retarded, and the
following symptoms  are present: violent cutting in
the abdomen  as if all  the contents of the  abdomen
would be torn to pieces, with  a bruised feeling and
tearing in the back and  small of the back, particular-
ly during motion and discharge of coagula, or attended
with pains in the stomach, chest or small of the back,
obliging her to bend double, sensation  of oppressive
fulness in the abdomen as if it would break,  constant
ineffectual attempts at eructations, aggravation of the
pains when eating ever so little, or when standing
erect  or  fastening the clothes  round the hypochon-
dria, relief being obtained by applying  warm flannel
and sand.
  Phosphorus:  retarded menses,  cutting colic on the
right side, towards the small of the back, violent pain
in the back as if bruised,  with  vomiting, palpitation
of the heart, and anxiety, etc.
  Acidum phosphor, may be substituted for Phosphorus
when the above symptoms  are  accompanied with
meteoristic distention of the uterus.
  Pulsatilla and Sepia have already been recommend-
ed for uterine hysteria, (see § 244).
  Stannum: Uterine spasms, characterized by repeat-
ed pressing deep in the  abdomen, aggravated by ex-
ternal pressure, and accompanied by a constant and
debilitating leucorrhoea.  The uterine distress  is ge-
nerally accompanied by a crampy, tensive pain below
and above  the umbilicus, towards the  small  of  the
back, relieved by stretching the trunk, extending  the
arms and pressing the  abdomen  against something
broad and unyielding, a table for instance.  Stannum
proved of little  use to me when the patient complain-
ed of a digging stitching  in the abdomen, at times on
the right, at others on the left side.
  Stramonium is excellent for  uterine  spasms with 
            TREATMENT OF LOCAL  HYSTERIA.        131

 profuse menses, hysteric states of the mind, and glo-
 bus hystericus.
   Magnes.  mur., Conium and Ignat. should not  be
 forgot in uterine hysteria.*
   § 249.   5)  Hysteria  vesicalis.   The statements  of
 the patient are not  always sufficient to enable us to
 distinguish  between  an inflammatory and spasmodic
 affection of the kidneys and bladder.   In such a case,
 all we can do is, to take a careful record of the symp-
 toms of the disease,  and to select a remedy in  ac-
 cordance with those symptoms.
   The remedies which the patient had better try first,
 are :  Cantharides, Mercur., Hepar s., Bellad.,  China,
 Mezereum, Colocynth., etc.—Zincum  is  excellent for
 burning pains,  though it may likewise be  tried for
 pressing-stitching,  and  lancinating  sore  pains.—
 Stitching pains in  the  renal  and lumbar regions are
 cured by Zincum,  Lycop., Canthar.,  Dulcam.,  Acid.
 sulph.
   For hysteric ischuria  and  stranguria:  Canthar.,
 Arnica, Digit., Pulsat., Nux vom., Camphor.,  Colch.,
 Sassap., etc., are the best remedies. (See § 177 and 223.)
   § 250.   Hysteria intestinalis.  The same treatment
 should be pursued here, which has been recommended
 for neuralgia of the abdominal  nerves. (See  §  196
 and subseq.).   The same remark applies to
   7)  Hysteria gastrica (see § 216) ; and to
   8)  Hysteria pulmonalis ; (see § 230.)  To this class
 belong the frequent nocturnal paroxysms of asthma
 preceding hysteric fainting fits, though these fainting
 spells may likewise be occasioned by  a violent boring
 pain  at a small spot of the head,  as from a nail being
 driven in, or by a periodical pain  in the stomach and
 bowels.  For such paroxysms Ignatia is an excellent
 remedy.  Other paroxysms  of nightly anguish, parti-
 cularly in delicate subjects,  with whining disposi-


  * Magnes. mur. is a specific for spasms of the ligaments of the womb.
—Hempel. 
 132         ECLAMPSIA,  ACUTE EPILErsY.

 tions and want of animal  heat, yield  to  Pulsat. or
 Veratrum,  according to  the symptoms.*
   9)  Hysteria  laryngea.  I re fir  the reader to ca-
 tarrhal fever, catarrh, laryngitis, tracheitis,  bronchi-
 tis, phthisis laryngea, etc., where the treatment of
 cough,  hoarseness, aphonia, is minutely described.—
 For a lisping,  low  voice, and for the  frequent  and
 sudden giving out of the voice,  I recommend Phos-
phor., Platin.,  Ignat., Angust., Spong.,  Pulsat.,  An-
 tim. crud.
   § 251.  10) Hysteria cardiaca and vascularis.  Hys-
 teric females frequently complain of palpitation of the
 heart and anxiety in the region  of  the heart, some-
 times accompanied  with great nervousness and de-
 bility.  Aconite  is generally the best remedy for this
 condition.
   If the palpitation of the heart be accompanied  with
 an oppressive pain in the stomach, extreme nervous-
 ness, languor, coated tongue, anorexia, etc.,  China or
 Pulsat. will  have to be given.
   The palpitation is frequently  accompanied  with
 fainting, vanishing of the senses, general insensibility;
these symptoms,  which  are very evanescent, are re-
 lieved by smelling of Nux mosch., Moschus or Aconite.
 These phenomena generally constitute symptoms of a
 general hysteric illness,  which is  very frequently re-
 moved  by  Nux vom., to be repeated several times
 during the  treatment.  It is an admirable remedy for
 the hysteria  of a so-called virago.
   11)  Globus hystericus.   I  refer the  reader  to § 244
 for the remedies.
   § 252.  Eclampsia,  acute epilepsy.

              A.  ECLAMPSIA INFANTUM.
   The disease is divided into the precursory stage, the
paroxysms, and the intervals.
* Also tc Ipecacuanha.  Hempel. 
ECLAMPSIA,  ACUTE EPILEPSY
133
   Precursory  symptoms are either  wanting, or pre-
 cede the disease  for  a shorter or longer time.   They
 are: bad humour, whining mood, sudden starting as if
 in affright, starting during sleep, sleeplessness, screams
 without sufficient cause, frequent and rapid change of
 complexion, sudden  relinquishing of the breasts ;  or
 the following group  of symptoms will be observed:
 heat and redness of the gums during dentition, fever
 with eruptions,  vomiting, stool  looking like  stirred
 eggs, acidity of the stomach.—By the term " internal
 spasms"  we mean a distortion  of the eyeballs,  which
 the children roll upwards so that only the whites can
 be seen;  the facial muscles  are trembling, and the
 children  seem to smile during sleep ;  the breathing
 is anxious and irregular ;  after a violent interruption
 of breathing,  the children suddenly take a long and
 deep inspiration; their limbs twitch  during sleep,
 they clench their thumbs and toes, and  bend the feet
 towards the retracted abdomen.  We frequently per-
 ceive a peculiar livid colour around the mouth and
 eyes ; the nose and features become pointed.
   Paroxysm: An attack of eclampsia is very similar
 to one of epilepsy; distortion  of the features, staring,
 rolling and distortion  of the eyes ; throwing the head
 backwards, convulsive jerking of the  chest and ab-
 domen ;  panting breathing ; hoarse  cries, or  moan-
 ing, rigidity  and alternate shocks of the extremities.
 The face swells, becomes dark-blue, purple-red, gra-
 dually the whole  body assumes the same colour, and
 the jugular and  frontal veins  swell; hands and feet
 frequently  remain cold, though  the  temperature  of
 the skin is elevated.    Such  a paroxysm  should be
 termed: eclampsia cumhyperaemia, in contradistinction
 from eclampsia cum anaemia, with pale, sunken face
 and cold  skin; the conjunctiva  and cornea are de-
 prived  of blood, without lustre.  In the former variety
the spasms are rather tonic, tetanic ;  in  the  latter,
clonic.  The  convulsions proceed from the  face, or
the abdomen, or chest.
  Intervals: The  paroxysms  generally  last a few se- 
 134         ECLAMPSIA, ACUTE  EPILEPSY.

 eonds or minutes, sometimes a little longer ; they are
 followed  by languor or comatose stupefaction.  The
 interval is sometimes very short,  during which  the
 symptoms of  cerebral congestion  continue, such as:
 hot face, injected eyes, restlessness or constant sopor,
 fever,  etc.  The more  frequent the paroxysms,  the
 more violent.  In many cases the very first paroxysm
 terminates fatally.
  § 253.  Etiology :  Convulsions occur most frequent-
 ly among infants, and among children of  from 3 to  4
 years.    In  many  cases  the  disease is   hereditary,
 and the disposition to such diseases  is said to be known
 by the large skull, retarded closing of the fontanelles,
 white and delicate skin, feeble muscles,  glossy eyes,
 rapidity of motion,   frequent  starting,   particularly
 during sleep, frequent internal spasms, rapid develop-
 ment of  the  mental faculties.   Other  causes are:
 Emotions, fright, spasms of the mothers  and nurses,
 mechanical pressure of the head during confinement;
 abuse of spirits and narcotics, mental efforts.
  Also : Gastric irritation, hence the disease is apt to
 occur  during  the period of weaning; over-feeding,
 sour pap, etc.
  Convulsions which occur during the first stage of
 febrile  diseases, are no  more dangerous .than the
 chilly stage in full-grown individuals.  If convulsions
 set  in at  the close of the period of dentition, Syden-
 ham considers them as indications  that the smallpox
 is going to break out, but  that, on the other hand, the
 eruption will run a favourable course.
  Prognosis:  Very unfavourable, particularly among
 infants, and when the disease is hereditary;  convul-
 sions caused by poisoned milk, either of the mother or
 nurse,  are almost always fatal.   Convulsions from
 worms  or gastric irritation, are less dangerous; the
 least dangerous are  those  which occur  in the first
stage of febrile or exanthematous diseases.  There is
great danger when the  disease occurs without pre-
monitory  symptoms,  when the paroxysms take place
in rapid succession, are very violent, and do not even 
ECLAMPSIA, ACUTE EPILEPSY.
135
cease entirely during the intervals ; the child is in  a
constant state of sopor, the head is hot, the face re-
mains livid, the child distorts the eyes all the time,
boring with the head into the pillow. Robust children
are more dangerously attacked than  children with the
opposite constitution.
  § 254.   Treatment:  See p. 107, vol. i.   As I  said
under ''etiology," the milk of the mother  or nurse is
sometimes changed to  a momentary  poison for  the
child, by various physical or psychical  causes.  Pas-
sions, for instance,  make the milk so poisonous,  that
the infant, if nursing at that  instant, will  at once be
attacked with the most violent convulsions.   However,
if the nursing  be omitted for 3 or  4 hours, the danger
is generally over, or, if the milk  be  drawn  off by
means of a breast-pump, the infant  may then  be put
to the, breast  without danger.  I consider it  highly
improper to lance the gums during a paroxysm of con-
vulsions.   Cutting  teeth is the  finale  or summing
up  of a  process of development which  cannot be
hastened or facilitated by lancing the gums.  It is per-
fectly proper to undress the infant completely, in order
to ascertain whether the convulsions  are  caused by
the prick of a pin or by a tight bandage.
  The lighter kinds of convulsions and their treatment
have been mentioned in the article on dentition-fever.
I will point out a few more  medicines:
  Cina is indicated by a spasmodic,  dry cough which
had existed for some time, getting worse  constantly,
and finally leading to spasms in the chest, with con-
vulsions and distortions of  the  extremities, epilep-
tiform convulsions  with  consciousness and shrieks;
frequent,  involuntary emission of urine between the
paroxysms; worm-symptoms  were likewise present,
such as nausea, vomiting, occasional attacks of colic,
eructations, loss of appetite, restless  sleep, starting
during sleep,  cries, tossing about.
  Rtius tox.,  when  the child would like to  sleep, but,
scarcely asleep, starts as if in affright, great orgasmus
sanguinis, throbbing of the arteries, spasmodic twitch- 
136          ECLAMPSIA,  ACUTE EPILEPSY.
ing of the limbs and  muscles, lock-jaw, sometimes
increasing to opisthotonos.
  Arsenicum: Burning heat  of the whole body, the
infant  is constantly licking its dry  and parched  lips
with  its  tongue.   The  twitching  of a  single limb
during sleep is a characteristic indication  of Arsenic,
and frequently  precedes  for  a time  the convulsions.
A dose of Arsenic frequently prevents the convulsions,
and terminates the disease as if by magic.  The child
is very hurried in his movements,  expresses anguish
in his countenance, symptoms which likewise point to
Arsenic.   For further indications  I refer the reader to
symptom 273 in the Mat. Med.
  Arnica  is suitable when a previous affection of the
brain  had left the brain dull and  stupid, owing to the
presence of a secretion in the cerebral cavities ; other
indications are : tremulous uneasiness  in the  limbs,
obliging one to move them all the time  and inducing
the patient to cry out when the least  attempt is made
to touch them.
  Platina, an excellent remedy in neuralgia and neu-
rosis generally, is useful for spasmodic rigidity of the
limbs without  loss of consciousness, with spasmodic
yawning  and subsequent closing of the  jaws,  speech-
lessness, distortion of the eyes, involuntary motion of
the eyes and corners of the mouth.  During the inter-
vals the patients are always lying on their backs, and,
during their restless sleep, endeavour to uncover their
limbs  which are drawn up to the abdomen, with the
knees  apart, the face being pale and sunken. Platina
is adapted to eclampsia cum anaemia.
  Hyoscyamus is particularly indicated  when the  con-
gestion of the  head is characterized  by unusual  red-
ness and  bloatedness of the face, the child blavers a
good deal, the  abdominal muscles are  spasmodically
contracted, the convulsive movements of  the  body
affect  now one, now another part, attended with ex-
cessive wakefulness and involuntary emission of urine.
Hyoscyamus  is likewise indicated when the paroxysm 
ECLAMPSIA, ACUTE EPILEPSY.
137
was caused  by  sudden fright.   It  corresponds  to
eclampsia cum hypercemia.
  Stramonium is suitable for lock-jaw, complete rigi-
dity of the whole body, or  rigidity of the extremities
alternating with convulsive shocks ; the patient lies in
a deep sleep with, stertorous breathing, and a quan-
tity of urine is emitted ; these symptoms are generally
accompanied with great heat over the whole body,
the patient drinks a good deal, the tongue is very dry,
the features  are distorted as if from pain,  the face is
red and as if bloated, the tongue seems paralyzed, deg-
lutition is difficult.   Stram. is principally indicated
in eclampsia cum hypercemia.   t
  Cicuta virosa should be used when the child, having
been playful and well a moment before,  suddenly be-
comes rigid and  immovable ; in  a few minutes a state
of languor sets in, during  which the child becomes
prostrate.  This paroxysm recurs frequently and lasts
a little longer each time.   Cicuta is likewise  useful
in  frequently  recurring paroxysms  of  eclampsia.
During these paroxysms the  extremities, head and
trunk are moved and distorted in  a strange manner,
the face is  swelled and bluish, foam  is at the mouth,
and, after the cessation  of the convulsions, the child
looks  like insensible and dead.
  Stannum :   the convulsions come on whenever the
child cuts a  new tooth,  increasing in violence  each
time ; the child suffers of spasms more or less general-
ly, and looks feeble and miserable.
  Cuprum metallicum : excellent  in the  most violent
convulsions from dentition, the whole head is bloated,
and the face red and swelled, the child utters crowing
screams;  the attack  is preceded by loathing and
nausea, and a lethargic state, or a quantity of phlegm
is forced up ; when  consciousness  returns, the child
writhes,  screams, the abdomen is distended, with in-
voluntary discharge of thin stool, occasional convul-
sive movements  and distortion  of the limbs ;  these
symptoms are succeeded by new  paroxysms, during
which the child  is without consciousness. 
138       ECLAMPSIA OF  PARTURIENT  WOMEN.

  A principal remedy for such convulsions is Zincum.
We give  it for  the  lighter paroxysms, characterized
by screams, shrieking during sleep without the child
knowing any thing about it; but,  if it should wake
up, its  features  express  fright,  it looks about with
great anxiety, as if waking from frightful dreams;
the child's body is very  hot on putting it to bed in the
evening ;  in the day-time  there had been a  good deal
of muscular twitching, more on  the right  than the
left side ;  for several days previous the child had been
irritable,  peevish, whining, eating with a ravenous
appetite, swallowing hurriedly, the abdomen distended
as if from flatulence; with  involuntary  discharge of
urine.

    § 255.  B. ECLAMPSIA  OF PARTURIENT WOMEN.

  This disease depends upon a  congestive  state, in
contradistinction from  hysteric spasms, and spasms
caused by exhaustion or loss of blood.
  The precursory symptoms generally point  to  con-
gestion of the  brain, characterized by intolerable pain
in the forehead  which  sets in suddenly in the most
violent degree;  vertigo, heat in the head;  halluci-
nations, scintillations, ringing in the ears, diminution
of sight even unto blindness, difficulty of speech, feel-
ing of lameness  in the extremities.  The patient is
out of her usual  mood,  melancholy, she  treats those
around her with  indifference, her  eyes are  staring,
with dilated pupils.  The  patient complains of a dis-
agreeable sensation and pain in the praecordial region,
nausea,  vomiting,  pressure and pain in the hypo-
gastrium,  sensitiveness of this region to  external  con-
tact ;  the pulse  is irregular,  or hard  and  full; in
parturient females the  eclampsia is  sometimes  pre-
ceded by a violent chill.   In some cases these precur-
sory symptoms  precede  the paroxysm  for  days,  in
others for a few  hours or minutes only ; they  may re-
main  away altogether;  the shorter the precursory
stage, the more dangerous the paroxysm. 
         ECLAMPSIA OF  PARTURIENT WOMEN.       189

  This paroxysm is almost like epilepsy.   Automatic
movements of the muscles  take place ;  first the abdo-
minal muscles, proceeding from the uterus ;  after that
the spasm extends towards the chest, and the patients
feel as though the chest were constricted, with violent
palpitation of the heart;  finally the spasms involve
the neck, which is drawn backwards, and  then  go to
the, head and the extremities.  A striking phenomenon
is the deep, livid redness and swelling of the face and
neck, violent throbbing of the temporal and  carotid
arteries, turgescence of the jugular veins, congestion
and  protrusion of the  eyes; the patients become ab-
sent-minded,  alternately delirious  and  in  a state of
sopor; this  condition  lasts more  or less  before the
patient  recovers her consciousness and complains of
headache, languor as  if she could not use  her limbs ;
she has  no recollection of the past.  Another parox-
ysm sets in shortly after ;  if  the  paroxysms should
occur in rapid succession,  the consciousness does not
return completely.
  § 256.  Etiology: It  is very probable that certain
states  of the weather,  particularly great warmth
and  an electric state of the atmosphere, favour the
development of the disease.  It occurs between the
period of conception and the period closely following
the birth of the  infant.  It occurs  very  rarely in the
first months of pregnancy,  only  towards  the fourth
and  fifth month ; it occurs more frequently about the
seventh and most frequently during the  act of partu-
rition; it  does not take place any  more  a few weeks
after  parturition.  Robust,  plethoric, irritable females
are most liable to  this disease.  Convulsions of de-
licate and feeble parturient women are generally of
an hysteric character; primiparae are mostly attacked,
and  then most frequently  during  the  act of partu-
rition ; when  occurring during confinement,  the dis-
ease  sometimes constitutes the  commencement of
puerperal fever.
  Prognosis.  This disease is  one of the  most dan-
gerous which can befal the female sex.   Generally 
140        ECLAMPSIA  OF PARTURIENT WOMEN.

speaking, one  half of the patients die, and the fret us
is  generally  destroyed  when  exposed  to  several
paroxysms.  It is said  that eclampsia occurring be-
fore  the  opening of the os tincae, is more dangerous
than that which occurs at  a later period of the act
of parturition.   The more advanced the act of par-
turition,  the  less dangerous  the  convulsions.   The
prognosis is the more unfavourable the more violent
and  protracted the paroxysms ; the more  marked the
venous phenomena, the more profound the sopor ; the
more oppressed the breathing after the paroxysm, the
shorter the remissions between the paroxysms.  Pri-
miparae  are the most exposed.
  §  257.  Homoeopathic treatment of eclampsia par-
turienlium : The remedies which require to be  used
in this disease,  must of course be  such as are ca-
pable of  affecting the nervous system and the  circu-
latory functions  similarly to the disease under  consi-
deration.  Such remedies are :  Opium, Laurocerasus,
Stramon., Hyoscyam., Bellad., Aconit., etc.  The suit-
able remedy should be continued  as long as  it is in-
dicated,  and the physician should  remain at  the bed-
side  of the patient  until the  danger is so far over
that he  can leave his  patient without being obliged
to fear any indiscretions being committed by  the at-
tendants in the administration of the medicine.
  Belladonna is  one of  the principal  remedies in this
disease.  It is particularly suitable to young married
women and primiparae with mild disposition, delicate
skin, vivid complexion, moist eyes.  The eclampsia
for which  Belladonna is  a  specific remedy, is cha-
racterized  by:  convulsions,  spasms with cries, deli-
rium, distortion  of the  eyes, stretching of the  limbs,
opisthotonos, etc. ; loss  of consciousness, insensibility,
rattling  breathing, deep and livid redness,  swelling
of the jugular veins,  bloatedness  of the  face, strong
and  quick pulse, and violent throbbing of the carotids
and  temporal arteries.  Even if the eclampsia should
abate,  the  loss  of consciousness  still continues, also
the obscuration  of sight, the patient neither  sees nor 
          ECLAMPSIA OF PARTURIENT WOMEN.       141

hears,  does not recognise any one of her family, from
which  we may infer that the sopor still continues.
  Hyoscyamus  is suitable when the spasms  of preg-
nant and parturient females, particularly of the latter,
set in after a good deal of blood had been lost during
the act of parturition ; the spasms resemble jerks that
are felt like shocks, which  continue even  when the
body of the  patient is in a  state of tetanic  rigidity ;
when the spasms abate, the face  becomes pale, the
body collapses, though  a complete  stupefaction  and
loss of consciousness, a real sopor, continue  during the
intervals.
  Stramonium corresponds to eclampsia which is si-
milar to  a paroxysm  of delirium tremens.   The cir-
culation is in a state of erethism.
  Opium is  sometimes an excellent remedy when the
disease was caused by sudden fright  or joy ; it  can
likewise  be  used as  a fine  palliative in some cases ;
a few strong doses of Opium will postpone the parox-
ysms,  and this may afford the vital powers time to
react  effectually  against  the  disease  without  any
further medicine.
  Laurocerasus is indicated when the eclampsia comes
on suddenly, like a flash of lightning; either before or
during parturition  the  patient  is suddenly  attacked
with tetanic spasms and loss of consciousness, mingled
with violent convulsions;  the  spasms return every
fifteen minutes, but the  patient's  consciousness re-
mains  disturbed during the intervals.  The body is in
a state of collapse, the pulse  being  at times feeble
and hurried, at others scarcely  perceptible and scanty.
In such  cases  Laurocerasus or hydrocyanic  acid, in
small  doses,  is  perhaps the only remedy  which can
effect  a  cure.
  Aconite is a most distinguished remedy for eclamp-
sia ; the symptoms of Aconite are so well known,
that it is needless to repeat them here.  For  other re-
medies, I refer the reader to the chapter on eclampsia
infantum.
  It is of the utmost importance to endeavour  by all 
142       CHOREA ST. VITI,  SCELOTYRBE, ETC.

proper means  to excite a uniform sweat all over the
skin.   It is therefore highly improper to uncover the
patient unnecessarily during delivery, as it would be,
on the  other  hand,  injudicious, to excite an  undue
temperature of  the  skin  by warm drinks,  excessive
temperature of the room, feather-beds, warming pans,
and the like.   Act calmly and considerately !

  § 258.   Chorea St.  Viti, Scelotyrbe, Choreomania,
Epilepsia saltatoria,  Morbus gesticulatorius, St. T itus'
dance.
  According to Canstatt there  are four distinct varie-
ties  of chorea:
     1)  Muscular jactitation, or the  minor St. Vitus'
          dance;
     2)  the major St.  Vitus' dance ;
     3)  Mania saltatoria; and
     4)  Tarantism.
  Symptoms of the first variety ; precursory symptoms:
derangement  of the digestive functions, distention of
the  abdomen, loss of  appetite, constipation, frequent
weariness, absence of mind,  low-spiritedness,  mental
excitability, anxiety.  This  condition may last for
weeks, and even longer.  The  patients are  rarely at-
tacked all at once,  except  perhaps  after  a  violent
fright; they gesticulate in a strange manner, hands and
feet  are unsteady; they shrug  their shoulders, throw
their hands  about,  drag  one  foot after  another  in
walking.   These phenomena  sometimes take place
only  on one side.  Soon, however, the gesticulations
increase to continuous twitching and strange motions
of the whole body; the patients eat, talk and walk in
a most awkward manner; they seem clumsy and lu-
dicrous.  Every  attempt  at  voluntary  motion  at
once excites the involuntary restlessness of the affect-
ed part.  By holding the part, the involuntary motions
increase ; this likewise takes place when the patients
suspect they are observed ; anger and fright increase
them  likewise.    Sometimes one  side  of the  body
twitches more than the other, or the twitching alter- 
CHOREA ST. VITI,  SCELOTYRBE, ETC.       14S
 nates from one side to another ; in some cases a series
 of  muscles are attacked one after the other.  The
 patients never complain of fatigue, even if the motion
 of the limbs should have been ever so constant.  The
 spasms generally cease during sleep, although, in bad
 cases, the sleep  is sometimes disturbed.  After a meal,
 the muscular jactitation is worse.   If the disease last
 a long  time, the  face becomes  pale, the  pulse  is
 hurried  towards evening, the patient becomes  thin.
 Wichmann terms this  chwrea Anglorum.  Schoenlein
 terms this and the following form hysteria muscularis.
  Symptoms  of chorea St. Viti  major.   It is parox-
 ysmal,  like epilepsy and  eclampsia, from which  it
 cannot  always  be easily distinguished.  The parox-
 ysms are a mingling of clonic and tonic, epileptiform,
 tetanic  and opisthotonic spasms, or a combination of
 the strangest motions;  the patients dance,  crawl on
 all  fours ; they act as if they would fly, swim, they are
 tossed off the floor, make the wildest leaps, turn  sum-
 mersets, laugh  in an  extravagant manner, imitate
 the  sounds of animals. Even the most  violent pa-
 roxysms do not cause any fatigue.  The patients are
 disposed  to  hide themselves in  corners  or behind
 other objects.  Intermissions  of several  days  occur at
 times.  The paroxysms take place both at night and
 in the day-time.   Symptoms  of mental  derangement
 are:  excitement of  the fancy, delirium,  craziness,
 somnambulism,  ectasy. After the paroxysm, the pa-
 tients are generally ignorant of what had taken place.
 This species of St. Vitus' dance sometimes disappears
 quite suddenly,  and the patients are cured.
  Mania saltatoria.  " This  mania showed itself  in
 its most  extensive and striking form in 1374 and 1418,
 immediately  after the terrors of the black plague, in
 Aix-la-Chapelle, in the Netherlands, Metz, Strasburg,
 etc.   The so-called St. John-dancers (whose numbers
 were swelled by impostors and mendicants), men and
 women,  danced for hours  in succession,  with  wreaths
 on their  heads,  and the abdomen  tightly bandaged,
jumping about  in the wildest  bacchanalian style, 
144       CHOREA ST. V1TI,  SCELOTYRBE, ETC.

foaming  and  screaming,   until they  fell  down  ex-
hausted.   Then  they complained of great oppression,
and moaned  as  if they would die, until the abdomen
was still more tightly  bandaged,  after which they
felt better.  The bandaging took place on account
of the  meteorism which set  in  after  the paroxysm.
Sometimes the  meteorism was relieved  by kicking
on the abdomen, or striking it with fists.  During the
paroxysm the dancers had  all sorts  of visions.   When
the disease  was at its  height, the paroxysms com-
menced with  epileptiform  convulsions, the  patients
fell down without  consciousness, with foam  at  the
mouth, stertorous breathing, after which they jumped
up  and commenced  their dance with frightful dis-
tortions.   In a paroxysm of religious mania they sang
during the dance, calling upon St. John for strength, in
whose  chapels the mania was appeased, and at whose
festival it afterwards broke out again."
  It is  said that a species of mania saltatoria occurred
in 1808  in the  states of  Tennessee and  Kentucky
among a sect of religious fanatics.  The mania which
Boerhaave observed  in the Leyden orphan-hospital,
the Bohnhorster St. Vitus'  dance described by Albers
in Hufeland's  journal,  1813, April No., p. 3, etc. etc.,
belongs under this head.
   Tarantism.  The  poison  of the tarantula,  when in-
serted under the skin, frequently causes a considerable
and intensely painful  swelling  spreading  over  the
neighbouring parts.  In a  few  hours melancholy,  an-
guish, oppression of the chest, vertigo, general tremor
set in ; the patients become convulsed  and  delirious ;
the pulse becomes  frequent and irregular; loathing
and vomiting supervene.   Unless help is speedily se-
cured,  the patients, in a few days, fall into  a  state of
imbecility and melancholy.  The heat of the summer,
and the sight of another  patient similarly afflicted,
excite  paroxysms of rage.  Music exercises a peculiar
charm over the patient;  it excites  a desire  to  dance,
which  he gratifies until  he feels tired and overcome, 
CHOREA ST.  VITL,  SCELOTYRBE, ETC.       145
and goes to sleep  covered with a profuse sweat; on
waking he generally feels well again.
  § 259. Etiology.  Persons with irritable nerves are
more particularly  liable to this disease, and women
more than men; children from9 to 15 years are princi-
pally attacked.  The  disease occurs  more frequently
in Northern than Southern countries.
  Exciting causes:  Fear, anxiety, fright; fright  is
one of the most powerful causes of the disease ;  imi-
f a five passion ; this always excites the major St. Vitus'
dance.  Worms or gastric crudities  never cause, but
only excite indirectly, the disease, provided the patient
was predisposed for it.
  Prognosis :   The disease scarcely ever terminates
fatally or leaves secondary diseases.  The prognosis
is most favourable  when the chorea occurs in the
period of  evolution; the prognosis  is less favourable
when caused  by  emotions or onanism.  The  first
variety  is more easily  cured  than  the second, parti-
cularly  when  combined  with symptoms of mania,
epilepsy.  Habitual chorea, termination in imbecility,
epilepsy,  cerebral affections,  scarcely allow  of any
hope.
  § 260.  Treatment:   In describing the treatment of
chorea,  I  shall not keep  up Canstatt's  classification,
but generally  describe the remedies which  have a
curative relation to St. Vitus' dance.
  The medicines which have been successfully used
in St. Vitus' dance, are:   Ignat.,  Cupr.  acet., Calc.
carb.,  Bellad., Asa, Sec. corn.,  Stram., Cina,  Crocus,
Hyoscyam., Rhus t., Caust., Jod., Puis., China, Sulph.
  Ignatia should be used  for chorea brought on by
fright.  Opium will  probably be found useful under
these  circumstances.  Ignatia is indicated when the
paroxysm comes on immediately after dinner, a charac-
teristic symptom  of the first variety, which is noted
by authors ; the symptoms abate when lying on the
baclc.   The vacillating  gait, the liability to  fall and
stumble  over  small   objects,  the  trembling,  the
twitching  of  various  muscles,  the  precipitancy of
      vol. rv.—7 
146       CHOREA ST. VITI, JSCELOTYKBE, ETC.

volition and the subsequent anxiety which the patient
expresses  in his movements, point to Ignatia.   Ignatia
is, however,  likewise a good remedy for the second
variety of chorea, which has often been cured by Ignat.
when caused by fright.  I may here observe that epi-
lepsy is probably very frequently mistaken for chorea,
and that a pretended cure of  epilepsy  was probably
one of chorea.  This, however, is of very  little con-
sequence,  as it is much better to know how to cure than
to know the disease without knowing how  to  cure it.
  Asa foztida is  of very  little use in chorea, except
perhaps where  an irritation of the abdominal nerves
by gastric crudities, worms or other causes, may have
led to chorea. There is sometimes abdominal pulsation
present, with twitching of single muscles,  or convul-
sive motions of the same.  The patients change their
minds constantly, are restless, and become easily con-
fused.
  Belladonna  is particularly  indicated  when the
twitching is observed in the flexor-muscles,  and the
paroxysms are preceded by  a creeping and a feeling
of numbness in  the muscles.  The moral symptoms
frequently point to Belladonna.
   Cuprum acet. or metallicum corresponds to twitching
of the muscles, sudden piercing cries, spasmodic dis-
tortions and motions of the extremities even  when
occurring at night, during sleep,  mostly commencing
at the  fingers and toes  and gradually changing to
convulsions  as  the body becomes involved, attended
with distortion of the mouth, alternate opening, closing
and distortion of the eyes.  Another species of chorea,
for which Cuprum is indicated, is the following : Red-
ness of the face, spasmodic distortion  of the face, eyes
and body, at times risus sardonius, at  others violent
weeping, anxiety, ludicrous gesticulations  and  desire
to hide one's-self. These symptoms are either attended
with melancholy and dread  of society, or with an
ecstatic mood.   Gross has reported a case of chorea
occasioned by fright, and characterized  by involuntary
motions of the  right arm and lower limb, gradually 
           CHOREA ST VIT1, SCELOTYRBB, ETC.       147

involving the other extremities, so that no part of the
body could be kept still while waking, all parts being
engaged in strange motions,  and even speech being
sometimes wanting.  Afterwards Gross recommended
Calcar. instead of Cuprum.  Bethmann cured the fol-
lowing case with Cuprum: the attack came on in con-
sequence of seeing a child in convulsions ; there was a
stitching  and burning in the left arm, followed by
violent convulsions of the arm, anxiety and weeping ;
the paroxysms returned 8 or 10 times within 24 hours,
the  fingers being seized first, afterwards the lower
limbs,  attended  with  heat in the face, sweat, thirst,
neck drawn to the right side, frightful distortion of the
eyes, face and body, afterwards some ludicrous exhi-
bitions, hiding under the table ; accompanied with ir-
ritable  mood, at times mild and  sensitive, at others
contrary.
  Agaricus muscarius  is indicated  by  the following
symptoms :  slight twitchings  here and there ; slight
distortion of the upper  extremities; convulsive con-
dition of the muscles of the head and neck,  constantly ;
extreme mobility of the lower  limbs, and the body
generally.  This medicine is  particularly useful in
mania saltatoria and tarantism.
  Secale cornutum.  In some  cases  I employed  this
medicine in conjunction with animal  magnetism,  and
always with a good success; the magnetism was par-
ticularly useful when whole bundles of muscles were
attacked at once, and even internal organs  were in-
volved.  The paroxysm, for which I prescribed Secale,
always commenced with oscillations of single muscles
of the face, increasing to convulsive twitchings which
produced distortions of either a frightful or ludicrous
character.  The  spasm then suddenly shifted to an arm
or foot, or to both arms or feet, causing a  dancing,
leaping or gesticulating motion  of those parts.  Or
the  spasm attacked the muscles of the chest and the
diaphragm,  causing loss of breath.   The spasm was
worst when affecting the abdominal muscles, in which
case it was always painful. 
148       CHOREA  ST. V1TI, SCELOTYRBE,  ETC.

   Cina is  very similar to Secale.   The  Cina-corea
frequently occurs  after dinner, in the  evening or at
night ; the  paroxysms  are  easily excited again  by
contact, or by pressing on the muscular parts that had
been  affected before.  It is useful when the intestinal
canal is irritated by worms or crudities ; the convul-
sions  of the various muscles of the extremities  are
attended with distortions of the  extremities,  and are
at times interrupted by colic.
   Stramonium should be used when  the patients  had
been complaining  of a creeping sensation in the limbs
for a  long time previous, with  impeded motion  and
melancholy mood.  These ailments  frequently  are
more  distinctly  felt at the  time of the fall-equinox,
and are soon followed by the chorea-paroxysm, which
has a peculiar character : it consists of violent, spas-
modic movements of the extremities, almost always
crosswise, of the left arm and  right foot;  afterwards
the head is attacked, or only the muscles of the lower
jaw, lips, etc. ; or the patient rotates her arms and hands
as if she would spin or weave.   Other symptoms are :
great mobility, the patient moves  about  so rapidly
that all  motion ceases at last, and the patient loses
her sight; she moves  about so hurriedly and with
such force, that she  is attacked with  anxiety  if she
cannot accomplish at once what she  wishes ;  sin1 runs
as fast as possible  if she wants to go from one place to
another; in going  up stairs, she  takes  two steps be-
cause she mistakes them  for one, and continues so
until  she falls; although her  gait is vacillating,  yet
she moves  her limbs  with an ease as if she had  not
got any; they seem to her elongated, so that  she
imagines she touches the floor when  her foot is  still
half a foot off. These symptoms include a great many
that point to chorea, particularly to  mania saltatoria.
Stramonium is likewise indicated  when the disease ter-
minates in idiocy and religious  mania.
  Hyosciamus corresponds to jactitation of the extrem-
ities,  as if the patient  did not know how to keep the
extremities in a proper position ; after the paroxysm 
          CHOREA ST. VITI, SCELOTYRBE, ETC.       149

 the patient lies  quiet, with his eyes closed.  During
 the intervals the movements of the patient are likewise
 very  hasty,  he seems exceedingly  busy, talkative,
 shows a disposition to laugh  at  every thing; and,  if
 the disease should last a certain  time, it terminates in
 idiocy, imbecility.
   Crocus.   With this remedy I cured one case of the
 following kind :  the patient  had  complained  of  a
 twitching  in the muscles for some  time  previous,
 which got worse at times and increased to spasmodic
 contractions  of single bundles of muscular fibres ; the
 patient suffered with bleeding of the nose, and felt the
 better the more profuse  it  was; the bleeding was
 preceded by a visible throbbing  of the temporal ar-
 teries and  a prostration of the child ; the blood was
 black  and tenacious.  Aconite,  Arnica,  China, etc.,
 were of no  avail ;  on the contrary, the symptoms
 seemed to get worse ; a few  doses of Crocus stopped
 the disease.  I was guided in the selection of Crocus
 by the cerebral congestion.
   China corresponds to chorea caused by onanism, or
 loss of animal fluids  by other causes ; the patients are
 nervous, very sensitive to external impressions,  etc.
   Causticum is  recommended by some physicians ; I
 have  never used it.
   Rhus  tox.:  Twitchings in the  extremities and
 muscles, unsteadiness of the  extremities, vacillation
 of the extremities when attempting to  stand  or walk ;
 it is particularly indicated for chorea  occurring  after
 a cold bath and repelled measles.
   Pulsatilla,  for the symptoms of which  I  refer the
 reader to the Mat. Med.
   Iodium is probably suitable  when the disease was
 partially caused by  a morbid state of the abdominal
 nerves, when the  stomach, liver, pancreas  and ab-
 dominal  glands are morbidly irritated, and the cerebral
 functions arc sympathetically  involved.  These patho-
 logical  states lead  to uneasiness in the limbs  with
 nervousness,   and  tremor from   the  region of the
stomach  to  the periphery;  trembling  of the ex- 
150       RAPHANIA,  MORBUS CEREALIS, ETC.

tremities,  hands,  fingers  and  eyelids ;  a vacillating,
unsteady  gait;  inability  to  move  the hand  to the
mouth  in  a  straight  line, pain on moving the body,
hurried, small,  wiry  pulse ; during rest the trembling
parts can  easily be held still;  the spasms are violent
in the back  and feet, with convulsive  twitchings  of
the  feet and arms,  occasional subsultus  tendinum,
sadness and lowness of  spirits,  particularly at the
period  of digestion.
   Sulphur might  perhaps be  tried  when the sudden
suppression  of  an acute or chronic eruption seems  to
have caused the disease.
   Chorea-patients are peculiarly  charmed by  music ;
chorea-paroxysms characterized by  dancing motions,
might perhaps be  cured by music*


   § 261.  Raphania,  morbus cerealis, convulsio cerealis,
ergotism.
   Raphania  is  a  disease  which is principally caused
by eating  spurred  rye.   There are  two  distinct
varieties  of the   disease,  the convulsive  and the
gangrenous  variety, the  former being probably caused
by Lolium temulentum, the latter  by Secale comutum.
The disease occurs epidemically at a period of famine,


  * Aconite is  a very useful agent in the treatment of chorea.
Very lately I cured two interesting cases of chorea with Aconite.
One was a case of three  years' standing, the  patient a girl  of
7 years; it  had come on after an inflammation  of the  lungs
treated alloeopathically.  The left arm was the seat of the dis-
ease ;  the patient  had no control over the  motion of this arm ;
there was a constant  twitching and jerking of the arm.  The
cure was effected in 3 weeks.   The second case was that of a
girl of 6 years.  For several  months past  the parents had ob-
served a good deal of twitching and jerking in  the left lower
extremity of the  child,  which increased gradually  so  that the
child was unable to stand or walk ;  she  could not sit still one
minute ;  the upper extremities were  similarly  affected ; she had
to be fed ; the mouth was constantly drawn to one side,  with
constant twitching  of the corners; the head was drawn close to
the left shoulder.   The  cure was effected  in  five weeks, with
the tincture  of Aconite.   Hempel. 
RAPHANIA, MORBUS  CEREALIS, ETC.       151
after a  bad harvest, and is caused by the use  of bad
food generally, and  spoiled grain in particular.
   Symptoms  of convulsive  raphania.    Precursory
symptoms :  Symptoms  of languor  and tiredness in
the extremities, frightful dreams, restlessness,  formi-
cation, stitching, cramps in  the  lower  extremities,
headache,  stupefaction, vertigo,  melancholy  mood;
constrictive sensation in the epigastrium, disposition
to vomit,  vomiting of a dark, or black-brown, imper-
fectly mixed bile.
   These symptoms belong to so many diseases, that it
would be  impossible to select  the proper remedy by
those symptoms unless we knew from other cases be-
fore us that they were the precursory stage of the dis-
ease.  In  such a case the right  remedy, if given at
the commencement, will cut the disease short at once,
without allowing it  time to  develop  itself.  Let us
describe the disease more in detail.
   The precursory stage lasts from 7 to  21 days, after
which the disease assumes its true form.  The pains
in the extremities become more  violent, and  extend
over the whole  body. The patient complains of an
intolerable  burning  in  the  feet,  knees and hands
tremble, and the upper and lower extremities are at-
tacked  by convulsive motions, particularly  the flexor
muscles,  so  that it  frequently takes a good  deal  of
force to straighten the limbs; the  heels  are forcibly
drawn to  the buttocks, the hands towards the shoul-
ders.  The  very painful spasms are at  first clonic:
sometimes the clonic spasms  are mingled with tonic
spasms, opisthotonos, trismus, strabismus ; a  bloody
foam appears at the mouth, as in  epilepsy, the eyes
are staring, or they are rolled about in a wild manner,
the, breathing  is   laboured,  etc.   Sometimes  the
patients retain their consciousness during these parox-
ysms, though, in some cases,  there  is headache, ver-
tigo, furious delirium, screams, mania, melancholy,
difficulty  of speech, stupor or coma, deafness, ringing
in the ears, optical illusions.  Sometimes a cold sweat
breaks  out on the  forehead  or the whole body, the 
152        RAPHANIA, MORBUS CEREALIS, ETC.

urine is discharged involuntarily, the face has a jaun-
diced or livid appearance.
  The  paroxysms frequently  last  for  hours,  recur
several times in the day, but sometimes intermit for
several days.  During the intervals the pulse remains
natural, the appetite is good, frequently  the  patients
have a sort of canine  hunger; in other cases, gastric
symptoms set  in,  such as cardialgia, nausea, violent
thirst,  heartburn,  bilious vomiting, colic,  diarrhoea,
evacuations of a foetid, liquid, yellowish matter; the
skin is icy-cold, internally the patients complain of a
burning heat.
  When the disease terminates  favourably,  the con-
vulsions abate; the disease lasts from 4 to  12 weeks.
Sometimes phlyctaenae,  filled  with an  acrid serum,
form on the skin.   For some time after, the  patients
continue to complain of  trembling of the hands,
weakness of the  eyes, stiffness of the  muscles  and
joints,  lameness, etc.  The disease terminates fatally
when the tetanic spasms continue, or when paralysis
or apoplexy sets in.
  § 262.  Symptoms of raphania gangrenosa (necro-
sis  ustilaginea).  The precursory stage  is  almost the
same as in the former variety : general malaise, tired-
ness, restless sleep with dreams, anguish ;  wandering
pains in  the back and lower limbs,  spasmodic con-
tractions of these parts,  frequent attacks of violent
pain and spasms, flushes of heat; pulse and appetite
are generally  unchanged ; the abdomen  is  sometimes
distended and painful ; the urine clear and copious.
  Gradually the convulsed limbs begin to  feel numb,
and the limbs that afterwards become gangrenous, are
exceedingly painful;  hurried, contracted, feeble pulse,
sweat  on face and head.   The patient complains of a
feeling of  icy-coldness in the hands and feet, nothing
can get them warm.  Erysipelas is sometimes seen on
the extremities.
  All at once  the pains in the extremities  disappear,
the icy-coldness increases, and sensation and motion
disappear; mostly  dry gangrene sets  in,  though in 
           RAPHANIA, MORBUS CEREALIS, ETC.        153

 some cases humid.   In  the former case, the limb be-
 comes  livid,  the  skin  is  withered,  wrinkled, turns
 yellow; finally, the limb becomes black, dry,  hard as
 horn.   In  the  latter  case,  (humid gangrene,) the ex-
 tremity  swells, phlyctaenae  filled with  a yellowish,
 bloody  serum,  form on the skin,  the  muscles become
 soft, and the gangrenous parts spread a most fetid odor
 of putrefaction.  The  pulse becomes  more and more
 feeble, the languor reaches the highest degree, symp-
 toms of a torpid putrid fever  set in,  the features be-
 come sunken, fainting fits,  delirium, coma, exhausting
 diarrhoea set in, and death  takes place with the symp-
 toms of gangrene  more or less extended.  Recovery
 is,  however, possible, before gangrene  sets in; and
 even after gangrene has set in,  the gangrened  limb
 may be separated  from  the healthy trunk by  sup-
 puration.  In dry gangrene, the dead  parts  fall off
 without bleeding;  in humid gangrene, the falling off
 is frequently accompanied with haemorrhage.  In many
 cases the  sick limbs remain mutilated,  atrophied, pa-
 ralyzed.  The gangrene  sometimes  extends  to  the
 toes,  hands,  feet, as far as the knee ; in other cases
 the  whole limb is lost.   If  the suppuration  should
 be very profuse, the patient may die of hectic fever,
 unless the suppurative process should be stopped in
 time.  (Canstatt).
  § 263.  Etiology: Raphania is an endemic disease,
 and occurs at periods when men have to be satisfied
 with spoiled flour, in consequence of war, famine, bad
 harvest or weather.  The  corn itself is either disor-
 ganized or it is mingled with poisonous plants, such
 as: Lolium temulentum, Raphanus  raphanistrum, Ni-
gella sativa,  Agrostemma githago, etc.   Disorganiza-
 tions  of  the  corn  take place by means of fungous
 formations shooting up on the grains, which may be
termed  Sclerotium clavus, Uredo caries,  Rubigo.   The
corn may  likewise get spoiled by moisture, fermen-
tation, insects, and, in  this way, its use may become
hurtful.
  There is no doubt that other causes concur in the
         7* 
154       RAPHANIA, MORBUS  CEREALIS, ETC.

development of raphania as an epidemic disease ; it is
principally met with  in marshy  regions, in certain
districts, and  among  men that are deeply sunk  in
misery.
  Prognosis: The convulsive variety  is less danger-
ous than  the  gangrenous.  The  more frequent  the
paroxysms, or the more they resemble epileptic tetanic
spasms, the less favourable the prognosis.  Favourable
symptoms are: phlyctaenae and cutaneous  eruptions,
sweat, diarrhoea.  In the gangrenous variety the prog-
nosis  depends  upon the. extension of  the  gangrene,
and upon the disposition of the gangrenous process  to
limit itself; humid gangrene is worse than dry.  Some
epidemies are particularly malignant.
  § 264.  Treatment.   The  precursory symptoms  of
raphania  resemble a good deal the precursory symp-
toms  of a violent inflammatory fever,  and will there-
fore induce us to give Aconite in small doses.  Arsenic
is perhaps preferable  to Aconite; it has the anxious
respiration, the spasmodic palpitation of the heart, the
peculiar coating of the tongue, the languor, etc., and
has been successfully used by homoeopathic physicians.
I think, however,  that it  is more adapted to the gan-
grenous variety.   Belladonna is likewise an important
remedy: it has the burning heat, the  violent, almost
unquenchable thirst, and  deserves a preference over
either of the other remedies, when the  nervous symp-
toms, the characteristic tremor of the extremities, the
contracted and immovable pupil, the clouds and spots
before the eyes are present.   Rhus tox. is indicated
when  the disease resembles  the typhus  stupidus,
without any  remarkable spasmodic symptoms being
present.
  Stramonium  and Hyoscyamus  are  important  re-
medies, corresponding  to the  spasmodic  symptoms
which make  their appearance soon after the com-
mencement of the disease.  Stramonium  corresponds
more  to the spasms which take place when the disease
is at  its height; Hyoscyamus should be  given at the
commencement of the disease. 
RAPHANIA, MORBUS CEREALIS, ETC.        155
   Subsequent observations have shown that the above-
 mentioned remedies are more suitable  for the second-
 ary diseases, particularly Belladonna  for a peculiar
 kind of stupidity and nervous debility.
   Solanum nigrum is recommended by Hahnemann as
 the most certain remedy for raphania.  In Archiv. XL,
 No. 1, p. 92,  Dr. Gross  reports several cases of
 raphania which  he  treated with Solanum nigrum; I
 extract the following from his report.
   " In the latter part of the summer of 1830 I  was
 requested to  send some medicine to a farmer who had
 been afflicted  for  some time  past  with  epileptic
 spasms and  rage.   I was told  by the messenger that
 a younger brother of the patient was afflicted with a
 painful creeping in the extremities with  curvature of
 the hands;  but  as  this  disease was very common in
 his district, and was considered incurable, I was not to
 prescribe anything for it.  Nevertheless I gave the mes-
 senger medicine for  this second patient, four pellets of
 Solanum nigrum of the 30th att.  I gave it on  Hahne-
 mann's recommendation  contained in his " Lesser
 Writings," published  by Dr. E. Stapf, vol. I., 1829,
 p. 162.   The epileptic patient was to take a  dose of
 Hyoscyamus, for it  did  not  occur to me that he  was
 suffering from the same cause as his brother.  In a
 few days the father of  my  patients reported to me
 that his younger son was  quite  well, and that the
 other son  had  ceased  raving, but was without  con-
 sciousness, and that his limbs were spasmodically dis-
 torted ;  two  other children  had been attacked as the
 second son, and I was requested to cure them likewise.
 I found out  that the elder son was likewise attacked
 with raphania, for  which  I  now gave him Solanum.
 Some time after I was told that all these patients  had
 got well, and I was  requested to treat a  number of
 other patients similarly afflicted, some  of whom had
 gone into the last stage of the disease, convulsions  and
 rage.  I cured them  all with Solanum nigrum.  After-
 wards I was called to  two patients in my neighbour-
hood, one of whom I had an opportunity  to examine. 
156       RAPHANIA,  MORBUS CEREALIS,  ETC.

He was a boy of six years, and had just been attacked.
His hands were bent inwards, and his feet likewise.
The boy was able to stand a minute or so, though the
involuntary contraction  of the  flexor muscles gave
him the appearance as  if he would jump.  There
were symptoms of risus  sardonius observable in  the
facial  muscles.  I gave  him Solanum nigrum 15, 2
  ellets.  Next day  he was unable  to stand,  and the
  ands  were bent inwards  more  than before.   On the
third day the symptoms were  as on the first, and on
the fourth  all symptoms  of spasm had disappeared.
It seems therefore that Solanum 30 acted better than
a lower attenuation."
  " Upon inquiry I am led to believe that the present
disease was very similar  to the  epidemic of 1770 and
1771  in the district of Zelle, and minutely described
by I. Taube in his " History of Raphania in 1770 and
1771, Gcettingen, 1783, oct."  With us the disease came
on suddenly,  without, however, being as  fatal as in
the former  epidemic; for then  it terminated  fatally
very soon,  if setting in without  precursory symptoms.
In both epidemics  were observed convulsions  and
afterwards tonic spasms,  curving inwards of the  ex-
tremities ;  for instance, the wrist-joint entirely bent
inwards, the fingers drawn to  the palm of the hand,
and the elbow to the chest, even tetanus; even epi-
lepsy, idiocy, rage were observed in some cases, and
indications  of risus  sardonius,  even  in  the  lighter
cases.   All these symptoms were removed in a  lew
days by Solanum nigrum.   Gangrene never occurred
in our  epidemic." For this condition. Secale cornutum,
as an  isopathic  remedy,  would probably afford the
best help.
  For  the highest degrees of this disease I dare not
propose  any remedies; the  symptoms characterizing
the last  stages of the disease, are too  various, and
too much mixed up with medicinal symptoms, pro-
duced by Valeriana, Camphora, Moschus, Opium, etc.,
which  are some of the remedies proposed for this dis-
1 
HYDROPHOBIA, RABIES  CANINA.
157
 ease, to admit  of any one remedy being exclusively
 recommended for the last stage.
   § 265.  The second variety of this disease is distin-
 guished  by longer  duration, distinct exacerbations,
 paroxysms and remissions.  I have seen a few mild
 cases of this  variety, but  always among low people
 who live in damp dwellings, on potatoes, potato-bread,
 etc.   Belladonna seemed to be a good remedy, but I
 had  to  use other remedies with it to effect a cure ;
 among others, Ignatia amara, which was particularly
 useful when the convulsive motions resembled those
 of chorea.   Cina was used in one  case with good
 success; the patient complained  of  crampy pains in
 the bowels, and vomited up some worms.  In a similar
 case, where the convulsive motions increased at every
 new paroxysm, I gave Cuprum acet. with great benefit,
 and, in  eight days, China for the remaining debility.
   Even  in this form  of raphania, Solanum nigrum,
 Secale corn, and Arsenicum are the specific remedies,
 particularly when dry or humid gangrene is present.

   § 266.  Hydrophobia, rabies canina.
   The disease arises  from the hydrophobic virus being
 inoculated in the bitten part.
   Symptoms of liydrophobia.  The first symptoms ge-
 nerally  manifest themselves between the 7th and 40th
 day after the bite; there  are said to be cases, however,
 where the poison  remains  latent in the system for
 years.  The precursory stage frequently lasts from two
 to twelve  days.  The wound heals very shortly, as
 every other slight wound.  If the  wound  should not
 be completely healed  while the precursory symptoms
 are  developing themselves,  it assumes  a livid and
 spongy appearance, and  secretes an ichorous humour.
 If the wound was closed, it inflames again and breaks
 open ; the patient complains of itching, pains striking
from  the  wound or  cicatrix along the nerve  to the
neck and trunk ; the  bitten limb frequently feels numb,
or as  if it had gone to sleep,  or it becomes rigid or is
convulsively moved. 
158         HYDROPHOBIA, RABIES  OAN1NA.
  General  symptoms : Anxiety, melancholy, tendency
to start, excessive apprehension  about his condition
and future  ; he wants to be alone, his sleep is restless,
interrupted by dreams (about dogs), and starting as if
in affright, or he is completely sleepless.  The patient
complains of languor, drawing  pain in the nape of the
neck and back, burning  sensation in  the fauces and
stomach ; sensitiveness to cold and draughts of air,
alternate heat and chilliness.  Frequently we observe
vertigo, ringing in the ears, obscuration of sight,  nau-
sea,  vomiting of green  bile.  The face is frequently
distorted, pale, the  eyes faint, the voice hollow and
trembling,   breathing  oppressed,  pulse  small,  urine
pale.   Many patients  manifest an uncommon desire
for an embrace, and a constant urging to urinate, the
urine being discharged drop by drop.
   Symptoms of the disease, when fully developed.  We
term  this  the convulsive,  hydrophobic  or  furibond
stage.  The patient shows the  most frightful aversion
to liquids, in spite  of his violent thirst; he cannot
swallow, nor see, nor hear the noise of any thing fluid ;
whenever  he  attempts  to swallow a few drops of
water, his  throat and chest  become constricted, and
the most violent, suffocative  convulsions of the facial,
cervical, thoracic and abdominal muscles take place ;
they  are  excited  even by merely swallowing saliva,
or by thinking of drink.  The patient experiences a
most  violent sensation of oppression of the chest, and
has to sigh frequently.  In some cases the convulsions
are excited by the least draught of air,  the motion of
the curtain,  contact of the  body; the eye dreads the
light; shining objects, looking-glass, a burning candle,
are painful  to the  patient,  and  excite  his spasms ;
every kind of noise is unpleasant to him ; hence  it  is
that frequently, without any apparent cause, periodical
paroxysms of spasmodic  oppression, constriction of the
fauces  and larynx set in.  At  first there is a constant
secretion of a thick,  tenacious, frothy saliva ; hence
slavering and spitting, for fear lest the saliva should
have to be swallowed. 
             HYDROPHOBIA, RABIES OANINA.         159

   At last  rage breaks  out, and tetanic or epileptic
convulsions take place ;  periodically the patient is at-
tacked with furibond delirium, during which his mus-
cular strength increases  to  an enormous extent, and
he can scarcely be controlled ;  at the same time he
spits  about, bites, endeavours to escape from his at-
tendants, tears clothes and beds, howls,  barks  like a
dog, and endeavours to destroy himself;  his bloodshot
eyes roll wildly in their sockets, and fright is depicted
in the features of the patient.  He is  frequently at-
tacked  with epileptic convulsions or  tetanus.  The
attacks last  a quarter or half an hour.  During the
intervals the patient is entirely exhausted;  he is ge-
nerally conscious  of himself,  warns his attendants of
the danger to which his  rage might expose  them, and
prays  them  to terminate  his  frightful  sufferings.
Sometimes vomiting takes place, and men are attack-
ed with priapism and seminal  emissions, and women
with furor uterinus.   The pulse  is up  to  130 to 150
beats, small, irregular.   As  the disease  increases, the
paroxysms become  more frequent and violent, until
death ensues after 24 hours, two or three, and less fre-
quently five to eight  days, generally  by exhaustion
(apoplexia nervosa); towards the end the patient some-
times becomes  quiet,  is even  able to drink, and dies
quite composedly  in  a state of sopor, or in a violent
paroxysm of convulsions, suffocated.  Modifications
occur in this disease  as in any other, but the  symptoms
are the same, except more or less intense: for instance,
in some cases the patient is able to swallow, in others
he is able to  swallow  coffee, beer  or solids,  but no
water ;  or the hydrophobic symptoms only occur dur-
ing the paroxysms ; or the patient is able to swallow
water, provided he does not see it and his nose is kept
closed.  There are cases where the disease did not
break out,  but the cerebral affection was confined to
anguish and sensitiveness; this is  probably the case
when the patient,  after being bitten  by a dog, is tor-
mented by the fear that he will be attacked by the dis-
ease ; this might be termed an imaginary hydrophobia. 
160         HYDROPHOBIA,  RABIES CANINA.

  § 267.   Anatomical changes : The bodies of hydro-
phobic subjects generally decay  very rapidly ;  the
blood is  dark, fluid, and is rapidly  imbibed by the
tissues;  the veins  are engorged.   Air is  frequently
found in  the larger vessels,  and emphysema develops
itself rapidly.  The  whole  surface  of the body  is
blue-red, the epidermis very dry,  all  tjie muscles are
dark-red,  and,  like the tendons, they are rigid  and
tight.
  Causes:  This  disease  develops  itself spontane-
ously among  the  canine and feline races.  Spon-
taneous rage has been observed among every species
of those races, wolves, foxes, jackals  and cats.  The
virus can be  transferred to men  and to all sorts  of
warm-blooded  animals, horses, cattle, sheep, swine,
goats; but  animals that live  on  vegetables do not
seem to reproduce the virus.   The same remark ap-
plies to man, and all the observations which have been
gathered on that subject, go to  show that the  bite of a
man is not dangerous.
  The primary cause of this disease is not known.   It
is supposed that it can be excited by excessive heat  or
cold,  unsatisfied  sexual instinct,  decayed food,  de-
privation  of fresh meat, want of water in  very hot
weather.
  The rage of dogs is either raving or  silent.  Former-
ly it was supposed that a mad dog dreaded the water,
that he had foam at the mouth, that  he took his tail
between  his hind-feet, and  went  straight on in his
course.   All this is either false or only partially true.
We now know that dogs, even  in the  last stage of the
disease, do not always  dread the  water ; on the con-
trary, real hydrophobia only attacks  man.   Foaming
at the mouth  and slavering occur only among dogs
attacked  with  silent rage, etc.
  Other and more important symptoms of hydrophobia
among dogs are :  Alteration in their conduct, restless-
ness, constant  roving about, escape from their masters,
loss of appetite, devouring of  things  which  are not
natural food for them, such as wood, straw, dirt, etc. ; 
HYDROPHOBIA, RABIES CANINA.
161
constipation,  vomiting,  a  peculiar rough,  hoarse,
howling bark, disposition  to attack and bite people,
hasty snapping at inanimate  objects,  altered, lean,
shaggy, sleepy appearance, redness of the conjunctiva,
photophobia;  in  dogs attacked with silent rage,  the
lower  jaw is moreover depressed  as if paralyzed;
they blaver, the tip of the tongue  is  protruded  be-
tween the teeth, and finally the hind-legs  are para-
lyzed.   Dogs  attacked with  rage, die  after six or
eight days, and sometimes even before that time, in
an apoplectic fit.
  The following anatomical  alterations have been
discovered in the bodies of mad animals : dark, tarry
blood ; inflammation of the pharynx, tonsils, epiglot-
tis, larynx and mucous membrane  of  the  stomach;
pieces of undigested food in the stomach. Sometimes
the duodenum and jejunum were found inflamed ;  the
trachea  and bronchi were filled with  a  tenacious,
bloody  foam, congestion  of  the brain and  spinal
marrow.
  The hydrophobic virus is transmitted  by the saliva
or blaver  being  applied  to  a sore  or a part covered
with a very delicate epidermis.  Contact is  necessary
to establish the infection.  The flesh,  spleen,  or  the
substance of the nerves, do not contain any virus.   It
has no  poisonous effect when received into the  sto-
mach.   A  peculiar  predisposition on the part of the
poisoned subject is likewise necessary to  create  hydro-
phobia.   Not every bite of a mad animal is contagious,
if the necessary  susceptibility be wanting.  Hunter
relates that four men and twelve dogs were bitten by
a mad animal: all the dogs died, but the men remain-
ed uninjured.  In another  case, twenty individuals
were  bitten by  the same dog, but  one  only was
poisoned.  It is probable that the virus loses of its in-
tensity,  when several animals  or men  are bitten in
succession,  and that those only who were bitten first,
are poisoned.  Age,  sex or constitution do not  modify
the action of the virus.
  The hydrophobic virus retains its infectious power 
162         HYDROPHOBIA, RABIES CANINA.
for a  long  time ;  it  attaches  itself to straw,  wood,
clothes and other substances covered with the blaver
of the mad animal; in this  way the disease may be
communicated a long time after a mad beast had been
seen on the spot.
  Physiologists differ as to the period how long the
virus  can remain latent in the organism before mani-
festing its destructive agency.  This rarely takes place
before the tenth day ; according to some it has  re-
mained latent for months and years.   This, however,
may be  an illusion,  for hydrophobic  symptoms may
supervene  while  some  other disease exists, and may
thus lead to the belief of hydrophobia having  set in.
Spasms  of the pharynx with dread  of swallowing
liquids, are observed in hysteric patients, individuals
affected with typhoid and other fevers, local diseases
of the pharynx, oesophagus, nervus vagus.—The  de-
velopment of hydrophobia in man can be hastened
by excesses, emotions and passions, anger, fear, fright,
sexual intercourse.  (Canstatt.)
  Prognosis:  Not very favourable.  Not every indi-
vidual   is poisoned by the bite of  a  mad animal.
It is not probable that, if no  ill effects have been ob-
served for months or years after  the bite took place,
the disease will break out.
   § 268  and 269.  Treatment: Hahnemann says in his
preface to Belladonna : " A small  dose of Belladonna,
every three  or  four days, is the  best  preventive of
hydrophobia: one  or  two doses  of  Belladonna will
cure it."   Belladonna, however, not being the only re-
medy for  this disease, it may break out even  though
Bellad. should have been taken as a preventive, but it
will probably be very much modified in intensity,  and
will then be easily combatted.
   The treatment should be both external and internal.
The  external  treatment,  in   homoeopathic practice,
consists in washing the wound, and afterwards cover-
ing it with lint or some fresh unsalted butter or simple
 ointment.   The internal treatment must be conducted
 in accordance with  the state of  the  patient.   If th' 
HYDROl'HOUIA,  RABIES CANINA.          163
patient had already  been treated  with the plaster of
Cantharides or had been salivated, the homoeopathic
remedies have to be chosen with reference to the re-
sults of that treatment.   It should be observed, that
under homoeopathic treatment, the patients experience
no pain from the treatment; whereas the alloeopathic
treatment  inflicts upon them untold tortures.
  The principal remedies for hydrophobia are:  Bella-
donna, Hyoscyamus, Stramonium,  Cantharides.
  Belladonna  is  principally  indicated by the follow-
ing symptoms :  ineffectual attempts at sleep, anxious
breathing,  frequent desire to drink, though the pa-
tient  rejects every drink which is  offered ;  burning
sensation in the throat with great dryness, red, bloat-
ed face and glistening eyes; excessive thirst with suffo-
cative constriction  of the throat on attempting to
swallow liquids;  (this constrictive  sensation  in the
throat does  not exist continually, but  only  at the
commencement of every new attempt to swallow a
liquid;) inability to swallow; fear alternating with a
desire to snap and spit at those present, or to escape
from the attendants; constant restlessness of the whole
body,  and jactitation  of single muscles, particularly
the muscles of the  face.
   Though  Belladonna is not counter-indicated by con-
vulsions of the extremities,  yet Hyoscyamus  is prefer-
able when the convulsions are more permanent, when
the spasmodic constriction of the throat is less violent,
and there  is not so much a desire to snap and spit at
the  attendants as to  injure  them in some  other
way.  Hyoscyamus is particularly adapted to the fol-
lowing symptoms:
   The patient complains of great dryness and burning
heat  in  the  throat, with stinging in  the throat, and
a suffocative constriction  of the throat when  swal-
lowing ; he  has a dread of drinks because he is un-
able  to  swallow them,  and, if he  does succeed in
swallowing  a liquid,  he is  attacked  soon after with
spitting and with convulsions that deprive him of his
senses.  He is constantly delirious,  even when there 
164         HYDROPHOBIA, RABIES CANINA.

is  no paroxysm,  or he is taciturn  and exceedingly
fearful, or he has paroxysms of rage  during  which he
endeavours  to injure others, and is so strong that he
can scareely be  controlled ; frequently  excessive an-
guish alternates with startings  as if in affright, trem-
bling and convulsions;  he shows a  peculiar fear  of
being bit by animals;  at  times the  upper and lower
extremities are only slightly convulsed,  at others the
extremities are spasmodically curved and the body  is
tossed off the bed ; during such attacks  the patient  is
often drenched  with sweat.   His  face is red  and
bloated.   There is some sleep, but it is disturbed by
starting, and by anxious visions and dreams.  In this
respect Hyoscyamus is distinguished from Belladonna,
which has ineffectual attempts  to go to sleep.
   Stramonium is indicated by the following symptoms:
Restlessness, violent convulsions  (of a rather  tonic
nature),  during which the patient  becomes so frantic
that he  has to be tied ;  he has no  sleep, and tosses
about his bed,  uttering hoarse screams ; he  is deli-
rious, without  memory or consciousness; his pupils
are very much dilated;  violent desire to bite, and  to
tear every thing with his teeth ; excessive dryness  of
the inner mouth and fauces : the sight, of a  candle,  of
a mirror or of water, throws him into frightful convul-
sions with irresistible aversion  to  water,  constriction
and convulsions of the pharynx, blaver at the mouth
and frequent spitting;  loquacious  mania with gesti-
culations, dancing, singing, laughing.
   Drs. Hartlaub and Trinhs recommend  Cantharides
as a preventive of hydrophobia. I  have no experience
on this point.  In my judgment, Cantharides should be
recommended for the following symptoms : alternate
paroxysms of rage  and  convulsions, the convulsions
can be excited by  touching the  larynx, which is pain-
ful, in the region of the thyroid cartilage, by making
pressure on the abdomen, and by the sight of water ;
the eyes look fiery and  flushing, and  roll about  in
their sockets in the wildest manner; the patient  is
scarcely  able  to swallow, especially liquids, on ac- 
HYDROPHOBIA, RABIES  CANINA.         165
count  of a  burning  and dryness of the mouth  and
pharynx.  There is an excessive  desire, for sexual in-
tercourse, with constant painful erections or constant
itching and burning in the internal sexual parts.  The
oppression of breathing and anguish are less striking
than in cases for which Bellad.  and Hyoscyam. are in-
dicated ;  the  convulsions,  however, are  sometimes
frightful.  In general, Cantharides seems to be more
indicated when the inflammatory symptoms are more
prominent, and  when the impeded deglutition  does
not proceed from a  spasmodic  constriction  of the
fauces, but the spasm proceeds from the inflammation
of those parts or from the pains caused by  the swal-
lowing.
   § 270.  Symptomatic hydrophobia is much less  dan-
gerous than the real disease: it is not contagious, and is
not always  attended with  violent  symptoms ;  the
frightful anguish is likewise wanting, nor is there any
blavering.   It is not  caused by virus ; frequently by
fright  or anger,  or it  is a symptom of some inflamma-
tory, nervous or hysteric disease, or attending a  very
acute  eruption,  or some other spasmodic or malignant
disease.   Fear  and  imagination, after  an innocent
bite, may, in very sensitive persons, cause the  disease.
The alloeopathic  preventive  treatment  with large
doses of Belladonna, Cantharides and  Mercurius,  may
likewise  lead to  a   medicinal hydrophobia,  which
ignorant physicians might mistake  for  symptomatic
hydrophobia.
   To cure this disease, it is of  the utmost importance
to find out its cause.  If it was caused by the continued
use of large doses of Belladonna, large quantities of
black  coffee should be administered by the mouth and
rectum, to be followed by one, two, three or four doses
of Hyoscyamus.  Repeated doses of Camphor may  like-
wise be  required, particularly if the disease  was oc-
casioned by the  abuse of Cantharides.  If there should
be  symptoms  of poisoning by  Mercury,  Camphor,
Opium, Belladonna, electricity,  or some other of the 
166
MORBUS SACER,  ETC.
above-mentioned remedies will have  to be given, in
accordance with the prominent symptoms.
  If,  however,  the symptoms  should point  to  the
existence of  a more general and  more  deep-seated
disease than  symptomatic  hydrophobia, in this case
the physician will have to select one of the remedies
mentioned in the preceding paragraphs ; and this will
be so much easier, as the hydrophobic symptoms con-
stitute the  more prominent symptoms of his patient's
illness.

  § 271.  Morbus sacer, morbus caducus,  epilepsy.
  Epilepsy consists of paroxysms of sudden and com-
plete interruptions of consciousness and of the sensual
functions,  accompanied  with  convulsions.   Every
single paroxysm  is  a development of successive
symptoms distinguished by stages.  This development
by stages is not regular in every case ; in many cases
one or the other stage is  wanting.
  First stage : A well-known precursory symptom is
the so-called aura epileptica, though it  is much  less
frequent than is commonly believed.  It is a peculiar
nervous action perceived by  the  patient, which ema-
nates from the peripheral nerves and seems to extend
itself to the brain, where it, terminates in loss  of con-
sciousness ; or it may  terminate in  this way at the
praecordia.   At times  this aura epileptica manifests
itself by cloudiness of sight, scintillations, ringing in
the ears, illusions of smell or of the other senses ; at
other times  its manifestations are a sensation of
warmth, chilliness,  titillation, prickling, formication,
sensation of a cool  breath or cool  current of air; at
other times  again the aura is perceived as  a  spas-
modic contraction, tremor, convulsive motion or sudden
paralysis of some portion of  the motor system, tongue,
muscles of  the extremities, palpitation  of the heart,
etc.  Every part of the body may be the starting-point
of this aura.
   There are other precursory symptoms of less impor-
tance : Symptoms of congestion of the brain,  vertigo, 
MORBUS SACER, ETC.
167
headache, gastric derangement, morbid states of the
mind, heart, respiratory and sexual organs, etc.  Vo-
miting is very frequent.
  Convulsive stage.  In the greatest number of cases
this stage sets in with a roar;  the patient falls down
without consciousness, after which all sorts of con-
vulsions set in ; distortion of the eyes, mouth, features,
the forehead is drawn into wrinkles,  the eyelids are
alternately  opened  and  closed, the muscles  of the
jaws are spasmodically  affected ; the  tongue  is con-
vulsively protruded and drawn back, and in this way
is frequently injured, which is  to be inferred from the
foam at the mouth ; grating of the teeth, they are even
broken by the violence of the convulsive  friction ; the
head is spasmodically turned, inclined  or bent back-
wards ; the breathing is  irregular, laboured, moaning ;
the face is livid and bloated ; the frontal  and jugular
veins are  swollen ; the eyes are protruded from their
sockets ; the hands and fingers are spasmodically con-
tracted ; the thumb is clenched, (this is,  according to
Hufeland, the only muscle which remains in  a state
of tetanic rigidity, whilst all  the other  muscles are
convulsively agitated ; the clenching of the  thumb  is
no constant symptom) ; the patients throw themselves
about, and it is  very  difficult to protect them from in-
jury ; the trunk  is curved and thrown about.   Among
men we  sometimes  observe  priapism,  emission  of
semen, drawing-up of the testes to the inguinal ring;
involuntary emission of urine,  involuntary stool; hic-
cough, sudden distention of the abdomen ; eructations,
vomiting.  As soon as the convulsions set in, there  is
an entire loss of consciousness ; this is the pathogno-
monic symptom  of epilepsy, and where this  symptom
is wanting, the  disease  is not epilepsy ;  on  the con-
trary, if this symptom should be present and the con-
vulsions should be ever so slight,  the disease is epi-
lepsy.
  It is important to  know, that  without loss  of con-
sciousness there  is no epilepsy.  The disease is fre-
quently simulated with great success.   If the patients 
168
MORBUd SACT.R.  ETC.
select a place where they  can drop down safely, this
is a sure sign of deception; for, in true epilepsy, con-
sciousness is gone as soon as the convulsions set in.
The same remark applies  to the perceptive faculties:
in true epilepsy, all the sensual functions cease, sight
and hearing are suppressed, the  skin is insensible  to
the  most violent impressions, even cutting and burning.
An  impostor is  not  apt to bear such treatment.  This
stage  lasts from a few minutes to half an hour.
  Third stage (stadium soporosum or apoplecticum),
stage of collapse, of muscular relaxation. The spasms
abate, the breathing is  easier, somewhat stertorous ;
the  pulse is  more regular, and the patient falls into a
sort of comatose sleep, resembling that of an apoplectic
person ; on waking from this  sleep, which has an un-
certain  duration, the patient  knows nothing  of what
has happened, he feels languid, tired, sad, the head is
confused and dull,  he frequently complains  of head-
ache.   Sometimes it takes several days before every
trace  of the attack has disappeared.   The  dulness
and the forgetfulness sometimes continue  for some
time.   It even happens that partial paralysis, strabis-
mus, distortion  of the eyes, delirium, or a somnambu-
listic, ecstatic, maniacal state remains after an epilep-
tic  attack.
  In some cases the paroxj^sms set  in  typically,  at
certain  periods  and on certain days, sometimes every
night (epilepsia nocturna); more frequently, however,
the  paroxysms occur at irregular periods, every week,
month, or even once or twice a year.
  § 272.  Etiology: Causes : The disease is heredi-
tary ; in this case  it frequently happens that the dis-
ease first makes its appearance at the  age of pubes-
cence and then lasts until the patient's  death.  Con-
genital  epilepsy may arise from  the mother  having
had a fright during pregnancy.—The disease is most
frequent and varied between the 6th and 11th year,
after which  the disposition decreases, increases again
at the age of pubescence, and  gradually disappears
during  manhood, but returns again in old age.  Ac- 
MORBUS SACER,  ETC.
169
 cording to Schoenlein, a particular formation of the
 skull, an extraordinary thickness of the bones of the
 skull, are  predisposing causes of this  disease.   Ner-
 vous irritation, scrofulous and rickety diathesis, predis-
 pose to epilepsy.   Celibacy seems to favour the deve-
 lopment of epilepsy.
   External causes of epilepsy are: violent emotions,
 fright,  fear, anger, excessive  mental labour, sexual
 excesses, onanism ;  sight of an individual in an epi-
 leptic paroxysm; worms, taenia,  metastasis  by sup-
 pressed itch, herpes ; arthritic formations ;  local, me-
 chanical irritants, such as : splinters, exostosis, occult
 caries, suppressed haemorrhage, particularly suppressed
 bleeding of the nose, etc.
   Prognosis.  It is  difficult to  cure  this disease.  It
 is not fatal, but exposes the patient to great danger on
 account of the falling ;  it is troublesome, frightful,
 dangerous, were it only on account of the mere possi-
 bility of infection, and finally induces mental debility
 and even imbecility.
   § 273.   Treatment:  This disease  is  generally in-
 curable, even under homoeopathic treatment.  It may
 be said that two thirds of all cases of epilepsy remain
 uncured.   It is likewise probable that not all  cases of
 epilepsy which are reported cured, were true epilepsy.
   The treatment should commence,  if possible,  with
 removing the cause.  Mechanical irritants have some-
 times  to be removed with the knife.   Suppressed
 menses have to be restored.    The apparent cause,
 however, is sometimes removed, and yet the  disease
 will continue. As regards treatment, I refer the reader
 to the chapters on eclampsia, hysteria, and St. Vitus'
 dance,  where  a number of  remedies have  been
 mentioned  that will likewise  be found useful in the
 treatment of epilepsy.
   According to v.  Boenninghausen,  Calc. carb. and
 Causticum  are two of the  best remedies for epilepsy.
 He pretends to have cured a number of patients with
them.   Calcarea has the  following two symptoms
pointing to an epileptic paroxysm : While performing
  vol. iv.—8 
170
MORBUS SACER,  ETC.
some manual labour, standing, he suddenly falls down
sideways, with loss of consciousness ; after the return
of consciousness he feels hot, and some  sweat breaks
out.  The  second symptom  is:  nocturnal epileptic
fits, with screams, at full moon.  The following  con-
siderations should guide us in the selection of  Cal-
carea :  It is  particularly suitable to  a venous-hae-
morrhoidal, plethoric constitution, to a scrofulous and
rickety diathesis, to young persons,  and  to females
with irritable nerves  and subject, to menstrual  irre-
gularities,  particularly  to  profuse and  premature
menses.   Calcareais an excellent remedy for epilepsy
caused by onanism and by exposure in cold water.
  In epilepsy of children, Belladonna is very often the
best remedy ; but there are cases where it  remains
ineffectual, even if strictly indicated by the symptoms.
In all such cases, Calcarea, in alternation with  Bella-
donna, will be found excellent.
  Calcarea requires very often to be given in alter-
nation with Cuprum  and Plumbum.    Cuprum  has:
convulsions with  loss of consciousness, foam at the
mouth, curving of the trunk outwards, pushing the ex-
tremities  outwards,  with  open  mouth.   In  purely
nervous  epilepsy, Lobethal  prescribed  Cuprum  with
good effect, and  afterwards gave Calcarea carb. or
Causticum.  In epilepsy from fright, Vehsemeyer gave
Cuprum and Ignatia, though Hyoscyamus is very often
preferable, which has: The  patient suddenly  falls
down with a scream, strikes about with his fists and
feet, clenched  thumbs  and set teeth.  Weigcl  cured
the following  case with Cuprum: The disease was
occasioned by a fall on the head ; every paroxysm set
in at night, one or two days after the cessation of the
menses,  with  loss of consciousness,  moaning  and
rattling, foam at the mouth, clenching of the thumbs ;
at times the  patient complained of crampy pains in
the  stomach, with loss of appetite  and yellowish-white
coating of the tongue.
  For nocturnal epilepsy, Calcarea is probably of very 
MORBUS SACER, ETC.
171
 little use.   Opium will be  found preferable ; at  any
 rate, Ignatia  would be better than Calcarea.
   For a particular description  of the epilepsy which
 is curable  by  Plumbum, I refer  the  reader to the
 article Plumbum  in  "HempeVs  Jahr."*  It will  there
 be seen that the Plumbum-epilepsy generally proceeds
 from the splanchnic nerves, thence extending over the
 sentient and  motor  nerves, and finally affecting the
 brain and the sensual organs. The Plumbum-epilepsy
 is generally characterized by  precursory symptoms;
 after a paroxysm, paralytic symptoms frequently re-
 main behind,  or total or  partial loss of conscious-
 ness  for some time ;  a characteristic symptom is pro-
 trusion of the tongue, which  is  enormously swollen
 and is bitten by  the-patient.
   Causticum  may be  an  excellent remedy in con-
 vulsive and spasmodic attacks, but I cannot recom-
 mend it in epilepsy.  It has only one trifling symptom
 pointing to  epilepsy: " Sudden  falling down without
 consciousness, during a  walk  in  the open  air,  and
 rising again as suddenly."   With all the other symp-
 toms the characteristic loss of consciousness and per-
 ception is  wanting.
   Petroleum is said to have been useful  in one case,
 but I cannot say any thing in its favour.
   Cicuta virosa,  which  I  have  recommended  for
 eclampsia, is  likewise  excellent in  epilepsy.  Beside
 the general and sometimes frightful convulsions, jacti-
 tation of the limbs, spasmodic  contortions of the ex-
 tremities, tossing of the body off the floor or bed, it
 has among its symptoms true epileptic paroxysms re-
 curring at shorter or longer intervals, and character-
 ized by strange motions of the  head and trunk, lock-
jaw,  foam at the  mouth,  bloated, bluish face, or else
 cadaverous paleness  of the face,  protrusion of  the
 eyes, vomiting,  feeble, scarcely  perceptible pulse,
 complete loss of consciousness, and scarcely perceptible
 or completely interrupted breathing; previous to the
• Published by W. Radde, 322 Broadway. 
172
MORBUS SACER, ETC.
paroxysm, the patient complains of a  strange feeling
in the  head, great sensitiveness of the  eyes to the
light, he is delirious while walking about; with  slow
pulse :  generally,  however,  the  paroxysm  sets  in
without precursory symptoms, and commences with a
sudderffall ;  after the paroxysm the breathing is l'\-cc,
but  the  patient remains lying  in  a  state of uncon-
sciousness, insensibility,  lethargy.
  Lachesis is said to be  one of the  best remedies
for epilepsy,  next to  Bell.,  Caust.,  Cicut., Hcpar.
sulph.,  Calc.  and Silicea  ; I am sorry to say, however,
that I am entirely  unwilling  to take  the responsibi-
lity  of recommending  it.
  Hepar s. is recommended for epilepsy, but I think
it can  only be employed against certain incidental
symptoms, and even these are better removed by Au-
rum, Calc. carb.,  Nitri ac, Sulphur, etc.  Hepar suits
scrofulous and psoric  constitutions, affections of the
reproductive system occasioning epilepsy, mercurial
cachexia, secondary syphilis, tuberculosis, excessive
irritation of the olfactory nerves, illusions of smell.
  Agaricus muscarius has :  epileptic paroxysms  with
great, muscular  exertions;  but  they arc so vaguely
expressed that we cannot avail  ourselves of such in-
dications.
  Alumina has been proposed, but  without reason, in
my judgment.
  Camphor  is, in many cases, an excellent palliative ;
it shortens the paroxysms, and, in this way, contributes
to the cure of the disease.   The paroxysms for which
Camphor is  indicated,  are generally  accompanied
with rattling, redness and bloatedness  of the face, jac-
titation of the limbs, and even twitching of the tongue,
eyes and facial muscles,  with hot,  viscid sweat on the
forehead and head, and  complete loss of consciousness;
the attack commences with a horrid cry, sudden falling
of the  patient,  with foam at the mouth; after the
paroxysm the patient lies  in  a state  of sopor,  with
slow, laboured breathing; on waking, he finds it dif-
ficult to recover himself. 
MORBUS SACER, ETC.
173
   Stannum acts on the whole animal  and vegetative
 sphere, and  on  single nervous trunks  and plexuses,
 particularly on  the  genital organs  of  both  sexes,
 where the epileptic malady frequently has its origin.
 The symptoms which indicate Stannum, are : Epileptic
 paroxysms, particularly in the evening, with clenching
 of the thumbs, or bending the head backwards, pale
 face, twitching  of  the hands and  eyes, loss of con-
 sciousness.  Stannum is  particularly  adapted to  epi-
 lepsy of children, though  it likewise cures epilepsy in
 any other age.
   Silicea is suitable to scrofulous and rickety patients,
 and for epileptic paroxysms proceeding from the cere-
 brospinal system  of nerves.  It  is indicated  by the
 following  symptoms: Loss  of consciousness after a
 sensation of great coldness in the left side  of the body,
 frequent slumbering and  starting  as if in affright; the
 patient talks  unintelligibly, does  not know any body,
 becomes so feeble that he is unable to turn to the other
 side;  afterwards violent  convulsions  with staring
 look, distortion of the eyes, twitching  of the  lips, ut-
 terance of inarticulate sounds, stretching and turning
 of the head sideways, distortion of the extremities, af-
 terwards a horrid  roar,  lachrymation, foam  at  the
 mouth ;  lastly,  warm sweat over  the  body,  easy
 breathing, slumber, and,   in  a few hours, return of
 consciousness and speech.  Silicea  likewise relieves
 nocturnal  epileptic  paroxysms,   particularly   when
 taking place at new moon : the body is stretched out,
 and  afterwards tossed off the floor; these paroxysms
 take place without the usual cry.
   Nux vom. may be tried  in epilepsy characterized by
 the following  symptoms:  Ascension of heat to  the
 heart, thence to the  throat, with nausea and oppres-
 sive  anguish,  trembling;  lastly, the heat goes to  the
 head ;  crampy sensation,  without much pain, in the
 muscles of the extremities, back, sc  pulae, etc., suc-
 ceeded by speedily passing convulsions which recur in
paroxysms and are easily  excited by contact;  convul-
sive paroxysms with disfigured countenance and ri- 
174
MORBUS SACER, ETC.
gidity of the  muscles :  closing of the jaws,  extension
of the trunk, the pulse being little altered, but hearing
and  tact being extremely sensitive; tetanic convul-
sions are excited by the least  contact  or noise ;  ex-
tremely painful muscular contractions which continue
from 3 to 4 minutes and are interrupted by a violent
spasm, with the body drawn considerably backwards,
feeble beating of the heart,small and scarcely percep-
tible pulse ; tension  in  the  temples and nape  of  the
neck, shortly  involving all  the muscles of the trunk
and  extremities;  this tension  or rigidity is  not conti-
nuous, but  comes in momentary paroxysms, increasing
suddenly ;  these spasmodic contractions are frequent-
ly preceded by a violent chill and shuddering,  and
succeeded by formication and painful sensations along
the nerves  in the extremities, which the patients com-
pare to  electric  sparks passing through the  parts;
after the chill, the spasms set in with greater violence
than before, so much the more, the more violent were the
precursory symptoms ; every three or six minutes the
patient has an attack of frightful spasms through the
whole body, a real tetanic  spasm, with opisthotonos,
retraction of the  pectoral muscles, loss of  conscious-
ness, rigidity of  the extremities, excessive hardness
of the muscles,  contortion of the eyes, cherry-red
face, etc.  For further indications, I refer the  reader
to Hempel's Jahr.*
  Beside the above mentioned remedies, the following
medicines  maybe considered: Secale corn., Solanum
nigr., Magnes. carb., Sulpliur,  Lycopod., etc.
  §  274. Schoenlein mentions  several other kinds of
epilepsy, in  accordance with the part where  the
paroxysm commences.  I will  mention them cursorily,
and  name a few remedies which I  have  found useful
in the  treatment of those varieties.
  First :
  Epilepsia  abdominalis,   ganglionic  epilepsy.    At
first it is imperfectly developed, and runs  through a

         * Published by Radde, 322 Broadway, N. Y. 
MORBUS SACER,  ETC.
175
succession  of degrees which Schcenlein divides into
two classes.  In the first period, the patients complain
of a gnawing, contractive, or  burning and stitching
pain in the praecordia or umbilical region ; this pain
changes  to  the above  described sensation, the aura
epileptica develops itself upwards and gives rise to
various morbid sensations in the abdomen, such  as:
constrictive pain in  the stomach,  sensation of  tight-
ness and distention, loathing, eructations,  disposition
to vomit, vomiting of an  albuminous  fluid, momen-
tary symptoms of jaundice, etc.  If the aura  reach
the pineal gland, the  sensual functions are disturbed,
the sight vanishes,  there are luminous vibrations  be-
fore the eyes, and a slight, transitory vertigo.  This
stage  sometimes lasts a  few weeks,  sometimes,
however, a year and upwards.
   Second period: The  more important parts  of the
brain, which  are  the  instruments   of the  higher
functions of the soul, become involved.  The paroxysm
commences with a constrictive or titillating  pain in
the  region  of the umbilicus,  changing to the aura
epileptica, which flashes over  the chest to the  head,
with loss of consciousness, falling and convulsions ;
afterwards  the patient falls into sleep, and, on waking,
is unconscious of what has just passed.  At first the
paroxysms occur seldom, afterwards more frequently,
and even eight or ten times in 24 hours.  This kind
of epilepsy  is influenced by the moon ; the paroxysms
are most frequent and last longest at  the  time  of full
moon.
   Etiology: The disease  occurs principally between
the 7th and  11th year; among poor people that are
subject to acidity of the stomach, it is excited by as-
carides,  taenia (which  is  known to be influenced by
the. changes in the moon's disk) ; according to Schcen-
lein,  this kind of  epilepsy is apt to  develop  itself
after  epidem c scarlatina.
   Prognosis:  This kind of epilepsy is generally cur-
able.
   Treatment:  For the treatment, I refer the  reader 
176
EPILEPSIA UTERINA.
to §§ 28, 41, 44, 53,  10S of vol. i., and to the  preced-
ing paragraphs.  I recommend particularly   Ignat.,
Chamom.. Cina,  Bellad.,  Nux vom.,  Merc,  Stannum,
Cupr., Magnes. carb., Calcar., etc.

   § 275.  Epilepsia uterina.
   Schaenlein  distinguishes   chlorotic  and  plethoric
uterine epilepsy.  Both  varieties  have  two  periods.
In  the first period  the patients  experience  a  con-
strictive sensation proceeding from the uterus and
rapidly ascending, as  globus hystericus, across the
chest to the brain, causing  blackness  of sight, scin-
tillations, which obliges the,  patients to sit down lest
they  should  fall.  In  the   second  period, complete
epileptic paroxysms  with loss of consciousness, and
convulsions, set in.   In the chlorotic variety the  face
remains pale, chlorotic;  there is no symptom of vas-
cular excitement.  This  excitement takes  place  in
the plethoric variety ; even several days  previous to a
paroxysm the patients complain  of increased  warmth
in the head, which is hot to the feel, of redness  of
the face, and  headache ; during  the paroxysm the
eyes are congested and  protruded,  the  breathing  is
hurried,  there is a bloody foam at the mouth,  and
even  blood-spitting.   In  both varieties  the  menses
are  disturbed.   The  chlorotic epilepsy principally
takes place with feeble, nervous, chlorotic individuals
at the age of pubescence; the plethoric variety, on
the contrary, during the  period of womanhood.  The
disease is  principally  excited by violent  emotions,
such as anger, during the menstrual period, arresting
or suppressing  the menses:  likewise   by  hysteria,
disorganizations  or retroversion  of the uterus.
  Prognosis :  Not unfavourable ; plethoric  epilepsy
is  sometimes  more easily cured than  the chlorotic
variety.
   Treatment:   For the treatment  I  refer the  reader
to the paragraphs on menstrual irregularities.  If the
disease should be occasioned by retroversion of the
uterus, this  organ should first be  restored to its na- 
EPILEPSIA TPSTICULARIS.
177
tural position.   The remedies are the same  as those
which have been mentioned for  epilepsy generally,
particularly those which have particular relations to
the female sexual organs.   The  following remedies
deserve particular consideration  in  either  variety :
Platina, Ignat.,  Pulsat., Sulphur,  Conium,  Magnes.
mur., Colocynth., Staphys., Phosphor., Ccccul.,  Caust.,
Stannum,  etc.

  §  276.  Epilepsia iesticularis.
  It runs  the following course :
  First period: From time to time, generally at night,
the patients complain of a  violent drawing pain, in
one, less frequently in  both testicles,  which are spas-
modically drawn to the abdominal ring.  In a quarter
or half an hour, these phenomena  terminate in  vomit-
ing, or, more frequently, in a seminal emission ; ver-
tigo and vanishing of the  senses  occur very seldom.
This period lasts  for months, and frequently a whole
year and upwards.
  Second period:  The genital organs are  again irri-
tated ; the attack, however,  does no longer terminate
in vomiting, but  the  head  is attacked,  the patients
fall down  without consciousness, and the characteristic
convulsions  take place ; the paroxysm terminates with
an  emission of semen.   As the  disease  progresses,
the irritation in the genital organs disappears, and the
epileptic paroxysm  sets in  without any  precursory
symptoms.
  Etiology: The disease occurs at the, age of pubes-
cence, in consequence of a  want of seminal emissions,
irritation of the sexual organs by novel-reading, onan-
ism, attempts at  sexual intercourse ;  also among men
who had indulged sexual excesses and suddenly prac-
tise abstinence.
  Prognosis : Favourable, when the disease is treated
at the commencement.
  Treatment: It is particularly in the first period, that
the  disease  should be grappled with ;  a cure will
then be found very easy.  Novel-reading and onanism
          8* 
178
EPILEPSIA THORACICA.
should be  given up entirely ; the  sexual  intercourse
should be practised moderately.  For the excessive ir-
ritability of the sexual organs, I recommend :  China,
Acid.phosphor.,  Staphys., Calc carb., Sulphur,  Sij>ia,
Natrum mur.—The  ill effects of extreme abstinence
are  best met  with  Con turn, Phosphorus, iSux vom..
Sepia, etc.—For excessive seminal emissions, 1 recom-
mend:  Sulphur, Sepia,  Conium,  Phosphorus,  Caust.,
Bovista.—For  the drawing  pains  with  spasmodic
drawing up of the testes :  Thuja, Rhodod., Pulsat.,
Zinc, Nux v., Terebinth., Clematis, Nitri ac, Coccul.
  The  second period  of testicular epilepsy requires
the same remedies as  all other epileptic paroxysms.

  § 277.  Epilepsia ihioracica.
  This  disease is  occasioned by an  irritation  of the
pneumo-gastric  nerve.  Schcenlein furnishes the fol-
lowing  description of this disease :
  "First period :  Towards evening, the patients, who
are frequently roused from sleep by it, are attacked
with  a sensation of great tightness, oppression  of the
chest, so that their breathing becomes laboured  and
panting, without, however,  any stitching  pain  being
felt.  This  constrictive  sensation  commences  at the
ensiform process, thence extending over the chest, fre-
quently  with  a sensation  as if a current of air (a
breath of air) were ascending.   The attack lasts from
a quarter to half an hour, and even longer, and either
terminates  with  spasmodic  cough, where but  little
phlegm is raised, or with  luminous vibrations before
the eyes, and vertigo.  This period  sometimes lasts
several  months,  or even years.   In  the latter  case,
the paroxysms are much more frequent and violent
durin: winter than during the summer-season.
  Second period: The patients  are roused from their
sleep, they utter peculiar sounds, like those of beasts,
sometimes screams, and are attacked with convul-
sions, which are frequently so violent that the patients
are thrown  out of bed.  Towards  morning they  feel
very much exhausted, and, if injured by the fall, won- 
EPILEPSIA THORACICA.
179
 der how those injuries came to take place, as  they
 have no  recollection  of any thing  that  took place
 during the night.  At first, the paroxysms  occur  only
 at night;  afterwards, if the disease  should  continue,
 the  paroxysms  likewise take place  in the day-time,
 but even  then the nocturnal paroxysms are always
 more frequent and violent than those which occur in
 the day-time."
   Etiology:  The disease occurs principally  among
 young men ; the most  frequent cause is:  suppressed
 itch,  but this is not the only cause, as is supposed by
 Autenrieth ;  it can likewise be occasioned by exposure
 to wet, and by taking cold while sweating profusely.
   Prognosis : Not unfavourable.
   Treatment: An excellent  remedy  is Aurum metal.,
 for great  tightness of the chest, with a crampy con-
 tractive  sensation  in the chest at night,  and a con-
 stant sensation of taking a deep breath, which is fre-
 quently accompanied  with violent palpitation of the
 heart.
   Next to Aurum we have Arsenic for nocturnal suf-
 focative  oppression  and dyspnoea, with considerable
 palpitation of the  heart.—Colc/iicum deserves consi-
 deration if the disease occur by exposure to wet while
 sweating profusely.
   Sulphur is  one of the principal remedies for epi-
 lepsia thoracica from suppressed itch.  It is indicated
 by the following symptoms: Arrest of breathing, fre-
 quently, during sleep ;   the patient has to be  roused
 from sleep, lest he should suffocate ; sudden dyspnoea,
 at night, in bed,  while turning to the left side, going
 off on rising ;  after falling asleep, at night, her breath
 was gone, she was going to suffocate, started up  with
 a  loud cry, and was unable to recover her breath;
 violent palpitation of the heart towards morning, fol-
 lowed by  a  light sweat;  suffocative  paroxysm, at
night, during  sleep, without great pain ; great weak-
ness of the chest, particularly  troublesome at night
when getting into bed, so that he  is  unable to re-
main  long in  one position. 
180
EPILEPSIA PERIPHERIC*.
  Sepia ranks with Sulphur, in the first period of the
disease, and is particularly indicated by the following
symptoms: Considerable oppression of the chest,  in
the  evening, rendering the  breathing  very difficult,
and obliging her to sit up in bed ; luminous vibrations
before her eyes.—He wakes in the night, with oppres-
sion and tightness ; he had to breathe heavily and
deeply for an hour;  afterwards cough with raising of
tenacious mucus.—These symptoms correspond to the
first period, when the aura is confined to the chest and
ends in cough with expectoration  of  mucus, or when
the head is involved, with luminous vibrations before
the eyes.   Sepia is  likewise  one of the  remedies, ac-
cording to Hahnemann, which is best adapted to the
ailments arising from suppressed itch.
  Sulphur  and Sepia may likewise be used to advan-
tage when a cutaneous eruption had been suppressed
a  long time previous,  and the present disease had
developed itself afterwards by some accidental cause,
such as a cold, exposure to wet, violent emotions, etc.
  In the second  period, the  same treatment  should
be pursued which  has been indicated for epilepsy
generally, except that particular reference should  be
had  to the remedies which  relate to nocturnal  par-
oxysms, such as : Calcarea, Kal. carb.,  Cuprum,  Sec
corn., Arsenic, Ipec, Moschus, Lycop., etc.

  §  278.   Epilepsia peripherica.
  It is probable that the exciting cause of this epilepsy
is seated in one of the peripheral nerves of the extre-
mities, if this nerve have been wounded or injured in
some way or other ; if the patient, previous to the par-
oxysm, experience  pain, or  some other disagreeable
sensation at the place where this nerve is  located ; if
the aura commence at this nerve, and, in its develop-
ment towards the  brain,  follow the  branches which
belong to the nerve 4 or if, by tying up the nerve,  the
development of the aura can be interrupted.   Some-
times  it is a  cicatrix or a hardness deep  under  the
skin, which leads to the  suspicion that the epilepsy 
CYAN"): IS.                  181
arises from  one of the peripheral nerves.  The irri-
tation of one  of the peripheral nerves has to be per-
manent,  if it  is to cause peripheral epilepsy : for in-
stance, a buckshot, ball, piece of wood,  must  press
upon a nerve constantly; or the irritation must  arise
from morbid products which have been formed in the
organism, such as:  exostoses, arthritic concretions;
or lastly, metastatic formations,  such as: suppressed
itch.
  Prognosis:   Always favourable if the cause can be
removed, and the disease  is not too far advanced.
  Treatment:   The same as that of the other varieties.
  I omit  the other varieties of epilepsy, such as: epi-
lepsia protopathica, arising from  fright,  anger, etc.,
epilepsia  spinalis, proceeding from the spinal marrow,
etc., because  the  treatment is entirely  the same as
that of   y other variety.


               TWENTIETH  CLASS.

  §  279.  Cyanosis.
  At first this  term was  used for a particular disease
of the heart; but, inasmuch  as  other  diseases,  chlo-
rosis for instance,  exhibit similar phenomena, especi-
ally as regards the composition of the blood,  I  shall
consider  cyanotic  and  chlorotic   diseases under the
same head, as  belonging to the same family.
  The blood of all cyanotic  patients  is  excessively
fluid, coagulates with great difficulty, and never forms
a perfect crassamentum ;  there is always a dispropor-
tionate  quantity of serum; the  blood is seldom red,
generally dark-coloured,  with a  violet or blue tinge;
not only  the mass of the blood itself, but also its  com-
ponent parts, crassamentum and serum, are  specifi-
cally lighter than in a healthy  state; there is less
fibrine and albumen, and  more aqueous matter.  Res-
piration and digestion are  likewise altered ; the  for-
mer is accelerated,  short, painful, though percussion
and  auscultation do not  reveal  any changes in the 
182
CYANOSIS.
respiratory organs.  The appetite is likewise extreme-
ly variable,  at times much  less, at others consider-
ably  augmented; sometimes the patient  exhibits a
craving appetite for unnatural things, such as whale-
oil, tallow, fat, chalk, etc.  The muscular and nervous
systems are likewise very much disturbed, the patient
complaining of  mental and  physical  debility.  The
patient feels cold; the. skin is  blue or dingy-yellow;
similar changes of colour are seen  in the urine.   As
the disease increases, the ordinary secretions diminish ;
the cutaneous secretions are either limited  or com-
pletely suppressed; the  alvine  evacuations likewise ;
sometimes nothing but blood is passed.
  Anatomical changes:  the  muscles are either dark-
brown or extremely pale ; they  are deficient in cruor ;
they can  easily be torn, are soft and their volume  is
considerably diminished.   The  veins  are engorged
with blood ;  the substance of the heart is dark-brown,
soft and  easily torn.—The  spleen  is  frequently en-
larged, and  in  this case, softened; sometimes con-
tracted, and, in such a case, indurated, hepatized, and
even  of a cartilaginous consistence.—In the cellular
tissue  the fat is either wanting entirely,  or, in  its
place there is only water, or, in some cases,  venous
blood ; or we discover an albuminous fluid with some
remnants of fat.
  § 280.  Etiology: Hereditary disposition;  organic
defects ;  a particular period, for instance,  the period
of  evolution and involution ;  cyanosis cardiaca of
children ; chlorosis at the age of pubescence ; scurvy
at the period of involution ;  in all patients we observe
great changes in the respiratory functions.
  External  causes: want  of food, bad food; atmos-
pheric causes,  air  devoid  of  oxygen, impregnated
with  animal and vegetable  effluvia,  or with mer-
curial  vapours,  chrome and the vapours  of chlore,
or with  the  vapours of water;  excessive muscular
and nervous  exertions,  or violent haemorrhage.
  Cyanotic  diseases  generally  run  a  slow course.
They terminate—1) in recovery ; generally, however, 
                CYANOSIS CARDIACA, ETC.           183

 not without  the  interference of art,  and even  then
 only very slowly, without critical changes,  generally
 by a gradual diminution of the symptoms. In summer,
 patients recover more speedily than in winter.—2) In
 partial recovery.  There remain derangements of the
 ganglionic system, hysteria, hypochondria, melancholy,
 dyspepsia.—3) Death, by sudden exhaustion in conse-
 quence of a momentary  want of  good arterial blood;
 the patients faint suddenly and die ;—or by exhaustion
 in consequence of  colliquative  haemorrhage ;—or by
 the supervention of dropsy and phthisis.—The prognosis
 may be inferred from our previous remarks.
   § 281.   Treatment.  It  is  of great  importance  to
 regulate  the  diet of cyanotic patients.  They  should
 use nourishing, but not stimulating  food, substances
 containing nitrogen rather than carbonic acid or hy-
 drogen ; fresh meat, saccharine  vegetables,  turnips,
 etc.; they should drink fresh water,  or, if the case
 allow, water  mixed with a  little egg  and sugar, or
 even water holding a little iron in solution.   Heating
 or stimulating  things,   such as  quantities of wine,
 brandy, acrid spices, etc., are hurtful.  The air should
 be warm, dry, containing a good  deal  of  oxygen, for
 humid or  cold air does not agree  with the patients ;
 it is therefore of importance that they should take
 frequent changes  of air, and, if their  means permit,
 frequent journeys  from  a  cold to  a warm  climate.
 Bathing is very useful.

   § 282.   Cyanosis  cardiaca,  morbus cozruleus, blue-
 disease.
   Plienomcna : Even in infancy the patients  have a
 peculiar blue tinge  of  the skin.   They are  more or
 less slender, without fat, have feeble  muscles, blue
 lips,  frequently a  blue nose, and  the upper limbs
 are  of  an unusual length.   The last phalanges of
 the  fingers are strikingly mal-formed, swollen, bul-
 bous, furnished with claw-shaped nails. The  patients
 look  as if they had  been  eating whortle-berries.
This livid  colour is especially seen in the  face,  on 
1S4
CYANOSIS  CARDIACA, ET".
the  lips,  in  the  buccal cavity,  on  the upper and
lower  limbs,  and particularly on  the fingers and
their terminal  phalanges; it  increases with the tem-
perature of the body,  on exerting  the muscles  or
lungs.   The  muscles of the patients are thin,  flab-
by ;  the patients get  tired on making  the least  ef-
fort, they  are indolent, and   dread  exercise.   The
skin feels  cold.   All  the  normal secretions,  of the
skin, intestines, uterus, etc.,  are limited, but there is
a great disposition to haemorrhage.   Young persons
are  subject  to  haemorrhages  from  the   nose and
mouth ; afterwards,  haemorrhages from  the lungs  set
in; haemorrhages  from the bowels  and urinary  or-
gans are  not unfrequent.   A  manual examination
of the  chest  frequently reveals  a considerable pur-
ring as of cats.  The pulse  is very  seldom normal,
generally small,   feeble,  irregular   or  intermitting,
from 80 to 120.
  §  283. Etiology :  Malformations of the heart: The
perforation of the septum between the auricles and
ventricles, is,  generally  speaking,  a congenital de-
fect; the  left and right ventricles are not  separated,
and  the venous  and arterial blood must necessarily
constitute  one mass.   The  violence of the disease
depends upon the size  of the perforation and  the
quantity of the venous blood  entering  the left ven-
tricle.   The phenomena  of  the disease are less  in-
tense when  it results from  the non-closing  of  the
foramen ovale, than when it  originates in the aorta
having a double root.  Frequently the symptoms of
cyanosis manifest themselves  only  in  after life,  in
consequence of  violent exertions,  after  whooping-
cough,  a fall, and  similar events,  which  cause the
latent  disease to  break out.   The  disease is parti-
cularly apt to manifest itself at the  period of den-
tition,  at the age of  pubescence, during febrile dis-
eases,  exanthemata, a catarrh, etc.
  The disease, whether it run a long or short course,
always terminates fatally.  Most patients  die a lew
days after their  birth, at  the period of dentition or 
CYANOSIS  CARDIACA, ETC.
J 85
 at the age of pubescence ; or  else  death supervenes
 during an affection  of  the  chest, or during measles,
 small-pox, scarlatina, dysentery, etc.
  Anatomical changes:  In a multitude of cases the
 foramen ovale, or the ductus arier. Botall., or both to-
 gether, are open, without any morbid symptoms having
 been observed as  the  necessary  consequence of this
 defect; but if other defects should supervene, the phe-
 nomena of the  disease  generally make their appear-
 ance.   Such  defects are  principally: origin  of the
 aorta from the right  and left ventricle, opening in the
 septum ventricul., either straight, or oblique, or canal-
 shaped, generally  close to  the origin  of  the large
 arteries, in which case the foramen  ovale is generally
 open ;  origin of the  aorta from the right, and of the
 pulmonary artery from the left ventricle ;  origin of the
 pulmonary  artery  from both  ventricles ; heart  with
 one  ventricle and atrium ; one  or the other of those
 defects is very frequently accompanied with contrac-
 tion or even obliteration of the pulmonary  artery,
 alterations  of the  valves ; in  such cases the heart is
 almost always  enlarged.    Among  the anatomical
 changes likewise belongs the cyanotic habit, the phe-
 nomena of which have been described, § 282.
  § 284.  Treatment: The disease depending upon an
 organic malformation of the  heart, the treatment can
 only be palliative, and is limited to the periods which
 have been  pointed  out in the preceding paragraph.
 If we succeed in carrying the patient through those
 periods, we enjoy  the satisfaction  of prolonging his
 life for a few years.
  Every thing  which might  excite the heart or lungs,
 or might impede the  circulation, should be most care-
 fully avoided.  The patient  complaining all the time
 of feeling cold, he  should dress himself warmly, use
 warm  baths, etc.;  colds and exposure to wet are ex-
 ceedingly hurtful.  The  action of  the heart should be
 favoured  by passive exercise,  such  as  riding in  a
 carriage, or on horseback, swinging, etc.  The  con-
stipation of which  such  patients frequently complain, 
186
CYANOSIS OARDIACA. ETC.
and which, on  account of the straining, might deve-
lop and  increase the phenomena of cyanosis,  should
be removed by  Nux vom., Bryon., Bellad., Opium, etc.
The patients should observe the greatest possible tran-
quillity of body and mind, tludr diet should be light
and nourishing, the stomach  should never  be over-
loaded, all heating food and drinks should be avoided.
  Asthmatic  paroxysms and  fainting fits  are treated
as usual.  It is useful to rub the chest  with  warm
flannel, to use affusions of the chest with water  or
vinegar,  warm hand and  foot-baths,  to  keep  very
quiet,  and to sit  erect.  Suffocative  paroxysms  are
most  speedily relieved by Ipecac,  Opium, and when
the face turns blue and the patient coughs with great
exertion, by Crocus and Moschus ; Ferritin, particular-
ly, when the paroxysm is accompanied with an almost
imperceptible movement of the thorax, and consider-
able dilatation  of the nostrils; and lastly, by Camphor,
Sambucus, etc.  The fainting  fits,  to which cyanotic
patients are subject, require principally Aconite, Mos-
chus,  Crocus, Veratrum, Nux vom., etc.
   I have always found that bleeding of the nose is a
most   dangerous  symptom  in this  malady.   Several
days  before  the bleeding took place, the livid color
around the nose,  lips, in the buccal cavity and  on the
fingers, was strikingly marked; the patients were in-
dolent, low-spirited,  suffered  with  catarrh, and slept
very restlessly at night.   Opium, Laurocerasus, Acid.
hydroc,  and whatever other  remedies seemed to  be
indicated, were employed  without success.  Crocus,
China, Bryon., Bell., Phiosphor.,  Carbo org., nothing
was of any avail; the patient went  into a state of
collapse,  death seemed to be  at hand, when Arnica,
five drops in one ounce of water, a tea-spoonful every
five minutes, and a  few drops being introduced into
the nose by means of a sponge, arrested  the haemor-
rhage ; the Arnica was continued for a few days, and
then I gave a little China,  to raise the strength of the
patient.
   Digitalis might perhaps be adapted to the state 
CYANOSIS  PULMONALIS.
187
preceding the bleeding, but it should then be employed
at once, before any thing else is given to the patient.

  § 285.  Cyanosis pulmonalis.
  According to Schoenlein, this form of cyanosis is as
frequent as the former.
  Phenomena : The patients complain of a sensation
of oppressive weight  on  the  chest; the breathing is
short, hurried, somewhat panting; the thorax does not
expand during  the breathing, but this  is  effected
rather by means  of the  abdominal muscles  and the
diaphragm.   If the  disease  is  uncomplicated, per-
cussion yields a dull sound, which, if the  disease is not
spread all over, is frequently limited to one side of the
chest or to one spot only.   At this spot the respiratory
murmur is either entirely wanting,  or is at  least  in-
distinct.  Instead  of the bellows-sound we hear mu-
cous  rattle,  not  a cough, or  bronchial rattle ; if the
disease be perfectly developed, these  sounds can  be
heard without the stethoscope.  The patients  raise a
glassy mucus, or a purulent mucus mixed with black
blood.  The livid colour  is most  marked  in the face,
particularly  on the cheeks, lips, and in the buccal ca-
vity ; suffocative fits and violent exertions increase the
livid appearance.   The extremities are cold,  the skin
is dry, the bowels are constipated ; the urine is scanty,
dark-coloured, brown-red ; the pulse is quiet; the pa-
tient  is very much debilitated, gets tired after the least
exertion, or an exertion is followed by suffocative fits
or shortness of breathing.
   §  286.  Etiology:  Pulmonary cyanosis is always
a secondary disease,  and generally  arises from a
chronic inflammation of the lungs.  Beside the above-
named organic defects of the heart, there are other
diseases, which,  inducing the same  mechanism of
venous engorgement, realize  the  phenomena  of cya-
nosis ;  such  diseases  are:  diseases of the heart; al-
terations of  the  lungs,  such as  emphysema of  the
lungs,  hepatization, effusion into the pleura ; cholera.
Pathologists distinguish  even a cyanosis  encephalica, 
1S8
CHLOROSIS. ETC.
 arising from some disease of the brain, hydrocephalus ;
 a cyanosis gastro-intcstinalis;  a  cyanosis  uterina  or
 dismenorrhoica ;  but. these varieties are mere symp-
 toms,  not  general diseases.
   Prognosis: The disease- is of a chronic nature, and
 always terminates fatally: in  the summer the symp-
 toms are much less intense than in winter, when the
 cutaneous secretions are  much less active,  and this
 diminished activity  induces  striking  aggravations.
 The patients almost always die from suffocation ;  the
 breathing  becomes shorter, interrupted, rattling;  the
 extremities are cold,  but the head feels  hot all the
 time.  Death  is near, if stupefaction, irregular breath-
 ing, and  particularly  organic defects of the heart
 (viz. dilatation of the right ventricle) sets in.
   § 287.   Treatment: The patient  should  be kept as
 quiet as possible, use passive exercise, and not exert
 his lungs;  the  patient should  eat  vegetables rather
 than meat, he should avoid spirits, drink fresh water,
 or perhaps a little light  malt-beer.   The skin and
 abdominal  organs should  be taken  care of; remedies
 have to be chosen in accordance with the principal
 symptoms.  Dropsical  symptoms have to  be treated
 as dropsies generally.   Sanguineous congestions have
 likewise to be met with  the usual remedies.

   § 288.   Chlorosis,  morbus virgineus, icterus albus,
febris  amatoria.
   Plienomena :  The patients have a peculiar chlorotic
 appearance ; the skin has a strikingly  pale  colour, not
 of a dazzling  white, as after haemorrhage, but with  a
 tinge of yellow and green; the blood  seems  to have
 retreated from the skin ; the skin is rather  flaccid, the
 lower eyelid is sacculated, and has a dingy blue ap-
 pearance.   The skin is cold to the feel, the patients
 are very  sensitive to  a low temperature,  are all the
 time  chilly, and  want to be in a warm temperature.
 The same  paleness is seen on the mucous membranes
 of the  tongue, which  is  frequently covered  with  a
 thick, tenacious mucus.  The muscles are very weak ; 
CHLOROSIS, ETC.
189
 the patients get easily  tired,  even after a slight ex-
 ertion ; they are indolent, and want to enjoy rest; the
 respiration  is oppressed, the patients complain of dif-
 ficulty of breathing, not dyspnoea but apnoea, for, if re-
 quested, they are able to expand the thorax.  Palpi-
 tation of the heart  and arterial  murmur are two cha-
 racteristic symptoms of chlorosis, which continue even
 when all  the other symptoms  have disappeared.  The
 pulse, when the disease is perfectly developed, is from
 120  to 140, small,  feeble,  wiry, empty, easily  com-
 pressible ; the cutaneous veins are pale, rose-coloured,
 as if filled  with coloured  water, but  are never dis-
 tended. Diminished appetite,  slimy taste in the mouth,
 oppression,  eructations,  flatulence after  every meal,
 even  after light food; constipation for three or four
 days,  which  is rarely interrupted by diarrhoea ; in
 which case  the food is passed  half digested.—If the
 patient be a female (which is generally the case), and
 the disease  have made its appearance before the age
 of pubescence, the menses  do not make their appear-
 ance  at the  proper time.  If, however, the menses had
 already appeared before the disease  set in,  they  then
 become irregular  as regards time,  duration, and na-
 ture ;  sometimes  some light-coloured blood  is  dis-
 charged every six or eight weeks, at other times there
 is no  blood,  but merely  a little mucus.
   Chlorotic  phenomena  are  sometimes observed
 among men;  the genital organs remain undeveloped,
 both physically and dynamically; no hair grows, the
 testicles remain small,  there is no erection, no secre-
 tion of semen ; the voice remains thin and feeble, like
 that of a child.
  The above-mentioned phenomena are  accompanied
 with striking derangements in the abdominal  system
 of nerves ;  the phenomena indicating either a  simple
 hysteric  allection,   or  a  highly developed  gangli-
onic disease,  spasms, somnambulism, burning in the
stomach,  frequently sour  vomiting  and desire for
things which are not eatable,  pica chlorotica.
  The oedema, to which chlorotic patients are liable, 
190
CHLOROSIS, ETC.
attacks only the feet in the evening, and  disappears
again during the night, except when dropsy has deve-
loped itself; in the morning the eyelids and lace are
bloated most.   It is supposed that no pit is left in the
cedema of chlorotic patients from  the pressure of the
fingers.
  § 289.   Causes:  Chlorosis is principally met  with
in Northern countries, and occurs more frequently  in
spring and fall than in summer and winter ; relapses
occur in those seasons,  and damp  and  cold  weather
favours the disease ;  lymphatic  and  nervous  indi-
viduals are principally attacked by the disease.
  External exciting  causes:  Premature, development
of the sexual system ; afterwards, deprivation of sexual
intercourse, widowhood, unhappy love, abuse of sexual
functions, onanism, physical stimulants, novel-reading,
rich living, sudden and permanent suppression of the
menses at the age  of pubescence, profuse menstru-
ation ; compression  of  the thorax  by tight stays.
Among city-girls, chlorosis is much more frequent than
among country-people.  Girls  with  blond hair are
more frequently attacked than those with dark  hair
and complexion.
  Duration, course  and termination: Generally the
disease developes  itself gradually;  in a  few cases,
however,  it seems to break  out suddenly,  or else, the
disease which had remained undeveloped  heretofore,
suddenly attains a very high degree in consequence of
a sudden fright or emotion. Sometimes the  disease
yields to proper treatment in a very short time, but
it may last for months and even years.
  Recovery takes  place gradually; the  face loses  its
pale colour ; the pulse becomes fuller and the tempera-
ture of the body is restored to its natural standard ;
the good spirits and the feeling of strength which the
patient now enjoys,  are sure symptoms of recovery.
The menses become regular.  At  first a red-coloured
mucus makes its appearance ; blood  sometimes is not
discharged till the third month.  Relapses are  very 
CHLOROSIS, ETC.
191
frequent, especially  in  a damp and raw season and
during the menstrual period.
   The following secondary  diseases remain after  a
badly  managed chlorosis:  Neuralgia, hysteria, me-
lancholy, even  idiocy and nymphomania: the  latter
particularly  if the disease arose  from the non-satis-
faction of the sexual desire.   Chlorosis can likewise
change to a disease  of the heart and lungs, dilatation
of the right ventricle with diminished thickness  of its
walls, finally phthisis. The spleen sometimes remains
diseased, viz., atrophied or hardened, and this  disor-
ganization generally leads to  dropsy.  Death super-
venes in consequence of the secondary diseases.
   Prognosis: Generally favourable; it depends upon
the duration  of  the  disease,  upon the constitution of
the patient, upon the mode of life  of the patient, and
the facility one possesses to modify  her external cir-
cumstances;  upon the intensity of the symptoms, the
violence of the cardiac and nervous phenomena, upon
the presence or absence of dropsy, disorganization
of the spleen, mental derangement, organic diseases
of the  heart, tuberculosis, hectic  fever, or other com-
plications.
   § 290.   Treatment: Every thing which might have
a  tendency to prolong  the disease,  and to interfere
with the treatment,  must, if possible, be carefully re-
moved.   The diet of the patient  should be carefully
regulated.  The sexual  sphere  is of the utmost im-
portance.  Every thing which might excite the sexual
instinct, has to be carefully avoided: stimulating food
and drink, emotions, passions, reading of lascivious
novels, balls, theatres, idle  life;  the patient should
not sleep long, nor lie on featherbeds, because the use
of featherbeds causes constipation, debility, and has a
bad effect on the sexual  organs.
   Haemorrhages and profuse menstruation should be
treated  with  the  remedies  that  have been recom-
mended  in former chapters, and,  if debility remains,
China should be administered,  which is  likewise the
best  remedy for the debility  caused by  sexual ex- 
192
CHLOROSIS, ETC.
cesses, onanism, frequent bloodletting and cathartics.
Closing of the os tincae or of the vagina has to be re-
moved  by the knife, after  which  it  will  be  seen
whether  such a mechanical difficulty  is the  only
cause of chlorosis.
  The slow  and gradual  development of  chlorosis
shows that  this disease is intimately connected  with
the general  organism, and that, therefore, the greatest
care is required to remove it.  As was said above, the
diet should  be particularly attended to.   All  stimu-
lants, wine,  brandy, spices, should be strictly avoided.
As  regards remedies,  Pulsatilla  is one  of  the best  at
the commencement of the disease, when the menses
are feeble or retarded, the complexion of the patient
is pale,  and  her  muscles flabby.  Next to Pulsatilla
we have Cocculus, particularly when the patient com-
plains of spasms deep in the abdomen, with irregular
menstruation.  Nux vom. is indicated by a vehement,
passionate temperament, by frequently appearing but
irregularly  flowing menses,  by various symptoms  of
digestive  derangement, vomiting,  constipation ;  also
when the patient had abused coffee and tea ; to the
latter circumstance Pulsatilla  and Ignatia  are  like-
wise adapted.  China is an excellent remedy when
the  following  symptoms are   present:  oedematous
swelling of single limbs, particularly oedema of the
feet, blue rings round  the  faint eyes, distention  of
the abdomen, costiveness, acute pains, drawing, ten-
sion or  creeping  in the abdomen,  bad digestion, sour
eructations,  strange desire for things which are not
eatable, etc.  Arsenicum is one of the best remedies,
if the above symptoms  are  accompanied  with trem-
bling, frequent fainting, and extreme debility.
  In the treatment of chlorosis we have sometimes to
employ intermediate remedies to remove symptoms of
a more or less particular character, particularly morbid
states of the sexual system.  One of the principal re-
medies in this respect  is Conium macula turn for the
following  symptoms: great  sensitiveness  of the ex-
ternal and internal pudendum, every four weeks, con- 
CHLOROSIS, ETC.
193
 slant  dry  heat of the body  without thirst,  anxious
 dreams, and feeling of heaviness in the limbs ; whining
 mood, restlessness, anxious  care  about every thing,
 stitching in the region of the liver, which sometimes
 continues  several days and  weakens the  body  very
 much  ; the menses are entirely suppressed.
   Phosphorus is indicated when  the menses  are not
 entirely suppressed,   but  appear irregularly;   the
 patient complains  of nausea, sour vomiting,  oppres-
 sion of breathing, vertigo, and great sexual excitement.
   Natrum  muriaticum may be given when there are
 frequent ineffectual indications of the appearance of
 the menses, accompanied with great sadness,  oppres-
 sion and anxiety, fainting spells, coldness of the pelvis
 and internal heat, heat in the face, weight in the ab-
 domen, tearing toothache, frequent burning and cut-
 ting in the groins.
   Sulphur is one of the principal remedies for chlorosis.
 On perusing the provings of Sulphur, it will be found
 that a number of chlorotic conditions  are represented
 by the symptoms  of Sulphur.  But  these symptoms
 very seldom point to any particular form of chlorosis;
 the symptoms of Sulphur indicate chlorosis generally,
 and this is  the reason  why it is difficult  to determine
 the particular form of chlorosis to which Sulphur cor-
 responds.   Sulphur can be  given alternately  with
 Pulsatilla.
   Sepia  is  likewise generally indicated for  chlorosis
 the same as Sulphur, except that Sepia has various
 morbid conditions in the sexual organs ; for instance,
 the patients complain frequently of a  painful pressing
 in the  inner pelvis from above downwards, sometimes
 accompanied with discharge of mucus ;  sometimes of
 a jerking, darting in the vagina from  below upwards,
 or of a stitch in the vagina with occasional discharge
of single drops of blood.  If no blood be discharged,
the patient complains  at particular periods of aching
pain in the abdomen, swelling of the pudendum, burn-
ing in the   pudendum, or even discharge of mucus.
 Belladonna and Platina should be carefully compared
   vol.  iv.—9 
194
HYPOCHONDRIA, ETC.
with  Sepia.  These  three remedies  should first be
thought of when the disease originated in onanism.
  Nitri acidum,  Lycopod., and Graphit., deserve con-
sideration.  As regards Psorin, I cannot recommend it.
  Errum is the  grandest remedy for inveterate cases
of chlorosis, and it  should-be continued until  every
vestige of arterial murmur has disappeared.   But it
must  be given in massive doses ; small doses are of no
avail.  Even iron-mineral springs have to be resorted
to,  and in some few cases we may have to give iron
in large alloeopathic doses.
TWENTY-FIRST  CLASS.
   DISEASES OF AN INTERMEDIATE ORDER, MENTAL AND
                     PHYSICAL.

  § 291.  Hypochondria, Hypochondriasis, morbus eru-
ditorum.
  For  the  better understanding  of this Protean dis-
ease,  we will bring  its groups  under the following
heads:
  a) Mental phenomena ;
  b) Symptoms of the digestive apparatus ; and
  c) Symptoms of the nervous system.
  A)   Mental phenomena.   Ill  humour,  particularly
during the  period  of digestion, lowness of  spirits,
sadness,  despondency, constant dwelling upon his ail-
ments, which the patient  considers  of great import-
ance, exaggerated  description of  his  sufferings, de-
light  in reading  medical  writings,  inexhaustible
readiness in discovering similar sufferings to his own
condition;  selfish desire that others should sympathize
with  his sufferings,  uncommon  mental  irritability,
melancholy, distrust, taciturnity, despair of the future, 
HYPOCHONDRIA, ETC.
195
dread of death ; no aversion to  life, in spite of all his
sufferings ;  lastly, inability to perform  any  kind  of
work, even to live, from distrust in his own strength,
from fear  lest he should injure himself.  Sometimes
his spleen  alternates with cheerfulness.   The changes
in the moon seem  to affect the patient  a good deal;
his condition is most painful when the moon is on the
increase.  Sometimes  these symptoms constitute the
whole of the disease,  or the disease  remains at this
point for a long time.
  B)   Symptoms  of the digestive apparatus.  Though
the patients  look well, and have a good  and even
regular appetite, they are constantly complaining  of
bad digestion. After  and frequently during the meal,
they  experience  a  tension  and pressure in the abdo-
men ;  sometimes  the  abdomen  is  really distended,
there is a constant formation of flatulence which is
said to  be the  cause  of the most varied sufferings.
Sometimes there is  a perceptible swelling under the
short ribs and in the epigastrium ; flatulence becomes
incarcerated, causing anxiety, palpitation of the heart,
rising of heat, and distress; sometimes there is loath-
ing,  heartburn, sour eructations, even vomiting of a
tenacious, sour mucus.  The distress occasioned by the
flatulence  sometimes  increases  to  general nervous
paroxysms,  vertigo,  fainting, coldness of the extre-
mities, etc.  Relief is  afforded by the passage of the
flatulence upwards and downwards.   In spite of all
these sufferings,  the appetite of the patient remains
undisturbed,  and his looks  and digestive powers un-
altered.   Only  when organic alterations   develop
themselves, the patient assumes a cachectic  appear-
ance  and  becomes  thin.  The patient  is  generally
costive, though the  costiveness,  which  is sometimes
very  obstinate,  at  times alternates  with diarrhoea ;
a good  evacuation relieves the patients, hence their
constant desire for cathartics.
  C)  Symptoms of nervous derangement, particularly
of the ganglionic system.  This series  is  still  more
varied than  the  previous ones;  there is  scarcely a 
196
HYPOCHONDRIA, ETC.
part or function of the body which remains undisturb-
ed.  We observe the following local symptoms:  sen-
sation of coldness and heat, formication, itching  of
various parts, asthma, cough, palpitation of the heart,
throbbing in various parts of the body, particularly in
the abdomen, hemicrania, vertigo, cramp in the neck,
buzzing in the ears, muscae volitantes, amblyopia,  neu-
ralgia, spasm of the bladder, frequent  urging to urin-
ate, congestions,  increased  secretion of saliva, lach-
rymation, copious sweats, trembling of the limbs,  con-
vulsive motions, paralytic paroxysms, etc.   Hypochon-
driacs  are so sensitive to external impressions, that the
least change in  the temperature  or pressure  of the
atmosphere, or  the slightest dietetic transgressions,
affects them beyond measure,  yea, that the least ex-
ertion is unpleasant to them.  They suffer with head-
ache, are sleepless,  troubled by heavy dreams,  start
up from  their sleep; sleep does not refresh them, and
in the morning they generally feel worse than the pre-
vious  evening.    The urine  of  hypochondriacs is
generally watery and clear, and  they void it in large
quantities ;  frequently, however,  the  urine is thick,
cloudy, with a sediment, and causes fears in the minds
of the patients they might be attacked with gravel and
stone.
   These symptoms  are  variously  modified; but the
rapid  change of the phenomena, the opposition be-
tween the subjective complaints of the patient, and the
objective condition of the  organ  which the patient
points  out as the seat  of the disease, and, yet, where
no disease can be discovered; the idiosyncratic sensi-
tiveness  of the nervous  system to  the most innocent
and most indifferent impressions; the monomaniacal
attention with which the  patient contemplates all his
sufferings, and interprets all the phenomena of his be-
ing as  phenomena of disease ; and finally, the anxiety
and depression of spirits  under which the patient is
constantly labouring ;  all this is, like a  red  thread,
winding  itself through all the various forms and man-
ifestations of his illness, marking its principal features.
( Canstatt). 
HYPOCHONDRIA, ETC.
197
   §  292. It is very difficult to comprehend hypochon-
dria, and it is of importance not to neglect anything by
means of which a correct diagnosis can be obtained.
It is very wrong to trifle with such patients, or to con-
sole them with the unmeaning and trite phrase that
their sufferings are all nervous, (meaning imaginary.)
It is a great feat for a physician  to  examine  a hypo-
chondriac patient  in such a manner that the patient
will seem to be satisfied.   A hypochondriac patient is
distrustful; he' has read a good  many medical books,
and he thinks that  he is fully able to comprehend the
character,  not perhaps of diseases  generally, but  at
least of his own  sufferings.   It  frequently requires
great tact to  answer the perplexing questions of the
patient to his satisfaction, and without his confidence
being shaken.   If this confidence  should have been
gained, and the physician should really comprehend
the character of his  patient's illness, then there is
scarcely a doubt that the physician will accomplish a
cure, even if it should proceed slowly.
   Hypochiondria can be distinguished from melancholia
by the following facts: melancholy arises from  men-
tal, hypochondria from corporeal  causes ; a hypochon-
driac is in  full possession of his reason ;  he  talks ra-
tionally about every thing, even about his health, ex-
cept, as regards this latter, in extravagant terms ; he
is conscious  of his condition, and  wants only to be
pitied by every body.   A patient affected with melan-
cholia, complains of spiritual sufferings, not of corpo-
real ailments; he is astonished to hear that he should
be considered sick; at last he becomes indifferent, and
does not even care for what he used to love; he cares
only for his illusion, to which he sacrifices everything,
even his life ; hence great disposition to suicide. This
is in direct contradiction  to  the disposition of  the
hypochondriac patient, who delights in life, clings to it,
and attaches himself to his friends and relatives.
   Causes: Only the male  sex  are  attacked with hy-
pochondria, and very  seldom before  manhood; it fre-
quently lasts during the whole life  of the patient.   In 
198
HYPOCHONDRIA,  ETC.
hypochondriac patients the abdominal veins are gener-
ally strongly developed, which has probably given rise
to the notion that the disease depends upon increased
venosity.  Hypochondriacs  generally have a spongy,
flabby constitution.   The disease  is  frequently  in-
herited.
   A sedentary mode of life is highly favourable to it;
this  is the reason why literary mem are subject to the
disease ; they are deprived of exercise, and their men-
tal faculties  are moreover strained in  one direction.
Mariners, arithmeticians,   copyists, weavers,  shoe-
makers,  tailors, are  frequently attacked with hypo-
chondria.  But by nothing is the nervous system more
irritated and weakened than by grief, care, watching,
home-sickness, disappointed love, ambition, hazardous
speculations disturbing  the mind;  persons who  are
exposed to the  operation of such  causes, frequently
become  hypochondriac.  The sudden passage from a
stirring and active mode of life to idleness and absence
of all business,  has  a similar effect in many cases.
Farther  causes  are:  Loathing of enjoyment from
satiety, diarrhoea, dysentery, colic,  fever  and  ague ;
extreme abstinence in sexual matters  from principle.
Also, constant overloading of the stomach with indi-
gestible, flatulent, sour, greasy  food, or heavy dishes
made of flour;  or, on the  other hand, fasting;  or a
quantity of warm drink : tea, coffee, etc.
   Prognosis: Not unfavourable ; the disease does not
endanger life, but the multitudinous forms in which it
is constantly harassing the patient,  tries the patient,
his physician and attendants to the utmost.   It is very
difficult to conduct the treatment of hypochondria sys-
tematically, for  this  reason, that the  patient is con-
stantly complaining of some new trouble, and wants
to consult another physician. The more wavering the
patient, the more unfavourable the prognosis.  Unless
the patient has  full confidence in his physician, is de-
termined to submit to all his dietetic regulations, and
is in possession  of the requisite means of accommodat-
ing himself to the arrangements proposed by his me- 
HYPOCHONDRIA,  ETC.
199
dical adviser, it will be very difficult for him to derive
any benefit  from  treatment.   The  more recent  the
disease, the less it had  been treated with  violent
means, the less the danger of material alterations, the
more  favourable is the  prognosis.   Hypochondriacs
who indulge sexual excesses or  onanism, are incur-
able.   I  advise a  young physician, however, to be
careful not to  express himself too unfavourably about
his patient's prospects; he might  be deceived by the
extravagant  statements  of the sick man, and might
afterwards have to blush at holding out such discour-
aging prospects.   Bad symptoms are : yellow, cachec-
tic complexion,  constant sleeplessness,  emaciation,
oedema of the feet.
   § 293.  Treatment. Without proper exercise, amuse-
ment, and a strict diet, it cannot be expected that the
hypochondriac should  ever recover  his health.  The
literary man must give up his sedentary life, and resort
to spade  and  pickaxe; the gourmand should confine
himself to a simple and nourishing diet, and  the sensu-
alist has  to renounce his excesses and mortify his flesh
with an unflinching determination.   Care  should, if
possible,  be avoided, and, if the circumstances of the
patient permit, he will derive vast  benefit from tra-
velling.
   As regards exercise, it should be  observed that ex-
cessive exercise is not advisable.  The best time for
taking exercise is in the morning and evening, never
immediately after a meal; the best kinds of exercise
are, walking, gymnastic  exercise, swimming, hunting,
sawing wood, etc.
   It is extremely difficult to restore  the mental health
of the patient; but we  must attempt  to afford adequate
amusement to the patient, suitable  to his talents, dis-
position and social position.
   If it should  be necessary to resort to  remedies, we
have in the first place—
   Nux vomica,  which  is suitable  to literary  men;
particularly with  a vehement temper, and a nervous,
venous, bilious constitution ;  sedentary life, want of 
200
HYPOCHONDRIA, ETC.
fresh air, constant mental efforts, and the use of stim-
ulants, develop the disease among that class of indi-
viduals.  Digestive derangements, derangements of
the portal and biliary system, constipation, etc., must
necessarily take place, and it  is at this stage of the
disease that Nux is specifically indicated.  Nux like-
wise corresponds to hypochondria  caused by rich and
excessive living.  In general, Nux is the best remedy
for hypochondria arising from a morbid condition of
the abdominal nerves ; after dinner, the patients gener-
ally experience a feeling of malaise and languor.
  Staphysagria is an  excellent remedy for hypochon-
dria arising from abuse of the  sexual instinct, or from
chagrin  with  indignation, or from care  and grief.
Staphys. is characteristically  indicated  by a  fitful
mood, or change of the morbid phenomena, except the
flatulence which remains all the time ; also by indif-
ference with indisposition to talk.
  Phosphorus is supposed, by Hahnemann, to be con-
traindicated by want of sexual desire, and debility of
the sexual organs.  I do not think that this observa-
tion is correct, and  I give Phosphorus particularly for
hypochondria arising from onanism.
  It is well, if the nervous system should be very much
excited, to give a few doses of Nux vom., and after-
wards a few doses of China before administering the
Phosphorus. Phosphorus is likewise suitable to hypo-
chondriacs with a thin, slender constitution.  Such hy-
pochondriacs are fond of walking about; all their sen-
ses are very much excited, and they are so irritable,
particularly after dinner when they experience a pres-
sure at the stomach, nausea, and heat in the face, that
their company becomes exceedingly unpleasant.
   Conium corresponds  to  hypochondria arising from
extreme abstinence in sexual matters.  Even on their
walks they are sad  and melancholy; they  become
more and more listless, indifferent, indolent, and final-
ly the  disease becomes so inveterate that the patient
becomes averse to life, and thinksof killing himself.
  This  last symptom indicates,  perhaps, Aurum me- 
                  HYPOCHONDRIA, ETC.             201

 ted.  more  characteristically than  any other remedy.
 This symptom is always accompanied with great op-
 pression and anguish, particularly in the region of the
 heart, and with constant congestion of the chest.   The
 J.//rMm-hypochondria is moreover characterized by a
 bruised  pain in the brain, which becomes excessively
 violent  by thinking, reading, talking,  writing,  and
 leads to an extreme confusion of ideas.  For the  gas-
 tric symptoms, I refer the reader to the Mat. Med.
   Gratiola may be tried,  when  the patient  complains
 of his stomach, hypochondria and abdomen ; his stool
 is hard and insufficient; there  is pinching and cutting
 in the  umbilical region, malaise with repletion and
 pressure in the  stomach, and a good deal of  eructa-
 tions.   Although stool relieves the  patient,  yet he
 keeps constantly thinking of his condition.
   Stannum.  The patient feels  better when walking,
 worse during rest, and yet he is all the time complain-
 ing of bodily and mental weakness ; he  feels  on  that
 account sad and low-spirited, cries,  and, if with all
 this there should be a stupefying pain in the brain as
 if the skull were screwed in, illusions of hearing, pains
 in the stomach, with irregular appetite,  feeling of emp-
 tiness in the  abdomen, constipation, exhausting night-
 sweats, etc., then the patient feels extremely unhappy,
 and is a source of great discomfort to his attendants.
   Zincum.  Crampy  pains prevail; the patient com-
 plains particularly after dinner, during rest; he is very
 sensitive, to the  open  air.  His sleep is  restless,  dis-
 turbed  with fancies  which  worry him  even in his
 waking  state,  inducing a hypochondriac mood   and
 frequent thoughts  of death.  These are, of course,
 favoured by his nervousness, a constant pressure under
 the short ribs, particularly on the right side, frequent
 empty eructations which afford  no relief, pressure in
 the middle of the spinal marrow, a frequent, constric-
 tive sensation in the pit of the  stomach, with anxiety,
 incarceration of flatulence in the  abdomen, frequent
ineffectual urgings to stool, a peculiar distress about
the head, etc.
         9* 
202          VENEREAL DISEASE, SYPHILIS.

  Natrum  carbon, is particularly indicated when the
slightest dietetic transgression causes a great digestive
debilitv. ill humour, etc.   The patient is at times rest-
less, anxious ; at times he dreads men and company, is
fearful and even listless  as though  he did not care
about living :  he complains all the time of an aching
pain in the head, bad taste, with tolerable appetite,
qualmishness, with tension in the hypochondria, draw-
ing  cutting in  the  stomach,  and   oppression   of
breathing.
  Sulphur is a great  remedy in this disease, even if it
should not always be indicated by-the symptoms; it
sometimes is required to restore the susceptibility  of
the organism to the action of the proper remedies.
  Beside the above-mentioned remedies, Veralr., Asa.,
Pulsat., Bellad., Plumb.,  Magnes.   mur.,  Valeriana,
Arnica, Moschus, Mezer.,  etc,  should  not  be  for-
gotten.
TWENTY-SECOND CLASS.
  § 294. Venereal disease, Syphilis.
  The doubts which I have expressed relative to Hah-
nemann's theory of psoric diseases, are likewise to be
applied to his doctrines about syphilis and sycosis.  It
is perfectly evident that  his experience  in  the treat-
ment  of  these diseases has  been very scanty; and I
shall therefore take the liberty, in describing the treat-
ment of syphilis, to substitute my own and  other phy-
sicians'  experience for Hahnemann's mode of treat-
ment.

  § 295. Name and origin of the disease.
  Syphilis has had different names, derived either from
the prominent symptoms,  or  from the  nation among
whom it  was supposed to have originated, or from the
saint whose aid was invoked for the deliverance from 
             VENEREAL DISEASE, SYPHILIS.          203

such a scourge.  The  Italian physician, Frascatory,
derives the term syphilis from a shepherd of that name,
who was said to have been punished by the gods with
that disease.  It was termed pudendagra,  mentagra,
morbus St.  Rochi, St. Jacobi, etc.,  from  saints who
had to be invoked to get rid of the disease.   It is like-
wise  termed mal de Naples, mal  de France.  The
people- of the East, the Poles for instance, term the
disease the German malady; the Russians the Polish ;
the Persians the Turkish ; the Dutch the Spanish ; the
Germans the French or Spanish ; and the Oriental na-
tions the Frankish malady ; the English term it French
pox.  Fernelius has termed it lues venerea, and, in
the language of the learned, this  name has been pre-
served up to this day.
  The opinions about the origin  of the disease differ.
Some derive it  from the remotest antiquity,  referring
even to the Scriptures for their authority,  considering
even the nocturnal pains of David and the disease of
Job, etc., as syphilitic  diseases,  without any further
proofs.  But if we understand by syphilis a disease
which can be transferred from generation to gener-
ation by means  of a specific virus  acting  upon the
genital organs,  it  becomes evident  that  the  above-
mentioned diseases of the sexual  organs  could not
have been anything  else except what  we observe
in our days after an embrace with females during the
menstrual flow, or as a consequence of the infection
caused by the lochia or whites.   For there is no well
authenticated proof that the syphilitic poison has been,
in those remote ages, transferred in a single instance
from one individual to another.   Others  date its ori-
gin from  the last ten years  of the  fifteenth century.
This is probably correct, for the disease spread, at that
time, all  at  once over  every country in  Europe, and
was regarded as a new disease, which could not have
been  the  case  had its character  and symptoms been
previously known.  It is a  fact  that the  first descrip-
tion of the  disease was  given in the year 1494, and
that it was said to have  come from Naples, where it 
204
CHARACTER OF  SYPHILIS.
 had been introduced by the army of king Charles VIII.
 of France.

   § 296. Character of syphilis.
   Syphilis is a dyscrasia  of the reproductive  system,
 manifesting itself in the shape of ulcers, excrescences,
 blennorrhoea, and cutaneous eruptions ; after having
 been developed in the individual by means of a pecu-
 liar, fixed contagium, it reproduces  the same virus, by
 means of which it can be transmitted to other indivi-
 duals.   The disease is distinguished by the fact that it
 is either attended  with decrease of the vegetative life,
 destruction of the  fibre by ulceration, or with the con-
 trary phenomena, hypertrophy of the tissue,  excres-
 cences and blennorrhoea; this opposition is observed in
 no other disease, except, perhaps, scrofula.

   §  297. Contagious character of syphilis.
   The syphilitic cpntagium is transmitted either—
   1st. Directly by coit, paederastia, a kiss, (provided
 primary syphilitic ulcers  have broken out around the
 mouth); by the contact of sore parts with the syphili-
 tic virus; or—
   2d.  Indirectly by the contact of substances that are
 infected  with  the  syphilitic  virus; tobacco-pipes,
 cigars,  drinking  vessels, spoons,   wind-instruments,
 tooth-brushes,  syringes,  bathing-tubs, privies, etc.—
 The -virus can even  be transmitted  by a healthy wo-
 man who had an embrace with a syphilitic individual
 without  being infected herself; the virus may have
 remained in the vagina, and, in this way, may be com-
 municated to another man.
   The period between the infection  and the breaking
 out of the disease, is very uncertain : the shortest pe-
 riod is  from  twenty-four  to  forty-eight  hours,  the
 longest seven weeks ; generally, however,  the first
 syphilitic symptoms appear between the fourth and
 eighth day.  The development of the syphilitic disease
seems to depend a good  deal upon  external causes,
violent physical  or moral  stimulating  influences, in- 
           GENERAL TREATMENT OF SYPHILIS.        205

creased temperature of the body by dancing, warm
baths, etc.   It depends  likewise  upon the greater or
lessersusceptibility of the patient to morbid influences.
  Prognosis. Generally speaking, favourable, provided
the patient is otherwise well, the secondary symptoms
are of a recent origin  and  not  much developed, no
osseous disorganizations have taken place, the patient
lives soberly, has not been poisoned with mercury, fol-
lows the instructions of  his physician, and  no  other
dyscrasia has been roused in his organism, combining
itself with the  syphilitic virus.  Relapses cannot al-
ways be avoided.  Disfiguring cicatrices,  deformities,
disorganizations, bony swellings, very often remain.
In scrofulous individuals the  syphilitic virus  is  ex-
tremely inveterate.

  § 298. General treatment of syphilis.
  This refers exclusively to the  diet.   We know that
the speedy cure of syphilis requires the observance of
the following rules:
  1st. An equal temperature, from eighteen to twenty
degrees R.,  and a pure air.  In warm climates  the
disease runs a much milder course than  in  northern
countries, and, in these,  the disease  is  more easily
cured in  the summer  than  in  winter.   This is pro-
bably owing to the fact, that the cutaneous action is
much more prompt and  regular in the summer than in
the winter.
  2d. Starvation ; the  less the -patient eats, the less
he feeds the disease.  Feeble patients, however, may
be  allowed  a more nourishing  diet.   The following
articles of diet  should be particularly avoided: acids,
such as vinegar and lemon-juice; spirits, such as wine,
brandy, etc.; a little light  beer  may be  used ;  light
vegetable  food and  mucilaginous  substances   are
allowable, likewise meal and flour ;  meat should be
strictly forbidden, and spices likewise, such as coffee,
tea, pepper, saffron, cinnamon, vanilla, cloves,  caro-
way ; scents, perfumes, artificial tooth-powder should
be avoided.   Moderate  smoking is admissible. 
206
ACUTE GONORRHOEA.
  3d. Rest, a recumbent posture as much as possible,
extreme cleanliness.  The patient should enjoy the
most perfect bodily and mental quiet;  he should walk
little or not  at  all. he should  not remain standing
long at one place, avoid tight clothes  and riding in  a
carriage or on horseback.   The ulcers should be fre-
quently  bathed  with old linen soaked in tepid water.
In phymosis,  warm milk or tepid water should be in-
jected into the urethra several times a day.

  §  299. Acute  gonorrhoea.
  Syphilitic gonorrhoea resembles a catarrhal inflam-
mation of  the mucous membrane of  the urethra, mo-
dified according to the seat or extent of the inflamma-
tion and the  character  of the  accompanying fever,
whether erethic, synochal, or torpid.
  Symptoms: The first symptoms of the disease show
themselves between the third and eighth day, seldom
before and seldom  after.   The  gonorrhoea generally
commences with the sensation of a voluptuous titilla-
tion at the tip of the urethra, with increased desire for
sexual intercourse ; frequent erections, particularly at
night; seminal  emissions, and increased desire to uri-
nate.  In three or four days this titillation changes to
a troublesome and  painful sensation along the urethra
and in the  fossa navicularis, which changes to a burn-
ing during micturition; the orifice of the urethra  and
the glans are swollen, red,  sensitive.
  Soon after titillation and pain have  set in, a whitish
fluid, which is  at first half-transparent, is  secreted
from the urethra, and  is partly  discharged and partly
dries up in the urethra and stops up the orifice ; soon,
however, the fluid  is changed to a purulent, milky or
greenish mucus, which is secreted in  large  quantities
and can be pressed out.   A burning, stinging, tensive
pain, is experienced along  the urethra during  micturi-
tion, it is increased by pressure, and frequently extends
to the perinaeum, the groin, and testicles.   The fevei-
ls generally very mild. This is the inflammatory stage,
which is at its height on or about the fifteenth day. 
MODIFICATIONS OF GONORRHOEA.
207
  Gradually the pains diminish, the erections become
less frequent and painful, the swelling of the glans and
tip of the urethra  disappears, the  discharge  becomes
thicker, jelly-like, diminishes, and finally disappears
altogether.

  § 300. Modifications of gonorrhoea.
  Gonorrhoea is not always as mild as I have described
it in the previous paragraph;  it frequently passes be-
yond a mere erythematous inflammation of the mucous
membrane, increasing to a synochal phlegmonous in-
flammation, much more intense than the former, run-
ning a more rapid course, and penetrating more  deep-
ly into the tissues adjoining the  mucous membrane.
This more  intense  degree depends upon the constitu-
tion of the patient, upon the character of the infection,
or upon  the treatment  which, when  too stimulating,
sometimes transforms a mere erythematous inflamma-
tion to a  synochal,  etc.  This latter inflammation
sometimes involves the prostate and even the bladder,
being attended with acute pains.  The glans is bright-
red, swollen, the urethra is very painful to pressure in
its whole length, and  feels hard in some places.   The
discharge is sometimes streaked  with blood ;  some-
times even pure blood is discharged from the urethra
during an  erection.  Micturition is difficult, very  pain-
ful, the desire to urinate intolerable ; sometimes  there
is complete ischuria, spasm of the bladder and tenes-
mus,  constipation,  chordee, orchitis, consensual bu-
boes, synochal fever.  The inflammation is sometimes
so intense that there is no secretion at all, in which
case the Germans term  it " dry gonorrhoea."
  A second variety is the so-called torpid gonorrhoea ;
the patient feels otherwise  well, and there is only a
discharge from the urethra.
  Another variety is the so-called erysipelatous  go-
norrhoea, with erysipelatous inflammation of the pre-
puce, oedematous, shining,  pale-red  swelling of  the
prepuce and orifice of the urethra, and discharge of a
rather watery mucus, with erysipelatous fever. 
208         MODIFICATIONS OF  GONORRHOEA.

  Chordee is generally present in the synochal variety;
this is a curvature of the penis downwards during the
painful erections,  and is caused by an ellusion of plas-
tic lymph into the interstices of the spongy body of the
urethra, to  which the  inflammation  of  the mucous
membrane had  extended ;  this effusion  prevents  the
free  passage of the blood  into the cells of the corpus
cavernosum during an erection.
  If the prepuce is very long, phymosis is apt to set in,
that is. the prepuce becomes inflamed or ocdematous,
and can no longer be drawn back over the glans.  By
paraphymosis we understand  a  constriction  of the
penis by the swollen prepuce being drawn back be-
hind the glans,  and not allowing of being brought for-
ward again  over the glans ;  it takes place  when the
prepuce is very tight, and has been violently drawn
back behind the glans, for instance, in consequence of
erection, embrace, etc.;  the prepuce forms pad-shaped
swollen folds behind the corona glandis, which some-
times swells up enormously, and  may even become
gangrenous unless the stricture is relieved very soon.
  § 301. Terminations of gonorrhoea.
  The usual termination is in dispersion, with gradual
abatement of all the troublesome symptoms and trans-
formation of the purulent into a rather  serous  dis-
charge.  Some  pains pass off sooner, others later.
  Secondary gonorrhoea frequently  remains,  trying
most severely the patience  of both physician and pa-
tient. All the morbid symptoms have  disappeared, ex-
cept  a chronic irritation  of the urethra which remains
and manifests itself by a constant discharge of mucus,
and very frequently by pain in the urethra.  Irritable
individuals get worse by exercise or stimulants ;  torpid
individuals are less affected by such causes.
  Long-lasting  secondary gonorrhoea may likewise
lead to strictures and ulcers, though I  have never wit-
nessed such results under homoeopathic treatment; I
have seen, however, difficulty of urinating and emis-
sion of the urine drop by drop under that treatment.
  It is a remarkable fact, that  gonorrhoea will rouse 
       HOMCEOPATHIC TREATMENT OF GONORRHOEA.    209

many ailments which had previously remained latent
in the  organism.   Even perfectly healthy individuals
frequency complain of distresses which make their ap-
pearance after the gonorrhoea and even during the dis-
ease, and first announce themselves by the  fact that
the discharge will not pass off under several  weeks, or
turns  into secondary  gonorrhoea.    In  a very  few
cases, the remedies which Hahnemann  has  proposed
for this disease effect a cure ; but in by far the greater
number of cases, the Hahnemannean mode of treat-
ment would  allow the  disease to run its course un-
checked.

  § 302. Homoeopathic treatment of gonorrhicea.
  This disease is exceedingly troublesome both to the
patient and physician.  The former would be  willing to
bear the pain  if it were not for the discharge ; and the
latter is perplexed by the uniformity of the symptoms.
The  different forms of gonorrhoea are only distinguish-
ed by the intensity of the symptoms,  and perhaps only
the synochal variety points more distinctly  to one or
the other remedy.  I have  not always  been able to
prevent the disease running into a secondary form; I
have even no hesitation in saying that, when I hit the
right remedy,  it was more  by accident than anything
else.
  Hahnemann proposes to  cure sycosic  gonorrhoea
with a few pellets of Thuja 30, allowing them to act
for thirty  or  forty  days, to be  followed  with a few
pellets of Nitric  aci/l  30, which are to act as long.
For  common gonorrhoea he  prescribes a drop  of the
recent tincture of Petroselinum, provided there is fre-
quent urging to urinate, or a drop of an alcoholic solu-
tion  of Balsamus Copaiva?,  provided the  excessive
inflammation of the urethra, or the  psora which  had
been roused by a  violent allceopathic treatment, does
not require the use of the antipsorics.
  As I said above, the treatment  proposed by Hahne-
mann  is entirely  insufficient.   Petroselinum and the
tincture  of  Copaivce  cure  but  very few  cases of 
210     HOMCEOPATHIC TREATMENT OF GONORRHOEA.

gonorrhoea.   Thuja alone  is  scarcely ever  sufficient
to cure sycosis;  Nitric acid  has  to be  given after-
wards,  or even Cinnabaris, or some other mercurial
preparation.   Some  cases  of  syphilis do not yield to
Mercury, but require Hepar sulph., Acid, nitr., Aurum,
Rhus tox., or some other remedy.  Some patients are
sufficiently impressed  with a dose of Mercurius  12,
others require repeated doses  of the first trituration.
   Some gonorrhoeas  require  a  variety  of  remedies.
In gonorrhoea  which  at once sets in with  great  in-
tensity,  I  give  from   the commencement a dose of
Thuja; this facilitates the treatment,  though  I con-
fess,  I am  entirely unable  to  distinguish  between
sycosic gonorrhoea and one of an ordinary  kind.   If
fig warts are present,  the   gonorrhoea always disap-
pears with  the general disease.   There are  syphilitic
gonorrhoeas capable of producing a  chancre ; these
gonorrhoeas  yield to Mercury.   This agent  is indi-
cated when the  urging  to  urinate  is  not relieved,
but rather  increased, by  Petroselinum, and when an
intolerable  burning is experienced in the forepart of
the urethra during micturition, particularly during  the
passage of the last drops  of urine, the  glans being
at the same time swollen and hot; the discharge has
a greenish tinge. The remedy  has to  be  repeated
frequently.  Mercury is particularly suitable when  the
gonorrhoea is attended with  phymosis,  paraphymosis
and balannorrhoea.  Mercury is perfectly suitable  at
the commencement of a synochal gonorrhoea, or when
an erethic  gonorrhoea is  about Jo assume a synochal
character.  If syphilitic ulcers are present,  Mercury
should be given  as a matter of course.
   In several cases where the  patients presented them-
selves  at  once,  as  soon as  they perceived any  un-
toward symptoms, a cure was effected immediately by
a small portion of a drop  of  Copaiva? bals.;  but there
was  no urging to urinate.   But,  if the  patient drank
coffee, took much exercise, used stimulants, etc.,  the
effect of the Copaiva was destroyed immediately, and
no subsequent dose was able to repair  the mischief. 
       HOMCEOPATHIC TREATMENT OF GONORRHOEA.    211

Petroselinum helps only in  very mild cases  which
would, probably, have got well in the end without any
medicine.
  Cannabis, three doses a day of the mother-tincture,
is the best remedy in the erethic stage of  gonorrhoea.
I continue it, until the pain has entirely gone ; the dis-
charge  of  mucus frequently  decreases at  the same
time.  If this, however, should not be the case be-
tween five or six days, I then frequently resort to
  Cantharides, 3 att., ten drops in one ounce  and a
half of water.  This will effect a cure in many cases,
but  in many other  cases  it  will not, and then the
choice  is  difficult,  for secondary  gonorrhoea now
makes its appearance.
  Torpid gonorrhoea requires to be  treated as the
other forms of gonorrhoea.   In  synochal  gonorrhoea,
with painful erections, violent burning and  tenesmus
of the bladder, we have  to  give repeated doses  of
Aconite,  in alternation with Cantharides,  after  which
the gonorrhoea assumes the ordinary mild  form,  for
which Cannabis or some other remedy should then be
given.
  In dry gonorrhoea, with inflammation of the neck of
the bladder  and of the bladder itself, Aconite, Pulsat.,
Thuja, Cannabis and Canthiar., are the principal  re-
medies.  In chordee we give  Cannabis,  Merc,  and
Canthar., or. when there is much inflammation, Aco-
nite, which  can sometimes be followed  by Sulpliur.
Sulphur is an excellent remedy in torpid  gonorrhoea,
even when the glans is red and swollen ; it frequently
proves efficient in secondary gonorrhoea,  and in the
gonorrhoea  of children,  produced by worms or some
other unknown cause.  For symptomatic buboes, Mer-
cur., is  the  principal remedy;  sometimes,  however,
Hepar sulph.; they disappear, however, of themselves
as soon as the urethritis is removed.
  Mercurius should  likewise  be administered for the
painful  swelling of  the  lymphatic vessels along the
penis and the prepuce;  Calomel, however, acts better
than Merc, sol., and, if Calomel should not produce an 
212    HOMOEOPATHIC TREATMENT OF GONORRHOEA.

improvement between sixteen or eighteen hours, Merc.
prcecip. ruber should be given.  In secondary gonor-
rhoea, Sulphur, Lycop., Conium, Hepar .v., iSatr. mur.,
Agnus cast., Acid, nitr., Sepia  and some other re-
medies  are the best.  Latterly  I have cured  many
cases of secondary gonorrhoea with  one drop  of Can-
tharides, morning and evening ; many other cases re-
mained uncured.  On one occasion  Hahnemann com-
plained to me  of the secretions of mucus  which con-
tinued to take place between the prepuce and glans
in  cases  of condylomata,  though  the  excrescenses
had been cured ;  " in  these cases," said  he.  " lime-
water, a solution of the acetate of lead, or  some other
external application, may  be used  without injury  to
the  general  health."  Why should not this  remark
apply  to secondary gonorrhoea?  I  have tried an in-
jection  of the acetate  of Zinc,  from  ten to  fifteen
grains in five  ounces of water,  three times a day, in
very difficult and inveterate cases, with great success.
When the secondary gonorrhoea was not  too old, an
injection of red wine and water was found sufficient.
  To moderate the nocturnal erections, the patient
should not only take Cantharides,  but he  should  eat
little or nothing at supper;  he  should  sleep on mat-
tresses, cover himself moderately, and urinate as often
as he wakes.  If Cantharides be not sufficient, Can-
nabis  will be  found  to answer the purpose,   parti-
cularly if the  phlegmonous symptoms had been re-
moved.
  Blood is frequently discharged from the urethra in
synochal gonorrhoea ; the patient feels rather  better
after it than otherwise ; only when the discharge is con-
siderable, cold applications  may be  made to the penis
and perinaeum,  or cold  injections   into the urethra,
or compression of the urethra may  be resorted  to.
  Dysuria and ischuria are  treated as usual.
  The phymosis  disappears with  the  inflammation ;
it does not require  any particular treatment;  the
parts  should be kept  very clean,  and tepid  vvalcr 
       INFLAMMATION OF THE GLANS AND PREPUCE.    213

 should be frequently injected  between  the prepuce
 and glans.
   Paraphymosis, on the contrary, has to be removed
 immediately,  lest  gangrene of the glans should su-
 pervene.   The glans has to be compressed  with the
 fingers,  and the prepuce should, at the same  time
 be drawn back  over  the glans; this  is frequently
 very difficult, and  takes from  one half  to one hour;
 the  operation is  frequently facilitated by previously
 bathing  the parts in warm water.
   Pulsat., Ferrum,  Capsicum, Mezereum,  Ledum, Nitr.
 acid, and  Sabina seem to be related to the symptoms
 of this disease, but I  have never derived any benefit
 from these remedies.   Nor have I  from  Tussilago
 Petasit.es,  recommended by Dr. Rosenberg,  or from
 Bignonia radic. minor, proposed by Dr. Wahle.

   §  303.   Inflammation of the  glans  and prepuce.
   These  inflammations most frequently set in as a se-
 quel of syphilitic diseases.  Sometimes, however,  they
 occur without  any  infection having  taken place, in
 consequence of sexual excesses, contusions,  irritating
 vegetable poisons ;  even the whole penis appears in-
 flamed, with violent burning pains through the whole
 penis,  and attended with  painful  stitches,  shooting
 from the back to the fore part of the urethra.   These
 inflammations  terminate  in  gangrene   more  easily
 than  any other,  particularly  when they  have an
 erysipelatous character,  as is sometimes the  case in
 gonorrhoea.
   If this inflammation  should  have been caused by
 abuse of  Canthiarides,  the antidote  is a solution of
JJamphor.
   Paraphymosis may arise from too tight an embrace,
 with  swelling  and  burning  pain of the glans  and
 swelling  up of the prepuce in the shape of a blister;
 in this case, the taxis, which has been  described in the
 preceding  paragraph,  should be attempted,  and ^4co-
 nite and Arnica, or, if these remedies be not sufficient,
 Rhus tox. should  be given.  But if the  whole penis 
214      BALANITIS, GONORRHOEA PRiEPUTIALIS.

should be inflamed, if violent erections should be con-
stantly taking place, or chordec should have set in, in
this case Cantharides will be found to act as a specific.
For a simple inflammatory swelling of the penis with-
out congestion, Ledum is  a good remedy.
  If the inflammation arise from  syphilitic  ulcers on
the glans and inner surface of the prepuce, Mercurius
is the best remedy, or else Hepar sulph., or jSitri acid.,
if  the patient should have  taken  much  Mercury.
Where  no  cause can be  assigned, Cuprum, Cannabis,
Cantharides, etc., will do good.
  For an erysipelatous inflammation Camphora, may
prove useful, or Belladonna followed by Calomel, first
or second tritur.  Rhus tox. corresponds  to  vesicular
excrescences on the inflamed parts.  If symptoms of
gangrene should set in, Arsenic must at once be given;
the approach of gangrene is diagnosed  by a sudden
abatement of the violent pains,  though the swelling
remains the same, and by the  livid colour.
  § 304.  For the primary gonorrhoea of females, leu-
corrhoea virulenta, I refer the reader to my remarks
on colliquations, § 93 of this volume.  I have nothing
further  to add.
          BALANITIS, GONORRHOEA PR^EPUTIALIS.

  This affection only attacks men with a long prepuce,
and subject to profuse secretions from the follicles of
the glans, and scarcely  ever occurred in my practice.
except among  men who  had  had  several attacks of
syphilis and had  not kept themselves  clean.   The
disease can likewise  occur in consequence of a me«
chanical  injury of the glans, pressure  and  friction
during too tight an embrace,  onanism, or an embrace
with  females  during  the  menstrual flow,  or females
affected with leucorrhoea.
  Symptoms of balanitis : The glans under the retreat-
ing prepuce appears  somewhat swollen,  red,  and
covered with a purulent mucus which has the odour 
          BALANITIS, GONORRHOEA PRjEPUTIALIS.      215

 of old  cheese.  On the glans we observe actual abra-
 sions.  There  is little pain, but heat and itching of
 the glans  and prepuce.  The disease  runs a rapid
 course, and frequently disappears merely after bathing
 the part with milk.  Sometimes abscesses form be°
 tween  the glans and  prepuce in consequence  of the
 accumulation  of mucus; this, however,  occurs very
 seldom in simple balanitis.  If balanitis is accompanied
 with chancres, there is  generally  phymosis, and the
 chancre is felt through the prepuce like a hard spot; it
 is  likewise probable that ulcers are present when the
 secretion is rather ichorous than purulent, sometimes
 mixed with blood, or when buboes are present.
   § 305.  Treatment:  Bathing with milk, or with  a
 decoction of althea, or tepid water, is of the utmost
 importance in simple balanitis, that is,  in balanitis
 occasioned by friction during too tight an embrace, or
 by enjoying an  embrace with menstruating females,
 or females affected with leucorrhoea ; it is likewise of
 importance to introduce  a linen rag soaked with one
 of the above mentioned liquids, between the glans and
 prepuce,  and to renew this three or four times a day.
 If this  should not be  sufficient,  the parts should be
 bathed  several times a day with limewater, or with a
 solution of one grain of the acetate of lead in from two
 to three ounces of water.   This will suffice.
  The more inveterate cases require internal remedies.
 If the  disease should return after  having  been re-
 moved by such applications,  it is fair to suppose that
 it is  more  deep-seated than appeared  at first  sight.
 This is  particularly the case with men who had been
 several times attacked with syphilis.  The best-remedy
 is Merc prcecip. rub., 2d or 3d trit., one grain morning
 and night, to be continued for  five  or six  days, after
 which period  the  medicine is to be discontinued for
 a few days to ascertain whether the disease requires
 further  treatment.  This  remedy is indicated  when
 only  part of the glans  and corona glandis exhibits
erosions, and the secretion  is not ichorous but white-
slimy, and has no very offensive smell.  If this  latter 
216            SECONDARY GONORRHOEA.

symptom was present,  if the ulcers were more exten-
sive, covering even the inner surface of the prepuce, I
always found Cinnabar is, 1st frit., preferable to the red
precipitate.   If the secretion be rather ichorous, with
a penetrating odour ;  or if  the erosions, particularly
behind the corona glandis,  should change  to  round,
unclean or flat ulcers; or if the  patient had taken a
good  deal  of Mercury,  then Thuja will be found the
best remedy, and it will be  rarely necessary to follow
it up  with Nitric acid.
  If the disease owe its origin to  onanism, the patient
must, in the first place, renounce  his habit;  he com-
plains of  itching and creeping of the glans, which is
covered with red spots  of  the size of a dime ; these
spots  secrete a humour,  especially  near the corona,
spread a fetid odour, and oblige the patient to scratch
all  the time.  Natrum muriat. is  the principal re-
medy for this condition, which requires to be followed
by  Lycopodium in a few cases, or, in some others,  by
Sulphur.  Attomyr recommends Corallia rubra, 3d trit.
This medicine has : the glans and inner surface of the
prepuce  are painful,  red  and swollen, secreting a
yellow-green, fetid pus, with red,  flat  ulcers  on the
glans and inner surface of the prepuce, and a quantity
of yellowish ichor.
   Of any other  remedies  which have  been  recom-
mended  for  this disease,  such  as Sepia,  Mezereum,
Nux  v.,  etc., I have  nothing to  say,  because  I have
never used  them.

  § 306.  Secondary gonorrhoea.
  Epididymitis gonorrhioica, orchitis gonorrhoica. Swell-
ing of the testicles.
  I refer the reader to § 255, vol. I., where  he will
find every thing I have  to say  on this head.  As a
preventive, the patient  may,  as soon  as  the gonor-
rhoea makes  its appearance, wear a suspensorium ;
he  should likewise  guard  against cold by every pos-
sible means. 
OPHTHALMIA GONORRHOICA.
217
   If orchitis  should have set in,  the patient must
 keep a horizontal position, and wear a suspensorium.

   § 307.  Ophithialmia gonorrhoica.
   This  disease is produced by a metastatic transfer
 of the  gonorrhoic  miasm  to the  eye,  not by the  in-
 troduction of the secretion into the eye.  This may
 induce conjunctivitis, which, however, can easily be
 removed by washing the  eye  with tepid water or a
 decoction of althea.
   Symptoms:  The  gonorrhoea disappears suddenly.
 Som after,  the patients  experience a burning sen-
 sation in the eye,  with visibly increasing dark red-
 ness of the eyelids and conjunctiva, which swells and
 becomes raised round the cornea like a wall.  Soon
 after, the cornea becomes involved,  turbid,  congested
 interstitially distended,  and assumes a granular ap-
 pearance ;  a quantity of  yellow or yellowish-green
 mucus  is secreted,  which  resembles a good deal the
 secretion from the urethra. In many cases the cornea
 becomes softened, the humours of the eye flow out, and
 the eye  becomes atrophied.  In lighter cases,  when
 the  cornea  is  only  partially  destroyed,  staphyloma
 takes place.   In such cases, help must  be afforded im-
 mediately, for the  destruction of the eye is sometimes
 completed in twenty-four hours.
   § 308.  Treatment: If the inflammation should de-
 velop itself  slowly,  it  may be proper to give first a
 few doses of Aconite ; but the more  specific  remedy
 should  not  be neglected.  If the inflammation and
 swelling should continue  in spite of the Aconite,  if
 there should be an increase of secretion with burning
 pains in  the eyes, Mercurius is probably  the  first re-
 medy.   Next to Mercurius we have Nitri acidum,  or
 Hcpar  sulph.,  unless  Thuja,  Cannabis,  Belladonna,
Aurum,  Euphirasia,  Sulphur,  should be required by
the symptoms.
vol. iv.—10 
218         RHEUMATISMUS  GONORRHOICUS.

  §.  309.   Rheumatismus gonorrhoicus.
  This is a peculiar rheumatic affection, especially of
the knee  and tarsal-joints.  The symptoms  are  the
following: The disease sets  in  either during or after
the gonorrhoea; it commences with pain and swelling
of the joints, and is generally confined to the knee and
tarsal joints, though  other joints may likewise be in-
volved.   It is seldom the  case  that  two joints  are
attacked at the same  time.  The symptoms  are most
violent  when  the gonorrhoea is on  the decrease,  or
after  it had been  suppressed by Cuhebs  or Copaiva.
The joints are generally somewhat swollen and pain-
ful, particularly  in  the evening, in  bed.  There is
scarcely ever any external  redness, nor  is there any
pain on pressure.  The pulse is hurried ; loss of appe-
tite,  derangement of the stomach.   Relief  is some-
times afforded by a sudden eruption  of  pustules,
papulae or spots, which remain a few days and then
dry up  and scale off.  The articular affection some-
times sets in  after a few days, or  after  weeks, and
even  months, afid either runs  an acute  or chronic
course.
   Causes:  Opinions  differ  in  this  respect.   Some
authors think  the disease is occasioned by a cold,  by
living in damp dwellings, by an imprudent suppression
of the gonorrhoea, metastasis to the joints, reflex-action
of the irritated urethra to  one or the other portion of
the spinal marrow;  others  consider the  disease as
something accidental,  existing  independently of  the
gonorrhoeal disease ; others again consider the disease
as produced by the action of Copaiva.
  § 310.  Treatment: In the first volume of this work
the reader will find a number of remedies  indicated
for rheumatism and  arthritis, of which a physician
may likevise avail himself in this  disease, provided
the symptoms correspond.  One of the principal reme-
dies is the Balsam of copaiva, of which  I dissolve one
drop in 99 drops of alcohol by means of long shaking,
and  give  the patient  a drop three times everv day in
water.  I used the medicine when the gonorrhoea and 
CHANCRES.
219
the articular affection was attended  with the break-
ing out of pustules  over the whole body;  these indi-
cations are sufficient, for the disease yielded in a few
days.
   If, after the cure of the gonorrhoea, when the urethra
was only left closed by a little mucus, the rheumatism
was caused by a cold  or exposure to wet, while the
body was heated, I  employed Colchicum 3 with great
success ;  the pains in the joints are most violent from
evening until day-break.
   Some alloeopathic writers (A Cooper,  Cumaus)  re-
commend small doses of Terebinthiina  for this disease.
I have never used it, though it may be a good remedy.
   Thuja  is perhaps  preferable whether  the disease
sets in during  or after the gonorrhoea.   The Thuja-
pains are worse in the warmth, especially in bed,  and
its curative  virtues  in  sycosic gonorrhoeas,  and in
rheumatic and arthritic affections, especially  of the
knee and tarsal joints, are well known.
   Sabina.  Both the upper and lower limbs may be
affected; small itching  pimples  which form  scurfs
after scratching,  frequently  appear  on the affected
joints,  and the patient feels more comfortable in a cool
room than in  a warm.
   Manganum aceticum  is useful for rheumatic pains,
particularly  when digging and shooting pains  in the
cross-wise affected joints torment the patient,  parti-
cularly at night, attended with little itching blotches
which  cause a burning after being scratched.
   Phiosphorus  and Hep. sulphi. are useful in the chronic
variety.   I refer the reader to the Mat. Med.  for the
symptoms.

   § 311.  Chancres.
   There are many varieties of chancre, though all are
of syphilitic origin; they secrete a humour which is ca-
pable of  transmitting the disease to other persons.
Baumes asserts that  primary chancre  has not a single
positive pathognomonic symptom. 
220
CHANCRES.
  The different varieties of chancre  may be classed
under the following heads, if we take their essential
characters for guides:
  1)  Sim/rfe chancre, including the raised ulcer ;
  2)  Indurated or Hunterian  chancre ;
  3)  Phagedenic chiancre, including the so-called diph-
       theritic, gangrenous and serpiginous  varieties.
  a)  Simple chancre.   This is  most frequent.   It  is
seated on the body of the penis, on the inner and outer
surface of the prepuce, and on the scrotum ; it is of the
size of from a small  pea to that of a shilling-piece.
  The simple  chancre  develops itself in this fashion:
first, a vesicle  or pustule which shortly  covers itself
wi:h  a scurf, which,  after falling  off,  leaves an exca-
vated, oval or circular ulcer, with a lardaceous, dingy-
yellow or brown bottom, and sharp edges  which are,
however, neither very much inflamed, nor  callous or
raised ; the surrounding parts are of  a brown-reddish
colour.   Neither the  bottom nor the edges of the ulcer
are hard.
  In eight or ten days,  the edges and sometimes even
the base of the ulcer become, raised,  exhibiting a sort
of spongy growth, and being  sometimes considerably
raised over the healthy parts (ulcus elevatum); in spite
of this elevation there  is no hardness as in the Hun-
terian chancre;  the pus is of a  serous  character.
There is little pain,  or else  it lasts but a short time ;
it is more painful when seated behind the glans or on
the inner surface of the prepuce, than when seated on
the glans itself.   It  may be complicated  Avith bubo
and phymosis ; in the latter  case it is not easy to diag-
nose  a chancre  on the internal surface of the prepuce,
as it is impossible  to feel any hardness through  the
prepuce.   Unfavourable  circumstances  may trans-
form a benign chancre to a phagedenic, or gangrenous
ulcer.
  b) Indurated or  Hunterian chancre.   This is either
a primary chancre or it develops itself out of a simple
chancre  in  consequence  of  bad  treatment.  This
chancre  is  most frequently seen  on the  frenulum. 
CHANCRES.
221
 corona glandis, glans, prepuce, body of the penis, and
 sometimes even on the anterior surface of the scrotum.
   This chancre is more or less circular, excavated, of
 a dark, livid, dingy colour, and  a lardaceous, yellow
 base, without granulations; the  edges  are hard and
 thick, the bottom  is callous.  The induration  termi-
 nates very suddenly, but  may  be of considerable ex-
 tent even when the ulcer is very small.  If the ulcer
 be seated on the penis,  it is generally  not excavated,
 the edges and base are less callous, the colour is less
 livid ; on the prepuce the induration spreads consider-
 ably.  It runs a slow course.
   After the chancre is cured, an obstinate  induration
 frequently remains.  This  is a bad omen, portending
 secondary troubles which seldom remain away.  The
 indurated part may become excoriated, tear during an
 embrace, and give rise to  an ulcer which may again
 assume a chancrous appearance.
   Secondary symptoms sometimes make their appear-
 ance even while the chancre is still existing, such as:
 syphilitic appearances on the skin, ulcers in the mouth
 and throat, exostoses.
   c) Phagedenic chancre.   This  chancre  is either  a
 primary disease,  though this is  rarely  the case, or  it
 develops  itself out  of a simple or indurated chancre.
 This variety is characterized by the continuous spread-
 ing of the ulcerative destruction, and has  two forms,
 the diphtlicrilic and the gangrenous.  The former ulcer
 is covered  with  a  white-gray,  pseudo-membranous,
 seated layer, which detaches itself in  pieces, and is
 reproduced at the expense  of the sound parts, so that
 the destruction keeps spreading more and more.  The
 gangrenous chancre has  a livid appearance, is sur-
 rounded by a livid areola  and co\7ered with gangren-
 ous scurfs of various sizes,  which, on being detached,
 open  to view a common phagedenic ulcer that may
 again become covered with a new gangrenous scurf.
  Both kinds of ulcer secrete a thin ichor, of a reddish-
brown colour, acrid, frequently sanguineous, and ex-
tremely fetid ; the  surface  of the ulcer is uneven as 
222
CHANCRES.
if corroded, without granulations, sometimes bleeding
very readily;  the  edges  are  irregularly  indented,
frequently oedematous, surrounded by  dark redness.
A  phagedenic  chancre is generally  very painful ;
the patient  complains of a violent burning as from
hot coal, of violent stitches  and  gnawing,  and the
pains spread to  the  adjoining parts.  There are like-
wise cases where the pain is  very  slight,  in spite of
the spreading  destruction.  The general organism  is
sometimes  considerably disturbed, pulse  120  to  130,
tongue brown and dry, face disfigured ;  the  patient
loses  his strength, and typhoid symptoms seem to be
approaching.
  This kind of chancre involves the glans, prepuce,
penis, labia, vagina,  perineum, buttocks,  and keeps
spreading,  until all these  parts are destroyed.   The
ulcer seldom cicatrizes before the end of the second
month,  even in the most  favourable case,  whether
the destruction run  a rapid or slow course ; in many
cases the disease lasts from  four to eight months and
upwards; the ulcer  keeping spreading from one part
to another, alternately healing and breaking again.
A chancre which  heals on one side  while  it keeps
spreading on  the other, has been termed serpiginous;
it  gets worse under the treatment of Mercury.  Bu-
boes  rarely exist  with a phagedenic chancre ; but  if
they  did exist before  this  chancre  broke  out,  they
too become phagedenic.
   § 312.  Every chancre  may be complicated  with
phymosis, or,  though  less  frequently,  with paraphy-
mosis.  Phymosis makes it frequently  impossible  to
diagnose ulcers  seated on the inner surface  of the
prepuce, until they have spread a good deal, or gan-
grenous destruction of the glans and urethra, or per-
foration of the  urethra, has taken  place.
   Females  are less  liable to chancres than males,
probably owing to the greater elasticity of the female
organs, which protects their mucous membrane from
infection. The chancres of females are generally more
benign than those of males ; the classification is the
 same. 
CHANCRES.
223
  Primary chancres may be moreover  seated  at  the
anus, on the lips, tongue, female breast; exhibiting, of
course, different forms, according as the tissue  of  the
parts where the  chancres are  seated ;  for instance,
ulcers on the glans are, generally speaking, round, ex-
cavated, indurated; when seated on soft skin or in loose
subcutaneous cellular tissue, the bottom of the ulcer
is more elevated, the edges are raised above the adja-
cent tissues, the base is hard and circumscribed.   On
the body of the penis the  chancre is broad and super-
ficial ;  on the thighs and  calves  it has a rounded-off
shape, etc.
  Diagnosis : The exciting cause must tell us whether
an ulcer is syphilitic  or not; besides, the following
characteristic   symptoms aid us in  determining  the
syphilitic character of  an ulcer:  rounded-off  shape,
sharp edges, lardaceous, whitish bottom,  hardness,
disposition to spread, swelling of the inguinal glands,
etc.
  Herpes  prcpputialis is  distinguished  from chancre
by its base, which is not indurated as in chancre.   On
a red spot of the  size, of a dime, groups of little vesi-
cles, from six to ten, start up, which  break  and then
change  to small  crusts ;  the ulcers which thus arise,
disappear in a few  days.   Psoriasis of  the prepuce is
easily  distinguished from chancre by its scaty  ap-
pearance.
  Prognosis : Favourable, provided the patient obeys
strictly ihe instructions of his physician, and does not
indulge the least  excess.   A simple  chancre most
generally  gets well without anysecondary symptoms.
A phagedenic chancre is  very difficult  to cure, parti-
cularly if  the patient be infected with dyscrasia, with
an impoverished  constitution, and living in unfavour-
able circumstances.   The  longer the chancre  had
lasted,   the more easily do  symptoms  of secondary
syphilis break  out.  An  indurated chancre is  almost
always  followed  by symptoms  of secondary syphilis.
They rarely set in after the serpiginous  or gangrenous
variety. (Canstatt.) 
224
CHANCRES.
   §313.  Treatment. According to the doctrines of the
homoeopathic school, a chancre  is not a local symptom,
but the visible representative of an internal syphilitic
disease.   A chancre does not make its appearance till
the syphilitic miasm has penetrated the whole organ-
ism, which, by means of its inherent vital or reactive
energies,  checks the destructive effects of the poison
by compelling it to locate its sphere  of action on
the externa] skin within definite limits.
   The specific  remedy  for syphilis is Mercury, not
only Mercurius solubilis, but all the other  mercurial
preparations combined with other chemical substances.
These will sometimes effect a  cure where Merc.  sol.
leaves us in the lurch.  Also in secondary syphilis, and
in the diseases which sometimes set in as consecutive
diseases  of syphilis, Mercurius is the principal reme-
dy, although we sometimes  have  to  resort to other
remedies on account of  the  psora and the mercurial
symptoms with which  we find the  syphilitic disease
combined.
   As regards the action of Mercury, I am entirely of
the opinion of Dr. Trinks, that,  " in consequence of the
slow  action of Mercury  upon the animal organism,
Mercury is very little adapted to diseases that might
soon terminate fatally, but only to diseases that run a
slow course, and allow the Mercurius sufficient time to
develop its action.  This is the reason why one  dose
of Mercury will seldom  be  found sufficient,  and why
repeated doses of this medicine are required to over-
come the inherent slowness  of its action, especially in
diseases which  are deeply seated in  the vegetative
system."
  The specific remedy for a  primary chancre is Mer-
curius sol.   The cure is  effected more or less rapidly
according as the patient is more or less sensitive to the
action of medicine  generally, or according as he had
been  treated with large doses of Mercury for previous
syphilitic  diseases.   The best dose  is one grain of the
first or third trit.. morning and night.  If no  improve-
ment should take place within  the first eight days, a 
CHANCRES.
225
 lower trit. must be given, should it even be one-third
 or  one-half of a grain of the pure Mercury.   If, how-
 ever, an improvement should have taken place, the
 medicine may  then be given less  frequently  until the
 cure  is completed.  I know very well that a cure  can
 be  effected in many cases by the attenuations of Mer-
 cury, but not near as safely as by the lower prepa-
 rations.
  If the lower as well as the higher preparations of
 Merc sol. should prove ineffectual, in this case Merc.
prac  rub. should be  exhibited  after an  interval of
 from one to two days.  I generally use the lower pre-
 parations, one-eighth or one-sixth, and so forth, of a
 grain, three times a day, gradually descending to  the
 lowest preparations, if necessary.
  If it should be  an elevated chancre, Merc, prcec rub.
 may  be employed  from the commencement; and,  if
 the middle portion of the chancre should be raised so
 as  to give rise to the supposition that a condyloma is
 forming, Cinnabaris, first trit., should at once be re-
 sorted to, the patient taking several doses a day.  If
 the chancre should not entirely disappear after Cinna-
 baris,  Tliuja  should be  given, not  too high, and, if
 necessary, Nitri acid, after Thuja.
  The  presence of Phymosis and Paraphymosis does
 not alter the  treatment of simple chancre.
  § 314.  Continuation of the treatment of chancre.  In
the Hunterian chancre the hardness does, in most cases,
not set in till a few days after the appearance of the
chancre.  The treatment is, at first, as above describ-
ed.   Only when the hardness sets in, it might perhaps
be necessary  to change the medicine; but  this has to
be done  very carefully, lest the patient should be in-
jured by the  improper substitution of one, remedy for
another.  Select your remedy with care, and then give
it a fair chance to do all  the good it can.
  Merc. sol.  will sometimes be found sufficient, but
the  red precipitate will generally have to be resorted
to.   This chancre is sometimes attended with conse-
cutive symptoms, such  as  ulcers in the throat and
          10* 
226
CHANCRES.
fauces, even while the primary ulcer is still existing.
It seldom gets well under forty  to  fifty days.  Avoid
all improper hurry.   I give a dose of the  above-men-
tioned remedies  morning and night, and discontinue
them  as soon as the consecutive symptoms make their
appearance.  Then I give Hep. sulph. first or second
trit., and if this  should not be  sufficient, Nilri acid.
This treatment is generally sufficient, and nothing re-
mains except the local chancre,  or even this symptom
may  have disappeared,  and  nothing may have been
left except a remnant of the tuberculous disorganiza-
tion.  For this I give  the Iodide of mercury, second or
third  trit., at first at  short, and then at  longer inter-
vals, continuing  it until the indurations have  entirely
disappeared.   I  have  tried Calomel for the consecu-
tive symptoms, but with no good  effect, for ptyalism
set  in even after the  smallest  doses ;  it  is perfectly
suitable, however, when ptyalism accompanies  the
above-mentioned consecutive symptoms.   In  cases
where the velum palatinum is sore and ulcerated, with
painful  burning, Acid, phiosph.  is preferable to  Nitri
acidum.
  § 315. Continuation of  the  treatment  of chancre.
The phagedenic chancre, this most destructive form of
the disease, demands  a most  energetic treatment.  I
formerly believed, with other physicians of our school,
that this  chancre derived its  destructive  properties
from its complication  with  scrofula or herpes ; but ex-
perience has taught me better.   Prescribing upon this
supposition, I have allowed the fauces to be destroyed
by  ulcers, the nasal bones to  become involved,  the
syphilitic ulcers  to spread over the whole body,  to
enlarge and to  discharge  a cadaverous  ichor with a
cadaverous smell.   The  patients scarcely looked any
more  like human beings, suffering dreadful pains, with
swelled bones or the  bones destroyed  by ulcers.   \o
remedies will do for this  kind of chancre  except Mer-
cury,  but it must be given in  proper doses ; the organ-
ism must be saturated with Mercury to overcome the
dire enemy.  Be not  afraid  of aggravations; away 
CHANCRES.
227
 with this foolish bugbear, and even if some medicinal
 symptoms should develop themselves, what is that to
 the patient, provided he gets well of his disease 1  But
 these symptoms will be found to amount to very little,
 if anything.
   The best mercurial preparation to be employed in
 the treatment of phagedenic chancre, is Merc, prcecip.
 rub. in substance.  Some physicians use  Cinnabaris
 for chancre ; whether it is of  use in the  treatment of
 phagedenic chancre, I am unable to say;  it seems to
 me, however, that it can only  be used in the incipient
 stage of the ulcer.  At a later period, more energetic
 and penetrating mercurial preparations have to be
 used.  Among these, Calomel  is excellent, were it not
 for the ptyalism which it is apt to excite, and for the
 illusory disappearance of the ulcer under the action of
 this agent.  For these reasons  I resort to Merc, corros.,
 commencing with one-tenth of a  grain several times
 a day, and increasing  the dose  gradually  until the
 spreading of the chancre is arrested.  Should  the pa-
 tient have taken much Mercury, it is well  to interpo-
 late a few doses of Acidum nitri before continuing the
 Mercury.  If, however, the Corrosive sublimate should
 not suffice, then the physician will havre to  choose be-
 tween Merc, praic albus and the Iodide of mercury.
  For serpiginous chancre, I propose Thuja as the best
 remedy.
  Chancres on other parts of  the  body,  anus,  lips,
 mammae,  require  the same  treatment as that which
 has been indicated in the last three paragraphs.
  If the treatment which I have indicated for a phage-
denic chancre  should prove fruitless, this  would be
a sure sign that, the disease is complicated with psora,
scrofula, etc. In this case, Hep.  sulph., Sulphur, Caus-
tic, Aurum mur., Merc, nitros., Dulcam., Acid,  phosp.,
Staphys.,  China,  etc., are required   as  intercurrent
remedies.   In an extreme case,  I would not hesitate
to use Zittmann's decoction. 
228              SYPHILITIC  BUBOES.

  § 316. Syphilitic buboes.
  They are  commonly found  among the superficial,
seldom among the more deep-seated inguinal glands.
They generally  appear  the  second week  alier the
breaking out of the chancre, are sometimes preceded
by  a chill, and set in with a slight pain in  the ingui-
nal fold, extending down the  thigh and impeding the
use of the lower limbs.   Shortly after, a gland begins
to swell, which  is  at first movable under  the  skin,
having a globular or flat-oval shape,  and being  pain-
ful to pressure.  Sometimes the lymphatic vessels ex-
tending from the chancre to the gland, are inflamed.
Little by little the gland enlarges, becomes immov-
able, and the skin which covers it becomes red,  cher-
ry-brown.  The swelling  is  either dispersed or else
the gland suppurates under homoeopathic treatment.
  The  bubo  requires  the  same treatment  as the
chancre.  It disappears  with or before the chancre ;
but, if the chancre should get  well first, another mer-
curial preparation would have to be chosen for the
bubo ; or, if the patient should have been  drugged
with Mercury, some suitable  antidote, or  some anti-
scrofulous medicine, if scrofula should complicate; the
syphilitic disease.  I do not deem it necessary to re-
peat the various remedies which might be required for
these different contingencies.

  §  317. Syphilitic excrescences, condylomata,  Hahne-
mann's sycosis.
  According to Hahnemann, sycosis is a disease  caus-
ed by a particular virus, not syphilitic, and generally,
but not always,  accompanied  by a discharge from the
urethra.  It  is probable, however,  that  sycosis is a
syphilitic disease, though not curable by Mercury.
  The phenomena which  characterize  this disease
we will designate by the term "syphilitic excrescences."
These are  the vegetations of the  skin  and  mucous
membranes known as venereal warts, figwarts, cond -
lomata,  mucous tubercles, etc.,  which are  nothing but
hypertrophies of the subcutaneous or submucous eel- 
SYPHILITIC EXCRESCENCES, ETC.
229
hilar tissue.   If covered  with a thick epidermis, they
are  dry, horny,  and  are  called venereal warts;  if
covered with a thin pellicle, or none at  all, they are
soft, moist,  secrete a  peculiar,  acrid fluid, and then
belong to the  class of moist condylomata or  mucous
tubercles.
  Condylomata are either fiat, with a broad basis, or
pediculated,  conical.   This depends upon locality,
warmth, greater or lesser degree of humidity, friction.
The  flat condylomata consist in a  soft, superficial,
almost circular elevation  of the cutis, smooth  on the
surface ; they are the more frequent, and are generally
found between the  buttocks, around the  anus, on the
perineum, thighs,  scrotum, on the skin  of the penis,
especially where it covers  the scrotum, and on the outer
surface of the labia.
  The acuminated,  pediculated  condylomata  are
small, sometimes from one  to two lines long, thread-
shaped, forming  groups  shaped like the crest of a
cock  or a strawberry ; they spread  very rapidly and
sometimes  cover a large  surface ; they  are less  fre-
quent, but more obstinate ;  they are generally found
on the inner side of the prepuce, on the clitoris,  at the
entrance of the  vagina,  on the  nymphae, even higher
up.
  There  are  pin-shaped  condylomata, seated  on the
border of the glans, and on  both surfaces  of the lesser
labia.
  The more delicate, vascular and nervous the tissue
of the condylomata, the more obstinate their course.
They secrete  a peculiar, fetid,  acrid  matter, Avhich
gives rise to now condylomata on the adjacent parts.
They are generally very  little  painful,  sometimes,
however, a good deal; on open parts of the skin they
look much paler than  on those parts which are not
exposed to the light and air.

  § 318.  Treatment of syphilitic excrescences.
  According to Hahnemann, the best  mode of treating
sycosis is the following:—A few  pellets  of Thuja 30, 
230          SYPHILITIC EXCRESCENCES,  ETC.

to be allowed to act for thirty or forty days, and to be
followed by  a  few pellets of Nitric  acid. 9. to be al-
lowed to act equally as long.  In bad  cases, the ex-
crescences may be  touched once   a  day  with the
essence of Thuja.
   It is true that Thuja and Nitric acid, are the best re-
medies for sycosis, but not in such small doses as have
been  prescribed by Hahnemann;  much less  should
the so-called high potencies be relied upon ; these are
positively useless in the treatment   of syphilitic dis-
eases.
   Physicians still differ in their opinions about the use
of one or the other of  these two remedies in sycosis.
According to my observations, Thuja is suitable for
condylomata attended with gonorrhoea, for such as
develop themselves out of chancres (not quite certain)
and for flat condylomata with a broad basis ; the two
latter varieties require the  external application  of
Thuja.  According to Attomyr, on the contrary, Thuja
corresponds  to condylomata which are not humid  at
first, but become so afterwards, and,  in shape, resem-
ble the cauliflower.
   Acid, nitri. seems to be the specific for pediculated
and pin-shaped condylomata.  The larger, readily
bleeding condylomata, which, by their rapid growth,
are apt to induce phymosis, should  at the same  time
be touched with a  solution of Argent,  nitric  There
is a kind of condyloma which develops itself out,  of  a
boil-shaped ulcer  on  the  prepuce;  the  ulcer has  a
dark blue, greasy  bottom,  and covers itself with  a
crust under which  an ichor is secreted which  causes
the ulcer to spread  more and more.   After the  falling
off of the scurf, we perceive, enormous abnormal gran-
ulations which at once reveal  the true character of
the excrescence. In two cases, the whole disease dis-
appeared in a few days  after  the use of Acid. nitr.
Six or  eight weeks after,  I saw the patients  again,
and other fresh-looking condylomata had started up
behind the glans.  I could not tell whether these were
a new development of the old disease, or the result of 
          SECONDARY SYPHILITIC DISEASES,  ETC.      231

 a recent infection.  They were pediculated, and yield-
 ed to Saliua 1, very readily.
   Sabina is an excellent remedy for condylomata ; I
 generally give it when Tliuja  and Nitri. acid, are in-
 effectual ;  it seems to rank with Nitr. acid.
   Cinnabaris is suitable for condylomata which deve-
 lop  themselves out  of chancres,  particularly when
 pediculated  and readily  bleeding.  I have used Eu-
phrasia for stinging or burning pains in the figwarts.
   Acid, phosph., Staphys., Lycop.,  seem to have  some
 relation to figwarts, but  I  am  unable, to  say where
 these remedies should be used.

   §  319. Secondary Syphilitic diseases.  Syphilides.
   Generally speaking, condylomata and cutaneous ex-
 crescences.  They sometimes appear even during the
 existence of the primary chancre, sometimes, however,
 not till months and years hav^e elapsed.
   The principal forms  of  these secondary syphilitic
 diseases are, scales,  tubercles,  maculae,  pustules,
 vesicles.
   a. Macula?. Roseola syphilitica.
   These are irregular, circular, measle-shaped, cop-
 per-coloured spots, momentarily disappearing under
the pressure of the finger ; they frequently spread over
a large portion of the body, disappear at one place and
reappear again  at another ;  they generally  appear
on the neck, head, face,  and fall  off in bran-shaped
scale-;; they are  generally attended with primary
syphilitic symptoms, and sometimes disappear without
treatment.
  b. Papula?.  Blotches, Lichen syphiliticus, venereal
itch.
  These are copper-coloured spots, from the surface of
which start  up papulae  without itching, of a gray,
brown, or brown-violet  colour, small  and conical, or
large and spherical; at  times  they appear  in  groups
like  lichen, at others they are scattered.  This erup-
tion  generally appears  on  the  upper extremities, the
back, shoulders, forehead, scalp, and abdomen.  The 
232      SECONDARY  SYPHILITIC  DISEASES,  ETC.

blotches scale off after a  time: the papuhr. on the
contrary, leave a yellow, brown-violet spot on the1 skin,
which disappears after a while.  The tip  sometimes
suppurates; or obstinate scales and scurls form on the
papulae ; or they increase  to the  size of tubercles.
This excrescence is likewise frequently accompanied
with primary syphilitic diseases, and is sometimes dif-
ficult to cure.
  c  Scales, Lepra ctpsoriasis syphilitica.
  Of these we have the following varieties:—
  ».  Psoriasis syphilitica guttata,  (see  § 30,  vol. II.)
These are  small,  circular, lentil-sized, copper-colour-
ed  spots, somewhat raised  on the  skin,  gradually
covering  themselves  with  small,   dingy-white,  or
grayish scales surrounded  by a white  border ; after
the scales  fall off, the  skin is still a little  raised and
dark-red.
  /3.  Psoriasis syphilitica diffusa.  Larger, round, or
irregular, yellowish, pale-red or copper-coloured spots,
covering themselves with scales ; in the centre of the
spots a little ulceration sometimes forms, covered with
a black crust;  the scaly  part frequently  appears
fissured.  The former variety is  almost always seated
on the scalp, the  latter  on  the trunk, extremities,
scrotum, anus, scalp.   On moist parts, a clear serum
is discharged  from these spots, after which  superficial
ulceration  or condylomata take place.
  y. Psoriasis syph. plantaru et palmaria.   Shining,
hard, dingy-gray or blackish scales, sea ed on small,
round, as it were  horny spo s,  with a pale-red or in-
distinctly-coloured bottom.
  2.  Lepra, nigricans.  Rare.   Circular  spots  of  dif-
ferent sizes, of a dingy or blackish colour, pitted in the
centre.  After the  falling  off of the little  scurfs, a
slightly swollen  spot remains, which looks  like  the
scurf, and retains its colour for some time.
  t.  Psoriasis syph.  frequently invades the finger and
toe-nails,  and causes them to  fall off, (onychia syphi-
litica,)  the nail  is not reproduced  with  a  regular
shape. 
         SECONDARY SYPHILITIC DISEASES, ETC.       233

   d. Pustules, ecthyma syphiliticum.
   Large pustules,  with brownish areolae, generally
isolated, sometimes flat;  give rise to an ulcer which
is not  very deep, and covers itself with  a blackish,
not  very thick crust.   Sometimes,  however, thick
crusts form,  which are reproduced several times, and
on falling off, leav^e deep ulcers (transition to rhypia).
They are principally seen on children with congenital
syphilis, on the buttocks,  on the upper and internal
surface of the thigh, on the genital organs.
   There is a species of impetigo syphiliticum, the
pustules  not being isolated,  but  forming groups.
These pustules likewise give  rise to badly-looking
ulcers and ugly cicatrices.
   e. Bulla?.  Rhiypia syphilitica.
   The pustules may become transformed to rhypia by
means of the scurf  which covers them increasing in
thickness from below, and assuming  the shape of an
oystershell.  After the falling off of the scurf, an ulcer
discharging a dingy ichor, with callous edges and sur-
rounded with  a livid skin, makes  its appearance.
Sometimes the rhypia commences with large pustules
containing a thin, bloody  serum with a fetid smell,
and giving rise, after breaking, to the abovre-described
thick crust.  It  is  rare that there are a  number of
pustules, and they are, of the size of a hazel or walnut.
The rhypia-ulcer may penetrate to the bone and cause
caries ; it is attended with general cachexia, livid ap-
pearance, sometimes with a phagedenic ulcer in the
throat, on the  genital  organs,  frequently even  with
periostitis, rarely or never with iritis syphilitica.   In-
dividuals, even when robust,  that  are attacked with
this form of syphilis, emaciate very rapidly.
   The above-described  syphilitic cutaneous eruptions
may leave  secondary  syphilitic  cutaneous ulcers
changing to the various forms  of  chancre, penetrat-
ing deep into the parts, destroying fibrous, cartilagin-
ous,  osseous tissues, destroying even the nose and de-
nuding the cranium.
  Rhagades are oblong, badly looking, sometimes very 
234      SECONDARY SYPHILITIC AFFECTIONS, ETC.

painful, ulcerated fissures which frequently arise from
pustules, with hard edges and a grayish bottom, prin-
cipally seated between the  lingers and toes and at the
anus.  Partial falling off of the hair is very frequent;
alopecia much lesu so.

  § 320. Treatment of secondary syphilis.  Mercury is
the principal medicine for  these  secondary syphilitic
eruptions, and for the syphilis, of wdiich they are mere
symptoms.   Alloeopathic physicians use Iodium  and
Sassaparilla for these eruptions, which homoeopathic
physicians only use for syphilis complicated with mer-
curial symptoms.  The  principal mercurial  prepara-
tions wdiich are of service  in  the treatment of these
secondary  syphilitic  diseases,  are:   M/re  pre/dp.
rub., Merc, corr.,  Cinnabaris, Merc, nitros.. though
the other preparations may likewise  be useful.   Be-
side these preparations,  we have : Thuja, Nitri acid.,
Hepar sulp., Clematis, Staphys., Phosphor, acid.,  Me-
zereum, etc.   (See cutaneous  eruptions at the com-
mencement of this second A^olume.)

  § 321. Secondary syphilitic  affections of the mucous
membranes.
  There are likewise syphilitic spots, pustules, tuber-
cles upon the mucous membranes  as upon  the skin,
except that  they cannot be distinguished as clearly on
account of the mucous  membrane not being provid-
ed  with a firm epidermis.   These  affections  are  best
divided into two groups, pustulous  and exanthematous
or condylomatous.
  The pustulous form is principally seen  on the  mu-
cous membrane of the tonsils  and the posterior  por-
tion of the fauces; sometimes it is likewise seen in the
inner nose and  larynx,  at the rectum, rarely some-
where else.  It frequently co-exists  with  pustulous
eruptions on the  skin.  The  ulcers on  the mucous
membrane are excavated, with a wmite bottom, sharp
edges,  red  border; they  frequently  cause frightful 
        SECONDARY  SYPHILITIC AFFECTIONS, ETC.     235

disorganizations, eating away the uvula, soft palate,
bringing on caries of the nasal bones, vertebrae, etc.
  The so-called exanthematous ulcer of the mucous
membrane is generally seated on the arch of the pa-
late, the inner surface of the cheeks and lips,  on the
tongue; much less frequently on the tonsils, the inner
nose, in  the larynx or rectum.  This ulcer is never ex-
cavated like the  pustulous ulcer ; the ulcerated sur-
face is white, papescent,  surrounded by a  small red
areola.   On the dorsum of the tongue, on the tonsils,
these ulcers  sometimes  give rise  to condylomata,
which may even make their appearance on the outer
larynx.   These? ulcers generally  are  attended with
condylomata and  a  scaly eruption,  rarely  with  an
affection of the bones; sometimes with diseases of the
testicles and eyes.   At first we sometimes do not dis-
cover anything but an erythematous angina without
ulceration ; the mucous  membrane  is red,  interstiti-
ally distended, traversed by varicose vessels, and parts
of it are covered wdth a layer of  tenacious mucous or
white lymph.  This  simple  syphilitic  angina some-
times precedes the chancres in the throat.
  These chancres  spread  to the nasal cavity, where
they induce destructions as well as in the bony palate.
They likewise  destroy the vertebrae, and  by eating
into the carotid and lingual arteries, they induce  fa-
tal haemorrhage.  By invading  the Eustachian tube,
they occasion temporary  or  permanent deafness;  if
invading  the larynx, they lead  to phthisis laryngea.
The remaining cicatrices are much  whiter than the
mucous membrane, resembling the cicatrices of burns;
they frequently cause dragging, drawing pains, espe-
cially when  there is a change in the weather.  The
speech  is altered, nasal.   Phagedenic  ulcers  in the
throat exist simultaneously with  rhypia-ulcers on the
skin,  are attended with rapid emaciation, cadaverous
complexion, and are succeeded at times  by colliqua-
tion, at  others by hectic fever.
  The secondary syphilitic can be distinguished from
the mercurial ulcers  in the mouth and throat by the 
236    SECONDARY SYPHILITIC  AFFECTIONS ETC.

following symptoms: the latter are  generally seated
on the inner surface of the cheeks, on the edges of the
tongue;  they do  not  spread,  like  syphilitic  ulcers,
from behind forwards, but  in  an opposite direction.
spread  more rapidly  than syphilitic ulcers, have a
whitish,  almost milky, not grayish-dingy bottom, and
are not surrounded by erysipelatous redness.
  §  322.  Treatment : The mercurial preparations are
the specific remedies for these affections.  The kind
of preparation must be left  to the  judgment  of the
physician.  But he will have  to act with energy to
counteract  the  destruction  which   sometimes  pro-
gresses very rapidly in these  tissues,  and,to attain this
purpose, he will sometimes have to  use local means,
such as gargling the throat with a solution of corrosive
sublimate.   If complicated with mercurial symptoms,
I used dilute nitric acid  for the same purpose, or the
liquor hydrargyr. nitros.   If del ached bones are in the
way of a cure, they have to be removed by surgical
means.
  The selection of the remedy does  not depend upon
the seat of the ulcer, nor upon the sensations experi-
enced by the patient, but upon the nature of the ulcer.
A. mercurial preparation  will  have to be used, and the
medicine will have to be given in much  larger doses
than  we are in the habit of  doing, otherwise fauces,
mouth, nose, etc., will all go  to destruction.  The re-
medy is sometimes indicated  by the  attendant syphi-
litic appearances  in other parts of  the body ;  for in-
stance, Merc, prcec rub., Cinnabaris,  Merc  nitros.,
Nitri ac, and  Thuja,  are required when out  of the
secondary exanthematic  ulcer, whether the Hunterian
or phagedenic chancre, condylomata  have developed
themselves. If accompanied with bullae, rhypia, Merc.
corros. is the principal remedy, unless Merc prcec rub.
or alb. is  more specifically indicated.  If complicated
with mercurial ulcers in  the mouth  and throat, Iod.
and Nitri ac. deserve a preference.
  If, after the secondary  syphilitic ulcer is cured, there
should be still a remnant of  the secondary syphilitic 
        SECONDARY SYPHILITIC AFFECTIONS, ETC.     237

eruption, some other medicine will have to be chosen
for the  latter.  Lepra and  psoriasis  syphil. will fre-
quently yield toDulc, Clemat., Lycop., Mezer., Calcar. ;
the scurfy eruption to Lycopod. and Calc, or to  Coni-
um, Psarin (?), Graphit., Ranunc, etc.
   It is almost impossible to indicate a remedy for sin-
gle syphilitic symptoms.   The medicine should always
be selected in accordance  with  the totality of the
symptoms.  The following paragraphs will furnish
some further indications in  reference to the  selection
of proper remedies.

   § 323. -Secondary syphilitic affections of thie osseous,
cartilaginous and fibrous systems.
   These syphilitic affections of  bones  generally ap-
pear  after the  secondary affections of  the  skin and
mucous membranes, and  have therefore been called
tertiary symptoms.   This generalization is, however,
incomplete.  Months and even years frequently  inter-
vene between the primary symptoms and the affections
of the bones, which, in most cases, announce themselves
a long time previous by bone-pains, from which the sub-
sequent syphilitic affection cannot, however, be  prog-
nosticated, although the concomitant  circumstances
and the origin of these  pains might justify such a
diagnosis.
   The bone-pains are at first vague, resembling  rheu-
matic pains,  coming and  going, not confined to one
bone ; they are boring, gnaw ing, generally continuing
from  evening  till early  in the morning, when they
abate after the breaking out of a pleasant sweat.
   The syphilitic affections of  bones are :  soft and
hard swellings  of the periosteum, (gumma and tophus,)
exostosis, caries and  necrosis..  They occur most fre-
quently on bones that are  only covered  by the skin,
such as tibia, fibula, bones of the forearm, nasal bones,
cranium, upper jaw.  The swellings of the periosteum
are small, of a doughy (gumma) or hard feel (tophus);
they are seated on the surface of the  bone, extremely
painful, leaving the integument  unaltered.   Both 
238    SECONDARY SYPHILITIC AFFECTIONS, ETC.

swellings arise after periostitis, tophus  between  peri-
osteum and  bone, gumma between  periosteum and
aponeurosis.
  Secondary syphilitic affections of the nasal and pa-
latine bones"are most,frequent. They disfigure the face
in the most horrid manner, unless the destruction is
speedily  arrested.  Every one of  the bony and carti-
laginous constituents  of the nose may be destroyed.
Generally one side of  the nose swells first, becomes
red and erysipelatous"^ a serous fluid is discharged from
the  nose,  (ozcena si/philitica) which  is  sometimes
bloody, incrustating, sometimes purulent or  ichorous,
having a fetid smell and mixed  with black .bony par-
ticles; the soft parts gradually cave  in, and, if the
cartilage should  be destroyed likewise1,  the nose is
gone.  If the destruction should proceed from the arch
of the  palate, the ossa palati remains sound ;  the1 pal-
ate is perforated, the voice becomes nasal, deglutition
is difficult, on account of food and drink getting into
the nasal cavity.
  Cartilages, especially the sternum, are likewise  in-
vaded by secondary syphilis; they  become inflamed,
swell, ulcerate, and necrosis sets in.  This is  likewise
the case w ith the cartilages of the larynx, which gi ve-s
rise to phthisis laryngea syphilitica.
  § 324. In  secondary  syphilitic  affections  of the
bones, the osteocopic pains are the real object of cure,
for as  soon as the pains have disappeared, the disease
itself may be supposed to have left likewise.  If. how-
ever, a remnant of the  disease should still  exist, the
same,  remedy  should  then be  continued  until every
vestige of pain and disease has disappeared.  In oste-
ocopic pains, three cases may occur :  uncomplicated
secondary syphilitic affections of bones, or complicat-
ed with mercurial symptoms, or, mercurial pains alone.
The physician will have  to discover by careful obse-r-
tion to which of  these  three classes the pains belong.
  Iodium and hydriodate of potash  are excellent reme-
dies for bone-pains complicated  with mercurial symp-
toms.   For  uncomplicated syphilitic bone-pains  we 
         SECONDARY  SYPHILITIC AFFECTIONS, ETC.    239

have Asa., Aurum.,  Hepar sulp., Nitri ac, Phosphor.
ac, Si lie, Mercur., etc.
  Mercurius is the principal remedy for uncomplicated
syphilitic bone-pains or  syphilitic caries; and if mer-
curial symptoms should be present, the Iodide of mer-
cury  may be  given.   Mezereum,  Lycop.,  Mangan.,
Sulph., Calc, Slaphys., should not be forgotten.
  For purely mercurial osteocopic pains, I recommend
Opium, Dulc, China, Carbo. veg., Guajac, Sassapar.,
Arsen., Sulphur, Nitri acid., etc., also small shocks of
positive  electricity.    I  am unable to  furnish  more
particular indications for the use of each particular
medicine, and have  to rely upon the judgment of the
physician to supply  this deficiency.

  § 325.  Secondary syphilitic affections of the eye.
  This affection always appears in  combination with
syphilitic cutaneous affections.  Iritis  syphilitica at-
tends more frequently  exanthematic than  pustulous
secondary syphilitic affections.   The usual attendants
of iritis are the small crusty pustule, the desquama-
ting papula, or a scaly eruption.  There are two forms
of syphilis in the eye.
  1.  Conjunctivitis  syphilitica.   It  is known  by the
peculiar,  sharply circumscribed, brick-red vascular
wreath in the conjunctiva and  sclerotica,  where the
cornea is inserted  in the sclerotica, appearing sur-
rounded  with a vascular wreath of a line in breadth ;
there is great photophobia and an intense pain in the
adjacent parts of the eye.
  2. Iritis syphilitica.  Characterized by contraction
of the pupil, immobility  of the  iris, which  protrudes
towards  the cornea  like a pad, profuse lachrymation,
acute pains in the orbital region, change  of colour;
this disease is frequently induced by condylomatous
excrescences,  which likewise produce striking altera-
tions  in the pupil.
  The principal remedies for  such  affections are:
Aconite, Bellad., Mercur., Thiuja,  Cannab.,  Hep.  sulph.,
Conium,  Nitri acid.,  Clematis,  etc. 
240     SECONDARY SYPHILITIC AFFECTIONS, ETC.

  § 326. Syphilis neonatorum s. congenita.
  The infection of  the fetus or infant takes place  in
the following  manner:
  1. Far her-or mother, or  both parents, are afflicted
with primary or secondary syphilitic symptoms at the
time when they are engaged in the act  of propaga-
tion, thus communicating  the  disease to  the  germ ;
such a fetus seldom arrives at a full period, but gener-
ally dies in  the fifth or sixth month  in the uterus, pro-
ducing miscarriage.
  2. Only the mother is syphilitic, infecting the fetus
during pregnancy.
  3. The mother is affected  with primary syphilitic
symptoms of the genital organs,  discharge, chancre,
condylomata,infecting the child while passing through
the vagina.   In such a case,  the syphilitic  symptoms
make their  appearance  a few  days or weeks  after
birth.
  4. If  nurses or mothers  are affected with  primary
syphilitic rhagades, ulcers of  the  nipples,  similar
ulcerations will break out on the  lips or in  the mouth
of the infant, and vice versa.
  Phenomena of secondary syphilis of new-born infants.
If the child is born with syphilis, the  skin generally has
a light-brownish  or dingy-straw-coloured appearance1,
the epidermis is easily detached, as on parts in a state
of decay, or else it  is raised in  blisters; the muscles
are soft, flabby, the children are exceedingly small,
impoverished,  they  look old ; their voice has a piping
sound, the nose is stopped, the  corners of the  mouth
are putrid.
  If the disease break out  after birth, this  generally
takes place two months after the  birth of the infant.
Wallace furnishes  the following description  of  it:
" In the first weeks, the disease looks like measles.
On the face, the eruption is  frequently confluent, and
the scales are so thick that the  eruption  looks like
psoriasis.    On  the nates,  the  eruption is likewise
strongly marked, and speedily terminates in  ulceration
when the children have an impoverished constitution. 
SECONDARY SYPHILITIC AFFECTIONS, ETC.    241
 If the  disease should break out still later after birth,
 condylomata  make their appearance on the  sexual
 organs, rhagades in the corners of the mouth, superfi-
 cial suppuration of the mucous membrane of the lips,
 mouth, ulcers in the throat, and  the  voice is  almost
 always altered, with  difficulty of breathing through
 the nose.   The older the child, the more frequent the
 condylomata, rhagades  in the corners of the  mouth,
 ulcers in the fauces and on  the  mucous membrane
 of the mouth."  Sometimes there is  otorrhcea, iritis,
 periostitis.  Hufeland thinks  that congenital syphilis
 frequently appears in the shape  ofscrofula.
   Prognosis.  Not very favourable; the disease  is
 curable, but weakly children die of it very often.

   § 327.  Treatment of congenital syphilis.  If the par-
 turient female should be syphilitic, the  vagina and
 vulva should be  greased, the  child should be disen-
 gaged  as soon as  possible, and, after birth, should be
 washed  very carefully, especially the  eyes,  inner
 mouth, and the different orifices of the  body and the
 folds in the skin ;  it is likewise necessary to examine
 the child  every day in order to meet by proper treat-
 ment whatever syphilitic symptoms may make their
 appearance.
   If the child should still be at the breast, it is best to
 give the medicine to the mother or nurse.
   If the medicine be given to the child, a  high prepa-
 ration of Merc. sol. is sufficient; if the mother, on the
 contrary,  take the  medicine, a  lower  preparation
 should be given.
   It frequently happens that a homoeopathic  physi-
cian is called upon to treat children that have already
been under allceopathic treatment. In this case, the
physician must examine  with  great care what  course
had been  pursued  by the allceopathic pl^sician ; for
it  is more than probable that  the  large doses of mer-
cury with which the little patient had been dosed, have
produced  mercurial symptoms.  It is the fashion of
allceopathic physicians to  give large doses of Mer-
   vol.  iv.—11. 
 242    SECONDARY SYPHILITIC  AFFECTIONS, ETC.

 cury even Avhen there is no positive proof of syphilis,
 and the homoeopathic physician is afterwards called
 upon to relieve the little patient of the horrid disease
 which the destructive action  of syphilis and  Me>rcury
 had occasioned.
   If the disease had been getting worse under the
 action of Mercury, this would be a  sure sign, that
 mercurial symptoms had developed themselves.  The
 prognosis is  rather doubtful.
   If the little sufferer should be  attacked with sto-
 macace, or angina mercurialis; if the soft and hard
 parts should even be partially  destroyed ; Aurum  3
 would be the most efficient  remedy to stop the fur-
 ther destructive effects of Mercury.   Aurum should
 be followed  by Hepar. sulp. 2d or  3d.   If the mer-
 curial disease have been caused by Calomel, a dose of
 Merc. sol. Hahn. or of Mercurius vivus, or, still better,
 of Merc, sublim. corros., may occasionally be given.
 If the stomacace should be  accompanied with dys-
 phagia, or with an immobility of the jaws,  swollen,
 retreating, spongy  gums, ptyalism, etc.,  Belladonna,
 Dulcam., and Acid nitri. should be resorted to.
   For caries of the nasal bones, give Aurum. For
 caries of other  bones, swelling of single parts of car-
 tilage, thickening of the periosteum, especially when
 these symptoms had been made  worse by Mercury,
 give Asafoetida.    It is therefore  eminently useful
 in scrofula mismanaged by Mercury.  Mezereum and
 Acidum phosphor,  rank with Asa.  If time permits, a
 dose of China may be given before the  above-men-
 tioned remedies are used.
   For suppurating lymphatic swellings  or for other
 suppurating  ulcers,  Pulsat.,  Acid, phosph., Silicea or
 Carbo veg. will be found very useful.
   Cicuta  virosa is  likewise very useful  in painful
 glandular  indurations and other pains produced  by
 Mercury.
   China should always be given first when the follow-
ing symptoms are present: great sensitiveness for ex-
ternal irritating causes, spasms,  tremour, and  other 
         SDCONDARY SYPHILITIC AFFECTIONS, ETC.    243

nervous symptoms, restlessness, want of appetite and
sleep, loathing, cold extremities, pointed nose, livid face,
hectic fever, with great prostration  and thirst, small,
hard, quick pulse.   After China may be  given Ferrum.
Perhaps  a few doses  of Spiritus  nitri  dulcis will be
found very  useful at first.   For the profuse  and ob-
stinate sweats or night-sweats, Phosphoric acid will,
next to China, be found very useful.
  For all the  above-mentioned mercurial symptoms,
Dulcam., Acid nitri., Sarsapar., are excellent remedies,
and deserve honourable mention even as intercurrent
remedies.
  For syphilis congenita without mercurial  complica-
tions, the well-known mercurial preparations are the
specific remedies, except  that the  dose has to be
adapted  to  the age  and constitution of  the  patient.
All the various remedies which have been named in
these chapters on syphilis, correspond both to syphi-
litic and mercurial affections.
THE END. 
 
GENERAL  INDEX
OF  THE   FOUR  VOLUMES
(The small figure immediately after the Dame of the disease, indicates the volume.)
 Abdomen,  dropsy  of,  3.
 Achor larvata,  3.      .       .       .
 Achores,  3.     .
 Acne,  3.        ....
  —  punctata,   3.     .       .       .
  —  indurata,  3.     .       .
  —  rosacea,  3.
  —  6irnplex,  3.     .
 Anasarca,   3.           .       ...
 Angina, 2.
  —  maligna, gangrenosa, putrida, diphterica
  —  membranacea, polypossa,  2.
  —  mercurialis,  2.  .       .       .
  —  cesophagea,  2.   .
  —  parotidea,   2.    .
  —  pectoris,  2.  4.  .
  —  pharyngea,  2.   .
Animi deliquium,  3.
Ankylog'.ossum,   3.
Anus, burning pain at,  4.      .
  —  itching of,  4.   .
Aphthae,  2.
Apoplexia cerebralis, or sanguinea,  4.  .
Apoplexy, from mechanical injuries,  4.
  —  gastric,  4.       ...
  —  nervous,  4.
  —  serous,  4.       ...
Apparent death,  3.      .       .       .
  —      —  by congelation,  3.
Arthritis,  2.
Ascites,  3. 
246      GENERAL INDEX OF THE
FOUR
VOLUMES,
Asphyxia,   3.
  —   by carbonic acid  gas,    3.
  —   by drowning,   3.
  —   by lightning,   3.       .
  —   by mephitic air,  3.
  —   by strangulation,  suspension,
  —   by the vapour of coal,   3.
  —   neonatorum,   3.
Asthma,    4.     .      .      .
  —   laryngeum,   4.  .
  —   Millari,    4.
  —     — distinguishing characteristics,
  —   uteri,   4.
Atrophia,   3.    .
  —   mesenterica infantum,  3.
Balanitis,   4.
Bleeding of the nose,    3.
Blepharoblennorrhcea,   2.
Blepharopleg'a,    4.
Blepharophlhalmitis glandulosa.    2.
Blotches, syphilitic,   4.
Blue-disease,    4.
Bronchitis acuta,   2.   .
Buboes,  syphilitic,  4.
Bullae syphil.,   4.
Burning and itching of the sexual organs,
Cachexia   —    China,   1.
Calculus biliarius or felleus,   3.
Cancer,    3.
  —   aquaticus,   4.
  —   of the cheeks,    4.
  —   of the face,   4.
  —   of the  lips,    4.   .
  —   of the  nose,   4.
  —   of the stomach,   4.
  —   of the tongue,    4.
Carcinoma,   3.
  —   of the stomach,    4
Cardialgia,   4.   .
  —   varieties, of,  4.
Carditis,   2.     .
  —   infantum,    2.
Catanuuia, see meases. 
GENERAL INDEX OF THE  FOUR
VOLUMES,
247
Catarrh, suffocative,
Cephaloetoma,    3.
Cephalitis,   2.
Ceratitis,    2.
Chancre,    4.
Chest, drospy  of,
Chilblains,   2.  .
China-cachexia,    1
Chlorosis,   4,   .
Choanorrhagia,   3.
Cholera, Asiatic,
3.
1.
  —   febrile conditions resembling,   1.
Chorea St. Viti,    4.    .
Choreomania,   4.      .       .       .
Cingulum,   2.  .
Clavus,   4.
Colic,  bilious,   4.
  —   copper,    4.
  —   depending upon local  causes,    4.
  —   flatulent,    4.     .
  —   gastric,    4.
  —   mucous,   4.
Colica,   4.
  —   aeruginalis,   4.   .
  —   herniosa,    4.    .
  —   inflammatoria,    2.
  —   sanguinea, plethorica  or hsemorrhoidalis,
  —   saturnina  or pictonum,    4.
  —   ventriculi,   4.   .
Colic-worm,   4.        .
Constipation of new-born infants,    3.
Colicodynia,   4.        ...
Colliquations,   3.
Complications of scarlet fever with other diseases
Condylomata,     4.      .
Congestion  of  the  abdomen,   3.
  —  of the  chest,    3.
                       3.
                        3.
  —   of the -head,
  —   of the  uterus,
Conjunctivitis syphil.,
Consumption,   3.
  —   aphthae in,
  —   bedsores in, 
248
GENERAL INDEX  OF THE  FOUR  VOLUMES.
 Consumption, colliquative diarrhoea in,    3.
   —  galloping,   3.     .
   —  heemorrhage from the lungs in,    3
   —  suffocative  anguish in,   3.
   —  sweats in,   3.
 Convulsio cerealis,  4.
 Cow-pox,'    2.
 Coxagra,    2.
 Coxalgia    2.
 Coxarthrocace,   2.
 Croup,   2.
 Crusta lactea,   3.
 Crusta serpigiuosa.   3.   .
 Cyanosis,    4.
 Cyanosis cardiaca,    4.
 Cyanosis pulmonalis,   4.
 Cynanche,    2.  .
   —  strenua, exsudatoria,   I
 Cystalgia,    4.
 Cystitis,   2.
 Cystodyuia,    4.        .
 Cystospasmus,   4.
 Delirium tremens,   2.   .
 Diabetes,   3.
 Diaphragmitis,   2.
 Diarrhoea,    1.   .
 Dropsy,   3.     .        .
 Dysentery,    1.  .
 Dysphagia inflammatoria,  2.
 Dysphagia paralytica,    4.
 Dyspncea,    4.
 Eclampsia,    4.  .
  —  infantum,    4.
  —  of parturient females,
 Ecthyma,    3.   .
  —  syphilitica   4.
Eczema,   3.
Eiii-iplialorragia,   4.
Encephalitis  potatorum,    2.
Encephalitis,   2.
Endocarditis,   2.
Endometritis septica,   2.
EnteraJgia,    4.
PAOH 
GENERAL  INDEX  OF  THE  FOUR  VOLUMES.
249
 Enteritis,    2.
   —  mucosa  infantum,   2.
 Enterodynia,   4.
 Enuresis paralytica,   4.
 Ephidrosis,   3.
 Epididymitis gonorrhoica,
 Epilepsy,    4.
 Epilepsia abdo.r.inalis,   4.
   —  acute,   4.
   —  peripherica,    4.
   —  saltatoria,    4.
   —  testicularis,   4.
   —  thoracica,    4.
   —  uterina,    4.
 Epistaxis,    3.
 Ergotism,    4.
 Eruptions,   2
   —  Crustacea,    2.
   —  maculosa,    2.
   —  papulosa,   2.
   —  pustulosa,    2.
   —  ulcerosa,   2.
Erysipelas,   2.
Excrescences, syphilitic,    4.
Fainting,   3.
Favus,     3.
Febrile  conditions resembling cholera,
Febris lactea,    2.
   —  putiida,    1.
   —  amatoria,    4.
Fevers, general remarks  on     1.
  —  critical diarrhoea in,     1,
  —    —   phenomena in,     1.
  —    —   ptyalism in,     1.
  —  dysenteric,     1.
  —  and ague,     1.
  — hemorrhages, critical in,    1.
  —  intermittent,     1.
  — of dentition,     1.
  — classification of,    1.
  —  prognosis in,     1.
  — general remote causes of,    1.
  — catarrhal,     1. 
250
GENERAL INDEX OP THE FOUR  VOLUMES.
Fevers, pituitous or mucous,    1.
  —  synochal or simple inflammatory,
  —  bilious,     1.
  —  worm,    1.
  —  hospital, or jail,     1.
  —  simple rheumatic,    1.
  —  diet and temperature in,    1.
  —  putrid,    1.
  —  suburral,    1.
  —  terminations of,     1.
  —  critical vomiting in,    1
  —  catarrhal,  of children,     1.
  —  gastric,     1.
  —  mucous,     1.
  —  yellow,     1.
  —  exanthematic,     2.
  —  puerperal,      2.
Fluor-albus.    3.
Fothergilli, dolor  faciei,     4.
Galactorrhcea,     3.
Gastritis,     2.
  —  toxica,    2.
  —  traumatica,     2.
Gastrobrosis,    4.
Gastralgia,    4.
Gastrostenosis cardiaca et .pyloric
Gastrodynia,    4.
Gastromalacia,    4.
Glossitis,     2.
Glossoplegia,    4.
Gonorrhoea,  acute,    4.
  —  modifications of,     4.
  —  praeputialis,    4.
  —  secondary,     4.
Gout,     2.
Grippe,    1.
Gutta  rosacea,     3.
Haematemesis,     3.
Hasmaturia,    3.
Haemoptoe,     3.
Haemoptysis,    3.
Haemorrhage from the lungs,     3.
  —  from the urethra,     3.
151
   PAOC
    151
    IDS
    151
    172
    254
    140
    102
    254
    154
    101
     93
    133
and 154
    165
    l>;>5
       1
    153
    113
     24
    113
    130
    136
    136
     8:2
     68
     77
     68
     8:2
     94
     13
    206
    207
    214
    216
     87
    136
     39
    134
    139
    130
    130
    130
    143 
GENERAL  INDEX  OF  THE  FOUR  VOLUMES.
251
Haemorrhages from other organs, practical observations on,  3,
H&smorrhagia petechialis,     3.
  —   renalis,     3.
  —   ventriculi et tractus intestinorum,    3.
Haemorrhoidal tumours, protrusion of,     4.
Haemorrhoids,     3.
  —   of the bladder,     3.
Helminthiasis,     1.
Hemicrania,    4.
Hepatitis,     2.
Hernia, incarcerated,     2.
  —   umbilical, of infants,
Herpes,     3.
  —   circinnatus,    3.
  —   phlyctasuodes,     3.
  —   prseputialis,    3.
  —     —     4.
Hiccough of new-born infants,
Hospital-fever,    1.
Hydrocephalus, acute,    2.
Hydrophobia,     4.
  —   symptomatic,     4.
Hydrometra,     3.
Hydrops,    3.
Hydrothorax,     3.
Hypochondria,    4.   .
Hypochondriasis,     4.
Hysteria,    4.
  —   local  forms of,     4.
  —   local, treatment of,    4.
Hysteritis,    2.
Icterus,     2.
  —   acutus,  febrilis, spasticus,     2.
  ■—   albus,     4.
  —   neonatorum,      2.
  —   senilis,     2.
  —   vulgaris, chronicus, a febrilis,
Impetigines,    3.
Impetigo,     3.
  —   figurata,    3.   .
  —   rodens,     3.
Incubus,     4.
Induration of the stomach,    4. 
252      GENERAL  INDEX  OF  THE
FOUR
VOLUMES.
Inflammation  of bones,
  —     of  the bladder,
  —     -   -  bowels,
           2.
            2.
           2.
cornea,    2.
diaphragm,    2.
ear,     2.
eye,     2.
fauces,    2.
glands and prepuce,
heart,     2.
iris,    2.
kidneys,     2.
labia and vulva,
liver,     2.
lungs,     2.
lymphatic glands and vessels,
mammae,    2.
meningeal membranes,
nose,     2.
ovary,    2.
psoas-muscle,    2.
spinal marrow,    2.
  —    -    -  6pleen,
  —    —    —  stomach,
  —    -    -  testicles,
  —    -    -  tongue,
  —    -    -  uterus,
Inflammations in general,
  —    with fever,    2.
Influenza,     1.
Intertrigo,     2.
Iritis,    2.
  —  syphil.,     4.
Irritation, spinal,    4.
Ischias,    2.
Itch,    3.
  —  venereal,    4.
Jail-fever,     1.
Jaundice,    2.
Labia, emphysema of,     3
Laryngitis,     2.
  —  exsudatoria,    2.
Lentescent typhus,     1.
 2.
2. 
GENERAL INDEX  OP  THE  POUR  VOLUMES.
253
4.
4.
3.
 Lepra syphilitica,
   —  nigricans,
 Leucorrhoea,     3
 Lichen, simplex,
   —  syphiliticus,    4.
 Lienitis,     2-
 Lieuteria,     3.
 Lipothymia,     3.      .        .
 Lumbago rheumatica,     2.
 Lungs, dropsy of,    3.
   —  oedema of,     3.
 Maculae,  syphilitic,    4.
 Malum caducum pulmonum,     4.
 Mammae, scirrhus and cancer of,    3.
 Mastitis,    2.   .
 Measles,    2.   .
 Megrim,    4.   .
 Meibomian glands, inflammation of,
 Melaena,     3.
 Menses, morbid phenomena occurring during,
   —   retarded appearance of the first,     3.
   —  scanty,     3.
   —   suppression of,    3.
 Meningitis,     2.
   —   spinosa,    2.
 Metritis,     2.
 Metrorrhagia,     3.
 Miliaria,     2.
   —  purpurea,     2.  .
 Milk-fever,     2.
 Miscarriage,     3.
 Mixtus cruentus,     3.
 Morbilli,     2.
 Morbus caducus,    4.
   —  cerealis,    4.
   —  coeruleus,    4.
   —  eruditorum,    4.
   —  gesticulatorius,    4.
   —  inaculosus hsemorrhagicus Werlhofii
   —-  niger  Hippocrat.,     3.
   —  aacer,     4.
   —  virgineus,    4.
Myelitis,     2. 
254
GENERAL  INDEX  OF  THE  FOUR  VOLUMES.
Nasitis,    2.
Nephritis,     2.
Nettlerash,     2.
Neuralgia,    4.
  —   coeliaca,     4.
  —   facialis,     4.
  —   of the heart,    4.
  —   of the spinal marrow,
Neuroses,     4.
Nightmare     4.
Noma,    4.
Notalgia,    4.
Odontalgia,  rheumatic,    2.
Oesophagitis,    2.    .
Onychia syphilita,    4.
Oophoritis,     2.
Ophorites,    2.
Ophthalmia,    2.
   —  arthritic,     2.
   —  catarrhal,     2.
  —   erysipelatous,     2.
   —  gonorrhoica,    4.
   —  neonatorum,     2.
   —  rheumatic,     2.
   —  scrofulous,    2.
 Ophthalmitis,     2.
 Orchitis,    2.
   —  gonorrhoica,    4.
 Orthopnoea,    4.
 Ostitis,     2.
 Otitis externa and interna,     '
 Ovaries, dropsy of,     3.
 Paedatrophia,     3.
 Papula?, syphilitic,     4.
 Paraplegia,    4.
 Paralysis,     4.
 Paraphrenitis,     2.
 Parotitis,     2.
 Passio hysterica,    4.
 Perforatio ventriculi spontanea,
 Pericarditis,    2.
 Pericarditis infantum,     2.
 Pericardium, dropsy of,    3. 
GENERAL  INDEX  OF THE  FOUR  VOLUMES.      255
Peripneumonia,     2.
Pern ion es,     2.
Pertussis,     4.
Petechias,     2.
Pharyngitis,    2.
Phlegmasia alba dolens,    2.
Phrenesia,     2.
Phrenitis,     2.        ,
Phthisis,     3.
   —  florida,   3.
   —  hepatica,     3.
   —  laryngeal and tracheal
   —  meseraica,    3.
   —  pulmonary,     3.
Piles,    3.
Pleuritis,     2.
Pleurisy,     2.
Pneumonia,     2.
Pneumonitis,    2.
Pneumo-typhus,     1.
Porrigo larvahs,   3.  .
Pressing pains in the internal sexual parts,
Proctalgia,     4.
Prosopalgia,     4.
Psoitis,    2.
Psoriasis,     3.
  ■—  syphilitica,    4.
diffusa,
guttata,
4.
4.
plantaris et palmaria
 Ptyalism,     3.
 Purple-rash,    2.
 Purpura rubra,    2.
 Pustules, syphilitic,    4.
 Putrefaction of the uterus,
 Rabies  canina,     4.
 Raphania,    4.
Rectum, prolapsus of,    4.
Rhachialgia,    4.  '  .
  —   metallica,    4.
Rhachitis,     3.
Rhagades syphil.,     4.
Rheumatalgia,    2.
95 
256
GENERAL  INDEX  OP  THE  FOUR VOLUMES.
Rheumatic affections,     2.
Rheumatism,  acute,     2.
  —   gouorrhceic,    4.
  —   of  the  extremities,
2.
  —   -   -   head,     2.
  —   -   -   heart,    2.
  —   -   -   thorax,    2.
  —   paralytic    2.
Rhypia,     3.
  —   syphilita,    4.
Rickets,     3.
Roseola syphilitica,     4.
Rubeolas,     2.
Salivation,     3.
Scabies capitis,    3.
  —   vesicularis or lymphatica,
Scaldhead,     3.
Scales syphilitic,     4.
Scarlatina,     2.
  —   and scarlatina  complicated with purplerash,
       preventing,    2.
  —   complications of, with other diseases,    2.
  —   miliaris  Hahnemanni,     2.
  —   secondary diseases succeeding,     2,
Scarlet-fever,    2.
Scelotyrbe,     4.
Scirrhus of the stomach,    4.
Screams of infants, without any perceptible cause,
Scrophulosis,    3.
Secondary diseases succeeding scarlatina,     2.
Sideratio,     3.
Skin, dropsy of the,    3.
Smallpox.     2.
  —   spurious,      2.
Softening  of the stomach,     '
Soreness,     2.
  —   of the nipples,    2.
Spasm of the bladder,    4.
       of  the  glottis,    4.
Spina  bifida,
  —   nodosa,
Spinitis,     2.
Splenitis,     2.
3.
 3.
means of
3, 
GENERAL INDEX OF THE  FOUR  VOLUMES.
257
4.
  Stomacace,     2.
  Stomatitis mercurialis,
  Strangury, of infants,
  Strophulus confertus,
  St. Vitus' dance,    4.
  Stymatosis,     3.
  Suffocatio uterina,    4
  Sycosis capillicii,     3.
  Sycosis Hahnemanni,
    —  menti,     3.
  Syncope,    3.
  Syphilis,     4.
    —  neonatorum,    4.
    —     -     secondary,
    —     -        -  of eye,
    —     —        -  -  muc. membrane,     4.
    —     -        -  -  osseous, and fibrous syst.     4.
 Sweating disease,     3.
 Swelling of the  breasts, of infants, soon after birth,     3.
 Swellings, partial,  of new-born infants, in consequence of heavy
        labour,   3.
 Swoon,    3.
 Tarantism,     4.
 Tenesmus,    4.
 Testicles,  swelling of,
 Thrush,    2.
 Tinea capitis,     3.
 Tongue, tied,    3.
 Tracheitis,    2.
 Tubercles  arising from cold  drink,
   —  arthritic,     3.
   —  exanthematic,    3.
   —  hereditary,     3.
   —  impetiginous,    3.
   —  in  the  brain,    3.
   —  -  -   liver,   3.
   —  -   -   spinal marrow,
   —  menstrual and puerperal
   —  pulmonary,     3.
Tuberculosis,     3.    .          .         .         .51
Tumor, bloody,  of infants,
Tussis convulsiva,     4.
Typhus,    1.
      VOL. IV.---12
    221
    203
    144
     66
    216
     36
     23
    221
  .  104
    70
    72
    71
    72
    71
    75
    77
    76
    69
    66
and 64
   221
    89
   220 
258       GENERAL  INDEX  OF  THE  FOUR  VOLUMES.
Typhus  abdominalis,     1.
  —  bellicus,     1.
  —  cerebralis,   1.
  —  contagiosus    1.
  —  icterodes,   1.
  —  lentus,     1.
  —  p.-& Hi ntialis,    1.
  —  pneumonalis,    1.
  —  putridus,    1.
Ulcera pedis,    3.
Umbilicus,  protrusion of,    Sk
Urethrorrhagia,  3.
Urina sanguinea,    3.
Urine, bloody,   3.
Urticaria    2.
Uterus,  cancer  of,     3.
  —  dropsy  of,    3.
  —  meteorism of,     3.
  —  prolapsus of,    3.
  —  putrefaction  of,     2.
  —  scirr'.ius of,     3.
Vagina,  prolapsus of.    3.
  —  sore  pains in,     3.
Varicella,    2.
Variola,    2.
Variolae vaccinae, tutorise,    2.
Varioloid,    2.
Vomiting of blood,     3.
Voniitus cruentus,   3.
Worm-fever,     1.
Whites,      3.
Whooping-cough,     4.
Zona,    2.  .
Zoster,     2.
PAGE 
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     LAURIE, DR. J.  HOMCEOPATHIC DOMESTIC MEDICINE,  with
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     G. L. RAU'S ORGANON of the Specific Healing Art  of Homoeopathy.
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     HAHNEMANN, Dr. S.  MATERIA MEDICA PURA.  Translated and
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     HAHNEMANN, Dr   S.  THE  CHRONIC  DISEASES, their Specific
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   delphia.  8vo.   5 vols.  Bound.   1845.   $7.
     TRANSACTIONS of the  A merican  Institute of Homoeopathy.    1846.
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     HEMPEL'S Homoeopathic Domestic Physician.  1849.   Bound.
     JAHR, G. H. G , M. D.  SHORT ELEMENTARY TREATISE  upon
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     BECKER, M. D., ON CONSUMPTION.  Translated from the  German.
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