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DYSENTERY
IIOKEOPATHIC  TBEATMENT;
CONTAINING ALSO
A REPERTORY AND NUMEROUS CASES.








  FRED. HUMPHREYS, M.^//- .'■.•-^--^// V
              NEW-YORK:

    WILLIAM RADDE, 322 BROADWAY.


Philadelphia: Rademacher<fc Sheer.—Boston: Otis Clapp.—St. Louis:
 J. G. Wessklhceft.—London: James Epps, 112 Great Russell-Street,
 Bloomsbury.—Manchester: II. Turner, 41 Piccadilly.
1853. 
wc
  \%53
    Entered according to Act of Congress, in the year 1853, by
                WILLIAM  RADDE,
In the Clerk's Office, of the District Court, for the Southern District of
                       New-York.
Henry Ludwig, Printer, 45 Vesey-st. 
PREFACE.
  Few diseases in the United States are more extensively
prevalent or more formidable in their character than Dys-
entery.   With the exception perhaps of Consumption,
there is not one that annually demands a greater  number
of victims.  The Cholera justly excited in its several visi-
tations no small amount of trepidation and alarm, and yet,
the  Dysentery annually carries  down  nearly as great a
number of persons as  did the Cholera during any  year of
its invasion.  For it should be remembered that while the
Cholera  was  confined to certain  locations and ranges of
territory,  the  Dysentery every year prevails as  an epi-
demic  over  the entire country,  from  New-England to
Louisiana,  and from  Virginia to Wisconsin, and  often
as a most  fearful and fatal scourge.
  Against this destructive  epidemic, as against Cholera
and other frightful diseases, the Homoeopathic  Method of
treatment has been eminently successful, often saving the
victim and establishing a  brilliant  renown.  As  yet  we
have had no systematic and reliable treatise upon its his-
tory and treatment, and it is to supply this want  that  our
labours have been directed.
  As it has been our aim rather  to be  useful, than  bril- 
iv
PREFACE.
 liant, to do good than to gain reputation, we have  not  at-
 tempted to write  an entirely original monograph, but to
 gather from every source whatever was important and re-
 liable, and whatever would  conduce  to  a  correct know-
 ledge  of the  disease  and  its  appropriate  treatment.
 Hence we have made free use of  all the authorities with-
 in our reach, Schcenlein, Canstatt,  Andral,  Rokitansky
 and others, have  been  principally  consulted for Natural
 History and Pathology, while none of the  writers of our
 school have been neglected in  the  department of Thera-
 peutics, and all has been modified and confirmed  from the
 results of our individual experience.
   An objection has been offered, that a treatise upon a
 single form of disease should  be so  extensive.   But we
 natter ourselves that the practitioner or student truly alive
 to the responsibilities of his position, standing in the pre-
 sence of a formidable disease, will not care how extensive
 the monograph may be, so that it shall readily convey to
 his mind all that he desires to know on the subject.  To
 him under such circumstances no fact belonging to it be-
 comes uninteresting or  unimportant, and hence  we have
 thrown in many facts concerning the  Natural History and
 Pathological Anatomy of the disease which might at first
 sight seem unnecessary.
   As the work will doubtless  be consulted by  inexperi-
 enced professional Homoeopaths and  amateur practition-
 ers, it was important to give the doses and proper mode
 of administration  for their benefit.   The  experienced Ho-
moeopathic Physician will require  no such guide.  We
have  indicated the doses  and mode  of  administration 
PREFACE.
V
which has been sanctioned in our experience,  and which
have proved with us very uniformly successful.
  In forming the Repertory, our  design  has been to
make one which should  be useful  for consultation in the
treatment of this disease.  Hence we have  limited it to
the symptoms most frequently occurring, and to the medi-
cines most likely to  be employed  in the treatment; fre-
quently omitting for the sake  of brevity, those medicines
which though corresponding to the single symptoms un-
der consideration, nevertheless did not correspond  to the
entire character of the affection.   Hence for instance un-
der  the rubric  Tenesmus during  stool: the practitioner
need not be  surprised to find only a dozen medicines men-
tioned in the Repertory,  while fifty medicines  probably
have  that symptom in the  Materia Medica, and  so of
others.
   The  insertion of  the reported cases from practice seem-
ed necessary only for  the sake of completeness.   They
doubtless have their value.   More  to some minds than to
others.   And though they may not serve as models in the
treatment, they are  not without value in other points of
view.
                                 Fred. Humphreys.
New-York, July, 1853. 
 
DYSENTERY.
      INTRODUCTORY REMARKS.

  Most practitioners  understand by  Dysentery  a
range  of symptoms  as follows: bloody,  sparse but
frequently repeated evacuations from the bowels, with
tenesmus, colic pains  and general febrile affection.
These symptoms are proper to every inflammation of
the colon and rectum.  But is Dysentery only a sim-
ple inflammation of the large intestines !  Many phy-
sicians rest satisfied with this view of the case, ac-
cording to which, the epidemic and endemic appear-
ance of dysentery, its evidently infectious and conta-
gious nature, the tendency to adynsemia, its relation-
ship to intermitting fever and typhus, and other pe-
culiarities of the  disease, are as little  explained, as
is  the  essence of Typhus when  we consider it as
nothing more than an inflammation of the illeum.
  Dysentery is not merely a simple  inflammation of
the large intestines.   Every circumstance indicates
that the epidemic dysentery, like  the exanthematous, 
8
DYSENTERY.
and typhus process of disease, is a disease from the in-
toxication of the blood, occasioned through the recep-
tion or development  of a morbid poison in the blood,
and localizing itself upon the large  intestine in  the
form of a specific irritation.   Whether the dysentery
is a  wholly specific process of disease, constantly
projecting itself upon the  large  intestines;—or,
whether it is one limb only out of a range of diseases
which are  produced by  a  similar injurious  agency,
belong to the same original source, and yet manifests
its varied local appearance through individual or cos-
mic influences,—or finally, whether the dysentery is
only an  expression  of the particular  localization of
the form of disease, but which may be  occasioned by
essentially different disease processes,  are questions
yet undecided.  The majority of physicians  hold  to
the view that the dysentery is a specific morbid pro-
cess, which requires a particular place among cosmic
diseases, as well as the variola, the yellow fever,  the
cholera, the typhus, &c.  In favor of this view among
other circumstances may be mentioned that the dys-
entery occasionally  appears  alone and independent,
and not in connection or dependence with other  epi-
demic diseases.  Without questioning  the variety of
epidemic dysenteries, those who accept this explana-
tion quiet themselves with the reflection that other
cosmic diseases, as variola,  scarlatina, typhus, &c, do
not always appear in the same form, but often assume
a mild or an  inflammatory, a bilious, or an adynamic
character—modifications which we are in the habit of 
INTRODUCTORY REMARKS.
9
referring to the unquestionably not yet well known
laws of intermitting diseases.
   Williams has with much ability maintained  the
opinion, that the dysentery is a branch  of a  large
family of diseases excited by marsh miasm, including
also the  intermitting and  remitting  fever, cholera,
&c.  He remarks that there is no  region,  where
swamp fever prevails, in which the dysentery  is  not
also endemic ;  that swamp fever  and  dysentery may
exist at the same time in the  same individual, or  suc-
ceed each other ;  that intermitting fever often ends
 in dysentery, and the contrary, and that  in swampy
 districts the dysentery  disappears  as soon  as the
 swamps are drained and the ground becomes dry, &c.
 But we learn only from this, that miasma, that great
 X in pathogenie, in the production of dysentery, as in
 many other diseases, plays a  certain part, without ex-
 cluding the concurrence of other injurious  potences ;
 or without our being enlightened as to the nature of
 this miasm. Eisenmann is the  most ingenious advo-
 cate of the theory that dysentery is the local mani-
 festation  of  very different  disease processes,  upon
 the mucous membrane  of the  intestinal canal; the
 processes  which localize themselves  under this  form
 may  be  the pyrosic, typhoid,  rheumatic,  scorbutic,
 cholorotic.  Dysentery  according  to this view, is
 not a peculiar disease process in itself,  but is a  ty-
  phus, a cholosis, a rheumatism,  which forms its  local
  focus upon the colon and rectum, and thus forms a co-
                1* 
10                 DYSENTERY.
lo-typhus, a colo-cholosis, &c.  The remarkable va-
riations in the appearance of the dysentery of differ-
ent epidemics he  explains  not  from the  accidental
complications with  gastrosis,  or other  modificationd
exibited according to the epidemic ; but  rather  from
an essential difference in the disease process which
chooses this portion of the intestine as  the place of
deposition for its product.
  After a careful examination of all the facts in the
case, we are inclined to  the opinion that  dysentery
should be considered the local expression of a morbid
process, which may vary both in its origin  and  cha-
racteristics.  In the majority of cases  dysentery is
the product of an earthy poison, and should be classed
among the type of diseases  having  a true  malarious
origin, and it thus appears in connection with typhus,
and is  observed in marshy regions in  summer and
autumn.   Other cases of dysentery arise from locali-
zation  of cholosis in the large intestine  and rectum,
and appear in connexion with other bilious  diseases ;
but often also, the dysentery prevails at the time of
the prevalence of typhus in a more fatal form, as an
offshoot of the typhus process. Colonitis and procti-
tis with dysenteric symptoms may be  occasioned by
many external causes, as traumatic injuries, worms,
&c.  But here  we only  speak of dysentery in its
stricter sense as a disease appearing epidemically.
  We  pass  now to the consideration of the disease
itself, and commence with a description of anatomi-
cal changes occasioned by it. 
ANATOMICAL CHARACTER.          11
           ANATOMICAL CHARACTER.
   The variety in the anatomical changes so far as we
 possess  them through  the diligent  labors of (xely,
 Thomas, Gueretin and Rokitansky, may be referred to
 the different stages and  grades  of intensity in the
 disease; and it may be difficult to infer  from these
 changes with  precision, what has been the genetic
 character of the disease.
   The principal seat of dysentery with reference to
 its focus of concentration and termination, is the mu-
 cous membrane of the large intestine, and the princi-
 pal alterations are found extending in  an increasing
 ratio from the ccecum to the rectum.  But the affec-
 tion does not remain limited either to this portion of
 the intestine, nor to its mucous membrane.   The pa-
 thological changes often pass above  the ccecum into
 the  small  intestines, often reach  even the stomach,
 and  the  neighboring organs  of the intestinal track,
 are sufficiently often brought into sympathetic suffer-
 ing.   The disease also always tends  to extend  in
 depth, invades the submucous  tissue, the muscular
 coat, and even reaches the peritoneal folds.  The dis-
 tinction of a circumscribed, and diffuse,  an erysipela-
 tous (limited to the  mucous coat) and phlegmoneous
 dysenteric inflammation,  which  have  been  derived
 from the variety in the  rays  of extending  inflamma-
 tion, are of no  practical value as  they  are by no
 means clearly marked by their symptoms.
  The  anatomical characteristics  at the commence-
ment of the disease, are difficult to be  described, as 
12
DYSENTERY.
subjects from this stage are rarely  examined.  The
slightest grade of change forms redness and swelling
of the  mucous membrane  on  the more prominent
plaits of the membranous  folds,  infiltration of sub-
mucous cellular tissue, redness, and an easily-bleed-
ing  softening;   according to Rokitansky, the epi-
thelium of the mucous membrane is elevated into small
miliary vesicles, and is cast off in minute portions, or
may be easily detached with the scalpel, so  that  the
membrane  lying  beneath appears to be  excoriated.
With the increase of the  serous  infiltration  of the
submucous cellular tissue, lumpy swellings, apparent-
ly hypertrophic, arise, while at the same  time, there
is a bilious softening of the mucous coat.
   The  anatomical condition of the  intestinal track
assumes in the farther progress of the disease, vari-
ous modifications, the consideration of which will be
facilitated by distinguishing the following points.
   The contents of the intestinal  canal  which  may
often be known  externally by  their  color; consist
in the  beginning of a greyish red mucus,  more  or
less mixed with food, and later of mucus  mixed with
cast-off epithelium, pseudo-membrane, blood, pus and
gangrenous exfoliated mucous membrane ;  and  it may
at last be changed to a dark brown, cadaverous smell-
ing fluid, like  coffee sediments.   A portion  of the
contents of the intestine are deposited upon the sur-
face of the diseased intestine, of more or  less thick-
ness, variously colored or green-villous stratum, which
may be taken off  with the scalpel.  This  layer con- 
ANATOMICAL  CHARACTER.          13
sists not only of a precipitated portion of the con-
tents of  the canal, but arises also from a dyphtheritic
secretion from the mouths of the mucous follicles, and
follicular ulcerations, and from the mucous membrane,
which is softened, may  be  easily  detached from  its
position, and is  swelled to  a raspberry-like  appear-
ance.
   The  redness of  the mucous  membrane  varies
from rose and bright red, to purple and brownish red.
Even at the beginning, the mucous tissue is macerat-
ed to softening, first  the epithelium,  later the  entire
mucosa in stripes, so that the layers continually ex-
tend in depth, and larger portions are excoriated or
laid bare.  The softening extends  in part on the sur-
face over large stripes, and in part is limited to cir-
cumscribed  spots.   We should  not  confound  the
changed mucous membrane  with the strata of pseu-
do-membrane, which often lies  upon the mucosa, and
gives it a pointed-like appearance, and beneath which
the mucosa at times  may be found uninjured.
   The changes  in the  intestinal follicles have been
carefully described  by Thomas  and Gely:   They
swell from the sixth  to the tenth day of the disease,
become dilated, and form small ulcers, covered  with a
pseudo-membranous  material.*   Dilatation  and  de-
generation of the follicles becomes more apparent in
the farther progress  of the disease.
  * We find says Gt-ly, along the whole  length of the  large intes-
tine  numberless small dark points, discernible with the naked eye,
surrounded by whitish plain broad elevations, which are clearly the 
14
DYSENTERY.
  Especially important is the  participation of the
sub-mucous cellular tissue.   The serous  infiltration
of this tissue at the beginning, penetrates by degrees
inio the muscular ;  hence arises a considerable thick-
ening of the intestine,  often  to  the extent  of  from
three to  five lines; at the  same time through the
contraction  of the  muscular coat,  the folds of the
mucous coat are pressed inward,  and the intestine as-
sumes a warty, glandular, hypertrophied appearance,
forming the  warty hypertrophy of the sub-mucous
cellular tissue, described by Gely.
  With  the extension of the  disease,  the  mucous
membrane over the knotty infiltrated sub-mucous cel-
lular tissue, frequently becomes overlaid with a firmly
adherent dark  red, darkish brown scurf, which final-
ly degenerates in large stripes to a  dark friable al-
most carbonized mass, which yet later  is  thrown off
in  the form of tubular patches, (the so called sphace-
lated membrane.)  The sub-mucous cellular tissue ap-
pears either as a carbonized mass of blood, or is  satu-
rated with bloody serous fluid, or bleached, and con-
taining in  its vessels  a mass of  dark  carbonized
blood, but which later, in consequence  of throwing
off of the sphacelated portions, is infiltrated with
pus in consequence  of active  inflammation, (Roki-

mouths of the swelled follicles.  Frequently the central dark point
is replaced by a small greyish ulcerous opening, which leads to the
base of the  krypt; aome of these ulcers are two or three  lines in di-
ameter. 
ANATOMICAL CHARACTER.
15
tansky.)  From destruction of the mucus membrane,
the muscular and even peritoneal folds may be expos-
ed, and even entire perforation at  times be produced.
   Usually the intestines are distended with gas ; the
colon is sometimes dislocated, so that the transverse
colon is pressed down into the sacrum.   Frequently
a  considerable  portion of the colon is  constricted as
from a ligature, while the portion of intestine  lying
above it is thinned and distended, while the contract-
ed portion may be of cartillaginous  hardness.^  Such
 strictures are found most frequently in the vicinity of
 the sigmoid flexure, and the arch of the  colon, more
 rarely in the rectum.
    The above described alterations belong especially
 to the acute period of dysentery.  In what manner
 in a termination in  health, a retroformative process
 in such changes is possible, can only be ascertained
 by an examination of those patients who having lived
 through the  dysentery, have finally succumbed to
 some other disease.  We find in  such cases often a
 new formation in place of the substance  lost by soft-
 ening and ulceration, and either  beginning or perfect
 cicatrization.  The denuded sub-mucus cellular tissue
 is changed into a smooth, serous, sero-fibrous tissue,
 the surrounding mucosa appears  wrinkled and re-
 tracted towards the centre, the  membrane  which re-
 mains island-like in the centre, shrinks together, the
 borders of the old ulcer become attenuated and reach
 out to the centre ;  the contraction of the cicatrizing 
16
DYSENTERY.
tissue, and the hence folding up of the part frequently
occasions stricture of the intestine.   It is not always
that the infiltrated febrinous  product of disease  in
the sub-mucous tissue is resorbed, but frequently it
becomes changed and organized to a hard lardaceous
mass, which not  unfrequently prejudices  the free
movement of the intestinal canal.
  The loss  of  substance  in the mucous membrane
may be changed to independent ulcerations,  the dys-
enteric process pass over into an entero-phthisis.  The
borders of the ulcer, as well as the mucous coat on the
surrounding membrane and ground of the ulcer, be-
comes a spongy, easily bleeding fungus,  the mucous
membrane becomes grey,  darkish colored, the  folli-
cles are filled with matter, in the sub-mucous cellular
tissue collections of matter form with fistulous  open-
ings, which frequently penetrate to  the peritoneum ;
and from the inflammatory irritation  returning  from
time to time in the peritoneum, the intestine may be-
come fixed in an abnormal position.
   Sometimes we find in the rectum a single extensive
ulcerative surface.  Not  unfrequently  pus  accumu-
lates beneath the rectum, and forms an abscess in the
right illiac  fossa.   Often, especially  in  children,
intestinal intusception occurs in one or more places,
especially in the illeum, the coecum, and colon ; the
constricted portion may even be thrown off without
destroying the  life of the patient.
   It is evident that  in a disease process so intense 
            ANATOMICAL  CHARACTER.           17

as that  of dysentery, the anatomical changes cannot
be limited  to  the organs  primarily  affected.   The
neighboring tissues  standing  in functional connec-
tion with the intestines participate in various degrees.
The mesenteric  glands are  frequently reddened,
swelled, softened, seldom infiltrated with matter, and
in the  last stages filled as if with some carbonized
substance.   These changes are most prominent in the
glands, most nearly  related to the affected portion of
intestine, and its ulcerations.   The peritoneum is
frequently inflamed  and coated with a dissolute exu-
dation $  in its cavity a bilious, dark colored fluid is
frequently found deposited.
   Inflammation,  softening, and abscess of the liver,
enlargement and softening of the spleen, and abnor-
mal changes in the  pancreas are not unfrequent in
cases of longer duration or chronic course.  Secondary
alterations  in  the  liver are frequent  in the  East
Indian  and North American  dysentery.  The omen-
tum and spleen, are usually found very full of blQod.
The bladder is always injected ;  before the twentieth
day contracted;  after  that period distended with
urine;  the ureters are often filled with a milky fluid.
The remaining organs are mostly destitute of blood,
also the lungs;  the  heart is relaxed, the vascular
walls contracted  and shrunk up ; frequently more or
less exudation is found in the  pleura  and pericar-
dium.   The blood  is  fluid;  the gall-bladder  well
filled with brown bile. 
18
DYSENTERY.
   Chemical analysis of the blood seems of some im-
portance.  A superficial examination shows according
to its physical character that it is thinned and forms
but  little coagula.   Masselot and  then Follet  have
made a careful analysis of the blood in the dysenteric
cadaver, and show that deficiency  in blood globules,
albumen and fibrine belong to the peculiarities of this
disease;   that with  the intensity  of  the  fever and
inflammation of  the  intestine the proportion of albu-
men and  fibrine as in other  inflammatory conditions
is increased.   There  is  in  this  peculiarity of the
blood in dysentery, nothing unusual or different from
other disease processes; for  anaemia or loss of blood-
globules,  occurs  in  all long continuing diseases of
cosmic origin (Typhus, Intermitting  Fever, Cholera,
&c.,) and is manifested by  the  rapid collapse and
remarkably  sudden emaciation of the patient.
   The excretions in dysentery, yet require a chemi-
cal  analysis.   Most remarkable  is their very acrid,
and.  acting  on  the mucous coating  almost  corrosive
nature, and  which perhaps may in part account for
the ready destruction of that membrane.  What par-
ticular acids they contain  has  not as yet been  fully
determined.

                 S YMPT OMS.
   We may distinguish a precursory, a  particular
morbid stage, and a stage of termination;  the pre-
cursory and morbid stadium may be considered as 
PRECURSORY STAGE.
19
the acute, and the terminating as the chronic stages
of the disease.
   This arrangement is more natural than to consider
them as  stages  of  inflammation  and  of maturation.
If we  should  consider  the presence of pus in the
stools  as the criterion of the period of maturation,
and from hence conclude the existence of ulcers in
the  intestinal  canal,  it  would be difficult to  avoid
falling into an error, as it is well known that pus-like
mucus may be  secreted  from the mucosa, without the
existence of ulceration, and on the other hand that the
existence of  ulceration cannot always be determined
from the presence of  pus in the dejections.   The
acute  stage  of the  disease continues  from eight  to
fourteen days,  the chronic an indefinite period.

              PRECURSORY  STAGE.
   Dysentery comes  on  more frequently with  than
 without precursors ;  but in its more violent form it
 may also appear suddenly as a fully developed dis-
 ease.  If precursors  are present, they are such  as    (
 usually precede other epidemic diseases, in which the
 general symptoms of intoxication precede the stage
 of localization, such  as:  great lassitude, and weari-
 ness of the  limbs,  pains in  the  neck, back, and ex-
 tremities, headache, Joss of appetite, chilliness, heat,
 transient sweats, loathing, sometimes vomiting.  As
 the disease by  degrees  localizes  itself upon the ab-
 dominal  organs, there are frequently returning colic
 pains,  experienced in  the umbilical region,  which 
20
DYSENTERY.
extend to the anus, and by degrees concentrate them-
selves in sigmoid flexure and rectum ;  borborigmi;  a
feeling of weight and  heaviness in the perineum, as
if a foreign body was fixed  in the rectum and urged
the patient to  stool;  irregular evacuations either
diarrhoea, which often precedes the dysentery several
days,  or  constipation.  These precursors often  con-
tinue only one or two days, sometimes extend to eight
days,  and  many times also consist of  only a  sin-
gle febrile  attack.

               ACUTE  STAGE.
   Symptoms of the disease consist of; colic pains,
which follow the course of the colon, from the region
of the  ccecum in the right  hypochondria, extending
upward and across over the  abdomen toward the left
hypochondria  in the region  of the sigmoid flexure of
the colon, and  extend down to the rectum, where  they
excite an urging to stool, tenesmus, and often termi-
nate in  an  actual evacuation.   Usually these  colic
pains  precede the evacuations, or are more violent  a
short time before them; and they often also continue
during a fruitless urging.   The tenesmus  continues
also during and  after a discharge, and  consists of an
especially painful  feeling of constriction of the rec-
tum.  Another characteristic mark of  the disease is
found in the discharges  themselves;  they are  very
frequent.  Twelve to twenty-four  or more times
within as many hours,  and often so frequent that the 
SYMPTOMATIC  VARIETY.
21
patient can scarcely leave the  stool.   The quantity
of each discharge is slight, often not more than a tea-
spoonful, and  is composed of mucus, fluid or coagu-
lated blood, membranous shreds,  in various degrees
and proportions,  with  little  or  no  fceculent matter.
Frequently the abdomen is painful to contact.
   With these local symptoms  are  associated, fever,
thirst,  hot, dry skin,  accelerated pulse, diminished
secretion   of  urine,  inquietude,  sleeplessness  and
general depression.
   The disease  may continue eight  or ten days and
terminate  in recovery, in which case the colic pains
and  tenesmus remit, the discharges become less fre-
quent, more copious and fceculent, and crisis through
the skin, (warm sweat,)  quietude and sleep come on;
or the disease may extend so as to  become a perito-
nitis, or, a typhoid condition, or end fatally by any of
the  unfavorable  terminations  of  this  disease,  of
which we shall speak farther.
   We shall endeavor, after  this  short sketch of the
disease, to consider more intimately the most impor-
tant varieties in the form of its manifestations, by a
more careful  consideration  of  its  single symptoms
and  their connection; so as to  show  the different
forms  of dysentery.
            SYMPTOMATIC  VARIETY.
   The  pain in the abdomen, in  dysentery, appears
in every modification, from slight colic to the most 
22                 DYSENTERY.
violent inflammatory pain.  Often there is only slight
termina, a griping, cutting, especially in the  above
mentioned  course  of the  colon, coming on and then
disappearing, while in the interval the abdomen is
painless, and  not sensitive  to contact.   The colic
pains may however  be especially violent, which the
patients express  by their groans  and complaints.
They have apparently  the same physiological  indica-
tion as the tenesmus  in the  rectum; they may be
excited in  part by the contact of the acrid secreted
matter, with  the  sensitive  denuded surface  of the
mucous membrane, and hence the pain immediately
precedes the stool, and they may also in part  arise
from the spasmodic contraction of the muscular coat,
excited from the irritation of the mucous  membrane.
These colic pains then appear immediately after as
well as before the discharge, similar to the spasmodic
constriction of  the  sphinctur  ani,  which continues
longer than the discharge itself.
  Should we presume, because these pains are often
only colicky, that the essence of the disease is limited
to the mucosa, we shall find on  the contrary that with
the increase  in the intensity  of the  disease, these
pains often become fixed  and permanent, exacerbate
perhaps periodically, but  no longer disappear in the
intervals, and  even continue with uninterrupted vio-
lence.   These pains are  mostly limited to a narrow
space, and  associated with distension, hardness, heat,
and meteorism of the abdomen ; the abdomen  is sen- 
' SYMPTOMATICAL VARIETY.         23
sitive to pressure, and every change of position in-
creases the pain so that the patient  either lies  im-
movably on the back  or the side, bent over, with the
legs drawn up towards the  abdomen; the pains are
also excited by the use of the mildest substances, but
especially by cold drinks.   Such a violent  grade of
pain is a sure indication of the deeper extension of
the inflammation to the sub-mucous  tissue, the fibrous
layer and even to the peritoneum.  Exacerbations of
the  continuous pain  are apparently  connected with
the above mentioned cause,  (acridity of the intestinal
contents, and reflex spasm of the intestine.)   Usually
the colic pains are proportionate to  the tenesmus, but
they frequently remain after the disappearance of the
tenesmus, and also the contrary.
   The abdomen may  be full, in consequence of accu-
mulated foecal matter, and become  tense from con-
traction  of the  abdominal muscles;  or  also  me-
teoristically  distended; distension  of the abdomen
does not always influence the abdominal pains.
   In some cases of dysentery, notwithstanding a con-
siderable intensity of the local affection  and degen-
eration, the pains are  wholly wanting ; such cases are
especially observed  in epidemics  of  an adynamic
character.  In an  epidemic described  by Wedel, all
the  patients died who had  no  pain, while those who
experienced  violent  colic recovered.   Thus  it may
happen, that  after  the  dysentery has  progressed
with the  most violent pain, and has come on under 
24
DYSENTERY.
 appearances of intensive inflammation, the pains sud-
 denly dissappear, with- at the same time, sinking of
 the strength, general collapse, involuntary discharge
 of cadaverous or sphacelated excrement;  indicating a
 termination of the inflammation in paralysis of the
 abdomen or gangrene.
   Tenesmus consists in a feeling of painful constric-
 tion of the rectum and usually follows a  sensation of
 heat, burning, cutting, excited by the passage of the
 excrements.  The tenesmus is a manifestation of the
 reflected spasm, which the excited membrane exhibits
 during the moment of irritation or excitement.  When
 the mucous membrane is  in  a condition of violent
 inflammation it requires but a  single irritation of the
 discharges, to excite an  almost  continual tenesmus.
 The contraction of the muscles of the anus may attain
 such a degree of vehemence as to frequently occasion
 and especially in children a prolapsis of the inflamed
 rectum.  Patients  complain of pain along the sacrum,
 as if a hot iron was  thrust  into  the rectum; and
 sometimes  tenesmus even occasions fainting, convul-
 sions,  and trembling of the limbs.  Often patients
 have a sensation as if a foreign body remained in the
 rectum, which occasions a fruitless urging  to  stool,
 and  continues  a  long time  after the  discharge.
 Sometimes the discharges are  entirely wanting,  not-
withstanding the most violent tenesmus.  (Dysente-
ria Sicca. 
BYMPTOMATICAL VARIETY.
25
  If the tenesmus is especially intensive in inflamma-
tory dysentery, there are also many cases of bilious
dysentery, where it is not much less ; and.certain indi-
viduals, as hemorrhoidal subjects, suffer much from
this symptom, when the collective character of the
disease is comparatively mild.   Every passing irri-
tation in the rectum, such as the introduction  of the
finger, or the point of the syringe excites and increases
the irritation.
   Tenesmus often continues  a long time 'in the sta-
dium  decrementi, and not  unfrequently into that of
convalescence.  Many times  chronic tenesmus is the
consequence of ulceration in the rectum, and only dis-
appears with the entire cicatrization of the ulcer.
   When paralysis comes on, the tenesmus as well as
 the abdominal pains may suddenly cease; in place of
 spasmodic contraction of the rectum there appears a
 paralytic relaxation of sphinctur ani, the anus remains
 wide open, and the stools  are  passed involuntarily.
 Relaxation  of the  sphinctur ani  may continue for
 some time  after the acute stage of the  disease, and
 remain, constituting a secondary affection.
    Nothing  is more varied than the character, quan-
 tity, &c. of the  evacuations  and their relation to the
 remaining symptoms.  At the beginning of  the dis-
 ease the stools are frequent, yet fceculent, and mixed
 with scabella.  That dysentery is sometimes preceded
 by constipation, and at others with diarrhoea has been
 already remarked.
               2 
26
DYSENTERY.
  The mucus diarrhoea, often present, is apparently
a symptom  of the catarrhal  irritation, yet limited to
the mucus  membrane,  and the hence occasioned  se-
cretion of its follicles.  On the  contrary, where the
disease declares itself from  a  condition of deficient
evacuation, it doubtless indicates  the first stage of ca-
tarrhal irritation, in which the mucous membrane has
become unnaturally dry, and its secretions are for a
period arrested.   This condition is  frequently found
associated with synochal dysentery (dysentery sicca).
In  the well developed dysentery the stools are un-
naturally small but frequent.  We have known 200
stools within 24 hours; every movement in bed, even
speaking, drinking, &c. immediately  excites an  in-
creased peristaltic motion, rumbling and evacuation.
From the frequency of the stools  we judge in part  of
the intensity of the disease; their  decrease usually
indicates a remission in the disease itself.  Especially
in cases of an adynamic character, the stools may be-
come  very numerous.   The  quantity of  the stools is
in inverse proportion to their number ; they are more
frequent towards night than by day ;  in proportion as
they increase, the amount of perspiration,  urine  and
expectoration diminishes.
  The stools are  fluid and  consist of mucus, blood,
epitheleum, shreds, pus, exudated croupy masses, mos-
sy-like fragments, faeces, undigested matter;—or they
are white, slimy or mattery, or gelatinous when such
prevail, forming the so-called  white dysentery;—or 
SYMPTOMATICAL VARIETY.          27
they are  bright  or dark-brown,  red, yellow, green,
mixed in various  shades, parti-colored,  dark, or like
water in which meat has been washed, and of shreds of
epitheleum, usually diffusing a  peculiar and  some-
times a cadaverous putrid odor around.  The masses
of mucus are the  product of the abnormal secretion of
the mucous krypts and often form in the earlier and
latter stages of the disease a large proportion of the
discharges ; the mucous diarrhoea often continues long
after the acute stage of the dysentery, and depends
upon the dilatation and enlargement of the mucous
follicles, as we find in the cadaver of cases which have
run a more lentescent course.  The evacuated mucus
is either uniformly mixed,  or bilious,  or  like frog
spawn,  or lumps  of fat; sometimes white or reddish-
white, or yellowish-brown lumps  pass off, which were
formerly taken for glands, and even for portions of the
intestine.   Very  frequently, especially during  the
first eight days of the disease, we find  upon the sur-
face of discharged material a yellowish or greenish
mossy substance  ; in  the farther progress of the dis-
ease this yellow or  green substance  appears more
rarely,  and always indicates, according to Thomas, an
aggravation of disease.
  The quantity of blood discharged with the stools,
is subject to great variations.  In the commencement
of the disease there is sometimes  a considerable quan-
tity of blood discharged with relief; also in synochal
dysentery the  quantity discharged is  considerable. 
28
DYSENTERY.
The blood is either only mixed in streaks through the
discharges, or it  is more intimately  mixed, and the
more so the higher the  point in the intestine from
which it has been secreted.   It is often fluid, and as
often coagulated.  There are always actual vascular
separations, if only occasioned by the superficial ero-
sion of the mucous membrane, which are the -source of
hemorrhoidal discharges.  In the later stages of the
disease ulcerations of the intestine furnish these in
good part, and they may continue until entire cicatri-
zation occurs.  The haemorrhage may also become
colliquative; often, especially with  intemperate per-
sons, the bleeding continues in considerable quantity
from the commencement of the disease until the death
of the patient.
   The exfoliated  intestinal epitheleum is found in the
discharges  in flocks,   shreds, which  after  standing
settle at the bottom  of  the vessel, and have the ap-
pearance of scrapings; often among them are found
remains of sphacelated mucosa.   These cast off mem-
branous fragments, may be known by their sphacelated
appearance,  the ichorous character and  the putrid
smell of the discharges, and the remains  of their vas-
cular structure upon microscopic  examination.
  Pus is often mixed with the stools in streaks or in
patches, and yet  may be mistaken for mucus.   The
secretion of pus  will continue so long as ulcers are
present in the intestine.
  Frequently the dysenteric  discharges are so acrid 
SYMPTOMATICA!, VARIETY.          29
as to occasion soreness and erosion of the anus, scro-
tum and neighboring surfaces, and may even excite a
gangrenous inflammation of the  parts.  Punctures
occasioned by leeches, poisoned by the acrid discharge,
become changed to malignant ulcers.
   The odor of the discharges is peculiar.   Naumann
describes it as a composition of the  smell of old fat
and boiled French beans !
   In  many cases, especially in children and in some-
epidemics, the evacuations  contain  large quantities
of worms.
   When the discharges in the  course of the disease
become bilious, and assume a more  fceculent appear-
ance,  a pappy and more consistent form, it is a favor-
able change indicating a return  to health.  Sometimes
after  a long  continuance  of the peculiar dysenteric
stools there is an unusual quantity of faecal balls dis-
charged,  although the  patient has  maintained  the
strictest diet.  These faecal masses have been spas-
modically retained in the small intestines above the
portion of  the intestine  affected by the disease, and
are only discharged when the inflammatory spasmodic
constriction has been relieved.
   During the course of the disease,  as well as in the
period of improvement, food  and drink often passes
off in  part or wholly undigested.  This may be oc-
casioned from the assimilating process being imper-
fectly  performed,  or what  is more apparent, that the
muscular coat, in consequence of the  disease, has  been 
30
DYSENTERY.
 left in a condition of irritable  weakness, so  that the
 otherwise  proper contents  of  the intestine  acts as
 an anomalous  irritation,  and provokes  a premature
 contraction.  Hence there is not unfrequently a stage
 of lienteria as a consequence of dysentery.
   When the reflex action  is unusually  excited, the
 irritable nerves frequently extend their reaction to the
 motor nerves in relation with them.   Hence there is
.frequently observed in dysentery  appearances  of
 spasm of the bladder,  strangury, ischuria, spasm  of
 the testicles,  convulsions and cramp in the calves,
 similar to what occurs in cholera, and these consensual
 spasms occur mostly during the tenesmus.  Paralysis
 of the lower extremities has also been observed as a
 consequence of dysentery;  and it is manifest that in
 such cases the  reflex irritation of the  spinal marrow
 has changed to a local alteration of this organ.  How
 easily a  sympathetic irritation may pass over into an
 actual disease and its consequences, is shown  from the
 frequent marks of inflammation of the bladder, which
 occur in the cadaver of dysentery.
   At times we find loathing, vomiting of slimy bilious
 matter or of blood,  which, according to Abercromby,
 indicates an extension of the disease to the illeum;
 the vomiting is often excited by every thing which is
 taken into the stomach.
   The voice in dysentery as well as in cholera is of-
 ten low and whispering.
   Eisenmann  distinguishes in dysentery as in other 
            SYMPTOMATICAL VARIETY.          31

diseases from poisoning of the blood, an eruptive and
a secondary fever, of which the first is the conse-
quence of the production and increase of the specific
miasm in the blood, occurring even before the localizing
of the disease, and the second from the reflex action
of the local affection upon the vascular system.  Very
frequently  the fever as manifested by the frequency
of pulse and increased temperature of the skin is very
slight;  the pulse not being accelerated, the skin even
cold  and lifeless, cyanotic  as  in cholera, which, to-
gether  with the  cramps in  the calves, collapse and
rapid emaciation, exhibits a great similarity to that
disease.  The higher the  affection extends in  the
small intestines the more violent and intensive is the
fever.
   The fever manifests an erethic, synochal, adynamic
or putrid character, which usually corresponds  to the
milder, more violent or finally malignant character of
the  local affection and  collective  course of the dis-
ease.  There are however cases which cannot strictly
be classed as above, where for instance the fever and
local affection do not harmonize; when the fever may
be erethic  notwithstanding  an intensive local inflam-
mation, or adynamic with a relatively slighter  intes-
tinal affection.
   There is frequently a feeling of violent internal heat,
associated with objective coldness of the surface; often
the abdomen only is hot to the touch ; and the  recur-
rence of decided chills in the course of the disease is 
32
DYSENTERY.
 a bad indication.  We have seen  in cases  of  violent
 dysentery the  tongue often cold  and blue, as  in cho-
 lera.   The thirst is usually very violent, and  the
 pulse is no  criterion for the intensity  of the disease.
 The scanty urine frequently has a milky appearance.
 The'  agitation  of dysenteric patients is usually very
 great;  they are  sleepless, and  it is a favorable sign,
 when the restless inquietude gives place to a calm and
 quiet sleep.  The  intellectual  functions remain un-
 disturbed to the last, even in  the worst cases ;  yet
 there sometimes comes on at  last delirium  and  a
 soporous condition.

           VARIETIES OF DYSENTERY.
  We distinguish with reference to the degree of in-
 tensity of this affection  the  following  grades; the
 mild or erethic, the synochal or inflammatory, and the
 torpid or adynamic, of which last the torpid, paralytic
 and the putrid  dysentery form varieties.
  The mild form of dysentery, known  as the erethic
 or catarrhal, has usually a short  precursory  stage,
 the fever  is moderate, often wholly wanting  or dis-
 appears  after the localization of  the disease;  is not
 continuous, but has clearly expressed periods  of re-
mission and exacerbation ; secretions of the skin and
kidneys are not entirely suppressed.  The abdominal
pains are colicky, have intervals of entire remission,
 the abdomen is  soft and not  sensitive to pressure.
The evacuations  are  yet partially colored  with bile, 
VARIETIES OP  DYSENTERY.         83
fceculent, streaked or mixed with blood, and contain
occasionally large masses of exuded fat or matter, and
comparatively more mucus than other varieties. Their
number rarely exceeds 12 or 18 in tie 24 hours, the
tenesmus is  moderate, and the  spasmodic reflective
action of other organs  is not present.  The disease
continues from 8 to 14 days, and  terminates usually
in health with appearance of perspiration, fceculent
 stools, and at times sedimentitious urine.   The ere-
 thic dysentery may under unfavorable circumstances
 assume the synochal or  adynamic form.
   The synochal or inflammatory dysentery is mani-
 fested from the beginning by a violent shivering chill,
 which often continues many hours, and is followed by
 an  intensive heat.   The  precursory symptoms  are
 stormy, or the dysentery makes  its  sudden invasion
 with full vehemence.  Soon, there are developed signs
 of violent abdominal inflammation; the pains in the
 abdomen are  continuous, become increased from the
 slightest pressure, the bowels are hard and tense, and
 the tenesmus especially distressing; often there is a
 large quantity of blood discharged through the frequent
 stools, from which at times the patient feels relieved,
 especially in the beginning  of  the disease.  Often-
 times  there  is complete retention of stools, notwith-
 standing the most violent pains and tenesmus. (Dy-
 sentery°sicca).  The stools frequently contain croupy-
 like membranous masses, the product of fibrinous exu-
  dation  from  the  ulcerated  surfaces.  Sympathetic
             2* 
34
DYSENTERY.
 sufferings, such as, cramp  in the bladder and calves
 of the legs,  are  usually very marked.   The inflam-
 mation often extends upwards to the small intestines
 and stomach ; and the use of all fluids is followed by
 vomiting.  The fever has the inflammatory character;
 the pulse is  full and  frequent, but often also  sup-
 pressed and spasmodically contracted, the tongue red,
 ragged,  sometimes  covered with a white coat,  the
 thirst can scarcely be allayed;  remissions are want-
 ing,  or  but very slight;  face generally red, eyes in-
jected ;  the urine  is dark-red, the skin dry and hot.
 Duration of the disease is from 14 to 21 days ; crisis
 as in erethic dysentery;  sometimes bleeding from the
 nose or  other  organs, and  patients  recover  slowly.
 In unfavorable cases  the synochal  dysentery  pass
 over into an adynamic stadium, with meteorism, ca-
 daverous smelling stools which appear dissolved and
 pass off involuntary, delirium,  small  sinking pulse,
 and tongue becoming dry, &c.   Inflammatory, dysen-
 tery may terminate  fatally in gangrene, or perforation
 of the intestines.
  The  adynamic  (neuroparalytic)  dysentery,  fre-
 quently  manifest in its precursors,  the pernicious
 character of the disease.   The whole system is deeply
 affected; the patient complains of headache, vertigo,
 great lassitude; often before the invasion of the pe-
culiar dysenteric symptoms, there is a violent chill, a
 feeling as  if cold water  was  poured over the back,
which precedes the diarrhoea.  The  acute stage is 
            VARIETIES OP DYSENTERY.         35

distinguished  by the  unusual number of stools, fre-
quently as  high as 200 in the 24 hours; the violent
tenesmus, and by the dissolute character  of the stools,
often manifest at the beginning or gradually increasing;
which consist of brownish or blackish masses, often only
dissolved  blood, diffuse a  peculiar cadaverous  odor,
and  are so  acrid as to excoriate the parts around the
anus.  The accompanying fever has the torpid cha-
racter ;  the pulse is small and weak, the skin at times
burning hot, often on the contrary cold, especially the
extremities; forehead, nose and face sunken, the tongue
dry, coated  dark-brown, as also the membrane of the
nose; often  on the skin appearance of petechia, ecchy-
mosis, rash, or decubitus.  Towards the end of the
disease there is frequently violent hiccough, vomiting
of dark  chocolate-colored masses, involuntary dis-
charges, then  often colliquative  bleeding  from the
bowels, at  times also  from other parts,  nose, mouth,
sexual organs, many times corroding aphthae in the
mouth,  swelling of the  parotids, delirium;  death
between the thirteenth and fourteenth days.
   In this form of dysentery especially,  there appear
numerous modifications, which render  it  somewhat
difficult to  present a  simple picture  of  the disease ;
for instance, the pains in the abdomen are either un-
usually violent,  burning, continuous, or in the  worst
cases the pain has been  entirely wanting.  In the
putrid septic  dysentery the chemical decomposition
takes place early and is manifested in the  odor and 
86                 DYSENTERY.
appearance of the evacuations, in the putrid smell of
the breath and exhalations, in the thick, at times dark
dissolute character of the urine, in the clammy per-
spiration and colliquative haemorrhages.  Those cases
have been indicated as paralytic in which the poison
of the disease has appeared rapidly to  oppress the
functions of the spinal  marrow and  the ganglionic
centres, and to destroy them, as besides the  other marks
of adynamic dysentery, there comes on sudden para-
lysis  of the  sphinctur ani (the anus remaining open
with involuntary stools), paralysis of the extremities,
marble coldness of the skin,  particularly  small pulse
and sudden collapse, such as we are accustomed to
observe in cholera patients.
  As qualitatively different forms  of  dysentery, the
malarious, the typhoid, the cholotic, and perhaps also
the rheumatic and scorbutic varieties have been men-
tioned.
  The previous description is appropriate to the ma-
larious and typhus dysentery.  The appearance of dy-
sentery in  intermitting fever districts at  the same
time,  or following other typhoid affections, the similar
simultaneous or successive relation of the dysentery
to the prevailing typhus process has led observers to
the qualitative nature of  this  disease.  In regions
where the intermittent  fever  prevails, dysentery is
frequently observed as an epidemic; and it frequently
follows  the intermitting fever.   In certain hospitals
the termination of intermitting fever in dysentery has 
VARIETIES OP DYSENTERY.        87
been  at times  very common;  the dysentery appears
to suspend the  intermitting fever ; but as soon as the
dysenteric symptoms are removed the  fever returns
again; in some cases the same patient suffers at the
same time with both diseases.   Williams observed in
the epidemic at St. Aignon, the dysentery following the
intermittent fever and assuming in its course an inter-
mitting character; usually however the fever  con-
tinued with the advance of the disease; in only three
cases the  dysentery followed an attack of intermitting
fever ; in the second half of the epidemic the disease
commenced as an intermitting  fever more rarely.
 Typhus dysentery assumes the  adynamic or putrid
form.   When  Rokitansky observed  that  although
here and  there dysentery might occur with typhus,
but that both processes could not be united in one in-
dividual,  he is contradicted  by  the  observation of
others, as Heim, who asserts  the contrary.  Accord-
ing to Engal, the  dysenteric  process always follows
the typhus, but we never find the order reversed.
   The symptoms of the so-called bilious, gastric and
mucous dysentery are those proper to this disease, com-
 plicated with a bilious, gastric or pituitous condition.
 The reactive character of the  disease may besides this
 partake of the erethic, synochal, or adynamic charac-
 ter, which would seem to require a subdivision into
 bilious-inflammatory, bilious-adynamic, &c.  The bi-
 lious condition often  precedes for some time the pe-
 culiar appearances of dysentery.  There is frequently 
38                DYSENTERY.
discharged by vomiting and stool bilious matter, yel-
low, grass-green, or dark-green fluid, often with relief
to the patient.   Bilious dysentery is frequently com-
plicated  with inflammation of  the liver, which may
occasion  abscesses of that organ.   The  crisis often
occurs with discharge of faecal stools, and the outbreak
of a  pustulous eruption around the mouth and nose.
In  some epidemics of this form, large quantities of
worms are discharged writh the evacuations, giving
rise to the so-called verminous  dysenteries  of some
writers.
  The distinction of rheumatic dysentery is sustained
with difficulty, and the scorbutic dysentery of  Cope-
land is not essentially different from the typho-septic
dysentery already described.

             COMPLICATIONS.
  Inflammation of the intestines necessarily  involves
the neighboring organs and portions of the intestinal
canal. Morbid changes in the liver, the spleen, pan-
creas and  mesentric  glands, frequently complicates
the dysentery and occasions many modifications in its
symptoms. Most  frequently the  liver is affected with
inflammation, maturation  or  softening, so  that many
physicians from the frequency of these  complications
consider this  organ as the one primarily affected, and
the starting point of this disease.  This complication
is particularly frequent in warm climates  and among
intemperate persons;  and they may be sometimes the 
COMPLICATIONS.
39
consequences of suddenly suppressed dysenteric dis-
charges, or of previous chill-fever.  The affection of
the liver may exist at the same time with the dysen-
tery or may follow it.  In very many cases the affec-
tion of the liver has remained latent during life, and
only been discovered in the cadaver, and often we
ascertain  the presence of the disease of the liver from
the presence of pains, swelling in the right hypochon-
drium   and  epigastrium,  jaundice,  vomiting,   &c.
Usually the first sign of abscess in the liver,  is that
the patient sinks into a typhoid condition.
  Affections of the spleen are  not  easily  diagnosed,
unless they are manifested and detected by a swelling
in that region.
  Some practitioners have observed complications of
dysentery with exanthematous diseases of the  skin,
scarlatina, erysipelas, small-pox and diptheritic an-
gina.  Siebert observed  an alternation between ery-
sipelas and dysentery, which induced him to consider
the dysentery as an erysipelas of the large intestinal
coat.   Gripal saw in  an  epidemic many patients sink
suddenly  with  a putrid erysipelas of the face.   Yet
these facts are  too scanty to enable us to conclude with
certainty as to the real connection of the two different
processes of disease. Only in very rare cases, as Roki-
tansky remarks, does  dysentery exist with pulmonary
tubercles, and never at the same time with intestinal
tuberculosa, which is  the more remarkable, as the dy-
senteric process  is often connected with  carcinoma 
40                DYSENTERY.
and especially with  open cancerous ulcers.   Kosch
frequently witnessed the whooping cough, complicated
with dysentery;  at  first the cough became  milder,
then continued, varying in intensity, until the dysen-
tery left, and then returned to its primitive violence.

    DURATION  AND  TERMINATION.
  The duration of dysentery extends in mild cases
from eight to fourteen days; if, however, we also include
the convalescence and the possible after diseases it may
extend to months.  On the other hand, in some cases
health is restored very promptly, sometimes after a
considerable discharge of blood, or the use of the appro-
priate remedies, and a fatal termination may also occur
in an adynamic dysentery within two or three days.
   The terminations in perfect recovery occurs usual-
ly under the appearance of warm perspiration, and
Hauff very justly remarks, that in  this disease  the
skin is the organ which exhibits the chief critical
activity. Most commonly this is followed by flatulent
discharges downward, the stools become less frequent,
colic  pains and  tenesmus  diminish, the fever mo-
derates, the  pulse  becomes more full  and free, the
urine  flows again and in  place of the agitation and
excitement we have rest  and sleep.   There is also
sometimes a critical sediment remarked in the urine,
ferunculous or other eruptions at times appear upon
the skin, or abscesses  form beneath  it.
   Relapses are very  frequent, especially when the 
DURATION AND TERMINATION.
patient remains exposed to the prejudicial influences,
which  have  occasioned  the 'attack,  as  in prisons,
camps, besieged cities, millarious  regions, &c.  Ac-
cording to Copeland, relapses are frequent in compli-
cations of the spleen and liver, when the dysentery has
followed an  obstinate intermitting fever,  or when it
has assumed a more chronic form.  In hot climates the
disease often assumes an intermitting form, leaving
but little hope for the patient; twelve or thirteen hours
pass over without pain or more than  a single evacua-
tion ; but the paroxysms soon return again.   (Wil-
liams).  In many cases convalescence is very tedious ;
the hair falls out and desquamation of the skin occurs,
the  remaining  weakness frequently occasions long-
continued inclination to profuse sweats, oedema of the
feet and hands, a certain laxity of the intestinal track,
 disposition to diarrhoea, lienteria, dyspepsia, habitual
 constipation,  aenemia, hardness of hearing, roaring in
 the cars, and evening  fever.   Tenesmus may remain
 for some time as a pure nervous symptom. Bouchut
 observed as a remains of dysentery, a  paralytic con-
 dition  of the rectum, which remained open, the eva-
 cuations passing off involuntarily, and clysters flowing
 back again;  the paralysis is usually not perfect, and
 from time to time contractions of the sphincter occur
 and  the anus  is  momentarily closed;  the trouble
 generally disappears with returning strength.
 D It  has been remarked, that  many  chronic com-
 plaints, such as, chronic rheumatism, affections of the 
42
DYSENTERY.
spleen,  asthma, &c., with  which  the patient had
suffered before the attack of dysentery, have been per-
manently cured through the revolution occasioned by
this disease;  such patients usually feel  as  if born
anew.
   Ulcerative formations in the mucous membrane of
the intestine even in the earlier stages of the  disease,
are evident from dissections.  That the erosions and
degenerations  of the  mucous membrane may cicatrize,
is evident  from numerous  examinations.  But fre-
quently  the ulcerative  process becomes permanent,
either   because  the  regenerative  activity  of the
exhausted  organ is  unable  to perfect the process of
cicatrization, or because the dyscrasic diathesis sus-
tains the destructive  process in the mucous membrane.
Under  such  circumstances  the  dysentery  becomes
changed into an entero-phthisis ;  its symptoms  are, a
fixed and permanent -pain in the  abdomen,  usually
limited to  a  circumscribed  space, which is the more
clearly expressed  in proportion  as the ulceration is
more  extensive; continuous diarrhoea,  consisting  of
purulent, sero-purulent, often ichorous, like flesh-water
or blood-streaked discharges, with  which emaciation,
colliquative sweats,  frequent  cough and hectic fever
associated.  The marasmus of such patients often
attains an unusual  degree, exceeding  that  of pul-
monary consumptives.  Sometimes only a single large
ulcer exists in the rectum, with tenesmus, and bloody
involuntary discharges.  Death follows mostly from 
          DURATION  AND TERMINATION.        43

exhaustion, and hectic, sometimes very suddenly from
perforation of  the  intestine.   The  so-called chronic
dysentery is usually only a range of symptoms aris-
ing from a continued ulceration of the intestine, or a
morbidly increased activity of the intestinal follicles;
a more accurate diagnosis must soon banish such de-
signations from the pathology of dysentery.
  A not unusual result of dysentery, especially in old
school practice, is  stricture   or contraction of  the
rectum.   If  the inflammatory  process is arrested, it
is not always that its product is removed; frequently
only the fluid portions of the exudation, lying between
the mucous coats, are absorbed, while the more firm
parts become hardened and organized in the cellular
tissue; the   oedema sometimes hardens  to a skirrous
consistence, and  hence occasions permanent contrac-
tions of the intestinal tube ; and this result may also
be the consequence of cicitrization of the ulcerations,
and contractions  of the affected tissue;  adhesion and
fixing of the  intestine  in a  false  position in  con-
sequence of secondary peritonitis may also conduce to
the production of such strictures.   We often discover
those  cases  by an external examination of the ab-
domen, knotty, rope-like circumscribed points of hard-
ness are present, which may easily  be taken for skir-
rous  degenerations.   Continued constipation,  pains
and flatulence occasioned by the passage of every stool,
and change  in the form of the faeces, are the  usual
disturbances occasioned by such strictures.   Inflam- 
44                DYSENTERY.
mation of the intestine may finally occur above the
contracted point in the bowel, and there occasion dila-
tation, and at last rupture of the part.
  Dysentery sometimes passes over into an extensive
enteritis, peritonitis, or hepatitis.   Lying-in-women
are especially  liable to peritonitis.   Copeland  saw
the inflammation extend from the coecum through the
peritoneum to the external cellular tissue, forming an
abscess in the  right  iliac  region, which discharged
into the coecum or externally.
  With children, and in dysenteries of hot climates,
intusseption of the intestines  is  not unusual in
the course of  the  disease, which usually terminates
unfavorably through illius; though there  are not
wanting cases, where the patient has recovered after
the sphacelated portion of *the invaginated intestine
has been thrown off.
  The disease  may terminate  fatally in all stages,
earlier  or later.  In the acme of the disease death
may occur through the violence and extension of the
inflammation, through abdominal paralysis, often at
the time of a crisis, gangrene, putrid fever, perforation
of the  intestine, and later through eutero-phthisis,
hectic, hydrops  or  other secondary diseases.  Some-
times the patient  complains a day before the fatal
termination of  a constricting sensation in the throat,
and aphthae appear in the mouth, which easily become
gangrenous.  In an  epidemic of dysentery, observed by
Mondiere, the  fatal result was preceded some forty- 
                    DIAGNOSIS.                 45

eight hours by a copious accumulation of mucus in the
mouth.   With  children, when the urinary secretion
is suppressed,  and the stools have also disappeared,
not unfrequently sopor and a fatal hydrocephalic con-
dition is established.

                 DIAGNOSIS.
   Haemorrhoids may occasion tenesmus  and bloody
dejection, to which there may be added fever and pains
in  the  bowels, and hence  arise a picture resembling
dysentery.  But  that we have not here to do with a
true dysentery is manifest from the history of the
haemorrhoidal affection, the invasion and course of the
fever, which in a cosmic toxicosis, is quite different in
violence from  a simple symptomatic fever ; from the
more rapid and critical course of the dysentery itself,
the character  of the discharges, which in dysentery
are not only blood-streaked, but otherwise changed,
while  in haemorrhoids they retain their natural con-
 sistence, and the  blood remains separate  from the pe-
culiar  faecal masses;  there are also  haemorrhoidal
 swellings present; the tenesmus is purely local, and
 docs not manifest itself as in dysentery, in connection
 with cutting  in  the  abdomen, or frequent urging to
 stool.
    In many diarrheas we also find tenesmus, without
 blood in the stools, or the stools are sometimes bloody
 without tenesmus.  Such cases, on  account of their
 resemblance  to  dysentery, have been designated as 
46                DYSENTERY.
dysenteric diarrhoea;  in dysenteric epidemics we ob-
serve them as fragmentary portions of the prevailing
disease process, and  especially at the beginning and
end  of the  epidemic.  Pain in the  bowels,  bloody
stools, and tenesmus may also be produced by the use
of acrid substances, poisons, drastics, and the hence
occasioned irritation of the mucous membrane of the
intestine.  Here the discovery of the occasional cause,
the disappearance of the symptoms after the removal
of the prejudicial moments, assure us of the nature of
the affection we have in hand.

                   CAUSES.
  Dysentery occasionally appears sporadically.  Epi-
demic  dysentery attacks all ages,* sexes and consti-
tutions without exception.  The observation  that
females are more subject to this disease than males,
is only correct as to certain epidemics,  in others the
contrary occurs.  Similar  variations  occur in some
epidemics in reference to the ages  of  those attacked.
Jews, in this as well as some typhus epidemics some-
times are said to be exempt;  on the contrary, Negroes
are more subject to this disease than  any other race,
and the disease is with them subject to assume a more
asthenic and putrid form ; it is among them the most
frequent and predominant disease.
  As predisposing moments may be considered: ca-
  * Examples are even shown where the foetus has been the subject
of this disease before birth, 
                     CAUSES.                   47

chectic condition, long retention of degenerate faecal
matter, especially accumulation of morbid secretions
in the first passages, previous and frequent abdominal
diseases, dropsies, scorbutis.
  That unknown something, on which the endemic and
epidemic  dysentery depends,  is  called dysenteric
miasm.  Its mode of development and peculiarities
are obscure, and only fragments of it lead us clearly
to the manifest action of such an agency.   Summer
and late summer are those periods of the year in which
dysentery  especially prevails; hot  days  and  cool
nights, a high temperature after continued  moisture
and cold, or also with dry weather, is most favorable
for its  development.  This however is  no  constant
law, and an intensive dysenteric miasm may prevail
at other seasons of the year and under contrary con-
ditions of weather.
   We have  already intimated the  relation between
dysentery and  intermitting fever.   Rodener and
 Wagner call  the  dysentery the daughter  of inter-
mitting fever.   There is no region where the  swamp
fever prevails,  in which the dysentery is not also epi-
demic.   The connection is so  intimate, says  Wil-
liams, that in tropical climates, of a given number of
people, equally exposed to the action of swamp miasms,
a part of the individuals will be attacked with dysen-
tery, and the  remainder come down with fever and
ague.   In many marsh regions  where dysentery pre-
vails, this disease disappears as soon as the swamps 
48
DYSENTERY.
are drained ;  but the ague disappears after the drain-
ing yet more rapidly than the dysentery itself; and
it appears that in some cases the dysentery prevails
in inverse proportion to the intensity of the marsh
fevers.
  Besieged cities, prison ships, jails, camps, and poor
houses are the rich  hot-beds of typhoid dysentery;
famine, continued hardships and privations, accumu-
lation of degenerate animal and vegetable effluvia, are
favorable for the production and increase of this miasm.
Dysentery is known as the most fearful scourge  of
camps and  invading armies.  Under  such  circum-
stances the intimate relationship between dysentery
and typhus, especially petechial typhus  and hospital
gangrene, is most  prominent.  They are often seen
prevailing at the same time, alternating, passing over
from one  to  the other, the miasm of the one alter-
nately exciting  the other,  and the contrary.  The
wounds of dysenteric patients are very subject  to
gangrene; the miasm of petechial fever excites  in
other individuals dysentery, typhus epidemics pass
over into dysenteries, and dysentery epidemics into
plague, while dysentery  and typhus prevail at the
same time.
  There has been much dispute as to the  contagious-
ness of dysentery.   A study of the history of dysen-
teric epidemics shows that this disease does not belong
to that class, which like the small-pox, scarlatina, glan-
ders, &c. always and constantly develops a contagium, 
CAUSES.
49
or that the disease is only developed through the agency
of such contagion.  In the majority of cases the ex-
tension of the disease  in  this  way is  not mani-
fest.  But on  the other  hand  it scarcely admits of
doubt, that at times a dysenteric contagion is developed,
though apparently it is only in epidemics of typhoid
dysentery that such a formation is evident.  Whether
this contagion is only the contagion of typhus, or
whether it is a potentized infection, formed from that
miasm, favored  in its  development by the concen-
tration of animal effluvia, (as from crowding men into
a narrow space),  are  questions  which  at present
remain undecided.  The dysentery contagion seems
to be of a volatile nature, commingled with the atmos-
phere from  the  excrements and exhalations of the
patient and received by the inspirations of other per-
sons ; perhaps it may also be conveyed  by the use in
common with the sick, of the chamber stool, privy or
 point of the clyster.   It however appears not to ex-
 tend far in the atmosphere, and to be easily destroyed.
The period of incubation is apparently from three
to eight days.
   Does  dysentery like  other similar cosmic diseases
 attack the  same  individual  more than  once, or is he
 thereafter exempt ? Here also there are various opin-
 ions.  Some  maintain  that the same individual  may
 have a second or third attack, while others hold that
 the predisposition to an attack is increased from hav-
 ing had the  disease previously, as in intermitting 
50
DYSENTERY.
 fever.  It may be here  as  in typhus  that though
 persons may have a second attack, such instances are
 in general seldom.  We should avoid confounding with
 this second attack, a morbid irritability of the intes-
 tinal track remaining after dysentery.
   As casual moments which  most frequently deter-
 mine the outbreak of dysentery  may be mentioned.
 Chills, exposure to cold, moisture, sleeping in the open
 air, and on wet ground as in bivouacs, excesses at the
 table, drunkenness, bad nourishment.  Of themselves
 such influences only  seldom and sporadically induce
 dysentery.  Merely taking cold does not localize such
 a disease  without the influence of  a prevailing epide-
 mic.  Many have  imputed to the use of  fruit a  most
 important cause in the production of dysentery.  That
 unripe sour fruit and bad vegetables, used during the
 prevalence of an epidemic dysentery, are injurious
 and contribute to the development of the disease is
 certain; this  however does not obtain to the same
 extent with ripe fruit, as experience has shown that
 it is not only unprejudicial, but under proper circum-
 stances  even  has been employed  as a remedy; fre-
 quently  dysenteric  patients  have  been  restored
 without any other remedy than the use of ripe sweet
 grapes,  plums, &c; watery fruits, such as  melons,
 oranges,  cucumbers, &c. are always injurious in this
 disease.
  This disease prevails much more frequently in the
equatorial, than in the cold and temperate zones.  In 
PROGNOSIS.
51
the East and West Indies, Central Africa, the Coast
of Guinea, in the  Antilles and in Egypt, and in the
southern and western portion of the  United States
it prevails  endemically;  Ceylon,  Batavia, Java, Cali-
fornia and  South Africa are often wasted by it.   To
strangers in those regions, who live improperly, use
luxurious irritating food and spirituous drinks, which
provoke  the development of the disease, it  is much
more fatal than with natives.  In Europe it is very
frequent upon  the coast of Spain, in  Madeira, Sar-
dinia, Bohemia, Scotland, and Ireland.   In this coun-
try it prevails  extensively in almost  every part, in
the  Southern,  Middle, Western  and even Northern
States,  few localities are  exempt, and in  many it
prevails at times as a most fatal epidemic.

                PROGNOSIS.
  The prognosis of dysentery varies  much with the
character of the epidemic ; it may be  so mild that a
large proportion  of its  subjects are  restored, or so
violent as to demand  a greater proportionate number
of victims than the cholera or  the plague, and scarce-
ly a third part of those attacked recover.   Such are
the results in the typhus and putrid varieties ; gas-
tric and  bilious dysenteries may run a mild or per-
nicious  course.   The  prognosis  in dysenteric epi-
demics is bad in proportion to the commencement of
the epidemic and  the proximity  to the locality from
which it was primarily  derived.  Also in  different 
52
DYSENTERY.
regions and locations  the endemic  dysentery has  a
mild or more fatal character.
  Aged persons and children are in greater danger
than adults ;  among pregnant  females abortions are
very common, and with the lying-in a fatal peritonitis
is very likely  to ensue.   Weakly cachectic  constitu-
tions, who have been previously subject to abdominal
diseases, often fall victims to even a very mild attack.
The external  influences  under which  patients are
placed has a decided influence upon the prognosis,
and it is worse when  patients are confined within  a
miasmatic atmosphere.
  In our experience and  under appropriate  homoeo-
pathic treatment, we have found, that young  infants
and children  occasionally become  victims;   women
and persons of weakly constitutions  rarely, and men
very seldom.
  As favorable signs in the course of dysentery may
be considered : slighter frequency of the discharges,
intermission of the colic  pains and griping, milder
grade  of the  tenesmus and fever,  stools  becoming
bilious and  feculent, discharge of flatulence down-
ward,  breaking out  of warm  perspiration,  slighter
reflex symptoms, natural urinary discharge,  return of
sleep.  Return of bilious vomiting if it has  existed
early in the disease, pustulous  eruptions,  abscesses
in  the extremities or   other peripheric parts,  may
also be considered as favorable symptoms.
   Unfavorable moments  are:  great exhaustion, in- 
PROGNOSIS.
53
crease and  constant continuance  of the colic  and
cuttings, tension and distension of  the abdomen, vio-
lent tenesmus, increasing, number of discharges, dark
dissolute stools  like flesh water, vomiting coming on
in  the  course  of the  disease, increased agitation,
hiccough, coldness of the skin and tongue, small ir-
regular pulse, dark  dry tongue, delirium, remaining
open  of the anus, suppression of the urine,  spasm
and paralysis of  the lower  extremities, sunken and
lead  colored tint of  the  face, ecchymosis,  putrid
apthae, rash, sudden disappearance of the pain in the
bowels, loss  of voice.   Of such prognosis is  also a
remaining pus-like  diarchea, after the acute stage of
the disease with increasing emaciation and  colliqua-
tion,  lienteria, oedema. 
54                 DYSENTERY.
                TREATMENT.
   It is important in the treatment of this disease to
place the patient in the most favorable position  for
promoting the  action  of  the medicines  employed.
His room should be carefully ventilated,  and the
utmost care taken to prevent as  far as possible an
accumulation  or concentration of  putrid effluvia and
miasm.  This is as  necessary for the welfare of the
patient as for the safety of the attendants.   Cleanli-
ness of the person and  bed, the prompt removal  of
the putrid evacuations,  and keeping the patient as
quiet as  possible with  his «feet,  legs and  abdomen
comfortably warm, are matters of no small moment.
In severe cases  the patient should be kept to his bed
if possible, and  use a bed pan for  his  evacuations,
instead of getting up and  exposing  himself  and ex-
hausting his strength, by going to his stool every few
minutes.
   Everything which is calculated  to irritate  the in-
testinal canal, should be carefully withheld from the
patient.   Cold,  fresh water,  as it  at once  excites
griping and tenesmus, is objectionable, and its place
may be supplied with water which has  been  heated,
and then cooled again, or  with mucilaginous drinks,
such as rice water, barley water, oat meal gruel, and
slimy soups and beverages.   For nourishment, milk
porridge, made of well cooked milk and flour, or gruel of
farina, oatmeal or rice-flour, are the best, and  patients 
TREATMENT.
55
  Bhould be mostly confined to them.   Sometimes fruits
  such as  very sweet, ripe plums  and  grapes have
  been allowed, and have been held beneficial, but  the
  use of  anything of the kind should  be regarded with
  jealousy.
    The  white of  an egg,  beaten up in water,  in  the
  proportion  of an egg to  a  half  pint of water and
  sweetened  with  sugar has been given  with benefit,
  as a drink.  Soups  of meat  can scarcely be allowed
  even during convalescense, and wine or spirits  of any
  kind are rank poison.
    Injections  of  thin starch, or what is far better,
  white of egg in water prepared  as above,* are often
  very comforting  to the patient, and if agreeable there
  is  no objection  to their employment.   Often much
  relief will be  afforded from seat baths of tepid  water,
  in  which the patient may remain from five  to ten
  minutes, according to circumstances,  and they may
  be repeated from time to time as occasion  seems to
  require.  These  accessories of treatment though not
  absolutely curative, sometimes contribute to the com-
  fort of the  patient, though homoeopathic physicians
  need tut rarely resort to them.
    Every case should  be treated as an individuality,
  and each medicine should be chosen with reference to
   * Some eYninent old school physicians in Europe, have recently
  relied exclusively on the use of egg water, and clysters of white of
»  egg and water, prepared as above  in the treatment  of this  disease.
  Their reports are very successful. 
56                DYSENTERY.
its similarity to this particular case and to the genius
of the prevailing epidemic.
  It is  important early in the epidemic to study this
prevailing character or genius, by a careful compari-
son of  several cases of the disease with the patho-
genesis  of the several medicines, and we shall  thus be
enabled to fix on some one or more medicines corres-
ponding to its epidemic character, and which will be
found applicable to almost  every succeeding  case,
and hence be saved much trouble and perplexity.
  The  dose  and repetition  of  medicines is by no
means  unimportant.   Every practitioner  must be
allowed to use his  own discretion and judgment in
the premises, the whole scale from the first prepara-
tions  to the 2000th, being open to him.  Each has
its use and place more or less rarely or frequently,
according to the ever varying circumstances of the
case.  Nevertheless, as some doses  and methods of
administration seemed to be required in a monograph
of this character, we have indicated those doses which
have  been employed in our  own practice, and they
have been arrived at by no small amount of study,
observation and experience.
  Aconite :  At the  commencement  of the  disease
and when we  have  high  inflammatory fever, full,
quick pulse, hot dry skin, colic pains and tormena,
frequent small soft stools with tenesmus ; or where
there are rheumatic pains in  the head, nape of the
neck, and shoulders, chills, heat and thirst. 
TREATMENT.
57
   Dose and Administration.—One drop, or twenty
pellets  of the sixth potencc,  may be dissolved in
six or eight dessert-spoonsful of pure well water, of
which a spoonful may be administered  every hour in
urgent cases, or every two hours, until  the  fever  and
violence of the disease have  abated, then  at longer
intervals, or follow with  Merc, Nux,  Colocynth, or
another indicated remedy.
   Aloes : is  unquestionably a valuable  remedy in
dysentery, though the indications for its employment
have  never been clearly settled.  Among them may
be  mentioned: abdomen distended  and sensitive to
the touch;  violent  pressing, burning and  rending
pains along the course of the  colon sometimes min-
gled with cuttings; fluid, slimy evacuations, mixed with
blood, and  attended  with violent  tenesmus, heat
and faintness when at  stool; burning in the rec-
tum ;  violent  colic;  excoriation  about  the  anus;
heat and thirst, tongue inclined to be dry and red.
   Dose and Administration:  Give eight  pellets of
the sixth potence, dissolved in a spoonful of water,
every hour,  until improvement sets  in, then at longer
intervals.

   Arsenicum is almost indispensable in certain  epi-
demics, and in  certain other stages  and  forms of the
disease.  It is  demanded when we find : great pros-
tration, stools  excessively black, bloody,  acrid,  pu-
trid, very foetid, often involuntary, violent  burning
pains in  the  abdomen,  retention of urine, or invo-
luntary urination, foetid urine, tenesmus and burning
             3* 
58
DYSENTERY.
 pains in the anus and rectum, dry, chapped, black
 tongue, hiccough, raging thirst, frequent vomiting
 of mucus  or  bile, or retching,  miliary  eruption  or
 petechia over the body,  excessive  anxiety  and rest-
 lessness,  cold sticky perspiration and  frequent  faint-
 ness,  delirium or stupefaction,  pale  sunken counte-
 nance, small pulse.
   The thirtieth potence repeated every two or  three
 hours has with us  been much more efficacious than
 the lower preparations.   Give six pellets of this, dis-
 solved in a spoonful of water, every two hours,  until
 an improvement takes place, then at longer intervals.
   Belladonna is often of value in the more inflam-
 matory varieties, either after Aconite or  where we
 find : sanguine temperament, full habit, lively ardent
 disposition, tendency  of blood to the head, and dis-
 tension of the superficial vessels,  face red and hot,
 partial or complete delirium, whitish tongue,  the tip
 not  coated but inclined to  be dry,  spasmodic and
 colicky or else cutting pains in the  bowels, distension
 and pain along the transverse colon, distended and
 very sensitive abdomen, constant urging to stool and
frequent fruitless tenesmus, or with slight dysenteric
 discharges; tenesmus with  pressing  and urging to-
 wards the rectum and  sexual parts ; violent slimy
 bilious vomitings,  evening  fever, intense  thirst and
 sleeplessness.

   Dose and  administration: One drop,  or  twenty
 pellets of tho sixth potence, may be  dissolved in six 
TREATMENT.
59
 or eight dessert-spoonsful of water, of which  give  a
 spoonful every two hours until  somewhat  relieved,
 then at longer intervals, say three or four hours.
    Colocynth  is  one of  our  most distinguished
 remedies in dysentery, often useful, and frequently
 indispensable.  It is indicated by: violent colic pains
 and griping  in the hypogastric  region,  causing  the
 patient to bend together, attended with great restless-
 ness, frequent evacuations, at first of greenish yellow
 or watery  mucus,  then  streaked with blood, or of
 bloody mucus ; pains disappear with every evacuation,
 but are renewed again from taking the least quantity
 of food or  drink;  the tenesmus is slight or entirely
 wanting; fulness and pressure in the abdomen, white-
 coated tongue,  chills, thirst and febrile heat, irritable
 dejected state  of  mind.
   Dose and  administration:  One drop or twenty
 pellets of  the  sixth attenuation may be dissolved in
 eight  dessert-spoonsful of water,  of  which give a
 spoonful every  hour,  or in very  urgent cases every
 half hour until an amelioration takes place, or until
 six doses  have been given.   Then prolong the inter-
 vals to one,  two or three hours.
   Colchicum is often appropriate  in autumnal dysen-
 teries, where we find :  bloody, or bloody-slimy stools,
 mixed with membranous portions  like scrapings of
 the intestines,  attended with severe pain and tenes-
mus, or where  in  red dysentery  more mucus  than
blood is passed; or,  discharges of  only white, trans-
parent, gelatinous mums with violent  tenesmus ; 
60                 DYSENTERY.
distension of the abdomen, prolapsus of the rectum,
colic pains and cuttings are also indications.
   Dose  and administration, the  same as for Colo-
cynth.
   Cantharides is very necessary when the urinary
organs are severely affected by sympathy, where the
tenesmus affects the bladder with frequent urging
to urinate, with only slight and painful discharge;
the stools consist of blood or bloody mucus, or  of
white slime mixed with shreds like the scrapings  of
 with intestines, and streaked with blood, and accom-
 panied with burning pains in the bowels, or cuttings
 and  griping with tenesmus.   The fever is  usually
 violent, burning, with dryness of the mouth and thirst,
 restlessness and anxiety, small, hard and intermitting
 pulse.
    Dose and administration: Same as for Colocynth.
    Capsicum is of value when  we  have: frequent
  small  stools of only  mucus,  or of  bloody  mucus
  with tenesmus, and preceded by flatulent colic in the
  abdomen;  or  where  the violent  cutting pains  have
  been removed, and only an intensely painful feeling of
  pressure remains. Thirst with evening exacerbations
  of fever, especially from evening to midnight, tenes-
  mus of the bladder, distension of the abdomen with
  pressure, irritable state of mind.
    Dose and administration:  Same as in Colocynth.
    Carho-veg.  may  be  very useful in those cases of 
TREATMENT.
61
adynamic or malignant dysentery when Arsenicum is
indicated, and yet fails of relief, and when we have :
putrid  stools, great prostration,  pressure  on the
rectum  and burning of that part, after stools.  The
patient complains of burning pains, has cold breath
and cold surface.   If after the use of Carbo-veg. the
putrid odor of the stools does not disappear, recourse
must be had to China.
   Dose and administration, the same  as  for Arse-
nicum.
   China may be  employed in  those  cases  which
clearly  owe their existence to marsh miasm, and which
are  inclined to assume  an  intermitting character, or
when the stools are black and putrid, and fail to yield
to Ars. or  Carb.-veg.  In some epidemics  it has
proved  very efficient.
   Dose and administration, the  same as for Bella-
donna.
   Ipecac, is valuable in dysenteries of decidedly gas-
tric  character, with: great repugnance and loathing
against  food, nausea and vomiting, pain in the pre-
cordia,  coated tongue, pressing headache in the fore-
head, violent urging to stools, which are mostly slimy,
stinking, and followed  by tenesmus; more chilliness
than heat, and evening exacerbations.   For dysentery
at the commencement,  where cramps prevail, and at
the close after the removal of the inflammatory symp-
toms, and there yet exists great weakness of the intes-
tinal canal,  and tendency to tenesmus. 
62
DYSENTERY.
  Dose and administration:  Same as for Colocynth.
  Mercurius-corrosivus is  justly regarded as the
chief remedy in most forms of dysentery.   It is par-
ticularly indicated in autumnal dysenteries when the
days are  hot and nights cool, and  where we  find:
very frequent small stools of bloody mucus, or of
chopped up greenish masses mixed  with  blood, con-
tinuing day and night, with almost constant cuttings in
the bowels, and an insupportable andpainful urging
and tenesmus. Sometimes the dysenteric  discharges
are bilious, very  fetid, green or brownish; frequent
oppression of  the stomach, and vomiting which affords
some relief.   Frequently after long continued violent
straining  and pressing a little bloody  mucus only is
discharged, the tenesmus scarcely abating for a moment
and then  returning again.   The colic  pains, griping
and  cutting in the bowels  are  very severe,  often
extend  to  the back  with chills, heat,  thirst  and
anxiety.
  Dose and administration :  We formerly employed
this remedy  in  the  second  and third  trituration,
repeating every hour in urgent cases, but latterly we
use it  only at the twelfth and thirtieth, and are con-
vinced from  repeated observation that it is far  more
efficacious in these potences than in the lower forms.
It should be prepared by dissolving the pure crystals
in distilled water for the first attenuation,  dilute alco-
hol the second,  and only pure alcohol at the third.
One drop, or twenty pellets of the twelfth attenuation,
or hio-her, dissolved in eight spoonsful of water, of
which  we  give  a spoonful  every hour  in urgent 
TREATMENT.                63
 cases, until an  improvement  takes  place;  or  until
 six or eight doses have  been given,  then only  at
 intervals of two or three hours.
   Mercurius-solubilis is employed by many prac-
 titioners  indifferently   with  the   Corrosivus-hyd.,
 although we think the grade of dysentery indicated
 by it not  so violent and sharply defined.   Its indi-
 cations are: violent  cuttings in the bowels; only
 interrupted by  short pauses, violent urging pains,
 burning and tenesmus, with which only small por-
 tions of bloody mucus  often resembling raw flesh
 are discharged;  at the same time more or less coated
 tongue, loss of  appetite,  rending  pains in the limbs ;
 in children the red slimy discharges  are  often mixed
 with masses of dark green mucus; the tenesmus con-
 tinues after, as well as before the stools, or is even
 worse ; nausea, eructations, chilliness and shudder-
 ing,  cold  sweat on  the forehead, great exhaustion
 and trembling, amelioration when quiet and aggra-
 vated by motion, prolapsus of the  rectum which is
frequently bloody, worse at night.
   Dose and administration:  Same  as Merc.-corr.
   Nux-vomica  is very useful in many forms of dys-
 entery, and especially if they threaten to assume an
 adynamic or an intermittent type.  The indications
 are : frequent small stools, consisting of bloody mu-
 cus, or when from time to time  bits of hard  fecal
 matter (scabella) are seen in the discharges.   Fre-
 quent small slimy stools with urging and tenesmus, 
64
DYSENTERY.
violent cutting pains about the umbilical region, in-
tense heat, great thirst, or  pitch-like, bloody, ragged
or villous  discharges, pressure on the rectum before
and  after stools.   There  may be also retention of
urine and fruitless urging to urinate, frequent retching
or actual vomiting, bitter or putrid taste in the mouth,
confused obstupefied head, and aggravation in the
morning hours;  especially appropriate for hemor-
rhoidal subjects.
   Dose and administration :  In cases of some stand-
ing with^great feebleness, administer the same as in
Arsenicum.   But in more active inflammatory con-
ditions in which it may also be indicated, give every
two hours as directed for Belladonna.
   Pulsatilla is  frequently  appropriate  in  the
milder  cases,  and when there are:  frequent small
stools of only yellow  mucus streaked with blood,
preceded by  cuttings in the abdomen, or dysenteric
stools of bloody  mucus making  the anus sore, with
twisting and cutting about the navel  and gastric com-
plaints, or,  autumnal dysentery with  slimy stools.
There is usually insipid  taste in the  mouth, white
coated  tongue, desire to  vomit, or  even  vomiting of
mucus, frequent  chills, especially towards night, and
evening aggravation, whining mood.
   Dose and administration, the same as for Colo-
cynth.
   Petroleum has proved serviceable in some bilious
and  erethic forms,  and where they have threatened 
treatment.
65
to assume a malignant character.   Frequent  stools
of mucus and blood, or of only bloody mucus, accom-
panied with great feebleness.   Frequent urging to
stool, where, after violent pressing, only a slight dys-
enteric discharge takes place, with a feeling as  if yet
more should come.   Often but slight discharge of red
or brown stinking urine, unusual febrile exacerbations,
frequent flying  heat, with  trembling  of the  body,
night-sweats, and irritable temper.
  Dose and administration, the same as for  Bella-
donna.

  Nitric-acid, is a valuable remedy in some  forms
of dysentery.   Hartmann says, it  is  probably the
best remedy where there is a constant pressing in
the rectum without any, or  only  very slight dis-
charge. Its symptoms are : Bloody dysenteric stools
with tenesmus,  fever and headache over the whole
head.  Frequent stools  consisting  only of mucus,
sometimes with cuttings in the abdomen, and violent
tenesmus, constant  urging  to stool without success,
or with only very  slight discharge.  Long urging
and pressing to  stool, which passes off with great dif-
ficulty although  quite soft.  There is frequently great
heat,  constant thirst, and an unequal intermitting
pulse.
  Dose and administration:  One  drop, or twenty
pellets, of the sixth  potence, dissolved in eight spoons-
ful of pure water, of which  give one spoonful every 
66                 DYSENTERY.
two hours, until an amelioration sets in,  then at in-
tervals of three or four hours.
  Plumbum corresponds to dysenteries of the  more
violent  character, where the  discharges are only
blood, with continual cuttings  in the bowels and sto-
mach, violent eructations, fever, burning in the anus
during an evacuation, and continuance of the tenes-
mus after the stool, or where in the absence of stools
there is violent tenesmus.
  Dose and administration, the same as for Nitric-
acid.
  Rhus-toxicodendron is an almost indispensable
remedy in this disease, where  symptoms of a typhoid
character appear, and the organic activity threatens
to become extinct.  The patient is weak and falling
away, the plasticity of the  blood  is diminished,  the
stools are  dissolute   of  sanguinous mucus,  often
passed  off involuntarily at night, without  pain or
tenesmus;  incontinence  of urine, great weakness and
prostration, especially after  stool.  Bleeding  from
the nose, confusion of the head,  evening chills fol-
lowed by  heat with  excessive thirst, dejection  and
 anxiety also form farther indications for its employ-
 ment.
   Dose and administration, the same as for Nitric-
 acid.
   Staphysagria has been successfully employed in
 this disease with: dysenteric stools, with tenesmus 
treatment.                67
and cutting in the boivels before, during and after
the discharges.  Frequent stools of yellowish mucus,
with bruised  soreness in the whole  abdomen,  and
muscular debility; dysenteric stools with much tenes-
mus and cutting in the abdomen.
  Dose and administration, the same as for Nitric-
acid.
  Sulphur  is one of our most valuable remedies in
the worst cases,  and where the disease, notwithstand-
ing some amelioration is slow to yield ; or where other
remedies, owing  to a chronic dyscrasia (psora) having
been aroused in  the system in the course of the  dis-
ease, do not  seem  to take  effect;  or, for : mucous
stools  streaked  with blood, violent tenesmus,  fre-
quent urging to  stool, especially at night; dysentery
with discharges  of mucus, with or without blood, pre-
ceded  by  cuttings  in  the abdomen, with  tenesmus,
fever, &c.  It is very suitable for hemorrhoidal  sub-
jects.
  Dose: Ten pellets of the thirtieth  potence,  dis-
solved  in  a spoonful of water, and taken  at once.
Permit it to act four hours, if there "is improvement,
permit it  to act undisturbed four  hours longer  and
up  to  twenty-four  hours, if the  improvement  con-
tinues, then the Sulphur may be repeated or followed
by Nux or another indicated remedy.

  Veratrum  is  very  appropriate  in dysentery,
where  we  have: watery sanguineous flocculent  dis-
charges in which  portions of faeces are manifestly 
58
DYSENTERY.
present; or,  dysentery with vomiting coldness of,
the surface,  extraordinary weakness, cramp in the
calves,  retention of urine,  and cold  sweat.   Eva-
cuations are more frequent at night than by day, are
accompanied  with and followed by colic and chills;
tenesmus is rarely present.

  Dose :  One drop of the sixth potence may be mixed
in six spoonsful of water, of which one may be given
every hour,  until an amelioration takes  place, and
then at longer intervals, two or four hours. 
REPERTORY.
I. Evacuations  according to their composition and
                       character.

♦Acrid, corrosive:  ARS.,  Aloes, Cham., CHINA, MERC,  Nux-
  vom., Natr.-mur.,  PULS., Sulph., Verat. -
Bilious:  Ars., CHAM., Dulc, Ipec, Merc,  Merc.-cor., Nux-vom.,
  PULS., Verat.
Black, Pitch like: Ipec, Lach., Merc, Nux-vom., Sass.
Bloody:   Aeon., Ars.,  Aloes,  Bell.,  CANTH.,  Chin., IPEC,
  MERC, MERC.-COR., Nitr.-ac, NUX-VOM., PULS., JRhus.,
  SULPH.
Bloody Mucus: Aloes,, ARSEN., Caps.,  Carb.-v., Ipec, MERC,
  MERC.-COR.,  Nit.-ac.  Nux-vom.,   Petrol.,  Puls,  Rhus.,
  SULPH.
Bloody mixed: Merc.-cor., Nux-vom., Puls., Rhus., Sulph.
Blood-streaked: Canth.,  Calc, Carb.-an., Merc, Phos., Puls.
Brownish:  Ars.,  CHIN.,  Dulc,  Merc,   Merc.-cor.,  SULPH.,
  VERAT.
Burning: Ars., Croton., Lach., Merc
Changeable, in color: PULS.
Corrosive: see Acrid.
Dark and dark colored: ARS., Camph., Chin.,Ipec, Merc, Sulph.,
  Verat.
Not digested: Ars., Bry.,  CHIN.,  Ipec, Merc,  Nit.-ac,  Nux-
  vom., Phos., Phos.-ac, Sulph., Verat.
Eggs, like hcaten: Cham., Puis.
Fermented:  Ipecac
Frothy:  Canth., Chin. Coi.oc.  Merc, Rhus., Sulph.
Flocculent: Ars., IPEC, VERAT.
  * See note concerning the repertory at the close of the preface.
                            69 
70
REPERTORY.
Fluid :  ARS., Calc, Carb.-v., CHIN., IPEC, SECAL., VERAT,
Dark Green: ARS., MERC,
Grass Green: Ipec
Grey: Ipec, MERC, Phos.-ac, Rheum.
Greenish: Ars., Bell., CHAM , Dulc,  Ipec,  MERC, Merc.-cor.,
  Puls., Sulph., Verat.
Gelatinous:  CALC, Colch., Rhus., Sep.
Involuntary: BELL., Carb.-v.,  CHIN.,  HYOS.,  Opium, Phos.,
              Phos-ac, RHUS , Sulph., VERAT.
  —    —  at night: Am.
  —    —  during sleep :  Arn., Puls., RHUS.
Membranous or skinny, like scrapings:  Canth., Colch.
Mucous or slimy: Ars.,  Bell.,  Caps., Canth.,  Carb.-v., Cham.,
  Chin., COLOC, Dulc, Ipec, MERC, Merc.-cor., Nux-vom.,
  Phos., PULS., Rhus., SULPH.                  x
Purulent: Bell., Canth., Chin., MERC, Nux-vom.,  Petrol., Puls,,
  SIL., Sulph.
Sudden : Croton , Graph., Lach.,  Rhus.
Transparent:  Colch.
Fnnoticed:  Ars., Colch., Lach.,  Phos.-ac.,  Puis.,  Staph., Sulph.
  Verat.
Viscous or Sticky: Ars.,  Calc, Carb.-v., MERC, Nux-vom., PHOS.-
  AC, Verat.
Watery: Acon.,  ARS., Calc,  Cham., CHIN., IPEC, Nux-vom.,
  Petrol.,  Phos.,  Phos.-ac,  PULS.,  Rhus., Secal., Sulph.,
  Verat.
Whitish: Acon., Ars., Cham., CHIN.,  Colch., MERC, Nux-vom.,
  Phos., PULS., Rhus., SULPH., Verat.
Yellow : Ars., Canth., CHIN., Coloc, Dulc, IPEC, Merc, Rhus.
White: Carb.-veg., Puis.

               II. Evacuations : odor of.
Cadaverous or corpse-like :  Carb.-veg.,  Lach., Chin.,  Sihc, Stram.
Fetid, stinking:  Ars., Carb.-veg., Cham.,  Ipec,  Merc.-cor.,  Nil.-
  rtc, Nux.-vom., Rhus,  and others. 
repertory.
71
Putrid : Ars.,  Carb.-v., Chin., Coloc, Ipec, Nux-mosch., Nux-vom.,
  Secal.  Sulph.
Sour :  Calc, Cham., Merc, Petr., Phos., RHEUM., Sep., Sulph.


III. Concomitants  of Stool, Symptoms before, dur-
                 ing,  and  after Stools.

Anus, burning in the, during: Lach., Merc, Puls.
  — itching in the, during: Merc, Sil., Sulph.
  — throbbing in the, after : Lach.
  — retraction of the, dnring: Thuy.
  —    —     —    after: Mez., Magn.
  — constriction of the,  during: Lach., Thuy.
  —     —       —    after: Ign.
  — pains in the, before:  Carb.-an., Carb.-veg., Lach., Nat.-carb.,
  Nitr., Phos., Sep.,  Sulph.
Anus, paralysis of sphinctnre: Bel1., Coloc, Hyos., Lach., Rhus.
Abdomen, distention of the, dnring : Lycop.
  —     pains in the, before;   Agar., Asar., Caps., Carb.-veg.,
           MERC, Nitr.-ac, Puis., Rheum., Staph.,Sulph., Verat.
  —     pains in the, during ; Ant.,  ARS.,  Bry., Carb.-veg.,  Ign.,
                            MERC, Nux-vom.,  Rheum., Spig.,
                            SULPH., Verat.
  —     —   —    after  ; Canth., Carb.-veg., Puis., Staph., Verat.
Anxiety, before : Kali-carb., Magnes.-mur., Merc
Back, pains in the, dnring :  Ferr., Puis.
  —   pains in the, after :  Mag.-mur., Puis., Sep.
Bladder, pain* in the, before : Carb.-veg., Canth., Nat.-mur.
Burning, before : Berb., Olcand., Rhus., Sabad.
  —    during :  Ars.,  Canth.,  Caps., Carb.-veg., China,  Gratiol,
                 Ipec,  Lach.,  Merc, Nit.-ac,  Nux-vom., Puls.,
                 Sep., Sulph., Verat.
        after :  Ars., Canth.,  Carb.-veg., Gratiol.,  Lach., Merc,
                 Nit.-ac,  Nux-vom., Phos., Phos., Sulph.,Tart.-e. 
72
REPERTORY.
 Chilliness, before:  Amm., Dig., MERC, Mez. Nat.-carb.,  Phos.
   —    during: Nit.-ac, Merc, PULS., Sulph., Verat.
 Colic, dnring: Ars., Baryta, Mur., Coloc
 Congestion to the head, during : Sulph.
 Cuttings in the anus : Calc, Canth., Carb.-veg., Ipec, Nit.-ac, Phos.,
                    Staph.
         —  abdomen, before:  Ars.,   Caps.,  Carb.-veg.,   Dulc,
                               Merc, Nit.-ac, Petr., Puis., Rhus.)
                               Staph., Sulph., Verat.
         —     —    during: Ars.,Carb.-veg., Cham.,Dulc, Lach.,
                              Merc,   Merc.-cor.,  Nux-vom.,
                              Rheum., Sulph., Verat.
  —     —     —    after:  Carb.-veg., Canth., Puis.,  Rheum.,
                               Staph., Verat.
  —     —  rectum ;  Calc, Canth., Merc,  Nit.-ac,  Phos., Sulph.
  —     —  dnring  stool:  Asar., Canth.,  Carb.-veg.,  MERC,
                            Nit.-ac, Phos., Sep., Staph., Sulph.
  —     —  after stool: Calc, Heleb., Puis.
Drinking, after:  Caps., Jod., Nux-vom., Rhod.
  —     renewed  after: Ars.
Erections, before: Thuy.
  —     during :  Ign., Thuj.
Eructations empty, dnring : Con., Dulc, Lach., MERC.
Faintness, during :  Aloes., Sass.
Flatulence, discharge of, dnring :  Agar., Calc-ph., Squill,, Staph.,
  Violtric, Chinin., Nitr.-ac, Nux-vom., Rhus, and others.
Face,  heat of, the during : Berb., Granat., Hep.j
 —   paleness of the, during: Ferr.-mag., Stram.,  Verat.
Head, rush of blood to the, during :  Sulph., Lach.
  —  pain in the, during :  Bell.,  Lach.,  Nit.-ac,  Phos.,  Rhus.,
                           Staph., Sulph.
  —  —   —    after: Lye, Nat.-carb., Plat., Sep., Zinc.
neat,  general, during : Kali-carb., Merc, Sulph.
Liver, pains in the  : principally Calc, Graph., Stan. 
REPERTORY.
73
 Loins, pains extending to the, before :  Berb., Carb.-veg., Natr.-carb.,
                                    Nitr.
   —  —   in the, dnring: Ars., Carb.-an., Lye. Nux-vom., Plat.,
                                    Stann.
   —  —    —    after : Alum., Carb.-veg., Plat., Puis., Sulph.
 Lassitude, prostration, during:  ALOES, Bry.,  Dulc,  Ferr., Hep.,
                             Kali-carb.,  Verat., &c
   —        —      after:  Aloes.,  Calc,   Carb.-an.,  Lach.,
                             Merc, Petrol., Phos., Rhus., Sulph.
 Mnens, discharge of, with :  Colch.,  Kal., Lach.,  MERC, MERC.-
                          COR.,   NUX-VOM.,  Petr., SULPH.,
                          Tart.-e, and others.
   —      —   — after : Asar., MERC, Phos.
 Nausea before:  Acon., Calc,  Gratiol., Sep., &c.
   —  dnring: Coloc, Ipec, Merc,  Nitr.-ac, Rhod.,  Sulph., &c.
   —  after:  Acon.,  Caust., Crot, Nitr.-ac, &c.
Navel, pain about the, before : Canth., Gratiol., Phos.
   —  —  — during: Canth., Caps,.  Crotal., Nitr., Nux-vom.
   —  —  — after: Ars., Crot., Gratiol., Iod., Natr.-carb., Platin.
Pressing, before, {compareurging): Dulc, Lach.,Nitr.-ac, Nux-v.,&e
   —   during: Canth., China., Colch., Merc, Nitr.-ac. Nux-vom.,
                 Petrol., Plumb., Phos., Puis., and others.
   —   after: Asar., Lach., Sulph.-ac, &c.
Rectum, pains in the, before:  Bell.,  Carb.-veg.,  Lach., Nux-vom.,
                      Puis., Rhus, Sep., &a   '
   —    —    —   during Ars , Canth , Carb.-veg.,  Coloc, Ipec,
                            Merc,  Nitr.-ac, Nux-vom.,  Puls.,
                            Ruta, Staph., Sulph., and others.
   —    —    —   after:   Ars., Carb.-veg., China,  Lach., Nitr.-
                            ac, Nux-vom., Puls.,  &c.
   —  prolapsus of the, during : Ars., Asar.,  Calc, Canth., Dulc,
                               Ign.,  Lack,  MERC, Nitr.-ac,
                               NUX-VOM., Ruta, Sulph.
           —    —    after: Merc.
   —      —    —    urination: Mur.-ac.
                4 
74
REPERTORY.
Rectum, stitches in the : Carb.-an., Chin., Ign., Natr.-mur.,Nux-vom.,
                      Phos., Puis., Sep., Sulph.
Screams, in children, before :  Borax, Rhus, Canth., Carb.-veg., Sulph.
   —   during :  Canth., Sulph.,  Valer.
Stitches in the anus :  Acon., Ars.,  Carb.-an., Carb.-veg., Chin., Ign.,
        More, Natr.-mur., Nux-vom., Phos., Sep., Sil., Sulph.
  —    before stools : Kali-carb.,  Kreos., Nitr., Phos.
  —   dnring — :  Caps., Carb.-veg., Chin., Ipec, Nitr.-ac, Nux-
                    vom., Sil.
  —   after   — :  Canth., Cham., Chin., Gratiol., Nitr.-ac, Nux-
                    vom., Puis.,  Sulph.
Sweat, anxious, with: Merc
 —   before: Acon, Bell., Sep.
 —   after : Acon, Caust.
 —   during: Bell., Crot., Sep.,  Sulph.
Tenesmus in the anus :  Acon., ARS., Bell., Calc, CAPS., Colch.,
         Hexl.,  Hep.,  Ipec,  Lach.,  Laur.,  MERC, MERC.-
         COR., Nitr., Nitr.-ac,  NUX-VOM., Op., Phos., RHAB.
         Rhus, Sep.,  Spong., SULPH., Zinc, and others.
   —    before: Merc, Rheum.
   —    dnring:  Acon., ARS.,  Bell.,   Colch.,  Ipec, MERC,
                  Merc.-cor.,   Nitr.-ac,   Nux-vom.,   RHUS,
                  SULPH., and  others.
   —    after:  Caps., Ipec, MERC, Phos., Rheum.. Sulph.
Urging to  stool, constant:  Bell.,  Canth.,  Con., Gratiol., Nitr.-ac,
                          Plumb., Sil., Sep.
   —      —    fruitless: Arn., Bell., Canth.,  Caps.,  Colch., Gra-
                          tiol.,Lach., Merc, Merc.-cor.,Nitr.- ae,
                          Nux-vom., Petrol.,  Plumb., Ruta, Sep.,
                          Sil. and others.
   —      —    violent: Bell., Lach., Laur., Merc,  Merc.-cor.,
          Nux-vom., Plumb., Rhus, Sep., Stan., Staph, and others.
Urinary sufferings, with: Acon.,   Bell.,  Canth, Carb.-an.,  China,
   Hyos., Lach , Phos., Tart., Verat.
Urinary tenesmus, with :  Canth. 
                       REPERTORY.                       75

Urging to stool, with anxiety :  Merc, Nux-vom., Phos , &c
  _*     —   —  abdominal pains: Ars., Baryta, Puis., Rhus.
  __      —   —  pain in the bladder :  Sulph., Canth.
  __      —   —  redness of the face :  Caust.
  —      __   —  discharge  of  flatulence:  Carb.-an.,  Lach.,
                     Magn.-carb., Sep.,  and  others.
  —      —   —  erections: Thuja.
  —      —  painful:  Ars., Caust., Sulph.
  —      —  on movement: Rheum.
  —      —  with pain  in  the loins : Baryta,  Carb.-veg., Con.,
                Nitr.
  —      —  with nausea :  Rhus.
  —      —   —  itching of the reetum : Euphr.
  —      —   —  prolapsus of the rectum : Ruta.
Vomiting before : Bell., Croton., Dig., Lach., Tart.-e.
  —    during :  Ars., Bell., Cup. acet., Dulc , Ipec, Lach., Rheum.,
                   Stram., &c.
  —      —    Eugen.,  Phos.
Weakness in the anus, with:  Rhod.
Weakness, feeling of, with: Aloes.,  Kali-carb., Nitr.-ac,  Petrol.,
                   Rhod., Sep., Sil., Stann.
    —    dnring :  Aloes., Rhod., Sil, Stann.
Womb, with pressure upon: Bell., Nux-vom.

      IV. Pains,  according to their  Location :
Anns: Acon.,  Ars.,  Bell.,  Canth.,   Caps.,  CARB.-veg.,  Colch.,
  Coloc, Lach., Merc,  NUX-vom.,  Nitr.-ac,  Plumb.,  Puls.,
  Staph., SULPH.
Abdomen, in general: Acon.,  Ars.,  Bell., Canth.,  Caps., CARB.-
  veg.,  CHIN., Colch., COLOC , Hyos., Ipec, Merc, NUX-VOM.,
  PLUMB., PULS., RHUS, Staph., SULPH., &c.
Epigastrium, upper  abdomen : Acon , Ars., Bell.,  Canth , Caps.,
  Carb.-veg.,  China,  Coloc, Ipec,  Merc,  NUX-VOM., PULS.,
  Rhus.,  Staph-, Sulph., &c, 
76
RErKRTORY.
Hypogastrinm, lower abdomen: BELL., Canth.,Ckrs., CARB.-VEG.,
  Chin., Coloc, LYC, Phos., Ruta, Sulph., &c.
Inguinal  ring: Ars., AUR.,  Bell., Canth,  Coloc, Ignat., Merc,
  Nitr.-acid.,  NUX-VOM.,   Plumb..   Rhod.,  Rhus.,  Sulph.,
  SULPH.-AC, &c
Loins: CANTH., Colch., Coloc, Lach.,  Nitr.,  Nitr.-ac, Puis.,
  RHEUM, Staph., Zinc, &c
Rectum,  Acon., Ars.,Bell., Canth., Carb.-veg., Colch., IGN., Lach.,
  LYC, Merc,- NUX-VOM., Nitr.-ac, PHOS., Plumb., Puis.,
  Rhus., SULPH.
Stomach: Acon., ARS., Canth., Chin., Colch., Coloc, Ipec, Merc,
  NUX-VOM., PULS., Rhus., Staph., SULPH., VERAT., &c
Umbilicus: Acon., Bell., Caps., Carb.-veg., China, Ipec, Nux-
  vom., PLUMB., Puis., RHUS, Staph., Sulph., VERAT., &c.

  V.  Pain, according to  its  Nature, (Abdominal).

Bruised,  pain as  if:  Camph., Carb.-veg., Cham., Coloc , Nux-vom.,
  Plumb., Puls., Staph., Stram., Sulph., Verat., &c
Burning: ARS.,  Bell.,  Canth., Caps.,  Carb.-veg., Colch., Lach.,
  Merc,  Phos., Rhus, Sec, Sep., Verat.,  &e
Colicky : Bell., Colch., Coloc, Nat.-mur.,  Sass., Sulph.
Constricting : Bell.,  Bov.,  Carb.-an., Chin.,  Coloc, Plat., Plumb.,
  Sep., &c.
Contracting : Bell., Canth., Carb.-veg., Chin., Lach., Merc, Nitr.-ac,
  Phos.,  Plumb., Rhus, Sulph., &e
Drawing:  Acon., Ars.. Caps.,  Cham.,  Nitr.-ac, Nux-vom., Plumb.
  Rhus,  Staph., &e
Griping:  Acon.,  Bell.,  Calc, COLOC,  Ipec, Lyc,   Nitric-ac
  Nux-vom , Petr., Phos., Puis., &c
Pressing: Bell., Cap.,  Carb.-veg., Chin.,   Colch.,  Coloc, Merc.
  Nitr.-ac, Nux-vom., Puis., Rhus., Staph., Sulph., Verat., &c
Rending: Ars., Cham., Colch., Coloc, Croton, Ipec, Lach., Nux
  vom., Puis., Rhus., Sulph., Verat.
Spasmodic: Ars., Bell., Bry., Lach., Nux-vom , Rhus, Sulph., &. 
REPERTORY.
77
Stitches, Stinging: Acon., Aloes., Bell., Bry.,  Canth., Colch ,  Coloc,
  Ipec , Lach., Merc, Nitr.-ac, Nux.vom., Plumb., Rhus, Staph.,
  Sulph., &c.
Violent:  Ars.,   Bell.,  Coloc,  Croton.,  Gratiol.,  Lach.,  Nitr.,
  Ophiot., Rhus, Sec, Sep , Stram , dec.

                VI.  General Conditions.
Distention of the abdomen : principally, Acon, Aloes., Am., Ars.,
  Bell.,  Canth.,  Caps.,  Cham., CHIN., Cocc,  Colch.,  Coloc,
  Hyos.,  Ipec,  Lach.,  Lyc,  Merc, Nitr.-ac,  Nux-vom,  Rhus,
  Sep , Sulph , Verat.
Flatulence, accumulation of: Bry., CUrb.-veg., Chin., Graph., Lyc,
  Petrol., Zinc.
Heat:  Aloes., Bell.,  Bry., Canth., Carb.-an.,' Chin., Phos., Plumb.,
  Ruta, Lie, Spong., Sulph., &c
Inflammation : principally, Acon., Ars.,  Bry., Bell.,  Canth., Chin.,
                Crotal.,  Hyos., Ipec,. Lach..  Merc,   Nux-vom.,
               Plumb., Puis., Rhus., Squil., Verat.
     —      of the intestines : Acon., Ars., Bell., Bry., Cham., Hyos.,
               Ipec, Lach., Merc, Nux-vom., Plumb., Puis., Rhus.,
               Tereb.
     —     of the peritoneum : Acon., Bell., Bry., Canth.,  Cham.,
                Merc, Nux-vom.
Mcteorism, (compare distension, &c): in general, China.
Paiufulness, on contact or movement: Acon., Ars., Canth., Carb-veg.,
              Colch.,  Coloc,  Hyos.,  Lach., MERC, Nitr.-ac,
               Nux-vom.,   Plumb.,   PULS., Rhus,  Sil.,  Sulph.,
               Sulph.-ac, Vip.-torv.
     —     of the external muscles :  Hyos.,  Puis.,  Sep.,  Sulph.
               Thuja.
     —     Hypogastrinm : Calc, Canth., Iod., Lach.,  &c
     —     Umbilical region :  Ars..  Croton., Lach.,  Lyc,  Plumb.,
               Vip.-red., &c 
 
  CASES AND CLINICAL OBSERVATIONS.

Aconite :  Dysentery conjoined with the presence of
  synochal fever.
Aloe :  Violent dysenteric evacuations, with the most
  painful tenesmus and faintness while at stool.
Aloe :  Dysenteric evacuation of bloody mucus, with
  violent tenesmus, excination of the anus, and pros-
  tration during and after stool.
Arsenicum: Dysenteric diarrhoea with burning in
  the anus, anxiety, thirst and great prostration.
Arsenic 30th: Dysentery consequent upon fever with
  constipation, which had been treated allopathically.
  Symptoms : Wild looks, hasty speech.—Is at one
  time  lying in the upper,  and then in the lower
  part of the bed.—Continual eructations.—Distended
  hard  abdomen, sometimes  with rumbling in it.—
  Fifty  evacuations in the 24 hours, with little mucus
  at a  time, attended with  violent  burning in the
  rectum.—Slight  discharge   of   urine,—parched
  brown tongue,—violent thirst,—great weakness,—
  occasional oppression of the chest,—no appetite,—
  sleepless,—great anguish.
Arsenic : Relieved a patient suffering from dysen-
  tery and who was without rest.   Sweat soon ap-
  peared after taking the medicine. 
4
80    cases and clinical observations.

Baryta-mur.,  3d : Frequent  daily  evacuations of
  bloody mucus, without particular pain, but with loss
  of flesh,  the  patient had formerly suffered from
  humid herpes.
Belladonna :  Is useful in some kinds of nervous,
  and sometimes also in inflammatory dysentery.
Calcarea sulph. : Has proved  useful in dysentery
  with violent tenesmus.
Cantharides  sixth : Proved  efficacious  in  dysen-
  tery  with violent  pains, severe  tenesmus,  and
  strangury, and discharge shredy mucus, like scrap-
  ings, mixed with blood.
Chamomilla :  Relieved the pains peculiar  to  the
  epidemic dysentery of 1830.
Chamomilla :  Dysentery with burning around  the
  anus.
China : Dysentery with rectile pains.
Colchicum 6th :  Cured a case of fall dysentery, at-
  tended with  severe  tenesmus,  and discharges  of
  only white transparent gelatinous mucus.
Colchicum 4th or 5th: Frequently corresponds to the
  gastric fall dysentery, having an epidemic character.
Colchicum : Helps in cases, where Merc.-corr. has
  lost  its effect, and more slime than blood is passed
  in the stools.
Colocynth : Dysentery attended with violent colic.
Colocynth : Violent rending pains in the abdomen,
  so that the patient must bend forwards, confined
  flatus, frequent  stools, streaked with blood. 
      CASES AND CLINICAL OBSERVATION'S.    81

Dulcamara : Was found very efficacious in the fall
  dysentery of 1834.
Dulcamara  o. :  One drop, relieved a  bloody diar-
  rhoea brought on by a violent  cold.—Symptoms:
  violent cutting in the bowels, especially around the
  naval, worse at night, which Was almost immediate-
  ly followed by an evacuation of more  blood ;—con-
  stant raging  thirst.—Considerable  protrusion  of
  the rectum with intense smarting of the same.
Dulcamara : Tenesmus before stool; which occurred
  suddenly, with apparent paralysis of  the  spincter.
Hepar-sulph.  :  Has been frequently found effica-
  cious in dysentery,  the troublesome evacuations
  being relieved by it, and the entire disease becom-
  ing less intolerable.
Hepar-sulph.  2d:  Half a grain every one or two
  hours  relieved  the  violent tenesmus the most
  speedily in an epidemic 1
Merc.-sol. 3d: Fall-dysentery.—Symptoms: Hor-
  rible  colic, as if the  bowels were being cut, most
  violent, when he is obliged to go to stool.—Exces-
  sive tenesmus,  as  if the intestines would be forced
  out, followed  by a  discharge of a small quantity of
  mucus  mixed with blood,  followed by still more
  tenesmus.  The evacuations were accompanied with
  hot sweat on  the forehead, which soon became cold
  and   viscid.—Sleeplessness,—great   failing  of
  strength,—the discharges  corrode  the  anus and
             4* 
82    CXSES and clinical  observations.

  cause a painful burning.  The remaining weakness
  was removed by one drop of China 3d.
Merc.-sol. :  Removed a case of dysentery occurring
  in an infant, with frequent stools consisting of bright
  blood, sometimes mixed with much mucus, or with
  green  hocked  stools.—The child had fever and re-
  fused to take the breast.
Merc.-sol. :  Dysentery with very  acute  pains, as if
  the intestines were being cut, particularly  severe
  while at stool; somewhat relieved on assuming a
  recumbent  posture ; excessive thirst, discharges of
  slime and  blood, the evacuations excoriating  the
  anus.  Nocturnal exacerbation, sleeplessness, pros-
  tration.   China  third, after two days, followed
  the Merc.
Merc-sol. :  Fever, with very severe cutting in  the
  abdomen, frequent discharge of small quantities of
  bloody mucus, with violent pressing, burning and
  tenesmus.  Tongue dry and coated, loss of appetite
  and rending pains in the limbs.
Merc-sol. 4th: Dysentery with nervous symptoms.
  Symptoms: Emaciation and languid appearance.
.  —Dry chapped  lips,—face bathed in perspiration
  and yet complaining of chilliness. No appetite and
  great  thirst,—headache and humming and ringing
  in the ears,—abdomen soft and somewhat distended,
  with cuttings in it, during stool.—Thin scanty eva-
  cuations every quarter  of an   hour, frequently
  streaked with  blood and accompanied with burning 
       cases and clinical observations.     83

  in the rectum.—Drawing pains in the lower limbs,
  which the patient  is  constantly moving about.—
  Soporous condition, alternating with delirium.  The
  nervous symptoms were relieved by Rhus 10th.
Mercurius : Slimy bloody diarrhoea, particularly if
  the stools  are mixed with greenish mucus.
Merc.-vivus or corr.  third : Two grains dissolved
  in four or  five ounces of distilled water, a teaspoon-
  ful every half hour or  hour was given by Dr. Gross
  in a form of dysentery, and some cases were cured
  in twenty-four hours.
Merc.-corr. 5th :  Dysentery with : first chilliness
  and heat,  anguish, diarrhoea and colic, pain in the
  back and  tenesmus with  some discharge of blood.
  —Afterwards increased tenesmus and thirst; stools
  every ten  minutes of bloody  mucus,  sometimes
  pure blood.
Merc.-corr. :  Effectual in red dysentery, when fol-
  lowed by  mucous  discharges and accompanied by
  fever.
Merc.-corr.:  Dysentery  with  chill,  heat, thirst,
  anxiety, stools with discharge of blood,  tenesmus,
  and cutting in the abdomen.
Merc.-corr. 9th: Three doses of three globules each,
  one each day, cured a case of dysentery in a child of
  six  years, as follows :  several evacuations an hour
  of bright red blood, mixed with green and white
  mucus.—Body hot, face pale and sunken.
Merc.-corr. : Patient had thirty or forty discharges 
84    CASES AND CLINICAL OBSERVATIONS.

  of watery or bloody mucus per day, with pain and
  great prostration.  Was cured in four or five days,
  and the remaining debility removed by China.
Merc.-corr. third: Helped in the case of a child
  of one year, where an evacuation of white gela-
  tinous mucus with blood, took place every hour.-—
  In one case the remaining disposition to diarrhoea
  was relieved by two doses of Petroleum.
Merc.-vivus : Dysentery with vehement constring-
  ing pains in the abdomen.
Nux-vomica 30th:  One drop in a child of nine years.
  Symptoms: Tenesmus every quarter  of an  hour,
  with  violent cutting pain in  the  umbilical  region
  and below it,  accompanied with tenesmus  of the
  rectum,—Evacuations consisting of small quantities
  of knotty  faeces,  mixed with mucus and blood, or
  simply bloody  mucus, after which  the pains  remit.
  Great heat and redness of cheeks, much thirst, no
  appetite or sleep.
Nux-vom. :  Dysentery,  in which very painful te-
  nesmus predominates.
Petroleum :  Bloody slimy stools, accompanied with
  pains and flatulent  distension of the abdomen ;
  frequent but small discharges of red brown  fetid
  urine, frequent flushes of heat and tremor  of the
  body  and nocturnal perspiration.
Petroleum :  Is said  to be most indicated in the
  bilious and erethic forms of this disease, and espe-
  cially, when it threatens to become malignant. 
       CASES AND CLINICAL  OBSERVATIONS.    85

Pulsatilla :   Was found efficacious in a  case of
  dysentery, characterized  by  great  difficulty  of
  breathing.
Pulsatilla : Was  efficacious in the fall dysentery
  of 1834, especially when the discharges were very
  slimy.
Pulsatilla : Dysentery, with very slimy stools, and
  also with severe respiratory affection.
Pulsatilla 12th :  One drop.   Chronic dysentery.
  Symptoms:  Frequent evacuations of mere* blood
  and mucus, day and night excoriating the anus, and
  accompanied with burning pain.
Pulsatilla:   Stool, was  preceded  by pinching
  and cutting around the  umbilicus ;  during stool
  patient experienced a  shuddering, with goose-skin.
  —Flat taste in the  mouth, tongue coated white,
  nausea with inclination to vomit and sometimes vo-
  miting of mucus.   Pain in the small of the  back, so
  that he could scarcely move.—Chilliness the whole
  day, more violent  in  the afternoon and  evening,
  sometimes alternating with flushes of heat, very
  faint and pale.  Weeping mood.
Rhus 30th, one globule : Was very efficacious against
  involuntary nightly discharge of  feces, remaining
  after the colic and tenesmus had  been  removed, in
  the fall dysentery of 1834.
Rhus : Where the dysenteric  stools are passed invo-
  luntarily  during the night.
Rhus : According to Hornberg, ought to be  very ef- 
86    CASES AND CLINICAL OBSERVATIONS.

  ficacious  against dysentery, on account of its com-
  prising  so many  symptoms of inflammation of the
  bowels.
Plumbum : Has proved very efficacious in cases where
  in the absence of stools (dry dysentery), there was
  yet violent tenesmus accompanied by fever.
Staphysagria : Has frequently been found curative
  in dysentery.
Sulphur third :  Cured dysentery in several  cases,
  where the other remedies afforded no substantial
  benefit.
Sulphur  30th:  Cured  a  case  of dysentery with
  violent tenesmus, in the course of ten  hours.
Sulphur rendered the most efficient aid in malignant
  dysentery, where the attacks were characterized in
  the beginning by difficulty of breathing.
Sulphur  is especially useful in cases of dysentery,
  occuring in haemorrhoidal subjects.
Sulphur third: Completed the cure of a case of dys-
  entery after the previous  administration of Merc-
  sol. 2, with the following symptoms:  Violent lan-
  cinating pain in the forehead, increased by contact.
  Obtusion of the head with want of memory and gid-
  diness.-Countenance pale and sunken, covered with
  cold sweat.—Tongue dark red, the margins being
  coated white without thirst.—Dryness of the mouth
  and throat.—Repugnance to food.—Violent cutting
  pains  in the umbilical region, increased by move-
  ment.—Hard spasmodically contracted  abdomen. 
      CASES AND CLINICAL OBSERVAEIONS.     87

  —Tenesmus  almost every  moment,  the  patient
  passing only a little mucus, streaked with blood,
  followed  by burning at the rectum.—The body is
  covered with sweat, but is rather cool than warm.
  —Frequent shuddering, especially during motion.
  ■—Great weakness and despondency.—Pulse quick
  and full.—Increase of pains at night.
Sulphur :   Dysentery with  cold  perspiration and
  anxiety, dry red tongue, abdomen hard and retract-
  ed, or with insupportable  pains in the umbilical
  region.
Tart. Emet. : Dry skin, lancinating abdominal pains.
  Thirst, bitter taste in the mouth, tenesmus, burn-
  ing in the rectum, bilious  discharges, tinged with
  blood. 
#
                    HOMCEOPATHIC  MEDICINES.
  Wm. Radde, 322 Broadway,  New-York, respectfully informs the Homreo-
pathic Physicians, and the friends of the System, that he is the sole Agent for
the Leipzig Central Homceopathic Pharmacy, and that he has always on hand
a good assortment of the best Homeopathic Medicines, in complete sets or by
single vials, in Tinctures, Dilutions and  Triturations; also  Pocket Cases of
Medicines ; Physicians' and Family Medicine Chests to Laurie's Domestic (60 to
82 Remedies).—EPP'S (60 Remedies,—BERING'S,  (60 Remedies to  102).—
Small Pocket-cases,  at $3, with Family Guide  and 27 Remedies.—Cases con-
taining 415 Vials with Tinctures and Triturations far Physicians.—Cases with
260 vials of Tinctures and Triturations to Jahr's New Manual, or Symptomen-
Codex.—Physicians' Pocket Cases with 60 Vials of Tinctures and Triturations —
Cases from 200 to 300 Vials with low and high dilutions of medicated pellets.—
Cases from  50 to 80 Vials of low and  high dilutions, <fec, <fcc.  Homoeopathic
Chocolate. Refined  Sugar of Milk, pure Globules, &c, Arnica Tincture, the best
specific remedy for bruises, sprains, wounds, &c.  Arnica Plaster, the best ap
plication  for Corns.   Urtica wrens, and Dr. Reisig's Homoeopathic Pain Ex-
tractor are the best specific remedies for Burns.  Also, Books, Pamphlets, and
Standard Works on the System, in the  English, French, Spanish, and German
Languages. 
               Dm.   Hall He'a


CATALOGUE  OF HOMEOPATHIC  BOOKS,

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  the Homoeopathic Medicines, with their names in Latin, English,
  and German ; the order in which they are to be studied,  with their
  most   important  distinctions, and clinical  illustrations of their
  symptoms  and effects upon the various organs and functions of
  the human system.  The second volume embraces an elaborate
  Analysis of the indications in disease, of the medicines adapted to
  cure,  and  a Glossary of  the  technics used in the work, arranged
  so luminously as  to form an admirable guide to every  medical
  student.   The whole system is  here displayed with a modesty of
  pretension, and a scrupulosity in statement, well calculated to be-
  speak candid investigation.   This laborious work is indispensable
  to the students and practitioners of Homoeopathy, and highly
  interesting to medical and scientific men of all classes.   Complete
  Symptomatology and Repertory, 2 vols., bound, $6 00.
Jahr's New Manual : originally published under the name of Symp-
  tomen-Codex.  (Digest of Symptoms.)  This work is intended to
  facilitate  a comparison  of the  parallel  symptoms of the various
  Homoeopathic agents, thereby enabling the practitioner to discover
  the characteristic symptoms of each drug, and to determine with
  ease and  correctness what  remedy is most Homoeopathic  to the
  existing group  of symptoms.  Translated,  with important  and
  extenshe additions from various sources, by Charles Julius Hem-
  pel, M.D., assisted by James M. Quin, M.D.,  with revisions  and
  clinical notes by  John F. Gray, M.D., contributions by  Drs. A.
  Gerald Hull, George W. Cook,  and  Dr. B.  F.  Joslin, of New-
  York ; and Drs. C. Hering, J. Jeanes, C. Neidhard, W. William-
  son, and J. Kitchen, of Philadelphia ;  with a Preface by Constan-
  tine Hering,  M.D., 2 vols., bound  $11 00.
Just published, the third  volume  of Jahr's  New Manual; or the
  largest Repertory of the Homoeopathic Materia Medica; by Dr.
  Charles J. Hempel.   1853.   1220 pages, bound, $6.   The three
  vis. bound for $17.
  [5** This is the most important and complete work ever published,  and in-
    dispensable for every physician.  From  the British Journal of Homoeo-
    pathy, Vol. XI., No. XLIV., April, 1853, page 327:  "The two volumes of
    Jahr's Larger Materia Medica were incomplete without a Repertory, and
    accordingly, the indefatigable translator of the Symplomen-Codex, Dr. Hem-
    pel, has been busily engaged in  constructing such a much needed key to
    the work ever since its issue from the press.  We now have before us the
    result of his incessant labors in the shape of a portly volume of upwards of
    1200 pages, for which he  deserves the best thanks of the Homoeopathic
    body at large. This volume will be a great acquisition to all the praction-
    ers of our art, as it will facilitate very much their search for the appro-
    priate remedy. We nave already madp extensive use of It; and though in 
92
    some respects we could have wished a different arrangement of some sec-
    tions, a more strictly anatomical arrangement of the symptoms (where that
    was possible,) and an alphabetical  arrangement of the medicines in the
    various subsections, whereby the discovery of the medicine and symptoms
    required would have been facilitated, yet we cannot, in the face of such
    evidence of unwearied industry and zeal for the cause as this volume dis-
    plays, venture to be hypercritical, so, thanking Dr. Hempel most heartily
    for his repertory, we commend it confidently to our English colleagues.  It
    will be found useful  by all, whether they  possess the two volumes of the
    Symptomen-Codex or not; and, though it will not supersede 'the use of
    other repertories and manuals, it will in many cases guide the practitioner
    to the ready discovery of an appropriate remedy, when all  the oilier works
    hitherto published in our language would leave him in the lurch."'

Hahnemann's.  Lesser Writings, collected and  translated  by It. E.
  Dudgeon, M.D., with additions  by E. E. Marcy, M.I)., author  of
  " the Homoeopathic Theory and Practice of Medicine," ai:d Editor
  of  "the North American Homoeopathic Journal."   A large  8vo.
  volume, with   a  fine Steel  Engraving  of  Hahnemann.   1852.
  Bound, $3 00.
  This valuable work contains a large  number of Essays  of great  interest to
    laymen as well as medical men, upon diet, the prevention of diseases, ven-
    tilation of dwellings, <fec.  As many of these papers were written before
    the discovery of the Homoeopathic  theory of cure, the reader will be en-
    abled to peruse in this volume, the ideas of a gigantic intellect when di-
    rected to subjects of general and practical interests.

Hahnemann's  Organon of Huma-opalhic Medicine, 3d American edi-
  tion,  with improvements and additions from the last German edi-
  tion,  and  Dr.  C. Hering's introductory  remarks.   Bound,  81. 00.

Hahnemann's  Materia Medica Pura.   Translated  by C. J.  Hempel,
  M.D.   4 vols. $6. 00.

E. Stapf's Additions  to the Materia Medica Pura.  Translated by
  C. J. Hempel, M.D.  $1.50.

Hahnemann's  Chronic  Diseases,  their Specific Nature and Homoeo-
  pathic Treatment.  Translated and edited by Charles  J.  Hempel,
  M.D., with a  Preface by Constantine Hering, M.D., Philadelphia.
  8vo.  5 vols.   Bound, #7. 00.
  E^* The above four or five  standard works of Dr. Samuel Hahnkmann are
    and will for ever be the greatest treasures of Homoeopathy, they are the
    most necessary books for Physicians and  they should grace the library of
    every lover of science.

The  North American Homoeopathic Journal,  a  Quarterly  Ma-
  gazine of Medicine and the Auxiliary Wc iences.   Conducted  by
  C.  Hering, M.D., Philadelphia; E. E. Marcy,  M.D.,  and J.  W.
  Metcalf, M.D.,  New-York.  Price per volume of nearly 800 octavo
  pages,  $3. 00.
  pp° The North American Homoeopathic  Journal commenced on the 1st of
   'Feb., 1851, and is published regularly every three months in numbers con-
    taining nearly 200 pages.   Physicians will  be regularly supplied by remit-
    ting $3,00 to Wm. Radde, 322 Broadway, New-York.  A few copies of the
    first volume of the North American Homoeopathic Journal of 1851 are still
    on hand,  and every  one who sends on five dollars to Wm. Radde will be
    furnished with the Journal of 1851,  and also for 1852,  the whole year of tho
    second volume.                              " 
93
Marcy, E. E., M.D., Homaopathy  and Allopathy.   An "An Exami-
  nation  of  the  Doctrines  and Evidences  of Homoeopathy," by
  Worthington  Hooker,  M.D.  By E. E. Marcy, M.D.   Author of
  "The Homoeopathic Theory and Practice," 1852.  Bound, 50 Cts.
E. E. Marcy, M.D., The Homoeopathic  Theory and  Practice of Me-
  dicine.   Second Edition, 1852.   Bound, $2.
Hartmann's Acute and Chronic Diseases,  and their Homoeopathic
  Treatment. Third German Edition, revised and considerably  en-
  larged by the author.   Translated, with additions, and adapted to
  the use of the American profession, by C. J. Hempel, M.D.  4 vols.
  $5. 75.
Esrey, M.D., A Treatise  on Anatomy  and Physiology,  with thirty
  illustrations.  1851.   Bound, 50 cts.
F. Humphrey's  M.D.,  The  Cholera and its Homoeopathic Treatment.
  38 cts.   In Press.
B. F. Joslin, M.D., Homceopathie Treatment of Diarrhoea, Dysentery,
  Cholera Morbus and  Cholera, with Repertories.   50 cts.
C. Hering's Domestic Physician.  Fourth American edition, revised,
  with additions  from  the  author's manuscript of the 7th German
  edition.  Containing the Diseases of Females and Children, $2.
Dr. Caspari's Homoeopathic Domestic Physician, edited by  F.  Hart-
  mann, M.D., author of" The Acute and Chronic Diseases." Trans-
  lated from the eighth German edition, and enriched by a Treatise
  on Anatomy  and Physiology, embellished with 30 illustrations.
  By W.  P. Esrey, M.D., with  Additions  and a Preface,  by C.
  Hering, M.D.,  containing  also  a chapter on  Mesmerism and
  Magnetism; directions for  patients  living some distance from a
  Homoeopathic physician, to describe their symptoms; a Tabular
  Irftlex of the Medicines and the Diseases in which they are used;
  and a Sketch  of the Biography  of Dr.  Samuel Hahnemann, the
  Founder of Homoeopathy.   Bound, $1. 50.
Homoeopathic Cookery, Second  edition,  with additions,  by the
  lady of  an American Homoeopathic Physician.   Designed chiefly
  for the use of such persons as are under Homoeopathic treatment.
  50 cts.
Joslin, B. F. M.D., Principles of Homoeopathia.  In a series of Lec-
  tures.   Bound, 75 cts.
An Epitome of Homckopathic Practice.  Compiled chiefly from
  Jahr,  Ruckert,  Beauvais, Bonninghausen, &c.   By J. T. Curtis,
  M.D.,  and J.   Lillie, M.D.  Second  enlarged  edition.  Bound,
  50 cts.
Ed.  C. Ciiepmell's Domestic Homoeopathy, restricted to its Legiti-
  mate Sphere of Practice, together .ivith Rules for Diet  aud Regi-
  men.   First  American edition,  with additions by Samuel B. Bar-
  low, M.D. Bound,  50 cts.
Bienninghausen's EsSay on the Homoeopathic Treatment of Inter- 
94
  mittent  Fevers.   Translated and edited  by C. J. Hempel, M.D.
  38 cts.
Epp's,  Dr. J., Domestic Homoeopathy ;  or, Rules for the Domestic
  Treatment of the Maladies of Infants, Children  and Adults, &c.
  Fourth  American  from the fourth London edition.  Edited and
  enlarged by Geo. W. Cook, M.D.   1849.  Bound, 75 cts.
The Family Guide  to the Administration of Homoeopathic Reme-
  dies.  5th edition after the 3d London edition, by H. V. Malan,
  M.D., with additions.   1852.   Price 25 cts.
Pocket-Homceopathist, and  Family Guide.   By  J.  A. Tarbell,
  M.D.  1849.   Bound, 25 cts.
Sherril's Manual of Homoeopathic Prescription, with an improved
  Repertory ; also, an Introduction  in which the doctrine and nature
  of the Homoeopathic system is explained.  1845.   25 cts.
Mariner's Physician and Surgeon ;  or, a Guide to the Homoeopathic
  Treatment of  those diseases, to  which Seamen  are liable.   By
  Geo. W. Cook, M.D.   1848.   Bound,  37* cts.
J.  A.  Takbell, M.D.   Sources  of Health, and the Prevention of
  Disease.  1850.   Bound, 50 cts.
A  Treatise  on  the  use of  Arnica, in cases  of Contusions,
  Wounds, Sprains,  Lacerations of the  Solids, Concussions, Para-
  lysis, Rheumatism, Soreness of the Nipples, &c, with a number
  of cases illustrative of the use of that drug.  By Charles Julius
  Hempel, M.D.  19 cts.
Diseases  of Females  and Children.   By  Walter Williamson,
  M.D, Professor of Materia Medica, &c, in the Homoeopathic Me-
  dical College at Philadelphia.   Bound, 38 cts.
Becker, M.D.,  on  Consumption.  Translated from the  German.
  38 cts.
---- on Diseases of the Eye.  Translated from the German.  38 cts.
---- on Constipation.  Translated from the German.  38 cts.
---- on Dentition.   Translated from the German.  38 cts.
---- on Consumption.   Diseases  of the  Eye, Constipation, and
     Dentition (containing all four above  works), bound in one
     vol., $1.
Wm. Henderson, M.D., Homoeopathic Practice.  50 cts.
 [j^ The above  three books have  been sold in England several thousand
   copies.  Bound in one volume, $1.
Forbes, M.D., Homoeopathy, Allopathy,  and Young Physic.  19 cts-
Wm. Henderson, M.D.  Letter to J Forbes.   19 cts.
Bryant, Dr. J., A Pocket-Manual, or Repertory of Homoeopathic
  Medicine, alphabetically and nosologically arranged; which may
  be used as the physician's  Vade-Mecum, the  traveller's Medical
  Companion, or  the  Family Physician; containing the principal
  remedies for the most important diseases, symptoms, sensations, 
95
  characteristics of diseases, &c.; with the principal pathogenetic
  effect of the medicines on the most important organs and functions
  of the body ; together  with diagnosis,  explanation  of technical
  terms, directions for the selection and exhibition of the remedies,
  rules of diet, &c.  Compiled  from the  best homoeopathic autho-
  rities.  1851.  Bound, $1. 25.
Jahr's and Gruner's New Homoeopathic Pharmacopise and Poso-
  logy of the  mode of preparing Homoeopathic Medicine,  and the
  Administration  of Doses,  compiled and translated fr^m the Ger-
  man works of Buchner, Gruner, and the French work of Jahr, by
  C. J. Hempel, M.D.   Bound, 82.
Jahr's Diseases of the  Skin: or, Alphabetical Repertory  of the
  Skin Symptoms  and External Alterations of Substance, together
  with the morbid phenomena observed in the  glandular, osseous,
  mucous and  circulatory  systems, arranged with pathological re-
  marks on the Diseases of the Skin.   By Dr. A. G. Jahr.  Edited
  by C. J. Hempel, M.D.  Price $1.
Jahr's Clinical Guide :  or, Pocket Repertory.  Translated from the
  German, by Chs. J. Hempel, M.D.   Bound, $1. 50.
Ruoff's  Repertory of Homoeopathic Medicine,  nosologically ar-
  ranged.  Translated from the German by A. H. Okie, M.D., trans-
  lator of Hartmann's  Remedies.  Second American edition, with
  additions and improvements, by G. Humphrey, M.D , &c.  $1, 50.
Homoeopathic  Treatment of Diseases of the Sexual System,
  being a complete Repertory of all the  Symptoms  occurring in
  the Sexual Systems of the Male  and  Female.  Adapted to the
  use  of physicians and laymen.   Translated, arranged and edited,
  with additions and improvements, by F. Humphreys, M.D. 1850.
  Bound, 50 cts.
Hartmann, Dr. F., Practical Observations on the two chief Homoeo-
  pathic  remedies  of  Belladonna and Nux-vomica.   By  A. H.
  Okie, M.D.   Bound, 50 cts.
G. L.  Rau's Organon of the Specific  Healing  Art of Homoeopa-
  thy.   By C. J. Hempel,  M.D.  81. 25.
Rueckert's Therapeutics;  or, Successful Homoeopathic Cures, col-
  lected from  the  best homoeopathic periodicals, translated and
  edited by C.  J. Hempel,  M.D.  1 large 8vo volume. Bound, 83.
Hempel's Boenninghausen  for  Homoeopathic  Physicians; to  be
  used at the  bedside of the patient, and in studying the Mate-
  ria Medica Pura.  1  octavo vol., most complete  edition,  includ-
  ing the  Concordances of  Homoeopathic Remedies.  Translated
  and  adapted  to  the use of the American  profession, by  C.  J.
  Hempel, M.D.  Bound, 82.                *
The  Homoeopathic  Examiner, Vols. I. and  II., new series,  by
  Drs.  Gray and Hempel,  1845—1847,  bound in two volumes,
  with an inoptical index  over  the two volumes,  can be used as
  a manual.   $6. 
96
       This is  the most valuable collection of Essays on the treatment of all the
        more important diseases,  such as croup, inflammation, typhus, measles,
        scarlatina, &c. The work contains, likewise, many valuable provings, a
        number of interesting cases from  practice,  critical  discussions, and ori-
        ginal articles,  and is altogether an indispensable aid to the physician.
     The Homoeopathic Examiner;  by A. Gerald  Hull,  M.D.   The
      'second and third volume n810.
       I3p* Only a few copies  of  this most valuable  Journal still on hand, a
t       single volume  $5.
     The  British  Journal of   Homoeopathy,  edited by  J. J. Drys-
       dale, M.D., J.  R.  Russel,  M.D., and R. J. Dudgeon, M.D.  The
       quarterly numbers of  1852 are on hand, at 75 cts. each  number,
       several volumes of  1846 to 1852 are  complete  on hand, at 83
       each vol.  of four quarterly numbers, with  title and index.
     American Journal of  Homoeopathy.  Edited  and published by
       S. R.  Kirby,  M.D.   81.
     Boston Quarterly Homoeopathic Journal.  Edited by Drs.  Jos.
       Birnstill  and  B. de Gersdorf.  Vol. I. 1849, Vol. II. 1850. Price
       per Vol. in numbers $3, bound per  Vol. 83, 50.
     Boston  Quarterly  Homoeopathic  Journal,  edited by  Drs.  J.
       Birnstill  and J. A. Tarbell.  1852.   Published July, October, Ja-
       nuary  and April.  Terms  81  per year, payable  in advance.
     The  North  Western Journal  of  'Homoeopathy.   Edited and
       published by  Geo.  E. Shipman, M.D., Chicago,  Ills.  Published
       monthly  at $1 per year.
       JTW* Vols. 1 <fc 2 of the  North Western Journal can be furnished, bound
        at $2, Vol. 3,  in numbers, at $1.  Vol. 4 commenced  on the 1st of Oc-
        tober. 1851. Physicians and families will  be  supplied regularly by re-
        mitting )1 to Wm. Radde.
     Curtis,  J. T., M.D., The relations of Homoeopathy to Chemistry,
       an  inaugural  address, delivered  before the Hahnemann Acade-
       my of Medicine.  January 14, 1852.  13 cts.
     Proving of  the Apis  Mellifica,  or  Poison of  the Honey Bee by
       Drs. Bishop,  Humphreys and  Munger.  1852.   25  cts.
     Metcalf, J. W., M.D., Homoeopathy  and its Requirements of the
       Physician,  an Address,  delivered before the Homoeopathic  Me-
       dical  Society  of  the  State of New-York, at Syracuse,  June  1,
       1852.  13 cts.
     Gray, John F., M.D., The  duty  of the State in relation to Ho-
       moeopathy ; an inaugural address, delivered before the Hahnemann
       Academy of Medicine, New-York, Jan. 9, 1850.  13 cts.
     Eustaphieve, A., Homoeopathia Revealed.   A brief exposition  of
       the  whole system adapted to  general comprehension ; with a
       notice of Psora*and  Dr. Duringe's  objections.  2d  edition  with
       a  sketch  of Isopathia.   50 cts.
     Channing,  W., M.D.,  The  Reformation of  Medical  Science, de-
       manded  by inductive Philosophy.  A Discourse delivered before
       the New-York Physician's Society.  2d  edition. 25 cts. 
 
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