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NATIONAL
LIBRARY
MEDICINE
Washington,D.C.
NLM051092262 
 
 
    Scrofulous  Affections


                    AND


THE ADVANTAGES OF THEIR TREATMENT ACCORDING
     TO THE PRINCIPLES AND EXPERIENCES OF



            HOM(EOPATHY.
DESCRIBED AND DEMONSTRATED BY NUMEROUS

     EXAMPLES OF SUCCESSFUL CURES.



                BY


        Dr.  H. GOULLON,

              OP WEIMAR.
TRANSLATED FROM THE GERMAN


              BY

       EMIL TIETZE, M.D.
" A misunderstanding only can place the essence of Homoeopathy in small doses."
                            B. Hirscuel.
       BOEEICKE & TAFEL.

 NEW YORK:   ",         'PHILADELPHIA:
NO. 145 GRAND STREET,               NO. 635 ARCH STREET.
 
    Entered according to Act of Congress, in the year 1872,




               By BOERICKE  &  TAPEL,




In the Office of the Librarian of Congress, at Washington, D. C.
SHERMAN & CO.. PRINTERS. 
  "Allopaths content themselves but too often with a removal of the pe-
ripheric phenomena, while the essence of the disease, the living centre, as it
were, from which the most various phenomena  issue, remains unmoved in
all its force, or is transposed to a locality still more dangerous.
  "The Homoeopath, on the other hand, after a careful search for the pe-
ripheric morbid phenomena, endeavors to pierce the centre of the disease
itself, and destroy it by a remedy homoeopathically corresponding to it.
                                                   "J. Bamberger." 
 
PREFACE.
   On superficial consideration it might appear superfluous to write
 upon a subject sufficiently dwelt upon by the most different authors
 in homoeopathic literature; to speak at length of a disease, to recog-
 nize which, in many cases, is no difficult matter for laymen, even.
 For here the question is not as to the establishment of a diagnosis
 by means of laborious and minute microscopical experiments, or as
 to researches for repugnant animal or vegetable parasites; on the
 contrary, scrofulosis moves among the crowd of mortals unveiled,
 clumsily  and  openly, impressing a seal upon its victims easily to
 be recognized.
   Though the fear of this momentous dyscrasia is not  so strong
 and intense, as that of its near relative, tuberculosis; yet the verdict
 of the physician, "your child is scrofulous," does nevertheless, not
 unfrequently occasion great anxiety.  And it will afford much con-
 solation to parents to know that their child may be freed from its
 evil by gentle means.
   This gentle liberation, however, can take place  only by the ap-
 plication  of the homoeopathic method of healing, and just here the
 advantages and invaluable blessings  of the new doctrine stand out
 prominently.
   In view of the enormous spread of scrofulosis, it is of the greatest
 importance to state those advantages, as well as to uncover, with-
 out fear or  favor, the shortcomings, not to say crimes, of the old
 antiscrofulous method of treatment, and to acquaint the attending
 physician with the new remedies in a comprehensible and practical
 manner.  To write  a monograph on  scrofulosis in this  sense,
 from the  standpoint of humanity, so  to say,  as well as of science,
 is  probably not without merit.  It ma}' be that  Prof.. Leo's notori-
 ous and ominous word of " the scrofulous plebs " will gradually die-
 out,  and be forgotten, if only the mild, rational method of curing.
gains ground over the erroneous one  favoring both degenerations,
and increase of the evil.   Then,  the uninvited and obtrusive  guest
will  certainly  have  to shorten his  visits, and the inmates of huts 
vi
PREFACE.
 and palaces alike fare much better.  The panic fear of parents, as
 well as of children, at mentioning the words "scrofula," and "anti-
 scrofulous treatment," may be removed, and changed into hopeful
 confidence.
   Although there is no  scarcity of reports of homoeopathic cures
 of scrofula and its many species, these  reports, nevertheless, are
 scattered, and mostly forgotten;  they  are, likewise, of unequal
 value, and not all equally commendable for imitation.   For  the
 purpose of obtaining homoeopathic antiscrofulosa of real worth, we
 will, hence, let pass in critical review those  reports of cures from
 the first  date of  their appearance to the present day, and recom-
 mend only what has proved itself of practical value.
   There are self-evidently, as we have stated above, complications
 of scrofulosis with other  constitutional anomalies which, however,
 cannot be regarded here; since the doctrine of genuine scrofulosis
 itself presents  to us a complete  literature of its own. Moreover,
 the principal momentum of the whole treatise will have to be placed
 in that portion of it pertaining to therapeutics.  For, of what good
 to the reader are  hypotheses, however ingenious; what help does it
 afford him, for  instance,  to be  told that, according to Arlt, photo-
 phobia, blepharospasmus, watering of the eyes  in scrofulous oph-
 thalmia (pustular ophthalmia) are said to be but the results of re-
 flex-action which the  irritation of the sensitive branches of the n.
 trigeminus exerts upon  the  ciliary, lachrymal  and facial nerves;
 wrould he  not prefer  to know, rather, that homoeopathy possesses
 remedies by which it masters  these reflex-phenomena together with
 their original source,  and what they are ?  Thus the possibility of
 a quick and  useful application  of the material presented, must be
 the leading tendency.   Besides, no great importance is to be placed
 upon the principle of classifying the various scrofula-forms, if only
 none of them are  forgotten that can be easily recognized, and thus
 are well-fixed on  account of their  sufficiently characteristic phe-
 nomena.
   It appears most convenient and practical, probably, to observe,
as I  shall  attempt to  do in the  following pages, a physiologico-
anatomical order. Before, however, the  general consideration re-
garding the origin and  essence of scrofulosis, may find a  place
here. 
CONTENTS.
Preface,......
  I. General Pathology of Scrofulosis,
    Dyscrasi^e Related to Scrofula,
        A. Tuberculosis,
        B. Syphilis,
        C. Sycosis,
        D. Rhachitis, .
 II. Special Forms of Scrofula,
        A. Cutaneous System,
        B. Muco-membranous System,
               I. Organs of Sense, .
              II. Organs of Respiration,
             III. Organs of Digestion,
        C. Glandular System,
        D. Scrofulous Affections of  Bones and Joints
III. Most  Approved Remedies against Scrofula,
    Resume of Cures Reported, 
 
ON
SCROFULOUS  AFFECTIONS.
                           I.

  GENERAL  PATHOLOGY  OF SCROFULOSIS.

  Schleiden, the celebrated botanist, used to open his lec-
tures by frankly confessing to his attentive audience that he
did not know what a plant was.   Something similar happens
to pathologists regarding scrofulosis; for while some form
an idea thereof that takes in too little, others entertain one
comprising too much.   And though the knowledge of this
disease dates far back in ancient times, there is yet, at the
present day even, neither a Virchow nor an Oppolzer able
to point out  the  last, so to say, biological  cause of this dys-
crasia.  Or is the definition satisfactory, to say that scrofula
results from  disturbances of nutrition, taking  place where
poor and  badly-aired dwellings,  unhealthy, non-nitrogenous
food,* an  effeminating way of living and other  conditions
begetting  disease, show their deleterious influence? Do we
not find this evil  in all its  innumerable manifestations even
where the conditions mentioned are absent ?
  Indeed,  in derision, as  it were, of all theories, we see that
constitutions  entirely opposite, are affected  by scrofulosis.
Fleshy, bloated, full-cheeked, phlegmatic individuals are free
from it as little as is the sanguine temperament with its slim,
vivacious, warm-blooded (arterial) character.  Children living
in miserable, overcrowded dwellings, who, all the year round,

  * Though  it is certain that aninal food, even, calls forth a predisposition to
serofula (Bazin, Jousset).
                           2 
18
ON  SCROFULOUS  AFFECTIONS.
have to support life by potatoes,  and other vegetable  diet,
fall victims to this dyscrasia, as well as do the pets  of for-
tune, and were they of royal blood, even.*
  And sea-baths, an atmosphere loaded with the most  pre-
cious perfumes; tender  game, extracts of the most strength-
ening kind ;  mineral springs most  carefully selected ;  amuse-
ments and  entertainments the  most  exhilarating, are not
always able to arrest the progressing decline.  And less so if
scrofulosis appears as a hereditary evil; or if unsuitable mar-
riages are contracted among near relatives; for, from  such
unions, forbidden as they were, by the most ancient  legisla-
tion for reasons, undoubtedly,  more philosophical than re-
ligious, arise  the  dispositions to mental disease, tuberculosis
and  scrofulosis.
  Bazin says: The scrofulous have "something in excess,"
"quelque chose d'excessif."  They are either too tall  or too
small;  too bright or too dull;  too  fleshy or too lean; too
pink or too pale; have either too craving an appetite, or none
at all; are either too amorous or too cold.   Unjustly, probably,
Jousset calls this  characteristic picture: "Un  tableau  oii la
fantasie a sa bonne part."
  But, as I have just mentioned, not only marriages  among
near relatives favor the  development of scrofula, but also the
descent from  a scrofulous father or mother; in  short,  heredi-
tability ; or there is, as  we are wont to express  it, an organic
predisposition to the disease in  question.  Many families ex-
hibit the taint through many generations, as Schoenlein has
proven of the Bourbons  in  France, and the Salis family in
Switzerland.  In fact, not only scrofulosis as such is inherited,
but  also its  special form, e. g.,  a scrofulous  affection of the
organ  of hearing, in a  similar  manner as mental disease, in
general, and  in  a special form (e. g., as melancholy ending in

  * In England scrofula is singularly called " king's evil;"  because since the
time of Edward the Confessor, the gift of healing it has been attributed to the
kings of England.  In Holland it is called Klieren, Kropzweeren ; in France,
ecrouettes, skrophules.  The Greek  spoke of xoipadec, from  xolP°G>  the noS i
on account of the similarity existing between scrofula and a disease peculiar
to hogs.  Finally, the Romans, on account of the roundness of the  swelling,
which is one of its most characteristic phenomena, used the term struma, and
designated by this word the whole dyscrasia.  So Celsus in his time.  The
term proper, scrofula, is derived from skropha (ypofKpdc), the sow. 
          GENERAL  PATHOLOGY OF  SCROFULOSIS.        19

suicide), not rarely transplants itself  hereditarily from one in-
dividual to another.   With regard  to the question, whether
scrofulosis be communicated by the father or mother, Cullen
says that the children obtain the constitution of that parent
whom they resemble, hence, of the one who took the leading
part in the act of generation.  Frequently we find the chil-
dren of one marriage scrofulous;  the father marries a second
time, and now begets entirely healthy children;  the same
takes place sometimes when women  marry other men.  All
that makes generation abnormal favors scrofula; hence, weak-
ness of the parents, in general, and of the sexual  capacity,
particularly.  Thus  onanists or  fathers  who  formerly  had
healthy children, but had  sexual intercourse  while conva-
lescent from a severe sickness, beget scrofulous children.  It
seems self-evident, almost, that influences favoring the devel-
opment of scrofula, generally, if they affect the mother during
pregnancy, or while nursing, indirectly carry the  disease to
the foetus or infant.
  Among  these influences  belongs  also  the return  of the
menses while nursing, or continued nursing during a  new
pregnancy.
  Whether Lalouette is right when he says in  his Traite des
Scrophules, that the offspring of a conception  having taken
place during menstruation, comes to the world  with scrofula,
is questionable without any reliable, comprehensive, and sta-
tistic proof.
  Even as regards  the predisposition of the female sex the
views differ.
  According to Lepelletier, the scrofulous affections of the
female sex compared to those of the male appear in the pro-
portion of 5 to 3; according to Doepp of 4 to  1.   Although
there is a great distance, no doubt, between the lymphatic
temperament, represented  by woman,  as it were, and the
scrofulous  state;  phthisis, glandular  swellings, scirrhous de-
generations, in short,  diseases in  the texture  of the tissues
mentioned,  nevertheless occur oftener in  females than in
males.
  However, let us not  be prevented by the  above statements
from answering the question: wherein consists  the essence of
scrofula ; particularly as most will agree, on closer considera- 
20
ON SCROFULOUS AFFECTIONS.
tion, that only one  answer can be  given; for we must say:
scrofulosis is that dyscrasia which  always aims at the forma-
tion of purulent  exudations.  Pyonosos (Vereiterungssucht)
we could call it very fittingly, perhaps.  There certainly exists,
from the very beginning, a wrong  proportion in the  physio-
logical mixture of the sanguineous elements, similar  to that
of the rheumatic, syphilitic, and other diatheses;  forthwith
the power dwelling within every living organism tries to rid
it of the defective, pathological blood-elements, though  this
may refer, pathologically, to the quantitative proportion only
between the parts constituting the blood.   An excretion takes
place, or there appear several peripheric deposits.   The  con-
test becomes localized.  We witness in this the same centrifu-
gal force which, after an infection  with dissecting-poison or
variola-poison, at once takes measures to reflect the  disease
upon the surface.   Indeed, the common eruptions of measles
and scarlatina, even, may be mentioned as analogies.*   The
scrofulous localizations,  however, are  not only characterized
by the tendency to puriform decomposition of the exudations
produced by a preceding inflammation, but  also by the  seat
itself, i. e., by the preference to certain histological elements,
to certain anatomical districts.
   Thus it appears  to be a most peculiar fact that the local
affections of scrofula  show themselves with the greatest  con-
stancy in the  organs of sense; or, more  correctly, in their
anatomical,  auxiliary apparatuses.  Scrofulous inflammations
of the eyes and ears are the most frequent.  The affection of
the nose is likewise so well known  that one can already diag-
nosticate the scrofulous habitus from its look.  The auxiliary
apparatuses of the  sense of  taste (lips, mucous membrane of
the mouth, periosteum—Parulis and Epulis) are  also often
enough the  seat of the  dyscrasia.   Finally, the  most extent
sive organ of sense, that of feeling, the skin, has undoubtedly
to suffer most; it has to intercept as an armor, so to say, the
blows which are struck for the radical expulsion of the scrofula-
poison.   Here, then, the disease relieves itself, the scrofulous
cinders being cast  out by  that Vesuvius, called healthy life-

  * Even the chronic ulcers of the foot are called by  Schroen a reflex of a
constitutional disease, against  which he recommends Arsenic in alternation
with Sulphur.  (Hyg., iii, 365-369.) 
          GENERAL PATHOLOGY  OF SCROFULOSIS.        21

 force, working deeply in the interior, now in the  form of
 aphthae, now as intertrigo ;  more unmistakably, it is true, as
 crusta lactea ; ozaena ; as blepharitis ciliaris;  or, to  hold on
 to the simile, the stream of lava rolls into daylight as the prod-
 uct of an obstinate otorrhcea.
   However, we have  thus far marked too insufficiently the
 importance of the lymphatic glandular system in its bearing
 upon scrofula.  Enlarged glands (the maxillary glands, espe-
 cially) are  frequently  considered as being  identical with
 " scrofula."   These turgescent  glands serve, no doubt, as re-
 ceptacles of the  scrofulous elements  and  products which are
 directed against and  inimical to  the normal  composition of
 the blood,  and the latter can remain  deposited  for a time
 indefinitely long, as does the syphilitic  poison in the indu-
 rated inguinal  canals, until they are  brought  into course
 again, as it were, into circulation by a cause  more external.
 From this now results forthwith a localized, new, scrofulous
 inflammation, with all the terminations possible.
   On account of the evident connection of scrofula with the
 lymphatic  (and,  very probably,  chylific)  vessels,*  we will
 direct the attention of the reader to a few physiologico-an-
 atomical facts.
   The lymphatic system is an appendix of  the venous.  The
 main trunks of the lymphatics run into venous  trunks, and
 smaller lymphatics even are said to open out into veins.  The
 structure of the larger lymphatics agrees  with  that of  the
 veins in many points.  The beginning of the  lymphatics is,
 as yet, not settled beyond dispute.   The most popular view
 is, that the  lymphatics originate  in certain membranes (e. g.,
 the serous)  from closed nets of a much larger  diameter than
 that  of the  capillary  nets of the  bloodvessels; while in  the
 connective tissue, on the contrary, they begin with free open-
 ings in the interstices of  the tissue.
  That the  lymphatics resorb is  sufficiently  proven by  the
 reception of  the  intestinal contents by the chylus-vessels, as
 well as by the observation that, after ligating the bloodves-
 sels, substances  easily resorbable, such  as ferrocyanide  of

  * " Of the essence of scrofulosis, Baumgaertner says, we know nothing more
reliable than that the lymphatic system, and especially the  lymphatic glands,
are the principal, and, as it seems, primary seat of the disease." 
 22            ON SCROFULOUS AFFECTIONS.

 potassium, for instance, are taken up after some time.  But
 this  kind of resorption shows the peculiarity that  not  all
 substances are taken up by the lymphatics, and that they
 require longer time for the process than the bloodvessels.
 Poisons are usually not taken up by the lymphatics.   Hence,
 after ligating the bloodvessels, an animal cannot be killed by
 bringing  strychnine into a  wound of the  foot.  (Emmert,
 Henle, Behr.)
   This slowness of resorption in the lymphatics is owing, no
 doubt, to their remaining in the lymphatic glands.   On cer-
 tain and always the same localities of the body (flexor-planes
 of the joints, interstitial  spaces of the muscles, &c), the lym-
 phatics show a tendency to simplify themselves by a reduc-
 tion of their numbers.   Several of them  enter a  lymphatic
 gland to reappear in smaller numbers.  The lymphatics, leav-
 ing a gland, hunt up now  a more distant, second, third, fourth,
 before they open out into the main lymphatic trunk.
   Hence,  aside from the chylific system, the lymphatics, as
 an appendix to the venous system, serve a purpose similar to
 the former, and the partaking of the lymphatic system in the
 process of scrofulous affections, allows the  deduction  that
 these processes are no strangers  to  the venous system also.
 Hence, the genuine scrofulous  habitus always shows a pre-
 ponderance of the venous system also.  The typus pasto-veno-
 sus is essentially the scrofula-type. Thus we find here guiding-
 points for a successful  therapia, knowing, as we do, a whole
 series of remedies which  have specific relations to the venous
 constitution.
   The function of the lymphatic and lymphatico-glandular
 system, in their bearing  upon the dyscratic  morbific matter
 inimical to  the whole economy  of life, appears  still  more
 plainly, if we quote the simple words of Hyrtl on the relation
 between the arterio-venous and lymphatico-vascular system.
   " The arteries," Hyrtl says, " branch off like trees, by means
 of countless divisions, into finer and finer branches, which,
 finally, pass over into veins.  The microscopically minute and
 structureless  connecting  avenues between the  arteries and
 veins we find in the capillaries.  Since the blood streams from
the heart  into the veins, and from the veins again is brought
 back to the heart, it makes a circle in its motion, and in so 
          GENERAL  PATHOLOGY  OF SCROFULOSIS.        23

far we speak of a circulation.  The capillaries allow certain
colorless fluid constituents of the blood to pass through their
walls, so as to bring them in contact with the organic parti-
cles to be nourished.  The organic particles select out of those
fluid constituents of the blood, wherewith they  are over-
flooded, whatever they wish to enter into  relation  with, and
want to exchange for the matter used up,—the  remainder,
lymph,  returns  from  those organs through  special vessels,
called lymphatics, on acccount of  their colorless, water-like
contents, which open out on certain places into veins.   Hence
the lymph becomes  mixed with  the venous blood, and flows
back with it to the heart."
   A circulation without the co-operation of the lymphatics
would be an ideal one. In such a  case the  organism would
have received but suitable (assimilable) material (and every-
thing in normal proportion).
   Scrofulosis, now, manifests itself ab initio  as that anomaly of
nutrition in which the organic 'particles, spoken of are overfiooded
with so defective a fluid from the  capillaries that the lymphatics
can scarcely effect the  removal of that  non-assimilable fluid.
   And  whither must this fluid  return, finally?  From the
lymphatics into the veins, from the veins into the heart, from
the heart through the aorta, provided the lymphatic  glands
do not intervene before, again into the surroundings of the
organic particles mentioned.
   From the excessive activity of the lymphatic system, atonia
of  the walls, inclosing the lymph,  results, for which  reason
authors  of  name (Hufeland)  pronounced  a  high  degree  of
atony of the lymphatic system together with a morbidly in-
creased  lymph,  and  a specific dyscrasia thereof, to be the
essence of scrofula;  its nearest cause.   Soemmering seems to
have been the first who in scrofulous affections saw a deeply
rooted weakness of the vessels of the  lymphatic glands, and
since Cabanis, Bichat, Pinel, Alibert, Richerand, and most of
the contemporaneous writers indorsed  this theory it has been
generally adopted.
  Girtanier attributed scrofula to irritability of the lymphatic
system,  and it is  known that Broussais gave pre-eminence to
this theory by all the weight of his name.
  Nowhere do we see, hence, the lymphatics work so indus- 
24
ON SCROFULOUS  AFFECTIONS.
triously for our physical welfare  as  in  scrofulosis, and  the
existence  of the numerous lymphatic glands, as mentioned
before, no doubt, assist them in their labor.   As we have said
above, the possibility is afforded by the lymphatic glands for
the lymph to become embodied in the  circulation after a con-
siderable  length of time, only.  Indeed, it is  certain even,
as we have  likewise pointed out before, that in the glands
the (scrofula) poison (tubercle) may remain inactive for years,
encased,  as it were, like a mature trichina.  "Tuberculosis
of the lymphatic glands," Alfred Yogel  says, and thus con-
firms the assertion made, "is not dangerous by itself; tuber-
culosis of the  lungs, however,  very  usually develops after
the appearance of  puberty,  and this danger  must, hence,
always be mentioned in our prognosis;"  and it is, moreover,
not unlikely that the quality  of  the poison  is changed in the
lymphatics, perhaps weakened, even, in its intensity of action.
  This supposition is based upon the metabolic, change-beget-
ting power  of the glands  in general.  "We are inclined,"
says Budge, " to accept the cell-formations which appear at
the inside of the glandular membrane, and are called enchyma
(Purkinje) as the very apparatuses for secretion.   We surmise
that these cells can assert an attraction, or a change-begetting
(metabolic) force upon the liquor sanguinis that courses around
them."
  Are we to suppose that the inner texture of the lymphatic
glands is  entirely indifferent as regards  the contents cours-
ing through the lymphatics ?   Scarcely.
  The contents of the lymphatics, however, are, without any
doubt, of much  greater importance  than the  lymphatics
themselves.  " From a deficient lymph, arrested in its course,"
says Baumgfertner, the  pathologist  already quoted above,
who, in this remark of his, squarely hits the nail on the head,
" may all the symptoms of scrofula be explained by  the phe-
nomena presented to us in the isolated plastic activity, and
cellular metamorphosis.  If on account of  weakness (mostly
inherited) of the lymphatic system, a  deficient lymph is pro-
duced, and arrested in its flow in any  part whatsoever, it ter-
minates in isolated plastic activity.   Cells are built up therein
which, in  their  turn, attract  matter, and thus increase their
number, and  form tumors.  But these isolated cells have a 
          GENERAL PATHOLOGY OF SCROFULOSIS.        25

 tendency to cellular  metamorphosis; they  decompose  into
 granula which unite into new cells, pus-cells.  By these means
 the  greatest destructions are brought  about in all kinds of
 tissue."
   This way of explaining the matter is, in my opinion, based
 upon a more correct conception than are those other one-sided
 ideas, according to which the  essence of scrofulosis is said to
 consist, at one time, in a peculiar scrofulous  matter (miasma
 scrofulosum) (Schaefer); at another in an abnormal  gastric
 juice (Willis); now, in acidity of the primse vise (Van  Hel-
 mont); now in an  over-amount of albumen in the. chylus
 (Sunderlin); or according to which it is pronounced to be the
 unfortunate offspring of the monster syphilis, even.
   Ilausmann, Hecker, Reichelt, Wharton, and Faure assert
 that the sperma, if not evacuated through the  natural chan-
 nels, is resorbed, and  thus  produces scrofulous  affections; a
 view which is the crown, so to say, of all theoretical arbitra-
 riness.  Hippocrates and Galen  attributed scrofula to mucus
 clinging to the lymphatics, an idea which is  based, probably,
 upon the obtuse guessing that the termination of the  dys-
 crasia in  question, as we suppose to-day, has to be searched
 for in an altered quality of the lymph; though the factor of
 that change may not have been found out, as yet, beyond
 dispute; because we cannot, as Baudelocque would have it,
 declare that the  factor to be blamed consists in spoiled air.
 " If  the air," said Baudelocque, " which we inhale, has suffered
 a change in the relative quantities  of the elements constitut-
 ing it, by a diminution of oxygen or an increase of carbonic
 acid, hasmatosis necessarily becomes defective  and incomplete;
 and  as the blood contains the materials of nutrition and secre-
 tion, it must necessarily occasion in the composition of  this
 fluid, alterations  more or less harmful, and induce the devel-
 opment of scrofula."
  Baudelocque is thus one of the main representatives of the
 humoral patholog}7.
  With good reason the objection. has been made to  this
 theory that, its correctness presupposed, the scrofulous would
have to pass through a kind of asphyxia, and would show
symptoms accordingly, which, however, is not the case.  Be-
sides, in cases of slow asphyxia, the lymphatic glands are 
26             ON  SCROFULOUS AFFECTIONS.
never affected.  And, then, why should scrofulosis not appear
upon the whole globe, provided the conditions for the depri-
vation of oxygen were present ?
  It is more correct, hence, to  accuse as etiological momentum
everything that impoverishes the lymph. (Borden.)
  Hain's view, by the way, is original, which declares scrofula
to be a metamorphosis of variola.
  The idea indorsed by Ettmueller, Hauter, and others, which,
at first sight, lacks both logic and science, and yet does  not
appear impossible,  is that alkalescence  or an  acid (which
Baumes believes to be phosphoric acid, others a specific one)
produces scrofulosis.
  But let us abandon now theoretical grounds, and return to
the soil of a more correct pathology.
  Thus it behooves us to listen to the views of several more
recent and famous authors upon scrofula.

                              I.
  Wunderlich calls scrofula an anomaly of nutrition, whereby,
it is true, but little  is said.
  In advance of it  he treats  on  pimelosis and stearosis, and
follows it up by marasmus.*
  Wunderlich's statement, according to  which scrofulosis is
said to have connection with hereditary syphilis, is more im-
portant.
  Besides coarse, indigestible food, he  mentions as  other
authors  do, among the  external  influences, deficient renewal
of air, want of sunlight,  upon which causes  the fact  rests,
  * He arranges the anomalies of nutrition mentioned (pimelosis, stearosis,
scrofula, marasmus), under the head of autogenetic constitutional diseases, and
counts among them:
  A. Anaemic forms.
  B. Plethoric conditions.
  C. Anomalies of nutrition.
  D. Hemorrhagic diathesis.
  E. Hydrops.
  F. Constitutional disturbances manifesting themselves by peculiar urinary
secretions.
  Q. Rheumatism.
  H. Gout.
  J. Constitutional diseases with peculiar multiple localizations. 
          GENERAL  PATHOLOGY OF  SCROFULOSIS.        27

probably, that the symptoms of scrofula commence  during
convalescence from  other diseases  (after measles, hooping-
cough, typhus, &c.)  Surprising but very pleasing is the con-
fession: "Scrofula characterizes itself, neither by a  demon-
strable and  peculiar change of the  blood, nor by products of
a peculiar quality."
  Almost all parts of the body may show changes, and the
anomalies originating are partly hypertrophies, partly serous,
plastic, purulent, tuberculous exudations, but very frequently
deposits  that remain firm; or, thinly purulent, and  caseous
or ichorous effusions.
  The parts especially affected are  the  lymphatic, secretory
and vascular glands, the skin, the  subcutaneous connective
tissue, the mucous membranes, the brain, lungs, serous mem-
branes, muscles, bones, and joints.
  The symptoms may show very different grades.
  As regards the habitus scrofulosus, Wunderlich does not
differ in his description from the one generally known  and
accepted.
  " This habitus," Wunderlich says, " shows more or  less dis-
tinctly the lymphatic character; at one time in a certain gross
nutrition, accompanied by a thick  nose, thick lips,  spongy,
bloated look, dirty-pale  color, coarse and stiff" hair,  swollen
abdomen, thin, and, at the same time, clumsy limbs; at another
in a delicate bodily constitution with a thin transparent skin,
flushed cheeks, but great sensibility of the parts."
  Wunderlich does  not  mention without purpose, first, the
processes upon the skin, then those  of the mucous membrane,
then those of the lymphatic glands; fourthly, the  affections
of the bones and joints; and, finally, those of the  fatal ter-
mination of scrofula,—appearance  of tubercles in the brain,
the lungs, and other internal parts—thus indorsing, to a cer-
tain extent, our theory  of the originally centrifugal, and,
finally, centripetal direction  of the scrofulous  anomaly of
nutrition.
  " The skin of the scrofulous becomes affected by the slight-
est causes ;  wounds  heal with difficulty, and suppurate for a
lono- time; excoriations secrete and ulcerate; the skin covers
itself with obstinate eczematous and impetiginous eruptions,
and serpiginous forms frequently appear  upon it; the meatus 
28
ON SCROFULOUS  AFFECTIONS.
auditorius externus often becomes the seat of an inflammation
with purulent discharge.
  " In a similar manner the mucous membranes are affected ;
especially, we observe, however, obstinate catarrhs and blen-
norrhoeae of the eyes, nose, oral cavity, and  pharynx; chronic
catarrhs of the  stomach  and intestines, with semi-paralysis
(paresis) of the intestinal musculature ; catarrhs of the  air-
passages, often, indeed, with tubercular deposits; catarrhs of
the female sexual organs, often with ulcerations;  not rarely
isolated, local pseudo-growths appear upon the mucosa, which
must be considered as a higher development of diseased por-
tions of the mucous membrane.
  "The affections most  frequent, however, are the swellings
and diseases of the lymphatic glands, which show themselves
especially in the glands of the throat and  neck, but also in
the axillary and inguinal, as  well as in the  bronchial and
mesenterial glands, and may appear  on  account of the most
insignificant peripheric affections, and originate spontaneously
even.   The disturbance  therein may consist in hyperemia, or
tuberculous deposits, or hypertrophia.
  "Not rarely do we witness among the scrofulous a hyper-
trophical  thickening, and firm infiltrations  of  single vascular
or secretory glands (of  the glandula thyreoidea, the ovaries,
mammse, even of the kidneys), mostly with a diminution of
their functional capacity.
  " As a frequent local manifestation of scrofula, malignant in
its nature, we observe affections of the joints, which, at  the
beginning, show themselves as moderate pathological altera-
tions in the parts surrounding the joints, and are accompanied
by swelling and  pains.  In  consequence of frequent relapses
and neglect, the evil becomes more stubborn and chronic, the
synovial membrane  becomes  affected, and it may end in firm
deposits beneath the latter, or in puriform  exudations in the
cavity of the joints.  Other destructions  of  the joint  may
develop therefrom,  and  the  epiphyses may become involved
more or less.   The affections run a different course in the dif-
ferent joints ; at the cervical vertebrae and the knee they lead
to induration and swelling, rarely to  extensive suppurations;
at the joint of the foot they tend toward isolated abscesses
and formation of fistulse;  in the elbow-joint to abscesses and 
          GENERAL PATHOLOGY OF  SCROFULOSIS.        29

fistuhe, which, however, usually heal up, producing anchy-
losis ; in the hip-joint, and at the lumbar vertebrae to the most
extensive purulent destructions.
  " Next come the affections of the bones, often combined with
those of the joints, or existing  separately.  They may com-
mence at the periosteum, and then terminate either in suppu-
ration, denudation of the bone, or necrosis, or lead to sub-
periosteal,  ossifying  exudation;  or  they  start at the  bone
itself, and appear, at one time, as simple ostitis, and may end
in thickening of the bone and hypertrophy, or form purulent
products, with the latter of which the construction of new
bony substance, in the form of osteophytes or hypertrophical
swellings, goes hand in hand, the bones becoming enlarged at
times ; now and then, however, the affection of the bones is a
tuberculous one,  to distinguish which from the simple bony
ulceration is not possible during life."
  The termination in tuberculosis depends  (according to Wun-
derlich) upon the intensity  of  scrofulosis ; it is possible, how-
ever, even in case of a scrofulous affection of a lighter grade ;
while in higher grades, on the other hand, it becomes a neces-
sity, a rule almost.
  Tuberculosis may become general;  or tuberculous  deposits
in the mesenterial glands take place; next in the brain and
its membranes, in the bronchial glands and lungs.
  Finally, ulceration of the bone, congestive abscesses, morbus
Brightii, and the development of stearosis, may occasion death.
  Even in case of a cure there is inclination to relapses.
  Wunderlich's picture  of scrofulosis, we see, is sufficiently
exhaustive ;  indeed, in accordance with it, certain histological
textures become affected, to which we are usually inclined to
attribute a certain immunity, as, for instance, the serous  mem-
branes, the mucosa of the stomach, the muscles, kidneys,  tes-
ticles,  ovaries, &c, although we may suppose it as unlikely, a
priori, that an entire guarantee can be given against scrofulosis
with regard to any organ.  If we add to  this the doctrine of
the pars minoris resistentim, well established, as it is, we may
easily  explain whj* now the one  individual suffers from  the
more rare form of a vaginal catarrh, now another from blen-
norrhea bronchialis, a third from  meningitis (tuberculosa)
without the usual initial phenomena of scrofula even. 
30
ON SCROFULOUS  AFFECTIONS.
                           II.
  As supplements we will quote here now the remarks on
scrofulosis  of  a French  writer  of high  standing, Jousset,
though only so far, of course, as he opens to us any new views.
(Elements de Medecine pratique,  i, 60.)
  Jousset names  as  a characteristic sign of scrofula the de-
posits of tubercular masses, especially in the lymphatic glands,
to which we have given due importance above.
  According to Jousset the scrofula-dyscrasia may manifest
itself in four forms:
  1.  As common scrofulosis (forme commune).
  2.  As malignant (f. maligne).
  3.  As benignant (f. benigne).
  4.  As well-fixed, primitive form (f. fixe primitive).
  Common scrofulosis comprises  the complete development of
the disease, thus defining at the same time the fourth form,
which does not show either multiple localizations or free in-
tervals,  but contents itself with one single attack.  It ap-
pears in the form of tumor albus, malum Pottii, tuberculosis
cerebri,  albuminuria, morbus Addisonii, lupus or meningitis
basilaris; -again as purulent pleuritis and pneumonia, as ob-
stinate inflammation of the eye with  destruction of it.   Jous-
set is right in believing  that some  forms of croup (l'angine
couenneuse) must be considered as  belonging here, and, above
all, phthisis pulmonum.
  The designation "fixe primitive" does not preclude the oc-
casional  appearance  of scrofulous peritonitis, pleuritis, and
especially of tuberculous  diarrhoea, towards  the  end of the
catastrophe.  In the form of common scrofula Jousset distin-
guishes four periods of development.  He confirms what we
have already said above,  that  it  belongs to the physiological
course, so to speak, that  scrofulosis attacks  at first the skin,
then the mucous membranes  (hence, at the commencement,
moves in a centrifugal, afterwards in a centripetal direction).
  Bazin very adroitly calls the scrofulous cutaneous eruptions
scrofulides (who would not think here of syphilides ?).   These
belong either to the moist or dry kind.   Among the former,
eczema, impetigo (in the face), crusta lactea; among the lat-
ter,  the erythemata, prurigo, lichen, psoriasis, acne.  The 
          GENERAL  PATHOLOGY  OF SCROFULOSIS.       31

swelling of the lymphatic glands in the neighborhood is char-
acteristic  of all.
  The scrofulous affections of the mucosa comprise that form
of coryza  accompanied by impetigo of the nasal openings and
lips, which finally produce the " mufle scrofuleux ;" the obsti-
nate otorrhoea with  sero-purulent discharge, " et encore sans
carie."
  Blepharitis and hordeolum;  ophthalmia of still benignant
character, granulous pharyngitis with hypertrophy  of the
tonsils, catarrhal bronchitis, diarrhoea, balanitis, leucorrhoea,
and vulvitis  among small  girls.   Scrofulous  children are
sometimes very fleshy, at others  very lean.
  Singular as it may seem, Jousset considers rhachitis a dis-
ease, strictly to be distinguished in its nature from scrofulosis,
and does  not agree with  the  idea  (as does Bazin) that the
delay in teething, and in learning to walk, is a commencement
of scrofulosis, but of rhachitis.
  Jousset having acknowledged the systematic progress  of
scrofula from outward  inward  (centripetal direction), the
second period begins, in his opinion, with the scrofulous affec-
tions of the  lymphatic glands, and he accepts, in the third
only, an  affection of the  bones and  viscera  (des visceres),
among  which we count  brain,  lungs, pleura,  peritoneum,
ovaries, liver, pancreas,  testicles ; regarding panaritia, with
caries  of  the  phalanges, a transition  state  from the  second
to the third period.  Generally a more intense aggravation of
the disease, self-evidently,  takes  place with its  progress, and
thus  the  fourth period ends  with the developed scrofula-
cachexia,  of which Jousset gives the  following description:
" Pale, ash-colored, bloated face, soft, flabby, dry skin ; ema-
ciation not too great; serous infiltrations ; rarely hectic fever
with  colliquative  sweats,  unless there exists, at the same
time, phthisis pulmonum.  Appetite continues to be good for
some time. Colliquative diarrhoea; daily decrease of strength;
great indifference.  Death from syncope."
  One word more on Jousset's malignant and benignant forms
of scrofula.  He bases the distinction between the two upon
the termination in tuberculosis,  merely, the latter of which
he identifies, without hesitation, with (malignant) scrofulosis.
He  deems himself justified in so doing upon the following 
32             ON SCROFULOUS AFFECTIONS.
grounds: 1. The scrofulous can beget the tuberculous, and
vice versa.   2. The tuberculous  are often  affected  in child-
hood by scrofulous affections (forme benigne).  3. In cases in
which the antecedents of the tuberculous show no symptoms
of scrofula, the malignant form (e. g., as meningitis tubercu-
losa), or the well-fixed, primitive form, mentioned above (in
the shape of the malum Pottii or tumor albus), may yet make
its appearance.
  Finally,  the  chronic  character  by no means  pertains to
scrofulosis.
  Of the English physicians, Clarke, and of the  German,
Cannstadt, side with Jousset;  who also believe  scrofula and
tubercles to be one and  the  same  disease.   Baumgaertner,
on the other hand, remarks: " The forms of the  two diseases
are very different; therapeutics,  frequently triumphant in
scrofula, is of no effect in tuberculosis; scrofulous individuals
are not much more frequently affected hy phthisis than others,
and most of the consumptives have  had no scrofula at any
period of their lives."
  The benignant form is said to characterize itself  by super-
ficial, local affections, few relapses, and an entire or apparent
restitutio ad integrum, even.  Females thus affected incline,
however, to abortus, dysmenorrhoea, leucorrhoea, and get old
early; men cannot stand much, have no endurance, " ne sup-
portent pas la fatigue."
  The  malignant  form,  on account  of  the sudden, simul-
taneous appearance of the various affections of the gravest
grade, is said to remind one of the poisoning by glanders (le
farcin).   Multiplex abscesses, enormous glandular swellings,
sudden carious processes quickly following one another at the
most various places of the skeleton ;  pleuritis of  a very acute
course, peritonitis, &c,  mostly evince, moreover, the malig-
nant character.
  Yet in case of a benignant character of scrofulosis, even
(forme  benigne), the children of those so affected not rarely
carry the germ of tubercular  meningitis or phthisis within
them.
  Jousset, aside from the usual momenta (see previous pages),
mentions  also the  following as  predisposing:  Excessus in
venere;  pregnancies too often following one another; but espe- 
           GENERAL PATHOLOGY OF SCROFULOSIS.       33

 cially nursing for too long a time.  A stronger predisposition
 exists likewise after typhus, hooping-cough, and measles.
   Bazin calls it a physiological prejudice, that  blondes are
 supposed to have more inclination to scrofula.   In his opinion
 the blonde race is the strongest race, and endowed with most
 energy.  He says that in France just the brunettes and lean,
 not the plethoric, are affected preponderantly.  The French
 author, who only asserts the frequency of the affection to be
 equal in Spain, England, and France, no doubt is in error as
 regards Germany, a country which, in fact, he does not men-
 tion, even.  He is  right, however,  in saying that scrofulosis
 is a disease of the  temperate zone.  Iceland has  no  " scrofu-
 lous  plebs."  The  torrid zone  enjoys  the  same exemption.
 The  fact is that the disease is much  more frequent in wet
 than dry countries, and, for this reason, is found especially in
 Holland, Poland, England, Vivarois, in the Sevennes, Alps,
 Pyrenees,  and in gorges and  valleys  which  separate  high
 mountains; besides, it appears  that the removal into a cold
 and wet climate is  especially one of the  most potent causes of
 scrofula.   Some observers have adduced as illustration that
 children, who were brought from  India to England, became
 scrofulous  there (Buchan, Sam. Cooper).  Others have made
 the same  observations  with regard to persons who  were
 brought from America  and Brazil to  France  (Guersent).
 Just  as in cold, damp, low, marshy localities, which are de-
 prived of  the  beneficial  influence  of air and sun,  colorless
 mushrooms and fungi sprout up, so the scrofulous  habitus,
 under the influence of the same local peculiarities, grows up
 luxuriantly in numerous specimens  without any possibility of
 arresting it.  This cause holds good in the etiology of scrofula
 as one of the most important and frequent.

                           III.

  Among the more  comprehensive German homoeopathic text-
books, Kafka's  treatise on scrofula is of prominent  interest,
especially as he has  bestowed the utmost care upon the thera-
peutic part. We shall return to his experience in this direction,
when we speak of the treatment of scrofula.   Kafka especially
points to the difficulty of reducing scrofulous exudations.  He con-
                            3 
34
ON SCROFULOUS AFFECTIONS.
siders the process of digestion and assimilation, suffering from
a cause not fully discovered thus far (see Baumgaertner), to be
the essential terminating point of this dyscrasia.  He thinks
that in acquired (in contradistinction to hereditary) scrofu-
losis, the first foundation is already laid in  the  first few
months by overfeeding.   Other factors, of no less importance,
are want of fresh air and exercise.   From these a slow ex-
change of matter results, and,  above all, the necessary pro-
cesses of  oxidation are wanting; hence the prevailing venosity
in scrofulosis.
  We  are reminded, as  already mentioned, by those unfor-
tunate and fading creatures, of  certain species of plants which
are deprived of light and air; pale and bloated, plethoric, not,
however, by really healthy juices, but by a watery, colorless
liquid, these "miserables" live  but half a life.   In  the same
manner,  in the  animal kingdom, many species of amphibia,
with their cold blood and wabbling fleshiness, their construc-
tion of limb incapable of quick motion, their indolent, sleepy
character, secluded, moisty-cold domiciles, represent scrofulosis
with a predominating lymphatic system.  This brings us to
the ingenious  hypothesis of Ruetes on scrofula.  He declares
the essence of  the disease to be a retrogressive metamorphosis,
by which the organism attempts to go back to a former stage
of life.
  Kafka  directs our attention to the fact that a too  scanty
supply of protein-substances favors the development of scrof-
ula. The  protein-substances contain, as is well known, Sul-
phur and Phosphorus.   Now, it is remarkable that the two
latter frequently are remedies which homoeopathists cannot
dispense  with  in scrofulosis.
  The authors" mentioned above have paid no attention to
the closing up  of the fontanel at a late date.  Kafka  especially
has marked it out.  Even Lepelletier, finally, compares the
vital process of the scrofulous with the  rapid sprouting (etio-
lement) of plants deprived of light.  Deficiency in the vital
functions, poor  assimilation, alteration of nutrition, are the
necessary consequences of the influences to which most scrof-
ulous individuals have been exposed.
  But we must remember, always, that  the variety of those
influences is great, that  for the begetting of what we term 
GENERAL PATHOLOGY OF  SCROFULOSIS.        35
 scrofula, neither the deprivation of light alone, nor solely the
 insufficient supply  of oxygen, nor  a highly non-nitrogenous
 food, nor one  too rich in nitrogen, nor the descent from un-
 healthy parents suffice.*
   On  the  contrary, a whole series of conditions  is wont to
 show itself as tending toward the development of this disease.
 Hence it will suffice for us to hold on to the two main factors:
 the organic predisposition, on one  side, and certain disturb-
 ances  of nutrition contaminating the blood, on the other.

   Note.—The  symptoms of scrofula, it  is true,  have  been
 divided into local  and  general.  It is difficult, however, to
 carry  out  this distinction,  since,  for  instance,  the movable
 swellings in the neighborhood of the lymphatic  glands and
 vessels, which  were mentioned among the  local, are as well
 the expression  of a constitutional affection, as the degenera-
 tion of the bronchial and mesenterical glands (phthisis mesen-
 terica), which  are named among the symptoms  not purely
 local.   The best proof of the great significance of those swell-
 ings, considered to be a purely local symptom, lies in the fact
 that they are frequently the forerunners of pulmonary tuber-
 culosis, and that  two and more children of the  same familjr,
 at the same  time, i. e., when they have attained to a certain
 age, become invested by such  swellings, from  which, as men-
 tioned, the ominous tuberculosis results.
   In the " Universal Lexicon  der practischen Medizin u.
 Chirurgie " (Leipzig, Voigt and Fernau, 1844), we find a good
 description of this stadium prodromorum of scrofula; for those
 swellings ought to be considered as nothing- else.
   " Most frequently," we read there," we notice, notwithstand-
 ing all  the external appearance of health, oviform swellings
 or globules  beneath the  skin on places where  the lymphatics
 take their course, and glands are present which, more or less,
increase in number,  and  by and by gain in circumference; at
the beginning remain painless  for months and years ; are fol-
  * Though Lugol, even, considers hereditability as the sole cause, and Cul-
len as nearly the only cause of scrofula ;  and Lemasson-Delalande says :  " It
is absolutely impossible that a well-organized being should become scrofulous
spontaneously, no matter into what surroundings it might be brought, and
be it imprisoned for years, even." 
36             ON SCROFULOUS  AFFECTIONS.

lowed  at a later date  by heat, redness, local  swelling and
febrile motions ; afterwards fluctuation frequently appears;
the skin becomes  thinner, ulcerates, and  simultaneously  or
successively allows a substance to penetrate it, resembling the
consistency of chestnuts or  cheese, or a fluid  filled up with
purulent or albuminous flakes.   The suppuration arising from
the lymphatic glands or neighboring  tissues, is more or less
considerable, and lasts for an indefinite  time, amounting to
months and even years.  At any rate, cicatrization proceeds
slowly ; the bottom of the ulcers consists of flat or little de-
veloped granulation ;  the edges are bluish-purple, and if they
unite, show at the place of the cicatrix, indestructible signs
of the disease  that has existed;  a  state of things that arises
from the loss of  substance of the integuments of the connec-
tive tissue of the lymphatic  glands, and the agglutinations
which  the edges of the ulcers form with the muscles beneath
the skin.  The symptoms usually manifest themselves around
the neck, more rarely in the axilla and groin, still more seldom
in the fossa poplitea.  The skin is, in many cases, the seat of
tumors and ulcers, which multiply  in various localities of the
body.   From  these  ulcers oozes a watery pus, which  may
leave  behind a thick cheese-like (tubercular) mass.  During
the whole time of  this  suppuration, likewise lasting for
months or years, the edges of the ulcers remain spongy and,
some time, muscular surfaces of considerable extent are de-
nuded.  In the ratio in which  these ulcers increase in num-
ber, the general state  of health  declines; cachexia shows
itself;  the disease has become general."
    DYSCRASIA RELATED  TO SCROFULA.

                    A.—Tuberculosis.
  We  indorse Wunderlich's and Jousset's views, that  the
tuberculous process appears where the conditions for scrofula
have reached their  highest degree, and  scrofula  itself its
greatest intensity.  When Baumgaertner denies the identity
of the  two processes on  the ground that  scrofula does  not
necessarily terminate in  death, while  tuberculosis does, we 
DYSCRASIA RELATED  TO SCROFULA.         37
simply reply that the greatest intensity of a disease must needs
render the prognosis more  unfavorable, and that, moreover,
many scrofulous  persons die of caries, necrosis, inflammation
of the joints, abdominal diseases, exhausting abscesses, &c.
  If we compare scrofula with a luxuriantly growing plant,
then tuberculosis is the blossom.  Now, as  there are many
plants (e. g., vinca minor;  or the  so-called porcelain flower,
asclepias odorata) which, in many cases, content themselves
with a mere luxuriant growth of leaves, so not every scrofu-
lous existence develops its blossom.  Or still more correctly,
perhaps, the scrofulous  affections  are the wild offshoots of
tuberculosis which, as is well known, seem likewise to be but
little adapted to  the development of blossom or  fruit.
  According to Baumgaertner's second objection, most of the
tuberculous did not evince  any sign of scrofula.  This state-
ment is exaggerated, not to mention that, in many cases, the
external cause  for the development of the scrofulous predis-
position existing, may have been wanting, thus far.
  If hereditability is assumed as the most evident  cause of
tuberculosis, we are compelled to concede the same  cause to
scrofulosis.
  And hereditability would much oftener be admitted, were
it not that existing tubercles were overlooked, for the reason
that they remain stationary, and are  harmless in their latent
state for any length of time.   Thus  post-mortem examina-
tions after previous diseases of a non-tuberculous character,
have  frequently brought to light such tuberculous deposits,
e. g., in the  apices of the lungs, bronchial glands,  &c.   Vice
versa, persons exposed to most unfavorable outside  influences
did remain  free  from tuberculosis, since they had no heredi-
tary predisposition to it.
  The reason why we cannot make up our mind to  refer all
such (scrofulous and tuberculous) dyscrasiae to hereditability,
is simply to be found in  the fact that modifications of the
disease, incalculable in  number, are possible which depend
upon relations more or less distant from  the  original  individ-
ual seat of the infection.  However, owing to  the fact  that
herpetic, syphilitic, carcinomatous, chlorotic, and other  dys-
cratic influences  are transferred simultaneously, or a surplus
of healthy blood  from father  or mother, asserts its influence 
38
ON SCROFULOUS AFFECTIONS.
during the  act  of generation, it happens that innumerable
varieties and shades of the disease, monoform  at the outset,
arise.
  Thus some members of a family escape wTith a chronic ble-
pharitis, or  an ophthalmia (frequently recurring), or  an in-
clination to bronchial catarrhs, &c, is the only expression of
the masked remnant of the dangerous tuberculous inheritance.
  Not long  ago I  saw a child who had the blue eyes of the
mother, and the dark-colored iris of the father.  If  such a
differentiation of  the  parental physical peculiarities were a
rule and  not an  exception rather, we  should more frequently
meet with pure forms of tuberculosis (and  not with bastard
forms, i.  e., scrofulous affections).   Here belongs also that,
only exceptionally, the child inherits  the blue eyes  of the
mother and the black hair of the father, and vice versa.


                      B.—Syphilis.

  Scrofulosis has often been compared with syphilis, and the
former has been considered a masked form of the latter.  They
resemble each other, it is true, among other  things, in this
that, in both, the  skin so often becomes the seat of the spe-
cific deposits;  that, moreover, the cutaneous affections (syphi-
lides and scrofulides) in both are apt to be of multiform,  or
as we are wont to  say, polymorph character.  But in syphilis
the auxiliary apparatuses of the organ of taste (tongue, buccal
mucosa) are  affected more than in scrofulosis; the ear and eye
much less.   Except syphilitic  iritis there is  little  mention
made of  syphilitic affections of the eyes.  For the direct in-
fection with gonorrhoeal pus (gonorrhoeic inflammation of the
eyes) cannot be counted here.
  The affection of the glandular system would be a tertium
comparationis as regards scrofulosis and constitutional syphil-
itic diseases.  Supported by this criterion we could speak of
secondary scrofulosis as well as of secondary syphilis. Indeed,
the degenerations into necrosis and caries, and the appearance
of tuberculosis pulmonum, even, in persons previously  scrofu-
lous,  might without any arbitrariness be understood as a
tertiary phenomenon of the scrofula-dyscrasia.   Hufeland di-
vided scrofulosis into Sc. occulta and manifesta.  Syphilidolo- 
           DYSCRASIA RELATED TO  SCROFULA.         39

gists  cling to this division  with regard  to  syphilis.  Even
Bazin speaks of masked scrofula.
  Even the possibility of transferring the latter by inocula-
tion does not constitute a characteristic distinction  between
scrofula and syphilis, for  although common scrofulosis is not
contagious as variola and scarlatina are,  nor transferable as
is syphilis, vaccinating experiments with  pus taken  from tu-
bercles  have nevertheless given positive  results.  And how
small is the gap between  the tuberculous  and scrofulous dys-
crasia ?  Moreover, it is  a fact, almost, that by transferring
the lymph of vaccina-pustules of vaccinated  scrofulous chil-
dren to others, scrofulosis can be communicated to them.
  Although it is said that Kortum, Pinel, Alibert, Richerand,
Dupuytren, Lepelletier, and others have tried in vain  to trans-
fer the  disease by laying healthy children into the same bed
with  scrofulous, or by rubbing, inoculating, or injecting pus
of scrofulous children into the  skin of  healthy ones; yet
there exist too many and well-authenticated cases in which
children, previously healthy, have been infected by  scrofula-
dyscrasia since vaccination.  Notwithstanding, however, we
do  not deny  that in the surety and certainty  with which
syphilitic pus causes syphilis, a difference, no doubt, between
syphilis and scrofulosis is well established  de facto; as scrofu-
lous pus does not, by any means, occasion  scrofulosis  with the
same certainty.  Yet we must not forget, on the other hand,
that  many do not believe secondary and  tertiary syphilis ca-
pable of being inoculated.
  Here belong also the interesting experiments of Sebastian,
which  have bearing, it  is  true, upon syphilis only.  This
Lyonese physician  maintains that if we take lymph of  a
(vaccinated) syphilitic child in such a  manner as not to trans-
fer any blood therewith, syphilis cannot be inoculated*  But
as soon as the blood of the diseased child gets into the vacci-
nation-wound with the clear, watery lymph, syphilis is trans-
ferred  (syphilis vaccinalis).   Ricord  contradicts this  view,
adducing that: 1. In the clear, watery lymph, even, blood
(blood-corpuscles) can be shown to exist microscopically.  2.
  * Sebastian, strictly observing his own rules, vaccinated himself with matter
of a syphilitic child, and did not become syphilitic. 
40
ON SCROFULOUS  AFFECTIONS.
   That it is very difficult so to transfer the blood of one human
   being to another that it will be  resorbed and  really become
   embodied in its circulation.   3. That in view of the frequency
   of syphilitic affections in large  cities, and the difficulty of
   collecting the poison  without  any  admixture of blood, the
   number of syphilitic cases transferred by inoculation would
   be much larger.  The second  argument adduced by Ricord
   proves, as every one will see at a glance, just the contrary to
   that wrhich  was to be  proven.   The very fact that, for the
   purpose of a lasting embodiment, the blood of one individual
   as a general thing is difficult to transfer to  another, explains
   the proportionally rare occurrence of an infection by way of
   vaccination.  This  holds  good  with syphilis as well as with
   scrofulous  children.  The latter, as I have  frequently ob-
   served, bleed more  copiously on making an incision into the
   vaccination pustule, and the blood shows a conspicuously dark
   color (excess of carbon).  It is too venous.
     As early as 1578 the French Parliament inquired of the
   medical faculty whether scrofula could be contagious, a ques-
   tion that was answered in the affirmative.
     We know now to what extent  this answer was  erroneous.
   Certainly no one will assume a real scrofula contagium, such as
   surely exists with  regard to syphilis.  For this  reason we
   cannot but agree with Baudelocque, to whom we are indebted
   for a comprehensive essay upon  this  subject, and who has
   proven that scrofula existed several  centuries before syphilis,
   when he argues in the course of his  work that the analogies
   set up between the  two diseases are only apparent:
     Cull en, Boehmer, Kortum, Gourfand, and others side with
   Baudelocque; i. e., they also deny such a connection.  Kortum
   in his district had  many scrofulous, but almost no syphilitic
   person, and Baudelocque  states that there are a great many
   syphilitic at Palermo, but almost no scrofulous.
     This does not  preclude, however, the possibility  of syph-
-   ilitic  parents  often having  scrofulous descendants; yet it
   happens often enough also, that  such children  cbme  to the
   world with syphilitic  but  not  with scrofulous  affections.
   What may have contributed to that error, is the fact, proba-
   bly, that both diseases, as already mentioned, are apt to have
   their seat in the same  organic parts (skin, lymphatic glands, 
           DYSCRASIJ3 RELATED TO SCROFULA.         41

bones, &c).  We are inclined, however, to find the most posi-
tive proof of a relation between the two affections in the fact
that  the specific remedy against syphilis, mercury (and its
various preparations) is able to cure scrofulous diseases innu-
merable; in short, that the homoeopathic antisyphilitica are
antiscrofulosa at the same time.   Moreover,  as mercury in
large doses produces the entire picture of the scrofula-cachexia,
we must not forget that persons affected by syphilis, who have
been fed upon that metallic poison, for this very reason, per-
haps, beget children with apparently scrofulous affections.
From all this the difficulty is obvious, at least, of  defending
in a one-sided manner one or the other theory.

                       C.—-Sycosis.

   There is another  dyscrasia, finally, that  has specific rela-
tions to the (lymphatic) glandular system, sycosis.  An essen-
tial mark of the sycotic constitution is, according to Virchow,
the excess of white corpuscles in the blood.   With good rea-
son v. Grauvogl asks:  Whence this  excess ?   The same au-
thor quotes in his text-book of homoeopathy (§ 297) the follow-
ing remarks of Autenrieth, bearing on this point:  "Sycotic
glandular formations appear even  in places where otherwise
no glands can be found.  Thus a  degeneration of the glands
cannot make  up the essence of this disease; the  scrofulous
glandular swellings, however, always  have  their seat in the
glands originally present."   Besides, he  points  to  the differ-
ence  between  sycotic and  scrofulous affections of  the bones.
If the chronic form of sycosis attacks the bony system the
affection shows itself in the bones of the nose, buccal  cavity,
hard  palate, superior and inferior maxilla, sternum, os sacrum,
ribs, and the processus spinosi.  In ozaena sycotica the fetid
smell is absent.  Upon the whole, the bones are not attacked
by sycosis immediately, but  the affection starts at the soft
parts, or the periosteum; no carious form ever appears, as in
syphilis, but only necrosis with formation of sequestrum and
sclerosis;  and while  bony substance destroyed by syphilis,
scrofulosis, and tuberculosis  is never repaired, a newT, dense,
bony  mass, endeavoring to fill up all the loss  occasioned, forms
after  the cessation of sycotic  necrosis.  We are of the opinion 
42
ON SCROFULOUS  AFFECTIONS.
 that  criteria, so well marked, fully justify a distinction  be-.
 tween scrofulosis, syphilis, and sycosis.  However, in view of
 the confounding chaos which, nevertheless, may be  possible,
 regarding syphilitic, scrofulous, sycotic, psoric, and other dys-
 cratic affections, we  have, in  my  opinion, but one reliable
 guide.  For  the  Ariadne  thread that leads us out of this
 labyrinth consists in the specific remedy.   From the fact that
 Acid. nitr. cured one  case,  Iodium another, Sulphur a  third,
 the nature of the disease  manifests itself.  Here wTe had  be-
 fore us not only the foundation of a rational therapia, but
 also of a rational  pathology.   Let us remember, however,
 that Hahnemann has laid this foundation.  Hence ex juvan-
 tibus, as we say, we must  infer the syphilitic, scrofulous, or
 any other disease-genus.  Thus we should at once have proven
 the existence of a scrofulous diathesis  where Iodium has
 effected the  cure of  any  morbid process whatsoever.   For,
 among other  affections, lod. cures the indolent infiltrations of
 the lymphatic  glands pathognomonic of scrofula (v.  Grau-
 vogl,  ii, 210).  In this way the  riddle  is  solved, why an  ob-
 stinate gonorrhoea is suddenly cured by the aid of antipsoric
 remedies ;  why, vice  versa, Iodium and  Fer. jodat. are fre-
 quently given in vain (for  the diagnosis of scrofulosis was a
 wrong one);  why a violent neuralgia disappears without any
 trace  whatever upon the administration of antisycotic  reme-
 dies ;  a fact  of which Gallavardin  has recorded remarkable
 examples.  Then it requires no heroic treatment, no altera-
 tive  method, no overfeeding with mercury, no Zittmann's
 cure, either large or small; nay, submissive and gentle as the
 refractory horse when it has found the right rider; the evil
 combated so long in vain takes a turn under the influence of
 the specific remedy.
  As  regards the course—to mention it  by way of  explana-
 tion—we  observe it in scrofulosis  to be  less fixed  than in
 syphilis, the  stability and successive outbreaks of  which can
be stated more easily and almost predicted.   A chancre of
the penis  will  never  return the second  time,  if there has
been no new infection; a  scrofulous ophthalmia may make
relapses, and does,  indeed, as a rule return.   A  scrofulous
ozaena maligna may be cured, but the possibility of a return
is not excluded. 
DYSCRASIA RELATED TO SCROFULA.          43
                      -D.—Rhachitis.
   The fact that the  same conditions which hasten the devel-
 opment  of scrofula occasion rhachitis also, already points to a
 certain  relation between the two.   Among those conditions
 belong, among other things, bad and spoiled air in dwellings.
 On this  account, also, rhachitis progresses most rapidly at the
 time of  spring, while it decreases after the children have ex-
 ercised in the open air during the summer.  In the Southern
 climate  rhachitis does not  show itself.  The nutrition of the
 bones is deficient in this disease, and the trouble depends not
 only upon a want of the salts which might be supplied by im-
 portation from without, but the essence of the dyscrasia con-
 sists in not assimilating the salts of  lime introduced by food.
 Likewise the bone does not soften in its entire diameter, but
 at its surface only.
   Healthy bones are changed in a threefold manner:
   1. By deposits of cartilage-cells upon the periphery.
   2. By ossification of these cells.
   3. By resorption of the layers looking toward the medullary
 cavity, a process by which the cavity gradually enlarges.*
   Cranium, thorax (ribs), pelvis, and bones of the extremities
 are most frequently exposed to the rhachitic process.
   As in scrofulosis,  hereditary influences can frequently be
 proven.  Father and mother usually exhibit, then, the peculiar
 rhachitic shape  of the cranium with very prominent frontal
 and  parietal eminences.
   Rhachitis in children of noble birth (in which cases the bad
 air of dwellings is of less weight as an etiological momentum)
 can  be traced sometimes to a  syphilitic affection (though it
 may have run its course long ago) of the father.
  The rhachitic disturbance of nutrition resembles, moreover,
 the scrofulous in its unexpected appearance during convales-
 cence from diseases of a grave character.
  Finally, the results of allopaths with cod-liver oil, and ours
with Silic, Calc. carb., Acid, phosph., Phos., &c, point to an
essential concordance.
  * The femur of a child can be placed into the cavity of a full-grown femur,
a fact which proves that the infantile femur gradually regenerates itself com-
pletely. 
44            ON SCROFULOUS AFFECTIONS.
                 Pathological Anatomy.

   Although Wunderlich maintains that the blood of scrofu-
 lous persons, and the products of  scrofulosis contain nothing
 characteristic, we must, nevertheless, stop for a moment  at
 the pathological anatomy of this dyscrasia.
   Hypertrophy, ulcerations, suppurations, and tubercles result
 from the scrofulous process. The chronic course is a sufficient
 characteristic of all.   Besides  the transition from one  into
 another, i. e., their  alternate appearance, is peculiar to them.
 In place of the eczema or impetigo an ophthalmia may set in,
 as well as a meningitis in place of lymphatic swellings.
   The lymphatic glands especially degenerate hypertrophi-
 cally ; their cellular elements  multiply—hyperplasia—a com-
 plete resorption is not excluded.
   The  scrofulous ulcer easily  becomes phagedenic,  shows
 itself, aside from its  appearance upon the skin,  upon the
 mucous membranes, and frequently produces hypertrophy of
 the ulcerous tissue.
   It  exhibits the following character: hard, uneven edges,
 which are undermined; it is painless,  and its surroundings
 show a pale or violet shiny redness  ; its bottom is covered with
 some lymph or thin pus;  when it heals, it leaves ufly, deep,
 and hard cicatrices.
   The suppurations generally produce  a serous pus with an
 admixture of caseous elements.
   The scrofulous caries exhibits a combination of ulceration
 and suppuration, which appears in a threefold form:
   1.  Simple caries.
  The bony tissue is infiltrated with blood  and atrophies, but
 the membrana medullaris  hypertrophies.  The purulent in-
 filtration immediately follows the  bloody.  From this results
 a spongious condition of the bone, which  softens, ulcerates,
 and discharges a sanious blackish pus  with fragments of bone.
  2.  Caries with sequestrum,  s.  pseudo-necrosis,  is distin-
 guished from the former by the dying off of  a considerable
piece of bone, and  thus exhibits  a transition-form between
caries and necrosis.
  3.  If we find well-marked deposits of tubercle in the bony
tissue, we have a third  form  before  us, tuberculous caries. 
           DYSCRASIA RELATED TO SCROFULA.          45

The tubercular mass is concentrated  upon one point, and the
bony tissue infiltrated with  it.   In the latter case there ex-
ists simultaneously interstitial hypertrophy, which represents
a kind of ivory-ossification, and ends in necrosis.
  Spina ventosa appears in the  long  bones only, and consists
in hypertrophy of the membrana medullaris, and a consider-
able thinning of  the bony cylinder.  In contradiction to the
negative results, which, according to Wunderlich, have issued
from the analysis of the blood and  pus  of  scrofulous persons,
the  pus  of scrofulous individuals, according  to  Gendrin, is
said to distinguish itself from that of the non-scrofulous by a
larger  percentage of soda, and  chloride of  sodium. Preuss
ascribes to it caseine such as belongs to the tubercle. Finally
it  is asserted, that the urine shows oxalic and uro-benzoic
acids in considerable quantities.
  In persons who have died of scrofulosis, we find the indur-
ated glands changed into  a whitish-gray,  more or less fatty,
and  often almost  cartilaginous mass;  in some cases they  have
changed into the  caseous mass which also  appears in the pul-
monary  tubercle, the  caseous  substance  being frequently
softened in the centre and  transformed into pus.
  However, let us turn as  early as this, even, to the essential
part of our task,  which consists in framing in the special pic-
tures of scrofulosis, in which the remedies soon to be mentioned
find their place, as well as in giving  special  and precise  indi-
cations for  the several antiscrofulosa, and in proving  their
efficacy by clinical examples. 
46            ON SCROFULOUS AFFECTIONS.
                      II.

THE  SPECIAL  FORMS  OF SCROFULA.
               A.—The Cutaneous System.

   The skin, Wunderlich says very truly, is the most sensitive
 organ for constitutional disturbances, and in none of them re-
 mains entirely intact.   The anomalies of the skin, brought
 about by the co-operation of scrofulous  constitutional  dis-
 turbances, appear polymorph with forms well  marked  but
 little characteristic.  It is always  as difficult as important  a
 task to recognize, aside from the local changes, the constitu-
 tional disease lying at the bottom.
   The scrofulous cutaneous affections do not belong either
 among the cutaneous neuroses, or the independent cutaneous
 hyperaemiae;—(roseola,  erythemata, erysipelas-forms) or  the
 anomalies  of  cutaneous secretions—sudori-sebaceous secre-
 tions*—or among the hemorrhages or apoplexies of the skin,
 but may be arranged  most  properly among the exudations.
 These exudative processes upon the skin show very manifold
 forms, which depend partly upon  the nature of the product,
 partly upon the character of the parts principally affected, but
 are inexplainable for the most part.  They appear in a four-
 fold form:
   1.  As noduli, papulae—strophulus; lichen; prurigo.
   2.  As hives (pomphi; urticaria).
   3.  As serous exudations beneath the epidermis—vesiculae
and  bullae—eczematous  forms—miliaria—herpetic  forms__
rhypia.
  * The hordeolum (stye) so frequent among the scrofulous constitutes an
ception. 
THE  SPECIAL  FORMS  OF SCROFULA.
47
   4. As elevations of the epidermis filled with lymph or pus ;
 as pustules—impetigo, acne-pustules—ecthyma.
   Only the two latter exudative forms  are of interest to us,
 here, they being truly characteristic of  scrofulosis.
   The process  in  the development of the eczematous form is
 the following:
   Upon a portion of the skin, more or less hyperaemic, small
 vesicles  appear, which mostly stand closely together,  have
 wratery clear or wheyish contents, and cover a surface indefi-
 nite in form and  extent.  The eruption is generally accom-
 panied by stinging and burning.
   The vesicles  terminate—
   Either by bursting, and lamellose desquamation of the epi-
 dermis ;
   Or by the formation of crusts, more or less thick;
   Or they become chronic  by successive eruptions, and  thus
 occasion a change of the skin, which exhibits intensely chronic
 injections, deposits a very  thin epidermis, never attaining to
 any  degree of density, and shows great inclination  to serous
 secretions. The metamorphosis of the vesicles, last mentioned,
 exactly corresponds  to the scrofulous eczema.  This eczema
 has  also been termed eczema rubrum (in contradistinction to
 E. simplex and  E. chronicum).  However, it always exhibits
 a form  which,  developing with  intense hyperaemia and  cor-
 responding violent burning, frequent and  considerable swell-
 ing of the subcutaneous  cellular tissue  and fever, mostly be-
 falls the face.   The vesicles, having turbid  contents, burst,
 and the cutaneous surface  appears abraded.  This form  fre-
 quently becomes chronic on account of fresh eruptions.
  The eczema  of  the cheeks  may also  be designated as E.
 rubrum, which, on account of its antagonistic relation to the
 uropoetic apparatus, we have mentioned above.
  However, since  genuine eczema  does not occur  very fre-
 quently in scrofulosis, but, in most cases, shows itself in com-
 bination with  serous and  purulent exudations; the forms
 accompanied  by pustular developments are not  of any  less
interest to us, and among these again the impetiginous erup-
tions especially.
  They consist  in small pus-vesicles, which appear in irregular
clusters upon a  surface more or  less  hyperaemic ; soon burst 
48
ON SCROFULOUS  AFFECTIONS.
and, by means of their contents, and in consequence of a con-
tinuous exudation, form flat, thick, firm or friable crusts.
  Sometimes they run through their course rapidly, and heal
up in from three to four weeks; mostly, however, they drag
out for a greater length of time, and become very chronic by
successive eruptions or slow growth of the crusts.
  As concomitants we observe sometimes fever during the
eruptive stage,  and frequently swelling of  the neighboring
lymphatic glands.
  As we have already pointed out, the exudative form, con-
sisting of impetigo and  eczema—eczema impetiginodes, im-
petigo eczematodes—is, no doubt, the  most frequent, though
we must also mention the genuine forms:
  Impetigo erysipelatod.es with prominent hyperaemia ;  located
in the face, especially.
  Impetigo figurata ; round or oval form of the eruption (gen-
erally appearing in  several groups) and of  the crusts  after-
wards  formed, which occasionally become  confluent.  The
latter frequently have a honey-like appearance (melitagra).
They are found mostly in the face, also at the upper extremi-
ties of young persons, and run an acute or subacute course.
  Impetigo larvalis, especially among children ; a chronic form
wTith confluent crusts of  a brown color, or a color changed by
the admixture of dirt.   They cover  the  face  like a  mask
(crusta lactea; tinea mucosa; achores).
  The  milk-crust—crusta lactea—is probably always asso-
ciated with scrofulosis.  This eruption, as is well known, dis-
figures children considerably.   They scratch it, knock against
it, and thus occasion is given for discharge of blood, and pain-
ful and too early detachment of the crusts. The surroundings
of the eyes often participate in* the affection, so much so, as
to make the latter appear crusted over, almost;  though two
blue, unharmed pupils may generally be seen  through the
opening left.   The tender skin is turgescent, and upon laying
the hand upon the inflamed spots of the head and face, a burn-
ing heat is often felt.
  This form of impetigo is not hard  to cure, but its sudden
disappearance  is frequently followed by the  most dangerous
consequences to the health and  life  of  the  child.   Such a
sudden  drying off  of the eruption I have  observed  after 
THE  SPECIAL  FORMS OF SCROFULA.
49
 Silicea (if the eruption appeared  on the head), followed by a
 real withering of the children who, but a short time before,
 were fleshy, and showed no  signs  of suffering from disease.
 For this reason the dose  of the proper  remedy ought  not to
 be repeated too often.*  The worst consequences, however,
 result  from the brusque besmearing and drying out of the
 eruption by means of lead or zinc  salves, and even from the
 external  application of cod-liver  oil, which ought not to be
 thought of here.
   On account of such attempts at  cure a  sudden transposi-
 tion of scrofulosis to inner organs may  happen, no  doubt; a
 fatal pneumonia, meningitis, general marasmus, without any
 visible local disease even, may result.  However, those disin-
 clined  to  believe Hahnemann in this respect, will probably
 believe Hufeland, who says:  " A\re must always try to direct
 the disease toward  the outer parts; cutaneous eruptions we
 ought  not to attempt to  cure."   Hufeland,  of  course, had
 reference to old-fashioned allopathic attempts  at cure.
   Wunderlich mentions  an impetigo scabiosa; an extensive,
 very thick, bark-like  formation of  crusts, frequently spread-
 ing over a whole limb with sanious secretion,  and often with
 ulceration.  I observed this form to run  across the face : hard,
 dry,  now  elongated, now round, elevated  crusts, more  dis-
 seminated, and well marked off from the healthy parts.
   Very often the auricula is affected by such impetiginous
 eczemata, especially in case of simultaneous otorrhcea.  But
 they  appear at  the neck and arms,  even.  Calcar. carb. in
 alternation with Lycopod. is specific.  Now and then Ferrum
jodat. sachar. hastens the  cure in a remarkable manner.
   Impetigo decalvans, with  sure loss of the hair.   (Graphit.
 30; Arsenic 9-24.)
   Impetigo granulata: Scattered  groups of  crusts upon  the
 haiiy parts of the head.  (Silic, Mercur. viv. 3d triturat.)
   Impetigo sparsa: Scattered small  groups of  pustules which
 may be found  on different  parts  of the body  (obstinate).
 (Arsenic.)
  * Next to Silic, Calcar. is to be considered, especially if the children are
pale, and suffer from habitual diarrhoea.  Sulphur in case of a large abdomen
and constipation.
                             4 
50
ON SCROFULOUS AFFECTIONS.
   Impetigo rodens: Phagedenic, enlarging ulcers, covered with
 crusts which, however, very rarely occasion any loss of tissue
 in depth.   (Kal.jod.)
   More frequent and, hence, more characteristic of scrofulosis
 than most of the impetiginous eruptions last mentioned is

                     Blepharitis ciliaris,
 which rightfully finds its place here.
   The inference as to a relation existing between the two is
 already justified for the two reasons that Silic. is just as effi-
 cacious  against blepharitis as  it  is against those  impetigo-
 forms upon the hairy portion of the head, and that, moreover,
 scrofulous persons are affected by both diseases so exceedingly
 often; inflammation and deposits of a plastic exudation into
 the connective tissue surrounding the glands of  the hair-bulb
 are, likewise not absent,  and  the crumbling, friable, dirty-
 colored masses agglutinating the ciliae distinguish themselves
 in nothing from the product of  genuine impetiginous erup-
 tions.   However, homoeopaths need  not ask with  anxious
 care, whether this form more deserves the name of impetigo
 figurata, or that should be called larvalis, &c, rather.  Such
 a pedantic  classification would be of profit  only if  a fruitful
 therapia could  be based thereupon.  But  the  latter is very
 rarely the case with professional dermatologists.  As regards
 the contradistinction  between homoeopathy and those gentle-
 men, we may  say, perhaps, that it  resembles that between
 Jussieu's and Linne's system.  We do  not  care any for the
 artificial nosological name which was obtained only by start-
* ing from this or that arbitrary principle of  classification, but
 wTe do care, above all, for  the natural relation of the several
 diseases among themselves; we search for  the  complexes of
 disease-phenomena, and compare them with similar  complexes
 or pathological pictures.  Thus the local reflexes of scrofulosis
 are to us but points of support, hints and guides for remedies,
 more  or less universal, eradicating the  evil.*  The concomi-
 tants  of the scrofulous exanthema are considered, at the same
  * For:  " Les lesions de texture sont la manifestation anatomique et sensible
de la maladie; mais la maladie dans son essence et son point de depart est
toute dynamique." 
THE  SPECIAL  FORMS OF SCROFULA.
51
time, and have an influence upon the selection of the remedy,
often more decisive than the anatomical region of the erup-
tion.  The slaves of nomenclature  never were great thera-
peutists.
  We will yet mention that ophthalmologists  speak of a
crusta lactea palpebrarum.  This eczema of the lids  appears
by itself, or in company with facial eczema.   The small vesi-
cles  filled  with a yellowish  liquid  burst, the secretion  ex-
coriating the neighboring parts ; crusts are forming, and fre-
quently the entire lid appears  to be  one ulcerated  surface.
From the complications  of this palpebral eczema which may
possibly occur together with blepharitis ciliaris, inflammation
of the  lid-glands, the close connection of these eruptive dis-
eases with the scrofula diathesis is plainly evident.
  For this very reason we  will interpone at this place the de-
scription  of this frequent  scrofulous localization, i. e., of ble-
pharitis ciliaris, and  not where we speak of the affections of
the glandular system or eye.
  The common inflammation of the glands  of the hair-bulbs
of the lids, blepharitis, more corectly blepharadenitis ciliaris,
is said  to affect the  upper  lid  most frequently, is mostly
bilateral and characterized by redness, swelling, and inclina-
tion to punctiform abscesses in the  edge  of the lid.  The
edges of the lids, on account of the plastic  exudation deposited
into the connective tissue surrounding the glands, assume a
tuberous, knotty shape and firmness.  At the beginning, fine
scales, dependent upon an  increased secretion  of  the glands,
show themselves around the basis of  the several ciliae which
may be observed as surrounding the latter  in ring-form, and
when detached, as adhering to them in the form  of circular
scales.   After the detachment the bottom around the cilia is
slightly excoriated and  even bloody, and encircled by very
minute  vessels.   If no resorption takes place, the edges agglu-
tinate during the night and photophobia sets in, which grows
more and  more intense; the eyes  tire  out by working  at
thinsfs near.  Now commences the formation of abscesses not
in the glands of the  hair-bulbs, but in the connective tissue
enveloping them ; the hair-bulbs remain intact until displaced
by oft-recurring inflammation, suppuration  and cicatrization
of their glands and the adjacent tissue; they are deprived of 
"52
ON SCROFULOUS AFFECTIONS.
nutrition, degenerate, decay, and are cast off.  Thus originates
trichiasis madarosis and, by subsequent deposits of plastic or
indurating exudations, tylosis;  in the lower  lid, ectropium.
Hyperemia of the conjunctiva  palpebrarum  and blepharo-
spasm accompany the more profuse secretion of the mucous
follicles  and Meibomian glands;  the  tears,  secreted more
copiously now, corrode the sore places freed from the  crusts :
the tears being collected behind the ectropic and hypertrophic
lower  lid, make  the  eye appear as if it were swimming in
water ; the puncta lacrymalia close up, or located more  out-
wardly,  do not extend any longer into the lacus lacrymarum,
and the tears  flow over the cheeks (epiphora).   At  a later
date tarsomalacia and deformities of the cartilages, ectropium
and epidermoid degeneration of the conjunctiva of  the lids
appear as complications of the former.
   Another  complication consists in the so-called asthenopia—
decrease  of energy in the ciliary nerves of the  eye—Romberg—
anaesthesia  with subsequent  optic hyperesthesia, which re-
quires the use of blue spectacles.  According to Begin, intent
looking, when doing fine work, is said to be  the etiological
momentum of it.*
   Aside from  the glands of the hair-bulbs of  the  lids, the
sebaceous  glands of the lids are extremely often affected in
scrofulosis, from which  the well-known styes — (hordeola) (
originate.   The hordeolum is neither a furuncle (since it does
not" discharge a cord and leaves no cicatrix), nor an inflam-
mation of the Meibomian glands (Desmarres,  Juengken), nor
of the glands of the hair-bulb mentioned before (Leis).  The
hordeolum has nothing to do, moreover, with the  chalazion
 (a tumor seated in the cartilage of the lid), or the milium, a
 nodulus originating in the sebaceous glands of the skin.   We
 o-ive these researches of more  recent observers  more for the
 sake of  completeness, than for the reason that the nice discus-
 sion upon the  essence of the  various processes in the lid will
 be of any influence upon our therapeutics.   For, aside  from
 the fact that several of the affections named  may be present

   * The author experienced on himself that even after protracted reading of
 small type—a number of the Berliner Volkszeitung—at dusk, a complete
 hordeolum developed within a few hours.  To the  subjective predisposition
 an objective cause must apparently always correspond. 
            THE SPECIAL FORMS OF  SCROFULA.          53

 simultaneously, and, according to experience, often are pres-
 ent ;  it must suffice for  us  to know  whether a suppurative
 process is  to be expected or not, and to this  our  therapeutic
 attention directs itself.   Whether the sebaceous, Meibomian,
 or hair-bulb glands, are  the seat of  the abscess, &c, is evi-
 dently of but little importance ; for, upon the strength of this
 one fact we  should  not be able to prefer Mercur.  to  Silic, or
 any  other remedy,  hastening the' suppurative  process, to
 Hepar.  Other  indications determine the selection  of  these
 several remedies.   As a  rule, the common stye always heals
 under the administration of Sil. (6-30) from one to two doses
 daily, according to the acute character of the case.
   Next, the cutaneous tubercle comes up for consideration.
 It consists in infiltrations of the cutis which owe their origin
 mainly to scrofulous constitutional anomalies—disturbances
 in the return of the blood and lymph.  Mechanical, local inju-
 ries, are sometimes  the  cause of the formation of such cuta-
 neous infiltrations.   The spot is mostly elevated, of a red or
 brown color, circumscribed and resistant.
   Cutaneous tubercles heal with difficulty by resolution, fre-
 quently under exfoliations, and with subsequent cicatrix-like
 contractions,  or after previous  softening and  formation of
 pustules; but they often persist for years, and may give rise
 to superficial or deeper ulcerations.  The several forms  to be
 distinguished are:
   1. Acne-tubercle (acne  rosacea, mentagra).
   2. Lupus, located most frequently in the face, especially on
 the nose  and cheeks.  Both do not belong among the  char-
 acteristic,  scrofulous eruptions.  Of  the lupus-forms, prob-
 ably the  one described as  lupus elevatus non  exedens  does.
 The noduli appear here above the level of the skin in groups
 as elevations of the  size  of  a  lentil, are  flattened, and, at a
 later period, become confluent, and show a yellow, red or red-
 dish-brown color.   They  are of moderate consistency, gradu-
 ally form plateaus or wall-like elevations from  \'" to 2'" in
 height, which, however,  are furrowed by incisions;  the epi-
 dermis detaches itself upon their surface, yet becomes more
and more dense, scaly, even  crusty, especially if some of the
spots  are discharging.  The affection spreads by new groups 
54
ON SCROFULOUS AFFECTIONS.
of tubercles at the periphery, while the older remain  as they
are, or sink in and dry up, forming cicatrices.
  Among  the remedies  against  acne-tubercle  (especially
against mentagra) as well as against the lupus-forms, Arsenic.
and Caustic deserve  the greatest confidence, Clematis against
simple acne, papule, and sycosis.

  Next to the cutaneous tubercle come the deep suppurations
of the skin, standing midwaj^s, so to say, between the pustular
forms and the infiltrations of the  cutis.  As principal repre-
sentation of the deep suppuration  of the skin,

                  Die Boil—Furunculus,
may be named.   It  plays a decidedly double role in scrofu-
losis.   It appears sporadically, i. e., at shorter or longer inter-
vals  separate boils develop, which signify that something in
nutrition is at fault,  be it  called a  humor or miasma scrofulo-
sum, or by any other name whatsoever; in short, the furuncle
most surely carries away certain cinders of the blood, or some-
thing else not beneficial to the entire econonrv; or (in  view of
the same aim) a rising en masse of boils, so to say, takes place.
We could call them a monster demonstration of scrofulosis.
The  whole body  is  covered  with boils more  or  less.   The
critical  nature of this eruption is to be doubted still less; for
it is preceded by a  general decline, dependent, as it seems,
upon scrofulosis of the mesenterial glands.  After emaciation,
increasing to a skeleton-like  appearance with aged look, has
preceded  for weeks, nutrition is entirely prostrated,  and
atrophy has reached its highest degree; the  organism  still
succeeds sometimes  in producing a  restitution of the inner
organs by the development of those furunculous inflammations
en masse.   Aside from  genuine boils, knotty abscesses, espe-
cially beneath the scalp, with a sympathetic affection of the
swollen lymphatic glands, are not a very rare phenomenon,
and undoubtedly  of a purely critical  nature.  We always suc-
ceed with Silic. in maturing the single boil, the breaking of
which  may be  preceded by violent pains and chills.  If the
treatment of the  multiple furuncle takes place  after a grave
internal disease, Sulph. 30 is preferable, or indicated, at least,
after Sil. 
            THE SPECIAL FORMS OF  SCROFULA.         55

  If the boil is located at the upper  eyelid, the latter is fre-
quently attacked  by  phlegmonous  inflammation,  and the
pains reach the highest degree.  Discolored, livid look, firm
swelling, often as  hard as a board,  and fever.   Here Mercur.
sol. and Acid.  nitr. are well indicated after Bellad.  In case
of threatening gangrenous decomposition, Arsenic (Apis, Carb.
veg., Laches.).
   The course  of boils, upon the whole, is too well known to
spend a single word on it. The exudation, consisting of a lump of
coagulated fibrin (cord), which is mixed with fragments of tis-
sue, and pervaded  and covered with blood- and pus-corpuscles,
is essential.  The  cord, at the beginning still  intimately con-
nected with the adjacent tissue-parts, becomes detached by
progressive suppuration; simultaneously the swelling increases
still more, the upper  layers of the skin are consumed and
break, and, on moderate pressure, the cord-like mass together
with a bloody pus, is evacuated in toto, leaving a cavity which
closes up within a very  short time with a small punctiform
cicatrix.
   Very often, however,  a general abscess develops from the
original furunculous inflammation, the breaking of which is
preceded by distinct fluctuation, a  circumstance under which
the characteristic  appearance of the cord cannot be reckoned
upon.
   But few affections of  the cutis and its appurtenances, pre-
ponderantly belonging to  scrofulosis, remain  for discussion
now.
                        Intertrigo.
   The detachment of too young an  epidermis, on places where
the  skin forms folds  and recesses,  can scarcely be attributed
always  to  uncleanliness and fleshiness, especially as the se-
creted smeary-mucous, often incrusted, now and then sero-
purulent or offensive  mass,  as  well as the obstinacy of the
affection in single  cases, and its extension with general fiery
redness of the skin, sufficiently point  to the specific signifi-
cance of the  trouble.   Intertrigo  will hardly  ever owe its
orio-in to simply mechanical  conditions; against this argues,
on the one hand, its appearance upon one side only (e. g., under
one arm), and its  transition  into other, for instance, herpetic
exanthemata. 
56
ON SCROFULOUS  AFFECTIONS.
  This shows the irrationality of treating, or driving away in-
tertrigo, with exsiccating salves or powders, such as Lycopod-
powder, starch-powder, &c, which answer the same purpose.
  On the other hand, Lycopod., in a homoeopathic preparation,
given internally, has proved its efficacy, we may say, perhaps,
in a very singular  manner.  Yet where it  has already  been
used externally, we must give  Sulph., or another remedy cor-
responding to the complications of the trouble.
  Next to intertrigo come the species of pityriasis, which, in
a strict anatomical view, likewise represent an anomaly in
the formation of the epidermis which may be referred to a
disturbance of nutrition.
  Since the connection between pityriasis and scrofula appears
to be less  evident than that  of intertrigo,  we pass on, at
once, to
                         Psoriasis.
  In  districts (cities) where scrofula is endemic, as it  were,
children are brought to us now and then, who are affected
over the whole body with a scaly eruption.  The epidermical
lamelle, which can be  detached  very easily, lay upon a red-
dened bottom.   Many spots, on account of their easy bleed-
ing and watery discharge, remind one of eczema or impetigo,
though they must not be counted  among them.  The  possi-
bility of  a sudden  spreading of the exanthema, its  power
for luxuriant growth, and the want of preference for certain
localities, are characteristic of it.  On the contrary, psoriasis,
leaps or creeps hither or thither, occupies the face as well as
the lower extremities, abdomen, calves, &c.  It seems incom-
prehensible, how authors of name, on the one hand, admit of
a hereditary predisposition to psoriasis, on the other, attempt
to refer its existence to local  causes (with bakers, storekeep-
 ers, &c.) to taking cold, the use of highly  seasoned food, and
 then again to depressing affections of the brain.
   We  need not stop at  the  origin of  the several species of
 psoriasis from small, round,  disseminate, rose-red spots, &c.
 We  take  the  picture in its full development, and point out
 that to psoriasis of the scrofulous—and this only interests us
 here—Arsenic, most frequently corresponds homoeopathically;
 next Graphit. (hence the specifics against eczema rubrum), and
 Causticum. 
THE  SPECIAL  FORMS OF SCROFULA.
57
   We have no right to treat of scabies here, since it appears
 wTherever the acarus has access; we will, however, not omit
 the remark, that dyscratic, hence scrofulous individuals, even,
 are more exposed to the influence of the acarus, and are visited
 by more obstinate consequences than healthy  persons.  Be-
 sides, we direct the attention  to our remarks in our treatise
 on Sulphur as a remedy against scrofulous diseases.


                   Favus—Tinea favosa.

   Favus, considered though it is by many dermatologists as
 solely depending upon vegetable parasites, just as plica polonica
 is declared by the most short-sighted natural philosophers to
 be but a local disease of the scalp, may certainly be  looked
 upon more  correctly as the expression of a scrofulous consti-
 tution.   Cazenave is very right in asking the question:  " If
 the disease were a formation of microscopical fungi, how,
 then, can favus disappear so suddenly during the course of
 pleuritis or typhus ?   Besides, how can a favus pustule around
 a hair give rise to other pustules in places where no hairs are
 to be found?"  If the hair is not essentially necessary to this
 evil, why does  the contagious  favus not  always spread over
 the skin more and more? (Prag. Viertelj. 5, Jahrg. iv, s. 59.)
   Favus, in its fully developed  form, presents a crust of gray-
 ish-yellow color, round shape, and mealy consistency, which is
 depressed in the centre, confluent, almost pustular without
 containing any pus, however, and has a smell resembling that
 of the urine of cats.   Each crust is built up from a countless
 number of fungous bodies and fibrils.
   These formations  are inhabited not  unfrequently by lice,
 occasion other  eruptions, excoriations, and ulcerations, ruin
 the hair, and produce infiltrations into the lymphatic glands
 of the neck.
  If we add that such patients  grow dull gradually, and their
 mental  development stands  still, we have reason to  rejoice
 over the fact that homoeopathic literature, at least, can show
reliable and real  cures, while the allopathic school confines
itself merely to mechanico-surgical assistance.
  Let us briefly recapitulate the  therapia of scrofulous cu-
 taneous diseases, in order to make some additions by way of 
58            ON  SCROFULOUS AFFECTIONS.
  complement.  " We ought to make no  attempt at healing
  eruptive diseases."  In these words of the ingenious Hufeland,
  already quoted above, the danger which an external treatment
  of scrofulous cutaneous  affections would have in its trail, is
  hinted  at.  We  homoeopaths  do not abandon, however, a
  specific internal treatment.  Our curative  apparatus  is ex-
  ceedingly simple, notwithstanding; we pay principal  atten-
  tion to the locality of the eruption, and  to  its dry or serous
  or purulent character.   Thus Arsenic, corresponds in most
  cases to the scrofulous eczema (E. rubr.). Two drops of the
  sixth or second dilution in  twelve teaspoonfuls of water, a
  teaspoonful morning  and evening, suffice.   In case of  simul-
  taneous obstruction, and when  the hairy scalp is affected, at
  the same time, Mercur., Silic, and Graphit.  (the eruption be-
  hind the ear being characteristic of the latter remedy).
    Ferrum jodat.  is required generally  at  the close  of the
  cure.  If the intensely itching  spots bleed easily, Nitr. ac is
  preferable to Arsen.
    Eczema impetiginodes (eczema with  purulent  discharge)
  requires Hep.  sulph.  calc, the  characteristic  indications of
  which  Hirschel enumerates  in  the interesting case of LVII,
  or Cede carb., if the face is attacked (XXXIX), or Mercur.,
  if the   hairy  scalp  presents  one purulent surface  almost
  (LXXXVI).  Besides Hep. sulph. calc;  Sulphur claims the
  same importance (CXII and CXXVII).  Even if the cure re-
  quires  weeks, the remedies mentioned nevertheless deserve
  more confidence  than  the  vegetable  drugs,  among  which
   Viola  tricolor  enjoys the reputation  of a specific against
  Crusta  lactea  (CXXXIII).   The same remedies come up for
  consideration in blepharitis ciliaris, characteristic on account
  of its frequency among the scrofulous.   Here,  however, Silic.
  most surely deserves preference to Arsenic, so important in the
0 most obstinate eczematous eruptions.   On the  other hand, be-
  sides Silic; He par. sulph. calc, as well as Merc, are indispensa-
  ble in many cases.  In complications with styes (suppuration
  of one  or more sebaceous glands of the lid),  Sil. is likewise in
  place, to mature the small abscesses.   Graphit, in case of in-
  tense photophobia, sensation of heaviness  of the lids, and itch-
  ing of  the edges.   Graphit, moreover, removes the predispo-
  sition to styes. 
            THE SPECIAL  FORMS OF SCROFULA.          59

   Mention  has already been  made of the therapia of the cu-
 taneous tubercle (Arsen., Caust, besides Silic, sometimes en-
 tirely corresponding  to facial eruptions in general, CI), and
 thus we proceed to the deep  suppurations of the cutaneous
 integuments, so frequent in the life of scrofulous individuals.
 These suppurations appear in an isolated form as furunculus
 or carbunculus.  The expulsion of the characteristic fibrinous
 exudation (cord), or the hastening of the abscess (at the spot
 of the  original boil), again is brought about best by Silic;
 Sulph. or Mercur. suits better for certain individualities.  A
 comparison between the pathogenesis of these minerals related
 in their action, presents the more minute differences.   Silic.
 seems to correspond  more  to mature age (to scrofulosis and
 arthritis), Hepar to childhood  alone  (genuine  scrofulosis),
 Mercur., probably, to scrofulosis upon an originally syphilitic
 bottom.  These criteria regarding the administration of these
 suppurative remedies mentioned, would apply then not only
 to blepharitis ciliaris, but  also to all other cases.  AVe will,
 however, not anticipate.
  One word more only as regards Rhus.  Rhus toxic, produces
 a pure form of eczema, and has proved itself  a remedy, espe-
 cially for that  form of it appearing at the nape of the neck.
 A complication  of scrofula -with rheuma would, moreover,
 direct the selection to Rhus.  The same holds good of Caustic,
 to which the purulent crusty forms of eruptions correspond.
  In tinea favosa which we mentioned lastly, Arsenic, with
 its faculty of destroying parasitic life, deserves consideration.
 Compare extracts taken from its pathogenesis.  Finally, we
 will  mention cod-liver oil which, according to Kafka, is indi-
 cated in all scrofulous skin diseases, combined with  exuda-
 tions, hence, in eczema, impetigo, kc.
  It cannot be  too strongly impressed that one remedy does
 not always correspond to the entire morbid state.  If we be-
 lieve, however, that our selection has been a correct  one, it is
better to change the dose than the remedy.  Moreover, in the
fact  that the cure does not always succeed with one remedy,
the reason is to be found, why certain  remedies marked out
as antiscrofulosa, are  represented by but few  cases, compara-
tively.  For reports,  clinical  observations with  one remedy
only, are suitable. 
60
ON SCROFULOUS AFFECTIONS.
           B.—The Muco-Membranous  System.

  The mucous lining of the organs of sense, of the eye, ear,
nose, and mouth, is predominantly affected.  Simultaneously
a secretion takes place  of so acrid a  nature as regularly to
occasion the  development of an eczematous eruption in the
neighboring locality.  Thus the catarrh of the nasal mucosa
produces an eczema in the surroundings of the nasal openings
and upper lip, that of the meat, audit, ext. an eczema on the
lobe  of the ear or its surroundings ; that of the conjunctiva,
an eczema of the cheeks; that of the gums, an eczema of the
corners of the mouth or the chin, but also that of the intesti-
nal tract, soreness of the anus.
  The traditional  antiscrofulous cures wdiich began with a
purification of the prime vie (Hufeland) probably owe  their
origin to this fact.  It was believed, a tout prix, that too much
acidity, or  too much mucus was the cause of scrofulosis.
  Aside from the mucous lining of the anatomical auxiliary
apparatuses of the organs of sense, the mucosa of the air-pas-
sages, tractus intestinalis, and genital organs is affected.  In
these affections we must not lose sight entirely of the  prin-
cipal  special  forms.  At first we will  speak, however, of the
organs of sense.

                  I. ORGANS OF SEXSE.

           1. Scrofulous Inflammation of the Eye.

      (a.) COMMON SCROFULOUS OPHTHALMIA.

  There is hardly a disease which, in its appearance and course,
is so well fixed  and conservative as  scrofulous ophthalmia.
For this reason it can be recognized at a glance, and needs no
elaborate diagnosis. Who would not remember-that children,
thus affected, anxiously avoid  the light, spasmodically close
the lids, and, when yielding to the friendly persuasion of the
physician, are able to open the eyes only with a simultaneous
discharge of acrid, corrosive tears. Agglutination of the lids,
redness, intense vascular injection of the eye, formation of
pustules (the disease being called, therefore, pustular ophthal- 
THE  SPECIAL  FORMS  OF SCROFULA.
61
 mia) do not  fail to appear.   Mostly we observe an unclean
 complexion, thick nose, blonde hair, and other signs of a scrof-
 ulous habitus.   Besides, the affection has a great tendency to
 relapses.  Under improper  treatment  it  may drag out for
 months.  Some children, notwithstanding the existing spasm
 of the  lids and the intense photophobia, attain to a certain
 dexterity in recognizing  objects of their  surroundings by
 winking.  Others squat for  days in  corners, and become al-
 most brutalized, giving way, as they do, to the incontrollable
 desire of searching for dark localities.
   It is not practical, although ophthalmologists do so, to sep-
 arate scrofulous conjunctivitis from  keratitis.  They appear
 too  often simultaneously, too frequently run into each other,
 and together form that scrofulous ophthalmia so common now-
 adays.
   If the conjunctiva is attacked, the affection locates mostly
 in the  conjunctiva sclerotice, not far from the edge of the
 cornea, around  which the exanthema often  appears in the
 shape of a rosary.   There appears at first a  circumscribed,
 dense, vascular injection, in the centre of which almost always
 a plastic exudation, resembling now a pustule, now a nodulus,
 may be observed at an early hour, and toward which a rami-
 fication of vessels of triangular form, with the basis looking
 toward the  orbita, develops itself sooner  or later  (" scrof-
 ulo-vascular  ribbon").  If the  exudation  is  deposited  very
 superficially, it  is soon discharged in an outward  direction,
 leaving, however, superficial ulcers of small size and unclean
 appearance; if the exudation is  situated deeper, the ulcer be-
 comes deeper and  more obstinate.  If the exudation is de-
 posited evenly over the cornea, it does not break so easily, and
 is more apt to occasion pannus scrofulosum.
  It suffices to remark that the origin of the vesicles is nearly
 the  same in scrofulous keratitis.  A reddened  spot in the
 cornea, the vessels of -which  communicate with those of the
 conjunctiva, and in which a few days afterwards a vesicle of
 a dirty-grayish color, as large as a millet-seed, develops itself,
above which the epitelium appears to  be loosened, shows itself
now, and is accompanied by photophobia, more or less intense,
discharge of tears, and injection  of the conjunctiva.   If there
is but one vesicle present, it  is apt, by depositing  a greater 
62
ON SCROFULOUS AFFECTIONS.
quantity of plastic exudation, to enlarge to the size of a hemp-
seed, which appears clear  at first, but later becomes  cloudy
and  thickish, and breaks  sooner  or  later according  to  its
being imbedded more superficially or deeply. If the epitelium
only had to be perforated, a clean superficial ulcer forms with
an inclination to heal up soon and completely.   If the exuda-
tion  is deposited more deeply, however, a dirt}T-grayish  ulcer
is produced, in the lardaceous  edge and bottom of which a
fine ramification of vessels may be  observed by  aid of a mag-
nifying glass.   In case of a favorable course, these ulcers may
heal very well, but if the disease has progressed so far, as not
only to crowd the fibrils of the cornea out of their position,
but also to destroy them, the  cure succeeds only under the
formation of cicatrix-tissue which occasions a lasting opacity.
If the ulcers remain for some time in the state of purulent
secretion, they not only increase in width, but also in  depth.
As consequences  we  observe,  then,  partial softening and
pouching out of the cornea by the contents of the eye-chamber
(keratoconus), or perforation  and its results; discharge of the
liquid  of the eye-chamber,  prolapse of the iris, &c.
  The latter eventualities  have to be marked out, especially
in order to  place in proper  light the value of  homoeopathic
treatment, so specific against scrofulo-pustular ophthalmia.
  The following we quote  from Dr. Boyer's prize essay: " On
Scrofulous, Herpetic, and  Rheumatic Ophthalmia, and their
Homoeopathic Treatment."
  Prof. Velpeau  sees in  every scrofulous inflammation  a
simple one only; according  to Boyer, however, the  three
kinds  of ophthalmia have  only the chronic course  (in Hahne-
mann's sense, s. Organon, § 78) in common.*

                  Scrofulous Ophthalmia
Boyer divides into:
   1. Genuine Scrofulous Ophthalmia, which shows itself either
as conjunctivitis scrofulosa or as scrofulous sclerotitis (termed
also scrofulo-rheumatic,  i.  e., a kind of conjunctivitis attack-
ing both sclerotica and cornea).

  * According to Mackenzie,  ninety out of a hundred cases of ophthalmia of
children are scrofulous ophthalmia, and this well-marked and  characteristic
disease is not seldom the first manifestation of scrofulosis. 
THE  SPECIAL  FORMS  OF SCROFULA.
63
  2. Non-vascular, Primitive Keratitis.
  3. Scrofulous Blepharo-adenitis.
  Terminations of Scrofulous  Ophthalmia.—1. Cure, reso-
lution ;  under proper  homoeopathic treatment  the usual ter-
mination.
  2. Transition into the chronic form.
  3. Ulceration (of the superficial, middle or deeper layers).
With the  aid of an  oblique illumination by means of a bi-
convex lens, the superficial formation of ulcers, even, may be
observed.  As long as their bottom remains shiny; the ulcers
increase in depth, and  photophobia, watering of the eye, and
blepharospasm are  intense.  If  the bottom of the ulcer be-
comes opaque,however (devient legirement opaque); cicatriza-
tion begins.  The rheumatic ulcera cornee are more exten-
sive (in periphery), and have uneven edges.
  Now and then acute ulcers become chronic.   Boyer cured
a case, which  showed twelve  ulcers on the cornea, with
Plumb, and Acid nitr.;  hypopyon and  iritis existed simul-
taneously.*
  Desmarre's ulcus perforans usually has its seat in the centre
of the cornea.
  4. The opaque staphyloma is  said to  be  a termination of
scrofulous ophthalmia.  It is produced when, during perfora-
tion of the cornea,  the latter softens all  over; it is of conical
shape.   In consequence of it the cornea becomes fibrous, non-
transparent, sclerotica-like.
  5. Pannus (vasculaire) is developed when the acute symp-
toms disappear, and it changes  the cornea  sometimes into a
scarlet-colored membrane.
  6. Formation of  abscesses between the fibrils of the cornea
and discharge of pus outwardly  or inwardly (hypopyon).
  7. Iritis, rare, and then always after preceding perforation.
  We deem it in place to make some remarks at this junc-
ture on Boyer's non-vascular primitive keratitis, especially as
the present text-books contain  nothing thereupon; at least
nothing of a precise character.

  * He cured a case (within a month), in which five ulcers had already formed
upon each cornea, with Silic. and Acid nitr. 
64            ON SCROFULOUS  AFFECTIONS.
  The development  and course  of  this inflammation of the
cornea without vascular formations is exceedingly slow, last-
ing months and years, even.
  Symptoms.—The cornea shows a slight opacity, which soon
communicates itself to the whole cornea.  The  latter, there-
fore, has an opaque coating, similar  to  glass that has been
breathed upon.  Interlamellose thickening of a dirty-white
color, which seems to inclose  one or more vessels, gradually
takes place.  At other times wTe observe real bloody exuda-
tions  of various extent which  are resorbed gradually, i. c,
the red-looking exudations become greenish and form a spot
often unremovable.
  Sometimes the  several exudations into the cornea may be
demonstrated, while  the parts  between  them remain trans-
parent.  These spots are likewise hard to remove.
  This  form  of keratitis is, now and then, entirely confined
to the cornea, though the sclerotica always  exhibits a  bluish
tint around the edge of the cornea, yet the remaining portion
of the membrane scarcely shows a rosy shine.   The conjunc-
tiva palpebrarum remains intact, the mucosa bulbi exhibits
but a slight injection in the circumference of the cornea. At
a later date the outer membranes and iris  become inflamed.
Exudations upon the capsula follow, which may be recognized
by a comparison with  that portion of the cornea remaining
transparent.  The cornea itself softens,  and assumes  a form
more  or less conical.   This kind of affection rarely ever ends
in ulceration.
  It may also happen that the  acute phenomena disappear,
the exudations become  resorbed peripherically, and exhibit
in their centre a characteristic appearance.
  The patients complain of fog before the eyes, but have no
pain ; sometimes photophobia  and watering of the eye during
aggravation.
  In certain  cases, finally, the  retina, also, is irritated, and
the process may terminate in real amaurosis.
  In  most instances digestion is  impaired simultaneously;
the patients are pale, and have lost flesh.  The skin is dry and
colorless.  At times hardness of hearing is connected with it;
oftener  a somewhat hoarse voice and swelling of the submax-
illary glands. 
            THE SPECIAL FORMS  OF SCROFULA.          65

   Prognosis unfavorable on account of the residues mentioned.
   Yet, we are able sometimes, at  least, to resorb the exuda-
tions by homoeopathic remedies.
   Terminations.—1.  Resolution ;  rare, slow, and difficult.
   2. Spots upon the cornea (usual termination).
   3. Staphyloma, very seldom fully developed.
   4. Amaurosis.
   5. Adhesions of the iris to the  capsula are frequent, since
 the iris often partakes of the inflammation.
   The third form of scrofulous ophthalmia, blepharitis ciliaris,
 we have duly considered above.
   The therapia of scrofulous  ophthalmia is satisfactory, if we
 consider that the most torpid cases  have been cured by Calc.
 carb.; now and then, by Calc jodat, Hep.  sulph. c, Acid.
 nitr., and Arsenicum.   Mercur.,  Sulphur., Graphit. occupy
 second rank,  probably.  Calc carb. is most efficacious in dilu-
tions from the 12th to the 30th.  Arsen. and Acid. nitr. cure
those cases in which an excessive irritation of the lachrymal
ducts exists.   Ilepar  is highly praised  (applied externally
also), by colleague  Teller, of  Prague, as a specific against re-
maining spots and  opacities of the cornea.*   It has also been
observed, moreover, that  upon the administration of Apis,
Senega, Baryta, Aurum, and  Bromium, the cornea  rendered
non-transparent  by exudations (keratitis  parenchymatosa)
becomes transparent  again.   Rhus  and  Caustic, would  cor-
respond, probably, to  the  simultaneous rheumatic diathesis,
the presence of which proclaims itself by a more intense af-
fection  of the fibrous sclerotica.   Ulcerous  processes come
within the sphere of Silic  and Acid. nitr.
   As regards the time, Bellad. (6th dil.)  would  be  the most
beneficial remedy in the (first) inflammatory period.  Later,
eight doses of Calc. carh.30 (one dose daily).  If this does  not
suffice,  we shall, probably, be undecided between Acid,  nit
and Arsenic,  to return, finally, however, to a preparation of
lime, either Hep. sulph. c. or.  Calc.  jod. or again Calc. carb. in
a different dose, according to the individuality of the case.

  * Internally the 3d trit. of Hep. sulph.. calc. (morning and evening) has
done, in my hands, extraordinarily good  services  in subacute  cases  with
simultaneous agglutination of the lids, intense photophobia, and formation of
ulcers.
                             5 
66            ON SCROFULOUS  AFFECTIONS.
   We shall be astonished at the superfluity of all adjuvants,
 allopathically considered indispensable, such as leeches, pur-
 gatives, counter-irritants, ej-e-lotions, or even the gray mer-
 curial salve, &c.  It is precisely in scrofulous ophthalmia that
 the natura  medicatrix,  if rationally aided,  produces almost
 miraculous  results.

               (b.) OPHTHALMIA NEONATORUM.
   Since infants, preponderantly scrofulous, are exposed to this
 disease, for  which reason it reaches its highest degree of ma-
 lignity, we will make the following remarks upon it.
   The inflammation appears either as a sporadic, an epidemic,
 or an endemic affection.   Predisposition (to psora), bright
 light, taking cold, infection of the eyes by impure  substances,
 especially by vaginal secretion—fluor albus—during  the pas-
 sage of the  foetus through the genitals—as well as direct  in-
 fection from one eye to another, contribute to the full develop-
 ment of the trouble.*
   Small Crusts around the ciliae, and a red  longitudinal stripe
 across the upper lid, which is but little swollen, mark out  its
 beginning.  Afterwards the swelling becomes more intense.
 The edge of the lid becomes red, the conjunctiva palpebrarum
loosened and velvety (on account of papillar  infiltration), and
on opening the eyes but a single drop of a wheyish secretion,
 intermixed  with  yellowish  flakes,  is  discharged,  at  first.
Later, the upper lid becomes intensely red,  often purple, tense,
 and shiny.  The  swollen upper lid  frequently overlaps the
lower entirely (oedema col id. urn).
   At this time a secretion resembling bloody water  signifies
 danger.
   Finally, the secretion  becomes entirely purulent, yellow,
even greenish, and often shows  traces of blood, produced  by
the affection of the conjunctiva.
   The cornea suffers from a subsequent parenchymatous  in-
flammation, becomes opaque, passes into suppuration, forma-
tion of abscesses, perforation, &c, or softens (malacia).  The
lens may drop out, and  phthisis bulbi  take place, even am-
  * Piringers vaccinated with the pus of such children, and obtained positive
results. 
THE  SPECIAL  FORMS OF SCROFULA.
67
 blyopia on  account of  the simultaneous  irritation  of  the
 retina.
   Therapia.—Homoeopathy, we may say without boasting,
 does not know of any termination of so sad a character.  We
 possess  in the red precipitate especially, a  remedy which
 answers nearly all demands  necessary to enable us  to pro-
 nounce it a specific*
   Two grains (0, 1) of the 3d trit., morning and evening (or
 three times daily) suffice even in neglected cases.
   This preparation of Mercury corresponds to the  most per-
 nicious  forms.   With Hep.  sulph. calc, given  in  the same
 manner, and which, probably, still better suits scrofulous in-
 dividuals, I have obtained results not any less favorable.
   Applications of tepid water (small linen compresses) which
 may be covered with a warm cloth, and remain upon the eyes
 during the night, advance the cure.
   In place of the pure water we  may also add to it a few
 drops of the specific remedy.   Thus Acid, nitri and Lycopod.
 in low dilutions (3'd to 6th) have proved themselves beneficial.
 A very efficacious remedy is ten drops of the first dilution of
 Acid, nitri with two grammes of  Spirit, vin. rectif.   Of this
 solution fifteen drops in a saucerful of water to moisten com-
 presses with.   Sulph., Calc. carb., and other remedies are like-
 wise not to be despised.   Yet, I have successfully treated the
 most intense forms of that fearful ophthalmia by the remedies
 first mentioned.  Indeed, these cases were frequently such as
 had been maltreated or  neglected  in  the most inexcusable
 manner, and in which perforation of and ulceration upon the
 highly inflamed cornea gave occasion to fears of  the worst
 kind.
  It is self-evident  that we will treat a slight inflammation
 of the eye by Aeon, or Bellad. (and a few doses  of Calc. carb.
 or Lycopod. at longer intervals), without taking  refuge forth-
with with the precipitate, &c.  The further course of the in-
flammation alone indicates the subsequent selection of that
remedy.
  * We mention here that, according to Adam Fischer, the white precipitate
of mercury (in the form of the Ung. hydr. pracc. albi) is said to be specific
also in common, scrofulous ophthalmia (with the " scrofulo-vascular ribbon"'
called after A. Fischer). 
68
ON SCROFULOUS AFFECTIONS.
  The advice of allopathic ophthalmologists, to wash out the
eyes with lukewarm water  repeatedly (from three to four
hours), and with cold water  in case of intense production of
heat, deserves some notice ; but, on the  other hand, we  are
inclined  to consider the solutions  of  Nitrate of  Silver  (as
strong as 15 grains to Sj) as well  as those  of Sulphate of
Copper, as causes of the many fatal terminations.
  Note.—The chronic, croupous blennorrhoea of the conjunc-
tiva described by Payr in his classical treatise on the diseases
of the conjunctiva (A. H. Z., 78, 71), which appears in form of
an affection of the texture of the corpus  papillare, in conse-
quence of which the conjunctiva assumes a granulated (frog-
spawn-like) appearance, according to the experiences of the
same physician, finds its remedy likewise in Hydr. prcecip.
rubr., a fact that may allow us, probably, to infer a certain
relation between the two diseases.


  2. Scrofulous Inflammation of the  Ear—Otitis Scrofulosa.

  Here we must distinguish two forms:
  (a.) The catarrhal inflammation  of  the meatus  auditorius
externus—otitis catarrh, externa.
  (6.) The muco-membranous inflammation  of the middle
ear; inflammatio  cat. s. catarrhus auris mediae, otitis catarrh.
interna.

       (a.) THE INFLAMMATION OF THE  EXTERNAL EAR.
                  Otitis Catarrhalis Externa.
  Catarrhal inflammation of  the external  ear-passage com-
mences with a slight itching, afterwards burning pain in the
meatus, the pain being ameliorated momentarily by inserting
the finger. While the pain diminishes, a discharge of a serous,
afterwards creamy, flocculent character,  yellowish  in  color
and of sweetish or  ammoniac smell, shows  itself.   Thus  we
observe a process somewhat similar to that of common coryza,
or of a gonorrhoeic inflammation even.  The secretion hardens
at the external ear to yellowish crusts, decreases or increases
periodically, and becomes more profuse during the  night.  If
the  discharge stops, the secretion of ear-wax, thus far absent, 
THE  SPECIAL  FORMS  OF SCROFULA.          69
reappears.   A slight disturbance of hearing is always present,
and roaring in the ears usually.  The membrana tympani, in
the neighborhood of the handle of the malleus, is  reddened.
The inflamed, serous,  infiltrated  lining of  the  meatus  is
loosened in its tissue, covered here and there with small pap-
ule, vesicles or pustules, has a flaky, villous appearance, and
finally swells  up to such a degree as  to make the opposite
walls touch each other; a state of things which sometimes
renders the inspection of the  membrana tympani utterly im-
possible.
   Since the membrana tympani remains unaffected, the prog-
nosis of this catarrhal, aural affection is favorable.   I should
compare it to herpes conjunctive or scrofulo-pustular ophthal-
mia.  If this  analogy is tenable, the remedies against both
affections will be the same.  And, in fact, Calc carb. (besides
Lycopod.,   Mercur., Sulph., Hepar sidph. calc.)  is  in  place
here as well as there.
   Scrofulous otitis inclines  toward  a chronic  course, and
changes, now and then, into genuine blennorrhoea, mostly with
an acrid, offensive secretion.   The membrana tympani  is apt
to lose its lustre and to thicken.  Upon longer duration papu-
lous excrescences may form, now starting at  the walls of the
meatus, now at  the membrana tympani.  The disease seldom
affects originally both ears simultaneously, yet, at a later date,
transplants itself almost always from one ear to the other, or,
perhaps, alternates between the two.
   Hence, the scrofulous  external catarrhs of  the ear exhibit
the characteristic that they do not very easily terminate spon-
taneously,  but drag out  in the form of a so-called otorrhcea.
According to Rau,  in catarrhal otitis, not only perforation of
the membr. tymp.  never takes place, but also no  secondary
inflammation of the periosteum of the meatus, of the mastoid
process, or of  the brain, even  such as are admitted by  many
to occur.  We may infer the scrofulous character of such cases
of otitis, especially  when they set in after exanthemata (scar-
latina ;  measles).
  It is a pleasing sign that  more recent therapeutics  (Rau,
Politzer) warns against the intense cauterizations.  It is true
it  deems injections of metallic  salts (Cupr. acet., Zinc, acet.,
Plumb, acet. and sulph., Argent, nitric.)  to be remedies, yet 
70
ON SCROFULOUS AFFECTIONS.
Politzer himself admits that by means of too strong injections
one obtains a result exactly contrary to that  he aims at, a
more profuse  discharge.*   The injections ought not to occa-
sion any burning.
  Rau deems medicated injections and the dropping of Infus.
chamom., millefolii, Liquamen myrrhe, into  the ears, the
painting of the inner  ear with Bals. peruv., the fumigations
of Mastix, Olibanum, &c, absolutely harmful.
  It is most remarkable, however, that Rau (especially in case
of a simultaneous and offensive discharge) recommends lime-
water, the carbonate of lime being with us the remedy most
frequently applied.

         (b.) THE INFLAMMATION OF  THE INNER  EAR.
                    Otitis Catarrhalis Interna.
  How much this inflammation interests us here is plain from
the words of  the  author mentioned above, who  says: " On
more  careful examination we  shall  usually observe that the
cause of the muco-membranous inflammation of the middle
ear is intimately connected with  a scrofulous  disposition.
There are families in which hardly one member remains free
from this  disease of  the middle ear.   Children of this predis-
position are exposed to  eruptions on the head a'nd face, but
especially  to frequent slight attacks of angina and  coryza,
under  the influence of which  the  disease develops now and
then entirely imperceptibly; or an acute exanthematic erup-
tion, hooping-cough, catarrhal fever, causes a sudden appear-
ance of otit. interna."  Rau, as a rule, regards otit. int. to  be
one of the most frequent disturbances of the ear existing, f
Besides the cavum tympani, the tuba Eustachii, and the pro-
cessus mastoideus participate  in the affection.  The catarrh,
in.fact, is  wont to start at  the tuba Eustach.|   Hardness  of
hearing, which may approach  to complete deafness, more in-

  * This was the case of a pale, feeble child, for whom a representative of the
school of " exact medicine " prescribed 3.0 (say three grammes) of Zinc, sulph.
(to 100 gramm. of water) as an injection.
  f Of 1000 patients, afflicted with aural diseases, he saw 352 who suffered
from inflammation of the mucosa of the middle ear.
  % v. Tscharner, of 200  patients  afflicted with aural diseases, found 62 who
suffered from inflammation of the  tub. Eustach. 
           THE SPECIAL FORMS OF SCROFULA.          71

tense in the morning, and dependent upon changes of weather,
is never absent.  Fresh catarrhal affections (a slight coryza,
the most insignificant beginning of an angina)  forthwith
occasion an aggravation.  The  air-douche, which, in  acute
forms, causes an unpleasant sensation, but improves the hear-
ing almost immediately as soon as  the air  enters the cavum
tympani, alone gives positive information.
  The acute form, almost alwaj's connected with  other ca-
tarrhal affections, coryza, cough, hoarseness, &c, mostly begins
with  hardness of  hearing, roaring in the ears,  sensation of
fulness, and heaviness in the  ear, dulness  in the  head, and
especially with stitches running from the neck to the ear.  In
case of  a milder attack these symptoms  imperceptibly  disap-
pear after a few days with an  increased mucous discharge
from the nose and pharynx, the air entering  sometimes sud-
denly into the reopened  cavum tympani with a loud report.
If the mucus collected in the cavum tympani cannot be evacu-
ated on account of the swelling of the tuba Eustachii, the hard-
ness of  hearing remains not only unimproved, but increases.
Perforation  of the membrana tympani, destruction of the
ossicula auditus, caries of the proc. mastoid, do not belong to
this form, and their enumeration  here  is  owing  to a con-
founding of the trouble with periostitis cavi tympani.


               (C.) PERIOSTITIS AURIS MEDIAE.

  This  affection must also be mentioned here, since as otit.
int. it manifests a characteristic pathological picture, and
there cannot be any doubt as to its independence.   Rau calls
it " the most important aural disease," endangering not only
the organ affected, but  also  life itself.  Usually departing
from the  membrana tympani, and  simultaneously attacking
all  parts of  the middle ear, this inflammation affects, above
all,  the periosteum. Without remaining confined to the mid-
dle  ear,  it passes almost invariably over to the tuba Eustach.,
and the cells of the mastoid process, is  frequently communi-
cated to the labyrinth, and may  transplant  itself to the men-
inges and even to the brain.
  With the commencement of the purulent, exceedingly of-
fensive discharge we always find the membrana tympani per- 
72
ON SCROFULOUS  AFFECTIONS.
forated, sometimes destroyed to a great extent.  In the acute
and chronic form the discharge, coloring the silver probe with
a blackish hue, is mixed with granules of bone, and at a later
date,  the  corpuscula  auditus  may be expelled.  This, how-
ever, does not always occur.   But if the caries makes any
progress, a soft, fluctuating swelling, with the color of the in-
teguments unchanged, appears upon the proc. mastoid, almost
without exception, which, settling in  a downward direction,
frequently  opens  at  a lower  place, whereupon the  destruc-
tion of the bony parts may be ascertained by the probe.  At
the appearance of the purulent discharge from the  meatus,
the cerebral symptoms (vertigo, one-sided pain in the head,
weakness of memory, sleepiness) often disappear temporarily,
and the  hearing often  improves to  a considerable degree.
Notwithstanding, however, the patient is in constant danger,
since fresh inflammatory attacks frequently take place with-
out any cause known, which at times occasion death by apo-
plexy very unexpectedly.
  The disease mostly appearing before puberty, is usually con-
nected with a scrofulous diathesis; so that the latter has to
be considered the  predisposing momentum.  In many cases
chronic exanthemata with reflex action upon the meat, audit.
ext. in form of  otit. catarrh, ext., appear previously; after the
disappearance of which the disease often breaks out suddenly.
                          (d.)
  Of less importance is the periostitis of  the meat. aud. ext.,
for the diagnosis of which the silver probe suffices.
                           (e.)
  The inflammation of the membrana tympani also occurs
preponderantly with the scrofulous, especially as a  secondary
pathological process, resulting from the inflammation of the
external meatus and the middle  portion of the ear.   A puru-
lent discharge, connected with hardness of hearing, frequently
is  the first symptom arousing the attention of the  patient.
Pain, if existing, is but transient in  case of decrease or dis-
continuation of the discharge.  The  secretion of ear-wax is
regularly suppressed. The membrana tympani always thickens
in course of time.  Partial destructions happen. Granulations
of polypous form ; rarely genuine polypi. 
THE  SPECIAL  FORMS  OF SCROFULA.         73
  Now, as regards the therapeutics of all these conditions, the
homoeopathic method of healing has  the great advantage of
never contributing anything to the forcible suppression of the
otorrhoea, always to be considered as a beneficial crisis, though
of an incomplete character.  If physicians, such as Hufeland,
warn against the suppression of cutaneous  scrofulous erup-
tions, how much more ought this advice to apply with regard
to the internal,catarrhal,and periosteal otorrhoee, connected,
as they are, with the brain in  a  manner more or less demon-
strable. Authorities in otiatrics admit at the same time that,
after the  cessation of an otorrhoea, pain, hardness of hearing
and  affections of the brain may appear, and when notwith-
standing they cling to the Lapis intern, divinus, Cupr. sulph.,
Plumb, acet., &c, they occupy the position of those Athenians
of whom it was said that  " they knew well enough what was
right, but did not do it."
  As homoeopath, moreover, one needs not. be a specialist and
yet may make  excellent cures of (scrofulous) diseases of the
ear.   In order to apply  the right remedy, it  is fully sufficient
to know, whether a catarrh or a carious process is present,
and  whether it bears the acute or chronic  character.  The
quality of the  secretion is easily ascertained, as well as  the
seat of the affection.  From the above remarks it is plain that
the five usual forms: catarrhal inflammation of the external
meatus, cavum tympani, periosteal inflammation of the meat.
extern, and  cavum tympani and, finally, meningitis must be
distinguished, and how.
  Our suppuration-remedies, if I am permitted to use the ex-
pression, act just as  surely upon that portion before as upon
that behind the membr. tympani.
  It has  already been  mentioned  that in  the treatment of
mechanical  conditions (narrowing of  the tuba Eustach.), we
cannot do without certain mechanical aids, such as catheteri-
zation, air-douche, &c.                  •
  Besides, it has also been said that every disturbance of the
ear finds its analogon in a corresponding affection of the eye;
hence, the specific therapia, if fixed with regard to one organ,
would likewise apply to the analogous condition of the other.
  In the treatment of scrofulous persons suffering from  dis-
eases of the ear, it is important to know that even the homoe- 
74             ON SCROFULOUS  AFFECTIONS.

opathic cure often requires a long time, weeks and months,
but that nevertheless the prognosis is not unfavorable.  We
could mention more than one pernicious case in which under
■allopathic treatment polypous growths, profuse, putrid dis-
charge, general decline and a considerable degree of hardness
of hearing had made their appearance, where notwithstand-
ing, Calcar., Silic, and Mercur. (the first and third in their dif-
ferent preparations) were fully sufficient to master the patho-
logical processes, Ferrum jod. sach. has to be given, occasion-
ally, as an intercurrent remedy, and as a drug improving the
constitution.
  Iodine vapors have been lauded  in chronic inflammation of
the  membr.  tymp.  developing  upon  a scrofulous  bottom.
(Tinct. Iodii, gtt. 2-6 to from 3 to 4 ounces of water) (Tschar-
ner, Schw. Zeitschr., 1851.)

       3. Scrofulous Affections of the Mucosa of the Nose.

  The scrofulous affections of the nose, like those of  the ear,
have also to  be distinguished as acute and chronic.

                       (a.)  CORYZA
  Is too well known to be described here.   I will mention,
however, that the cure of the chronic form is often of great
importance, scrofula in its totality not rarely being removed
with it. (Kafka.)
  Besides the  usual remedies  (Sulph., Hep.  s\dp>h.  calc)
Graphit. and Arget nitric  have effected results  when pro-
fuse, puri-sanguineous nasal  secretion  existed, the sense of
smell was blunted, and  the nasal  mucosa appeared  sore and
ulcerated. (Eczemata at the nasal openings and upper lip.)
  In case of a bloated face, swollen nose and upper lip, offen-
sive discharge, dried-up crusts  in the  interior of the  nose,
ulcerated nasal openings,  Calc. carb. 6.   If this be  without
result, Silic.  or Mercur. prcecip. rub. 3.  Aurum mur. natr. and
Kali, bichrom., and lastly, Arsenicum (Lachesis).  Arsenicum:
anemia of a high grade, oedematous swellings of the lower
extremities,  emaciation, increased thirst, eczemata, swelling
of the submaxillary and axillary glands.
  Among the most important scrofulous affections of the nose
we count: 
THE  SPECIAL  FORMS OF SCROFULA.
<0
                         (b.) OZvENA.
   Formation of ulcers and fetid smell accompany it.  If but
 the latter is present, the trouble is Oz. spuria, Oz. non-ulcerosa,
 only.
   Complete or but partial loss of smell, now a light-colored,
 fluid, or reddish, now a yellow and thick quality of the secre-
 tion intermixed with streaks  of  blood, frequently drying up
 to crusts, and  the  insufferable smell of the discharge charac-
 terize the ulcerous ozena.
   Sometimes we can observe the ulcers directly; any portion
 of the nasal mucosa may become affected.
   The obstinacy of the disease, frequently defying all thera-
 peutics, is owing to the participating of cartilages and bones
 in the pathological process.
   Though  Calc. carb.,  Hep. sulph., Phosph.,  Graph., Pulsat,
 Nux vom., Silic, and Sulphur have been recommended, they
 nevertheless not rarely fail.*
   We may explain the recommendation of the various reme-
 dies in this way that (by means  of a remedy, or without it,
 even) the subsequent amelioration was taken for a  cure too
 readily.   We  have seen  such improvements after Graph.,
 Arsenic, &c, but no radical  cures.  The same holds good of
 Kal. hydroj., which, in  doses of one grain  daily, still deserves
 most confidence.   Nasal  suctions of Chlorine-water even do
 not dispel the penetrant " mouldy or caseo-putrid smell."
   Kafka has recorded (Horn. Therap., ii, 743, case of ozena
 of eight years' standing) a cure by Hydr. prcecip. rubr. 3 inter-
 nally (externally the crusts that  could be reached  were be-
 smeared with Unguent hydr.  pr&cip.  rubr. (0.06: 2.0) ).  The
 difficulty of a cure is owing, no  doubt, to the  peculiar con-
 struction of the nose, and (besides the partaking of  cartilage
 and bone in the pathological process)  to the arrest  of the
 ulcerous secretion dependent thereupon.
   Dr. Baer cured  a girl, et.  13, with Aur.  met., who had
 already suffered for a long time to the greatest torment of her

  * Thus Dr. Gentzke also describes (A. H. Z., 22, 9) an interesting case of Oz.
scrof. in a female servant, a3t.  22, and frankly confesses  that Puis , Merc,
Phosph., Aur., Thuj., Sulph., and Calc. carb., had not improved it any. He
closes with a modest quid hie faciendum ? 
76
ON SCROFULOUS  AFFECTIONS.
friends from a horribly smelling, nasal discharge of a viscid,
purulent character, and very offensive breath.  Her appear-
ance was almost ruddy, yet somewhat " scrofulous " (A. H. Z.,
54, 1).
  We  repeat that ozena is apt to show a very malignant
character, but that  the want of therapeutic success is owing
to homoeopaths, rather than homoeopathy.  It is an interesting
fact, however, that the remedy deserving of most confidence,
the red precipitate, is specific also against ophthalmia neona-
torum, a disease which may be marked out as an expression
of a scrofulous  constitution not any less obstinate.   We may
be  inclined  to  infer that both diseases belong, perhaps, to
scrofulous affections, modified  by syphilitic antecedents.


           (C.)  POLYPI OF  THE  MUCOUS MEMBRANE.

  A peculiar termination of the  chronic muco-membranous
inflammation is the polypous growth.  They are distinguished
according to their consistency as fibrinous and mucous polypi.
Besides the aural mucosa, the nasal, especially, produces polypi,
which  recur most obstinately in spite of surgical extirpation,
or  their removal by torsion.   The appearance  of polypi  is
mostly identical with intense scrofulosis, and especially with
that form of it modified by more  advanced age.   The soft
polypi  start at the subcutaneous tissue or perichondrium.
  In case of larger polypi we observe  loss of smell, gaping  of
the mouth, nasal voice, frequent but ineffective blowing of the
nose.   Firm, fleshy polypi, may displace the lachrymal canal,
and thus occasion watering of the  eyes, or since they affect
the tuba Eustach., hardness of hearing.   Mucous, purulent
coryza, and ulceration even, may accompany the presence  of
polypi.
  If the  polypus is seated high up, the diagnosis is facilitated
by closing up one nasal opening, and requesting the  patient
to blow  through the other.   We recognize the presence  of
polypi  by the impossibility of  air passing through it.

  Therapia.—Whoever denies the efficacy of homoeopathic
remedies, sees himself confined, as already said, to incomplete
surgical aid.  Yet we possess drugs capable of counteracting 
THE  SPECIAL  FORMS  OF SCROFULA.         77
the polypous process, among which belong, especially, Calc.
carb. and Teucrium marum.  Aside from these, according to
the individuality  of the case,  Conium, Phosph., Aurum, Bel-
lad., Graphit., Mercur.,  Add nitri, Silic, Sulph., Staphisagria.
(Journal de la Medec. Horn., 1, 5).   Polypi frequently appear
contemporaneously with those  ominous  chronic swellings of
the tonsils, which, likewise, have to be considered as an unde-
niable, partial phenomenon of general scrofulosis.   Calc. jod.
has proved itself efficacious against these  tonsilar swellings.
We request homoeopaths to try it against polypi.


                  4. Mucosa of the Mouth.

  The connection between the affections to be mentioned here
and scrofulosis  is  more  difficult to prove than that with re-
gard to the eye, ear, and nose.  Yet such affections do exist,
notwithstanding.  Among them we count:

     (a.) THE CATARRHAL INFLAMMATION  OF THE MUCOSA.
                    Stomatitis Catarrhalix.                 ^
  It is connected  with redness  and increased secretion.  The
tongue looks as if it were covered with a thick layer of rasp-
berry syrup.  On longer duration  a white coat appears upon
it.  The children do not like to have any portion of the mouth
touched. Mucus always flows down the corners of the mouth,
excoriating them,  reddening the chin, and soiling the clothes.
The mucus is wont to react acidly.
  When redness and soreness have lasted a  few days, small
vesicles, as real  exudations, in  appearance  and course much
resembling herpes (labialis), rise  up at the  mucosa of the
tongue, gums, lips, and  cheeks.   They soon burst and leave
small,  superficial  ulcers with a yellowish-white  bottom, in-
crease in the first few days  in all directions, become confluent,
and produce ulcerated  surfaces of some  extent, especially at
the edge of the tongue, and the mucosa of the lower lip.
  These ulcers never have a peculiar smell.
  Therapia.—Acid.  nitr.   when  small ulcers are  present.
Mercur. in case  of great  flow of saliva.  But from the internal 
78            ON SCROFULOUS AFFECTIONS.
and external application of Borax, also (1st or 2d trit.), bene-
ficial results have been obtained.
  A characteristic fetid smell we find in

                      (b.) STOMACACE,
which is not accompanied by increased secretion of the buccal
mucosa, as stomatitis catarrh, is, from which, according to
some authors, it may develop,  and which occasions ulcera-
tive processes of greater  extent.  It shows but little inclina-
tion to heal spontaneously ;  swelling, ulcers, and smell, with-
out treatment, may last for  months; the teeth become loose
and fall out, and the children become emaciated to a danger-
ous degree.
  I should compare Stom. catarrh, to coryza with  its termi-
nation  into ozena benigna (non-ulcerans), stomacace to ozena
maligna.
  The  subsequent  course  (after the forerunners of simple
stomatitis) of stomacace is that the parts adjoining the gums,
are infected by contact, and suffer  the  same  changes.  The
mucosa of the cheeks swells considerably, so much  so as to
show the impression of the several teeth upon it.  The same
is true  of the tongue (swelling of the cervical glands).
  Alfred Vogel  says: "Calomel, in  children,  produces a  dis-
ease of the mouth that cannot be  distinguished in any way
from stomacace, unless  the  absence of  contagiousness of
stomac. mercurialis, above mentioned, is  to  be  set  up  as a
diagnostic sign."
  By this remark, and the fact that Mercur.  is homceopathi-
cally indispensable in stomacace, we again see the correctness
of the law of the simile confirmed.
  Besides Acid,,  nitri., Sulph., and  against stomac. catarrh.,
Borax  is indicated.  Since Borax is used allopathically, even,
against catarrhal inflammation of  the buccal  mucosa ; there
could, as regards stomacace, also be no objection raised homce-
opathically against Kali  chloric.; especially, as according to
the testimony of able allopathic therapeutists, it is said to be
the most specific remedy for it, existing.

                       (C.) APHTHiE.
  A form of stomatitis connected with the formation of fungi
(oidium albicans) which  depends upon predominant acidity. 
THE SPECIAL FORMS  OF SCROFULA.          79
 Aphthe are related to scrofulosis, probably, as tinea favosa is,
 of which Jousset says:
   " Quant a  la teigne faveuse, decrite  si longtemps comme
 une affection scrofuleuse, elle est rangee  aujourd'hui parmi les
 affections parasitaires,  seulement  les scrofuleux  offrent  un
 terrain tres favorable a son developpement."
   Therapia.—As against stomat. catarrh, good results have
 been  obtained by Borax (1st and 2d trit.).   Everything con-
 taining sugar (even milk, on account of its  containing sugar
 and caseine) is to be  avoided, since aphthe owe their origin
 to a surplus of acidity.*

               II. ORGANS OF RESPIRATION.

                         1. Croup,
 Though not  a genuine form of scrofula, preponderantly af-
 fects  scrofulous children.  Kafka has observed that the torpid
 course of croup,  especially, is owing to a scrofulous constitu-
 tion.   For quite  different reasons we should claim croup to be
 a disease  almost  specifically scrofulous;  we mean on account
 of the efficacy of the  remedies, successfully employed against
 it, all of which are  antiscrofulosa of first rank.
   (Torpid) Croup is  cured  by the  ametals or metalloids of
 anorganic constitution.  Except those  existing in gas-form
 (oxygen,  hydrogen, nitrogen) almost every one of them  has
 been successfully used against this malignant and pernicious
 disease of children.   Sulphur (as Hep.  sulph. calc), Phosph.,
 Carbon, Spongia, Iodium  among  the solid  metalloids, and
 lastly, the fluid  Brom.  which plays a  role exceedingly  im-
portant.f
   The distinction between spurious and genuine croup is of
subordinate value, for  the latter may develop from the  former.
  * Some refer scrofulosis, as is well known, to a surplus of acidity, and thus
explain the usefulness of alkalies.
  f Dr. Sybel of Aschersleben observed cases of angina membran., in which
Aeon., Hep., Spong., lod., Brom., Ant. tart., could not prevent the fatal ter-
mination. Upon theoretical grounds, i. e., supported by the pathogenesis of
the remedy,  he proposes  Ammon. caustic, internally, and  to be inhaled by
the nose.
  In the fatal cases, referred to above, the cough was absent almost entirely. 
80
ON SCROFULOUS  AFFECTIONS.
Hence, every inflammation of the larynx, accompanied by the
characteristic croupy sound, is to be treated as croup from the
very beginning.  The prognosis is unfavorable in the highest
degree, and the formation of real membranous exudations is
to be expected most surely, if tonsilar diphtheritis precedes
the croupous process.  But, then, we may be assured that the
characteristic chronic swelling of the tonsils, so often observed
with the scrofulous, has already existed previously.  The ac-
tion of the skin or nasal mucosa, present or  absent, is also of
prognostic  importance,  since the appearance of  sweat  and
coryza- (especially if  the latter had stopped suddenly) point to
a crisis, and dispel all fear of a plastic exudation.  Finally,
from the continuing hoarseness and aphonia  we may almost
always infer that the croup  is genuine (membranous), just as
a case of scarlatina, diagnostically doubtful, documents itself,
a posteriori, by the desquamation and peeling off of the epi-
dermis.
  Although we always prefer the record of cases treated to
pathological remarks of a lengthy and general character, and
shall present in the course of our treatise more than one such
cure of croup; we will yet give in the following a few addi-
tional items as regards its pathology.
  Sometimes,  but proportionally rarely,  croup begins sud-
denly with a rough, barking cough and difficulty of breathing.
  It is  mostly preceded by  forerunners, such as hoarseness,
sharp cough, catarrh of  the  larynx and pharynx.  Signs of a
diphtheritic affection of the latter.  Weakness, ill humor,
fever, loss of  appetite, difficulty of breathing during sleep.
  The increase of the trouble manifests itself by the rough-
ness of the paroxysmal cough, the' pain in the larynx, extinc-
tion of voice, or by a violent, almost always nocturnal attack
of suffocation with a whistling, short, and tormenting cough.
  If at this period amelioration does not set in, the difficulty
of breathing increases amid the most powerful efforts, redden-
ing and paling and swelling of the face, and paroxysms which
are interrupted by intense exhaustion, though of but momen-
tary duration.  A few hours later, general collapse; a pulse
growing smaller  and smaller,  secondary  emphysema of the
lungs, and death set  in as early as on the first day.
  But in most cases the first attack remains moderate yet, 
THE  SPECIAL FORMS OF SCROFULA.         81
although the cough is rough and suppressed, the voice weak,
hoarse and interrupted by whistling sounds; the patient falls
asleep again, but breathes with  whistling noises,  and shows
restlessness during sleep with repeated starting. On the next
day there is  a decided amelioration of  the phenomena, but
still greater  weakness remains.  In  the course of the same
day, or the night following, or on the next day, even, parox-
ysms of suffocation again set in which become more and more
violent.
  In the intervals between the attacks we may observe mostly
pain in the region of the larynx, heaving and whistling respi-
ration, now  restlessness, now a  semi-soporous condition  to-
gether with  a very accelerated pulse and increased tempera-
ture.   At a later period the paroxysms come at shorter inter-
vals, continue longer, and are interrupted only by soporous
exhaustion ;  the lung begins to distend itself  emphysemati-
cally, and continuous dyspnoea with a  cyanotic appearance
shows itself during the intervals, even.   Though the attacks
themselves gradual!}- grow more moderate now, yet the respi-
ratory impediment becomes  more and more permanent, and
slight jerks and more violent convulsions appear in addition.
In some cases pseudo-membranes are coughed up, always with
relief, which, however, usually is but temporary.   Now and
then, a mucous and viscid liquid is evacuated by vomiting
with some benefit.
  In some cases, not so exceedingly rare, the  symptoms  de-
crease, it is true;  the breathing becomes more free, and more
rest is obtained, yet the  pulse remains extraordinarily fre-
quent, and though the respiratory impediment is removed,
the sopor increases, and death occurs from gradual collapse
with or without the addition of oedema pulmonum.
  Therapia.—There cannot  be the slightest doubt but that
the prognosis of croup is not as hopeless under homoeopathic
as under  allopathic treatment.  Indeed,  we need but take up
allopathic textbooks of a recent date and more enlightened, to
perceive that the aids, formerly considered indispensable, such
as venesection, counter-irritants, cauterizations, and others,
are  condemned ; at the same time, however, so great a help-
lessness becomes apparent that things of the  most contra-
dictory nature are recommended.  There a Wunderlich, even,
                            6 
82
ON SCROFULOUS  AFFECTIONS.
does not scorn the idea of appealing  " without hesitation,"
now to mercurial salve, now to inhalations of chloroform, now
to moschus, now to opium  " in large doses," now to asafoetid.,
now to tracheotomy.   Indeed, in order to make the irony
complete, he mentions Hep. sulph., even, in doses from one to
six grains.  In the latter recommendation  we see the obtuse
presentiment of the possibility of a  better therapia of croup
than the present one.  Yet,  there  is no  mention made of
remedies, such  as  Spong., lod.,  Brom., Phosph., and Kali
bichrom., so important in the most severe cases  of genuine
croup.
  Nowhere is  the  recommendation of medicines connected
with so great a responsibility  as in croup.   For the most tor-
tuous death would  be the consequence of an erroneous treat-
ment.   Our recommendation  of the homoeopathic therapia,
aside from  its  being based upon  numerous  and trustworthy
reports  of others, rests, therefore, upon clinical observations
of our own. At this juncture we will not fail to remark, 1,
that we entirely agree with Dr. Weil's views, that when  one
declares that he has treated croup in one and the  same indi-
vidual, five or more times, the disease was not membranous
croup, but pseudo-croup; 2, that the homoeopathic specifica,
though efficacious, are not able  to  arrest a case of croup at
once, but sometimes let us wait very long, indeed, for the final
removal of  the ominous attacks.
  Moreover, in case of a malignant course of the disease, we
would not  like to  do without the  wet bandage around the
throat  as an auxiliary means.  It is remarkable how well it
is borne at the height of  the disease.  Upon the whole, we
have in the natural  curative instinct a guide for the various
curative apparatuses.   The cold bandage, if not  appropriate
any longer, is  refused.  The same holds good of inhalations,
which, likewise, at  a certain  period and  stage, prove them-
selves very beneficial (S. LXIII),  Thus I let Iodium (1 drop to
circa four grammes of water) or Bromium, or Hep. sulph. calc,
even, vapor off, or be inhaled  with benefit  as  long as no re-
sistance is made.
  The wet bandage is apt  to  produce  sweat, which, starting
at the throat, spreads over the rest of the body. But it is the
sweat, especially, which is  absent in membranous croup ; the 
THE  SPECIAL  FORMS  OF SCROFULA.
83
skin remains hot and dry.  When warm sweat is present, cold
water ought not to be applied.
  Spurious croup, which, fortunately, is observed much oftener,
is cured by A con it.  (within the first twenty-four hours), and
Hep. sulph. calc.  (Kafka), or Spongia.  If the  crisis (loose
cough, sweat, discharge from the nose) has set in after Aconi-
tum, Bellad. is well indicated for the second day.  Hot, sweet-
ened milk, drank in large quantities within the first hours of
a sudden attack of croup (usually at night) assists the crisis.
It is difficult to give tenable  indications as regards the seve-
ral  croup-remedies.  If we look at the respective  reports of
cures, we find that, in most  desperate cases, the metalloids
named, lod., Brom., Spong., have almost always been given
(and in this fact we notice, in contradistinction to the allo-
pathic school,  the observance  of a uniform principle); but, at
other times, it  required Kal. bichrom.,  Tr. Sambuci, Kaolin,
Tart. stib.  (in  horn, trit.),  or  Phosph.  (applied locally, even),
before the  disease was broken.  It is a disadvantage that in
this disease we feel less inclined than almost in any other, to
allow the remedy to develop  its full  action, since otherwise
the danger might reach an incontrollable height.
  Hoarseness, amounting to aphonia, pathognomonic of genu-
ine croup, as we may say, sometimes requires an especial after-
treatment, lest it  may continue for months even.  Lycopod.,
Caustic., Graph., Phosph., Silic. would  be the remedies to be
tried.  Also, hot milk and Seltzer water as auxiliary means.


         2. The Bronchicd Ccdarrh of the Scrofulous

Characterizes  itself by its  chronic  course—its  appearance
during childhood, the partaking of the lungs in the affection—
an occurrence  that may easily  happen—and the great quantity
of sputa of a  sero-purulent quality.  On account of the rela-
tion of scrofulosis to tuberculosis such catarrhs  ought to be
watched with  the greatest care.   The children have mostly
fever with  it, lose flesh, and auscultation often shows sur-
prising differences in the resonance between the right and left
pulmonary apex.  A peculiar shortness of breathing, always
suspicious, and signs of disturbed digestion, mental depres-
sion, and changed disposition, are always present. 
84
ON SCROFULOUS  AFFECTIONS.
  Therapia.—Sulphur, especially, is able to prevent the evil
terminations of this  catarrh, and to resolve the infiltrations
in the  pulmonary  tissue.  Afterwards Phosph.,*  Mercur.,
Hep. sulph. calc, Calc. carb., Silic, Lycopod., but also Pidsat,
Scill., and China, &c, effect much.
  Ipecac is likewise most valuable, especially in case of simul-
taneous chronic looseness  of the bowels,  and  a spasmodic
character of the cough, but mostly is efficacious only in form
of a weak infusion.
  Finally, we must not forget Kal. carb., which plays so im-
portant a part  in incipient phthisis, and is indicated in case
of predominant stitching pains  in the breast; hence, in case
of pleuritic symptoms,  shortness of breathing, especially in
childhood, and with  females.  Hemorrhages would point to
Kal. carb. all  the more.  I use  the 3d  trituration (morning
and  evening 0.1 gramme) with very  great benefit against the
respective chronic or subacute  pulmonary catarrh of scrofu-
lous persons, in whom I suspect a predisposition to tubercu-
losis.  The  characteristic swelling of the tonsils  and crusty
soreness of the nasal mucosa (in the region of the nasal open-
ings) mostly existed  simultaneously with those catarrhs.
  In such cases too much importance cannot be placed upon
a corresponding change of air, a  residence in a country, sunny
and  rich in  pine forests, and upon the milk-cure, &c. (milk of
asses and goats, &c,  warm as it  is drawn from the bag).

               III. ORGANS OF DIGESTION.

  " Chronic  catarrhs of the  stomach  and  intestines,  with
paresis of the intestinal musculature," according to Wunder-
lich, are troubles not rarely found with the scrofulous.  These
conditions are either of a more transient  nature (in which
now constipation, now diarrhoea, has to be met) or continuous,

  * I found Phosph. repeatedly specific when breathing was so impeded  that
one felt as if he should help the children in their respiratory efforts ; hence,
when a certain degree of dyspnoea existed.  Also Lycopod., in case of so-
called consonant rales, when a concomitant noise, like the sound from an
organ, or a whistling was heard while breathing.  So in the cough accom-
panying influenza.  Scilla (in a low dilution, a few drops at a time) in case of
excessive mucous rattling, when the children  cannot get control over the
mucus.  Here China (in a low dilution, or the  mother-tincture  even)  is  also
indicated. 
            THE SPECIAL FORMS OF  SCROFULA.          85

and  then  of evil  omen.   An affection of the  mesenterial
glands,  and, in  consequence,  degeneration  of those organs
takes place, and such children die miserably under the symp-
toms of a follicular enteritis or chronic atrophia, probably in
combination with ascites.   The nosological picture of such an
abdominal localization of  scrofula we find most instructively
given in the curative results of Baryta mur. and Arsenic (see
those).  There we regularly find also scrofulous concomitants,
such as  swollen glands of the neck, cutaneous eruptions of the
head, &c.   The character and  course of abdominal scrofula is
drawn nearly as precisely  as is that of scrofulous ophthalmia
or ozena.
  Therapia.—Aside from the remedies mentioned, Calc. carb.
and  Phosph., and in those  cases characterized by eruptions of
all kinds, especially furunculous  abscesses on the head and
trunk, Sulph. and Silicea. will suffice, perhaps.  Carb. veg., also,
may come under  consideration in  atrophia infantum, espe-
cially if decided symptoms of scrofulosis  were present pre-
viously  (see cures by Carbo veg.).

  Note.—Probably  hydrocephalus  acutus may, with  more
propriety  than any other  disease, be compared to this mani-
festation of scrofulosis; and it seems that, at a certain period
of time, the nature of the child remains, so to say, undecided
before this  alternation, until an  external incidental cause (a
mistake in diet, chilling of the head,  &c.) influences  it to
decide itself for this or that cavity (abdominal or cranial).
               C.—The Glandular System.

                 1.  The Lymphatic Glands.

  That the lymphatic glands frequently are affected by scrof-
ula, and become the seat of abscesses, is not to be wondered
at in view of the predominant significance of this anatomical
system with regard to scrofulosis in general; for swellings of
the neighboring glands  never fail  to appear in case of any
extensive  peripheric  localization of  that diathesis. 
86
ON SCROFULOUS  AFFECTIONS.
  We may distinguish between inflammatory, scrofulous, and
non-inflammatory infiltrations.
  We observe the  inflammations  most frequently behind the
ears, at the lower jaw, neck, in the axilla, more rarely at the
inguinal region.  According to the degree of the inflammation,
its extension over the subcutaneous connective tissue, and the
number of the glands affected, such inflammations are accom-
panied, more  or less, by febrile  symptoms, local pains, and
nightly exacerbation.  They mostly terminate in suppuration,
sometimes after the previous appearance of severe chins.  Not
unfrequently a complete cure follows upon the spontaneous or
artificial evacuation of pus ; the inflammations often recur at
short intervals, or appear slowly with but slight inflammatory
symptoms; then the inflammatory infiltrations remain at  an
incomplete stage of development, and, by mostly spreading
from one portion of the gland to another, and thus forming
a connected chain of suppurative foci, pass  over into the pro-
cess of softening not before weeks or months, occasioning  an
unhealthy look, loss of flesh and strength, and  leaving behind
disfiguring and contracted cicatrices.   In other  cases a sup-
puration-focus develops  only at a circumscribed spot of the
glands,  infiltrated  by inflammation ; the pus, however, does
not perforate the glandular capsula, but  thickens and passes
over into  caseous  metamorphosis.  In consequence of these
hard knots the glands may assume  an  irregular, tuberous
appearance.  If the cheesy content of the gland calcifies it
acts like a foreign  body.
  The non-inflammatory infiltration of the lymphatic glands
consists in chronic swelling of the separate glands, which oc-
casion neither pain nor redness, mostly feel like round, oblong,
smooth or hard bodies, and often  attain  to  a  considerable
size. If several glands standing in a row, or forming clusters,
become scrofulously infiltrated simultaneously, or in succes-
sion, they frequently appear as knotty ropes, or as disfiguring
not smooth but tuberous packages. Resorption can take place
only, when the glandular contents (infiltration)  are cellular
(increase of cells—Yirchow), but  hardly ever in case thej^ be
lardaceous or chalky.  Therefore, we  cannot always expect,
as we have said above, cheesy or albuminous contents.   Yet 
THE  SPECIAL  FORMS OF SCROFULA.
87
the idea of scrofula does not agree with that of cellular infil-
tration.
   "With many practitioners, however, the appearance of glan-
dular infiltrations is taken to be a pathognomonic symptom
of scrofula.
   Therapia.—The acute, scrofulous glandular inflammations
are treated with Bellad., Aconit, Mercur., or other  remedies
corresponding to the individual case.  If abscesses threaten to
form, Hep. sulph. calc, Mercur., Silic.   If the opening does
not close up, but continually discharges a watery fluid, Caus-
tic, (pledgets of  lint saturated with it) is well suited.   After
Sil., Phosph. will often  be  indicated,  to which Kafka rightly
attributes  a vitalizing effect upon the paralyzed curative ac-
tivity.   The same  author recommends Kal. hydrojod.  2d or
3d, externally and internally, or Conium, twice or three times
daily, in case of want of reaction in  the purple, swollen,  and
nearly painless glands,  which do not pass on either  into sup-
puration or resorption.
   Silic.  and  Acid,  nitri.  modify  too  profuse  suppuration.
They correspond also (besides Phosph.) to torpid (weak in re-
action)  scrofulous ulcers, such as may develop from abscesses
in the lymphatic glands.
   In case of an ichorous, offensive discharge, Arsenic, Kreo-
sot, Asafoet.  However, the most sovereign remedy against
indolent non-inflammatory glands is  Iodium and Kal. hydro-
jod.  Sep., Con., Baryt carb., without excluding Phosph.  and
Silic, may be applied, if simultaneous coughing up of blood
exists, or if frail individuals pass, at the same time, through
the period of evolution.  Carb. an.,-finally, is a remedy not to
be despised in benignant as well as  malignant glandular af-
fections of the most various kind.
  If the remedies mentioned are of no avail, we may infer a
lardaceous or colloid content of the glands.   Then Brom.  and
Aurum  mur., in  spite of the obstinacy of the trouble, are able
occasionally, to bring about resorption.   The same holds good
of the mineral springs containing lod.  and Brom., such as
Hall,  Kreuznach,  Wittekind  near  Halle,  Rehme, Kcesen,
Reichenhall, Ischl., &c.   Besides, we  refer to the  clinical ob-
servations  with Aur. and  Baryt, but  also with Con.,  Ly-
copod., &c. 
88             ON SCROFULOUS  AFFECTIONS.

  Note.—It is not so unimportant, as it may seem, to strive
in a rational manner for the diminution of hypertrophical
glands.   Let us be reminded of the consequences of such, fre-
quently hard,  glandular swellings.  On account  of  the un-
avoidable pressure upon the adjacent parts, they may produce
results (asthma ; atrophia of the  respiratory muscles ; convul-
sions; paralysis) endangering life which, without proper help,
have occasioned painful  death.   In  a like manner  we can,
vice versa, do a great deal of good with  curative means so
well adapted as ours.  Thus we may  explain why  Spong.
cured diseases of the heart of a  grave (secondary) character,
or why lod., Brom., Con., &c. softening and resorbing, as they
did, occult  glandular indurations at a critical locality,  re-
moved diseases  which, in fact, were to be  considered but the
sequele of a primary glandular affection.

                        2. Struma.

  The swelling of the thyroid gland is so intimately connected
with scrofulosis that formerly the term  struma was used for
scrofulosis.  Goitre is mostly a stationary phenomenon, simi-
lar to hypertrophy of the lymphatic glands of the neck, axilla,
&c.  But its growth, as well as its first unexpected appearance,
may make it seem desirable to interfere  with it, especially, if
dyspnoea or  considerable disfigurement results from it.  The
symptoms of compression depend upon the direction in which
the thyroid gland, or  single portions  thereof,  increase in size.
A growth anteriorly  is  most  disfiguring, but, at the  same
time, most favorable as regards general health, especially res-
piration.   On the other hand, disturbances of circulation and
respiration appear in consequence of a displacement of the
musculi sterno-cleido-mastoidei, in case of lateral or posterior
hypertrophy.  Disturbances  of deglutition and impediments
of respiration,  if the struma  surrounds  the oesophagus or
trachea in ring form.  Enlargements,  inferiorly, as far as
below the manubrium sterni, are most dangerous.
  We distinguish between struma lymphatica, a simple enlarge-
ment of the glandular knots, and str. cystica,  an enlargement
of the several knots  into cysts.  Thus, with children  cysts
may develop of one  inch in  diameter.  A  colloid  mass (a 
THE  SPECIAL FORMS OF  SCROFULA.
89
 thickly-fluid, gluey, yellow or brownish liquid) constitutes the
 contents of the cysts.  From globular, tuberous enlargements
 we may infer struma cj^stica.
   Therapia.—To extirpate  strumata for esthetical reasons
 is  generally condemned.   There exists, however, the  short-
 sightedness  of  recommending painting with Iodine (from six
 to twelve times, at intervals from  three  to six  days) for the
 purpose of effecting  a cure.  The relation of the  thyroid
 gland to the lungs is  too important (though not  sufficiently
 understood) to permit without obnoxious  consequences, the
 removal of such hypertrophies (which  certainly do not  exist
 without purpose) by external means.
   The removal of the pathological products by internal reme-
 dies specifically homoeopathic is a different matter, however.
 Among these strictly belong  only the  Carbonate  of  Lime,
 which produces  strumata, and Iodium, of which the same is
 maintained,  and both of which are advantageously combined
 in the preparation of Calcjodata;  besides these, Iron, which
 favors the growth of goitre, may be mentioned here, probably.
  . Aside from Calc.  carb., and Iodium, Apis has the  name
 of  removing goitre;  against struma cystica we  should prefer
 Calc carb., because, according to experience, other cysts also
 have given way under its systematic (i. e., temporary discon-
 tinuation and administration of the remedy in different dilu-
 tions) application.
   Spong. and Brom., moreover, in suitable dilutions bring no
 danger.   The term of " Kropf-Schwanirn " (goitre-sponge) for
 Spongia is very properly applied.*
  Finally, there is nothing to contraindicate the prudent ap-
 plication of Kali hydrojod.  (IX.)

           3.  Chronic Hypertrophy of the  Tonsils.
  It may be doubtful whether it is always inherited, as Alfred
Vogel thinks, but it is certain that children two years old
may be already affected by it.  If we inspect the oral cavity

  *  I can hardly sufficiently recommend the following treatment:  Spong 1,
ten drops in two gramm. of Spirit, vin. rectific.  Of this morning and even-
ing from two to three drops for several weeks.  In chronic  cases Spong., in
alternation with Brom., lod., Phosph., especially if dyspnoea, shortness of
breathing while walking and ascending stairs result from struma. 
90
ON SCROFULOUS AFFECTIONS.
of such patients, we see two fleshy plethoric swellings  at the
side of the uvula; smaller and larger vessels cover them, and
single spots are frequently denuded of their common encasing
membrane in a manner that makes  it appear as if a real al-
mond could be seen behind the defective shell.  From the en-
largement toward the nose, a nasal voice, snoring and difficult
breathing during sleep result, and there is in such children a
noticeable disposition to angina, diphtheritis, and membranous
croup.  Other symptoms of a scrofulous diathesis hardly ever
are absent.  The enlarged tonsils take position in front of the
tuba Eustachii, and occasion hardness of hearing of a higher
or less grade and abnormal sounds.
  There can be no doubt as to  the  scrofulous nature of this
trouble, for the reason that Iodium and its preparations, espe-
cially Calcar. jodata (Vehsemeyer)  affords help.  It charac-
terizes itself, moreover, by this, that, though admitting of a
certain  spontaneous diminution of  the  glands, in the course
of years (in the same manner as inherited strumata heal spon-
taneously), it yet continues to the age of manhood, and to a
later date even.  Allopathic physicians praise the efficacy of
Cod-liver oil in this affection—a praise that is identical with
that of Iodine.
  Dupuytren thinks  that  these glandular swellings, in con-
sequence  of the pressure  upon the muscles of respiration,
atrophy the latter, and  thus produce the " chicken-breast"
(pectus carinatrum) afterwards.  But it  is our opinion that,
where such tonsilar hypertrophies exist, there is predisposition
to tuberculosis ab initio.  Hoarseness, shortness of breathing,
and  easy  tiring while speaking, appear  in  company.   If we
deprive scrofulosis of the locality chosen by it, e.g., by extir-
pation or cauterization of the tonsils, or a forced Iodine-treat-
ment, it is likely to be followed by the same sad consequences
as are wont to set in in case of treating strumata in the same
manner; hence, here even the  essence of the disease ought
not to be lost  sight of over the anatomical lesion.
   However,  a reasonable  administration  of the  remedies
named, as well as of Cede phosph. (jodata ?), almost specific in
this trouble, and of Baryt mur., is  not excluded.*

  * In the Journal des Connaissances Medicales (May 20,  1806), Lambron
recommends the mineral sulphur-waters ("en boisson et en douches locales "), 
THE  SPECIAL  FORMS  OF SCROFULA.          91
  On theoretical grounds, and because this affection, together
with  ozena scrofulosa and ophthalmia neonatorum, repre-
sents, so to say, the prototype of scrofulosis, two diseases, for
which Mercur. prcecipitat ruber has proved its efficacy  in  a
brilliant manner,  we  are inclined to consider this  remedy
worthy of trial here.
  Kali bichromicum, a remedy that shows its  curative power
peculiarly in the most intense  and inveterate symptoms  of
scrofulosis, has likewise produced good results.
  Finally, a concentrated extract of the Folia jugland is, with
which the tonsils were painted, has been used.  This means
is almost as little deserving of imitation as the gargarisms
with Alum and the applications of Nitrate of Silver.
  Hardness  of hearing, occasioned by hypertrophy of the ton-
sils, gives way, sometimes, in an amazing manner, upon the
administration of  lod. and  Brom. (S.  XXX), a fact  not ex-
plainable  without a simultaneous partial resorption of the
hypertrophied tissue.
  (S. under Baryt., Dr. Zwingenberg's method against hyper-
trophy of the tonsils.)
   D.—Scrofulous Affections  of  the Joints and  Bones.

   At another place we have called  them—rightly or wrongly
—the tertiary phenomena of scrofulosis.   Other (primary and
secondary) scrofulous conditions are wont  to precede them,
and, no doubt, always do precede them, until the osseous sys-
tem and skeleton are affected in their turn, as occurrences of
much greater significance.   As  regards our treatise this sec-
tion is of especial interest to us, in so far as it again  offers
us a chance for indicting the old school  for the inexcusable
thoughtlessness which permits it  to make use, without the
slightest ado whatever, of amputations and operations, where
homoeopathy treats in the most considerate and conservative
manner.
  Far from denying the necessity of surgical interference for

Luxeuil-Bar^ges.  Dr. Caffe recommends the partial removal of the tonsils
(in which case they continue to secrete when food is  swallowed). 
92
ON SCROFULOUS  AFFECTIONS.
diagnostic purposes, as well as the removal of pieces of dead
sequestrum, the charge of hasty removal of whole limbs by
means of saw and knife, has nevertheless to be sustained.
  Note.—It would be slandering our opponents if, in making
the above assertion, not one example observed, at least, stood
before our mental eye.
  A woman who had suffered  for years from  caries  of the
metacarpal bones, and had been advised by every one to have
the hand amputated, consulted me last year. Profuse, ichorous
suppuration, at several places, exhausted her.   The hand was
remarkably disfigured by the destructive process.
  By means of  exclusively  homoeopathic  remedies at  long
intervals, as well as in more frequent repetitions, I succeeded
in relieving the woman to that degree that she could knit, lift
cooking utensils, and perform almost all domestic labors with
the hand that  was considered lost.  She received but Sulph.,
Calc.  carb.,  and Ferrum jodat   Her gratitude  knew no
bounds.  The  suppuration became confined to a minimum,
which worked a favorable change, especiall}7 in the disposition
of the patient.  She became pregnant again, all  the  while
retaining her  healthy appearance, gained  in flesh, notwith-
standing that during pregnancy the suppuration became more
profuse  and offensive with  elimination  of small bony frag-
ments.*

        I. SCROFULOUS DISEASES OF THE BONES.

                  1. Periostitis Scrofulosa,

            (INFLAMMATION OF  THE PERIOSTEUM,)

Shows itself as an acute or chronic affection. Yet the chronic
form  can become  acute.   Spongy bones  are  attacked very
rarely, but the compact and long ones (tibia, femur, humerus).
  The termination in suppuration or ichorous decomposition
is preponderantly frequent.   Pus is  formed between  perios-
teum and bone; abscesses develop in the adjoining soft tissues,
which communicate with the pus-foci of the bone, and thus

  *  In our remarks upon Silic, as one of the most important antiscrofulous
remedies, the reader will find a few more such results as described here. 
THE  SPECIAL  FORMS  OF SCROFULA.
93
 may form a large cavity.  Usually the periosteum is detached
 to a considerable extent, the bone itself necrotizes and ulcer-
 ates (caries).
   Tuberculous masses appear as products of inflammation.
   The pain, dull at  the beginning, and worse upon touch, is
 aggravated by changes of weather and at night.  The skin
 becomes stretched and hard at the diseased spot, until fluctu-
 ation and breaking of the abscess take place.  Spongy granu-
 lations that bleed easily.
   The prognosis is  unfavorable  on  account  of the frequent
 transition  into necrosis or caries.  Its course, to the horror
 of the patient and his friends, is sometimes exceedingly chronic.
 A hectic condition may occasion death before complete ulcera-
 tion and necrotic detachment have taken place.


                 2.  Osteomyelitis, Endostitis.

              (INFLAMMATION OF  THE MARROW.)

   The inflammation of the marrow within the cavum medul-
 lare of the cylindrical bones happens with scrofulous subjects,
 and that very frequently.   There exists simultaneously in-
 flammation of the periosteum, and likewise not rarely inflam-
 mation of.  the marrow in  the bony network of the short cylin-
 drical bones.  All the spaces within the osseous network and
 the cavum medullare are filled  up at the commencement with
 dark-red marrow, which is rich in blood and cells, sometimes
 even of a decomposed, puriform character. In its later stages
 the process is called osteoporosis, osteospongiosis, spina  ventosa.
 Purulent softening and resorption of osseous substance takes
 place and make the bone appear inflated.  In a certain sense
 we could  speak of eccentric hypertrophy, especially, as the
 simultaneous periostitis deposits lamellose neoplasmata.   The
joints are apt to remain free from the affection; on this ac-
 count, and in view of the  tuberous swellings  in places where
 enchondroma makes its appearance (metacarpal and metatar-
 sal bones), the  affection reminds  us of the latter.  If those
 swellings break, numerous but small fistulous openings are
 formed. 
94            ON SCROFULOUS AFFECTIONS.
                   3.  Ostitis Scrofulosa.
            (INFLAMMATION OF THE BONE ITSELF.)
  A frequent manifestation of scrofula. The spongious bones
(short  bones of the  hand  and foot,  epiphyses of the long
DOnes—vertebre) are attacked, especially.
  At first, one or more inflammatory foci show themselves.
The osseous spaces, which are soon taken possession of by
granulations, and show a great richness in cellular structures,
are filled up to excess  with a fatty-gelatinous liquid; the
meshes of the long bones enlarge, bony substance being re-
sorbed by the growth of the granulation (osteoporosis).
  The bone  appears more voluminous at the spot inflamed,
though the whole  amount of its mass has grown less. Fre-
quently we notice, even if the inflammation reaches the depth
of the bone, that the adjacent soft tissues already show form-
ing abscesses.
  The tuberculous form of ostitis is frequent among the scrof-
ulous.  Several foci  form, or a uniform infiltration  of the
bony substance with a  semi-transparent, grayish-yellow, and
gelatinous exudation.  If separate foci exist, they are  sur-
rounded with a kind of capsula which encases, so to say, that
exudation, but disappears in consequence of  the  subsequent
changes in the latter.   Softening soon takes place; the foci
assume a yellowish color;  crummy, cheesy elements may be
found in a thick-flowing, pappy mass,  and in  case of a quick
enlargement (of the foci), not rarely  small bony fragments.
In consequence of this process in the bones, caverns are  formed
which, if several of them run together, make the bones brittle.
A cure may be accomplished by resorption of the liquid con-
tents, with simultaneous calcification  of the remainder, while
in the surroundings thickening of the  bony tissue takes place,
by which, now  and then, encasement  is effected.  However,
perforation and discharge of tuberculous pus with continu-
ation of the process as tuberculous caries are more frequent.
  The tuberculous infiltration affects either an entire bone
(e.g., a vertebra) or a portion thereof.   In the bones, which are
permeated  by grayish-yellow products of inflammation, yel-
lowish streaks and spots appear which  rapidly enlarge,  become 
THE  SPECIAL FORMS  OF SCROFULA.
95
confluent, and consist of a purulent liquid, intermixed with a
crummy mass, which soon assumes  the pyonichorous  and
sanious character.  By its influence  the bony tissue is de-
stroyed in larger or smaller portions, and may be found some-
times in the ichorous discharge.  If the  process progresses, it
may affect the periosteum, and occasion its  ichorous decom-
position and destruction.
  The terminations of scrofulous ostitis  are:
  1. Resorption (exceedingly rare).
  2. Suppuration  with subsequent healing without transition
into caries.   This  termination also is rare, if perforation and
discharge have taken place.  Under the  influence of the dys-
cratic diathesis,
  3. Caries, or
  4. Necrosis,
follow much oftener.

                            Caries.
   The characteristics of caries consist in this, that it affects
spongious bones, usually develops from  primary ostitis ; pro-
gresses  from the  interior of the bone  to its  surface (caries
centralis), and much more rarely migrates from the periosteum
inwardly (caries peripherica).  The osseous ulcer " par excel-
lence"  is produced, if the carious  inflammation attacks a
 circumscribed spot;  for  several  spots may be affected.   The
bone may ulcerate at one time  in separate portions (C. par-
 tialis), at another in toto (C. totalis).
   Caries develops in this way: the granulations secrete a
 reddish-brown liquid which, in combination with the decom-
 posing fat-cells and the few pus-corpuscles, produces the ichor
 with  which  the  spaces  of the  osseous network are  filled.
 Then atrophia of the  osseous partition-walls takes  place, in
 consequence of which the bone thus diseased becomes soft and
 compressible until  it  entirely disappears on  account of  the
 destruction  progressing from layer to layer.
   Caries necrotica takes place, if  portions of the bone,  them-
 selves normal, which are adjacent to  the carious spots, are
 deprived of nutrition, die off, and form smaller or larger pieces
 of sequestrum.
   The soft tissues participate the more  as the carious process 
96
ON SCROFULOUS AFFECTIONS.
 progresses; the connective tissue is attacked by ulceration,
 especially, where the  periosteum is destroyed.   Larger or
 smaller purulent foci and fistule form ; perforation outwardly,
 discharge of the carious ichor.
   The  secretion is mostly thin, of a nauseating disgusting
 smell (similar  to decomposing meat), intermixed  with bony
 particles, or in case of tuberculous caries, with caseous crumbs
. and flakes (and bony  particles).   Spongious granulations
 sprout  up around the fistulous opening which frequently cover
 the entrance and easily bleed upon touch.  The ichor often
 gets to the surface  by a circuitous  route.  The silver probe,
 which becomes blackened on account of the sulphur-compound
 of the ichor,  feels  the diseased  bony  part  rough, uneven,
 worm-eaten, as it were, and compressible.
   If smaller bones, distant from  the trunk, are affected by
 caries, the general health suffers but little.
   In  case of a cure the atrophy of the  bones ceases, the dis-
 charge stops, the granulations become more firm and richer in
 fibres ;  then ossification and repair of the substance lost start
 at those  granulations, as well as at the adjacent tissue, and
 especially at the thickened periosteum.

                         Necrosis.

   All  the causes and  conditions of caries may also  produce
 necrosis.  In consequence of undermining the periosteum or
 membrana medullaris, and of pressure upon the vessels after
 copious exudations have  been deposited, a piece of bone
 becomes isolated, and dies off.  According to  the seat  and
 extent, we distinguish likewise between superficial,  internal
 (central),  partial, or total necrosis.   In contradistinction to
 the carious process, necrosis affects more the long, cylindrical
 bones.  It is plain,  moreover, that the anatomico-physiologi-
 cal peculiarities of the part affected modify scrofulosis, which,
 in its essence, remains the same always.  Hence necrosis ap-
 pears here, and caries there.   In the  same manner sclerotitis
 develops in one case, and a stye in another under  the same,
 e. g., rheumatic influence.   But necrosis itself, even, appears
 to be different  according to its seat.
   a. In central necrosis  the isolated piece of bone, deprived 
THE  SPECIAL  FORMS  OF SCROFULA.         97
of nutrition—the sequestrum—is found to be inclosed in a cap-
sula lined with  granulations—death-shrine.  From  the eap-
sula incasing the  sequestrum, openings, varying  in  number,
take their departure, which are also lined with granulations,
and lead in an outward direction  (cloacce).
  The holes in the bones are round or oval, variable in size,
and externally surrounded by a wall of granulation ; pus issues
therefrom as long  as the sequestrum is within the capsula,
and though they may temporarily heal up, usually break open
again soon.
  If the sequestrum is removed the cavity is filled  with granu-
lations, and forthwith by a granular mass, provided that the
general health has not run down too much; and the fistulous
sinuses heal up,  mostly by leaving cicatricial contractions.
  b.  In superficial  necrosis, after periostitis, the  sequestrum
usually is not incased in a complete capsula ; on this account
it can be expelled more easily.  The canal in which it wTas
imbedded fills up with granulations, and a cicatrix is formed
immediately  adhering to the bone.
  c  In necrosis totalis a complete "death-shrine" is likewise
but  rarely formed ; this is pierced, on the  contrary, by open-
ings ; the soft tissues are traversed by wide and long fistulous
sinuses.
  d. Lastly, the dying off of whole bones takes place occa-
sionally, e. g., in case of scrofulosis at the hand  and foot, as
sequela of intense ostitis and periostitis.  Hence, the seques-
trum, consisting of the entire bone, show3 traces of inflamma-
tion, sometimes is carious, even, in a high degree, osteo-porous,
and  imbedded in a wide cavern filled with pus and ichor.
  If the swelling  has  broken, or been opened, we  reach the
dead bone through the opening; in most cases it gives a hard
sound upon touch, and feels smooth and firm.

                    Spondylarthrocace.

 SCROFULOUS INFLAMMATION OF THE  VERTEBRiE—MALUM POTII,
                   KYPHOSIS PARALYTICA.

  In scrofulous  children, either spontaneously, or upon some
injury, such as  a fall, &c, one or more vertebre become in-
flamed often, with inclination to  ulcerous destruction of the
                            7 
98
ON SCROFULOUS AFFECTIONS.
 bone (as central caries);  the affection  usually sets in in form
 of infiltrated tuberculosis.   If caverns have formed by soften-
 ing of the tuberculous masses, and the vertebra cannot resist
 any longer the weight of the parts above it, curving in of the
 vertebre takes place.  The curvature mostly takes place pos-
 teriorly (Kyphosis, Malum Pottii),but is combined with lateral
 curvature also (Skoliosis,  Kyphosis skoliotica).  The symp-
 toms of  an  affection of the spinal marrow, dependent there-
 upon, are not always of a grave character.
   Another  sequela we  observe in  the  so-called  metastatic
 abscesses (which extend mostly along the anterior side of  the
 spinal column, and appear at the groin or small pelvis). Per-
 foration  with discharge  into the  spinal  canal  is rare. The
 quality of the pus corresponds to its origin; it  is thin, ichor-
 ous, intermixed wTith  decomposed tuberculous masses  and
 osseous fragments  and remnants of ligaments;  has an offen-
sive smell, and discolors the probe, &c.
  Pains,  either fixed  or  migratory, are the firnt symptom.
 Afterwards  loss  of appetite, febrile  attacks,  sleeplessness,
 decrease  of  mental capacit}\   The  curvature  appears at a
later date, and mostly gradually.
  According to the seat of the affection we speak of spondy-
larthrocace thoracica, eervicalis (angina Hippocratis), lumbalis,
 and sacralis.
  Therapia.—The acute  stages of periostitis may be met with
 Aconit. and Bellad., yet Mercur., above all, seems to be able
 to effect resorption and amelioration of the intense nocturnal
 pains (LXXXV).  Mercur. and  Phosph.  produce  necrosis,
 and  both have  done excellent  service in  its  homoeopathic
 treatment.   The excessive formation of pus, and the consump-
 tion of strength therewith connected, may be  prevented  hy
 injections of Iodine.  Though Aurum  is said to correspond
 more to syphilitic necrosis,  yet  we  know that scrofulous
 ozena, depending upon bony ulceration of  the  nose,  is also
 cured by Aurum; more  frequently, however, by Hydr. prccc.
 rubr.  From the curative influence of the remedies mentioned
 upon the carious and necrotic  process, the cures of some cases
 of hardness of hearing, and many results in dental  practice,
 may be explained.   However, Silicea has been and remains the
 most important remedy in the treatment of (scrofulous) diseases of 
            THE  SPECIAL FORMS  OF SCROFULA.         99

the bones; no other drug so hastens the elimination of the dead
bony particles (to the largest piece of sequestrum) necessary for a
cure.
  Caustic, which may also be applied externally as injection,
or in the form of compresses and pledgets, as has been de-
scribed above, removes the burning  pains often very trouble-
some in the neighborhood of the fistulous openings of carious
affections.
  Calcar. and Sulph., by improving the general  constitution,
are surely able to exert a favorable influence upon the course
of caries  or  necrosis,  though they  do not  exert  the direct
influence that Silic. does.   The same is  true of Hep. sulph.
cede and Baryt.  (S. XYIII).
  Of the metastatic abscesses, such as occur in malum Pottii,
those only ought to be opened (subcutaneously) the breaking
of which is to be regarded as unavoidable at any rate.  Here,
also, Iodine injections may  be used  afterwards, for  the pur-
pose of averting  the appearance of hectic  fever  (Jousset).
The action of Calc. carb. in spondylarthrocace is plainly visible
from Case XLVII.
   II. SCROFULOUS INFLAMMATIONS OF THE JOINTS.

  According as the inflammation takes its departure, either
from the osseous portion or from the synovial  membrane
lining the joint, we observe two pathological processes en-
tirely different from each other.   In the former case, arth.ro-
cace ; in the latter, Tumor albus, or the fungous inflammation.
  Displacement of the epiphyses, by a disturbance of the
apparatus holding the  parts together, may easily occur.
  Although  any synovial membrane may be affected, and
give rise to fungous inflammation, and every end of the bone
that helps to form a  joint may lead to arthrocace,  yet the
most favored seat of the latter  is the hip-joint, and of the
former the knee-joint; and we select, therefore, coxarthrocace,
as representative of the one class of scrofulous inflammation
of the joints, and tumor albus genu of the other. 
100           ON SCROFULOUS AFFECTIONS.
         The Scrofulous Inflammation of the Hip-Joint

   COXITIS SCROFULOSA ;  COXARTHROCACE ;  COXALGIA MORBUS
               COXARUM ; LUXATIO SPONTANEA.

   This affection belongs to those scrofulous troubles which are
 apt to show themselves during the second period of dentition.
   1. Acute Course. — Starting at  the caput femoris, it is, in
 acute  cases, accompanied by the most intense  pain at the
 inside  of the thigh down to  the knee, increasing upon touch
 or use of  the joint.  Sleep is disturbed.  Exhausting, febrile
 motions.   The thigh is somewhat  adduced inwardly.  The
 buttock swollen.   Its fold stands lower.  The  affected ex-
 tremity appears longer  or shorter.  The  termination in sup-
 puration is accompanied by the formation of abscesses in the
 neighborhood of the joint which communicate with the latter.
 In consequence of the consumption of a portion of the femoral
 head a disturbance in space  takes  place, and escape of the
 head out of the acetabulum.   Hectic fever and pyemia lead
 to fatal  termination.   In  rare cases only the  suppuration
 diminishes, portions of the bone are detached, and the open-
 ings of the abscesses close up.
  2. Chronic Course.—Insignificant dragging of the extremil y
 in walking; easy tiring and complaints of weakness and stiff-
 ness of the leg as  well as unsteady gait indicate the beginning
 disease.  The vague, insignificant pain running down the leg
 resembles the rheumatic.  It is present mostly in the morn-
 ing, and  sometimes  in  the evening  accompanied by febrile
 symptoms.  There  is hardly anything abnormal  in  the hip-
joint ;  yet, the  diseased extremity when  lifted up, is apt to
 assume the position mentioned  above (drawing up of the leg
 with foot inverted).  These  conditions,  with intermissions
 may exist for months and years even.
  If the disease exacerbates, the characteristic pain  in  the
 knee appears which, however, does not aggravate upon touch
 or motion, and which some  have attempted  to  explain by
 irritation  of the  nervous obturatorius or saphenus int.  In
 stooping the patients use the healthy knee and keep the dis-
 eased leg stiff.  Limping is  occasioned.  In sitting also, the 
THE SPECIAL FORMS OF  SCROFULA.         101
 body rests upon  the healthy hip.   In walking the point of
 the foot of the diseased extremity touches the floor.   As re-
 gards the question, agitated for a good while, whether short-
 ening or  elongation of the diseased extremity takes place,
 this much is settled now, that neither the one nor the other
 exists, but such an  elongation or shortening takes place ap-
 parently* only, on account of a sinking down, or rising of one
 side of  the pelvis  (displacement  upwardly  with subsequent
 spinal curvature).  Hence, those theories, according to which
 the (apparent) shortening is said to arise from muscular strain
 and contraction which were -to press the femoral head against
 the acetabulum ;  or, according to which, on  the other hand,
 the head  was  to be pressed downwardly in consequence of
 effusions,  exudations, &c, to produce the (apparent) elonga-
 tion, must be abandoned forever.
   In this, so to say, second stage even, resorption, i.e., a cure,
 is possible.  If not, the suppuration  increases after previous
 swelling, redness, fluctuation, metastatic abscesses into the
 knee-joint and still  lower down ; finally, on account of carious
 destruction of the femoral head and  decrease of its size; dis-
 proportion with regard to the acetabulum, and real, not  ap-
 parent elongation or shortening  and spontaneous luxation
 occur.  The femoral head escapes mostly  posteriorly,  and
 upon the upper external surface of the os ilei, rarely into the
 foramen obturatorium, or upon the horizontal portion of the
 os pubis.   Exceptionally the decayed femoral head  has been
 discharged through  a fistulous opening.  If the ligamentum
 capsulare  is perforated by pus, the  perforation takes place
 mostly at its posterior or inferior portion.  Not unfrequently
 we observe that the pus escapes from the cavity of the joint
 at the point of communication with the bursa mucosa subcu-
 tanea  beneath the  musculus ilio-psoas  into  the latter,  and
 thence into the pelvic cavity, though the pus  may also get
into the  pelvic cavity by perforating the os ilei  at the point
  * In proof thereof the following modus operandi has been proposed :  Both
spina? anteriores superiores of the patient, who is in a lying position, are
brought into a line as straight as possible ; upon this a second straight line is
drawn, starting at the processus  xiphoideus sterni.  Then we try to bring
both extremities in precisely the same position, and measure with a rule of
solid material from the spina to the condyl. int. tibiae and malleolus int. 
102
ON SCROFULOUS AFFECTIONS.
of the gluteal muscles.  The fistulous openings formed by the
perforation of the skin are mostly surrounded by spongious
and easily-bleeding granulations which rise above the level of
the skin.
  Extensive cutaneous and subcutaneous ulcers in  the neigh-
borhood of the point of perforation are not of rare occurrence.
  Therapia.—In Rhus and Silicea we possess two remedies
which, according to experience,  have  cured cases of cox-
arthrocace not too far developed (S. XCV, CII, CCV, CXIII).
But Silic would be preferable to other remedies in the most
desperate cases of coxarthrocace, even ; for the  malignity of
the trouble could be owing only to a  deeper affection of the
bones, the very domain  of Silicea.  Iodium  and its prepara-
tions require caution, though we shall  report at another place
an  interesting cure with  01. jec  aselli. (LXVII).   After
Silicea; Calc.  and  also Sulph. have to be  given frequently,
after which fresh doses of Silicea evince a more penetrating
effect.  A change in the dose (between  30th and  3d), and  a
steady, slow  action of the remedy (one dose daily,  at  the
highest) secure a good result.

        The Scrofulous Inflammation of the Knee-Joint

    TUMOR ALBUS GENU; GONARTHROCACE; GONALGIA, WHITE
                  SAVELLING AT THE KNEE.
  The affection has been counted among the white swellings
for the reason that the synovial membrane is the terminating
point of the inflammation more  frequently than the condyli
and ligaments.  Its  course, as in similar cases, may be ex-
ceedingly acute, even suddenly  lethal,  as  well  as slow and
dragging.
  Its pathological picture is self-constructing,  so to say, since
the usual symptoms of inflammation, redness, heat, swelling,
stiffness, functional disturbance of the part and pain manifest
themselves.  At the beginning the knee is bent.   If it conies
to suppuration, the pus discharges now above the knee, now
burrows  toward the malleoli of the leg, and  may appear at
an}^ place (though not anteriorly).  In consequence of caries
of the bones, dislocation of the lower leg may  take place.
   Terminations: cure in  every  stage of the disease ;  con- 
THE  SPECIAL  FORMS  OF SCROFULA.        103
tinuous stiffness of the knee, produced by spurious or genuine
anchylosis; hence, tendinous  adhesions of the  connective
tissue, or osseous adhesions.  In case of fatal termination it
is preceded by oedematous swelling and very copious, ichorous
discharge.
  Therapia.—The chronic white swelling of the knee is very
obstinate, though very good results may be obtained by Ccd-
car.  and Silic.   According to Kallenbach's experience,  the
pressing, stitching pain, intermitting at rest and  during  the
night, is bearable, if  the case corresponds to Calc. carb.  In
the reverse case, Baryt. carb. is said to be preferable.
  Mineral springs (Teplitz) ought  also not to be undervalued.
Sulphur springs, as well as  sand-baths, the value of which is
more and more appreciated nowadays, deserve our full  confi-
dence.  The more the  organism is  attacked  in  its inmost
parts by the scrofulous  process, as is the case in all affections
of the bones and joints, the more we must endeavor to produce
a more energetic exchange of matter and a more efficient ex-
pulsion of organic cinders  by an increased activity of  the
peripheric organs, i. e., of the skin in our  case; and this is
accomplished by the full bath, aside from the  possibility of
thus permitting the specific remedy to act upon the body upon
an extent of surface  as  great as possible.  Among the cures
by Silic, a case is also mentioned in which decoctions of grass-
seed, applied externally, were of essential benefit.  We gladly
notice such observations, because they all evince the purpose
to allow the really active  agent (here Silic),  to  exhibit its
effect by breaking up the cohesion of its particles to a con-
siderable extent.
  Besides Silicea, Calcar., Baryt., and the preparations of Sul-
phur ; Rhus, Caustic, Ferrum, Kali, Merc, and Phos., as well
as Iodium, in low dilutions, may be recommended, most of
which have already proved their efficacy by clinical tests.
  Heyne prefers  Calcar. phos. to Calc. carb. in  tumor albus.
The  cure of a scrofulous inflammation of the knee joint we
shall report at another place.  See Case LI. 
104            ON SCROFULOUS AFFECTIONS.
                           III.

THE  MOST APPROVED  REMEDIES AGAINST
                      SCROFULA.
  The rationality of the antiscrofulous treatment is certainly
decisive as regards the prognosis and eventuality of relapses.
Orthodox allopathic treatment offers the worst guarantees.
By its mania forthwith to bleed in every case of hyperemia
and trifling pain, it contributes to the  derangement of the
bodily constitution.  The blood, already predisposed to dropsy,
is made still more watery.*
  Moreover, by its anointing and exsiccating method (using
zinc, lead, and mercurial  salves, astringent injections, &c), it
induces the vis medicatrix nedurcz, aiming at the expulsion of
the inimical matter, again to transfer those causes, imponder-
able though they be, yet  morbific in their action, to internal
organs.  For  this very reason  we can indorse only that  por-
tion of the therapeutics of allopathic authorities which dwells
upon general hygienic rules, and is, for the greatest part, of a
purely prophylactic nature.
   Self-evidently, the homoeopathic physician will  not oppose
the recommendation of pure  air,  proper  strengthening and
concentrated food, the culture  of the skin as far as it can pos-
sibly go, nor a cautious hardening  of the body, if the disease
has not, as yet, progressed too  far.   An exclusively vegetable
diet is to be forbidden from the very fact that the scrofulous
represent the  vegetable type of man in an abnormal  manner,
  * It is certain that in the scrofulous an anomaly exists in the proportion
between the solid and liquid organic parts;  and this anomaly, as Portal has
shown, exists, in all probability, at the expense of the red parts of the blood,
or in favor of its serous portion. 
      MOST APPROVED  REMEDIES  AGAINST SCROFULA.  105

 and live a life that is already too vegetative.  Hence, an ani-
 mal diet has  to  be ordered at the same time.  Everything
 favoring the production of acidity (eating of too much fruit),*
 very salty, also sweet (cane sugar), highly  seasoned and  fat
 food, has to be  avoided.   In short, the diet ought not, as a
 general thing, to be irritating.
   As  already mentioned, pure, dry,  and  warm air, is also
 necessary for a radical removal of scrofulous affections. Warm
 clothing prevents the recession of sweat.  Dancing, fencing,
 hunting, riding on horseback, swimming, working in the field
 or garden, would, no doubt, be very risky undertakings, since
 in all such  exercises the body is thrown into a profuse sweat.
 Gymnastic exercises, rationally conducted,  seem most bene-
 ficial.
   Scrofulous  residents  are  found but rarely near the  ocean.
 Hence the  benefit of residing near  the sea might be  inferred
 a  priori.  Let us add  to this that, according  to experience,
 sea-baths have rendered  most excellent  service in  removing
 the scrofulous habitus.   The percentage of lod., Brom., Natr.
 mur., &c, contained in sea-water, no doubt explains this effect.
 Sea-air alone contributes essentially to an increase of appetite.
 Tissot, Cullen, Borden, and  others, place  especial  value in
 therapeutic aid.   Here  belong also,  the baths of Bareges,
 Plombieres, Mont d'Or, as well as our baths  in the North and
 Baltic Seas.
   There exist  different views,f however, as regards the value
 of milk.  Baillon, Richard, &c, recommend the milk of asses.
 Others believe that all  milk does harm.  The idea that by a
 strengthening regimen, living in  the country,  &c, the diges-
 tive organs can be so strengthened as to bear milk is, probably
 correct.  Then,  it  certainly  becomes  and  remains a  very

  * I frequently observed an increase of scrofulous exanthemata and aggrava-
 tion of scrofulous  ophthalmia from eating cherries or prunes, and after  the
 abuse of apples and apple-butter.
  f Thus Alfred Vogel, the celebrated physician of diseases of children, whom
 we have already quoted several times, says with regard to the diet of rha-
chitic children : "Cow's milk is the best food for children up to the age of
three years.  It cannot be compensated by  any other, and ought to be given
in  quantities as large as possible."  Dr. Weil, on the contrary, says : "In
rhachitis milk must be entirely dispensed with, because by the use of it  the
 bones grow softer  and softer." 
106            ON SCROFULOUS  AFFECTIONS.
 valuable article of food which is to be estimated more highly,
 since, as is well known, all the constituents of the blood may
 also be found in the milk.
   Scrofulous children frequently suffer from diarrhoea.   In
 such cases milk-diet ought to be abandoned for a time.  Salep
 and arrowroot hardly answer as substitutes; even  Liebig's
 celebrated soup does not always agree with children.  Grits
 and barley-water, when they are borne well, are not nutritious
 enough.  On the contrary chicken broth prepared from an old
 chicken with soft-boiled farina, is to be greatly recommended,
 and may be  taken as a  substitute for milk for a  week and
 longer.  Goat's milk is  tried too little, as yet, where cow's
 milk  is not well borne.  We  hear the objection also, that
 goat's milk  is too fat;  yet, the capricious stomach, in  such
 cases, just requires fat, in a similar manner, as there  is often
 an unexpected tolerance of  Cod-liver oil.  Besides  I have
 ordered the goat's milk to be  given warm as it is drawn from
 the bag, and imagine that I have saved more than one child
 by this means.
   Finally, we mention acorn coffee as a dietetic aid of import-
 ance.  I heard from  trustworthy mothers that their weakly
 children had begun to walk only since they had  been given
 acorn coffee.   This is easily explained, if we remind ourselves
 of the roborant and tonic property of this drink which con-
 tains tannin.
   Dr. Weil, no doubt, was supported  by similar experiences,
 since  he orders the following regimen for weakly, scrofulous,
 and rhachitic children.
   For breakfast: two cupfuls of acorn coffee, or of homoeop.
 coffee (prepared of half an ounce thereof) with the addition of
 some sugar and a little milk.
   For luncheon, he recommends finely scraped (raw) veal or
 beef spread over a piece  of twist.
   For dinner:  beef tea, lean,  roasted meat, a few vegetables,
v stewed fruit, wheat bread, light desserts (prepared of eggs).
   For supper: soup prepared of farina or grits.
   The use of good  and pure malt-beer is very beneficial  to
 such children.*

   * Anleitung zur diaetetischen Krankenpflege von  Dr. med. "Weil, S. 161.
 Gotha,  1869. 
      MOST  APPROVED REMEDIES  AGAINST  SCROFULA.   107

  Bathing  in  water  containing  lod.  and Brom., still ap-
proaches to homoeopathic ideas ; though we have accustomed
ourselves to set up strict indications for such aids.  The same
holds good of Cod-liver oil, of which we shall speak anon.
However, "we will here mention that authors of name deem it
indispensable in rhachitis.
  The following recommendations in allopathic textbooks we
consider to evince but  little rationality:
  " Several vegetable substances, such as Dulcam., Sarsapar.,
Cicuta, Folia jugl., &c," as if one and the same antiscrofulous
principle were contained in all of them. How differently the
physician thinks and  judges  who treats  according  to  the
strictest symptomatic  similarity, and is guided by the Mat.
Med. Pura.  He knows that among the  " several vegetable
substances " the one corresponds only to this, the other to that
pathological complex,  diseased individual and disease-stage.
In place of arbitrariness a necessary law exists for him.
  It is remarkable, notwithstanding, that as regards the most
sovereign  antiscrofulosa, both  schools join  hands  uncon-
sciously.  Who would  wish to deny that Cicuta, in fact, is one
of our  foremost  (antiscrofulous)  remedies  (I refer only to
blepharitis cil., scroful.).  Hufeland concedes  to Baryt. mur.
one of the first places  among the exceedingly few antiscrof-
ulosa which he accepts, and our homoeopathic literature con-
tains the  most remarkable  cures  of intense  scrofulosis by
Baryt. mur.  What important parts do lod., Ferrum, and the
compounds of both  ; the mercurialia and  ammonia prepara-
tions, play  here as well as there.  Aside from these, however,
we possess  a sufficient number of peculiar remedies.   For,'of
what value are Arsen., the Carbonate of Lime, Sulph.,  and
Nitri acid., to traditional medicine?
  Let us now proceed to the valuation of the several anti-
scrofulosa.   We intended at first to arrange them in a man-
ner differing from a mere alphabetical enumeration;  yet, no
essential gain would result  therefrom for  practice.  If we
divide,  for example, the antiscrofulosa into such  as are of
organic or inorganic  nature, we  should have to separate
Graphit. from Carb. veg.,  and the latter again from Carb.
anim., though all three of them have many  phenomena in
common, e.g., their relations to the glands ; moreover, for the 
108
ON SCROFULOUS AFFECTIONS.
sake of consistency, we should have to separate Lycopod. from
Calc. carb., and to place the former in the category in which
Calendula, Viola tricol , Euphrasia, &c, belong.   And where
should we speak of Apis which we cannot pass over in silence,
entirely ; though its curative power in scrofulous ophthalmia
and its result (opacity of the cornea) has been doubted, or is
not proved, at least, as is that of Acid, nitri., Calcar. carb., &c.
  For this reason let us not sacrifice to the mania for classifi-
cation, the only principle which can engage our consideration
regarding the comparison of the various medicinal substances,
i. c, the principle of the physiological proving.  And here we
find that remedies of the organic world  may bear similar re-
lations to the same organs as do remedies of the inorganic;
hence, that in therapeutics they call for a similar application.
  We have given  the several  reports of cures  mostly ver-
batim, because a short  resume, no matter  how good a survey
it may offer, always lacks  the  agreeable impression of im-
mediate, personal experience. It is more  profitable, if we par-
ticipate in the subjective impressions of the author in the
course of  a clinical report; if we feel with him his troubles,
and finally enjoy with him the favorable termination.
  Finally, we have interfused, here and there, in a somewhat
independent manner, practical remarks and hints of the  most
various observers, and hope that every one—notwithstanding
he may miss therein, perhaps, organic connection—will judge
for himself and, by the aid of experiences already gained for
himself, gain in surety and ease, successfully to grapple with
the host of scrofulous diseases.


                    ACIDUM  NITRI.

                      GENERALITIES.

  Acid, nitri is homoeopathically specific in all  aphthous
ulcers of the mouth, in phlyctene of the cornea developing
into superficial ulcers ;  inflammations of the connective tissue
of the inner canthus (ccgilops), terminating in suppuration and
subsequent ulceration ; in superficial and offensive ulcers ac-
companying balanorrhoea.
  Moreover, in  many cases of common scrofulous ophthalmia 
      MOST APPROVED REMEDIES  AGAINST  SCROFULA.  109

 (ophthal. pustul, herpes conjunctive, Ruete), especially in the
 later stages, at the height of the inflammation, and after Cal-
 car. carb. has been given in vain.
   Most of my colleagues will admit that those  cases of scrofu-
 lous  ophthalmia sometimes belong among the most tedious,
 because most  obstinate objects of cure existing.  Merc, Arsen.,
 Hepar., Lycopod., Conium, and Heaven knows what else, are
 tried, with and  without the patience of the  physician and
 patient, and—fail.   However, in many such cases, we will yet
 be rewarded upon the administration of Acid, nitri*
   Aside from scrofulous ophthalmia, which is  not dangerous,
 but often very obstinate, Acid, nitri is indispensable in ophth.
 neonat., a fact from which we may, probably, infer very cor-
 rectly the scrofulous nature of this disease ; or we may say
 that, in both cases, one and the same morbid diathesis exists,
 which finds its curative simile in Acid, nitri.f
   It remains but to point to the following symptoms of Acid.
 nitri, as recorded in the M. M. P., the complex of which pre-
 sents a characteristic picture of scrofulous ophthalmia:
   " Pressing in the eyes as  from  sand, in the outer canthi;
 winking; great seusitiveness to light; stitches  and itching in
 the eyes;  smarting and burning; redness of the white; inflam-
 mation of the conjunctiva; swelling of the  lids; spots upon
 the cornea; watering of the  eyes; acrid humor; agglutina-
 tion ; difficult opening of the lids in the morning; photopho-
 bia ; obscurity of sight; the right eye becomeg obscure; objects
 appear dark ;  mist before the eyes ; myopia."
   The symptoms of Nitr. ac, enumerated under the head of
" Ears and Nose," likewise indicate  that we possess in this
remedy a true antiscrofulosum, and practice has long ago con-
firmed this supposition in a brilliant manner.  It has proved
efficacious in hardness of hearing (afterwards Petroleum).
  * Six drops of the 3d dil. in 60 grammes of water, morning and evening a
teaspoon ful.
  f Ten drops of Acid', nitri 1 or 2, in a saucerful of water ; compresses moist-
ened therewith, and applied to the eyes; over the compresses a cloth for pro-
tection ; the dry compresses to be removed. 
110
ON SCROFULOUS AFFECTIONS.
                        CLINIQUE.

               1.  (I.)  Ophthalmia Scrofulosa.
  L. W., et. 4, for a year has suffered from scrofulous oph-
thalmia.   The lids of the right eye are red and swollen; ves-
sels of the eye  injected, the cornea opaque, especially below
the pupil; photophobia; the eye waters, especially when look-
ing into the light; lids are agglutinated in the morning, and
itch; from  the right nasal  opening a watery discharge;  a
nodulous eruption at the buttocks; crusts and soreness behind
the ears.   The trouble  began with a purulent, offensive tinea
capitis et faciei.
  Sulph., Bellad., Calcar., Euphras. effected  nothing.  Puis.
12, alternated  every fourth day with Ac. nitr. 12, occasioned
a considerable aggravation, upon which improvement followed
so rapidly, however, that this chronic  trouble was completely
removed within twenty days. (Erfahrungen aus der Praxis v.
Haustein, A. H. Z., 39, 10.)


              2. (II.) Blepharitis Phlegmonosa.
                (Observation of my own, A. H. Z., 69, 13.)
  The daughter of the  stonemason G., et. 5, has  been treated
allopathically for six days, until  the  increasing  aggravation
has induced the parents to abandon this treatment.   There
existed a phlegmonous  inflammation of the  upper, and after-
wards of the lower lid; the skin of the lid discolored, swell-
ing of the connective tissue considerable, so that the bulbus
could not  be seen ; the  ciliary glands  secrete a gluey humor,
which mixes wTith the tears discharged in profusion ; the child
had fever, was very restless, and the whole affection made an
unfavorable impression.
  Mercur. viv. 3. (Cotton to the swollen lid.)
  December 7th (i. e., the day following). The  swelling has
gone  down  remarkably.  Less  pain.  Skin less discolored.
Better in general.
  One dose  of Mercur.
  Dec. 9th,  without any cause (known)  the  lower  lid is  in-
flamed again and swollen.  Bellad. 12, every two hours. 
     MOST APPROVED REMEDIES  AGAINST  SCROFULA.   Ill

  Dec. 10th.  More satisfactory state of things.  Yet the con-
dition remained oscillating, notwithstanding Bellad. given in
alternation with Sulph.
  In the surrounding of the eye, purulent-crusty exanthemata
formed which bled easily.  This symptom led us to give Acid.
nitri 9th  dil., every two hours.  The  effect was surprising.
From this time on improvement was steady  and rapid.


                          APIS.

                      GENERALITIES.

  Dr. Genzke, of Buetzow, aside from an increased frequency
of the pulse, which he rightly ascribes  in part to the action
of the alcohol, observed obscuration of sight from the continued
use, and large doses of Apis-tincture. At the conjunctiva and
membrana nictitans  (of the dog experimented upon) distinct
vascular injections showed themselves, on account of which
the cornea assumed a smoky appearance, and the eyelids were
agglutinated in the  morning by the mucus  secreted.  These
symptoms continued during the remainder of the proving, and
soon disappeared  after its termination (N. Z. f. h.  Kl., 5, 23).
  These are facts.  On the other hand,  there is scarcely any
remedy in the application of which one may deceive  himself
more than in that of Apis (see, also, Bolle's popul. Zeitschrift,
Jahrg.,1866, 1 and 2).
  Dr. Genzke noticed, further, that Apis (2d dil.) produced
satisfactory results in rheumatic, catarrhal, and scrofulous
ophthalmia,   It acted splendidly in young persons, and espe-
cially in acute cases.   In older persons and in inveterate  cases
the effect was but palliative or naught.  (In both of the latter
conditions we would direct the attention to Euphrasia inter-
nally and externally.)
  Dr. Battmann, of Grossenhain, has observed of Apis 2—
other remedies had  been given in vain previously — several
times a very  surprising effect in inflammation of the conjunc-
tiva palpebrarum,  sclerotice and cornee,  with vesicles or
small ulcers, and infiltrated vascular nets around  them, ac-
companied by photophobia, often of a very high grade, water-
ing of the eyes, pressing and smarting pain.   B.,  for his dilu- 
112
ON SCROFULOUS AFFECTIONS.
tion, used a mpther-tincture  prepared of three bees, which
were mashed in one drachm of diluted alcohol.  (N. Z. f. h.
Kl., iv, 4).
  Dr. Paulson obtained good results with  Apis in struma
(Apis 15th and 30th) (A. H. Z., 72, 22^.  A remedy that ac-
complishes results  in  this direction surely deserves to  be
counted rightfully among the antiscrofulosa.  The cures, more-
over, were obtained in  individuals who had passed childhood
long ago, and of whom no other symptoms of scrofulosis are
mentioned.

                        CLINIQUE.

              1. (III.) Ophthalmia Scrofulosa.

  A girl, aged thirteen  years, who for nearly a year had
been suffering from an inflammatory affection of the right
eye — a condition  which, in  spite of former  medical treat-
ment, and especially within three months, became  so ag-
gravated gradually that the  power of sight was totally an-
nulled, and the patient was tortured by severe pains appear-
ing in  paroxysms, exhibited  the following pathological pic-
ture: Conjunctiva inflamed in its entire extent; redness more
saturated at the outer  canthus.  From this  point a so-called
" scrofulo-vascalar ribbon" departs, which threatens to develop
into  a  pterygium, and  sufficiently explains the complete dis-
turbance of the power  of sight.  On examination of the eye
a stream of tears gushes out.   Great photophobia; pain  on
opening the eye; increased secretion of mucus.   Agglutina-
tion of the lids in the  morning. The  nose of the child con-
siderably swollen without being inflamed.
  Every evening one dose of the 2d dil. of  the bee-tincture.
Within fourteen days a considerable improvement had set in;
the conjunctivitis had nearly disappeared, the pseudo-mem-
branes had become thinner, and had redrawn from the cornea ;
an opacity still remained upon the latter which did not  permit
of complete sight.  Pain, flow of tears, agglutination of the
lids had entirely disappeared.   Four weeks afterwards the
same prescription, after which the trouble could be considered
as entirely removed, with the exception of a nebulous spot
upon the cornea at the pupillary edge. 
      MOST  APPROVED  REMEDIES AGAINST  SCROFULA.   113

  The power of sight is completely restored.  The opacity gave
way rapidly upon  the use of Aurum. 3 (one dose every, other
evening).
  Dr. Genzke, to whom we are indebted for this report, adds
with good reason:  This removal, rapid and mild as it is, of a
firmly-rooted disease of the eye, allows of no comparison with
the treatment of allopathic oculists who, in such a ease, under-
take at first to combat it by local applications of caustic,  or
so-called astringent remedies;  and  since  they almost always
fail  in this, proceed with an operation  which, in the  most
favorable case even, too often only leaves behind a permanent
opacity of the cornea (N. Z. f.  h. Kl., 5, 34).

                2.  (IV.)  Ophthalmia  Scrofulosa.
   Dr. Bolle recommends Apis against scrofulous diseases of
the  eye.   He reports (A. H. Z., 52, 6) two interesting cures.
Apis  1,* was given, and in the one case an obstinate photo-
phobia removed, in the  other  total blindness, i. c, complete
opacity of the cornea in front  of the pupil.   Even a scabious
eruption at the neck appeared upon the girl, one year old,
after six powders (morning and  evening one  powder).  She
had been afflicted previously with genuine itch.
   Regarding these results, Dr. Gerster remarks that we ought
to be cautious in judging of the influence of  such remedies.
His words deserve to be quoted here.f

                        3.  (V.)  Struma.
   A young  lady had  an enlargement of the thyroid gland.

  * Six grains of Apis to  one and a half drachm of Alcohol. Globules
wetted with this tincture.
  f Without doubting in the slightest the highly praised curative action of
Apis  against scrofulous ophthalmia, and especially against photophobia of
scrofulous children, I beg to be permitted the remark  that such troubles fre-
quently make remissions, intermissions, exacerbations, and metastases with or
without the use of remedies.  The aural discharge, facial and cranial erup-
tions, for instance, disappear, and in their place inflammations of the ocular
membranes, phlyctasnas, photophobia, &c, appear; or the aural disease ceases,
and otorrhoea, tinea faciei, crusta lactea, swelling of the cervical glands, flowing
coryza, &c, set in.  Since scrofulous affections of the eye are not a local dis-
ease but the expression of a constitutional anomaly, relapses are avoided most
surely, if we succeed in removing as much as possible the fundamental trouble
by the aid of nature or art.
                               8 
114
ON SCROFULOUS  AFFECTIONS.
Iod., Calc carb., and Rhus effected nothing; Apis 15 and 30.
The swelling of the size of a goose-egg has disappeared within
fourteen days.  Patient was  somewhat amenorrhoeic  during
the time of her illness.

                     4. (VI.) Struma.
  Mrs.  G.,  et. 35, suffered every eight  days from profuse
uterine hemorrhage.   She was pale, and could scarcely walk ;
the right lung hepatized; violent cough morning and evening,
with yellowish-gray expectoration; at the same time she was
afflicted with goitre.   Calc. carb. and Natr. mur. entirely cured
the patient; the goitre only, though somewhat smaller, still
existed.  After Apis  3, within three weeks, no decrease of
the struma; after Apis 30, morning and evening four globules,
the enlargement disappeared gradually.

                    5. (VII.) Struma.
  Mrs.  L., et.  43, in  climacteric  years.   Menses  irregular.
Pain in the left and  right ovary; large struma, with  diffi-
culty of breathing.  Apis 15, six globules morning and even-
ing, completely cured  the  struma within  fourteen  days (the
remaining symptoms  were cured by Sepia) (Western Horn.
Observe/, July 15th, 1865).
                      AKSENICUM.

                    GENERALITIES.

  Arsen. does not act directly or specifically upon the morbid
product, as an antiparasitic, as it were, but upon the healthy
tissue, the vital energy of which it  increases, and  which it
enables to resist the inroad of the pathological element.  Re-
storing general health, it becomes one of the surest remedies
to counteract the development of neoplasmata.   This occurs
in the scrqfulides which aggravate the scrofula-cachexia, and
in superficial and deep suppurations, pulmonary catarrhs, ac-
companied  by profuse,  offensive secretion, fever, emaciation,
and marasmus ; in parasitismus, in the course of convalescences
dragging out for a long time ; finally in tubercle.  Its efficacy 
      MOST APPROVED REMEDIES AGAINST SCROFULA.   115

 in cancer is still illusory, though we possess several observa-
 tions not to be underrated in this direction also.*
   With Arsenic we find, as a rule, a check of the  organic ac-
 tivity, similar to paralysis;  ou the other hand, inclination to
 profuse  secretions chemically alienated (Northoff, d.  Horn.,
 33, 108).
   " It is always," says a third author, " the ulcerative process,
 and especially the ulcerative process inclining to  atonia and
 gangrenescence which succumbs to the  curative power of
 Arsenic.   Against phagedenic impetigo and herpetic ulcers,
 Arsen. has often  been  recommended" (Dr. Frank, Osterode,
 A. II. Z., 31, 23).
   From Rueckert's " attempts at utilizing the curative mate-
 rial obtained  ab usu in morbis," we  quote the following indi-
 cations : Nasal  openings, corners of the mouth and  anus red
 and sore ; ulcers  at the nostrils; annoying burning; sensa-
 tion of paralysis of the tongue ;  unquenchable thirst; intense
 burning at the  anus ;  coryza, acrid, corroding the upper lip;
 violent burning beneath the skin (in bed);  chronic eruptions ;
 tinea capitis in  which Arsen. proved itself  curative,  predomi-
 nantly  showed  pustules  and vesicles containing  a  purulent
 liquid—ulcers discharging  a thick, greenish,  and  offensive
 ichor—itching violently, burning, worse at  night; better from
 warmth, worse from cold air.  Small pustular elevations re-
 sembling scabies burst, and the corroding liquid forms phage-
 denic ulcers.   Phagedenic bulle at the soles of the feet, and
 painful  burning over the entire ulcerating surface.

                         CLINIQUE.
  In cases  of scrofulous ophthalmia, Arsenic has produced the
 following results (Z. f. h. Kl., 2, 20):

              1. (VIII.) Ophthalmia Scrofulosa.
  A girl, et. 20, with opacities upon the cornea from former
inflammations suffered from scrofulous ophthalmia of the
right eye and lids.   Pain at the edge of the cornea ;  a phlyc-
tena developing, photophobia, flow of tears.

  * Die Iluilsamkeit des Antimon-Arseniks gegen Lungenemphysem, v. Dr.
Payr in Wuerzburg (A. H. Z , 79, 15). 
116
ON SCROFULOUS  AFFECTIONS.
  Bellad. 3; cure within three days.  A relapse  was cured by
Bellad. within four days, and the remaining flow of tears by
Arsen. 6.
              2. (IX.)  Ophthalmia Scrofulosa.
  A girl, et. 12, for three weeks  suffered from Ophth. scrof.
of the left eye with two ulcers on the cornea.  Shooting pains.
Flow of tears.  Bellad.  3 without  effect.   Arsen.  3;  cure
within twenty-three days.

               3.  (X\) Ophthalmia Scrofulosa.
  A woman, et. 27, frequently suffering from  styes, for the
space of four months  is  affected  with scrofulous ophthalmia
of the left eye with pricking pain ; ulcers on the cornea, pho-
tophobia, flow of tears.   Ars. 12  improved  her rapidly, and
cured within sixteen days.

  Note.—The affections of the eyes cured by Arsen. are char-
acterized, according to Dr. Gauwerky, by burning pains  and
soreness of the inner surface of the lid, obscurity of sight, and
amelioration from warmth; spots and ulcers on the  cornea,
and  acrid,  corroding  tears  (9. Jahresvers. d. horn  Aerzte
Rheinlands und Westphalens, 31. Juli, 1856).

         4.  (Xb.) Scrofulous Blennorrhoea of the  Eye.
  Dr. John Weber, of Brilon (A. H. Z., 39, 9,1), cured an
intensely itching crusta lactea (in a fleshy girl, six months old),
by Arsen. 30.  The eyes were entirely closed by the swelling,
and  between the lids  an acrid matter oozed out corroding
everything around.  The child rubbed its  head and face al-
most constantly, and the parents feared that she would  become
blind.
  He also cured a similar tinea by Arsen. and  several others
by Rhus.

      5.  (XI.) Abdominal Scrofula, Atrophia Infantum.
  In order to give an instructive illustration in which cases
Arsen. is of extraordinary efficacy,  we quote  the following
clinical observation,of .Kafka (N. Z. f. h. Kl., 2, 1). 
      MOST APPROVED REMEDIES  AGAINST  SCROFULA.   117

     Atrophia in consequence of Chronic Intestinal Catarrh.
  A boy, et. 2, had already been affected by diarrhoea for six
months.   All professional and non-professional  means used
against it, remained without any result.  I was consulted De-
cember 9th, 1853, and found the boy emaciated to the highest
degree, pale, like a corpse, of withered and senile features.
The eyes rolled about wildly in their deep sockets, animatedly
following every word and motion of mine and those surround-
ing.  His thirst  was not  to be quenched ;  every five or six
seconds he asked for a drink.   Appetite tolerably keen, yet
as soon as food is taken, rumbling in the abdomen sets in, and
from four to six fluid, painless stools of an excessively nause-
ating and cadaverous smell follow each other in quick succes-
sion.   Their  number  within twenty-four hours, I was told,
approached to from 16 to  20.  The abdomen is distended me-
teoristically, and gives a clear, tympanitic sound at all points
with the exception of the region of the liver and spleen, where
percussion proves a considerable organic enlargement.  Nasal
openings, mouth and anus red and sore; dentition has nearly
terminated; worms were never passed.
  Upon the use of Arsen. 6 (10 drops in half pint of  water),
two teaspoonfuls every two hours, the  child was completely
convalescent within four weeks.

  Note.—Although Kafka does not say that  the  child  was
scrofulous; leaning upon  considerable  experience, I yet may
maintain that scrofulous  children,  affected  by such chronic
diarrhcee, endangering life, are exceedingly well  served by
Arsen.  The  6th dilution has  proved  itself to me also, the
most effective.  It is very important not to confound the in-
dications for Arsen. with those of Carb. veg.
  In the N. Z. f.  h. KL, 4, 20, we read of very interesting cures
by Arsen., obtained by Dr. Eidherr, of Vienna, in atrophia
infantum.
  In  those cases in which intermitting fever, hot head  and
hands and  a  disturbance  of the process of nutrition  plainly
manifested themselves, he gave Arsen. 15, and followed it up
by Calc. carb., if the intermitting fever  had disappeared, the
children  became more lively, and  looked  better, but  the 
118           ON  SCROFULOUS AFFECTIONS.
diarrhoeic green stools, hardness and  tenderness of the ab-
domen remained.

      6. (XII.)  Abdominal Scrofula, Atrophia Infantum.
  Harriet B., et. 1J, a miserable child, emaciated to a skele-
ton, with a large, distended abdomen, and thin legs, upon
which the muscles hung down like old rags, the skin of the
whole body shrivelled, dry and of a dirty-grayish color, has
suffered  for nearly six months from a watery, cadaverously
smelling diarrhoea which passes involuntarily from  20 to 25
times a  day.   Besides, she  has an enormous navel-hernia,
nearly as large  as a hen's egg, eats little, sleeps still  less, but
drinks all the time, especially cold water, greedily; the voice
resembles that  of  a  kitten.  Arsen. 30, three drops in  two
ounces of water, a  teaspoonful twice a day ; fourteen days af-
terwards the child looked  better, and no longer drank so
much.  Diarrhoea, though still passing from 10 to 15 times a
day, no longer offensive. Arsen. as before.  October 25th, 1866,
her mother came to me wTith another child of hers afflicted
with otorrhoea, and told me that Harriet had been  running
about lively and healthy for eighteen months (A. H. Z., 80,
15, Dr. Bojanus, in Moskau).

  Note.—Arsen. and  Graph, in alternation (continued for six
months with intervals), are praised against malignant im-
petigo of the head upon a scrofulous bottom (also, when plica
polonica exists  at  the same time*)  (Bericht ueber die am 20.
Juli, 1868, in Dortmund  abgehaltene Versammlung der Ho-
mceopathen Rheinlands u. Westphalens).
                        AURUM.

                      GENERALITIES.

  Aurum. has many characteristic ,drug  effects  in common
with Arsen.  Thus great difficulty of breathing during the night,
and violent palpitation of the heart.  But as Aurum acts more

  * Others praise here Staphisagria 1, one drop morning and evening for
weeks. 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.   119

 decidedly upon the glandular system, it is  a  more useful
 remedy in scrofula.  In the torpid form of scrofula it has been
 given with more success.  Thus especially, Aur. mur. natro-
 nat 3 trit.  (according to Schweikert,  of Breslau), against
 scrofulous glandular ulcers with torn,  indented edges,  and
 caseo-lardaceous secretion; scrofulous ulcers of  the conjunc-
 tiva and cornea, but also against knotty, scirrhous glands.
   Nightly pains in the bones, especially of the  nasal bones,
 fetid smell from the nose.   Aurum, it is true, cures ulceration
 of the bone, also, but more when the anamnesis  allows us to
 infer the influence of syphilis or Mercury.  Swelling and  sup-
 puration of the inguinal  glands.   Induration or swelling of
 the testes.
   Next to Arsenicum., Aurum much resembles Silic.  It may
 also be mentioned that mental depression, hence melancholic
 temperament, decrease of memory, rabid appetite, simulta-
 neous affections of the gums would speak for the selection of
 Aurum (S. Dr. Ber's Beobacht. fiber Primarwirkg. von Gold..
 A. H.  Z., 54, 1).

                        CLINIQUE.
                   . 1. (XIII.) Ozcena.
   C, a young girl, et. 18,  suffered for several years from
 ozena with caries of the  nasal bones.  The affected  organs
 made so fearful a smell that doors and windows had always
 to be opened where the patient remained.  Aurum 3, one dose
 every third day, restored her health completely.

                    2. (XIV.) Ozcena.
   Dr. Ber within  three weeks cured a girl, et. 13, by Aur.
met, who to the torment of her friends suffered for a long
while from a horribly smelling nasal discharge of a purulent,
viscid character, and very offensive breath. She looked almost
ruddy, but somewhat " scrofulous"  (A. H. Z., 54, 1).

       3. (XV.) Chronic Inflammation of the Cornea.
  Dr. Genzke cured with Aurum 3, one dose every evening, a
chronic keratitis in a  scrofulous girl, et. 10.  The cornea of
the left eye was completely opaque.  All the external reme- 
120
ON SCROFULOUS  AFFECTIONS.
dies  used against the trouble had  proved inefficient.  The
whole cornea had a  marbly appearance.  In the periphery of
the cornea a vascular wreath, highly developed.  No  pain,
no increased secretion of tears.
  The cornea had been in this condition four months.   It re-
quired eight wTeeks  to restore its transparency (A. H. Z., 55,
10).
             4. (XVI.) Opacity of the Cornea.
  In another case Hep. sulph. had removed the main trouble,
while Aurum 3, one grain every evening, restored  the  clear-
ness of the cornea.   Before the patient came under homoe-
opathic treatment the powTer of sight was lost almost entirely;
with the left eye he could not recognize anything, but merely
distinguish between light and darkness;  with the right eye
he saw something, but could not distinguish forms and out-
lines of objects.

         5.  (XVII.) Scrqfulo-rheumatic Ophthalmia.
  That the effect of Aurum, in such cases, is not accidental,
another  cure by the same  author  plainly demonstrates, in
which a remedial aggravation upon each  single dose of  the
gold could be distinctly proven (A. H. Z., 55, 11).
  Mrs. K., of D., had suffered the year previous from scrofulo-
rheumatic ophthalmia which, finally, had given way to a long
allopathic treatment, but left a considerable cicatrix upon the
pupil of the right eye, on account of which the power of sight
was much impaired.  At the  beginning of the new year she
was affected by the  same inflammation on both eyes which,
in spite of the  immediate curative  efforts of the  same phy-
sician, increased to such a degree as  to enlarge the cicatrix on
the right eye, and produce opacity  over the whole surface of
the left,  so that the power of sight was  entirely suspended.
Conjunctiva reddened, great photophobia, burning hot  tears,
and violent cutting  pains  tortured the patient.  The former
physician strewed calomel into the eye, and hoped to cure the
woman within  the course of one year.
  Spigel. 4, morning and evening, lessened the inflammation,
afterwards Phosph.  30, against taking cold easily, with  the
result that now the inflammatory symptoms disappeared. 
      MOST  APPROVED  REMEDIES AGAINST SCROFULA.  121

   Now, of Aurum 3, which taken in doses of a whole powder
 daily, increased the irritability (photophobia), one grain was
 given every other day,  which brought forth the following re-
 port : " There is, Heaven be  praised, so essential an improve-
 ment that my wife is already able to read well."   The com-
 plete cure (July 1st) resulted from the sole and continuous
 administration of Aurum.   At  the same time with it the di-
 plopia disappeared, which was occasioned by a perpendicular
 cicatrix upon the cornea.

   Note.—The experiments of Dr. v. Pratobevera do not seem
 to be void of interest with regard to the indications of gold.
 Aside from  the boring and  burning  pains, accompanied by
 redness and swelling, even, which he felt in various parts of
 the body, especially in the bones of the foot, he observed that
 an eczematous eruption  which, thus far, had not molested him
 any, began to discharge after itching  previously, and spread
 considerably.  The axillary glands in the neighborhood were
 swollen.
   A dose of  Aurum 12, taken at a later date, compelled him
 to give up his experiments.


                  BARYTA  MURIATICA.

                       GENERALITIES.
   Baryt mur. was  used for a time as an excellent antiscrofu-
 losum, especially on Hufeland's recommendation, who advised
 its application in inflammatory conditions of the glands.   At
 present its use  is more limited, though Baryt.  is equally in-
 dispensable as Iodine, and in  its  place  equally efficacious.  It
 is true  the  indications  regarding its  application  cannot be
 given so definitely.  Its  physiological effects upon the glandu-
 lar system were principally observed in the tonsils and axillary
 glands.   As a therapeutic effect it was observed that, during
 its administration, scrofulous and other glandular swellings
 decreased, and inflamed  glands became more painful.
  Of the  several preparations, Baryt mur.  seems to act more
energetically than Baryt. acet, and the latter less than Baryt
carb. (Dr.  Reil in N. Z. f. h. Kl.,  1, 10). 
122
ON SCROFULOUS AFFECTIONS.
  While gold corresponds to  the  torpid  forms of scrofula,
Baryt is indicated in all forms of scrofulosis florida (glandular
indurations and swellings) (Altschul).   Also in hypertrophy
of the thyroid gland (struma), induration of the mamma; in
tumor albus (Lisfranc), a specific in existing predisposition to
angina.*  Among the characteristic  drug effects, Baryt has
even swelling of the testes in common with Aurum.
  According to the valuable experiences of Dr. Altmueller, of
Cassel, the sphere of action of Baryt. mur. is principally the
lymphatic  and glandular  system,  and  the  tissues standing
upon  the same step of organization with the former.  Its cura-
tive effects are confirmed only in scrofulous diseases, scrofulous
ophthalmia, scrofulous cutaneous eruptions and diarrhoea result-
ing therefrom, as well  as in pulmonary blennorrhoza.
  Dr. Altmueller, in our opinion, is the first who  has pointed
here to the connection of scrofula with certain affections of
the mucosa of the respiratory organs.  Most surely, however,
there exists such a  connection.  The  proof of  it must be of
the greatest importance to therapeutics.  It is, no doubt, more
generally known that, among the  diseases of the  upper por-
tion of  the organs of respiration, i. e., of  the larynx ; croup
frequently  enough coincides with the most developed habitus
scrofulosus.  For this reason the specific beneficial influence
of the genuine antiscrofulosa, Hcpar., Calc, Spong., lod., and
Brom.  This connection, marked out by Altmueller, becomes
still more evident, if one reminds himself of the cases so fre-
quent in practice, from which, after spontaneous or non-spon-
taneous disappearance of a scrofulous cutaneous eruption, an
obstinate cough (bronchitis), and even pneumonia, with copious
expectoration, result.  But we have, also, frequently enough
opportunity of observing that scrofulous diarrhoea appears as
a substitute.   That  the diarrhoea is a scrofulous one, is  plain
from the fact that the an ^scrofulosum, Calc carb., corresponds
to it in  the most effective manner.
  " The application  of Baryta mur." Altmueller further says,
" I have found most  powerful in the following fluid form: One

  * Dr. Zwingenberg (Brandenburg) recommends against  scrofulous  hyper-
trophy of the tonsils: Liquor, baryt. mur.  one drop in one-half a cupful of
lukewarm water, as a gargarisma, from two to three  times  a day, with inter-
missions,  used for weeks. 
      MOST APPROVED REMEDIES  AGAINST SCROFULA.  123

 scruple (1, 2) of the third trit. in  four tablespoonfuls of dis-
 tilled  water.   Of this a  child one year of age was given a
 tablespoonful every three hours; and in this way the quantity
 of  doses was  increased or decreased,  according  to age and
 individuality.*

                         CLINIQUE.

         1. (XVIII.) Atrophia.  Abdominal Scrofula.

  The son of  Mr. A., a child two years of age, suffered from
 atrophia.  The whole  neck, covered with indurated glands of
 egg-size; the abdomen much distended and hard;  the seventh
 and eighth dorsal vertebre grown out into  a hump; from both
 ears discharge of offensive pus; tongue coated ; stool produced
 by  enemata only; the feces, small in quantity, as hard as a
 stone, and white of color ; the urine yellowish, very offensive ;
 the feet  swollen.  Such was the pathological picture when I
 was called, after an  unsuccessful allopathic treatment of
 many (years ?f) months.  I gave twenty grains  of  the third
 trit. of Baryt. mur. in four tablespoonfuls of distilled water, a
 teaspoonful three times a day.  The vegetable diet, consisting
 of mucilaginous food, the animal diet of milk only.  To coun-
 teract  the progress in the dislocation of the vertebre, the
 child was laid upon a  sand-pillow one hand in width and one
 foot long, corresponding to the dislocated part.  An injection
 of oil and water was given every day.  In the course of four-
 teen days the  child improved from  day to day and became
more lively;  appetite returned, especially for milk ;  the urine
 changed for the better. Three  months afterwards all troubles
had subsided;  no trace is left of the dislocation of the verte-
bre, and the boy is  now well and  healthy.  He  received no
 other remedy but Baryt mur., and took twelve doses, such as
mentioned, during the whole treatment.
  * Dr. A. triturated four grains of baryt.  mur. with ninety-six grains of
sach. lact., and prepared from this the second, and from this again the third
trit.
  f Dr. A. seems to have forgotten that the child wa's only two years old. 
124
ON SCROFULOUS  AFFECTIONS.
                   2.  (XIX.) Atrophia.
  E. K., et. 1|, was covered with ulcers over the whole body ;
the whole head with thick, offensive crusts ; abscesses behind
the ears, which discharged an offensive pus;  fetid discharge
from the ears like rotten cheese ;  both eyelids swollen;  the
bulbs of  the  eye very much inflamed; photophobia, so that
the child always  lay upon  its face ;  abdomen considerably
swollen;  thin, watery,  very  offensive  stools ;  both feet very
much swollen.
  Sixteen grains of Baryt mur.,  third trit.,  in  three table-
spoonfuls of distilled water, a teaspoonful three times  a day,
improved before the exhaustion  of the  solution to such a
degree as to completely restore health within six months ; and
now, a year from the time, a healthy and fleshy girl has  de-
veloped from this  complete picture of misery, for whom  the
parents had frequently wished liberation from her sufferings
by death.   During the treatment, the dose was increased two
grains  from time to time.

             3.  (XX.)  Ophthalmia Scrofulosa.
  The  daughter of shoemaker G., et. 6, was afflicted with
scrofulous  ophthalmia, and was treated for a wThole year by
the allopathic physician Dr. Stilling.   After  Dr. S. had  dis-
missed her as incurable, I undertook the  treatment  of  the
child, her condition being then as follows: Total opacity of
the cornea; the sclerotica inflamed  and loosened in its  tissue;
entire blindness; both nasal openings sore and inflamed.  She
received 20 grains of Baryt.  mur., in  four tablespoonfuls of
distilled water, half a tablespoonful three times a day.  After
a treatment of three weeks the ophthalmia disappeared, and
four months afterwards the child's eyes were entirely clear,
and her power of sight complete.


                       BROMIUM.

                   GENERALITIES.
  By its  continued use enlargement of glandular organs and
swellings of the lymphatics were observed to disappear;  but 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.  125

from its similarity to  Iodium, its similar physiological action
and therapeutic usefulness were  inferred.   Especially Glower
frequently applied Kal.  brom., successfully in scrofula and
chronic diseases of the glands (Dr. Reil in N. Z. f.  h. Kl., 2, 9).
   The celebrated springs  of Kreuznach (Elizabeth-spring) owe
their  antiscrofulous action, aside from  Iod.,  to their contents  of
Bromium.
   Brom. has been warmly recommended by  Gauwerky against
obstinate scrofulous affections, and by Hofrichter, against sup-
puration of the glands.
   Among its characteristic, pathogenetic effects are: Flow of
tears; burning in the mouth and oesophagus ; cough and par-
oxysms of suffocation; impeded respiration and  gasping for
air; stitches in  the lungs while breathing; glandular affec-
tions.  Its action upon the organs of respiration, and among
the glandular organs,  upon the thyroid gland and testicles, is
remarkable.
   Succor has been obtained in membranous croup from the
vapors of Brom., when Iod. had failed.*  Upon the whole, the
cures of  scrofulous affections effected  by Bromine may be
principally divided into  such as pertain either to glandular
diseases or croup.
   As regards the  dose, Dr.  Kaesemann  remarks that Brom.
would prove itself most efficacious,  probably, in the  lower
dilutions.  He bases his opinion upon  a passage of the II.
M. M. of Noack and Trinks  which reads as follows: "If the
volatility of a remedy constitutes  a reason for its application
in the lower grades of dilution and more frequent repetition;
this rule will be worth observing with regard to the adminis-
tration of Bromine."

                         CLINIQUE.

                 1. (XXI.)  Cure of  Croup.
   K. W.,  et. 1J, feeble,  descending  from  rhachitic parents,
and  living upon unhealthy food, pot-bellied and of scrofulo-

  * Pathological anatomy teaches us that swelling  and induration of the
mesenterial glands, inflammation of the larynx and air-passages with exuda-
tions of a plastic lymph (inflammation and  hypertrophy of the heart), result
from toxical doses of Bromine. 
126
ON SCROFULOUS AFFECTIONS.
rhachitic habitus.   About eight days ago she had an intense
coryza which suddenly  disappeared, previous to  her sickness.
For a few days past the child  has suffered from hoarseness
which has so increased since  evening that at  9 p.m. entire
aphonia has set in;  besides, very laborious, long-drawn inspi-
rations, at times resembling snoring ;—according to report pre-
viously mucous rattling to such a degree, as to make one fear
suffocation.   Cough is absent;  temperature of the  skin but
little raised;  no thirst:  she does not wish to  eat anything;
during the day she  has still eaten and played.
  Brom. 0, 3, six drops in twelve teaspoonfuls of  water, a tea-
spoonful from one-quarter to one-half hour.  Better; she has
already left her bed for several hours.   After Bromium relief
had set in at once;  cough and expectoration  had appeared,
something that recurred several times through the night.
  One dose of the above prescription every hour, 9 p.m., I was
told that her condition had grown worse again, considerably ;
return of aphonia  with mucous rattling on  respiration, so
much so, that suffocation was  feared ; the skin covered with
cold sweat.
  Brom. 0, 3, nine drops from one-quarter to one-half  hour.
  Had left her bed  next day, though she had perspired much
during the night.   Cough, the evening previous barking and
laborious, to-day  more  sonorous, easy, moist  and more fre-
quent, seldom during the night, though accompanied by much
rattling and difficulty of breathing.  The  same prescription.
  The child, although poorly cared for, recovered under the
continued use of Brom.  within a few days.
  It was discontinued, however, when  slight coughing up of
blood and nose-bleed set in.   Dr.  Kesemann considers the
latter symptoms to  be the effects of Bromium ; from this it is
self-evident, no doubt, that the  dose might be a smaller one,
and, indeed, very brilliant  results have been  obtained  since
with higher dilutions given at long intervals (S. the next cure,
but also No.  8*;.  Moreover, in  another cure of genuine croup
(by Kali bichr.), blood and bloody mucus were coughed up at
the termination of the disease.
  * Heilungen von Croup, Croupine, Asthma, &c, mit Brom. von Dr. Kaese-
mann in Lich. (A H. Z., 48, 24). 
      MOST APPROVED  REMEDIES AGAINST SCROFULA.  127

                 2. (XXII.) Cure of Croup.
   Of the many cases of croup cured by Dr. Kirsch, of Wies-
 baden, we will report but the following (A. H. Z., 47, 18):
   Dec. 7th, 1853. Mrs. M. came to Dr. K., requesting him to
 give her a remedy against an attack of croup in her niece, et.
 5, who had been treated for three days already, by two allo-
 pathic physicians, with emetics.  Since the disease showed no
 amelioration,  they had  agreed to  perform the operation of
 tracheotomy in the evening.
   Aconit.  ~, and Brom. °-£-, each powder to be dissolved in
 a separate tumbler, containing  three tablespoonfuls of water.
 Of these solutions a teaspoonful  every twenty minutes alter-
 nately.
   Three hours afterwards (at 6 p.m.) K. was told that the phy-
 sicians had come between 5 and 6 p.m. ; but as they had been
 at the eve of taking out  their instruments,  had heard the
 changed sound of the cough, looked at each other in surprise,
 and remarked: " The operation is not required any more, but
 continue with the powders (pointing to the Sulphate of cop-
 per  prescribed by them), and  when they are all taken, send
 for another supply forthwith."   K. was  informed that after
 taking the first, and especially the second remedy, a visible
 relief,  steadily progressing, had set  in ; that the child, before
 cold and blue, with the terrible tight and barking cough, had
 broken out in a warm sweat, and that the cough soon had
 become changed,  i.  e., got looser and soluble.
  Seventy-two hours afterwards the same remedies, now dis-
 solved in four tablespoonfuls of water, were given at longer
 intervals, until a  complete  recovery set in, accompanied by a
 general sweat  and loose expectoration.
  At the close Dr. Kirsch combats Dr. Lutze's assertion that
 a child, homoeopathically treated for croup, would  never have
 a return of it.  The return, Dr. K. says, was prevented only
 after the scrofulous affection, which was at the bottom of it,
 was  entirely removed by the proper remedies (and, probably
by means of a  more correct diet)!

               3. (XXIII.) Cures of Croup.
  The A. H. Z. (48, 22, and 24, and 49, 16;, contains interest- 
128            ON SCROFULOUS AFFECTIONS.
ing cures by Brom., especially in croup and affections related
to it.   Loc cit, Dr. Kesemann designates Brom. as, probably,
the grandest remedy in croup.  Dr. Kirsch, of Wiesbaden, has
had similar experiences, which he has published in A. H. Z.,
46, and 47, 141, &c

                4. (XXIV.)  Cure of Croup.
  In a desperate case of croup in a feeble, scrofulous girl, et.
5, Spong'., Hep., and  Brom. 30, were unable  to arrest the in-
crease of the disease.  But upon the use of Brom. lx, six drops
to two ounces (60, 0) of water, a teaspoonful from  one-half to
two hours, improvement set in slowly.
   A highly interesting  case was cured only  after Phos. 1 and
Brom. 2 had been given (A. H. Z., 53, 14, Theuerkauf.).

                 5. (XXV.) Cure of Croup.
   In  the  A. H. Z., 54,  2, a cure of a case of intense torpid
croup is communicated by Dr. Elb, in which Brom. 3 (two
drops every hour) likewise averted the danger to  life* (after
Aeon. 2 and Iod. 3 had been given in vain).   But upon return-
ing aggravation he  was compelled to give  Brom. in alterna-
tion with Hep. s. 2 (gr. ij).   " With the disappearance of the
croup, coryza had appeared."  When refuge was taken with
Brom. the first time, Dr. Elb found the boy, et. 21, icy cold,
the breathing  short, superficial, and  violently  sawing ;  the
head  bent back, the face pale and bloated, the lips  blue, the
pulse very weak and rapid; total aphonia; the eyes set; cough
had been absent almost totally for two hours.  The remark inter-
poned here by Dr. Elb  is of interest:  " During  a  practice of
nineteen years it was the first  time that Iod. failed to do its
service in such a case, apparently so suitable for it."

                 6. (XXVI.) Cure of Croup.
   In  L'Art. Med., Jan., 1858, cure of a violent case of croup
by Brom. ; Dr. Milcent.
  * Dr. Elb calls croup " torpid" on account of the slow development and
long duration of the cough, comparatively rare ; the degree of dyspnoea, slight,
upon the whole, and absence of synochal fever; though a considerable quan-
tity of exudation was present. 
      MOST APPROVED REMEDIES AGAINST SCROFULA.  129

  The child was seven years old, had a rough cough, violent
fever, and pain in the throat.  Two days afterwards the voice
became hoarse, the cough more dry, respiration more difficult;
a rough, dry  whistling, seated  in the larynx, accompanied
every breath of air; the fever increased ; delirium; paroxysms
of suffocation; the child lay on its back with a pale and some-
what livid face; totally aphonous;  breathing frequent and
short; pulse 160 ; now restless, now comatose ; the short, dry
cough threatened  to  suffocate  it;  skin burning hot; the
pseudo-membranous exudations confined to the larynx; while
coughing the child vomited up, now and then, a serous liquid,
in which shreds of the pseudo-membranes were observed.
  Brom. 4, gtt. 4, in 125, 0 of water, every two hours, effected
at least an arrest of the progress of the trouble for two days ;
indeed, the paroxysms of suffocation had become less frequent,
aud the fever less.   Upon renewed hourly doses of the remedy
(Brom. 4,  gtt. 10, in 240, 0 of water), the improvement was
surprising, and ended with complete  recovery; the hoarseness
lasted longest.


  BROMINE IN SCROFULOUS GLANDULAR AFFECTIONS.

      7.  (XXVII.) Affection of the Mesenterial Glands.
  Dr. Hilberger, of Trieste, communicates, in his "Klinischen
Beobachtungen" (Z. f.  h. KL, 2, 15), a very interesting ease of
" scrofulous infiltrations of the mesenterial glands and chronic
pneumonia," in which  Brom. 6 effected the resorption of the
mesenterial glands after Arsen. 6, in alternation with Carb.
veg. 6, had removed the existing oedematous swelling and in-
tense dyspnoea, in short, the pneumonic portion of the disease,
■which did not point by any means to a spontaneous improve-
ment, not to say recovery.  It is probable that Carb. veget. also
had influence upon the resorption within  the glands.
  " Of late Hofrichter says, I have sufficiently convinced my-
self of the extraordinary and sure effect of Brom. in scrofulous
affections, i. e., in inveterate indurated and already partly sup-
purating glandular swellings.  I began my experiments  with
the 15th dilution, descended, however, to  the 6th, and believe
that  the latter is to be preferred to the former, since by its
                            9 
130
ON SCROFULOUS  AFFECTIONS.
aid glandular swellings  and indurations soften more rapidly
without in any way affecting the rest of the organism."

  8. (XXVIII.) Scrofulous Affections of the Cervical Glands.
  H. H., pupil of the Polytechnic Institute, et.  20, has suf-
fered four years from swollen suppurating cervical glands on
the right  side.   There is, likewise, a  hard painful gland  of
the size of a fist, studded with several cicatrices, still  suppu-
rating, in  the right axilla, which  hinders him especially  in
drawing, and threatens  to compel him from continuing his
studies.  The neighboring glands feel like  large  peas, and
some still  larger;  he has to carry the arm in a sling, to keep
the upper arm at a distance from the chest; cold lodging;
poor food.
  Jan. 15th, 1852. Sulphur 60, four doses; every second day
one powder.  A month  afterwards pain less ; swelling some-
what smaller.
  Feb. 17th.  Silic. 30 in the same manner.  First the glan-
dular swelling seemed to increase in size, discharged a good
deal of pus, but finally the openings seemed to have closed up.
  March 26th. Cede carb.  30.  Upon its use for two months
the glandular swelling  decreased, broke  open again a few
times, and healed again, but finally a standstill took place,
and Calcar. did not seem to exert any subsequent effect.
  Aug. 1st.  Brom. 15. Fourteen days  afterwards the axillary
glands became painful, blisters formed  upon its surface, which
broke and developed into  suppurating ulcers; yet, in propor-
tion to the suppuration  the swelling decreased.   His general
health improved remarkably, and  his face  assumed a healthy
complexion.
  Brom. was continued  for a whole year, whereupon  the en-
largement of the cervical and  axillary glands had been re-
sorbed, and the best health followed.

        9. (XXIX.) Scrofulous Glandular Affection.
  A youth, et. 17, suffered from  his childhood from swollen
cervical glands.   When he came  to Dr. N. he could wear no
neckcloth; the left submaxillary gland was twice as large as
a walnut, and hung down on the neck like a bag;  on the 
     MOST APPROVED REMEDIES AGAINST SCROFULA.  131

right side the glands were swollen to the  size of hazelnuts.
They were, however, not painful, and not sensitive upon touch,
though several parts  thereof  during the treatment became
red and painful, and  made  us suspect suppuration, but t}ie
the process always ended with resorption.
  He was treated for  nine months with Brom. 6, one powder
every forty-eight hours, and the swellings  disappeared com-
pletely.
  What important relations exist between the curative effects
of Brom. and the scrofula-dyscrasia, that just the presence  of
the latter, if we are undecided  among several remedies, de-
cides for Brom., evidently seems to follow from the following
clinical observations of the same author.

        10.  (XXX.) Chronic Swelling of the Tonsils.
  A boy, et. 8, after preceding chronic inflammation of both
eyes, suffered from  such extensive opacities of the cornea  as
to compel him to roll the eyes in a horrible manner, in order
to distinguish the road before him; the lids swollen and knotty
to the touch; purulent discharge of the swollen conjunctiva
palpebrarum ;  besides, the child was deaf in consequence  of
the disease.   Inspection of the throat showed  very large ton-
sils ; otorrhoea had been present  previously. The whole face
bloated; the nose thick; continuous  and  offensive coryza;
lips swollen ; most of the teeth carious, and the submaxillary
glands as large as walnuts, but painless. Yet notwithstanding
all  this Brom. 6, one powder every forty-eight hours, made
such an improvement  as to enable his parents to send him to
the country.  The  glandular  swellings, as  well as the deaf-
ness, had disappeared with the decrease of the tonsilar enlarge-
ment.  Even the opacities of the cornea were removed so far
that the darkest portion only looked opaque;  the lids re-
turned to  their normal form ; the chronic inflammation of the
conjunctiva, and thus its swollen condition,  even, disappeared,
as well as the discharge from the nose, in consequence of which
the swelling of nose and lips wrent down naturally.

  Note.—Dr. Kallenbach has  often prescribed Brom. or Kal.
brom. 6 in scrofulous affections, but cannot maintain that it
has done  any more than the well-known  remedies, Sulph., 
132
ON SCROFULOUS AFFECTIONS.
Calc, Iod., Con., when closely corresponding to the individual
case.   He deems it specific, however, in chronic ovaritis, such
as may be found in young women who have had no children.
(A. H. Z., 50, 1.)

     11.  (XXXI.) Affection of the Submaxillary Glands.
  Theuerkauf fully confirms the efficacy of Brom. in scrofu-
lous affections, especially in stone-hard swellings of the glands,
such as  are wont to  appear on the  lower jaw and  neck of
scrofulous subjects.
  A poor scrofulous girl, et. 14, with blonde  hair  and rosy
cheeks, who had suffered for a long time from a hard swelling
of the submaxillary glands, and taken against it various hom-
oeopathic remedies with  but little result, received Brom. 30,
one dose every fourth day.  The  remedy having been  con-
tinued for  some time, she may now be discharged as cured.
When  Brom. 30 was given  the left  submaxillary gland had
reached the size of a small hen's-egg, was hard, painless upon
touch,  and the neighboring  glands were affected more or less
in the same manner.

     12. (XXXII.) Affection of a Submaxillary Gland.
  A scrofulous youth, et. 16, for  several years had  a hard,
painless,  and swollen  gland, as large as half a hen's egg, at
the right side  of the  lower jaw.  Allopathic  remedies had
been fruitless.
  He took Brom. 30  four times (as above).   This caused a
reduction of the gland to the size of a hazelnut; and, when
Theuerkauf made inquiries, afterwards, this rest of the trouble
even had disappeared* (A. II. Z., 53, 22).


                CALCAREA CARBONICA.

                      GENERALITIES.
   Water that  contains the salts of lime in excess (and de-
posits drop-stone in its course) is accused by some of produc-

  * Dr. Gerson saw good results from Merc, bijodat., if the tuberous, scrof-
ulo-glandular swellings were accompanied by intense redness of the skin, but
very little pain (A. H. Z., 54, 5). 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.   133

ing scrofula.  Thus it is said that  the inhabitants of Rheims
owe the large number of persons affected by scrofula among
their population to this circumstance.  Does there  exist  a
greater triumph to Hahnemann's discovery?  The  Hahne-
mannian  school, if it  were to do  without  the salts of lime,
would not wish to treat scrofula.  Cede carb. performs won-
ders in scrofulous ophthalmia ;  like Sulph., it removes scrofu-
lous pot-bellies, if I may be  allowed to use this expression;
like Phos., it cures scrofulous diarrhoea, &c.
  It acts, to  express  it in general terms, directly upon  the
ganglionic system and the organs under its control, but espe-
cially upon  the skin and intestinal mucosa.*
  Calcarea, another author says, has but few specific relations
to single organs, but has  bearings of a decided  and well-
marked character upon definite tissues and organic systems,
and to the  whole process of formation and reformation—to
the life of the blood.
  Of the tissues and organic  systems upon which Calc shows
a well-defined action, the glandular system, osseous tissue,  and
mucous membranes must be marked out especially.
  Thus Calcar. principally suits in those diseases and individu-
alities in whom the process of  formation and reformation  is
exposed to  disturbances—the  age of  childhood,  the female
sex, the lymphatic and leucemic constitutions ; moreover, in
the  process of  dentition, in  scrofulosis, rhachitis, chlorosis,
arthritis, and lithiasis (N. Z.  f.  h. KL).
  Dr. Reil's general remarks upon this remedy finally agree
with this.  In therapeutics, he  resumes, the preparations of
lime (Calc. acet, carb.  caustic, phosphor., muriat, and sulphur-
ata ; Hep. sulph. calc.) have played a great part as remedies
for the glands, antidyscratica,  antiscrofulosa,  and antilym-
phatica;  pharmacodynamists,  such as Vogt,  Richter,  and
Greiner, ascribe to it the direct power  of producing a specific
internal change in vegetation; a  specific influence upon the

  *  " The carbonate of lime predominates in the non-vertebrate animals  with
pale-looking ganglia, the phosphate appearing at the same time in the verte-
brates.  Phosphate of lime genetically is the  contrarium to the medulla
nervea.   A rapid waste of nerve force immediately occasions, hence an
equally rapid production of earths, of which the carbonate of lime again cor-
responds to the ganglionic system, the phosphate to the cerebro-spinal." 
134
ON SCROFULOUS AFFECTIONS.
nervous system of the entire lymphatic and glandular system
(especially upon the mesenterial glands).
   In view of the characteristic pathogenetic  effects  of Calc
carb., such as glandular swellings, ophthalmia scrofulosa (opac-
ity of  the cornea), otorrhoea; discharge of an offensive fluid
from the nose; distension of the abdomen ; constipation (but
also diarrhoea), the remedy has been tried and found effica-
cious in the various manifestations of scrofulosis:
   1. In crusta lactea, acne, facial  eczema, impetigo,  pemphi-
gus, and onychia, especially when acidity of the stomach is
present.
   2. In scrofulous  degeneration of the mesenterial,  thyroid
(struma), and cervical glands.
   3. In chronic headaches of scrofulous persons.
   4. In ophthalmia scrofulosa.
   5. In otorrhoea purulenta scrofulosa.
   6. In ozena scrofulosa with loss of smell, as well as against
the formation  of polypi.
   7. In dyspepsia, accompanied by water-brash and eructa-
tions with the taste of the food taken.
  8. In habitual diarrhoea, sour-smelling diarrhoea of children;
ascarides.
   9. In incipient rhachitis (walking of children at a late date),
difficult dentition of infants, slowly-closing fontanels.
   Caustic, and Lycopod. much resemble Calcar. carb.
   Caustic is indicated also in  strumatous swellings, in pustu-
lar eruptions,  moist eczema, scrofulous  otorrhoea ; (nervous)
dyspepsia; panaritium; ophth. scrof. of a chronic character,
with spots upon the cornea; but it is  hardly possible to con-
found  them, if we consider that Caustic, (like Rhus) corre-
sponds more to the rheumatic than scrofulous diathesis.
   At the  head of the Caustic symptoms  stand arthritic and
rheumatic tearing  in the limbs; contractions of the limbs,
with paralysis ; paralysis  after apoplexy ; pain as from luxa-
tion in the hip-joint, &c.
   It is more difficult to draw a line between Calcar.  and Ly-
copod., since both complement and  not oppose each  other in
their action.  Lycop. resembles Sulphur, but  the  fact that
Calcar. carb. does excellent service in suppressed hemorrhoids
and their  evil consequences—(Richter recommends here injec- 
      MOST  APPROVED  REMEDIES  AGAINST SCROFULA.  135

tions of lime-water)—hence is an anti-hemorrhoidale—shows
how closely related in  their action Calc. and Sulph. are.  In
absence of other points of support, we may say that the dis-
eases cured by Lycopod. are more  frequently associated with
disturbances of the liver than is the case with Calcar.  Hence,
the  yellowish (greenish) color of  the  secretions (yellowish
complexion, yellowish tongue, yellowish sputa), &c
  Lycopod. suits (probably for this reason) oftener in diseases
of grown persons; Silic., Graph., and Arsen. resemble Lycopod.
more than Ccdcar.
   Ca.lcare'a is indicated in many cases before Lycopod., in the
first stage, so to say, when an opposite condition has not fol-
lowed, as  yet,  upon exaltation.  In  connection therewith
Lycopodiurn more than Calcar. has "obstruction" in  a  more
extended sense of the word.
  When Lycopod. exceptionally cures diarrhoea (Sulph. excep-
tionally does the same), it has been, then, so to say, a second-
ary diarrhoea, a sequela to preceding  constipation.   Calcar.,
however, is a specific remedy in innumerable cases of diar-
rhoea of teething, scrofulous infants, which, probably, may
constitute  reflex-phenomena, yet do not deserve the name
secondary.
  In  short, Calcarea carbonica is a  more sovereign remedy
against scrofula than  Lycopod.  Besides Silic. aud Phosph.,
it is the antiscrofulosum par excellence.

                         CLINIQUE.
                       1. (XXXIII.)
  A boy, et. 6, on account of the continuous use of purgatives
for expelling worms, fell  a victim to scrofulous  atrophia,
which resisted all homoeopathic remedies applied, even Cede
carb.  12, until  upon giving  the 6th  potency of the  same
remedy, prepared by a thousand arm-strokes* a rapid and
complete cure was effected, and even the glandular swellings
and the hard abdomen  entirely disappeared.
  * Momorabilien aus der Praxis von Dr. Wahle in Rom. S.S., 17-50.   The
author believes that powerful and long-continued shaking calls forth a greater
medicinal efficacy, and that the whole mystery of Jehnichen's high potencies
mainly rests upon this manoeuvre. 
136
ON SCROFULOUS AFFECTIONS.
                 2. (XXXIV.)  Otorrhea.
  Dr. Rentsch, of Potsdam, reports  instructive cases Of ca-
tarrh of the  meat,  audit, ext. in originally scrofulous indi-
viduals by Cede carb.  They  are instructive for the reason
that they  testify to the possibility of a lull in scrofulosis, last-
ing for years, as well as  show that the sudden disappearance
of habitual otorrhoea has bad consequences; that, moreover, if
such a morbid drying up takes place, the lymphatics swell,
and tliat the scrofulous materia peccans moves  thither, as  it
were.*
  In one case, Ferr. metal. 1, ten  grains morning and evening
had to be given besides Calc carb., the patient being a chlor-
otic girl, eleven years of  age.

      3. (XXXV.)  Scrofulous Inflammation of the Knee.
  Dr. Kallenbach, of Cleve, describes the Calcarea—affections
of the knee-joint,f and  says  that  they attack  mostly scrof-
ulous individuals.  Slight digestive disturbances, loss of appe-
tite, irregularity in the stools  are present.  The pains are
bearable (in contradistinction to the  i?an/ta-affections of the
knee-joint), pressing and  stinging, intermitting  at night and
when at rest, worse in going up and down stairs (flexion).
  Very often the trouble aggravates  at the time of the full
moon.  Swelling, if present  at all, at  the inner and lower side.
The painful spot at the inner  side of  the patella.
  In his  " Klinischen Beobachtungen,"  Dr.  Hilberger,  of
Trieste, compares Calc. carb. with Coniurn, and says: "While
the curative power of Con.  confines itself to the softening of
the induration, the effect of Calc.  is  more marked.  It cor-
responds upon  the whole to the scrofula-dyscrasia.  That this,
without having manifested itself  in childhood, may become
the cause of many diseases, frequently in an  advanced age,
every  practitioner will have convinced himself."
  Its  special relation  to glandular affections is equally evi-
dent, and fully justifies its application (Z. f. h. KL, 3, 14).

  * Beitraege zur Erkenntniss und  Behandlung einiger Ohren Krankheiten
v. Dr. Rentsch XXXVI, 1, 6.
  f 52, S. 51. 
     MOST APPROVED REMEDIES AGAINST SCROFULA.  137

  But that Calc. carb. has a more extended sphere than the
glands,  and especially corresponds  to the affections  of the
mucous membranes, the organs of sense and their auxiliary
apparatuses, the cures of polypi of the mucous membranes by
Calc. carb. prove among others.

             4. (XXXVI.) Cure of a Polypus.
  Goullon, Sr., reports an interesting case of nasal polypus
which had enlarged so much as seemingly to render an opera-
tion necessary.  Twelve doses  of  Calc. carb.  30, one  dose a
day; afterwards eight doses of the 18th dil. and lastly  of the
9th dil.  taken in the same manner, effected so rapid  a  reduc-
tion and withering of the polypus  that fourteen days after
taking the second medicine but a fold of the mucosa remained.
The cure still continued two years afterwards (A. H. Z., 45, 5).

            5. (XXXVII.) Cure of a Polypus.
  In the N. Z. f. h. Kl., 3, 3, we find the cure of a polypus by
Calc. carb. 9.
  A woman, et. 54, who had suffered from  eight to nine
years from continual hoarseness, received Calc carb. 9,  a dose
every fourth day. After about eight days' use of this remedy,
cough set in which was dry, whistling, and spasmodic, and a
few days afterwards occasioned the  expectoration of firm,
fleshy pieces from the size of a hemp-seed to that of a pea
which, on closer examination, showed  themselves to be poly-
pous masses, and thus gave information of the cause  of the
hoarseness of many years' standing.  After from ten to  twelve
such pieces had  been coughed up, the cough  ceased, and
nothing of a similar kind reappeared, notwithstanding the
longer  continued use  of Calc. carb.  Though  Dr. Buerkner
who made this observation, did not  conceal the fact that the
hoarseness itself continued unchanged, he yet is right, no
doubt, in ascribing to  Calc. carb. a  direct influence upon the
life of the polypus.

          6.  (XXXVIII.) Ophthalmia Scrofidosa.
  J. L., et.  6,  of  a well-marked  scrofulous  habitus, pale,
bloated  face, very much distended  abdomen, and emaciated 
138
ON SCROFULOUS AFFECTIONS.
extremities, has suffered for  two years  from scrofulous oph-
thalmia which, thus far, has been combated with all sorts of
remedies, but not cured.
  Eyelids much swollen and inflamed, the cornea of  the right
eye, just in the centre opposite the pupil, shows a pearly-gray,
lymphatic turbidity of  considerable extent, non-transparent
in its  centre, and  as large  as a lentil.  Conjunct, palpebr.
loosened, conjunct,  bulbi much injected.  Excessive  photo-
phobia ; burning pain in  the eye, if she looks toward the win-
dow, with a  stream of  tears running over  the cheeks  simul-
taneously.
  After  the  necessary regulation of diet, Calcar. carb.  3  was
prescribed in daily alternation with Sulphur 3, and the result
was surprising, indeed.   Within  ten days  the inflammation
proper, with its concomitant symptoms, was removed almost
entirely, and the spot on the cornea grew smaller, so as to
disappear entirely within the course of four weeks. (Pract.
Mittheil. v. Dr. Perutz,  A. H. Z., 54, 6.)

                  7. (XXXIX.) Impetigo.
  Dr. Cramoisy treated  a case of impet. figurata.*   The pa-
tient, et. 20, was of lymphatic temperament; when a child,
had had tinea and a scrofulous ulcer upon the thigh.  The
eruption, slightly itching, spread from the  left cheek over to
the right, the chin, and the entire face, almost.  Calc. carb.
6, two drops in 250,0 of water, a teaspoonful three times a
day, gave the first impulse to a cure.  Afterwards, however,
Hep., Graphit, and, lastly, Calcar. and Sulphur in alternation,
were  given (Journal de  la  Soc. Gallic, de  Med.  Horn., 15
Mai, 1857).

                  8. (XL.)  Cures of Cysts.
  In  L'art. Medical, October and  December, 1866, we  find
some very instructive cures with Calc.  carb. (Dr. Bourgeois),
the names  of which we will mention merely, since the per-
sons cured are not expressly mentioned as having been  scrofu-
lous.   He cured:
  Three cysts at the knee.

  * First described by Willan.  Impetig. fig. possesses the characteristic of
assuming the form of the part upon which it takes its seat. 
      MOST  APPROVED REMEDIES  AGAINST  SCROFULA.   139

   One cyst on the finger.
   One cyst at the metacarpal joint.
   Two cysts at the eyelid.
   One cyst on the breast.
   Lipomata.
   Three times warts on the face and hands.

                 9. (XLI.)  Cure of Struma.
   M. D., et.  10, of rosy complexion and delicate musculature,
suffers from rheumatism and diarrhoea.  Aversion to meat.
   Was affected in his seventh year by goitre, against which
Iodine preparations and Spongia were given in vain; on  the
contrary, the swelling increased all the time.  No treatment
for the past  six  months.   The tumor is located to the left,
anteriorly, as large as a pigeon's egg, soft, doughy, painless,
movable, and pervaded by blue veins.
   May 16th.  Calc carb., 15 centigrammes of the third trit.
every day for ten days.
   A month later  the  appetite had improved, but the humor
was not changed  essentially.
   Calc. carb.  6, six drops in 200,0 of water; a  teaspoonful
morning and evening.
   July 10th.  Remarkable improvement; struma decreased in
circumference, and otorrhoea  of one year's standing disap-
peared.  Calc. carb. 3.
   The struma has grown decidedly smaller during September,
and toward the end of the year is completely cured. (A. H. Z.,
94,6.)

               10. (XLII.) Cure of Struma.
   Lucie J., et. 17, of delicate, scrofulous constitution,  for-
merly suffering from swollen submaxillary glands, which had
suppurated three  times, from her 15th year on; menstruated
from every six weeks to two months.
  Oct. 28th, 1869, a strumatous swelling, that had made its
appearance at the time of puberty, is as large as a hen's egg.
Both lobes are  affected.  The swelling is soft  and  painless.
At the time  of menstruation  patient notices an increase of
the tumor, especially if the flow  is scanty; then difficulty 
140           ON SCROFULOUS AFFECTIONS.
of breathing sets in  also, compelling her repeatedly to jump
up at night.
  Calc. carb. 3, trit. 0,12 centigrammes for twelve days; a dose
every evening.
  Three weeks afterwards, menstruation, more copious, ap-
pears at the  26th day.  The struma has not increased any
during the menses.   No difficulty of respiration.
  The same prescription.
  Dec. 20th. Considerable improvement of the struma, which
appears softer, less tense, and prominent.  Menses after four
weeks.
  Calc. carb. 6, six drops in 200, 0 of water, two tablespoonfuls
every day. At the end of January the swelling was unmis-
takably decreasing in size.
  Calc carb. 30.
  During  the  course of March  there is but a single spot at
the  neck  which  transgresses  the normal level;  nothing is
seen, however, if one is not looking at it intently.
  Dr. Bourgeois's method, in a long-continuing treatment to
run  over  the  entire  scala of the Hahnemannian posology, is
not at all  unessential.

               11.  (XLIII.)  Cure of Struma.

  Miss K., et. 19, affected with a considerable swelling of the
thyroid gland, the increase of which she notices  since a few
days, and  the  origin of which she is not able to account for,
wished to be freed from it.  Difficult respiration,  on lying on
the back during sleep, is the only complaint made.
  Brom. 0,3, one drop in a tablespoonful of water, three times
a day.  No change within ten days.
   Calc carb. 0, 3, morning and evening, as much as will lay
upon the point of a pocket-knife.
  Eight days  afterwards noticeable decrease  of the swelling.
Complete  cure after  three weeks more.
  Dr. A. Starke, of Nagy Karolyi,  remarks,  upon this  case,
that Miss K.  previously had been  treated allopathically  for
one  year,  yet, without noticing the smallest change in her
condition  (i.e., the smallest change for the better);  for the
famous Iodine-coryza appeared frequently, since she had been 
      MOST  APPROVED  REMEDIES AGAINST SCROFULA.  141

advised  continually to apply Iod. tincture  and a  salve of
Iodide of Potass.

                  12.  (XLIV.)  Melitagra.
  Thin, yellowish, crusty eruption (melitagra of Alibert) at the
right temple in a stout girl, et. 29, who still showed the resi-
dues of scrofula, cured by Calc. carb. 4, one drop every other
day; afterwards Calc. carb. 30, two globules, and Calc. carb. 1
gtt. j (A. H. Z., 21, 13, Dr. Frank, of Osterode).

         13. (XLV.) Blepharoblennorrhoea Scrofulosa,
In a scrofulous girl, 10 years old, which had existed for several
years, and had frequently been treated externally without any
success, was completely cured within four weeks by Calc. carb.
2, and Sulphur. 1 (Bd. XXI, 13.  Reported in the catalogue
of patients received in the hom.  department of the Elizabeth
Hospital of  Berlin, from August 20th  to November 26th,
1841).
               14.  (XLVI.) F\brous Polypus.
  Dr. Gross, of Regensburg: Fibrous polypus cured  by Cede
carb. 4X trit., dissolved in diluted alcohol, two drops a day.
  The patient, the son of a peasant, et. 12, was of lymphatic
constitution, and frequently disposed to scrofulous affections;
cough, hoarseness, difficulty of swallowing, and coryza  wrere
the beginning of the trouble (A. H. Z., 57,  12).

              15. (XLVII.) Spondylarthrocace.
  In the last number of Vol. 73, of the A. H.  Z., we find a
very good report of a cure by Cede carb.  by Anton  Starke,
practical physician of Pesth, in which all the advantages and
peculiar medicinal virtues of the remedy come to view.
  Before the appearance of the trouble, patient was tormented
by cough and backache.  Fever and weakness compelled  her,
finally, to stay in bed continually.  For two months  she  had
been treated allopathically without any success.  Lately she
suffered violent pains of a  boring character in the region of
the last  cervical and first thoracic  vertebre.  She also felt
drawing pain in both shoulder-blades and along the spinal 
142
ON SCROFULOUS  AFFECTIONS.
column.  She could not hold up her head without support
from one hand or the other.
  Status presens: H. B., et. 16, of middle size, considerably
emaciated.   Cheeks reddened.  Thorax flat.   Notwithstand-
ing the suspicious short cough, no demonstrable abnormity of
the lungs or heart.  Sounds of liver and spleen also normal.
Abdomen distended but not painful. Secretion of urine some-
what retarded ; bowels somewhat constipated.  Boring pain
in the last cervical and first thoracic vertebre. Arms feel as
if they were asleep, now and then, and heaviness of the head.
The whole day she remains in a  semi-recumbent position.
Appetite keener than ever.  Thirst increased.   Menstruation
not set in for two months.
  Processus spinosi of the  seventh cervical  and first three
thoracic vertebre are very much protuberant and, upon touch,
show  themselves  to be larger in size.  Upon pressure, pain
increases.  During the hours of the morning, fever that in-
creases in the evening.  Palms of  the hands hot.   The skin
dry, at the same time.  Pulse 104.  Depressed in mind.
  Diagnosis: Spondylarthrocace.
  The symptoms of  Calc. carb. correspond  mostly to the
above:
     1.  Melancholia and mental depression.
    576.  Ravenous appetite.
    801.  Hard stools in small quantity.
  1149.  Painful stiffness in the spinal column with heaviness
          and stiffness of  the legs.
  1158. Stitches in the back and left shoulder-blade.
  1160.  Drawing, tearing  and cutting between the shoulder-
          blades.
  1175. Stitches in the neck and shoulder-blades.
  Finally he rightfully quotes Dr. Koch's  remark  (Noack
and Trinks. Horn. M. M.).
  " Carbonate of lime has no direct relation to any one single
organ, but  produces a morbific effect  upon certain systems,
namely, upon such as >by  virtue of their organic structures
either cover  other organs, or form canals and cavities, the
membranous and  serous.   It especially acts upon the mucous
membranes, the fibrous  and osseous system, nervous system, 
      MOST APPROVED REMEDIES  AGAINST  SCROFULA.  143

serous membranes and  upon the venous (but also upon the
lymphatic) system."
  From this it is evident, therefore, that it becomes one of the
most important remedies in diseases of reproduction.
  Thus Calc. carb., 3 trit, one grain morning and evening, was
given.
  Every other day ablution of the whole body in the room,
with  water of a temperature of from fifteen to eighteen de-
grees (R.), and walking about of the patient with  the assist-
ance of her friends.
  As early as fourteen days afterwards the improvement  was re-
markable.  Not only  the  dry cough, but  also  the fever de-
creased from  day to day.   After the  course of a month the
head did not require to be supported any longer.  Pain in the
back upon pressure only.  Can walk around in the room with-
out  assistance.  Mind  more lively and active.  LTpon the
upper part of the body and both arms, as well as at the nape
of the neck, a slight eruption, somewhat itching, has shown
itself within a short time.
  Now Silic. 30, every second day, five globules, till  the end of
May, when patient could take walks out of doors again.
  Of the disease nothing remained except that the head was
carried bent down somewhat, but in case of  an energetic will
of the  patient, it may be presumed that in this respect, even,
improvement is still possible.

  Mention must also be made of Calc phosph.  The role it
plays in scrofulous products  is evident.  We know7 that, be-
sides carbonate of lime and chloride of sodium, Calc. phosph.
preponderates in the lymph or the serous portion of the blood
of scrofulous persons; we  know, further, that the milk  of
scrofulous (tuberculous) cows contains seven  times more phos-
phate of lime than other milk.*  This surplus of saline salts
is not accidental, and may, probably, be made use of by  hom-
oeopathic  therapeutics, as well  as the fact that the abuse  of
Mercury reflects the entire picture of scrofulosis. Calc. phosph.
so far  as we know, has been justly recommended by French
authors only, against chronic swelling of the tonsils, no doubt
mostly upon a scrofulous bottom.

  * Clark refers scrofulosis to an overloading of the general constructive ma-
terial with phosphate of lime. 
144
ON SCROFULOUS AFFECTIONS.
  Heyne,  of  Beckum, praises Calc.  phosph. 12 (to be given
from three to four days every fourteen days) in tumor albus.
  One  word more of  Calc. acetica.  Dr. Hofrichter (Prague)
calls it, as Spirit calc. acet., or as trituration of 1: 100, or 1:
10, repeated several times a day, the principal remedy in in-
fantile diarrhoea.  The principal  symptoms,  which,  in his
opinion, urgently demand its application  are: inclination to
looseness of the bowels and diarrhoea; diarrhoea with prolap-
sus ani; diarrhoea of scrofulous infants during dentition ; in
short, those cases  of infantile diarrhoea described under the
head  of " softening of the  stomach and intestinal  tract"
(gastromalacia). The diarrhoea sets in without any noticeable
cause; the copious discharges rapidly following one another,
according to the  violence of the disease, consist of- watery
mucous, now greenish, flocculent stools, the cadaverous or
characteristically sour smell of which, characteristic of the
flatus also, soon communicates itself to the garments and bed-
linen, and thus  continually contaminates the atmosphere; at
the same time slight fever, burning of the hands and soles of
the feet, continual and intense thirst, loss of appetite, rapid
emaciation of the whole body, and especially of the face, which
assumes an aged look; continuous restlessness, tossing  about;
wailing and crying; pale, dry skin; sensitive elastically dis-
tended abdomen ; occasional vomiting ; scanty, pale urine, or
easily disturbed sleep  with e}res half closed (A. II. Z.,43, 11).


                CALENDULA OFFICINALIS.
                       GENERALITIES.
  " It promises to become a useful remedy in glandular dis-
eases ; the physiological proving, though aphoristic, already
gives a few hints.  Especially, it was recommended and used
against scrofula by Tournecort, against bubo by Franc. Val-
leriola ; against induration  and carcinoma  (scirrhus) of the
mammary glands by Rudolph"  (Dr. Reil, N. Z. f. h. KL, 2, 9).
  In developed scirrhus, carcinoma of the mamma and uterus,
as well as in  cutaneous cancer. 
     MOST APPROVED REMEDIES AGAINST  SCROFULA.   145


                  CARBO VEGETABILIS.
                      GENERALITIES.
  " When in acute as well as chronic diseases the vital forces
are nearly exhausted, the circulation begins to flag, a condi-
tion that reflects  itself externally in cyanosis of evil omen;
when the vital temperature sinks to  a minimum, and the dis-
tress of the patient, whose mental capacities are mostly undis-
turbed, reaches its maximum; when all motions are expres-
sive of the last smouldering vital spark; when we despair of
all  reaction, the  effect of this truly magic  remedy still  sur-
prises us, now and then."

                        CLINIQUE.

                  1.  (XLVIII.) Atrophia.

  With the above words Dr. Hilberger, of Trieste, introduces
a few interesting clinical  observations on Carb. veg.,  from
which it is plainly visible when this  remedy is indicated.
  1. A feeble boy, 9 months old, whose mother while nursing
him, became a victim to cholera, from this moment on suf-
fered from  diarrhoea  that  had  lasted several months and
seemed incontrollable. Though it had, finally, begun to abate
somewhat,  yet the little fellow did  not pick up in  the least,
and the picture of atrophia infant, more and more developed
itself.  The child, emaciated to a skeleton,  got into such a
state of  weakness that all capability of motion ceased, com-
plete aphonia set  in, and it could not take nourishment any
more.  Pulse small,  scarcely perceptible, the body cold.  Only
the power of  sight did not  seem to be lost, just as a feeble
breathing seemed to be the only sign of life left.  For  eight
days it remained  in this condition.   For the sake of experi-
ment, and more on  account of the  friends, I gave  remedies
which, howrever,  were all fruitless; (Sulph., Arsen.,  China,
&c), finally, I administered twTo doses of Carb. veg. (6), and to
the greatest  surprise of all,  as  early  as the  next  day, the
child's voice returned, the temperature rose, and it  was con-
valescent after receiving the remedy for  fourteen days, and
now is a lively and strong boy.
                             10 
146
ON SCROFULOUS  AFFECTIONS.
    2. (XLIX.) General Scrofulosis. Broncho-pneumonia.

  A child, et. 2, who in the first year of life, had fortunately
recovered from hydrocephalus, was attacked  by whooping-
cough, epidemic here  the winter previous.  For three weeks
the disease took a tolerably favorable course, when on taking
cold, pneumonia of the right  side and an intense bronchial
catarrh developed themselves additionally.  The  upper por-
tion of the lung had already become somewhat emphysema-
tous, the  characteristics of the whooping-cough disappeared
forthwith, but on the other hand, an  extraordinary and con-
tinuous dyspnoea, mucous rattling, audible at a distance, even,
and intense fever set in.   In  spite of all remedies (Aeon.,
Bryon.,  Sulph., Phosph.,  Tart) no improvement  had taken
place, and eight days afterwards the patient was in  almost a
dying condition.  The skin cold, face bloated  and cyanotic,
extremities swollen, expression of the face corpse-like. Breath-
ing so rapid that one could not distinguish the  number of
respirations.  Excessive distress.  The ominous wringing of
the hands and the dull glances, looking out for help, of the
child, who had its full consciousness, enlisted the strongest
sympathy.  Pulse could not be felt.   Nothing but death by
suffocation could be looked  for now every hour.  However, I
gave the child one dose of Carb. veg. 6, and left two doses for
the night.  When I called the  next morning,  I  scarcely
credited my ears to hear that already after the  first dose, half
an hour afterwards, after so terrible an aggravation that  the
child was believed to be dead, more comfort set in.  Upon the
second dose the remedial aggravation had likewise appeared,
but much weaker, and afterwards the dyspnoea decreased con-
siderably, the pulse rose, the expression of the features became
brighter.  Improvement continued now for five days, when
in consequence of stormy weather the child had a relapse, and
the same sad phenomena reappeared.  Upon  Carb. veg., an
entirely similar reaction followed again, from which time on
the child recovered slowly upon the administration of  Baryt
carb., which I always have seen act beneficially in similar
cases, when such affections appeared in scrofulous individuals.
The child now enjoys complete health. 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.   147


                    CARBO ANIMALIS.
                      GENERALITIES.
   Dr. Weiss takes  a considerable quantity of beef or veal of
 which the fat is properly removed, adds bones amounting in
 weight to a third of the weight of the former, and burns the
 whole to coal in  a  common coffee-drum.  After cooling, the
 coal  is pulverized, and  two and a half ounces thereof are
 mixed  with two drachms of sugar, and of this mixture as
 much as the size of a pea, taken dry into the mouth  and
 swallowed with a little water, against inveterate and  obstinate
 indurations of the glands.
   Healthy persons who take  this remedy, are said to get
 knots in the mamme, induration and swelling of the parotis
 and acne in  the face, all of which affections, however, grad-
 ually disappear again.
   According to Dr. Reil, a more rapid and  energetic effect
 upon the glandular system is ascribed to animal than vege-
 table coal (Rust's Magazine, Bd. 22,  198).

   Animal coal, on account of its peculiar relation to the glan-
 dular system and skin deserves the name of an antiscrofulo-
 sum with more  right than  vegetable coal.  Especially the
 transition of scrofulosis into scirrhus would require the use
 of Carb. animal., also the change of a benignant suppuration
 into a malignant ichorous discharge, and the presence of hard,
 painful glandular swellings.  Carb. veget, undoubtedly, mani-
 fests its curative effect, where pathological  conditions are de-
 pendent upon  a predominant  venosity.  Now, since many
 persons afflicted with scrofula,  show such a predominance of
 the veno-vascular system, and especially torpid scrofulosis
 rests  upon venous  hyperemia, Carb. veg.,  also, ought to be
made use of, especially, if burning pains accompany scrofulous
affections.
  Finally, let us not forget the  great importance of Graphites
in the therapeutics  of scrofulous conditions, and that Graph.,
though  taken from  the inorganic world, very much resembles
the two kinds  (Carb. animal, and veget) of coal.   For this
reason we treat next on Graphites. 
148
ON SCROFULOUS AFFECTIONS.
            CARBO MINERALIS—GRAPHITES.

                      GENERALITIES.

  Graphit seems able to effect an improvement in the (crasis
of the)  blood.  Many scabious,  impetiginous, and  dry exan-
themata of the skin are cured by Graph.  It is just the blood
insufficiently oxidized, such as  characterizes scrofulous indi-
viduals, that profits by the administration of Graph., which
has been used with benefit against highly developed forms of
hydrops (hydrocele).  It  is no contraindication that Graph, is
a remedy suitable to the female sex, and, at  the same time,
acts as an antiscrofulosum.  Of the latter  affections, two
especially  come within the sphere of its curative action: oph-
thalmia,*  accompanied by photophobia and predisposition to
hordeola,  with simultaneous fissured eruptions  around the
mouth and  nose; and impetigo of the hairy portion of the
head, or herpetic eruptions upon various parts of the body of
scrofulous youths.  An affection related to herpes, its  most
intense  expression, so to  say, we find among women in the
chronic ulcers of the foot with burning pain. In short, scrofula,
in connection with an herpetic constitution, is the most appro-
priate field for cures with Graph.
  Dryness of  the parts affected (hence, burning  pain, which
manifests  itself, for example, in ophthalmia, by acrid  tears) is
a symptom never absent  where Graph, has  helped.   Here
belongs, also, the often  exceedingly obstinate  constipation,
very characteristic of Graph. Graph, resembles Arsenic, with
which it shows more points of contact (even  in that form of
gastralgia of the most violent kind, which is accompanied by
vomiting  and thirst), than Iron—a fact wmich  might occasion
surprise at the first glance, f
  In  common with'the veg. carbon (Carb. veg.), the mineral
(Graphit.) has the antiflative action.  It cures (though not so
often) the annoying distension of the stomach by gases, espe-
cially when such are found in  females of sedentary habits.
The accumulation of gases leads to real strictures, and in con-

  *  Especially in chlorotic, anaemic subjects, with simultaneous itching of
the lid-edges, and a sensation of heaviness of the lids.
  f  Compare, also, the cure of Atrophia infant, by Arsenic, and Carb. veg. 
      MOST  APPROVED  REMEDIES AGAINST  SCROFULA.  149

 sequence thereof to gastralgia of a periodical character (e.g.,
 at 4 a.m. and 4 p.m., &c).
   From this we see that Lycopod., also, is not a very distant
 relative to  Graph., not to mention  that Lycopod., probably,
 surpasses Graph, in its bearing  upon the phenomena of the
 herpetic constitution.  In order to comprehend this  existing
 connection, we must return to the genesis  of herpes, which
 owes its origin in so many cases to suppressed activity of the
 skin (to a hypercarbonization of the blood).
   In common with Silic, Graphit bears relations to the nutri-
 tion and plasticity of the skin ; on the other hand, however,
 it does not mature abscesses as Silic. does.
   This reminds us of another peculiarity of  Graph., which it
 has  in common with Silic. in an eminent manner, to restore
 suppressed secretions, especially (venous) hemorrhages; while
 the  secretions restored by  Silic. directly refer  to the sweat
 upon the skin of the feet.  Graph, and Silic cure fissured,
 withered ulcerous affections.  Hardness  of  hearing  (upon a
 scrofulous bottom) has also been  removed by both.  We must
 adhere, hence, all the closer to the  differential  momenta,  ac-
 cording to which Silic, more than Graph., has direct relations
 to processes combined with suppuration, and alone deserves
 the name of a gland-remedy, and, above all, of a bone-remedy.
  But there are  still more remedies which  have indications
 similar to Graph.  Among these belong  Acid, nitri., an excel-
 lent remedy in scrofulous ophthalmia.  Acid: nitri. is indicated
 in fissured, easily bleeding, and little secreting eruptive affec-
 tions, in cases of chronic laryngitis  (like Graph.), in cough,
 with a rough and dry voice; it is an ear-remedy (after  scar-
 latina^, and presupposes almost  a similar constitution, as  do
 Graph., Arsen., Silic, and Lycopod.
  However, a finer difference seems to lay in this, that Nitr.  ac
 corresponds more to the sycotic dyscrasia (condylomata, gon-
 orrhoea,  and gleet).  Graph., more  to the  scrofulo-herpetic
 contamination  of the blood.   Coarser  differences are  with
 Graphit. constipation, with Acid, nitri. diarrhoea.   Graph.
 produces  hemorrhages  (similar here  to  Iron).   Acid, nitri.
arrests  them.  In regard to suppurating glands, Acid, nitri.
is similar to Silic.   Finally, no relation to the liver is known
of Graph. ;  many, on the other hand, of Nitr. acid. 
150           ON SCROFULOUS AFFECTIONS.
  Scrofulous children, more than  others, are subjected to
hemiplegia  of the face,  though  the occurrence  may rarely
happen by itself.  Here, besides Graph., the curative action
of which has been  proved (Kafka), Caustic, and Petroleum
come under consideration.  Caustic, however, distinguishes
itself forthwith  by its antirheumatic virtues, suits, hence, in
scrofulo-rheumatic affections; while  Petrol.,  aside from the
similarity mentioned,  has the following in common with
Graphit: " Scrofulous and  rhachitic affections, itching her-
petic eruptions, eruption on the head, hardness of hearing and
deafness (from paralysis  of the  aural  nerves), itching and
swelling of the scrotum, and herpetic eruptions between scro-
tum and thigh.  Cracked and fissured skin of the hands."
  How, then, are we to distinguish Graphit?  For our pur-
pose it suffices to know that, in doubtful cases, we may follow
up Graph, by Petrol., if constipation, already mentioned as a
characteristic of Graphit, does not forthwith decide  for the
one or the other remedy.
  Finally, we could ask, What scrofulous affection does
Graphit. cure, which is not also cured by Sulph. ?  We know
that Sulphur suits decidedly more in scabious, Graphit in her-
petic eruptions ;  that, secondly, Graphit presupposes more the
peculiarities of the female sex, Sulph. more those of the male ;
boils, panaritia, suppurations of the tonsils, arthritic and rheu-
matic affections  point to  Sulph. alone, while eruptive  disease-
forms  marked by their locality (behind the  ear, at the scro-
tum), and such as are sufficiently characterized by their essence
(erysipelas,  the  return of which  Graph, is said  to prevent,
psoriasis palmaris, mentagra^, allow of no other selection than
that of  Graphit.  In  short, Sulphur has  a more  extended
sphere of action in the pathological  processes characteristic of
scrofulosis than  the mineral coal.
  Graphit. is also  a  coryza remedy.  Kafka recommends it
against ozena scrofulosa, in case of purulent and offensive
nasal discharge,  ulcerated nasal openings, blood-streaked mu-
cus on blowing  the  nose, smell as from burned  hair, intense
catarrh of the pharynx, with the  sensation as if the food had
to be  swallowed over a  lump, with simultaneous roughness
and rawness of the throat. 
       MOST  APPROVED  REMEDIES AGAINST SCROFULA.  151

   According to Rosenberger, cases of coryza exhibiting the
 herpetic character, are suitable for Graphit.


                      CAUSTICUM.

                        GENERALITIES.

   When speaking of Calcar. carb., we have already mentioned
 the place which Caustic, holds within the series of antiscrofu-
 losa, and content ourselves with enumerating the scrofula-
 symptoms pointing to Causticum :
   1. Scabious eruptions, Scabies florida.
   2. Stitching itching, with burning and redness after scratch-
 ing.
   3. Burning on all places touched.
   4. Nightly agglutination of the eyes; frequently dark-col-
 ored webs and fiery sparks before the eyes.
   5. Otorrhoea.
   6. Obstruction of the  nose, and continuous coryza.
   7. Yellowish, discolored, sickly complexion, with yellowish
 temples and palish-blue  lips.
   8. Pressure in the stomach from eating bread, even ; much
 inclination to empty eructations.
   9. Large abdomen in children; chronic  constipation;  fre-
 quent, but unsuccessful attempts at stool.
   10. Involuntary escape of urine.
   11. Chronic hoarseness and weak voice; feeling of soreness
 in the chest and larynx.
   12. Strumatous swelling of the thyroid gland.
   Thus  we have  an imposing  series of scrofula-symptoms.
 Aside from Calc. carb., we  probably think of Hepar and Mer-
 cur.  as analogues, with which it has, moreover, great  chilli-
 ness and profuse sweats in common.
  We have to consider, hence, all the more the few differential
 momenta.  Caustic,  is, so  to  say, the Rhus, of the mineral
 kingdom, and, besides, acts more upon scrofulous affections
 with burning spread over a surface  (Scrofula cutanea).  It
has not the specific relation to pus that Mere and Hepar have,
which we mentioned.
  The true significance of  Caustic, in general, and to scrofu- 
152
ON SCROFULOUS AFFECTIONS.
losis particularly, will, probably, become  more clear by pre-
senting a few of  the exceedingly practical remarks  of A. C.
Clifton, of Northampton.
  According to them, Caustic has proved itself efficacious in
scrofulous and rheumatic ophthalmia, especially if  constipa-
tion existed simultaneously; in general dryness of the skin;
in rheumatic paralysis of the left side of the face,  in conse-
quence of cold northwest wind, and in rheumatic prosopalgia
of the same side.
  Moreover, the same author cured with Caust fistula lacry-
malis, and fistula in ano  (by its internal and external applica-
tion).*
  Caustic,  was very efficient in chronic  rheumatism with
swelling and stiffness, with  contractions of the tendons  (in
getting up after sitting the tendons in the knee-joint as if too
short), with stinging and  tearing pains, especially in scrofulous
subjects, though  it frequently  required Calc. carb., Silic, and
Sulphur to finish the cure.
  Caustic,  helped in psoriasis palmaris, also in otorrhoea of
children, when a  dry eruption behind the ear and around the
nose existed at the same  time.  The author found this remedy
very efficacious in  constipation of children, especially if ac-
companied by enuresis nocturna; in case of a diy, unhealthy
skin,  upon which every small wound passes into suppuration
(a principal criterion of  scrofula); in dryness of the rectum,
with  vehement contraction of  the sphincter ani, on account
of which children were compelled to retain the stool for sev-
eral days.
   It is, also, a valuable remedy in laryngeal cough ;  in phthis-
is, if  the cough appears  in the morning, and  is accompanied
by tickling in the throat, and difficulty in raising the mucus;
in hoarseness and aphonia.f
   Its relations to  the  uro-genital  system, the local atonic
affections of which it cures, enable us almost alone to distin-
guish between Caustic, and Graph., with which it has no fewer
than the following characteristics in common:
  * Staphisagr. 30 (one dose every evening), is also praised in fistula lacrv-
malis (A. H. Z., 77, 79).
  f In acute cases Causticum 3; one drop every two hours. 
      MOST  APPROVED REMEDIES  AGAINST  SCROFULA.   153

            1. Antiscrofulosum;
            2. Constipation;
            3. Burning and itching pains ;
            4. Eruption behind the ear;
            5. Psoriasis palmaris;
            6. Hemiplegia facialis;
            7. Chronic larjmgitis ; rough voice ;
            8. Dryness of skin ; fissures ;
            9. Ophthalmia.


                   CLEMATIS ERECTA.

                      GENERALITIES.

   " Regarding it the same holds good that has been  said of
 Calendula;  homoeopaths  saw satisfactory cures from it in
 swellings of various glands and in torpid  scrofula " (Dr. Reil,
 N. Z. f. h. Kl., 1, 9).
   " As regards the exanthemata, in which we are guilty of
 generalizing too  much,  Clematis seems to have been much
 neglected.  It  has proved itself efficacious  especially in  the
 pustular forms (papule, acne, sycosis).  Here I have found it
 to be specific and exceedingly prompt in its action ; much more
 efficacious than in eczema (impetigo, bulle, ecthyma);  in
 short, in the vesicular forms, in which it has also been recom-
 mended from different quarters " (Hirschel, N. Z. f. h. KL, 2,
 23).
   Dr. Steus  names Clematis among the cancer remedies  (be-
 sides Con., Lycopod., Sep., and  Sulph. ac) (N. Z. f. h.  KL, 4,
 19).
   Dr. Kallenbach praises the curative power of Clemat erecta
 in tumors of the mamme, with simultaneous affection of  the
 whole  mammaiy gland (otherwise not), especially if the pains
 are aggravated by west  wind, cold weather in general, and
 during the night.
  Dr. Weber corroborates the efficacy of Clemat. in such cases,
saying that  he had found it confirmed in a girl  to whom he
had given this remedy for soreness of both nasal openings.
  v.  Boenninghausen  remarks upon  this that the principal
indication for Clemat, in such glandular affections, is a burn- 
154
ON SCROFULOUS AFFECTIONS.
ing,  tensive,  and itching pain, which is considerably aggra-
vated, especially after cold washing, or cold, wet applications
(Neunte Jahresvers. d.  hom. Aerzte Rheinlands und West-
phalens, 31 Juli, 1856.   A. H. Z., 53, 12).

  Note.—The testicle corresponds to the mamma.*  We see
now that Clemat. shows its action upon  that also.  From all
this  it may be  seen that Clemat suits  better  for grown-up
persons; hence for the scrofula-forms more modified by in-
creasing years, among which affections, finally, we may rightly
count the scirrhous degeneration of the glands.   At any rate,
the  remedy ought  to be tried in affections of the skin and
glands, with  due observation of the indications above men-
tioned :
  1. Torpidity of the trouble.
  2. Aggravation from cold and wet.
  3. Glandular organs affected, or the skin amid efflorescence
of a papulous exanthema.
  4. Burning, tensive, and itching pain in the part affected.
                 CONIUM MACULATUM.

                      GENERALITIES.

  Conium. has a more decided action upon the glandular sys-
tem than Cicuta, belonging to the same natural family, which
manifests  its effects more in the nervous system.   Not only
the ancients, Dioscorides, Plinius, Avicenna, observed  after
the use of Con. the glands of healthy persons to grow smaller
in size, but also more recent experiences have confirmed these
facts.  Especially do all agree in its pain-allaying action.
  Dr. Kurz (N. Z. f. h.  Kl, 2, 9) recommends Con. against pe-
riodical, nightly cough, if predisposition to scrofula sustains
the cough.   My own clinical observations corroborate these
recommendations.  Con. 3, a few drops  in two grammes of
alcohol.  Of this from 2 to 3  drops from three to twelve hours
(N. Z. f. h. KL, 2,14).

  * For this reason abuse of Iodium occasions atrophia of the testicles, as
well as of the mammae. 
      MOST APPROVED REMEDIES  AGAINST SCROFULA.  155

   The relations of Conium, says Dr. Hilberger, of Trieste, to
 glandular affections, and especially to the mammary gland,
 were already surmised by old school physicians.   Physiologi-
 cal provings  have confirmed these properties de facto.   The
 considerable  hardness  of  an infiltrated gland,  and the flying
 stitches resulting from its pressure upon the nerves, form a prin-
 cipal indication for its administration.  It develops its effect
 most likely by causing a reaction in the compressed, and hence
 relaxed nervous and vascular ramifications, and in this man-
 ner brings about the resorption of the softening tissue, with-
 out, however, being capable of altering the dyscratic character
 itself.
   The N. Z. f. h. KL 2, 21, recommends Con. 6 against photo-
 phobia and presbyopia, already manifesting  itself  in early
 years.
   In the same journal, Bd. vi (x), 24, a cure by Conium is men-
 tioned; a few noduli, resembling hard  beans, in the left mam-
 ma, with a slight short cough (in a young  lady et. 25), were
 resorbed upon the use of—

                  R. Conii macul. fort. gtt. iij.
                     Sach. lact., gr. vij (0, 5).
           M. f. p. d. dos. t., No. xii.—Two  powders,daily.

   Dr. L. Battmann (of Grossenhain) deems Con. (2) the most
 specific remedy in suppuration of the mesenterial glands, and
 in support of  his opinion quotes the report of an  interesting
 case (A.  H. Z., 54, 21).


                         CLINIQUE.

       1. (L.) Affection of the Nervus laryngeus inferior,

   Consisting in a clapping sound in the larynx, in a scrofulous
boy et. 13, with previous spasmodic pressure in the region of
the ligamenta glottidis. Dr. Schwenke supposechpressure upon
the n. vagus, in consequence of glandular swelling, and cured
the trouble by Con. mac. 6 rapidly and permanently. Allopaths
had given the same remedy before  without result (A. H. Z.,
49, 19). 
156           ON  SCROFULOUS AFFECTIONS.

                     DULCAMARA.
                      GENERALITIES.
  Characteristic remedial action (according to Altschul):  sup-
purating, wetting, herpetic eruptions; vesicular eruptions, with
a yellowish, watery liquid ; glandular  swellings, and indura-
tion of the glands ; bad effects of taking cold, especially from
wet, cold  weather; sudden hydropical swelling of the body
(hydropical dyscrasia).

                        CLINIQUE.
                   1.  (LI.) Scrofulosis.
  In the long account of suffering of a boy, et. 14;, in whom,
as usually, accompanied by obstinate, sour diarrhoea, vomit-
ing, knotty distension of the abdomen, subsequent cough, and
furunculous eruptions, &c, an exceedingly high grade of gen-
eral scrofulosis and atrophia  developed itself, Dr. Buerkner
(N. Z. f. h. KL, 3, 9) marks out two periods.  After the  mal-
ady, in spite of the  most careful dietetic as well as therapeutic
treatment of the child, had already become very severe; when
the child, emaciated to  a skeleton, with a shrivelled, wrinkled
skin, covered on the back, buttocks, and legs, with furuncu-
lous, hard, red knots, lay in bed, which it soiled  several times
daily by excessively fetid, thin  discharges, not crying  any
more, but hoarsely moaning the whole time; a pemphigus,
the bulle of wThich partly had  the size of a pigeon's  egg,
broke out over the Avhole  body, amid the most  distressing
restlessness.  Against this, though with no hope of success,
Dulcamara 1 was prescribed every two hours; a remedy which
the writer remembered to have seen recommendeded against
this disease-form.  Almost from the very moment of its appli-
cation, improvement set in in the  general condition of the
child; it  became more quiet;  the diarrhoea grew less ;  sleep
came on; and when, five or six days  afterwards, upon the
continued use of the remedy in  a higher dilution, even the
pemphigus blisters, to  which, at the beginning, a few  fresh
ones had been added,  began to heal up, the whole condition
was so changed, that one could  again  entertain hope for the
child, given up long ago.  And, in fact, from this date on, re- 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.  157

covery evidently progressed without any further medicine;
yet an unexpected occurrence was  again to endanger the re-
sults so laboriously obtained.  After matters had been com-
paratively well, and the child had  improved considerably, an
intense inflammation of the knee-joint developed itself.  The
left knee was thickly swollen, painful, tense, and red; violent
fever; great restlessness, and a return of diarrhoea accompa-
nied the localization of the scrofulous process.  The develop-
ment into suppuration and gonarthrocace seemed inevitable.
However, a  few doses of Silic. 12 quickly arrested the evil, and
after  that time the recovery progressed so rapidly that from
six to eight  weeks afterwards the patient was completely well,
and could run about again upon healthy legs.


                      EUPHRASIA.
                    GENERALITIES.
   We can easily name a dozen remedies  which are said to
cure scrofulous ophthalmia and its concomitant phenomena.
At what  time, hence, is  Euphras.  to be  applied? It cor-
responds apparently to a simultaneous sycotic (condyloma-
tous)  dyscrasia, and has been given against condylomata after
Thuja had been used in vain.
   Euphrasia has, moreover:
   Inflammation and redness of the eyes.
   Inflammation and ulceration of the edges of the eyelids, with
headache.
   Spots, vesicles, and cicatrices on  the cornea ; also opacity of
the same.
   Watering of the eyes, especially  in the wind.
   Much secretion of mucus in the  canthi, with nightly agglu-
tination of the  lids.
   Profuse coryza  with discharge  of acrid tears  and photo-
phobia.
                        CLINIQUE.
              1. (LIT.) Spots upon the Cornea.
  Dr. Jackson as long  as forty years ago, has recommended
this remedy against spots upon the cornea.  In  a boy who
suffered from a very violent and obstinate  scrofulous ophthal- 
158
ON SCROFULOUS AFFECTIONS.
mia which left spots of considerable size on the  cornea, this
remedy alone was efficacious (Brit. Journ. of Horn., 1850, Jan.).

              2.  (LILT.) Opacity of the Cornea.

  In  April,  1851, I observed  the rapid  curative effect  of
Euphras. 1, daily one drop in three tablespoonfuls of water,
four days in succession, in a young female badger dog, against
a severe blennorrhoea of the conjunctiva of the right eyeball,
and pterygium, which, departing  from the inner canthus,
spread over nearly the whole transparent cornea.  The patho-
logical formative process ceased forthwith, and the pterygium
disappeared in the  shortest time without any further local
application.  The most prominent symptoms  were:  intense
redness of the eye, swelling of the lower lid, increased muco-
purulent  secretion,  nightly agglutination of  the lids, and
photophobia  (A. H. Z., 44, 16>

  Note.—Dr. Lobethal, on the contrary, says that in  scrofu-
lous ophthalmia the effect of Euphras. is uncertain, and ap-
propriately assisted by the internal use of Cannabis and Nitri
acid., and in case  of severe photophobia by Rhus 1.
  He thinks that in catarrhal  ophthalmia Euphr. is of ac-
knowledged efficacy, a reason for which it  is kept officinally
in all drug stores.*
  We also believe that Euphras. in the  most pernicious form
of scrofulous ophthalmia, can never render superfluous such
remedies  as Calc. carb., Acid, nitri., Mercur., Arsenic, &c.   It
can claim here, consequently, but the name of  a  so-called in-
tercurrent remedy.

                        FERRUM.
                      GENERALITIES.

  If Iron were of benefit  in anemia alone, we  could not  use
it much in scrofulosis;  however, it cures those diseases coin-
cident with dropsical conditions, and, from this view, it is an
antiscrofulosum.
  * Aus den Verhandlungen des Vereins schlesischer hom. Aerzte, in Bres-
lau, A. H. Z., 76, 10. 
         MOST APPROVED REMEDIES AGAINST SCROFULA.   159

      We  name  (according  to Rueckert's industrious compila-
    tions) the following confirmed indications:
      1.  Relaxation and weakness of the entire musculature and
    emaciation, weakness of digestion, coldness of the extremities.
      2.  Anemia under the mask of plethora and congestion, ac-
    companied by a whitish color of the mucous membranes.
      3.  Pulmonary tuberculosis, especially in young, florid sub-
    jects with  a  remarkable erethism of the vascular system, in-
i    clination to congestion toward the chest.  But we will remind
    here of the property of Iron, in larger doses, to occasion  hem-
    orrhages, a reason for which allopathic physicians do not give
    it in tuberculosis with inclination to hemorrhages.
      4.  Aphonia, very distressing.
      5.  Chronic, watery diarrhoea in children, usually soon  after
    eating and  drinking, without pain and effort, mostly containing
    undigested substances.*
      Iron is the remedy, also, indicated after previous abuse of
    Iodine (likewise after Arsen. and China), and what scrofulous
    patients have not already been overfed by Iodine (or a  com-
    pound thereof > when they are transferred to us from allopaths ?
      The Monatsblatt to the 82d vol. of the A. II. Z., presents a
    very interesting contribution to the action of Iron.  There we
    find an essay by Dr. E. Seitz (of Buer, near Osnabrueck), which
    shows that a great number of strumata decidedly grow in size
    and are produced by the  use of Iron preparations (confirmed
    in Virchow's Jahresbericht of 1868, Bd. 1, Abth. 2, S. 287).
      "Very similar relations," continues Seitz, "exist moreover,
    with regard to  scrofulous  glandular swellings, and every ob-
    jectively observing physician may convince himself that  with
    some scrofulous children the submaxillary glands grow larger
    and more painful  after the  administration of Iron prepara-
    tions"f (Allgem. med. Central-Ztg., 1870, 103).
      There exists scarcely a more direct appeal to give Iron in a
    homoeopathic preparation  against  such glandular hypertro-
    phies.  Allopaths  can, probably, best  quiet their conscience
    by giving Iodide of Iron, in place of Iron.  For Iodine as surely

     * Calc. carb. or acet., Phosphor., Arsen., are more frequently administered
    against this affection as the expression of a scrofulous trouble.
     t Calc. carb. or acet., Phosph. and Arsen , are more frequently indicated
    in this affection as an expression of scrofula. 
160
ON SCROFULOUS AFFECTIONS.
reduces the size of the glands (especially of the gl. thyreoidea)
as Iron, according to Seitz, increases it.

           HEPAR SULPHURIS CALCAREUM.
                      GENERALITIES.

  Coinciding, as a general thing, with the action of Sulphur;
Hep. sulph. calc, on account of its combination with lime, still
more acts upon the lymphatic and glandular system, and  es-
pecially moderates plasticity.   Hence its curative  action in
pathological  processes  with  pseudo-membranous deposits
(croup).  Secretions of the skin and mucous  membranes are
excited by it, as well as exudations of serous membranes more
rapidly resorbed by it.  Like Sidphur itself, Hep. sulph. calc,
affects disturbances dependent upon prevailing venosity.  All
this insures to it a prominent position among the  antiscrof-
ulosa.
  Hepar has shown itself useful in  the following forms of
scrofula-dyscrasia:
  1.  In abscesses, the  maturing and suppuration of which are
hastened under its influence.
  2.  In moist and wet tinea.
  3.  In panaritia, in which Hepar  in alternation with Silic.
renders surgical interference superfluous.
  4.  In inveterate glandular indurations, which are brought
to suppuration or resorption by it.
  5.  Its curative action is indubitable in scrofulous ophthal-
mia, in which it acts all the surer the more pure the habitus
scrofulosus presents itself in its totality.
   6.  In scrofulous, purulent otorrhoea.
   7.  In angina  membranacea,  in  croup and  pseudo-croup.
They,  as is well known, cannot always be distinguished from
each other during life,  as long as real  membranes are not
coughed up.  Hep. sulph. soon changes  the  dry, harsh, and
crowing cough into a loose one.  We do not always succeed in
this with Spong., which is still more used in the treatment of
croup.  The torture of emetics is spared to children, treated
homoeopathically, on account of the certainty with which  our
remedies, among which  Hep. sulph. belongs par  excellence,
bring about a crisis. 
     MOST APPROVED REMEDIES AGAINST  SCROFULA.  161

  8. Again Hepar recommends itself in relapses of amygda-
litis.  We find chronic enlargement of the  tonsils as an un-
mistakable expression of existing  scrofulosis.   Every  cold
settles  there.   After  Bellad., the  reduction of the  tonsils
which  have  grown  still  larger, hesitates  sometimes;  then
Hep. ought to be given.
  9. Against ulcerated corners of the mouth.
  10. In ophthal. neonator. (simultaneously with the external
application of Acid nitri.  See that).
  11. In febrile flowing coryza, when the flow becomes  very
easily arrested, especially in scrofulous and rhachitic children ;
if hoarseness  or a hollow rough cough  appears in addition
(Kafka).
  12. In ozena scrofulosa (Kafka).
  Mercurius is the remedy with which Hepar sulph. could be
confounded most easily.  Mercur. within  the domain of scrof-
ulosis has almost  all the therapeutic virtues of Hepar sulph.
Hence we shall have to fall back upon the  total characteris-
tics of both, in order not to commit any mistake.   Yet this
is not to be understood as if both, now and  then, were not in
place, one soon after the other (in a similar manner as Lycopod.
may immediately  be given after Calc. carb.), e. g., if the im-
provement obtained by Hepar comes to a standstill (see note
to LIV and LVl).
  Both remedies have in common:
  1. Pain as  from being bruised.
  2. Excessive sweats.
  3. Inflammatory swellings of the glands.
  4. Acne rosacea.
  5. Scrofulous ophthalmia and  otitis.
  6. Inflammation and suppuration of the tonsils.
  7. Great flow of saliva.
  8. Dry cough.
  9. Symptoms of rheumatismus acutus; inflammatory ery-
sipelatous redness  and pains.
  10. Leucorrhcea.
  11. Panaritium.
  12. Coryza, with copious discharge of  an  acrid fluid.

                            11 
162
ON SCROFULOUS AFFECTIONS.
                        DIFFERENCES.

                        Hepar sulph.
   la. Difficult stool as from inactivity of the intestines.*

                         Mercurius.
   lb. Bloody mucous stools, excoriating the anus.  Greenish,
slimy (bilious) stools.   Tenesmus.  Dysentery.

                        Hepar sulph.
   2a. Has many more specific relations to the exudative pro-
cess of the larynx.

                         Mercurius.
   2b. Mercur. is  never used in croup so often;  in hoarseness
and pseudo-croup we find Hepar indicated.
   On the  contrary, Merc, more than Hep. in cases of angina
which are occasioned by swelling (formation of abscesses) of
the tonsils, inflammation of the uvula (accompanied by copious
flow of saliva).

                        Hep. sulph.
   da. Efficacious in mercurial dyscrasia.
      Long-continuing or retarded suppuration.
      Festering, easily  ulcerating  skin;  putrid,  fetid, carci-
        nomatous ulcers.  Hair falls out very much.

                        Mercurius.
  3b. Various manifestations of syphilis fall within its thera-
        peutic sphere.
      Nightly  inflammatory pains of the bones.   Inflamed
        swollen suppurating glands.
      Highest degree of emaciation.
      Ulcerated, whitish-dentated, detached gums, looseness
        and falling out of the teeth.  Fetid salivation.
  * In certain cases Hepar even is to be considered as a remedy in dvsenterv ■
yet we read in the proving of Hepar more of whitish and muco-sanguinous
diarrhoea, or sour-smelling and whitish discharges. 
MOST APPROVED REMEDIES  AGAINST SCROFULA.  163
      Inflammatory swelling and suppuration of the inguinal
         glands (bubo venereus).

                       Hepar sulph.
   4a. Hep. s'dph.  corresponds  more  to  the torpid form of
         scrofula.

                         Mercurius.
   46. In scrofulosis erethica et florida.
      Merc, moreover,  cures  also  the following  affections
         which cannot be reached by Hepar.
       a.  Epilepsia (Trinks).
       b.  Zona with violent burning-itching at night (Schroen).
       e  Icterus and  cutaneous oedema after scarlatina.
       d.  Nervous fever with pain in the  region of the liver,
           diarrhoea, and easily-bleeding gums.
       e.  Typhus  abdominalis, in its first stage, v\ ith tender-
           ness of the liver (status biliosus et pituitosus;.
      /.  Gastric and scorbutic stomacace.
       g.  Glossitis.
       h.  Atrophia mesaraica, with a large abdomen of the in-
           fants, soft stools, and hectic fever (see Arsen).
       i.  Gonorrhoea, dysuria, stranguria, hematuria.
       k.  Balanitis from suppressed gonorrhoea (Trinks).
   We briefly repeat that the affections cured by Mere pre-
supposes a greater participation of the organs connected with
the production of bile than is the case with Hepar.  The latter
better corresponds and is more suitable  to the  infantile or-
ganism, and for this  reason, even, better  fitted to be  a  more
many-sided remed}7 in scrofula than 31ercur., inseparable from
the idea of syphilis.

                         CLINIQUE.

              1. (LIV.)  Scrofulous Ophthalmia.

  A. N., et. 7, of  a very well-marked scrofulous habitus.
  The left eye  intensely inflamed ;  the sclerotica of a violet-
reddish  color; the  cornea turbid and dusty-looking; the eye
watering profusely ; the lower lid swollen ; great photophobia. 
164           ON  SCROFULOUS AFFECTIONS.

  High potencies of Bellad., Calc, and Hep. had no effect.
  Feb. 21st. Hep. sulph. calc. 3, trit. four doses.
    "  23d. Pain decreased.
    "  24th-28th.  One dose daily.  As early as on the 25th,
the ulcer is evidently smaller and flatter ; and, on March 2d,
a complete cure has been accomplished.*

  Note.—« Scrofulous ophthalmia, in which the lids are red-
dened, swollen, and  agglutinated, accompanied by ulcers  on
the cornea, require Hepar sulph. as their principal remedy"
(sometimes beneficial in alternation with Mercur.,—Hyd. prce-
cip. rubr.) (A. H. Z., 77, 10.)

                      2.  (LV.) Croup.
  Anton Scholz communicates a cure of croup (probably of
pseudo-croup only) with  Hep. sulph , of which he gave one
grain (4th trit.) every hour : " All danger was removed as by
magic, and I had good reason for praising Hep. sulph. as an
excellent remedy"  (A. H. Z., 24,13).  '

             3. (LVI.) Ophthcdmia Neonatorum.
  Rueckert does not  doubt that Hep. sulph. calc, this effica-
cious remedy in catarrhal and scrofulous ophthalmia, espe-
cially in intense affection of the Meibomian glands (KL Erfahr.
1,235 and 271), now and then, will act favorably also in ophth.
neonat. (N. Z. f. h. KL, 5,12); and  we read on page 79, Bd.
77, of the A. II. Z., of a very bad case, in which the cornea
was pouched out, all the soft tissues of the eye were thickly
swollen and of  a  spongy appearance, accompanied by a  ter-
rible purulent discharge  and photophobia, which was treated
with the  best result by Hep. sulph. (in the morning) and
Merc. 3 (in the evening).

              4. (LVII.) Eczema of  the Head.
   Mr. N., a government officer of high  rank, asked advice
with regard  to his  children, who exhibited a  well-marked
  * Ein Beitrag zur Frage ueber die Hochpotenzen von Dr. Kallenbach in
Goerlitz. A. H. Z., 30, 7. 
     MOST APPROVED REMEDIES AGAINST  SCROFULA.   165

scrofulous  habitus, and suffered at  times from  glandular
swellings and acne, as well as from numerous small boils.
  The whole family went to Kreuznach, since the father, like-
wise scrofulous, suffered from a chronic conjunctivitis of both
eyes ; he also took the baths, and afterwards drank the water
of the Elizabeth spring.
  During the  drinking-cure small  vesicles had already ap-
peared upon the head ; first at the occiput, which soon spread
over the vertex and synciput as far as to that portion of the
forehead free from hair.  The vesicles had become larger and
larger, formed thick crusts, which discharged a moisture, and,
upon drying up, thickly covered the  portion affected, so that
but  one yellowish-white crust was  visible, which  detached
itself in form of light scales and lamelle, covered the clothing
and  floor, and  caused violent itching, especially at  the parts
covered with hair.  The hair itself seemed sickly, died off,
and fell out more and more.
  A Parisian physician, who declared the trouble to be Eczema
rubrum, and  a consequence of the use  of the Kreuznach
springs, since it had been present once before, prescribed, with-
out result, Rhus tox. and Merc, sol., after which the  discharge
became more copious. Graphit, which counteracted the latter
effect, and produced more dryness;  Sulph., Phosph., Clematis,
which comforted  much; Laches., which subdued the redness,
did most without curing definitely,  however;  Sulphur-Ami-
dine baths, which acted favorably upon the thickness of the
crusts;  Dulcamara.
  When Hirschel saw the  eruption it  was confined to the
scalp, and presented  the form well known as eczema impeti-
ginosum.   Hepar sulph. was selected, 1, in view of the  anti-
dotal relation to the effects of Iodium and Bromium contained
in the waters of Kreuznach, which, at all events, had awak-
ened the dormant scrofulo-dyscratic  conditions, and brought
them to the surface ; 2, in view of the existing  scrofulous
foundation of the cutaneous affection itself; and  3, in con-
sideration of the peculiar form of the eruption, the " moisten-
ing soreness,"  "inflamed cutaneous surface," "puriform dis-
charge," " crusty character," of which, as well as its " secre-
tion of  a whitish-bubbly  liquid,"  "its  itching and itching- 
166
ON SCROFULOUS AFFECTIONS.
gnawing,"  together with the " falling out of the hair," are
distinctly recorded in our M. M.
  He gave  the remedy in the 3d trit., one grain of it morning
and evening, combined with the use of baths, each containing
two ounces of Hep. sulph., of which, however, on account of
the advanced season, but three could be taken; forbade the
use of all others, even the most innocent washes or softening
oils,  in order to keep the head perfectly dry, and ordered the
strictest diet.  After eight days already a complete arrest of
the trouble manifested itself; since the  eruption  did not
spread any further, the moisture decreased, and the itching
grew less.  Six weeks later the cure, in its main feature, was
completed.  The eruption dried off more and more; the crusts
separated easier, grew thinner and thinner, the cutaneous red-
ness, at the place of the detached crusts, more and more disap-
peared.   The subsequent crop, in place of the crusts, showed
but  scales  which easily  detached  themselves; small, dry
noduli, in place of the filled vesicles.  The hair fell out more
and more.  Only  at  the occiput it  remained; and here, also,
the most intense itching was experienced, against which glyc-
erine was allowed to allay it.   At first the vertex healed up,
next the synciput, then the occiput, and, latest of all, the
right parietal surface, upon which  the most intense redness
of the skin  had been  observed.   AVhen the friseur — two
months too late—brought the wig ordered, he was surprised
that it had become unnecessary, since  all parts of the scalp
were healed, and the  hair in  a  healthy growth.  Only one
spot made a stubborn resistance; for, after the affection  of
the  scalp  had  healed, the  eruption spread from the  right
parietal  bone over the right  ear, and  crept from  the right
auricula into the meatus audit.   This affection  was removed
by Hep.  sulph. 2 within four weeks, so that the whole cure
required the  time of ten weeks.
   Besides  Hepar sulph., Mercur. sol. Hahn. 2 was interponed
but  two or  three  times when the reaction following upon
Hepar came to a  halt.  Then discharge and  aggravation*
always set in, but forthwith upon  the reapplication of Hep.
sulph. the improvement progressed in a most decided manner.

  * This aggravation, no doubt, could have been prevented in the most simple
manner by selecting a higher dilution in place of the 2d trit. 
      MOST APPROVED REMEDIES AGAINST SCROFULA.  167


             5. (LVIII.) Scrofulous  Ophthalmia.
   Dr. Genzke communicates  a very interesting cure with
 Hep. $ulph. (A. H. Z., 55, 10), in a boy, et. 10, who suffered
 from highly developed scrofulous ophthalmia.  Photophobia,
 g.ush of tears, considerable opacity of the  cornea, and what-
 ever  else characterizes such an inflammation were present.
 Hep. sulph., 2d trit., one grain every evening, removed the
 inflammatory stage within  four weeks ; afterwards Aurum 3
 the opacity of a high grade.

          6L (LIX.) Swelling of the Axillary Gland.
   The -same author applied with the best success Hep. sulph.
 2, three tim-es  a day, against  an  affection of  three months'
 standing.  The trouble  had begun with  violent tooth and
 face-ache, which were accompanied  by drawing pains  in the
 whole body, especially in the arm, in addition to which the
 right axillary gland began to swell and became painful.  Loss
 of appetite.  Sleeplessness.   Presently enormous swelling of
 the axillary gland, whieh renders any motion of the arm im-
 possible.  The gland  was firm, here and there studded with
 pus-pustules, discharging  a viscid  pus.   Inunctious  of  all
 sorts,  and continued  for months, and warm  poultices had
 proved themselves useless;  only periodically the pus-pustules
 broke, the swelling itself successively increased in hardness
 and circumference.  Within eight days we succeeded in scat-
 tering the swelling by Hepar  sulph., and  in simultaneously
 removing the morbid general symptoms (A. H. Z., 55, 20).

  Note.—We see  from the reports, or rather cures, presented
 that,  as we have said above, Mere. sol. frequently insures and
completes the effect of Hep.   Upon the whole we may say
 Merc, with its indication of thin stools, suits, cceteris paribus,
in the first stage, that  of irritation; Hep. sulph., with  its
pathogenetic effect, hard stool, in the second, that of paral-
ysis, to express it in a somewhat extreme manner. 
168           ON SCROFULOUS AFFECTIONS.
         IODIUM AND ITS PREPARATIONS.

                  ^.—IODIUM PURUM.

11 Iodium est avec Silicea le meilleur medicament de la scrofule.'-—Jousset.

                      GENERALITIES.

  Notwithstanding many contradictory statements, it is a
fact that Iodium, in its physiological action, has a specific in-
fluence upon the glandular  system.  At the beginning and
after small doses the secretions of the glands are mostly  some-
what  increased, but even if intense salivation has sometimes
been observed after Iodium, it is, as a general  thing, much
less the case  than with  Mercury, and more dependent  upon
individual irritability.   On the other hand, two other impor-
tant phenomena have been noticed  to appear after the use of
Iodine, namely, atrophia of  the mamme and testes.  It was
found, however, in autopsies that other glandular structures
even,  such as the mesenterial  and suprarenal glands, had
grown smaller  after the continued  use of Iodine, as well  as
that the fat and connective tissue had been consumed.
  However,  experience ex usu in morbis much more decidedly
argues for the specific  action of Iodium  upon  the glands.
Hypertrophies of the most  various glandular structures, as
well as of other formations  differently constructed, tubercu-
losis and scrofulosis have always been, and will ever continue
to be, the curative domain of this potent remedy.  (Dr. Reil,
N. Z  f. h. KL, 1, 9.)
  The remark  of Dr. Knod v. Helmstreit, that  Iodium has
proved itself efficacious against  mercurial ulcers,  salivation
and stomacace of scorbutic  nature, may also be mentioned
here,  because the scrofula-process is frequently  complicated
with the affections named.
  Dr. Schweikert is of the opinion that among the inhabitants
of regions, the springs of which contain Iodine, struma is oc-
casioned by  the physiological  action of the frequent use  of
Iodium ; hence, in a similar  manner as we see it with regard 
      MOST APPROVED REMEDIES  AGAINST SCROFULA.  169

 to Calc  carb., which possesses the power both of causing and
 curing goitre.
   Iodine, as we have seen above, cures the affections provoked
 by the abuse of Mercury; but, since  the latter represent a
 pathological  picture very similar to scrofulosis, Iodine will
 be, hence, of decided usefulness in scrofula.  Thus Iod. recom-
 mends itself  against  glandular swellings with induration;
 ophthalmia and aural diseases; scrofulous bubo; large, chronic
 strumata ;* laryngitis ; tracheitis ; angina membranacea; tu-
 mor albus, even of an inflammatory character, and with vio-
 lent pains and suppuration; against inveterate cutaneous dis-
 eases (impetigo  scrofulosa).


                         CLINIQUE.

                 1. (LN.)  Cure of Struma.

  A female servant, et. 28, since her fifteenth  year, has suf-
 fered from a considerable enlargement  of the thyroid gland.
 Since  eight days, there  is a noticeable  swelling of the left
 thyroid gland, already enlarged, which increased so consider-
 ably that she scarcely could  breathe any more.  She talked
 so laboriously, and her respiration was  so difficult and noisy,
 that she had to  hold head and neck entirely stiff, and distort
 the facial muscles of the left side.   Upon the thyroid gland
 (of the left cervical region), already much enlarged, a swelling
 as large as a man's fist is  to be seen, which is but little mova-
 ble, oviform, and presses upon larynx and trachea.   Iod. 3, in
 pellets, two pellets every  two hours.  After four days, condi-
 tion the same.  Iod. 20, for three days, without any percepti-
ble improvement; from this  time on, however, the  swelling
 decreased so much from day to day, that on the tenth day of
treatment the portion  situated at the right side of the trachea
had  entirely  disappeared, and  there could be found but a
somewhat hard swelling, as large as a pigeon's egg, at the left.
  * Iodium acts beneficially only in struma lymphatica, less so in st. cystica,
but is absolutely harmful in st. aneurismatica, such as develops in women
during the act of parturition (Altschul). 
170            ON SCROFULOUS AFFECTIONS.

Respiration entirely good ;  can remain in every bodily posi-
tion* (A. H. Z., 60, 11).
  Swelling and induration of the glands, emaciation with rav-
enous appetite, inclination to tubercular meningitis, all point
to Iodium.  It corresponds  to caries, to pleuritic exudation,
phthisis, and tubercles; suppuration, with and without caries.
According to Jousset, injections of Iodine  (the pure or diluted
tincture" prevent the appearance of hectic fever; it moderates
suppuration, and unexpectedly often effects a cure.   On  the
other hand, we read in the  " Universal-Lexicon der pract.
Medicin und Chirurgie," in  the article on scrofulosis, written
with much industry and professional knowledge: " In case of
tubercular degeneration and suppurating abscess, the results
of Iod. have been naught.   Frequently the effects wrere harm-
ful  and fatal in cases of scrofulous cachexia, which were ac-
companied by  febrile symptoms and emaciation."
  In the A. H. Z., 46, 8, we find the following warning  ex-
ample against  traditional doses of Iodine:
  " A girl, et.  18, ruddy, and well  developed, consulted a
physician on account of a swelling of the throat, a  so-called
'saddle-throat' (Sattelhals).   He prescribed an Iodine salve
and Tr. iodii  in increasing  doses  up to fifteen drops  three
times a  day.   When I  was  called to see the girl, six months
afterwards, she had changed  so that I scarcely could recog-
nize her. Her form was withered, the bosom had disappeared,
her face was of an ashy pallor, and around the eyes blue rings
had formed.  She complained of a large number of troubles,
especially of oppression, dry cough, palpitation of the  heart,
loss of appetite, pressure in the stomach.  The menses, pre-
viously  regular, and at  first failing  to reappear after taking
the medicine, had afterwards appeared all  the more copiously,
and since that time she had  almost from every three to four
days, a  discharge of a  thin watery blood from the vagina.
The situation of the patient was a dangerous one.  At any
rate, by the clumsy experiments with Iodine, the  blossom of
a youthful life is destroyed forever."

  Where, then, is to  be found the true,  curative  sphere of

  * Dr. Lobethal  cannot do without a salve of Kali jodat. (05 : 90, 00) in the
treatment of large lymphatic strumata. 
      MOST  APPROVED REMEDIES  AGAINST  SCROFULA.   171

Iodium?  The following case may present the answer to this
question.

               2. (LXI.)  Asthma Laryngeum.
   A child, nine months old, suffering  from atrophia  mesen-
terica, underwent treatment for this trouble.  Emaciation has
not yet reached the highest degree ; abdomen large, legs thin,
stools irregular, now constipation, now diarrhoea. In addition
there were troubles from teething.  Upon the administration
of Cede carb. and  Sulphur, alternately every other day, the
child improved rapidly.  But fourteen days afterwards con-
vulsions set in, which presented  the following symptoms :
Sudden rigidity of the body, bending back of the head, tight
closing of the hands, lips growing purple and, in connection
therewith, the  appearance as  if the child were strangling;
respiration momentarily suspended ; dry heat of the skin, and
frequent jerks and starts.   The attack appeared usually when
crying or coughing, and at waking up.
  In consideration of the periodical heat  of the skin, Aconit,
and afterwards Bellad. was given, but although the heat dis-
appeared, the spasms nevertheless remained as before. Ipecac,
as well as Hep. (the latter on account of the peculiar sound of
the cough, reminding one of  croup) effected nothing ;  after
Zinc, met, it is  true, no general and fully developed spasm re-
appeared,  but  still momentary constriction of the  larynx.
The sound of the cough, the glandular affection and the gen-
eral emaciation, as well as the  irregular stools, led me to give
Iod.   Upon  its  use  the  attacks  soon became weaker, and
finally ceased entirely.   Under the continued application of
this remedy, the child is now strong, fleshy, and healthy.
  In a second case of asthma  laryng.,  Iodium did the same
good service; in a third it only helped  in  alternation  with
Sambucus (Dr. Seybel, Aschersleben, A. II. Z., 50, 15).

  In croup  of  scrofulous  children, which  likewise  has its
asthma  laryng., Iodium deserves the  greatest consideration,
and it seems almost as if  many cures  with Spongia, which is
related to the former, in most cases had appertained to spurious
croup (without formation of  membranes) only.  Otherwise,
how could such facts as the following find an explanation ? 
172
ON SCROFULOUS AFFECTIONS.
C. A. Tietze, 1839, treated fifteen children affected by croup
with Aeon. Spongia 30, and Hep. sulph. 3.  Not one of them
died.  One year afterwards five died out of six.  (An  omi-
nous symptom was the entire absence of cough.)
  From the experience obtained, Iodium is, hence, a sovereign
remedy against croup.  Before  we make mention of the sur-
prising cures effected by it, we will briefly cite the following
symptoms  from its  pathogenesis: " Intense disturbance  of
respiration. Oppression with pains when taking a full breath ;
stronger  and more accelerated pulsation of the heart, and
smaller and more frequent pulse.  Difficulty of breathing  in
the throat.  Soreness with whistling in the throat.  Inflam-
mation of the trachea, hoarseness ; sensation as if something
had lodged in the larynx that could be removed by hawking.
Titillating and  tickling (in  the  throat).  Increased  secretion
of  mucus.  Viscid  mucus.  Dry cough with  oppression.
Heaviness in  the chest, &c.
  " Great lassitude.  Weariness.  Great prostration.  Weak-
ness of the muscles.
  " Distress.  Anxiety.  Oppression  in the chest."
  Trinks knows of but two kinds of croup, the acute and the
torpid.  Iodium is specific to both ; he needs  no Aconit, rarely
Hepar sulph., and  ascribes  the  favorable results obtained  to
the continued  administration of the specific remedy in  re-
peated and increased doses, if the intensity  of the disease is
not broken by weaker doses,  and  there is  no qualitative
change.

                    3. (LXII.) Croup.

  A boy, et. 5, very scrofulous, with many and large  cica-
trices on the  neck, occasioned by glandular suppurations, was
attacked by croup.  On the second day of the sickness, which
presented all the symptoms of croup in the highest degree,
"attacks of suffocation, sawing  sound, dry, crowing cough,
soundless voice with intense fever, &c," patient received Iod.
2, two drops every hour,  besides,  oatmeal poultices.  For
three days no change in his condition; at the fourth, decrease
of the synochal fever with simultaneous eruption of a rash on
the throat, back, and chest which,  on  the  day following,
covered arms and feet also.  The croupous symptoms, not  so 
      MOST  APPROVED REMEDIES  AGAINST  SCROFULA.   173

 intense any more, increased on the next day, more and more.
 Iod. 2, up to five drops, every hour.   At the eighth day de-
 crease of the croup symptoms, only the cough remains dry,
 and has a metallic sound up to the eleventh day, when it be-
 comes more loose  and solvent.   Hepar sulph. 3, one grain
 every four hours, removed all the remaining symptoms (Horn.
 Vierteljahrschrift, 3, 2, Trinks).

  4. (LXIII.) Iodine  Vapors successfully applied in a Severe
                      Case of Croup.
         BY DR. TV. ARNOLD, OF  HEIDELBERG (A. H. Z., 2, 19).

   Membranous croup, by the specific  remedies that homoeop-
 athy has given into our hands,  is usually treated with  such
 success as  soon to remove all its danger.   Though the cases
 which resist our method of treatment for a longer time, are
 rare, they yet occur sometimes ; especially if the patient comes
 under our treatment after the disease  has already lasted some
 time and has progressed considerably.   In several cases  of
 this kind,  which  partly had been given up by  other phy-
 sicians, I have successfully used Iodium internally. In a few
 other cases which resisted this remedy, even, and which would
 have prompted some physician  to perform the operation of
 tracheotomy, I found myself induced to let Iodium act di-
 rectly upon the mucosa of the respiratory organs ;  and I have
 always seen  the best result from  this procedure. Not only
 were t/ie lives of the three children  in whose cases I saw myself
 compelled to  apply Iodine  vapors,  saved, but they recovered com-
pletely, i. c,  no subsequent  diseases of the respiratory  organs
 occurred.
  In one of  the three cases the  croupous inflammation had
 confined  itself to  the larynx; in  the two others bronchial
 croup was plainly marked.   The effects of the  Iodine-vapors
 could soon be recognized by the fact that after the cough had
 become somewhat  moist, some mucus  intermixed with mem-
 branous fragments was expectorated shortly afterwards, which
brought  some relief,  though very slight at the  beginning.
However, upon the repeated application of the  vapors, the
cough became more and more loose, and, aside from a mostly
very viscid mucus, and amid the strong efforts of coughing or 
174
•ON SCROFULOUS AFFECTIONS.
vomiting, the children threw up smaller or larger pieces, and
sometimes longer shreds of the pseudo-membrane.  Upon the
frequent use of the ibrfme-vapors and under the continuation
of the expectoration mentioned, the distress and dyspnoea of
the little patients  decreased rapidly; they fell into a  sleep
which, though lasting but a short time at the beginning, be-
came longer and more quiet after each expectoration brought
about by the paroxysms of cough.  In this manner the danger
had disappeared within sixteen hours in the one case in which
the croupous inflammation was  confined to the larynx, in the
two others within from forty to forty-eight hours.
  The plainly perceptible effect of the ibrfme-vapors consisted,
hence, in changing  the  character of the cough, making  it
more moist, in the detachment of the membranous formations
and the relief of respiration dependent thereupon.
  The modus  operandi simply  consisted  in dropping a few
drops of the second decimal solution up to several drops of the
strong Iodine tincture into a flat vessel with  boiling water, and
letting the child inhale the vapors ; which  was accomplished
by holding its head over the steaming water or closely to it.*
The  process, according to necessity, was  repeated oftener or
less frequently from two to six hours.  At the commencement
the vapors appeared  to be agreeable to the children, for they
tried to come  near to  the steaming vessel.  Afterwards the
effect seemed to be disagreeable to them, for two of the chil-
dren offered resistance against  their application, after relief
of the symptoms had already set in.

         5. (LXIV.) Laryngitis exsuda'iva (Coup).
           BY DR. SCHL0SSER, OF MUNICH (A. II. Z , 49, 20).
  M. S., a boy, et. 2\, for three days hoarse, has a dry cough,
which daily increases under increase of the fever.
  July 14th, 1853, about 1 a.m. the child wakened up with a
violent  attack of suffocative  cough,  which lasted several
minutes, afterwards it went  to  sleep again, but at dawn was
again disturbed in its slumber by a dry, hoarse cough, accom-
panied by great difficulty of breathing.

  * Nowadays we would use one of our  common inhaling apparatuses.  Thus
I have applied locally not only Iod. but  also Graph., Brom., Hep sulph., &c. 
      MOST APPROVED REMEDIES  AGAINST  SCROFULA.  175

  On the next  morning fully developed idiopathic laryngeal
croup.  Intense fever, dry skin, hoarse rough voice, short la-
borious, sawing respiration, with frequent, dry, and barking
cough returning in paroxysms.  Pharynx intensely reddened,
the larynx painful on  touch.   The symptomatic picture did
not leave any diagnostic doubt as  to the trouble being laryn-
geal croup.
  Aconit. 3, three pellets pro dosi, and Iodium 3 gtt. j ; in Sach.,
lact., 1, 0, m. f. p.  To be given alternately ; one hour Aconit,
the  other  of the Joanne-powder as much as will  lay  on the
point of a pen-knife, with a little water.
  After a few hours, considerable amelioration in the attacks
of cough and difficulty of breathing set in;  six days later he
was completely cured, though  no exudative membranes had
been removed by vomiting, so that a complete  resorption has
to be presumed.
  In  conclusion Dr. Schlosser says:  Though  this favorable
termination is usual with our curative method, every cure of
genuine  croup deserves,  nevertheless, to be recorded, since
under allopathic treatment most of the children affected by it
die,  and the cure of  this  disease may  possibly induce the
thinking portion of old-school physicians to turn to the study
of homoeopathy ;  especially, such of them as cannot befriend
themselves with the barbarous, though unreliable method of
the local internal cauterization with Nitrate of Silver, and
have  found the emetic and local-antiphlogistic methods in-
effective.

6 and 7.  (LXV and LXVI). Two Cases of Angina  Membrana-
                 cea cured by Iodine Vapors.
          BY DR. KIRSCH, OF WIESBADEN (A. H. Z., 57, 13).
  One of the children, a girl, et. 2|, had already been treated
without success allopathically with emetics for  four days, and
an older child of the  same  family had shortly  before died of
croup (at the eleventh day of the disease).
  When the second child was attacked  by the disease, the
physician had declared, that it seemed to set  in with the same
violence.  In fact, all the symptoms of croup had reached so
high a degree in the surviving child, that there was but very
little  hope for  resorption  of  the  exudation  and recovery. 
176
ON SCROFULOUS  AFFECTIONS.
Aconit and Brom. had not the slightest effect.  Now from
fifteen to twenty drops of the  first  alcoholic dilution  of
Iodium, to a saucerful of hot water (put over an alcohol-lamp)
were allowed to vapor off near the child.  It became stupe-
fied, but did not improve in the least, and was near suffoca-
tion.  Now the third trituration of Iodium was used for the
development  of the vapors.  Improvement set in as early as
after the first inhalation, and within forty-eight hours, during
which time five such inhalations  had been taken, the child
had recovered.
  If from this report, rightly remarks Dr. Kirsch, the efficacy
of Iodine-vapors  becomes evident, the proof is also presented
thereby, that the curative power of a remedy does not lay in
the quantity of the substance, but that often only a smaller
portion of a medicine renders it a curative remedy, and that
the expansion of the molecules is of no little importance.

  Another child, ten months old, also took inhalations of
Iodium  (3d trit. two grains in a saucerful of water, vapored
off over an alcohol-lamp). The vaporing off of such a quantity
lasted half an hour.  Repetition in two and a half hours. After
three  inhalations the cough became looser.  Afterwards in-
halations every six  hours, Aconit as an intercurrent remedy
against the fever. The  croup terminated with the appearance
of coryza.

  We interpone the remark here that cases of croup have ter-
minated  fatally in which neither in the larynx nor trachea
a trace of exudation was found on autopsy.   These cases (ac-
cording to Dr. Schlautmann  and Professor  Niemeyer), are
said to have been occasioned  by a collateral oedema of the
laryngeal muscle's, and in  consequence thereof  by paralysis
glottidis.*  From this  the inefficiency of the remedies, other-
wise helpful, may be explained, as well as the curative power
of drugs not employed  usually.
  According to Kidd  (Brit. Journ. of Horn.,  April, 1859),
Iodium is thus far the most efficacious remedy against diph-
 * See A. H. Z., 20, 57. Vortrag des Herrn Dr. Schneider aus Magdeburg:
" ueber den croup." 
     MOST APPROVED REMEDIES AGAINST SCROFULA.   177

thelitis.   He advises to give large doses of it, frequently re-
peated, also inhalations of pure  Iodine, vapored off in the
room.   We take  notice of this view  without indorsing it.
It is  possible that in those cases in which Iod. (even in a
homoeopathic dose), helped, diphtheritic croup was present.
It is suspicious in  Dr. Kirsch's case that two children of one
and the same family were sick with croup.  Genuine  (non-
diphtheritic) croup, so far as we know, is not contagious.

   In No. 12 of the N. Z. f. h. Kl , Dr. Lobethal (Breslau\ re-
ports upon the administration of Iodium dilutions in " malig-
nant  cases of membranous croup," and continues as follows:
" But also in acute catarrhs of the larynx and in inflamma-
tion of it, in hoarseness of singers from taking cold (not in
aphonia), as well as in chronic irritation of the larynx with
hoarseness in the evening, especially  in persons who  were
scrofulous when children, dilutions of  Kali iodatum, or still
better, of Iodium,  are of great value."
   He sees between Kali iod. and Iodium  a relation similar
to that between the mother-tincture of a remedy and its di-
lution.

               B.-OLEUM JECORIS ASELLL*
   "As regards its local-specific  action, cod-liver oil is a very good sympto-
matic remedy in scrofulosis and tuberculosis.  But in tuberculosis it is by no
means a curative drug in the true sense of the word.'*—Kafka.

   It would be one-sided were we not  to take notice of cod-
liver oil in our treatise on anti-scrofulous remedies.  Because
it has been greatly abused, does it therefore possess no virtue ?
The fact alone  that  it  contains Iodine ought to point  to its
importance in scrofulosis.
   Moreover, have not many of our invaluable remedies been
taken from  the ocean?  Chloride of Sodium, Sepia, Iodium,
Bromium, Spongia, and even the Carbonate of Lime, obtained
from oyster-shells, all have important and, we  may say, in
many respects unknown relations to the processes of scrofu-
losis.

   * -The unpurified (brown) C. L. 0 , according to A. Vogel, is preferable to
the purified white.
                             12 
178            ON SCROFULOUS AFFECTIONS.
  "An  extended sphere of action," Dr.  Madden says, in  a
paper on 01. jec. asell., read before the Brit. Hom. Society, in
1848, " is conceded  to it, especially in scrofulous diseases and
all  their kin, and above all  where the osseous tissue suffers,
as in rhachitis, caries, spina ventosa, &c.   In diseases  of the
mesenterial glands  and atrophia dependent thereupon, it is
not any less efficacious.  Scrofula, as is well known, appears
in individuals of two different bodily states ; individuals of
the one look fresh, fleshy, and fat; those of the other  pale,
lean, emaciated, and cachectic.   The remedy is especially effi-
cient in the latter, but only exceptionally in the former."
  According to Dr. Madden, Iodine even is  effective only in
lean scrofula, and not in the fat.
  In osteomalacia, atrophia mesenterica, and phthisis pulmo-
num, especially in tuberculosis, when the tubercles have not
yet softened entirely, cod-liver oil proves its efficacy.  Accord-
ing to Bennett's* observations, it surely cures chronic cutane-
ous diseases, scrofulous ulcers, and ophthalmia.
  The administration of cod-liver oil, limited though  it be,
can be justified from the standpoint  of homoeopathy all the
more, as the symptoms which the oil occasions in the healthy
correspond wTith those of Iodine as recorded  by Hahnemann.
Kopp was the first to point to the fact  that 01. jec aselli is
efficacious in those cases in which physicians prescribe small doses
of Iodine.  And Falkner found that the oil  contained  4^-^(5
portion  of Iodium, a  quantity which  is equal to that  in our
4th or  5th dilution.   The mineral springs  of  Kissingen,
Kreuznach, Nauheim, Salins, likewise act as antiscrofulosa
by virtue of their homoeopathic contents of Chlorine, Iodine,
and Bromine.
  But since Iodine does not show itself as  efficient as the oil
the oily  menstruum  must  share essentially in its  curative
power.   Observations have taught us that those continually
handling fatty substances are fleshy and free from  scrofula,
It has been  endeavored to demonstrate by experiments  in
what manner the fat exerts a beneficial influence upon the
body, and it has been found that it forms a kind of emulsion
  * Dr. Hughes Bennett has exhausted in his work (1841) everything that can
be said on C. L. Oil. 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.   179

 with albumen, in which emulsion every molecule of fat is in-
 closed in a kind of albuminous capsula.*  Since the chymus
 contains much albumen and acid, the acid becomes neutralized
 by the admixture of bile, among the constituents of which
 fat and soda belong, and the fat  in connection with the albu-
 men  forms the chylus.  The most  recent  researches have
 demonstrated  the importance of the  oil for the animal econ-
 omy, from which the great  benefit  of the cod-liver oil in
 scrofulous diseases  becomes evident, the origin of which de-
 pends upon deficiencies in the process of digestion, in which
 the emulsion does not possess the normal quantitative char-
 acter.  Some  have proposed  even to diminish the scrofula-
 diathesis by inunctions of the body with various kinds of oil.
   01. jec. aselli, Dr. Madden concludes, has hence two import-
 ant bearings upon the organism :
   1.  On account of  the oil itself; and,
   2.  On account of its contents of Iodine.
 The physiological effect of the former does not interfere with
 the pathogenetic (therapeutic) effect of the latter, in conse-
 quence whereof the remedy, besides being very digestible, is
 very  appropriate for the diseases mentioned above.
   Though Dr. Madden may probably  expect too much of cod-
 liver  oil, he yet gives us important hints  for  its application,
 the remark, by itself, being of great value, that the scrofulo-
 plethoric habitus does not correspond to it, a thing that many
 allopathic physicians do not seem to know, for to them  cod-
 liver  oil is the true  antiscrofulosum a tout prix.  As regards
 the digestibility of the cod-liver oil, it is plain from what has
 been said, that not every stomach will bear it; and why  not ?
 This  much is  sure, however, that some  children  evince no
 aversion to it, while others show the  greatest  disgust for it.
   It would be interesting to ascertain whether  scrofulosis is
to be found among the  inhabitants of Greenland and  the
Esquimaux, who count all kinds of oils among their delicacies,
and do their  share  in using  inunctions.   However, we  may
infer its exemption with regard to the polar regions, a priori,
from the fact, previously mentioned, that the  disease belongs
to the temperate zone.

  * Sunderlin—Behrend's Vorlesungen, Bd. 5, 220—is of the opinion that in
scrofulosis the chylus contains too much albumen. 
180              ON  SCROFULOUS  AFFECTIONS.
   It is, probably, not superfluous to quote here a remark from
the A. II. Z., 46, 6:
   " Test of cod liver oil.—If we dip a strip of copper or brass
into pure cod liver  oil, the metal  is not  changed by it.   If,
however, the cod-liver  oil  is  adulterated  with vegetable  oil,
the metal assumes a green color, if after dipping it into the
oil, we expose it to the air."
   In the Dublin Medical Press, Oleum cocos is recommended
by Thompson as one of the best antiscrofulous remedies, which
is equal in effect to cod-liver oil.*

   We add the  data of a chemical analysis of cod-liver  oil,
according to Dr. Jongh :
Oleic acid, gaduine, and two other substances
  as yet not definitely determined, .
Margaric acid, .......
Glycerine,    .......
Butyric acid,  .......
Acetic acid,
Choleic acid (Acides felliniques et choliniques),
Bilifuolin and bilifellinic acid,
Substance soluble in alcohol,  ....
Substance insoluble in water, alcohol, and ether,
Iodine,   ........
Chlorine, with some bromine,  ....
Acid, phosph., .......
Acid, sulph.,  .......
Phosphorus,   .......
Magnesia,    .......
Soda,........
Lime,    ........
Waste,........
Cod-liver Oil.
Black.
69,951
16,145
 9,711
 0,159
 0,125
 0,299
 0,376
 0,038
 0,005
0,0295
 0,084
 0,054
 0,010
0,0075
 0,004
 0,018
 0,082
 2,569
100,000
White.
100,000
91,000?
 100,000
 100,002
(E. T.)
  * But we remind the reader of the fact that the black, as well as the white
C. L. O., contains acetic acid, by virtue of which such a  reaction may  take
place. 
     MOST APPROVED REMEDIES AGAINST SCROFULA.   181

   Hence, cod-liver oil, according to the opinion of all authors,
acts by virtue of its  contents of Iodine, Bromine, Phosphorus,
and Chlorine.   But, as we see from the above table, all those
substances exist in truly infinitesimal proportion, if compared
to the quantity of fat, indifferent in its nature.
   Dr. Weil, without hesitation, calls cod-liver oil "a natural
homoeopathic dilution of oil in fat."*  However, the recom-
mendation of cod-liver oil in cases of scrofulosis, with emacia-
tion, speaks eloquently and decidedly in favor of the idea that
we have to do with a homoeopathic  preparation, not only as
regards the quantitative proportion of Iodine, but also, and
above all, as regards its therapeutic action ; for the effect of
large doses of Iodium upon the healthy consists in atrophia of
all the glandular tissues, as well as other structures ; in short,
in emaciation.
   We  meet with an entirely  similar view  in  the excellent
pathologico-therapeutic study of Kafka, " Ansemia, or Blood-
pallor" (A. II.  Z., 59, 24).
   He considers cod-liver oil  to be " a homoeopathic  dilution of
an Iodide of Phosphorus," and for this reason deems it to be
appropriate only to definite  disease forms, corresponding to
its physiological sphere of action.          /
   Since, however, the glands, the skin, the mucous  membrane
of the respiratory  organs, and the osseous system, are the
principal parts upon which Iodine, as well as Phosph., have a
decided effect, its therapeutic application, in his opinion, ex-
tends only:
   1. To all forms of scrofulosis and tuberculosis  of the glands,
especially if the hyperaemic and inflammatory processes have
run their  course, and a chronic swelling has remained.
   2. To all forms of scrofulous cutaneous diseases which pro-
duce exudations, such as eczema, impetigo, pityriasis  rubra,
tinea, favus, prurigo, &c, as  well as in that degeneration of
the cutaneous follicles which is known by the name of cuta-
neous tubercle.
  3. To all chronic catarrhal processes of the organs of respi-
ration, e.g., of the  nose, larynx, pharynx, trachea, bronchi,
&c, which accompany scrofulosis and tuberculosis.
* Anleitung zur Krankenpflege, von Dr. "Weil, S. 102. 
182
ON SCROFULOUS AFFECTIONS.
  4. To all scrofulous diseases of the bones, joints, periosteum,
as well as to tuberculosis of the bones.
  5. Also rheumatic  affections, so far as they lay within the
sphere of action of Iodine, especially if  they are  connected
with chronic exudations in the joints, between the muscles,
or in the subcutaneous  cellular tissue, are suitable for the ap-
plication of cod-liver oil.

  Moreover, the opinion of those therapeutists deserves notice
who attribute an essential share of its action to " the admix-
ture of decomposing liver-elements," which can be found in  all
kinds of cod-liver oil.
  " There has been a good deal of debating, A. Yogel says, as
regards the  active substance proper of cod-liver oil.   Some be-
lieve that by its large amount of fat it simply act as a means
for respiration; others search for its efficacy in the traces of
Iodine  and Bromine ;  still Others, finally, in its fatty acids, and
the admixture of decomposing liver-elements."
  Since experiments with pure fat as well as with small doses
of Iodine and Bromine,  did  not produce  the  results desired,
the latter view seems probably the most tenable.
  It yet remains for us  to utter a word of warning as regards
the external use of cod-liver oil.  By the application of com-
presses saturated with it, we very easily succeed in  the rapid
removal of tinea-eruptions on the head;  but  these very exan-
themata  by no means are local processes, but the expression
of scrofulosis coming to the surface.  A sudden suppression
occasions  an obstruction and exsiccation  of the innumerable
springs, the  contents of which now make a retrogressive move-
ment ;  or, more scientifically, the liquid pathological products
are resorbed and deposited  in  the  interior;  meningitic and
pneumonic processes are developing, or in the most favorable
instance, hardness of hearing, otorrhoea, diseases of the eye, &c.
  To our treatise on  the physiological and chemical peculi-
arities  of cod-liver oil we finally attach the appeal to try it in
the form of inhalations in croup.  In almost all grave cases of
genuine croup it has thus far been necessary to employ several
of the  most approved remedies.   Since,  however,  Bromine
Iodine, and  Phosphorus, above all, belong to  the latter, and
all of these are contained in the cod-liver oil, it is possible that 
      MOST APPROVED REMEDIES  AGAINST  SCROFULA.  183

by virtue of  this combination  of  the  specific antiscrofulous
elements, a great preventive and curative power results with
regard to the disease named.

                         CLINIQUE.

                1.  (LXVII.)  Coxarthrocace.
   Dr. Knod v. Helmstreit has  published (in Hufeland's and
Osann's " Journal der pract. Heilkunde, Bd. 74, Mai ") several
cures of chronic rheumatism and coxarthrocace by cod-liver
oil.
   A boy, aet. 6, in consequence  of a fall on the knee, wras af-
fected by coxalgia, which, on  account of improper manage-
ment, reached the suppurative stage, so that the femur was
entirely driven out of the hip-joint, and the leg became short-
ened. The abscess opened anteriorly, and daily produced from
four to six ounces of pus of such acrid nature as  to inflame
the parts to  which  it adhered for a time.   The  boy had a
severe hectic fever,  was exceedingly weak, emaciated to a
skeleton, and inevitably seemed to be doomed to  die.  For
fear that cod-liver oil would still more disorder the appetite,
already very  poor, it was first applied in injections (1| ounces
twice a  day).   Later the child took two, and  four  weeks
afterwards three tablespoonfuls daily.  Improvement was per-
ceptible as early as after six days, and progressed without in-
terruption.  The fever gradually disappeared, suppuration be-
came  benign and less copious, the pains ceased, and strength
returned; in short, the fistulous ulcer had healed completely
after the use of cod-liver oil for six months and a half.
                P.-KALI HYDKOJODICUM.

  The action of Kali  hydrojod., Schoeman  says, in general
agrees with that of Iodine, but nevertheless undergoes unmis-
takable modifications by the combination of the latter with
Kali.
  It is used by the old school:
  1. Against  all forms  of  scrofula, swellings of the glands, 
184
ON SCROFULOUS AFFECTIONS.
scrofulous  blennorrhea, chronic skin diseases  upon scrofulous
bottom. Scrofulous ulcers.  Scrofulous ophthalmia (Magendie);
against pannus and  leukomatous  obscuration of the cornea
(Chelius); induration of the mammae and hypertrophy of the
lacteal glands.
  2. Against goitre — struma lymphatica — allopathic  text-
books recommend from 2 to 5 grains three or four times daily.
  It seems absolutely necessary, however, to illustrate by an
example what value  is to be  placed upon recommendations
from this  side, especially as it is to be the principal aim  of
this small essay to expose the dangers contained in the ortho-
dox allopathic therapia ;  to show howT, in fact, the efficacy  of
the  remedy, correctly selected, is only  too often annulled by
the senseless adherence to large doses.
  "A. man, aet. 62 (Goullon, Sr.,  writes, A.  II. Z., 45, 5), very
bilious, and  suffering from gout since  his youth, received  of
an allopathic physician Kali jod. (3ij in Siv of water) against
ischias, with the advice to take  a  tablespoonful morning and
evening for weeks.   About eight days  afterwards a very sud-
denly increasing swelling of the whole thyroid gland appeared,
with tenderness on touch and dyspnoea; he nevertheless was
told to  continue the remedy, and  in the  second week mani-
fested all the symptoms of endocarditis: dyspnoea; fainting,
with great exhaustion ;  violent, jerking, intermitting, and  ir-
regular beat of the  heart and pulse ; tensive pain across the
chest; especially the  right ventricle was affected, which at the
same time gradually enlarged  somewhat.  Besides, loss of ap-
petite and vomiting.   Mercur. 2, in several doses, and Arsen.,
on returning aggravation a few days later, removed the trouble
almost entirely.   Sepia removed the remaining symptoms."
  If the obnoxiousness of massive doses is demonstrated by
the  report of this  case, the highly specific  relation of Kal.
hydrojod. to strumata, very  correctly pointed out  by the old
school, is  evident from  the following communication of the
same author, just as the very fact mentioned that upon the
use of large doses of Kali hydrojod. intumescence of the glan-
dula thyreoidea was observed, clearly  enough proves such a
specific bearing. 
MOST  APPROVED REMEDIES  AGAINST SCROFULA.   185
                          CLINIQUE.

                   1. (LXVIII.) Struma.
   A young blooming girl feebly menstruated on account of a
 dry, oppressive, and painful cough, which had lasted for years,
 and was  connected with heaving and whistling respiration,
 both troubles  being  dependent upon a large swelling of the
 thyroid gland, which pressed inwardly and downwardly; after
 a resultless administration of Phosph. and  Calc, received but
 four grains of Kal. jod., in four ounces of water, half a table-
 spoonful  morning and evening.  As early as ten days after-
 wards the cough, and the symptoms connected therewith, had
 entirely disappeared, and  the  thyroid gland become smaller
 and soft,  so that it did not occasion any further trouble.
   Is not the truth of the homoeopathic curative  principle bril-
 liantly set forth in these two reports ? In the pathogenesis of
 Kali jodat, swelling of tbe thyroid gland after large doses ;
 according to clinical  experience,  decrease of the strumatous
 swelling after small doses.*

   Finally, another example of theinjuriousness of large doses.
   A girl, aet. 13,  took Kali jod., a few grains  morning and
 evening for several weeks against scrofulous ulcers, caries of
 the lower jaw, and a very malignant scrofulous ophthalmia
 with ulcers  on the cornea.  Under this treatment the oph-
 thalmia was cured rapidly and permanently, and the ulcers
 improved so much as  to  form cicatrices, when she was at-
 tacked by pneumonia which rapidly passed into suppuration,
 and of which she died.
  According  to the  above, Kali  hydrojod.  has  a cumulative
 effect,  similar to chloroform, which  makes the  person to be
 operated upon fall into a beneficial sleep, but  which, above
 the effect desired, has already put many to eternal sleep.
  The syphilitic bear Kali hydrojod. better than the  scrofu-
lous.

  *  We cannot omit the remark, however, that in the case mentioned the
small doses were still not small enough ; for we read at the close of the report
of the second case : the patient, who felt entirely well, had lost flesh in a re-
markable manner (during the administration of Kal. hydrojod.). 
186
ON SCROFULOUS AFFECTIONS.
   The  sleeplessness of which patients complain, even after
 proportionally small doses of Iodide of Potassium, is worthy
 of notice.

                  D.—FEKRUM JODATUM.

                       GENERALITIES.
   Ferrum jodat. is indispensable also to us homoeopaths in
 complicated  scrofula.   It accomplishes more  here  than the
 pure antiscrofulosa, such as Silicea, Phosph., Iod., Calcar., &c.
 One does well not to give it  in infinitesimal doses.  Ferrum
jod.  is indicated where chlorosis, rhachitis, and syphilis com-
 bine with scrofulous processes. It removes especially impetigo
 of the cheek, and eczematous exanthemata of the face and
 whole body.

                         CLINIQUE.

                1. (LXIX.)  Hydrocephalus.
   A child who suffered from Hydroc. acutus in a high degree,
 and  previously had been treated with Calomel and  Jalappa,
 and  fly-blisters to the head, was  saved yet by Ferr. jodat in
 the paralytic stage.*

   Dr. Langheinz states having observed this specific curative
 power of Ferr. jodat. in from six to eight cases, when children,
 who are anaemic  and  poor  in flesh, were attacked, or when
 such a  condition had  been produced  artificially by previous
 antiscrofulosa (leeches, calomel, jalappa).
   Rueckert in his attempt  at utilizing the curative material
 obtained  ab  usu  in  morbis, gives as indication for Ferrum:
 Hydrocephal. acutus, with large, open fontanels, from which fol-
 lows that the iron in the Ferr. jod. was probably more essen-
 tial  in the cases quoted above than Iodine.
  * The diagnosis had been made out by Prof. Winter and another experienced
physician of the University of Giessen (A. H. Z., 60, 19). 
      MOST APPROVED REMEDIES AGAINST  SCROFULA.   187


      2. (LXX.)  Eczema  of the Whole Body (E. rubrum).
                       (My own observation.)
   C. S., a small,  fleshy, and very scrofulous boy, was brought
 to me with  a general,  moist, eczematous eruption which
 formed thick, dirty crusts  on several places  (temples, fore-
 head).  Extensive, circumscribed eczematous spots on various
 parts of the body ; at the outer surface of the right lower leg
 a fiery-red, hot, and moist spot resembling raw-meat. Violent
 itching and ill-humor accompanied this characteristic eruption.
 Graph, and Arsen. caused the beginning of the improvement;
 but the crusts fell off in the course of fourteen days upon the
 use of Ferr. jodat sack (0, 03 triturated with 2, 0 Sach.  lact.,
 as much as will lay on the point of a knife).   The presence of
 crusts resembling bark seems of some importance for the  selec-
 tion of Ferr. jod.

                 K— CALCAREA JODATA.

                       GENERALITIES.
   Recommended by Yehsemeyer against struma and chronic
 hypertrophy of the tonsils.   It corresponds to scrofulosis of
 an intense form.   For those chronic scrofulous intumescences
 of the tonsils  remain up to virile age, and frequently occasion
 intercurrent catarrhs of  the larynx.  Upon the use of  Calc.
jod. the swellings, the fissured appearance with the cup-shaped
 excavations of which is characteristic, decrease in size.
   I have  learned highly to appreciate the remedy in ophthal-
 mia perniciosa of scrofulous  persons, when Calc  carb. re-
 mained without effect.*  Calc. Jodat undoubtedly has a great
 future.

                    FOLIA  JUGLANDIS.
                      GENERALITIES.

   Xegrier (Arch. gen. Fevr., Avr., 1850), praises walnut leaves
 in scrofulous  affections.  According  to him, they produce

  * The report of the respective case is to be found in the A. H. Z., 22 Mai,
 1871. 
188
ON SCROFULOUS AFFECTIONS.
diuresis, sometimes  also diarrhoea, and  especially affect the
digestion, a statement wmich is confirmed by CI. Mueller's
experiments (Dissertat. inaugural, de jugl. reg. viribus. Lips.
1843).  They are said to have less effect in  diseases of the
bones, than in affections of the skin, glands, and eyes (Z. f. h.
KL, 1, 1).
  Besides Xegrier, Miraut, Jurine, and Altschul corroborate
the antiscrofulous effect of walnut leaves. Xasse recommends
the remedy against helminthiasis, otorrhoea, and  fluor albus
scrofulosus; Hauser in cutaneous eruptions, tinea capitis.
  Recently it  has been used in Irvpertrophies of  the tonsils
and their chronic  swelling (4,  0 of the extract to 30, 0 of
aqu. dest., applied by means of a painter's brush).* Internally
0, 2 in 15, 0 of water, from ten  to fifteen drops daily against
infantile diarrhoea.
  It has also been employed externally against spots upon the
cornea.
  In ophthalmic practice, I saw good results of the internal
administration  of Tinct.  juglandis (1st  or 2d dil.), against
chronic blepharadenitis ciliaris with tendency to general vas-
cular injection of the eyes.
          KALI AXD ITS PREPARATIOXS.

  We should leave a great gap in our work, were we not to
mention the salts of potash in our compilation of the  anti-
scrofulosa.   For Kali carbonicum is  able  to arrest incipient
pulmonary tuberculosis; the latter, however, is the  most in-
tense expression of scrofulosis.   The Chromate of Potash cor-
responds, as we soon shall  see, to all the remaining, most ob-
stinate manifestations of scrofula.  The principal character of
the Kali-preparations consists in the arrest of profuse and ab-
normal secretions, whether they appear as hemorrhages or
purulent or serous secretions.   Besides this we know  that
Kal. curb., has an  undeniable influence  upon the heart (hence
upon circulation), and that portion of the nervous system

  *  Calcar. jodat. (Vehsemeyer) or Kali bichrom. (Drysdale) are probably
more specific. 
     MOST APPROVED  REMEDIES AGAINST SCROFULA.   189

regulating the activity  of the  heart.  Otherwise  the two
preparations of Kali differ so much from another, as to induce
us to speak of them separately.


                A.—KALI CARBONICUM.
                       GENERALITIES.
  We have already mentioned the importance of Kal. carb.,
as regards the lungs; before, however, tuberculosis has fully
developed, catarrhs of the nose and larynx  precede it;  our
preparation corresponds, therefore, to these troubles of a defi-
nite and specific character.  The chronic character and incli-
nation to relapses, as in all scrofulous affections, stand  out
prominently even here.
  Hence Kal.  carb. cures dry  coryza, which renders breathing
through the nose impossible,  but becomes fluent upon walking
in the  open air, and returns in the room, and  is accompanied
by a great deal of itching in  the nose and secretion of a  yel-
lowish-green or bloody mucus; in other cases,  a  puriform
mucous  discharge, mostly from  one side of the nose,  and of
ah  offensive smell;  burning  pain in the nose ; sore,  crusty
nasal openings, even entire obstruction of the nasal openings ;
bluntness of smell; in the evening  often intense, fluent coryza
with frequent sneezing and headache, rough voice, a titillating
sensation in the throat, which creates a desire for hawking and
coughing, and the feeling of firmly lodged mucus (A. II. Z.,
1 Febr., 1869).
   "Kali, says also Kafka, is an  excellent remedy  in  dry
coryza with complete hoarseness and aphonia, in catarrh of the
pharynx with the sensation of a plug  in the throat;  in  noc-
turnal spasmodic cough and tussis titilans ; in strangling and
gagging which terminate in vomiting, especially in the morn-
ing."  Graphit. also has the  symptom of the  "plug" when
swallowing; Caustic,  the symptom of hoarseness and apho-
nia.*
* Stinging pains, in many cases, indicate Kal. carb. 
190           ON  SCROFULOUS  AFFECTIONS.
                 B.— KALI CHROMICUM.

   The Chromate as well as the Bichromate of Potash deeply
 affect inveterate scrofulous troubles, and it is just their obsti-
 nate character  that furnishes a  palpable indication for the
 administration  of these remedies.  For this reason they cure
 genuine membranous croup, ozaena, and such forms of coryza
 as by their long duration  have almost become physiological
 processes, so to say.  The  hypertrophy of the tonsils, of no
 less chronic a nature, as well as  the malignant forms of cu-
 taneous eruptions, fall likewise within the curative sphere of
 these drugs.  Suspicion of a  combination with  hereditary
 sjrphilitic causes render more sure the propriety of selecting
 them.

                        CLINIQUE.

             1. (LXXI.) Membranous Croup.

   A boy, aet. 8, with all the symptoms of membranous croup
 received  Tinct.  Aconit. and  Tinct Iodii, of each four drops in
 half a wineglassful of water, a teaspoonful every two  hours
 alternately; besides a  wTet, cold  towel across the chest  and
 throat, renewed as often as it became warm.
   The disease was not removed by these means ; on  the con-
 trary some symptoms had grown worse, and, upon local exami-
 nation, one  could plainly  see the upper part of the larynx
 covered with white and thick membranes.
   In  place of  Iodine, Kali chromic. 1, two drops  in  four
 ounces of water, was given every  three hours, alternately with
 Aconit.   Since the skin was burning hot, the cold applications
 were continued with more energy.   Four hours afterwards a
 piece of membrane as  large as a  finger-nail was coughed up.
 The fever decreased, and within four days several pieces of
 membrane, one  more than  three inches long and half an inch
 wide, were thrown  up by the cough, and blood and bloody
 mucus were coughed  up from four to five  days, until the
 cough changed into a simply catarrhal one.  After this remedy
 had been given  for a week the boy could be considered cured.
Wherever this  remedy proved efficacious the mucosa of the 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.   191

nose became sore (from " The Horn. Times," by Dr. Bamberg,
Berlin (XXXII) 9).
   As regards the developing soreness of the nose, we deem it
in place to remind the reader of a remark of  Goullon,  Sr.
(during  a discourse before the meeting of the Centralverein,
August  10th, 1854).   He  observed scrofulous nasal crusts to
develop  after the  cure of genuine croup, which,  as a general
thing, he considers to be a scrofulous affection.*
   Connected  therewith is  the recommendation of Chromate
of Potash against  the obstinate and intense form of chronic,
dry coryza (upon scrofulous bottom).

           2.  (LXXII.) Chronic Scrofulous Coryza.

  A young, apparently healthy girl, for several years suffered
from ozaena and an affection of the throat.  Syphilis had been
the primitive cause.   Continual  discharge of a yellow mucus
from  the nose;  the  mucosa red and  shiny; the bones not
affected or tender.   Dryness and rawness of the pharynx ;  its
mucosa red, as if varnished, here and there covered with shiny,
red, and  somewhat elevated spots.  Treatment  of the mos,t
various kind has been employed.   Kali bichrom. 6 and 3, with
simultaneous  application  of cold water  as a gargarism, and
nasal suction, as well as cold applications to the  throat, soon
improved.   The discharge soon stopped almost entirely ; only
occasionally a little  blood-streaked mucus appeared;  in the
throat only a slight sensation of dryness remained, symptoms
which gradually  disappeared.  During the administration of
Kal. bichrom. the menstruation ceased, and was delayed even
at the next  few terms.  Simultaneously swollen lips and con-
stipation (Dr. Black, Brit. Jour, of Horn., April, 1857).
  * In the same manner did Strophulus confertus in several children alternate
with Asthma MUlari; Acne and cutaneous tubercle with internal tuberculous
irritation; Vitiligo with disturbances of the liver.  Finally, after the artificial
suppression  of a crusty, herpetic eruption of the nose, Chlorosis in one case,
and an apparent hypertrophy and enlargement of the heart in another, both of
which evils  disappeared upon the use of Calc. carb., under beturn of the
ERUPTION. 
192
ON SCROFULOUS  AFFECTIONS.
  3. (LXXIII.) Kedi chromicum against Enlarged Tonsils.*
  A man, aet. 50, for a long time suffered  from swelling of
the tonsils and submaxillary glands.  At the same time the
Eustachian tube was obstructed, and in consequence thereof
there existed hardness  of hearing.  Various  remedies  had
been applied for a good while without result.  Kal. bichromic.
1, within fourteen days restored the hearing, and within other
fourteen days almost completely removed the swelling.   The
same author employed  Kal. chromic, with excellent  results
against torpid swelling  of the tonsils, not accompanied by
inflammatory symptoms, especially in children  of lax, leuco-
phlegmatic constitution, and if loosening of the nasal mucosa
and crusts in the nose existed simultaneously (Dr. Drysdale,
Brit. Jour, of Horn., 1857).

4. (LXXIV.) Kedi chromicum and bichromicum against Chronic
             Inflammation of the Nasal  Mucosa.
  A woman, aet. 50, who had suffered much from congestion
and a  sensation of  coldness in the head, after  an attack of
coryza which appeared  with the cessation of menstruation,
since two years presented the following symptoms: Continual,
thick, yellowish discharge from the left nasal opening,  which
became offensive upon the influence of the open air, and was
most copious in the  morning.  Violent pain in the muscles of
the left side  of the neck, extending to the head, and  called
forth and  aggravated by blowing the nose.   In the nose  feel-
ing of soreness extending to the cheeks.   Sneezes but rarely ;
smell undisturbed ;  general  health good, with the exception
of some constipation, with  a  white coating of the tongue.
Kali bichrom., now the 6th,  now the 3d, or  2d dilution every

  * The following notice regarding the physiological action of the Bichro-
mate of Potash is probably of some interest:
  " A lean, anaemic man, set. 30, engaged in a factory with the preparation of
Bichromate of Potash, for a few months had had several ulcers on the tonsils
and oesophagus, which are covered by an ashy gray crust, and surrounded by
a dark-colored, livid, and swollen  mucosa.  Pulse small, 120; great thirst;
tongue dry and red; ditficult swallowing and sleeplessness. He stated that
all his comrades in the  factory were suffering  more or less from the same
trouble (Lancet,.February, 1854; Schmidt's Jahrb., 1851, 82). 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.  193

 other day,  and a solution  of Kal. chrom. (J grain to 5j  of
 water) externally, removed the trouble  within a fortnight
 (Dr. Drysdale, Brit. Jour, of Horn., 1857).

 5. (LXXV.) Kali chromicum and bichromicum against Chronic
                Eczema of the Head and Face.
   A  healthy servant, aet. 36, for three years suffered from  an
 intensely irritating and  burning eruption,  which extended
 over  the whole head, almost deprived of  all  hair, to the eye-
 brows.  The  whole surface was red, raw, and discharged a
 thin  matter,  here and there drying up into yellow  crusts.
 Rhus,  Graph., Mercur.,  &c, had sufficed temporarily only.
 Kal.  bichrom. 2, morning and evening, together with one daily
 application  of a solution of Kal. bichr.  neutr. (1 grain  to 1
 ounce of water), soon removed the trouble.
   A  relapse of it was permanently removed by Kal. chrom. 0,
 2]0th  of a grain daily, and the external application mentioned
 above (Ibidem).

               6. (LXXVI.) Coryza  Chronica.
   A  strong youth,  aet. 17; coryza of three  years' standing,
 without interruption, accompanied by heaviness and dulness
 in the head, nasal voice, and a thin, mucous  discharge.  Pul-
 sat 2, for fourteen days, did not improve  any.  Kal. bichrom.
 4, sixteen doses.  Radical cure within eight days (Bolle).

          7. (LXXVIL) Catarrh with Hoarseness.
   Kali bichrom., 2d trit., removed a laryngeal catarrh with
 hoarseness in a singer.  Dr. Teller recommends Kal. bichrom.,
 one grain of the 2d trit. in  four ounces of water, a teaspoon-
 ful from one to two hours, against catarrh, even with feverish
 conditions of a lighter grade (A. H. Z., 59,10).

  It is not  unimportant to know, as we have  already men-
 tioned, that Kal. bichrom. has also been given advantageously
against secondary and tertiary forms of  syphilis.  Drysdale
cured with it syphilitic periostitis and exanthemata, probably
of a syphilitic nature (A. H. Z.,  55,14).   It seems to be suit-
                            13 
194            ON SCROFULOUS AFFECTIONS.
able, precisely as  is the red precipitate of Mercury, against
scrofulo-syphilitic affections.

  Note.—The Chloride of Potassium has a characteristic
curative  action so definite  that we will also mention it here.
It is the specific  remedy against  stomacace (always  accom-
panied by a peculiar fetid smell).  It is remarkable that both
allopaths and homoeopaths give it in this disease.
  According to the " Homoeopathic Times," 1853, Xo. 188', p.
449, Laurie cured a case of stomacace by Kal. chlor., 1st trit.,
one grain three times  a day, which  had developed to such a
degree as to cause perforation of the cheek.
  And Alfred Vogel says, in his excellent text-book  on dis-
eases of children:
  "We are so fortunate  as to possess one remedy against
stomacace.  By this remark enough is said for its  recom-
mendation.  It is Chloride of Potassium."  To children  less
than one year old Vogel gives 20  grains daily; to those less
than two years of age, 30 grains; to those less  than three
years   old, 40 grains;  and continues, somewhat  naively:
" Children who have reached the fourth year  already bear a
drachm of it very well."  We know, however, that one needs
not give so much  of the specific remedy as may be borne.

  Odor foetidus from the stomach:  Chloride of Potassium, 6, 0
in sugar-water 120, 0, a teaspoonful three hours after eating.
(Stanislaus Martin.)
                     LYCOPODIUM.

                      GENERALITIES.

  " Lycopodium is closely related to Sulphur, which  is also '
contained in the plant from which we obtain the Lycopodium
seeds."  For this reason alone the second designation of Lyco-
podium, " Sulphur vegetabilis" is justified.
  By this fact only a series of curative  results can be ex-
plained, so especially its efficacy  in malignant ophthalmia of 
     MOST APPROVED REMEDIES AGAINST  SCROFULA.  195

the new-born* (ophth. neonator.), related to scabies  on ac-
count of its great contagiousness.
  But Lycopod. is also a bone-remedy, and suitable in rhachitis
(after Calc. carb.), if the bones suppurate and become crooked.
Further, in chronic skin diseases, incipient caries  (similar to
Silicea), in ulcers which bleed easily (similar to Mercur.), in
suppurating and  moistening herpetic eruptions, and suppura-
ting eruptions on the head. Again (besides in ophth. neonat.),
in ophthalmia with nocturnal agglutination  and watering of
the eyes in the open air, sensation of coldness in the eyes in
the  evening; obscurity of sight, inflammation of the  lid-
glands, swollen glands of the neck ; in gastric symptoms, such
as the scrofulous frequently exhibit, especially if chronic con-
stipation  and flatulency are connected therewith.   In dry
coryza with dulness in the head.  Against scrofulous coryza,
if the discharge is yellowish or greenish.   Xose ulcerated and
crusty in  the  inside.  (Kal. carb.)  Dry cough.   Shortness of
breathing.
  It seems to us as if Lycopod. was suitable more  to the pro-
cesses  of  scrofula, which  are not connected  with excessive
secretion, especially not  with a  profuse, purulent  discharge,
for which Calc carb., Mercur., and others are the more appro-
priate  remedies.   Lycopod. corresponds more to  suppressed
secretions, or  to scrofulous processes without discharge, with
exsiccation and hardness  of the parts  (similar to Silicea),f
and to Arsenic, which, for example, cures  ichthyosis, or to
Graphit.,  which restores the suppressed haemorrhoidal flow.
  One becomes more convinced of this when he considers the
curative power of Lycopod. in the affections of the plica-polon-
ica-dyscrasia,  the principal character of which is sluggishness
of the peripheric activities (e.g., of  suppressed perspiration),
and which offers many points of contact with scrofulosis.
  The exanthemata within the confines of the head and face
which Lycopod. cures, may be moist,  and suppurate, but lack
the thick, fat, and profuse discharge of pus.
  * Lycopodium 12, internally every two hours, and Lycopod. G (four drops
in four ounces of water) externally.
  f Moreover, Lycopod., precisely like Silicea, is recommended against noc-
turnal pains in the bones from abuse of Mercury. 
196
ON SCROFULOUS  AFFECTIONS.
  Lycopod. is especially suitable in hardness of hearing, with
discharge of a thin, yellowish liquid from the ear.
  In  scrofulous tumor albus Lycopod. is given in alternation
with  Calc. carb. (and Silicea).
  Croup, an  eloquent expression of existing scrofulosis, some-
times requires Lycopod., if hoarseness remained, or  (in the
critical  stage) loose cough during the day, and hoarseness and
paroxysms of suffocation  are present at night; or, as a general
thing, if suffocative  paroxysms interchange with  free  in-
tervals.
  Finally, we will mention the therapeutic, preventive power
of Lycopod.  in the following affections of the  bladder:  In
the bladder, feeling of heaviness; burning during  micturition;
constant, and sometimes  very violent urging to urinate, with
subsequent ischuria;  catarrhal inflammation of the bladder;
urine turbid, milky, and flocculent; frequent urging, some-
times with the impossibility of passing water, whereby chil-
dren always  hold the lower part of the abdomen, and cry im-
patiently ; in connection therewith a pale and clear urine.
  Anuria neonatorum.*

  Lycopodium, as a general thing, is to be used  more in dis-
eases of grown persons than of children.  If the theory is cor-
rect, according to which  scrofula is said to represent a kind
of infantile gout, we will think of this remedy, especially when
we  have to do with children of gouty parents.  At this junc-
ture we will  again remind the reader of the fact  that the rest
of the famous gout remedies of our, i. e., the homoeopathic
therapia, such as Calc. carb., Silic, Phosph., even  the  prepara-
tions of Iodine, and especially Hepar sulph., are just as useful
and indispensable antiscrofulosa; a  decisive momentum  no
doubt, in the solution of the question:
  Are scrofulous  affections related  to the arthritic  or not ?
  * It is singular that the allopathic school, which, in its rationality, goes so
far as to place this remedy between 01. ricini and 01. jec. aselli (see Schceman's
Arzneimittellehre, 2 Auflage), also recommends Lycopod. against Spasmodic
and inflammatory irritation of the urinary organs (dysuria, stranguria
ischuria), as well as against cardialgia.  Even the Lycopod. growing on the
Antilles is used there internally as a diuretic, and externally against gouty
tumors (Altschul. Beallexicon, S. 187). 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.  197

In contradistinction from Calc. carb., which corresponds more
to the pastous form, combined with mental  indolence, Lyco-
podium wrould correspond more to the erethic form.
  From Rueckert's " Attempt at utilizing the curative mate-
rial  obtained ab usu in morbis," we quote  yet  the following
indications for Lycopodium:
  " 1. Sensation in the oesophagus as from  a hard body, with
stitching pains, a feeling of swelling, and morning expectora-
tion of a yellowish, thick mucus, which is firm, almost hard
in the centre, and of a greenish-yellow color.
  " I have several times had the pleasure of completely curing
with Lycopod. 30 that  disease of the oesophagus, otherwise
known to be incurable, which ends with caries of the cervical
vertebrae, and which, as the expression of an affection of a very
grave nature, we see accompanied by a swollen and irritated
mucosa of the throat, varicose vessels, and  a herpes-like erup-
tion thereupon, together with small, fleshy  excrescences luxu-
riantly growing and passing into suppuration."
  2. Chronic scrofulous eruptions, which always cover them-
selves freshly  with dirty-yellowish, brownish, or greenish
crusts, have a nauseating, flat, mouldy, or decaying smell, are
partly dry,  partly discharging,  mostly show  a fungus-like
formation under the magnifying glass, and predominantly
appear upon the hairy parts of the body.
  3. The  boils preceding panaritium diffusum exhibit the
characteristic that they  terminate  incompletely  only, sup-
purate but  little, but become bluish, cease to suppurate, and
leave incomplete cicatrices and  purple spots.
  The boils in and around the axilla, with discharging, crusty,
and  itching  herpetic eruptions upon it, and swelling of the
axillary glands.  The boils suppurate for  a long time, and
fresh ones appear continually.
  Lycopodium is also a coryza remedy.
  Present are: Dryness of the nose, and acrid secretion, espe-
cially, however, an annoying frontal headache (for which Mer-
curius also comes under  consideration), with aggravation in
the evening, and final blowing out of a  lemon-colored mucus
(Goullon).
  Crusts in  the nose; nocturnal agglutination of the nasal
openings, with dry coryza (Hahnemann). 
198
ON SCROFULOUS AFFECTIONS.
  Dryness of the choanae, with offensive nasal secretion, hoarse-
ness, rawness  and soreness in the chest; in nocturnal tussis
titilans, with a sensation as from sulphur vapors (Kafka).
                         CLINIQUE.

         1.  (LXXVIII.)  Lycopodium against Warts.

  In a  scrofulous girl, aet. 6, who was affected with several
facial ulcers, corresponding  to  her constitutional trouble, a
considerable number of small, soft, pedicellate warts formed
upon the chin over night.   When I was shown the child, I
remembered having read that  Leon  Simon successfully em-
ployed Lycopod. in a similar trouble.   I prescribed Lycopod. 6,
two drops morning and evening, and recommended to moisten
the epidermoid formations twice daily with Lycopod. tincture,
diluted with alcohol.  After a few days all the  warts disap-
peared, and the scrofulous ulcers assumed a better appearance.
  It is questionable in this  case whether the external or in-
ternal  treatment  effected most.  Skeptics may  attribute  a
portion of  the effect  to the influence of the alcohol, yet the
action of Lycopod. upon scrofulosis  and abnormal vegetation
has been confirmed in too many cases to admit of any doubt*
(Z.  f. h. KL, 4, 21, Verrucae, Dr. Teller, of Prague).

                  2. (LXXIX.) Intertrigo.

  An infant, one year old, suffered from intertrigo.  Violent
crying   when urinating.  Tr. Lycopod,., in water, internally
and externally.   Cure within a  few days.

             3.  (LXXX.) Glandular Swelling.

  Miss  S., about 30 years of age, a true type of  the scrofulous
habitus, for more  than a year  has  suffered from glandular

  * A. H. Z , 31, 3.  Segin took from 20 to 50 drops of the 30th dil. for 5
days. On the third day, papulae on the legs, stinging like needles.  After 8
days, sweat and feeling of soreness between  the toes.—Enuresis nocturna.__
The latter, as well as the pain in the toes, returned after 14 days.  (Never
experienced previously.) 
     MOST APPROVED REMEDIES AGAINST SCROFULA.  199

swellings.  Along the right  side of the throat and neck a
number of glands, about as large as nutmegs, were observed,
which were painless and movable, but very hard.  However,
a hypertrophical swelling of the submaxillary gland, as big
as a man's fist and  as hard as cartilage, surpassed all the
others.   It was  firmly fixed, painless, reached far above the
level of the jaw, and gave to the scrofulous face a very de-
forming appearance.   Patient had been scrofulous since child-
hood, but could not remember having had any other diseases,
and even presently did not  complain of any other trouble
except constipation.
  Treated without result from January 20th to July 18th
with Staphisagria, Sulph., and Calc. carb. (high potencies).
  July  18th, August  7th and 22d, and September 9th, three
doses of Lycopodium (high potency), one to be taken every
third day.
  Four weeks after  the first doses, the  effect upon the glan-
dular tumor was perceptible.  It began to get movable, could
be displaced, and the  examining finger could feel a  beginning
division of the conglomerate.  These divisions became more
plain from week to week; the  swelling separated  more and
more into single and  smaller glandular portions, which sev-
ered from another, and thus the hard tumor dissolved, no
more medicine being given after  the middle of September.
At the end of the year the ungainly swelling was entirely
removed. The cervical glands were reduced  simultaneously.
  " I would like to  know," Dr. Fielitz  concludes, " whether
the Mat. Med. of the physiological school possesses remedial
powers which cure  such  an evil more surely and without
poisoning by Mercury and Iodine.   A cure of this kind by
the vis  medicatrix naturae alone  I have never witnessed in my
practice of thirty-six years' standing" (A. II. Z., 52, 14). 
200
ON  SCROFULOUS  AFFECTIONS.
                        MEECURIUS.*

                          GENERALITIES.

   Experience  teaches  that the various  preparations of  this
remedy can impress upon and communicate to the whole lym-
phatic system a peculiar modification, and  to the whole econ-
omy of the body a tendency similar to the  scrofula-dyscrasia.
Indeed, John  Hunter, Vigaroux, Samuel Cooper, Richerand,
Alibert, and others demonstrated that persons who, in conse-
quence of their calling, were exposed to the evil influences of
quicksilver, frequently beget  scrofulous  children.  Homoeop-
  * According to A. Lutze, it does not make any difference which prepara-
tion of quicksilver is employed, since the symptoms produced by all the vari-
ous preparations agree.  He generally uses, however, Hydrargyrum oxydatum
rubrum as the purest, and, therefore, most suitable preparation for triturations
and potencies.  According to Dr. G. Gerson the red precipitate is vastly su-
perior in  its specific curative action against single forms, especially the scrofu-
lous, to Merc, solubilis.  He bases his remark upon the relation between scrofu-
losis and  syphilis,  and  believes that the contagiousness is a characteristic of
both.   Of the several forms of the scrofula-dyscrasia in which the red  pre-
cipitate deserves preference, he names :
  1. Scrofulous ophthalmia (believing that even its external application  is to
be considered  as a specific and not as a caustic), if the swelling of the conjunc-
tiva is not very considerable, its redness of a bright color, its discharge puru-
lent, and  photophobia has not reached its highest degree.  Also where troubles
from teething were present at the same time.
  2. Scrofulous  eczematous eruptions which have their principal seat at the
flexor-planes of  the extremities, especially near the joints and at the musculi
glutaei, and  are characterized  by the severity of the pains.  The  discharged
pus is contagious.   The healing up starts at the centre of the plaques.
  3. Scrofulous bubo with acute inflammatory irritation and tendency to sup-
puration.  The pains quickly ameliorate, and  where resorption does not  take
place, suppuration appears soon, and is of  benign nature, without any turbid
ulcers developing at the opened spot.
  4. A peculiar form of scrofulous ulcers among girls and  boys from 4 to 10
years of age, which entirely simulates the character of syphilis.  Among boys
the ulcers appeared at the anterior portion  of the penis, on the pneputium and
scrotum ;  among girls at the labia and urethral orifice, and even at the peri-
neum.  They lacked the hardness of the subcutaneous cellular tissue.   Char-
acteristic, is their painfulness and the sympathetic irritation and swelling of
the inguinal glands.
  5. Scrofulous  superficial ulcers developing from large, doughy tumors at
the neck and thorax. 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.   201

athy has good reason to hold on to this experience without,
however, overrating this source of scrofulosis.   Because we
are indebted  to it for a series of  genuine curative results,
which furnish  at  the same time a brilliant testimony of the
truth of our therapeutic principle, "Similia  similibus curan-
tur."
  The physiological effect of Mercury upon the salivary glands
is most remarkable and known.  Dieterich (Mercurial Krank-
heiten, Leipzig, 1837), above all, counts the '■'■hypertrophy of
the glands" i. e., the enlargement of the inguinal, axillary, mes-
enterial glands, of the parotis, the pancreas, and even the testes
and liver, among his forms of mercurial dyscrasia.  Increase
of the glandular secretion is almost always connected there-
with.   3Iercury, hence, has been the first refuge in all glandu-
lar diseases, and, as a general thing, is still considered as one
of the  principal remedies in scrofulosis (glandular diseases'*.
But as there  can  be no  exclusive panacea against diseases of
single systems or  organs, the use of Mercury also  has  been
carried too far, and its administration in diseases of the glands
ought to be restricted without any doubt (Dr. Reil, X. Z. f.
h. KL, 1, 9).

  As regards its influence upon the osseous system, Mercurius
is closely related to Silicea, and in fact is utterly indispensable
in most of the scrofulous processes  by virtue of its property
as a  suppuration  remedy.   We  mention, moreover, of the
mercurial effects pertaining here: " inflammatory, especially
nocturnal pains in  the bones ; crookedness and great fragility
of the  bones.   Eruptions  resembling scabies florida, or dry,
rash-like, easily bleeding, itch.   Inflammatory swelling of the
glands ; suppurations of  every kind ; swelling of the head, or
eruptions upon it;  ophthalmia, especially if the lids are red and
swollen ; tearing and itching pains  in the ears; purulent or
bloody  discharge;  hardness of  hearing with bellowing  and
roaring in  the ears ; also in otitis interna acuta with violent
nocturnal pains and suppuration (Trinks); inflammation and
swelling of the nose, especially of  its tip;  stomacace;  angina
with swelling  of the tonsils  and copious flow of saliva ;" (An-
gina tonsillarum ulcerosa—Gouljon).
  For scrofulosis erethica et florida, inflammation of the glands 
202
ON SCROFULOUS AFFECTIONS.
with phlegmonous redness, swelling and pains aggravating in
the evening, Mercur. is especially suitable.  Further in bleph-
aroadenitis of scrofulous persons (here surpassed or comple-
mented only by Silic).  Ulceration of the cornea and photo-
phobia.
  Though  not  always connected  with scrofulosis,  angina
uvularis (elongated and swollen uvula) presents a perspicuous
proof of the therapeutic action of Mercury.  Dr. Bolle (Aachen)
has been first in pointing out that such an inflammation, even
if it has already become chronic, gives way amazingly quickly
to the influence of sublimate.*
  Trinks, moreover recommends Mercurius against atrophia
meseraica, pot-bellies of children who mostly have been brought
up by hand, with diarrhoea and fever from teething.   Hart-
mann's recommendation in mastitis, in which Mercury is said
to hasten  suppuration, confirms the analogy between this
remedy and Silic. mentioned by us.   Both remedies resemble
each other  also in their curative power against coxalgia (clau-
dicatio spontanea).
  Again, the greatly experienced Trinks calls Merc, (sol.) one
of the most efficacious remedies against  coryza with  copious
discharge of a corroding (mucous—Baer) liquid, and finally
against the inflammatory stage of panaritium.  Here it ame-
liorates the pain, hastens  the formation of pus, and again, un-
questionably, shows its therapeutic  relation to Silicea.  But
why do we administer Silic. in one case, and Mercurius in the
other?  What is the essential difference between remedies ap-
parently agreeing so much ?

                        SILICEA.
  Bone-remedy.
  Aggravation at the time of the new moon and full moon ;
pains on changes of weather.
  Indurations (scirrhous).
  Herpetic eruptions.
  Beginning suppuration, or defective suppressed suppuration.
  Suppressed sweat of the feet.
  * A few grains of a lower trituration mixed with four ounces of distilled
water, and used as a gargarism, suffice. 
MOST  APPROVED  REMEDIES AGAINST SCROFULA.  203
  Yellow, crippled, and brittle finger-nails.
  Constipation.

                      mercurius.
  Gland-remedy.
  Appearance of the symptoms at night (in the'warm bed).
  Established suppuration.
  Easily bleeding ulcers.
  Bloody discharge from the ear.
  Bloody, blood-streaked, and  bloody-mucous diarrhoea.
  Looseness of the bowels.

  Mercurius more resembles Calc. carb., Caustic, Phosph., and
Acid nitr.  Silicea, on the contrary, finds its best analogue in
Arsenic (besides in Graphit. and Lycopod.), and in common with
it has " vomiting every time after drinking."  The antagonism
existing between  Silic. and Mercur., notwithstanding all simi-
larity, already follows from the fact that Silicea cures  ulcers
which owe their origin to abuse of Mercury.


                        CLINIQUE.

                 MERCUKIUS SOLUBILIS.

            1.  (LXXXI.)  Ophthalmia Scrofulosa.

  Mercur. sol. Hahn. 2, one grain morning and evening, within
five weeks cured a genuine scrofulous ophthalmia of three
months' standing.  Flow of acrid tears corroding the cheeks.
Lids swollen ; a pustular eruption upon them and the cheeks ;
dried-up pus on  the ciliae.   Whitish-gray spots have formed
upon the cornea  of both eyes.  Photophobia.   The child lies
upon its face continually.  Xose  and lips swollen; a copious,
green, thick, and acrid mucus, which makes the  nasal open-
in o-s and upper lip sore, flows out of the former.  The profuse
nasal discharge requires  constant wiping.  The outer surface
of the hand  and  the outer side of the lower part of the fore-
arm, with which  the child wipes off the acrid nasal discharge,
are corroded by it.  The  parotid glands are swollen; the child
is very ill-humored and impatient, and cries almost constantly. 
204
ON SCROFULOUS AFFECTIONS.
  Several remedies, also Arsenic (high and low), had remained
without any effect.

2.  (LXXXII.)  Offensive Otorrhoea  with  Polypous Formations,
    Chronic Inflammation  of the  Membrana  Tympani,  and
    Hardness of Hearing.*

  After the measles (in the sixth year), otorrhoea.   The smell
of the discharge so offensive that nobody could remain near
the patient, and its quantity so great that clothing  and pil-
lows were really wet with it.
  The right meatus closed by a soft polypus.   Mucosa of the
meatus red, loosened, sore, and  tender.  Hearing distance on
the right side = 0.
  To be taken, two grains  of Merc. sol. H. 3 in the  evening.
(Externally, frequent injections of tepid water, and  powdering
of the meatus with one grain of Merc. sol. H.)
  The offensive smell of the discharge, as well as the discharge
itself,  decreased rapidly, and  the polypus  became detached
after using the remedy for  six days.   At the inmost and pos-
terior portion of the meatus (at this spot polypi of the meatus
almost always  originate) only a trace was  to be  seen of the
spot where the polypus was inserted, but the membrana tym-
pani presented a dark-red, granular (frog's-spawm-like),  con-
vex surface, which proved itself very tender on  touch with
the probe.
  Distance of  hearing, two inches.
  Upon the continued internal use of Merc. sol. II., two grains
every other evening, and daily injections of  tepid water, the
otorrhoea entirely ceased within four weeks, the granulations
upon the membrana tympani and meatus likewise disappeared,
the hearing distance increased to 8", the roaring  in the ear
passed away, but the sound of the tuning-fork was still heard
stronger on the right (?) side.


                3. (LXXXIII.)  Stomacace.

  One dose of Mercur. sol. II. 2, gr. j, removed aphthae, bad

  * Beitraege zur Erkenntniss  u. Behandlung einiger Ohrenkrankheiten.
Von Dr. Kentsch, in Potsdam, XXXVIII, 5. 
     MOST APPROVED REMEDIES  AGAINST  SCROFULA.   205

breath, swelling of the glands, diarrhoea, and fever-heat in the
evening in a child.


             4. (LXXXIV.) Angina tonsillaris.

  In the same manner a violent case of angina tonsillaris, with
intense redness, great swelling of the left tonsil, nasal voice,
a swelling below the left lower jaw of the size of a hen's-egg,
and painful high fever, in a patient aet. 20, gave wray without
any  unpleasant consequences and  subsequent  suppuration
within  three days, upon two doses of Mercur. sol. 4,  gr. ij
(Hygea, 15, 4).

  The  above  reminds us of Dr.  Goetze's remark, who, while
reporting  several handsome cures by Mercury, says: " Merc
sol. Ilahn. 3  is  specific in most cases of angina with swelling
of the  tonsils  or submaxillary glands, especially in that form of
angina in which caseous  exudations are observed at an  early
hour upon the inflamed portions  of the mucosa, and which
must be designated as croupous, though not as truly diphther-
itic."

                 5. (LXXXV.) Periostitis.

  In a feeble child, five years old, who got sick  under febrile
symptoms, and had  pains in one of its lower legs, a swelling
developed at  that locality, and especially at the tibial region,
which  was very sensitive on the  slightest touch even.
  Upon the administration of Merc. sol. H.2>,& dose from two
to three hours, with simultaneous wrapping  up  of the leg in
raw cotton, the intensity of the violent fever, as well as the
local phenomena, decreased as early as within a few days, and
I succeeded in curing the intense periostitis within the course
of one  week without any suppuration following  (Dr. Goetze,
of Itzehoe, A. II. Z., 79, 12).


                 6.  (LXXXVI.)  Eczema.

  Paul Dubois, who saturated  the  whole body with  large
doses of Mercury for the purpose of curing a case of peritonitis 
206
ON SCROFULOUS  AFFECTIONS.
puerperalis,  frequently  produced  thereby  eczemata.   Dr.
Banks, of Xew York, remembered this fact and removed with
Merc. sol. (1:10), five  grains of the first trituration,  given
from four to five times daily, an eczema that had been treated
without success for four years.   The case occurred in  a tall
weakly girl, aet. 9|, with delicate skin, blue  eyes, and flaxen
hair.  The skull was completely covered with a thin yellow-
ish crust, wdiich had burst on many places and discharged a
pale, straw-colored, and viscid liquid.   The hair was matted
together, and  came out.  Behind the ear a raw, cherry-red,
secreting surface.  This spot was completely surrounded by
small vesicles of different stages of development.   There were
similar spots on the face, neck, and shoulders.
  The disease had begun with  a circular, eczematous  erup-
tion  at the occiput (Arsenic, Hep.  sulph., Sulph., Rhus, &c).
Washing with alkalies and acids only aggravated.
  After using Mercur. sol. for a few days in the manner men-
tioned there was decided improvement.  In three weeks al-
most a complete cure.  But two doses daily.   In eight wTeeks
a complete cure and luxuriant growth of the hair.
  Dr. Banks reports  having cured  two other similar cases of
eczema with the same success  by Mercury  (Xorth Americ.
Journ., May, 1857).
                       XATRUM.

              A.— NATRUM MURIATICUM.

                      GENERALITIES.

  Chronic skin diseases; urticarious and miliary eruptions.
Boils, pustules, and  eruption on  the face, especially at  the
corners of the mouth.   Profuse night-sweats.  Watering of
the eyes (in the open air).  Snapping of the eyelids; obscurity
of sight.  Roaring in the ears.  Hardness of hearing.  Puru-
lent discharge from  the ears.  Swelling of the submaxillary
glands, lips, and cervical glands.  Strumatous glandular swell-
ings (the same as in scrofulous persons).  Easy bleedino- of
the gums.  Looseness of the teeth.  Hard stool alternatinc
with diarrhoea.  Hoarseness.  Pain in the larynx and trachea. 
       MOST  APPROVED  REMEDIES  AGAINST SCROFULA.   207

 Dyspnoea ; purulent expectoration  at coughing (tuberculosis).
 Can any one find any more pregnant symptoms of scrofulosis
 than in these characteristic drug-effects of the common Chlo-
 ride of Sodium ?   For this reason we do not doubt for a mo-
 ment  the reports of French physicians who observed that sea-
 salt, solved  in water, proved itself efficacious against scrofu-
 lous ulcers upon the cornea with photophobia.*
   Otherwise, the clinical use that has thus far been made of
 Natrum muriaticum in  scrofulous  troubles, is proportionally
 little.   In consideration of the  great pathogenetic  range  of
 the remedy, its  principal  character, " Weariness and  weak-
 ness "  ought to be kept  in  view.
   Natrum muriaticum (with  the exception of Kali) mostly
 resembles Lycopodium probably, which shows, however, more
 direct relations to scrofulosis.
   And, now, a few more especial indications:
   Natr.  mur. is indicated  in  fluent coryza, alternating with
 dry coryza which is accompanied by hoarseness, a scratching
 and digging sensation  in  the trachea, or  tussis titilaii3, in
 which, however, the irritation producing the cough starts  at
 the epigastrium (status gastricus).   Entire absence of taste
 and smell.   Finally, in case of continuous  watering of the
 eyes on account of obstruction of the canalis lachrymalis.f
   Lastly, we will quote  yet a few of the  exceedingly practical
 remarks from Rueckert's " attempt at utilizing the curative
 material obtained ah u§u in morbis."
   The pure kitchen salt is  one of the most  active antipsoric
 remedies.
   v. Grauvogl mentions it  as  one of the drugs corresponding
to the hydrogenoid constitution.
   The totality of its  action is expressed in its  decided  in-
fluence upon vegetative  life.
   The lymphatic and nervous  systems are principally affected
  * The observation of Busch that eyes which pain intensely when they are
washed with river-water, can be kept open for a longer time without pain in
sea-water, and that even distilled water irritates the eyes, while that contain-
ing a small portion of salt, does not do so, is instructive.
  f There is also a kind of coryza accompanied by an increase of smell. This
is cured by Phosphorus (Trinks).  In case of a complication with hoarseness
and bronchial catarrh. 
208
ON SCROFULOUS AFFECTIONS.
by Natr. mur., and this already shows its especial adaptation
to chronic diseases.
  The intermitting character of the trouble still  more points
to Natr. mur., which, otherwise, can easily be confounded with
Lycopodium.  The latter circumstance argues in  favor of its
antiscrofulous action.  Under certain conditions Natr. mur.
seems to be especially suitable in ophthalmia scrofulosa.  One
of these conditions is the secretion of acrid tears,  corroding
nose and upper lip.   Obstruction  of the canalis lacrymalis.
Again: turbid  look of the eyes; suppuration of the cornea.
Watering of the eyes, aggravated in the open air.  Photo-
phobia with  stitching pains in the eyes.  Eruptions at the
mouth, lips,  corners  of the mouth  ;  pustules;  crusts; ulcers
(similar to Graphit and Causticum).
  Scrofulous persons  are frequently afflicted with constipa-
tion, and in  this condition Natr. mur. is a remedy that has
removed such obstructions of the most stubborn kind.  Such
momenta must  strictly be taken in consideration, if we wish
to give to Natr. mur. the preference over the many antiscrof-
ulous remedies  with more numerous indications, and do not
want to regret our choice.*


               B.— ^ATKUM CAKBONICLM.

                         CLINIQUE.

             1.  (LXXXVII.)  Coryza Chronica.
  A young girl, aet. 16, of lymphatic constitution,  pale face,
lings around the eyes, delaying and feeble menstruation, for
years suffers from coryza, accompanied by discharge  of a thick
and  copious  mucus during the day, and obstruction of the
nose at night.   Her voice has assumed a very, disagreeable,
nasal sound.  Since the middle lobe of the thyroid gland was
swollen, a dosis of Spongia 3, was given morning and evening.
But her condition remained the same three weeks afterwards.
Now, after Natr. carbon, £ had been given in the same man-

  * If we wish to use Natr. mur., in the form of baths, it is done by mixing
brine with river-water (equal parts), or by adding one pound of common salt
and one pound of sea salt to common warm  water. 
     MOST APPROVED REMEDIES  AGAINST  SCROFULA.  209

ner for four weeks, the secretion of mucus has nearly become
normal; the gland, still somewhat swollen, had become softer,
less resistant, and four weeks afterwards both troubles  were
completely removed.


            2. (LXXXVIII.)  Coryza Chronica.

  A lady, aet.  40, who supported herself by singing, took cold
in the concert room, and her skin did not perspire since, on
the contrary remained entirely dry.  What annoyed her most
was a chronic coryza with  abundant  discharge and  an un-
pleasant effect upon her voice.
  Sulphur aggravated.  Sach.  lact. to  wait for the action of
the remedy.  Xo result.  Natrum carbon, cured the coryza and
restored the normal activity of the skin (Hirsch of Prague, A.
H. Z.).
                      PHOSPHORUS.

                       GENERALITIES.

  For the very reason  that  Phosph. frequently complements
and completes the curative action of Silicea, e. g., in cases of
mastitis and its terminations, we may infer its antiscrofulous
character.   Like Silicea it is a bone-remedy, but still more a
lung-remedy.   However, its antiscrofulous character  shows
itself more distinctly in  croup, and just in the most dangerous
forms of genuine croup, which  rightfully is counted among
the characteristic expressions of the scrofula-dyscrasia.   Act-
ing, as it does (even according to the views of the old schooL,
as an irritant upon depressed nerve-force, it has done wonders
even in the last stage of croup, and at this point mention may
be made of the physiological action of Phosphorus: "Pulse
scarcely perceptible ; cold, clammy sweat; chronic hoarseness ;
burning in the larynx."  Moreover, its curative action in
chronic diarrhoea, by which scrofulous  children are  afflicted
in the period of dentition and afterwards, in which only Cole
carb., Calc acetica, and Arsen. contend with it for supremacy,
is well known.
                            14 
210            ON SCROFULOUS  AFFECTIONS.

  Otherwise, as regards the curative action of Phosph. in the
special forms of scrofula, its use must be called limited. Aside
from its effect upon croup in the last stage with rattling res-
piration in the upper portion of the chest and trachea (Goul-
lon, Sr.), and in diseases of the bones, such as caries, scrofu-
losa with hectic fever, and exostoses (Trinks, Knorre), it plays
an important part in ozaena narium  scrofulosa (Strecker).
We  could ask the  question, moreover, whether the  well-
known action of Phosph. to produce necrosis of the maxillae
has not been taken advantage of in homoeopathy.   We be-
lieve that we can answer in the  affirmative, since we possess
in Phosph. a valuable remedy against toothache of carious
teeth (which form, so to say, a part  of the jaw).  Phosph. cor-
responds to caries sicca  (Mercur. to caries  humida).    Both
kinds of toothache undoubtedly count among the annoying
privileges of scrofulous individuals.


                        CLINIQUE.

                  1. (LXXXIX.) Croup.

  The daughter of teacher P., five years of age, was attacked
by croup in the night from the 20th to the 21st of March.
The family physician, who had been called immediately, pre-
scribed an emetic of Tart, stibiat. and Radix ipecac, which
produced  repeated vomiting, but no change in the course of
the disease.  On the next  day, after a second physician had
been called in, leeches were applied to the throat, and calomel
was given  internally, but the disease rose to its  highest de-
gree in spite of this treatment continued up to the third day.      *
In the evening of that day, after the physicians in attendance
had pronounced the prognosis to be  most unfavorable, the dis-
tressed father requested Dr. Vehsemeyer to take charge of the
child.
  The latter found the little patient  lying in bed, purple in the
face, covered with cold sweat, looking about in agony, and
periodically boring her head backward into the pillow; re-
spiring with a highly raised chest and stretched  neck; then
again hastily rising in the greatest distress,  grasping herself
at the  throat and pulling her hair.   Respiration wheezy and 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.  211

whistling; voice whispering; speaks by hastily thrusting out
single words ; cough soundless.   Larynx and trachea painful
upon touch ; palse small, irregular, and  not countable on ac-
count of its frequency.
  During the night five grains of the 2d trit, of Hepar sulph.
and  Spongia* every hour in alternation, were given to the
child, and sponges, dipped in hot water, laid upon its throat.
There was not the slightest improvement on the next morn-
ing,  the fourth day of the sickness.  Xow two drops of the
undiluted Spiritus Phosphori, in sugar-water, were given every
hour, but already after a few hours the child was  not  able
any more to swallow.  I found her apathetic, with her lower
jaw hanging down, her eyes deeply sunken and half closed,
only  now and then making efforts of breathing; face and
hands bloated, purple, cool, the whole body covered with cold
sweat.  Cough set in, but very seldom, in single, soundless
thrusts; (abdominal) respiration irregular, voice entirely gone.
The  unfortunate parents stood, loudly crying, at the bedside
of their darling, and  I had  to confess to  myself that  there
was  no  hope in  this case.   At that instant  the  thought
flashed  through  Dr.  Vehsemeyer's  mind  to try externally
what  could not   be  administered any longer  internally.
Phosph.,  gr. 2, with  01.  amygdal.  dulc. 5?, was  prescribed.
This was  to be rubbed in every ten minutes upon throat and
chest, and the latter  to  be covered with flannel.  After this
treatment had been continued for 1| hours, the child showed
signs of returning life by reaching at her throat, and making
the motion of rubbing in a distressed and imploring manner. •
Xow the  inunctions were repeated  at  longer intervals (from
1\ to 1J hours).  The cough, still soundless though, returned.!
During the night the child began to swallow again, and forth-
with Spirit Phosph. was resumed in the dose mentioned above.
On the  morning of the fifth day, the little patient  had im-
proved so far that the most dangerous sjTmptoms  wrere re-
moved, and  her condition resembled that in which Dr. Vehse-
  * Vehsemeyer calls these " his usual croup remedies,'1'' and at the beginning
of the disease they seem to be sufficient, indeed, and render leeches, Spanish
flies, and especially emetics superfluous.
  f Also C. A. Tietze calls the entire disappearance of cough in croup ua?i
omi?ious syniptom." 
212
ON SCROFULOUS AFFECTIONS.
meyer had found her on his first visit.  In the course of the
day, the cough became more frequent, and though remaining
dry, reassumed the usual  croup-sound ; respiration  became
more even, yet remained accelerated and whistling (rhonchus
sibilans), and  was  still  predominantly abdominal, the chest
raising but little, and the  intercostal spaces not  expanding
any.  Yet the paroxysms of distress, less frequent though, re-
turned, during which the  child begged for the inunctions.
Thus intermissions  of shorter or longer duration set in.  The
pulse remained still small and exceedingly frequent (135); the
urine showed  a white sediment; the expression of the face
was less distressed, except during the real paroxysms.   Phosph.
was continued, externally and internally, in smaller doses, and
given less frequently (2d dil., 3 drops).  In the course of the
sixth day, the  cough finally assumed the catarrhal sound, and
brought up several  coherent, firm pieces of  mucus, with evi-
dent relief to the patient, respiration began to rattle (mucous
rattling),  the  pulse became stronger and less frequent, the
skin warm and moist with perspiration; the voice, however,
was still without any sound.
  For the following six days Hep. sulph. c. 2 was given, at
first frequently, afterwards in rare doses.   During this time
the cough became more and more loose, large pieces of cohe-
rent mucus (no real membranes) were thrown up, respiration
became more and more free and deeper, the appetite returned,
only the voice  of the child remained without sound ; and not
before six weeks  afterwards, when the child had already re-
covered and left her bed for some time,  did  the  voice, still
hoarse though, assume a louder sound, wThich, two years later
even, was muffled, and deprived of its metallic toue.*


                     2. (XC.)  Croup.

  A. K., son of Prof. K., a  weakly, scrofulous boy, ten years
old, one morning, when just at the eve of taking  his break-
fast, was  suddenly  seized by a  violent and distressing sen-
  * Let it be mentioned here that Dr. Vehsemever published this certainly
highly instructive cure on account of Dr. Elb's remark, "that Phos. was not
exerting any curative action in genuine croup " (S.; A. H. Z., 51, 8). 
     MOST AP-PROVED  REMEDIES AGAINST SCROFULA.  213

sation  of  suffocation and  cough, with  croupous  sound.  As
soon as his mother heard  this sound, too well known to her
only, she immediately applied for help. Half an hour later Dr.
V. found  the boy with all the phenomena of croup, and an
allopathic physician  already engaged with the application of
leeches, three of which were already drawing.   Xotwithstand-
ing the immediate removal of the leeches, it was no easy matter
to arrest  the bleeding, which  reappeared at every fresh out-
break  of  cough.  For this reason  no  application  of warm
water, highl v valued by Dr. V., could be made.
  He gave patient Hep. sulph.  calc. and  Spongia, without,
however, removing by this treatment, which was continued
for twelve hours, the existing  danger;  for, although  decided
intermissions set in, the cough nevertheless retained its rough,
barking sound, the respiration  remained sawing, and the par-
oxysms of distress, less frequent though, were more  violent,
so that Dr. V. concluded to give four drops of the 1st dil. of
Spirit. Phosphori every  hour, by means of which he succeeded,
after the disease had lasted eighteen hours, in bringing about
a favorable crisis, which,  in this instance, was hastened by
the  administration of  Tart. stib. 2.   The latter  remedy was
indicated  by an uncommonly strong, full, and widely diffused
mucous rattling (A. H. Z., 51,  9).

              3. (XCL) Bronchitis  Capillaris.

  The following case proves the direction in which  Phosph.
develops its curative action, as wTell as the connection (meta-
schematismus), recently doubted by authors of name, between
the cutaneous organ and  inflammatory processes in the inte-
rior of the body.
  A child, six months old, for  three months suffered from
eczema, producing discharging crusts,  which  occupied fore-
head and  cheeks ; two older children of the same family had
been scrofulous.   The eczema now began to dry up suddenly;
the mother of the child denying, howrever, of having applied
any  external remedy.  The child coughed, and the cough
increased in the ratio in which the eczema diminished; hoarse-
ness ; expectoration of glassy mucus; the cough, appearing in
paroxysms, tormented the child day and night.  Hepar sulph 
214
ON SCROFULOUS AFFECTIONS.
without result.  On the second day fever, accelerated respira-
tion and pulse.  Child lies in bed with a distressed expression
on the face ; mucous rattling over both lungs.
  Tart. emet.  1 in solution, a teaspoonful every hour.
  In the following night the child is in a very critical condi-
tion.  Pulse small, quick, and intermitting; face purple; heat
over the whole body; abdominal respiration ; crackling, with
mucous rattling.  In this case  of bronchitis capillaris,  con-
nected with the greatest danger of life, Dr. Schleicher  now
administered Phosph. 1 in water, a  teaspoonful  every  half
hour.
  As early as  after one hour the child respired more  freely,
and expectorated; expression on face more quiet and content.
6 a.m., quiet sleep.
  Pulse energetic again ; temperature of the skin moderate ;
respiration free.  Phosph. every  three  hours.  Three days
afterwards the affection was  completely cured; but  at the
same time the  eczema began to develop again, and  a week later
was at its height.
  One  dose  of Sidph. 3, every  morning, cured  the  eruption
within three weeks, without  any subsequent affection of the
lungs, or relapse (A. II. Z., 55, 2).


              4.  (XCII.)  Scarlatina Scrofulosa.

  In the meeting of  the homoeopathic physicians of Saxony,
at Dresden, August  30th, 1857, Hirschel reported a case  of
scarlatina scrofulosa, with convulsions,  in which, after the
administration of Zinc met. 1, sopor and collapse of  the vital
forces, stertorous respiration, involuntary discharge of urine
and faeces appeared, and in which considerable  improvement
set in on the same day after Phos. 2.   The exanthema did not
break  out until the day  following, so that  the good result
cannot be attributed to it, but to Phosphorus (A. II. Z., 55,  4).

              5. (XCILL) Ph'hisis Incipiens.

  There have  been many discussions on the question, whether
tuberculosis and scrofulosis are one and the same  dyscrasia.
Since there are remedies which are able to arrest the tubercu- 
      MOST APPROVED REMEDIES AGAINST  SCROFULA.   215

lous process, as well as the scrofulous, we  are undoubtedly
compelled, to a  certain extent, to consider both identical.
Among these remedies, especially, Phosphor, belongs, and the
following case will probably suffice as illustrative of this view:
   A landed proprietor of Krajoda, thirty some years of age,
slenderly built, brunette, was declared to be consumpted  by
Drs. Sigmund and Oppolzer.  Patient has had many chancres,
and frequently gonorrhoea.
   Great weakness of all functions ; dry, short cough ;  pain in
the chest; flabbiness of the muscles; great nervous irritability;
want of appetite.   Discharge  of a mucous liquid from the
urethra.  Severe pain  in the  lower part of the back, and
irregularity of the bowels.
   Six  doses of Phosph. 30, a dose of six pellets every eighth
day, completely  cured the patient, who  now feels  entirely
strong and healthy  again.


                  6. (XCTV.) Bronchitis.
                      (My own observation.)
   0. S., ten weeks old, could be nursed onlj^ the  first week.
Since that time  he  lives on cows' milk diluted with water
(2^1), and some salep mixed with it, without gaining in flesh,
however.  On the contrary, the little face frequently looks miser-
ably and full of wrinkles,  like the face of a little old man.  From
the beginning of his life he suffered much from flatulency, cried
much, and drew up his legs similar to one who has severe
pain in the bowels.  He but  very  rarely slept quietly, and
several hours at a time, and when he drinkrs, does it so greedily,
that he frequently chokes;  and then he cries again,  until he
falls into a sleep, which, however, is  but short, and often
interrupted.
   In the third  week  he was  attacked by  a cough, -which
disappeared and reappeared in  alternation.  At present it is
loose, but the poor  little fellow  has  such a rattling on the
chest, as makes one feel always as if he should help him clear
the throat.
   His  stool is not  watery,  and looks  yellow.  He has  an
evacuation, probably, four times within twenty-four hours.
   Phosph. 30, five pellets every morning.  Eight  days  after- 
216
ON SCROFULOUS  AFFECTIONS.
wards: " Your powders have had a very good effect, especially
on the stool.  He usually has a stool now of firm consistency
twice within  twenty-four hours.  Since about eight days we
all see that he improves very satisfactorily, he is much fleshier,
and feels a good deal better."
  This child, whose  mother is exceedingly scrofulous, grew
up to be a stout boy, but had a permanent  disposition to
cough.  He is affected by that chronic swelling of the tonsils,
which apparently characterizes a dyscrasia, standing midway
between scrofulosis and tuberculosis (A. H. Z., 74, 8).

  Moleschott (Kreislauf des Lebens, S. 44), as well as G. Rose
and Bromeis, are of the opinion that Phosph. acid (and Fluor),
is introduced into our blood and bones by the consumption of
barley.  For this reason Kafka orders barley, either roasted
as coffee, or broken up and put into soup, or boiled with milk,
to pap for children, in whom the formation of bone goes on
slowly.   On using this article of diet he observed the repair
of matter in general, and, above all, the formation of the bony
substance to go on more rapidly (see Die Anaemie oder Blut-
blaesse, Eine pathol.  and therapeut. Studie, A. H. Z., 59, 21).
  L. C, " a chronic, dry, and short cough, with vague stitches
deeply in  the breast,  which, though  not  continuous,  hinder
respiration, and  increase on deep respiration," is mentioned
among the symptoms of an impending or freshly developing
tuberculous localization.

  Since Cod-liver oil  (especially the brown), aside from Iodine,
contains  Phosph. (0,0114 in  100,000), a fact of essential impor-
tance, we are probably justified  in supposing that this old
remedy has frequently owed its results to this circumstance.
It was applied then, we may say, in cases which were appro-
priate for small homoeopathic doses of Phosphorus.
                     PETROLEUM.

                      GENERALITIES.

  Petroleum is an important remedy in scrofulous diseases of
the ear.  When the Eustachian tube participates in the coryza 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.  217

which occasions the most various noises, such as bellowing,
roaring, crackling  in  the ears, we  likewise  think of Petr.
Kafka gives Petrol, in coryza with hoarseness and obstruction
of the choanee, accumulation in the oesophagus, with pressing,
tickling, and  roaring; in tussis titilans nocturna, with dry-
ness of the trachea.
   Besides,  Petrol, has  cured facial hemiplegia (of scrofulous
children).   I will not omit the remark, however, that my ob-
servations in two cases gave negative results.


                 RHUS TOXICODENDRON.

                      GENERALITIES.

  Dr. Gentzke says of Rhus:  Its beneficial action in the first
stage of coxarthrocace, which colleague Ressig of Berlin has
tested in several cases, seems to confirm itself.  (This remark
is preceded by the report of a cure of coxarthrocace by Rhus:
6.)  Meyer praises Rhus against eczema (besides Sulphur).


                         CLINIQUE.

              1. (XCV.) Luxatio Spontanea.

  Mary H., aet. 6, who formerly has  suffered from glandular
swellings at the  neck, which suppurated, assumed a dragging
gait in walking, and had pain in the hip-joint, which was in-
creased by pressure upon the large trochanter.  Violent pains
set in, however, if upon fixing the pelvis, some one with a jerk
pressed the femoral head into the acetabulum, one of the surest
diagnostic signs of  this disease.  There could be observed as
yet no elongation  of  the leg and flattening of the glutaei
muscles.
  The trouble had already existed for from three to four weeks
with  amelioration  alternating with aggravation, the latter
being wont to set in amid the appearance of febrile symptoms
and with  drawing pains  in  the leg.  Forbidding all motions
I gave Rhus 6 every evening,  afterwards less often.  The  re-
sult was favorable.  Six weeks  later  the  child could stand 
218            ON SCROFULOUS AFFECTIONS.

upon the leg without pain, and the dragging gait had entirely
disappeared.

             2. (XCVI.) Ophthalmia Scrofulosa.
  Mary S., aet. 10, has  already suffered from scrofulous oph-
thalmia  for four years.   Swelling and redness of the con-
junctiva  with injected vessels and  swelling of the sclerotica
at the  outer  edge of the  cornea.  Spots on  the cornea  and
opacity of  the  same ; photophobia; bloatedness of the face,
especially around the nose, the skin of which appears rough ;
glandular suppuration behind the right ear; watery discharge
from the nose.
  Sulph., Calcar., and Bellad., without result.
  Three  doses of Rhus 3, two drops as a dose, once a day, for
the first few days produced aggravation, and by the secondary
action of the remedy, great improvement.
  Since,  fourteen days later, the improvement seemed to have
come to a halt, I gave a few more drops of Rhus 18, and again
with  the most favorable result;  complete cure (Erfahrungen
aus der Praxis, Haustein XXXIX, 10).

  Xote.—Eruptions on the head  dependent upon scrofula are
cured  by Rhus, if a greenish-yellow liquid  oozes out, which
dries up into yellow, thick crusts, and if the trouble is at the
same time  of an herpetic nature, itches violently at night, and
causes the  hair  to come out.  Other characteristic effects of
the remedy are:  wet tinea, herpes upon the hairy scalp, oph-
thalmia; oedematous swelling  of the  entire eye and its sur-
roundings.   Inflammatory swelling of the parotis.   For this
reason Rhus has clinically proved its efficacy in scrofulous
ophthalmia;  in parotitis after scarlatina, and in induration of
the parotis.

                         SILICEA.

                       GENERALITIES.
       "Silicea est le grand medicament de la scrofule."—Jousset.
   The primary effects  of Silicea manifest  themselves in the
 cerebro-spinal sj'stem and the vegetation of the bones. As a cura- 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.  219

 tive  remedy it is especially useful against paralysis in the
 most extended sense, hence, in chronic weakness of the higher
 nerve-apparatus, generally; in suppressed capacity of feeling
 and motion, suppressed secretions, especial peripheric, hence,
 for the same reason in processes of suppuration thwarted by the
 former.  Moreover, it is one of the principal remedies in pseudo
 erysipelas, boils, carbuncles, panaritia, caries, swellings of the
 bones, and hard tumors.
   Dr. Xoack, Jr., recommends Silic. in scrofulous cutaneous
 eruptions, if they occupy  more the hairy parts (cuir chevelu),
 and against  such  as we observe at the tip of the nose.*
   He says, in his excellent  essay on uSilicea in processes of
 suppuration"  (L'Art Medical, March, 1865), "Massive and
 repeated  doses are indicated, if  wre have to do with  (scrofu-
 lous) glandular swellings  without suppuration.   But where
 there  is  actually  suppuration, or even  a tendency  thereto
 only, high dilutious (30th) help."  In chronic cases we are in
 the habit of giving Silicea once a day (and even less often) in
 subacute  cases, morning and evening, and in acute cases from
 two to three hours.
   As regards the power of Silic.  to restore suppressed sweat
 of the feet (which, no doubt, sometimes may become a vital
 point), the A. II. Z., 73,10, contains five examples, sufficiently
 supported by the name of Gallivardin, in which  mention is
 made also of the apparent contradiction that, vice versa, Silicea
 cures morbidly increased sweat of the feet in a  similar manner
 as Calc. carb. in a homoeopathic dose can cure strumata ; and
 again, that overfeeding with carbonate of lime produces such.f
  Icy coldness of the feet, ephidrosis, offensive sweat of  the
feet (Hartmann\ affections of the chest and stomach after sup-
pression  of  sweat of the  feet (Xunez),  all call  for  Silicea.
Jousset says  of Silicea: " It corresponds to pustulous eruptions
  * Schwarze had given Graphit., with the best result, to a man set. 23, whose
face was covered with eczema, and showed a number of fissures and sores.
However, eyelids and mouth had not yet healed.  Two doses of Silicea  (one
drop of Silic. 30 pro dosi), cured within three weeks.
  f Among other remedies which cure abnormal sweat of the extremities, yet
are able to restore normal perspiration that has been suppressed, Dr. Galli-
vardin names:  Lycopod., Kali carb , Calc. carb., Sepia, Ammon. carb , and
Baryta carb., according to the individuality of the case. 
220
ON SCROFULOUS AFFECTIONS.
on the head and extremities, and to suppuration of the lym-
phatic glands.   Among its symptoms it has swelling of the
abdomen and nose and dry coryza (le coryza epais).*
  Otorrhoea, with or  without caries;  leucorrhoea, chronic
diarrhoea.  Ophthalmia with ulceration of the cornea ; torpid
abscesses; caries of  the  phalanges, the  clavicula,  and long
bones; tumor albus ; phthisis with purulent expectoration.
  Suppression of bones and soft tissues point to Silicea.

                        CLINIQUE.

      1. (XCVIL) Caries of the Right  Metatarsal Bones,

In Franzisca F., aet. 13, who  formerly suffered  from swollen
submaxillary glands.  One year ago affected by nettle-rash,
which healed spontaneously.
  The back of the foot swollen and reddened ;  two openings
upon it at a distance of one inch from each other,—the upper
about as  large  as a good-sized  pea, the lower  somewhat
smaller, which discharges a good  deal of greenish pus.  At
the edges of the  openings, in form of a wall, growth of wild
flesh.   Especially at  night she  complains of  tearing pain in
the whole right  foot.  Besides tearing  and stitches in the
forehead, noise as from bell-ringing in the ears; vomiting of
food.
  Mezereum 2X,  a drop morning and  evening, had improved
considerably; after it had been  taken  for six weeks a piece of
bone,  half a line  thick,  and about half an  inch  long, had
become  detached; the other concomitant symptoms had not
improved any.  Iodium removed the vomiting of food and the
other  nervous symptoms, but I could not observe any effect
from it upon the disease of the  bone.
  Mercur. improved after four weeks.   But the  disease of
the bone was cured entirely only after Silicea, one grain of the
3d trituration, had been given for three weeks (Erfahrungen durch
die Praxis vom Wundarzt Ilaustein zu Gottesgab,  Bohmen).
  * In simultaneous chronic tonsillitis and painless swelling of the submaxil-
lary glands (Kafka). 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.  221


              2. (XCVIII.) Spondylarthrocace.

  Dr. Kampfer (A. H. Z.,  24, 9) cured a case  of spondylar-
throcace with Silic. g30.   Afterwards Calc. carb. s%.
  " I several times observed scrofulous caries of long duration
in children to heal within a short time after a few doses of
Silic. 30, a few pellets at the time (though larger doses were
required in other cases)."

            3. (XCIX.)  Abscess of the Upper Leg.

  In a boy, about two years old, a large inflammatory swelling
developed at the right upper leg.  A surgeon had ordered the
application of some herbs, without result.   The whole upper
leg shiny-red and hot;  not the  slightest touch could be en-
dured ; the child groans, and is in a continual fever, with pro-
fuse sweats, very much emaciated, and without any sleep and
appetite.
  I had the  external application removed, and gave Silic. 30
in several doses.  The child became more quiet and went to
sleep.  Some time afterwards a small opening formed spon-
taneously in the swelling, into which the thinnest probe could
scarcely be introduced;  there was a thin discharge  from it,
after which the opening  closed up  again.  From this time on
the boy  improved rapidly (A. H.  Z., 39,  2.   H. Weber, of
Brilon).

                 4. (C.) Caries-Dyscrasia.

  A girl, aet. 8, could not  straighten the left knee.   Several
fistulous ulcers upon it as well as on the lower leg. The tibia
could be seen entirely denuded in  several places, and smaller
or larger pieces of it became detached.  The whole tibia and
knee  was one single crusty ulcer  almost, which bled on the
slightest cause, and pained  much, especially at night. Besides
a few other remedies, the girl received Calcar. and Silicea for
from  three to four  weeks.   After the course of a year the
crutches were laid aside, and gradually the whole leg healed.
The crooked knee became straight and movable again, and at
present the girl walks about as well as other people.   Xo one 
222           ON  SCROFULOUS AFFECTIONS.
would see that she ever had been sick (A. IT. Z., 39, 19. Dr.
Weber, of Brilon).

              5. (CI.) Eruption on the Face.

  Dr. Kampfer (A.  H. Z., 24, 10) reports a remarkable ex-
ample of the great medicinal power of Silicea.
  A woman, aet. 32, a blonde, who since childhood had suffered
from a  psoric-scrofulous ophthalmia, and against wThich she
had  formerly  tried  various  cures, including  homoeopathic
remedies, without result, was affected by an eruption of large,
hard, brown crusts all over her lips, especially at the corners
of the mouth, which very much disfigured the face. The eyes
were almost  entirely healthy.  The remedies  administered
against it, among which was also Silicea 30, remained without
any result.
  I now  prescribed Silicea 4, one drop to be taken every morn-
ing, and later every fourth  morning  before breakfast.  She
felt unwell  every time after taking the medicine.  After the
first doses she was attacked by intense vertigo, violent head-
ache with fulness and dulness in the head, heat  and  redness
of the face, intense pain in the abdomen, nausea, heaviness in
the limbs, feverish  pulse, &c, so that she had to lie in bed for
a few hours ; affections she had never had before,  and to which
no  cause could be assigned  except  the remedy, and which
troubles  always disappeared spontaneously.  After the third
dose these symptoms became lighter, and after the fourth she
felt only fulness in the head and weakness.  At the same
time the eruption improved rapidly and without interruption,
so that  it healed up after five doses.  The eyes and her gen-
eral health continued to remain good.  But soon afterwards
a large and deep ulcer formed at the inside of the left lower
leg, which continued for years.
  It cannot be mistaken that the acute morbid phenomena,
repeatedly  appearing in this case  after the  remedy, were
primary effects of the drug, and neither can it be doubted that
the formation of the ulcer on the leg was owing to the action
of the medicine (which has proved itself to me one of the most
efficacious  remedies against  inveterate ulcers of this kind).
Hence, in this case also, intense remedial aggravations took 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.  223

place, while high dilutions remained without any effect what-
ever.   I have frequently made this  observation,  and could
mention several similar cases.

   Xote.—With Silicea 3, I have repeatedly cured complaints
that owed their origin to suppressed sweat of the feet.
   Nausea, fainting, weakness, especially were complained of;
hence, just the very symptoms called forth by Silicea 4, in
Kampfer's case.   The sweat of the feet returned after the re-
moval of the morbid phenomena mentioned.

                6. (CIL)  Luxatio Spontanea.
   Dr. Weber, of Brilon (A. H. Z., 39, 2), reports:  "A boy,
aet. 8, from  lying upon the damp ground in spring, was at-
tacked by a fixed pain in the right hip-joint; the leg shortened,
and patient began to limp.  Soon afterwards the whole buttock
swelled, the swelling, which is burning hot, extending down to
the knees;  patient has to lie down, and  can lie only on the
healthy  side.  Finally, the swelling threatened to break in
several  places, and to discharge the fluctuating contents.
   " For this affection I  treated patient for more than eight
weeks.   He received  within this  time Aeon., Arnic, Arsen.,
Calcar., Chin., Hep. s., Lycopod., Phosph., Phosph. ac, Rhus,
Sulphur, and Silicea.  The latter remedy was given repeatedly.
The swelling did not break but scattered  entirely, and the
boy was completely cured, and  did not limp any longer.  Every
one who saw the swollen leg  deemed resorption impossible;
and yet it was possible, after all."


    7. (CHI.)  Collection of Pus in the Cervical Glands and
            Lymphatic Swelling at the  Elbow-Joint
                      TUMOR ALBUS.
  A girl, aet. 15, a blonde, w7eakly formed, of phthisic habitus,
and not menstruating yet, from her third year on  frequently
suffered from oft-recurring scrofulous glandular swellings. At
her 9th year, without any cause known, a painful swelling of
the left elbow-joint formed, wThich continued to grow for fully
three years, and finally terminated in a painful hard swelling 
224
ON SCROFULOUS AFFECTIONS.
and anchylosis of the joint.  After a pause of two years the
pains returned,  and  the  swelling began  to enlarge again.
Various cures tried against this trouble remained without any
result.  Lastly, on account of a  fresh aggravation, warm ap-
plications and inunction of Iodine-salve were used; internally
Kali hydrojod. in large doses.  During this treatment, con-
tinued for two months, a considerable swelling of the  right
cervical glands formed again, swelling and pain increased, and
the general health assumed a threatening aspect, which in-
duced the parents to place patient under homoeopathic treat-
ment.
  Status praisens: Patient is very much  emaciated, has a pale
face with circumscribed redness on the cheeks.  Increased re-
spiratory murmur; percussion normal.  Transient stitches be-
low both claviculae.   Dry, short cough, slight dyspnoea.  Pulse
very variable.  At  times febrile  symptoms.  The  cervical
glands of the right side had united into a swelling of the size
of a hen's egg which was reddened and evenly fluctuating in
its entire circumference-.  At  the elbow-joint of the left arm a
fluctuating swelling as large as a man's fist, which covered the
olecranon  partially,  but  the condylus humeri  entirely.  The
forearm was bent at an angle of sixty degrees. On account of
the great pain, the nights were passed sleepless; the stool was
diarrhoeic, especially at night.
  The threatening  development of  acute  pulmonary tuber-
culosis renders her condition  very precarious.
  Patient received now of Arsen. 15 (T£0) two doses daily, five
pellets pro dosi.
  Ten days later her general health improved somewhat,
Arsen. was continued for other eight days, when the swelling
at the joint broke in  several places, and discharged a  large
quantity of thin, fluid  pus  and caseous  masses" Since the
chest symptoms had considerably improved.   I gave Silic.  4
trit.  (T]D)  two grains of it daily, and ordered  the arm  to be
bathed twice  daily in  a decoction of hay.  This popular remedy
is probably efficacious in scrofulous diseases, as I repeatedly had
the opportunity of observing, only on account of its contents of
terra silicea.  This  treatment was continued a whole  year,
during which time the complete cure of  the arm, and the re-
sorption  of the swelling of the  cervical glands were  accom- 
      MOST APPROVED REMEDIES AGAINST SCROFULA.  225

plished.  The discharge of caseous masses which gave way,
finally, to a serous  secretion, continued  for several months.
The openings cicatrized aud, with the exception of an insig-
nificant swelling, no trace of a morbid state remained.
 . The mobility of the forearm has improved, since the angle
of mobility now amounts only to Jg degree.  Xo trace is  to
be seen any  longer of the (resorbed) swelling  of the cervical
glands (X. Z. f h. KL, 1, 6, Klinische Erfahrungen v. Dr. Hil-
berger, in Triest).

  Davet (Journ. de la Soc. gall., Ill, 8,1872) reports two cures
of scrofula of the bone, which, although  requiring some other
remedies besides  Silicea, would surely have been treated with
far less success without it.   Thus we better report them here:


 8. (CIV.) Caries of the Tarsal Joint and Bones of the Foot

  Patient, aet. 20, upon whose foot the scrofulous affection had
concentrated itself in consequence of luxation of  the tarsal
joint, for four years has not been able to  put his foot down,
and is cachectic in  the highest degree.   Around the diseased
joint  nine fistulous ulcerous openings.   Great  emaciation;
grayish pale  complexion ; hectic fever ; entire loss of appetite;
now diarrhoea, now constipation; great  irritability and sleep-
lessness.
  Silicea 30, 15, and 200, in rare doses,  continued for fifteen
months (frequently with Xux vom. 6 as  an intercurrent rem-
edy against  constipation;  Arsen. against  diarrhoea; Coffea
against nervous  irritability; and Ignatia when the latter in-
creased to the development of  phenomena resembling chorea)
rapidly improved his condition, especially  after a few bony
splinters had been expelled, but did not effect cicatrization of
the fistulous ulcers. This was accomplished two months later
upon  the continued administration of Argent, nitric. 3.

                   9. (CV.) Gonarthrocace.

  In  a  boy, a^t. 10, very much  run down  in  flesh, a chronic
osseous ulceration at the knee-joint of several years' standing
                             15 
226
ON SCROFULOUS AFFECTIONS.
was removed by Sil. 30 (together with Sulph., Asafoetid., Bel-
lad , Merc, sol., Acid, nitri, as intercurrent remedies), and after-
wards by Silic. in alternation with Calc. 30 within two years,
while his general constitution was  improved  by  sea-baths.
The shortening of the leg, of course, remained.

            10. (CVI.) Luxatio spontanea femoris

In  consequence  of preceding coxitis.    Cured  by Surgeon
Schnappauf, of Dresden (Z. f. h. KL II, 9).
  In an infant, seven months old, the femoral head had  com-
pletely escaped out of  the acetabulum and taken position pos-
terio-superiorly ; the leg was  nearly one-twelfth of an  inch
shorter than the healthy one, yet not atrophic.  Several phy-
sicians had declared the evil to be incurable on account of the
acetabulum  being filled up by exudations.  When I reduced
the femoral head  and  moved the extremity in various direc-
tions I distinctly heard a  crackling and rubbing noise of the
femoral head, entirely similar  to that observed in  fractures.
As  soon as  the  leg was  released, and  the child made a few
motions with it, the femoral head again  slipped out  posteri-
orly with a  crackling noise, without, however, causing the
slightest painful  sensation.  The infant was a delicate but
fleshy girl, and was nursed by her mother.  In the first eight
days after her birth, which had been natural and easy, a cer-
tain stiffness and immobility of the left leg had been observed;
the babe always held it in a  drawn-up position, and did not
stretch it out even while  being in the bath.  Dr. K. declared
the disease to be inflammation of the  hip-joint.  The entire
region of the hip-joint was inflamed and swollen, a condition
which had communicated itself  also to the upper  portion of
the femur.  An  inunction had removed the  inflammation, it
is true, but now the femoral head was  noticed  to be outside
of the acetabulum.  Two experienced  allopathic colleagues,
in agreement with the first physician,  declared  that nothing
could be done any more.
  The attempts at reduction  which Dr. K. daily made for
some time, remained without permanent  result.  The  advice
of another physician, who ordered a pair of lace-boots, which
sole side by side of sole were fastened to a tin plate, in  hope 
      MOST APPROVED REMEDIES  AGAINST  SCROFULA.   227

that thus the healthy leg might draw down the diseased and
keep it in the same position, proved  also of no benefit to the
affected  extremity.   This  machine had almost occasioned
another deformity, since the child, on account of the discom-
fort or pain originating therefrom, assumed a position inclin-
ing with the pelvis and vertebral column to the left side, for
which reason the father of the child soon removed this con-
trivance.
  Under such unfavorable circumstances the child wras passed
over to homoeopathic treatment.
  Prescription : Silicea 5 dil. from 2 to 3 drops to be taken in
a teaspoonful  of water every other evening.  The child was
not interfered with in its voluntary motions.  After the course
of five w^eeks no perceptible change in the condition had taken
place, and the femoral head, after attempts at reduction, again
slipped backward as on previous occasions.  Xotwithstanding,
I continued Silicea, except that in place of the solution I gave
the trituration in the same potency, because I presumed that
in the trituration all  the efficient constituents of the remedy
were contained.  This change was rewarded by the best re-
sult.  After Silicea had been given  in this manner for about
three weeks, the crackling noise on  moving the  leg became
slighter, the femoral head, after attempts  at reposition, re-
mained longer  in the acetabulum, a fact which allowed the
inference that the resorption of the hardened exudation had
already begun.   In order to support the soft tissue also, I
ordered, at the intervals when no Silic. was taken, a teaspoon-
ful of a mixture of one part of Arnica fort to two parts of al-
cohol, to be rubbed into the region of the hip-joint and leg.
  By the aid of these prescriptions, which I continued with-
out alteration, I had the great pleasure of observing that the
exudation was entirely resorbed at the latter part of January,
and the femoral head, without any inclination to escape out
of the joint upon motion and stepping on the foot, remained
in the acetabulum, as well as that every noise had disappeared,
of course, and could declare the child entirely cured at its first
birthday, February 19th.
  The author concludes his reports of  this certainly highly
instructive clinical observation  with the following remark:
" This cure has to be considered as  the result of medical art 
228
ON SCROFULOUS  AFFECTIONS.
all the more as the child meanwhile was carried about, and
rest, which no doubt has effected a cure occasionally in single
cases, was not observed in  this one.   An influence upon the
main trouble could be attributed to the simultaneous use of
Arnica all the less as the most evident signs  of  a  beginning
cure already appeared previously to it, and  as such an influ-
ence upon cartilage and bone-tissue seems foreign to the action
of Arnica, but is very characteristic of Silicea.


                    2. (CVII.) Abscess.

  Dr. Billig, of Hohenstein (Z. f. h. KL, 3, 8), reports  a very
remarkable result of the action of Silicea in a case of  scrofu-
lous suppuration.  It was that of a boy, aet. 10, in whom, after
recovery from  typhus, an abscess developed.   It opened at the
right side of the thorax.   From a fistulous opening at  the
place named, pus was discharged  for three and a half years.
Whenever the discharge stopped for a day or two, pain and
dyspnoea set in.  The fistulous character of the sinus, and the
well-known powrer of Silic. in suppurations of various kinds,
induced Dr. B. to give nine  doses of Silic. 3, one  grain  pro
dosi.   These wrere  consumed within the  period of time from
January 20 to February 6.  Afterwards, six  powders, with
the direction to take one of the first three every third, of the
remaining, one every fourth day.   February  24th, the  pus
has become thinner and less.  Six more powders, one from
three to six days.   They were the last given.  Because sup-
puration soon ceased, the wound closed up without any com-
plaints of the patient, similar to those previously experienced
upon the arrest of the suppuration.

  Against  panaritia with which the scrofulous  are so often
afflicted, there is, aside  from Causticum (Goullon), no better
remedy than Silicea.


 12. (CVIII.)  Thickening of the Last Phalanx of the Finger.

  A remarkable example of the amazing  action of Silicea
Kafka communicates (X. Z. f. h. KL, 3, 4):
  The last  phalanx of the ring-finger of the right hand was 
      MOST APPROVED REMEDIES AGAINST SCROFULA.  229

observed to be enlarged to double size; the skin around the
edges of the nail is swollen, purple, and shiny ;  at both sides
of the nail we see club-shaped, purple, and fleshy excrescences,
as long as the nail, which nearly cover  half of it with their
broad, free surface, while, with their pedicle, they grow out
of the side-walls of the matrix;  the nails  bleed very easily,
and cause the most violent pain.  Moreover, the nail over its
whole length is undermined by pus, almost excavated under-
neath, and movable.  Upon every motion  or touch, indeed,
even while at rest, throbbing  and burning  pains torture the
patient during the day, which become  unbearable at night,
occasion sleeplessness, in consequence of which she looks very
pale, and her appetite has become very poor.
  The beneficial  effect of Silicea 6  (morning and evening  a
powder,  and  externally  white cerate), manifested itself  as
early as in the first night, since patient quietly slept several
hours, and at waking up found the pains to be ameliorated in
a high degree. Improvement progressed very rapidly; about
six days later the excrescences looked shrunken  and withered,
were  almost painless, and did not bleed any  more.  After
other eight days  the nail  began to grow already, and after a
treatment of three weeks the cure was accomplished, and  a
new, smooth,  and pretty nail decorated the formerly diseased
finger.
  The woman had been under allopathic treatment  for three
months, and the nail was to be removed at the time she placed
herself under  homoeopathic treatment.


                  13. (CIX.)  Panaritium.

  Dr. Eidherr, of Vienna, may be mentioned here as another
authority.   He says (X. Z. f. h. KL, 5, 15):
  Xo  doubt every homoeopathic physician has  sufficiently
experienced in his practice what value is  to be ascribed  to
Silicea in diseases of the bones.  I, at least, have  learned its
efficacy in felons, which were   accompanied   by  the most
violently stitching pains; in caries, and  especially tumor
albus, three cases of which I had the opportunity of observing
within a very short time.   I believe that Silicea  in the disease-
forms  mentioned cannot be surpassed  by any other  remedy. 
230           ON SCROFULOUS  AFFECTIONS.
It is a peculiar fact that the most violent lancinating pains
soon disappear after its administration.   In caries I observed
the carrion-like smell and ichorous discharge to give way very
soon to a normal pus.
  It seems that Silicea,  from the very beginning, has to  be
given in all those cases of panaritium in which destruction of
the bone (violent, nocturnal pains), can  be proven.  Mercur.,
on  the contrary, when  the  pains  are  not so violent, more
throbbing than stinging, and the periosteum is not affected
by the morbid process.*

                        14. (CX.)

  Dr. Eidherr observed the same beneficial action of Silicea
in caries of the metatarsal bones, and illustrates this observation
by excellent examples (A. H. Z., 5,14).

  However, it may also  happen that Silicea leaves us in the
lurch.  What then?  Dr. Meyhoffer, of Xizza, reports an in-
structive case of this kind. The trouble, arising from scrofula,
was caries of the epiphyses of the third, and, very probably,
of the second cervical vertebrae.  The surrounding soft tissues
had become inflamed by the ulceration of the bone, and the
pus broke through  in an outward direction.   At the left side
of the spinal column a congestive abscess  developing.  Obso-
lete, tuberculous infiltration of the left pulmonary apex.
   Mercur. bijodat.  0, 3, gr. 2, pro dosi.
   Xovember 4th. The discharge from  the fistulous opening
is very copious, but the pus better, creamy, and not so offen-
sive any more.
   Xovember 10th.  Xo  further progress.   Discharge of pus
very considerable ; the lower opening  produced  by a  seton
begins to cicatrize.  Above the congestive abscess a slight
arching of the skin may be noticed.
   Silicea 0, 3, gr. 2, pro  dosi, for eight days.
   Xov. 20th.  Xo essential change.  Discharge of pus very pro-
fuse, the  pain still considerable, the congestive  abscess  has
arched out still more.  Pulse 90, somewhat tense.
* See, however, under Mercur., cures of periostitis obtained by this remedy. 
      MOST APPROVED REMEDIES  AGAINST SCROFULA.  231

  Since Silicea has had no effect, and the copious suppuration
might exhaust the  patient, Iodium wTas administered inter-
nally and externally.
                    R. Iod. pur., gr. ii (0,1)
                      Kali, hydroj., 9j (1,50)
                      Aqu. destil., ^iv (120,0)
  Of this solution twenty drops were put into one-half litre of
fresh water, and  linen compresses  dipped into it, wrung out,
and  laid on  the  congestive abscess and the swelling at the
right side.   In the same manner  the  lint was dipped in the
same liquid.  The compresses, when dry, were renewed.   At
the same time an injection was made into the fistulous ulcer
every time after  the evacuation of pus (tepid in place of cold
water).  The injected liquid remained in it from ten to twelve
minutes.  Internally Iod. 0,3, gtt. 6 pro die.  This was done
till the end of Xovember.
  Xov. 30. The congestive abscess has disappeared entirely;
the skin is livid on a small spot only, the pain has also ceased.
The skin resumes its normal color.  The edges of the fistulous
opening are not callous any more, the spongy excrescences have
disappeared and, at the bottom of the ulcer, we observe healthy
granulation.   The purulent discharge is exceedingly small.  The
right arm of the  patient, which had become paretic, probably
in consequence of the pressure of the inflamed soft  tissue upon
the  dorsal nerves, is entirely  relieved  from  this affection;
appetite and sleep excellent.
  Patient resumes work as a type-setter.
  The same treatment is  continued  eight days  longer, and
since meanwhile  the purulent discharge had stopped entirely,
no more injections wTere  made.  The compresses are still con-
tinued ;  internally three drops of Iod. daily.   At the end of
December complete cicatrization of the ulcus fistulosum.  The
cure still continues a year afterwards.


     15.  (CXI.) Caries cubiti sinistri cum anchylosi  spuria.

                 BY DR. MEYHOFFER, OF NIZZA.

  Aliss----, for fifteen months suffering from an inflammation
of the left  elbow-joint, got steadily worse  under the applica- 
232           ON  SCROFULOUS AFFECTIONS.
tion of gray salve, local baths with sea-water, painting with
Iodine, purgatives, and sulphur-waters (Challes in Savoy).
  The inflammation is said to have originated without any
perceptible cause.  With  the exception of measles and occa-
sional slight glandular swellings, patient had been healthy thus
far; menstruates regularly since her fourteenth year, and has
a blooming appearance.   The diseased arm is in  a state of
complete extension ; neither active nor passive  motions of
flexion, supination, and pronation can be executed ; every at-
tempt at such calls forth the most violent pains in the cubital
joint; the latter is  considerably  swollen  and reddened  at the
inner  as well as  outer side; its temperature increased.  The
fossa supratrochlearis posterior has not only disappeared, but
there  is also a swelling in its plaCe.  At the condylus internus
humeri a fistulous  opening from six to eight millimetres in
diameter, from which  pale and spongy granulations  sprout
luxuriantly ; from the opening a discharge of sanguino-serous
pus in small quantities; the probe penetrates to the depth of
one centimetre.  Another fistulous opening can be seen in the
centre of the olecranon from which very little serous  pus is
secreted ; the probe on this spot, inwardly and upwardly pene-
trates the bone nearly to the depth  of two centimetres.
  Pain constant, but most violent in the evening, which prob-
ably may be  accounted for by the tiring of  the arm in conse-
quence of its hanging position and the pressure of the  exuda-
tion upon the nervus medianus.
  The pathological process in  this case has, hence, affected
both epiphyses, and  by the deposit  of an exudation into the
fossa cubiti anterior major, the introitus of  the processus cor-
onoideus has been rendered impossible.
  In consideration of the inflammatory  condition of the joint
patient received (March 12th) Aconit. 0, 2 gtt. 6 pro die; ab-
solutely horizontal  position of the arm.
  March 20th. The swelling of the joint considerably less, the
redness almost entirely gone ;  no more spontaneous pain ; the
radius  more free, slight  passive motions  of  pronation and
supination can  be  executed.  The purulent discharge from
both openings more copious and of a better  quality.
  Silicea 0, 3, one grain morning and  evening; daily attempts
at flexion.   This treatment was continued  a whole month, a 
      MOST APPROVED REMEDIES  AGAINST  SCROFULA.   233

pause of from three  to four days being made after every six
days' use of the remedy, as well  as during menstruation.
  April 25th.  The forearm can be flexed without any pain so
far as to form a right angle.  The ulcer  at the olecranon is
cicatrizing.  At the  bottom of the ulcer healthy granulation.
  Continuatur.
  At the end  of May even the fistulous opening at the con-
dylus internus had  healed by cicatrization, and  Miss  ----
was  able to flex her arm so far as to form an  acute angle;
in short, to execute any kind  of motion w7ith  it (Z. f. h. KL,
10, 20).

         16. (CXII.) Caries of the F<mur  and  Tibia.

  Dr. Godee treated a scrofulous person, aet. 14, suffering from
caries of the femur  and  the upper portion of the  tibia.  He
received Silicea -3% from  six to  eight days, according to the
profuseness of the suppuration and detachment of the osseous
fragments.  He was told here  that he could be cured only by
an amputation of the leg. Indignant at this  advice he re-
turned to the former treatment, and was cured in ten months.
Xow twenty  years of  age,  he enjoys the best  of health
(L'Hahnemannisme, 1868, Xo. 9 ; Silicea terra, Dr. Desterne).

  Jousset calls Silicea le grand medicament  de la  scrofule.
Should it, therefore, have no beneficial  effect in scrofulous
ophthalmia, which is the frequent expression of this dyscrasia?
Dr. Schlosser, of Munich, may answer this question  in  place
of us (A. H. Z., 56,4).


  17. (CXILL) Photophobia.—Perforating Ulcer on the Cornea.

  Linna II., aet. 7, of decidedly scrofulous constitution, a blue-
eyed blonde, with delicate skin,  since her  vaccination has fre-
quently been afflicted with cutaneous eruptions  and  ophthal-
mia.   For six weeks she has suffered from photophobia, with
pains in the eyes.   On the right cornea an ulcer, with deeply
imbedded bottom, and nearly perforating;  considerable hyper-
aemia of the  conjunctiva  bulbi  and eyelids; moist, vesicular
eruption on the occiput. 
234
ON SCROFULOUS  AFFECTIONS.
  Clematis 3, five pellets, twice a day, as well as Graphit. 12,
remained without any effect.
  One dose Silicea 200.
  As early as in the evening patient  complains less of pain.
On the next morning she  opened her eyes for the first time
within seven weeks; simultaneously an exanthema, resembling
measles, had broken out over her whole body during the night.
The ophthalmic trouble remained cured; slight desquamation
of the epidermis followed at the same time.  The ulcer of the
cornea so rapidly healed from the bottom and edges, and amid
constant decrease of the conjunctivitis, that the effect of Silic.
cannot be doubted.

                   18. (CXIV.) Coxitis.

  The A. H. Z.,  56, 9, among "Klinische Beobachtungen aus
dem hOm. Spitale in der  Leopoldstadt zu Wien," contains a
case of coxitis.
  Silicea,  it  is said at the close, had  a permanent effect.
Though slowly, the pain nevertheless steadily decreased upon
the continuation of the  remedy until remarkable  improve-
ment had set in.

              19. (CX.)  Caries of the  Big  Toe.

  G. B., of K., aet. 19, for more than a year suffered from caries
of the right big toe.  The physicians proposed the amputa-
tion of the toe as the only means to free him from  his afflic-
tion. The toe was very thick, red, and swollen  around the
carious ulcer, so that he  could not step on the foot.  April
2d, Silic 30.  In June the toe was cured.  Increased  irrita-
bility in it again required Silicea, and August 14th patient
wrote as follows: " I always think of you, and do not know
what I ought to do to you out of gratitude for the delivery
from my dangerous disease.  I would never have believed
that your powders, apparently a mere nothing, could produce
such miracles."*
 * Homo'opath. Heilungen v. Dr. Kirsch, in Wiesbaden.  A. H. Z., Bd. 79,
No. 4. 
MOST  APPROVED  REMEDIES AGAINST  SCROFULA.   235
     20. (CXVI.) Silicea against Nocturnal Convulsions of
                    Scrofulous Children.
                      (My own observation.)
  An extraordinary, as well as sure curative action of Silicea,
is the following:
  E. B., a small, handsome, erethic-scrofulous boy, after hav-
ing slept for an hour, suddenly wakes up amid distressing
cries, jumps up, and cannot be appeased in less than  half an
hour.  Trembling and spasmodic jerks of single  groups  of
muscles remind one of the  gesticulations  of  chorea minor.
The agony forces the sweat out of the pores.  At the same
time he has the sensation as if something crawled  over his
face, and he repeatedly  attempts to grasp it.  Presence  of
ascarides proven.   They have kept quiet, however, lately.
These  attacks, daily recurring for three  weeks,  forthwith
ceased after the first dose of a solution of Silicea 30  (2 drops
in 12  teaspoonfuls of wTater, morning and  evening a tea-
spoonful;.
  Finally, a few clinical hints from Riickert's " Attempt at
utilizing the curative material obtained ab usu in morbis:"
  The percentage of Terra silicea contained in so many min-
eral springs, and thus far overlooked, is  to be rated higher,
since several of  them owe their character to this constituent.
  v. Grauvogl mentions Silicea as a nutrition remedy among
the series of substances against the hydrogenoid constitution.
It certainly has  very special  bearings upon the organs of the
vegetative system.
  Aggravation of the whole morbid condition when the moon
is waxing.
  Constitution feeble; skin thin, delicate; face pale.
  Moreover, the fact that nutrition is poor, not, however, in
consequence of poor food, but deficient assimilation (such per-
sons are usually constipated), argues in favor  of the impor-
tance of Silicea  as an antiscrofulosum.  Quiet sleep is a con-
traindication to  Silicea.
  Again Silicea  deserves the rank of a specific against hema-
toma cerebrale. 
236
ON SCROFULOUS AFFECTIONS.
  Its indications, corroborated  as they have been  in diseases
of the eye, are valuable : Swelling of the right  saccus  lacry-
malis ; the discharged tears are hot.
  In the gravest  affections of the most various kind, especi-
ally in ophthalmia, when perforation of the cornea threatens,
in ulcerations of the cornea with swelling of the lids, if it has
become chronic and painful.
  Formation of abscesses of the size of a lentil in the upper
part of the iris appearing as yellowish-red swellings, covering
the entire pupil.   The pus, a portion of which has escaped
into the anterior  eye-chamber, was entirely removed*
  Sensation as from smoke or mist before the eyes.  Eyes in-
flamed, red, and watering.  An unmistakable, intense, and
grayish turbidity of the crystalline lens  of the right eye was
removed so far as to leave but  a very minute small speck.
   Complete cure of a gray cataract of more than one year's
standing by Silicea, one dose every month.
   In dysekoia and  amblyopia of sensitive persons.
   A woman got rid of the sweat of the feet, but was afflicted
in consequence by a decrease of  the power  of  vision so that
she could see but capitals.   The sweat of the feet having re-
turned upon taking Silicea, she sees better now than before.f
   Scrofulous  otorrhoea of several years' standing, offensive,
with soreness of the inner nose and a crusty eruption on the
upper lip.
   For scrofulous and rhachitic persons whose teeth are mostly
carious and necrotic, and when the toothache aggravates, es-
pecially at night and on inhaling cold air.
   The throbbing toothache cured by Silicea is connected w7ith
swelling of the periosteum or the lower jaw itself; the pain
is seated more in the latter than in the tooth, and sleep is dis-
turbed on account of general heat.
   Spitting of a  viscid and  mucous saliva is frequent^ con-
nected therewith ; profuse secretion of saliva indicating Silicea
 all the more. Here we observe a  relation to Mercur., with
 which remedy, moreover, Silicea has in common the name of
  * Senega is also recommended for the resorption of hypopia.
  f 1 recollect a similar cure with Silicea, in which, according to report, the
hearing of the ear previously diseased became better than that of the healthy
ear. 
       MOST APPROVED REMEDIES AGAINST SCROFULA.  237

 a toothache remedy.  This may also be said of Arsen.  All
 three frequently relieve the sleeplessness of persons afflicted
 with toothache, which tortures them to desperation almost.

   If resorption cannot be expected any more in tonsillitis, the
 tongue is thickly coated, and the face distorted spasmodically
 while swallowing, Silicea rapidly matures  and cures the ab-
 scess.
   It is  also suitable  if the throat, without  being inflamed,
 pains on swallowing.
  ^ Further, in  scrofulous swelling and  induration of the cer-
 vical  glands, in  parotitis, gradually developing,  slowly in-
 creasing, very chronic, frequently attaining to an enormous
 size, nearly without pain, redness and heat  of the skin.   (See
 also Cure III, Lycopod.)
   Again, in malignant scrofulous ulcers and fistulous sinuses
 of the lymphatic cervical glands, and caries of the clavicula.
   Finally, panaritia (p. cutaneum, p.  tendinosum, and p. peri-
 osticum), so frequent  among the scrofulous, as well as the
 carbuncle  at the neck, offer excellent opportunities  to  con-
 vince us of the specific curative action of Silicea.

  Xote  L—Dr. A. R., of S., reports : " I have not known that
 Silicea is also a popular remedy.  In this section  of the coun-
 try the inhabitants use the fine dust of a pebble, the so-called
 ' Teufelsfinger' (deviVs-finger), against  ulcers and  suppurating
 wounds.  It is  a very hard,  blackish, and  smooth  stone, of
 elongated form, somewhat resembling a finger. It is scraped,
 the powder being strewed upon the suppurating spot.  I have
 been  told  that  frequent  cures of old, malignant sores have
 been accomplished by it" (A. H. Z., Marz, 1869).

  Xote 2.—Kaoline, potentized porcelain-earth, recently often
mentioned in the A. II. Z., is  related  to Silic*  October 4th,
1869, Dr. Landesmann, of Geneva, published a few interesting
cures of croup by Kaoline 6.   It helped in the very worst
cases  in  which  Aeon., Hep. sulph., Spong., Brom., Phosph.,
and Iodium had failed.
  Shortly afterwards the homoeopathic veteran Aegidi claimed
* Kaoline is a Silicate of Alumina = Al3 S3 -+- 6H. 
238
ON SCROFULOUS AFFECTIONS.
the priority of this remedy, stating that, at a much earlier
date, he had obtained excellent  results with it (the 6th and
30th), in croup.
  Landesmann finds  Kaoline indicated  if  the seat of the
croupous inflammation is in the lower portion of the larynx,
and the upper portion of the trachea, a condition which may
be diagnosticated from the much more laborious and sawing
inspiration,  experiencing an impediment just at this  spot,
situated lower down.
  Since, especially, the most  grave cases of  croup coincide
with scrofulosis, we take notice here of these observations  of
Landesmann and Aegidi.*


                    SPONGIA TOSTA.

                      GENERALITIES.
  Is Spongia a remedy against scrofulosis ?  Certainly not  in
the same sense as Sulph., Calc. carb., Phosph., and others are.
It undoubtedly enjoys its most  extensive fame in croup, yet
the cases ought to be strictly individualized,  since examples
are known in which Spongia  surely did  not accomplish any-
thing.  The beneficial influence exerted by sponges, dipped
into hot water  and applied to  the throat of croup patients,
most surely is  not foreign to  the  antiscrofulous action  of
Spongia.  Its  curative  action  upon  strumatous  swellings,
which, as is well known, in former times  were identified with
scrofulosis, hence, the former name struma for scrofula is just
as certain.  For this very reason the remedy,  also designated
as " Kropf-Schwamm," rightfully claims  its place among the
series of antiscrofulosa.  However, we shall be less surprised
at the excellent effects of  Spongia, in  scrofulous  processes, if
we consider that it contains Iod., Sulph., Phosph., Kali hydro-
jod., Kali bromic, and  Carbo veget.  It is not improbable,
that  the  greater  or less reliability of the  remedy in  croup
depends upon the various  quantitative  proportion of these
substances.   By this, its modus  operandi  upon the glandular
  * Here we will remind our esteemed colleague, Aegidi, of his promise to
give us other clinical hints for the administration of Kaoline. 
      MOST APPROVED REMEDIES AGAINST  SCROFULA.  239

system may also  be explained.   Aside from its action upon
the  thyroid gland, its influence upon the  testes (in orchitis),
is unmistakable.

                          CLINIQUE.

                    1. (CXVII.) Croup.

   Bolle, of Paderborn (A. H. Z., 48,8), reports two interesting
cures of croup, from which he infers that Spongia, by itself,
cures not only fresh, but also neglected cases.  "I  could," he
continues, "mention still many more fresh and neglected cases
which were  cured by me with Spong. 3.   It would be of no
interest, however, to do so, since one case of angina membran.
too much resembles the other, in order to find it worth while
to report them separately."*

                        2; (CXVIII.)

   Dr. Billig cured his own blooming boy, five years old, who
was attacked by croup, with Tinct. Spongia^ alone  (gtt.  vj to
a cupful of water, two teaspoonfuls from 4 to 1 hour) (A. II.
Z., 44, 22).


                         SULPHUR.

                       GENERALITIES.

  " After Serapion, of  Alexandria, 270 A.C., had discovered Sulphur as the
specific against chronic cutaneous eruptions, it was used and praised in all its
preparations for centuries, to the most recent times."

   The great range of the curative  action of Sulphur can be
explained only by the aid of Hahnemann's psora-hypothesis,
wrhich, taken cum grano salis, allows a deep  insight into the
inner nature of many chronic diseases.  For seven-eighths of
the latter, according to Hahnemann's researches,  owe  their
origin, and especially their obstinacy to this cause.  By psora
  * Bolle gives 1 gr. of Spong. 3, and then waits for another spell of cough
before administering a second dose. 
         240            ON SCROFULOUS  AFFECTIONS.

         we do not understand, however, the eruption produced by the
         acarus, but the sum of certain biological obstacles which re-
         sist, deface, and  complicate the natural course  of diseases.
         These hindrances do not refer to the  phenomena comprised
         by the term " syphilitic," but, on the contrary, occupy a  posi-
         tion opposite thereto.
            The constitutional conditions of our ancestors play, prob-
         ably, the principal part in the appearance of psora.  For, in
         the  same manner as mental  deficiencies and anomalies are
         transferred to us from our parents, grandparents, and ances-
         tors far  more  remote, so their physical deficiencies, though
         modified, are also transferred to  us; hence, mental and  phys-
         ical  tendencies.*
            It is  of practical importance to abandon the  division of
^        chronic diseases into two large classes (psora and  syphilis, to
         which, as the third, we  must properly add sycosis) and, ac-
         cording to the name of  the  specific remedy eradicating the
         disease, to speak of Sulphur-psora, Arsenic-psora, Phosphor-
         Silicea-psora, &c
            So many " antipsorica,"  so many " psora species."
            Without  these remedies no chronic psora-disease is ever
         cured.  On  the contrary,  however, innumerable other non-
         psoric (non-syphilitic  and non-sycotic) diseases heal spontane-
         ously by proper diet  and manner  of living (a fact that was
         known to Hahnemann as well as to the more recent physio-
         logical school).
            The great merit of the introduction of psora, in our opinion,
         consists in this, that, by means of it, the connection of certain
         (not of all) processes on  the skin (the mucous membranes in-
         cluded) with the entire organism has been fixed for all time to
         come, and the doctrine of the local nature of cutaneous  erup-
         tions has been completely overthrown.
            Virchow's remark, " The parasitic acari may pass through
         their whole development on a human being, they may copu-
         late, lay eggs,  and the  offspring may  be developed without
         any perceptible trace whatever  of scabies in  some persons "
         (Handbuch  der Pathologie und Therapie, 1, 471), presents a
  * Among the primary groups of psora-symptoms, the so-called " Grind-
kopf" has received the name of "Erbgrind," not accidentally, perhaps. 
      MOST  APPROVED REMEDIES AGAINST SCROFULA.  241

brilliant proof of the acarus becoming only the occasional
cause of awakening the  slumbering  disease (the slumbering
psora-poison) which, otherwise, might probably not have man-
ifested itself before months or years, or even not at all.
  And now we will pass on to " Sulphur-psora," and thus to
the relations of Sulphur to scrofulosis.
  Since Sulphur in its principal physiological  action affects
the venous  system, it becomes the most excellent  scrofula-
remedy.  It is  specific  in all  scabious forms  of cutaneous
eruptions, of wThich scrofulosis can exhibit  so many without
any  dependence of the eruption upon the presence of para-
sites.*  The therapeutic bearing of Sulphur to the  glandular
system becomes plain from the  fixed fact that  it affects the
whole lymphatic system as well as all secreting surfaces and, hence,
also the glands, and has been employed with the best results
in diseases that have taken root there (Reil).
  Sulphur removes troubles of the respiratory organs (hoarse-
ness, blennorrhoea pulmonum, difficult respiration, asthmatic
affections, symptoms of incipient phthisis pulmonum—conden-
sation of the pulmonary tissue in the apices ; irritation in the
larynx, dry cough), the more easily, the more plainly the scrof-
ulous habitus is associated with the symptoms mentioned.
  The same holds good of aphthae, panaritia, inflammation of
the eyelids,  photophobia, &c, finally of the swellings  of the
lips, nose, submaxillary glands  and tonsils so  suitable for
Sulphur.
  What an  immense difference between the  vague recom-
mendation of laxants consisting of  calomel and jalap, or  of
teas said to purify the blood, or cures with Cod-liver oil, &c,
and the recommendation of Sulphur, incomparably more clear
and sure, where it is indicated homoeopathically.  Within the
firmly fixed sphere of its positive,  curative power belong,
moreover:  Crusta  lactea;  tinea   capitis  humida,  ophth.
scroful.  (ulcera corneae), ophth. neonat. (here especially Hepar
sulph. c), otorrhoea scrof., rhachitic affections, and such com-
plaints especially as owe their origin to an irrational removal
of exanthematous  affections,  i. e., of peripheric curative at-
  * Scabies of a pointed form, according to Heichelheim, was not cured by
Sulphur.
                            16 
242
ON SCROFULOUS  AFFECTIONS.
tempts of the vital forces.  (See CXXIII.)  Thus  Sulphur (as
does Graphit.) restores the haemorrhoidal flow.  Insufferable
itching is characteristic of Sulphur (especially at night), if we
wish to cure  an existing exanthema;  but eruptions " of all
kind " are not suitable for it.

                        CLINIQUE.

              1. (CXIX.)  General  Scrofulosis.

  A boy, If year old, descending from  scrofulous parents and
himself scrofulous in a high degree, suffering from  swellings
of the cervical glands, ulcers and inflammation of  the eyelids,
has been  treated allopathically for a long time by Baryt. mur.,
Kal. hydroj., Digitalis, Conium mac, and salves of red precipi-
tate and  zinc, and since all  this proved of no avail, by Calomel
in pretty large  doses, and afterwards Iodine.   Finally, my
advice was requested, and I found a real picture of misery ; the
child seemed to be doomed to die without any possible hope
of saving it.  The boy was not able to  walk yet.  The Avhole
neck was covered partly with open, glandular  swellings dis-
charging a thin, yellow liquid ; partly with such as threatened
to break  ; the crusty ears discharged, and  diffused a very of-
fensive smell.  The eyelids were swollen  and  inflamed, the
cornea opaque, and covered with cicatrices and fresh ulcers ;
the scalp was overspread  by stinking crusts; profuse flow of
saliva constantly tormented the patient,  and intense, hectic
fever, accompanied  by a  dry cough, had exhausted  all vital
powrer and produced great emaciation.
  In view of these conditions, I could not prognosticate favor-
ably, and advised the father better not  to begin  another cure
but to leave everything to nature.  But he would  not consent
to this, and thus I  prescribed Tinct. Sulphuris 1, and ordered
one drop of it to be given morning and evening.
  A good while afterwards I w^as not a little surprised upon
hearing that gradually everything had improved, the ulcers
had healed  by and by, and the boy was  now  entirely well
and nobody able to imagine his former  condition from  his
present appearance.  Entirely satisfied  with the  result, they
had not deemed it  necessary to give any  more medicine (A.
H.  Z., 60, 22). 
MOST APPROVED REMEDIES  AGAINST SCROFULA.   243
                           2. (CXX.)

   Spirit. Sulphuris, within fourteen days, cured a  gray cata-
 ract which had developed after driving away a crusty eruption
 on the head (A. H. Z., 55, 3).

   Dr. Eidherr, in cases  in which the internal  administration
 of Sulphur  led to no result,  uses with  the best success the
 tincture of Sulphur*  of which a few  drops were  put into
 water, as a wash (A.  H. Z., 60, 12).


              3.  (CXXI.)  Ophthalmia Scrofulosa.

   Caroline II., of W., aet. 5, of scrofulous diathesis, at the end
 of 1840 wTas attacked by scrofulous ophthalmia, against which
 the parents had sought the advice of a few allopathic phy-
 sicians.  The child had taken a good deal of Mercury, but
 was not cured.
   Status prcesens: Only the right eye is  affected.  Photopho-
 bia in  a  slight degree; several red vessels traverse the eye,
 especially from below toward the cornea on which a nubecula
 can be observed.  The  child complains  sometimes of pain
 in the eye, and is sad  and depressed, as the scrofulous mostly
 are.
   Sulphur  (gtt. i, dil. 3, pulv. iii, every  fourth  day), Bellad.
(gtt. i,  dil. 3, pulv. viii, one a day), again Sulphur  (gtt. i, dil.
3, pulv. iii, every  fourth day), and  finally Calc. carb. (gtt. i,
dil. 4, pulv.  xii, one every other  day), completely  cured the
  * Spiritus Sulphuris.  Mr. Peters, the apothecary, writes Kummel, a short
time ago, showed me a Spirit. Sulph., which he had prepared at first by a care-
ful trituration of Sulphur alone and then with alcohol, and which manifested
itself already by its sensible properties  as an exceedingly powerful prepara-
tion. For, a few drops of it put into water developed the smell of Sulphur so
intensely that all doubt as to its solubility in alcohol is removed. Hence, we
see how much a careful trituration adds to the development of medicinal
forces, how much, moreover, is depending upon the proper preparation, and
how important it is to procure medicines only from reliable pharmacies, or to
prepare them ourselves.  At the same time he expresses the wish to prepare
Mercur., Carb. veg., Graph., Silic, &c,  inthesame manner (A. H. Z., 11, 11). 
244           ON SCROFULOUS AFFECTIONS.
child within a short time* (Bd. xxi, Xo. 19, Beobachtungen
und Erfahrungen aus der Praxis v. Dr. Frank).


             4. (CXXII.) Scrofulous Eruption.
  A boy, three years of age, pot-bellied, with pustules and
herpetic crusts in the face, around the ear, and on the hairy
scalp;  a swelling as  large as a pigeon's-egg, dark-red, elastic,
and painful, on which a punctum suppurativum could be seen,
and disturbed general health, was cured within ten days by
Sulphur, a dose every other day.
  (I wonder whether the favored laxantia and the Pulv. alte-
rans Plummeri, which is said to have helped frequently, would
have effected a cure of the eruption as rapidly and pleasantly
as Sulphur indicated here ? Counting eczema among the most
benignant forms of cutaneous eruptions, we are notwithstand-
ing told by Schonlein that in the majority of cases the disease
lasts from six to seven weeks. Rep.)  (Hygea 15, 3 Heft.)


                 5. (CXXIII.) Otorrhoea.

  In another case Sulphur 3, a dose every other day, within
six days cured  a purulent, offensive otorrhoea, with discharg-
ing crusts behind the ears (Ibidem).


                      6. (CXXIV.)

   Three  panaritia and a digital  ulcer, treated partly by poul-
tices,  partly  with salves  and knife, were  rapidly  cured by
Silicea and Sulphur, in which cures the speedy removal of the
pains proved itself an especial blessing (Ibidem).


                       7. (CXXV.)

  Riickert cured with Sulph. 30 and 2, two cases of ophthal-
mia neonatorum (X. f. h. KL, 5, 22).
  * In this case we deem the simultaneous application of Calc. carb.
sential. 
      MOST APPROVED REMEDIES  AGAINST SCROFULA.  245


                        8. (CXXVI.)

  A child, aet. 3, which in the first year of its life had suffered
from crusta  lactea, and  afterwards from a febrile condition,
had a stupid look, permanent diarrhoea, and was emaciated to
an  enormous degree.   CEdema of the  extremities,  ascites,
ferocious appetite, thirst, and lentescent fever.
  Arsen. 30,  three doses, within two days decreased the fever,
thirst, and diarrhoea.  During the following eight days the
child received no medicine. Xo change.
  Xow Sulphur one dose in twenty-four hours.
  Fourteen days afterwards the little patient could hardly be
recognized; he was cured.  Watering of the eyes and consti-
pation, which had remained,  gave way within a month to
Sulph. and Calc, so that somewhat later  the child  enjoyed
complete  health (Espanet.-Journal de  la  Societe Gallic, de
Med. hom., 15 Xov., 1857).


             9. (CXXVII.) Scrofulous Eruption.

  Dr. Cohnfeld (Berlin) found Sulphur efficacious in all forms
of eruptions wTith the exception of the syphilitic and the ring-
worm.  He,  therefore, calls Sulphur (and  Arsen.) the  apostles
who converted him, truly and radically, since by the irresisti-
ble  force of facts they eradicated  the skepsis with which, as
a disciple  of chemico-physical science, he arraigned  himself
against homoeopathy, and  especially against the doctrine of
potencies.
  The indication for Sulphur in eruptive diseases, more limited,
as it is, becomes plain from a case of  the same author which
we  report here.
  The son of a laborer, aet. 5, is covered  over the whole face
with a coppery-red, shiny, and crusty tinea, which  is over-
flooded here and there by a greenish ichor.   He has scratched
in several places bleeding sores  in the  disgusting mask, which
render his  appearance  still more hideous.   The body of the
child, not too much emaciated, was covered with crusts and
crusty herpetic spots, varying from the size of a dime to that
of the palm  of the hand.  The disease  had appeared  three 
246            ON SCROFULOUS AFFECTIONS.
 months  after birth, had developed itself within a year or so
 to  its present height, and existed to this extent  nine  months.
 Besides large quantities of Cod-liver oil, all allopathic remedies
 had been used, wdthout, however, effecting an amelioration of
 the evil, even.
  Four powders of Sulph.  30, one every third day.
  Fourteen days later, says Dr. C, the woman returned with
 another  boy who  likewise suffered from tinea faciei, though
 of  a  very slight  nature.  It  consisted  in dry, red, herpetic
 spots on  cheeks and forehead, and a small discharging spot on
 the chin.  Above all I  inquired how  the other patient was.
 " Well," said the woman, " he is better, as you see."  As I see!
 The woman had to assure me repeatedly that the boy before
 me looking like a human being was  the frightful sight I had
 seen  fourteen days  ago.  The remedy is repeated, and in
 another fortnight the face was  completely clean and healthy.
  The crusty herpes upon the  body considerably diminished.
 After four more doses of Sulph. the whole eruption had  disap-
 peared, with the exception of a few crusts.  The propter hoc,
 Cohnfeld concludes this interesting report,  in which  every
 word is conviction, cannot be  subjected to any doubt  in this
 case* (A. H. Z., 60, 25).

  We will  yet mention that  C, in his recommendation of
 Sulphur  and  Arsen., has in view the higher potencies.  Dr.
 Freitag  (Leipzig) also says (where he speaks  of the  nature
 and treatment of scabies, A. H. Z., 60, 9): " Sulphur,  in the
 higher potencies, always seemed to me to  act more favorably than
 in the lower."
  From  this very able article we will quote yet the following
 passage,  deserving our consideration:
  "Every homoeopathic physician,  industrious  in  his  re-
 searches, and impartial  in his observations, will be able to
 adduce examples which  show that upon the  internal  use of

  *  Dr. I.  0. Muller is of the opinion  "that the external application of Sul-
phur, in fresh, genuine itch, can  be made without any harm, and that  only
those forms have to be excluded, probably, the  duration of which for years
proves a relation (which  cannot be defined more precisely though) between
the affection and  the entire organism, in which case, then, the internal treat-
ment offers results all the more satisfactory."  Cohnfeld's case belongs here. 
     MOST APPROVED REMEDIES AGAINST SCROFULA.  247

the antipsorica, so called, especially of  Sulphur, eruptions  of
the most various kind develop, eruptions by the appearance
of which a gradual cure of the diseased  inner organ is ini-
tiated.  I have seen such very extraordinary results obtained
by  the  homoeopathic method of healing in inveterate and
neglected  cases of eczema, lichen, prurigo,  &c, dependent
upon scabies driven away previously. Cases which, for years,
resisted all the artificially compounded washes and salves of
allopathic  physicians, gave way  within months to the (so-
called) antipsorica employed without any external medicines
whatever  having been administered as aids.   And here Sul-
phur, again, is an inestimable remedy.

  Xote 1.—Scrofulous troubles (especially among  children)
in which  the eye seems to be affected little  proportionally
(the eyes are somewhat red, hardly agglutinate, and show but
a slight degree of photophobia), but a formation of small pus-
tules takes place at the temporal region, and around the eye,
are cured, even after a duration of years, in a short time,  by
Sulph. 3, a dose every evening (A. H. Z., 77, 10).

  Xote 2.—Sulphur deserves consideration in fluent  coryza
with spasmodic sneezing, intense catarrh of the choanse, in
which the nasal discharge is frequently intermixed with blood;
in hoarseness, with a rough bass voice, dryness in the throat,
and burning on swallowing (Kafka).
  Sulphur affords  help yet in neglected cases of chronic
coryza (Bar).
              TEUCKIUM MAKUM  VERUM.

                      GENERALITIES.

  Against nasal polypi, and the catarrhal discharge depend-
ent thereupon (Dr. Black, Brit. Journ. of Horn., Apr., 1857).
Especially against mucous polypi (Kopp).  We must not over-
look this remedy on account of its action upon the nasal mu-
cosa, though we may not be justified, on the other hand, to
count it among  the most approved  antiscrofulous remedies. 
248
ON SCROFULOUS  AFFECTIONS.
Besides, Teucrium.  is used against ascarides, the presence of
which so frequently coincides with the scrofulous habitus.
  Of  the  remedial effects pertaining  here we name: Head-
ache ; dulness of the  head ; pressing  in the forehead above
the eyes; eyes red and inflamed, accompanied by coryza; vio-
lent sneezing; great obstruction in the nose; dry cough, wdth
tickling in the trachea.


                        CLINIQUE.

                  1. (CXXVIII.) Polypi.

  Dr. Tuwar, of Prague, reports a case, in wiiich nasal polypi
were  removed by  painting with  Tinct Teucrii  mar. ver.  In
similar cases Teucrium was also used in the form of snuff (as
errhinum).

                  2. (CXXIX.) Polypi.

  Dr. Rhees (Amer. Hom. Review) reports:
  A woman, aet. 25, had a polypus in the right  cavity of the
nose, wiiich had been .removed by an  operation twice within
the last three years, but in consequence of coryza had re-formed
again for the third time.  Patient felt tickling and painful
pricking at the root of the nose, and  in the left frontal pro-
tuberance.  The eye watered, and much mucus  is discharged
from the left nasal cavity.  Blowing the nose occasions pain,
and occasionally hemorrhage.  She  can  inhale  only through
the right nasal cavity.  Teucrium 6, twice a day, for fourteen
days  remained without result.   Xow the  1st  dilution was
given for one week, in the second week the 3d dilution, and
in the third week again the 1st dilution.  Hereupon decrease
•of the polypus in size, and decrease of the mucous discharge.
Air can pass through the left nasal cavity.  Durino* the next
week the same prescription.   After  that  the polypus had
disappeared, and patient experienced only an unpleasant feel-
ing in the left nasal cavity, which soon disappeared, however.
Four years later, in consequence of coryza, patient was affected
by obstruction of the left nasal cavity  and occasional pricking
at the root of the  nose, yet an examination  did not disclose 
      MOST  APPROVED REMEDIES  AGAINST SCROFULA.   249

anything.   This trouble disappeared after the first dose of
Teucrium 6.

                    3. (CXXX.) Polypi.

  In the Hygea, Veith reports the cure of a nasal polypus by
Teucrium.   And, in the same manner, Dr. Hermel cured one
by Teucr. 3  (2 drops in 200, 0 of water, morning and evening
a spoonful). L'Art. Med., Xov., 1858.  We repeat that other
remedies have relations much more  specific to the scrofula-
process itself, and hence come into consideration in cases of
polypus upon purely scrofulous bottom.  Among these Calc.
carb. especially belongs.
  As regards external applications in the treatment of polypi,
we deem it  in place  to say that polypi of the meatus audit.
ext.  were also cured in the same maimer;  but in these cases
it was not done by Tinct. Teucr., but by Tr. Opii, in its reme-
dial  relation  very different, no doubt,  from  the  former*
(Rainer).

             4 and 5. (CXXXI and CXXXIL)

  Dr. Gabaldo also cured a nasal  polypus with Teucrium 12,
and  afterwards T. 24, and  Dr. Roth a pear-shaped, soft, and
flat polypus, five inches in length, protruding from the vaginal
opening in a girl 25 years of age (L'Art. Med., Xov., 1858, in
A. II. Z., 58, 4).   ,
                VIOLA TRICOLOR, IACEA.

                       GENERALITIES.

  Stark regards it a specific against crusta lact.  Although,
aside from its action upon the urinary organs, intestinal tract
and  skin, the secretion  of which it increases, it affects  the
  * As early as in 1809, Primus cured an aural polypus by applying to it lint
saturated with Tr. Opii several times a day.  As early as after a few days the
polypus very perceptibly decreased in size, and eight days later fell off spon-
taneously as a dried up, skinny concrement.   In the cases observed by Kau
the polypus withered much more slowly, and did not become detached before
several weeks. 
 250           ON SCROFULOUS  AFFECTIONS.

 lymphatic system also ; the indication  for it,  nevertheless,
 appears to have been based upon too general grounds.  How
 often, on  receiving  scrofulous patients, must we hear the
 answer to the question, "Have you given the child something
 already?"  " Yes, we did let it drinkpancey tea"  It is a fact,
 however, that the provings of Hahnemann, Franz, Wislicenus
 a. o., mention  as \special remedial  effect, "Eruption wTith
 nightly itching, and dense,  thick crusts in the  face, from
 which a yellow pus discharges."


                        CLINIQUE.

               1. (CXXXIII.) Crusta lactea.

  A girl, six years  old,  for  weeks suffered from  scrofulous
ophthalmia of both eyes.  The face was covered formerly with
a dry, and now, in  consequence  of poultices,  discharging
crusta lactea.   Viol.  tr. caused the eruption to  become dry
again, and  cured it within three weeks.   The eyes improved
with the disappearance of the eruption (Z. f. h. KL, 2, 21 j. 
RESUME OF CURES REPORTED.
	A.—SKIX	
XXXIX.	Impetigo figurata,	. Calc. carb.
LI.	Pemphigus, .	. Dulcamara.
LVII.	Eczema capitis, .	. Hep. sulph. calc
LXX.	Eczema rubrum, .	. Ferrum jodat.
LXXV.	Eczema capitis et faciei,	. Kali chrom.
LXXVIII.	Verrucse,	. Lycopodium.
LXXXVI.	Eczema impetiginodes,	. Mercur.
CI.	Eruption on the face, .	. Silicea.
CXII.	Impetigo capitis, .	. Sulphur.
CXXYII.	Impetigo larvata,	. Sulphur.
CXXXIII.	Crusta lactea,	. Viola tricolor.
XLIX.	Abscess on the lower leg,	. Silicea.
CYII.	Abscess, B.—EYES.	. Silicea.
I.	Ophthalmia scrofulosa,	. Acid, nitri.
II.	Blepharitis phlegmonosa,	. Acid, nitri.
III.	Ophthalmia scrofulosa,	. Apis.
IV.	Ophthalm. scroful.,	. Apis.
Till.	Ophthalm. scroful.,	. Arsen.
IX.	Ophthalm. scroful.,	. Arsen.
X.	Ophthalm. scroful.,	. Arsen.
XV.	Keratitis chronica,	. Aurum.
XVI.	Keratit. chronic,	. Aurum.
XYII.	Ophthalm. rheum atico-scrof.	, . Aurum.
XX.	Ophthalm. scroful.,	. Baryt. mur.
XXXYIII.	Ophthalm. scroful.,	. Calc. carb.
XLV.	Blepharoblennorrhoea, .	. Calc. carb.
 
252
RESUME  OF CURES REPORTED.
LII.	Spots on the cornea,		. Euphrasia.
LIII.	Opacities of the cornea, . . Euphrasia.		
LIY.	Ophthalm. scroful.,		. Hepar.
LYI.	Ophthalm. neonatorum		, . . Hepar.
LYIII.	Ophthalm. scroful.,		. Hepar.
LXXXI.	Ophthalm. scroful.,		. Mercur.
XCYI.	Ophthalm. scroful.,		. Rhus.
CXYI.	Ulcus cornese perforans, . . Silicea.		
CXX.	Cataract after suppressed tinea, . Spir. sulph.		
CXXI.	Ophthalm. scroful.,		Sulphur.
CXXY.	Ophthalm. neonat.,		. Sulphur.
	C—EARS.		
XXXIV	Otorrhoea,		. Calc. carb.
LXXXII.	Otorrhoea,		. Merc, solub.
CXXIII.	Otorrhoea,		. Sulphur.
	Z>._NOSE.		
XIII.	Ozsena,.		. Aurum.
XIV.	Ozaena,.		. Aurum.
XXXYI.	Polypus,		. Calc. carb.
XXXYII.	Polypus,		. Calc. carb.
XLYI.	Fibrous polypus,		. Calc carb.
LXXII.	Coryza chronica,		. Kali bichrom.
LXXIY.	Coryza chron.,		. Kali bichrom.
LXXVI.	Coryza chron.,		. Kali bichrom.
LXXXYII.	Coryza chron.,		. Xatrum carb.
LXXXYIII.	Coryza chron.,		• Xatrum carb.
CXXYIII.	Polypus, ' .		. Teucrium.
CXXIX.	Polypus,		. Teucrium.
CXXX.	Polypus,		. Teucrium.
CXXXI.	Pohypus,		. Teucrium.*
	E.—MOUT		:h.
LXXIII.	Aphthae,		. Mercurius.
* CXXXII.  Polypus vagina?. 
RESUME  OF CURES REPORTED.
253
	F.—GLANDS.	
XXVII.	Mesenterial glands,	Bromium.
XXYIII.	Cervical " .	u
XXIX.	it u	;.
XXX.	Amygdalitis chronica, .	it
XXXI.	Submaxillary glands, .	u
XXXII.	u u	u
L.	Hypertrophical gland, .	Conium.
LIX.	Axillary gland,	Hep. sulph. calc
LXXYIII.	Ifypertrophia of the tonsil,.	Kali chrom.
LXXX.	Cervical glands, .	Lycopodium.
LXXXIV.	Angina tonsillaris,	Mercurius.
CURES OF STRUMATA.
V.	Struma,
VI.	u
VII.	u
XLI.	u
XLII.	u
XLIII.	u
IX.	u
XVIII.	u
Apis.
Calc. carb.
Iodium.
Kali hj'drojod.
67—BONES AND JOINTS.
XXV.	Gonarthrocace,			Calc. carb
XL VII.	Spondylarthrocace,			u u
LXYII.	Coxarthrocace,		.	01. jec. as
LXXXV.	Periostitis, .		.	Mercurius
XCY.	Luxatio spontanea,		.	Rhus.
XCYII.	Caries of the right		metatarsal	
	bones,		.	Silicea.
XCVIII.	Spondylarthrocace,		.	u
C.	Dyscrasia cariosa,		.	u
CII.	Luxatio spontanea,		.	u
CHI.	Tumor albus,			u
CIV.	Caries of the tarsal	joint, .		;;
CY.	Gonarthrocace,		.	u
 
254           RESUME OF  CURES REPORTED.
  CVI. Luxatio spontanea
CVIII. Thickening of phalanx,
  CIX. Panaritium,
   CX. Caries of the metatarsal bones,
  CXI. Caries of the elbow-joint,  .
 CXII.   "    femoris,   .
CXIII. Coxitis,     .
 CXY. Caries of the big toe,  .
Silicea.
#.—LARYNX.
	CURES OF CROUP.			
XXI.	Croup, .... • Bromium.			
XXII.	u			u
XXIII.	tl			u
XXV.	u			u
XXVI.	u			a
LV.	u			. Hep. sulph. calc.
LXI.	Asthma laryngeum,			Iodium.
LXII.	Croup, .			a
LXIII.	ti			a
LXIV.	:t			a
LXV.	u			a
LXVI.	t.			u
LXXI.	u			. Kali chromicum
LXXXIX.	u			. Phosphorus.
XC.	u			u
CXVII.	u			. Spongia.
CXVIII.	u			u
            /.—CRANIAL CAVITY.

LXIX. HjTdrocephalus acutus,     .     .  Ferrum jod.
K.—PECTORAL CAVITY.
   XLIX. Broncho-Pneumonia,  .
LXXVII. Catarrh with hoarseness,
    XCI. Bronchitis capillaris,  .
   XCIII. Phthisis incipiens,
   XCII. Bronchitis, .
Carb. veg.
Kal. chrom.
Phosphor. 
RESUME OF  CURES REPORTED.
255
/.—ABDOMINAL CAVITY.
GENERAL SCROFULOSIS.
     XL
     XII.
  XVIII.
    XIX.
  XXIII.
XLYIII.
      LI.
   XCII.
  XCIV.
  CXYI.
  CXIX.
 CXXYI.
CXXVII.
Atrophia infant.,
Atrophia,
Scarlatina scrof., .
General scrofulosis,
Convulsions of scrof. children,
General scrofulosis,
Atrophia,   ....
General scrofulosis,
Arsen.
  u
Baryt. mur.

Calc. carb.
Carb. veg.
Dulcamara.
Phosphor.
    it
Silicea.
Sulphur. 
-J 
 
NLM051092262