UNITED STATES OF AMERICA WASHINGTON, D.C. «PO 16—67244-1 1 DISEASES OF THE . ALIMENTARY CANAL. . / ...-I HOM(EOPATIIIC PRACTICE OF MEDICINE. TO BE PUBLISHED BY SUBSCRIPTION, Hartinaim's Practice of Medicine AND Therapeutics of acute* forms of Disease. TRANSLATED FROM THE GERMAN By A. Howard Okie, M. D., of Philadelphia. In this work, it has been the design of the author, to elucidate as clearly as possible, all of the broad practical principles of Homoeopathy; his energetic mind, extensive opportunities, and vast experience, have in every way fitted him for the task which he contemplated—theproduction of a work which should render the facts and practical rules of this novel science comprehensible and available to every medi- cal man. The work treats of acute diseases in general, in- cluding diseases of females and children, and the Homoeopathic treatmentof femalesduring pregnancy and after parturition. Under each particular head our author has been specific and accurate. In the pathological portions he has been peculiarly happy, and this part of the work will probably vie with any treatise on the practice of medicine extant. The onward progress of Homoeopathy in America and Continental Europe renders it necessary that the wants of American Practitioners should be supplied through the medium of translations. The work of Hartmann is universally conceded to be the best Homoeopathic Practice of Medicine extant. This being known to most of the friends of Homoeopathy, renders any laudatory notices superfluous. The work will be put to press as soon as two hun- dred and fifty subscribers are obtained. It will be published in two handsome octavo volumes, at Five Dollars per copy. J. DOBSON, 106 Chestnut Street. [In press, an entirely new edition of the MANUAL OF HOMOEOPATHIC ME- DICINE, translated from the third edition of C H. C Jahr. by J. Laurie, M. D., with a Preface by P. Curie, M. D. It will be published in parts—those gentlemen who are desirous of receiving it immediately on publication, will please transmit their names without delay to J. Dobson, No. 106 Chestnut Street.] * DISEASES OP THE ALIMENTARY CANAL AND CONSTIPATION, TREATED HOMCEOPATHICALLY. By W. BROACKES, M.D. and M.R.C.S. WITH PREFACE AND NOTES Bv GIDEON HUMPHREY, M.D. AN ESSAY ON HOMCEOPATHIC DIET. * i PHILADELPHIA: )s J DOBSON, 106 CHESTNUT STREET. * 1841. \R\ Entered according lo the .-.>... .1 Congress, in I he year 1811, by J. Doiison, in the Clerk's Oflice (:onrt for the Eastern Distrid ofPemisylv if the District ania. E. G. Dorsey, Printer, Library Street. C ONTE NTS. PAGE. Advertisement, ..... vi Preface,...... ix Structure of the First Passages, 13 Their Derangements, .... 14 Exercise and Mechanical Means to Remedy these, ...... 15 Aphthae—Thrush,..... 16 Stomacace—Ulcerated Gums, 18 Bad Breath,...... 20 Flatulence,...... 20 Spasms of the Stomach, .... 21 23 Derangement of the Stomach, . 24 Dyspepsia and Hepatic Affections, 42 Obstruction in the Intestinal Canal, 46 Constipation,...... 51 Colic........ 61 Hemorrhoids,...... 67 Enteritis, or Intestinal Inflammation, 87 *2 VI Diarrhoea,.......M Dysentery,......105 Sporadic Cholera,.....Ill Asiatic Cholera,.....115 Cholerine.......119 Worms,......123 Homoeopathic Diet and Regimen, . . 127 ADVERTISEMENT. There is, perhaps, nothing in London life so remarkable as its combination of epicurean and sedentary habits. Its dis- eases, as remarkably, are precisely those which should arise from such causes; namely, affections of the abdominal viscera. These diseases, however, do not in general arise immediately from the habits now mentioned, but chiefly from such habits at once overloading and rendering torpid the intestinal canal, or producing constipation. Constipation may, accordingly, be reck- oned the parent of metropolitan disease. It abounds in every district, in every age, and in every profession; and its conse- quences tend, perhaps, more than those of any other affection to embitter life and render it burdensome; for it is not only in V1U its evident effects that we must regard it— in dyspepsia, affections of the liver, diar- rhoea, dysentery, &c; but in its less direct, though not less sure, influence on the cir- culating and the nervous system. Constipation, happily, is peculiarly un- der the control of reformed Homoeopathy; and scarcely less happily, it brings its beneficent aid without any of the pills, potions and boluses, which constitute so disgusting and hateful a tax on social indulgences, and which poison even their happiest moments by anticipations of the frightful and inevitable future. PREFACE TO THE AMERICAN EDITION. Among the numerous and valuable Ho- moeopathic works which have been pub- lished on the various affections incident to the human system, there has not as yet been presented to the American public, one treating exclusively of diseases of the alimentary canal. The book, now offered to the public, has the advantage of being confined strictly to the disease called Constipation and its accompanying train of phenomena which present themselves in the various organs of the body. These are treated of in a plain and practical manner, and, without doubt, it will be found a valuable little work of reference to the practitioner. Knowing the distressing character of the X disease, to which our author's remarks are confined, and consequently the utility of a work specially treating of the subject, the Editor has no hesitation in offering this to the reader, hoping, at the same time, that the principles which it lays down, and the treatment it inculcates, may be found to answer every purpose for which it is in- tended. As regards the most advisable dilutions in which remedies may be exhibited, a great diversity of opinion is entertained. As it is altogether a matter of experience, the physician, almost universally, regu- lates his mode of prescription by the re- sults which may have attended his obser- vations in his own individual practice. Dr. Ruckert says on this point, "In respect to the doses, most generally, I make use of the first dilutions, and never exceed the twelfth, giving them in increas- ed volume and repeating them frequently. I have been more successful in this course of treatment, than formerly in the use of the smaller doses." This plan has many adherents, whilst others, as Dr. Gross, &c. vary the dose from the highest down to the lowest preparation. XI If the remedy, properly indicated, be selected for administration, it is of little practical moment what dilution is used, and in a plurality of cases from the twelfth to the thirtieth potence will be found to produce the desired effect. As a general rule, in cases of patients whose constitutions are very susceptible of medical impressions, it is thought best to administer the higher dilutions, and vice versa. In some particular cases the first dilution may be given with advantage where symptoms appear to demand its exhibition. So varied are the constitutions of pa- tients, that the repetition of doses must depend altogether on the nature of the impression which the remedy may have upon the disease; therefore, the practi- tioner must rely almost exclusively on his own observation in this instance. In reference to this subject, however, it may be said, that where the medicine acts in such a manner as to cause suffering to the patient, and it is evident that its opera- tion is only to aggravate the disease in a too powerful manner, great care should be taken in repeating the dose; and where xu there is any sensible degree of improve- ment it would be highly improper to in- terfere with the favourable action by ad- ministering an additional dose. As the progress of Homoeopathy has every where been marked by valuable ac- quisitions in the treatment of disease, and as the experience of every day throws increasing light upon the cure of maladies, the Editor has thought proper to make some few practical additions to the work in question. DISEASES OF THE DIGESTIVE ORGANS AND CONSTIPATION, TREATED HOMffiOPATHICALLY. The first passages.—Few persons are ignorant that these, technically called the firimce viae, consist of the oesophagus or gul- et, the stomach, the small, and the great intestine; that the small intestine, which is of nearly similar diameter throughout, is con- sidered as composed of three portions, the duodenum which commences at the smaller or right extremity of the stomach, the jeju- num which is its continuation, and the ilium which, continuing the latter, terminates in the great intestine; and that the great intestine which, though of much greater diameter than the small one, is also nearly similar through- out, is considered as composed likewise of three portions, the coecum which forms a bag with a vermiform appendix where the small A 14 intestine opens into it, the colon which is its continuation, forming by far the greater por- tion of the great intestine—in the arch which ascends on the right side, crosses under the stomach, and descends on the left side, and the rectum which, continuing the latter, ter- minates at the anus. It is also well known that there are innu- merable apertures, more or less minute, on the whole inner surface of these passages, as well as the openings of ducts from the liver, gall bladder, pancreas, &c. which pour into them digestive and lubricating fluids which blend with the food, convert it into chyme, and facilitate its passage; and likewise that innumerable other apertures on the same surface, form the beginnings of the absorbent vessels, by which the nutritive matter is taken up from the chyme and poured into the great veins near the heart to increase the quantity of the circulating blood. Such is the general idea of the digestive apparatus, and though it is less complex than some other portions of the organization, it is evidently liable to many causes of derange- ment, in very different portions of its struc- ture. Their derangements.—The more obvious causes of intestinal derangement, are evi- dently errors in the quality and quantity of 15 the food we use, and neglect of regular eva- cuations. Exercise and mechanical means to remedy these.—To promote evacuation, no means are either so natural or so effective as regular and abundant bodily exercise. In the metro- polis, and especially in the city of London, this is by some imagined to consist in a bustling and merely fatiguing walk through crowded streets; but no exercise is of much use that does not induce perspiration—the expulsion of the old and useless or noxious matters of the body, before it is gorged by new ones. In addition to exercise, it is always bene- ficial to attempt to obtain evacuations at a stated period of the day. Now, as persons when in good health, have usually an inclina- tion to relieve the bowels soon after break- fast (because the pressure of the distended stomach upon the transverse arch of the colon causes it to contract and propel its contents towards the rectum, which, becoming dis- tended, gives rise to the desire to relieve itself,) this opportunity should never be ne- glected, for the activity of the absorbents in the bowel soon removes the softer particles, and the bulk being thus reduced, the disposi- tion subsides. When exercise and this precaution have 1G been neglected, and when the bowels remain very inert, accompanied with some degree of hardness and fulness of the lower part of the abdomen, nothing will be more conducive to restoring regularity of the bowels than the use ol lavements, in conjunction with Ho- moeopathic remedies. Perhaps the simplest and best way of con- sidering the affections of the primse vise, is to begin with those of the mouth, and to take those of the stomach, intestines, &c, accord- ing to the succession of the parts. For that reason, I may first consider: APHTHA.—THRUSH. These are pustules or vesicles which may have their seat on any part of the membrane which lines the cavity of the mouth. They are sometimes distinct and dispersed, and sometimes approximated, so as occasionally to form a sort of continuous membrane, which entirely covers the tongue, palate, gums and pharynx. The precursory symptoms are great agitation, want of sleep, difficulty of breathing, foetid breath, hoarse and feeble voice, tongue a little swollen, dry and mem- branous only in the inside, thirst considera- ble, burning and redness in the throat and 17 mouth, fatigue and somnolence in particular, deadening of the senses. Then appear little points or elevations of a pale or grey colour, which grow by degrees, and form superficial pustules, round, of the size of a millet seed, and filled with a sanious liquid. The viscous mucosities which escape from them soon form little crusts which fall speedily, or at the end of a few hours, and are renewed more or less promptly. Aphthae are mild when they are white, pearl-grey, or yellow, transparent, humid, small, easily broken, isolated, when they fall easily and quickly, and affect only the mouth. But frequently they become malignant, and then they are larger, dull, blue, grey, brown, blackish, gangrenous, corroding, foetid, nu- merous, close, confluent, covered with a thick and very adhesive substance, or quite dry and hard, re-appearing frequently, and easily invading the pharynx, the intestinal canal, and even the trachea. The aphthae which often attack children at the breast are almost always mild. It is these only that we have here to consider: the others are always a consequence of some serious malady. The most common cause of aphtha? in little children, is food of bad quality, or which does not suit their age. A 2 18 The best remedy in this case is a small dose of* borax, 30th, which usually dispels the evil in two or three days. We "may also administer acidum sulphuricum, 30th, and mercurius vivus, 12th, if no circumstance contra-indicate their employment. STOMACACE.—ULCERATED OR FQ3TID GUMS. This name is given to a disease which be- gins by attacking the mouth, its glands, and the palate. The first symptoms are stiffness and shoot- ings in the throat, a coppery taste with heat, burning, redness, swelling and extreme sen- sibility of the gums, the inside of the lips, the cheeks, the tongue and the palate. To these phenomena are afterwards joined a cadave- rous smell from the mouth, painful swelling of the glands of the neck, abundant flow from the mouth of saliva, or of viscous and * Sulphur and mercurius viv. have been verv suc- cessful in these cases—occasionally calc. curb, or arsemcum if attended by diarrhea, 10 foetid mucus. The gums are spongy, ex- tremely swollen or retracted, the teeth pain- ful, dirty and often loose, mastication, deglu- tition, speech and respiration painful. There are formed, on the parts affected, small flat ulcerations, very sensible and obstinate. These ulcerations extend; their base is dirty or spongy; their edges are soft, little elevat- ed, inflamed and unequal. In a great num- ber of cases we observe spongy excrescences of different form, colour, consistence and size. Very frequently there flows from the ulcerated and tumefied parts, especially the gums, and particularly when we touch these parts, a putrid sanies, or liquid and deep red blood. At the same time, there is great weakness, and sometimes slight febrile move- ments. The best remedy against this disease is mercurius solubilis, 12th, which often com- pletely cures it in a few days.* * Nitric acid, given in water and frequently re- peated, has been found beneficial in extensive ulcera- tion of the gums, tongue, and cheeks, attended by a repulsive stench from the mouth. 20 BAD BREATH.* The cause of this is often uncleanliness of the teeth; and it consequently disappears if they are cleaned, and if the mouth is rinsed with warm water after eating. If the odour come from the stomach or lungs, it must be opposed by the following remedies: carbo animalis, 5th, agaricus, 12th, iodium, 30th, if it is observed imme- diately after washing the mouth with spring water; ammonium, 18th, if it is felt by the patient; baryta, 18th, if it is strong, but not felt by the patient; and sulphur, 6th, if it is augmented after eating.t FLATULENCE. I refer here only to such flatulence as de- pends upon errors of regimen and is of short * Vide ante. t If it be accompanied with acidity of the stomach, lycopodium and petroleum, may be given. 21 duration. Flatulence occurs most commonly after eating certain vegetables, especially if these have been taken at the same time with fermented liquors. It does not cause pain, but it swells the abdomen, embarrasses respiration, and usually occasions general uneasiness. China, 12th, commonly produ- ces good effects. However, we usually give nux vomica in preference to persons of vivid temperament, and pulsatilla, 12th, to women of a mild disposition. The latter is also indicated when flatulence follows the use of fat food. SPASMS OF THE STOMACH. In certain cases of spasm in the stomach, bryony deserves to be noticed as a proper remedy; and the necessity of using it is indi- cated by the following symptoms: the softest food or liquid occasions a constrictive pain in the stomach, frequently manifested ivhilst eating, or at all events immediately after- wards, accompanied by a sensation as if the epigastric region were swollen; and the ap- 22 plication of the hand diminishes or at times removes the pain by producing eructation. Case.—A man aged thirty-eight, of pletho- ric habit, suffered sudden and violent pres- sure at the stomach. He suffered most after eating, with constant numbness and pricking in the hands, and loss of feeling. The pa- tient looked ill, perspired all day, and was very weak and peevish. Paralysis of the upper extremities was dreaded; but two doses of rhus, 4th, gutt. 1, at intervals of six days, put a stop to that condition. This was succeeded by a shooting pain across the ster- num, which was increased by motion, not by respiration, and was most acute when the stomach was empty. The patient constantly suffered a trembling or sensation of leaping in the pit of the stomach. All the symptoms were removed by bryony, 6th, gl. 1, one dose. Very severe spasms in the stomach, grip- ing and twisting pains in the epigastrium, accompanied by vomiting of a clear and acid liquid, towards evening or even night, and sour returns, were cured with phosp., 10th, gutt. 1, administered every third or fourth day. In one case, the spasm was so violent that several medical men believed it to be a schirrus commencing in the pylorus. 23 VOMITING. The treatment of this affection is regulated principally by the causes which produce it, because they determine its nature. If the vomiting arise from an excess of nourishment, it would be wrong to prevent it by the employment of medicine; for it may be considered as an effort of nature to free the stomach from substances which overload it, and thus to prevent sometimes a serious disease. But it cannot always effect this evacuation, and art is often necessary to as- sist it. In vomiting, when it exists not as a symp- tom of other diseases, but as a dynamic affec- tion arising from the nerves of the stomach, ipecacuanha is valuable. This is of frequent occurrence in children, in whom the slightest irritation of the stomach, caused either by food or liquid, suffices to produce immediate vomiting. In the sickness of pregnant women also, ipecacuanha is useful.* * jXux vomica has also been used in these cases where the vomiting is accompanied with aversions, extreme lowness of spirits, and involuntary fits of weeping. 21 DERANGEMENT OF THE STOMACH. This has for its cause excess of nourish- ment, food and drink which are heavy, indi- gestible, fat, sour, tainted, &c. Returns either acid or of the same taste with what has been eaten, disgust, heaviness, pressure and pain in the stomach, swelling and fulness of that region, trembling of the lower lip, vertigo, weight of the head, titillation or roughness of the throat, spitting, haemoptysis, disagreeable taste in the mouth, foul tongue, inclination to vomit, heat in the throat, weak- ness, anxiety, countenance puffed, pale and sometimes covered with spots of different colours, emission of foetid air, the urine some- times mixed with mucus, &c.—such are the symptoms of derangement of the stomach, which usually show themselves some hours after a repast, and speedily terminate by acid vomiting of the nature of the aliments which have been taken, and sometimes of a green colour. However, there often remain for some days, anorexia, pain of the bowels, or diarrhoea. Nux vomica, 26th, remedies derangements of the stomach caused by nocturnal dissipa- tion, by the abuse of wine and of coffee, or 25 by severe cold, and presenting the following symptoms: sensation of vertigo, confusion of the head, heaviness in the back of the head, shooting pains in the molar teeth, ringing in the ears, heat in the face, red and distinct efflorescences on the forehead, the nose, and the angles of the mouth, tongue white and loaded, dryness of the mouth, with thirst, much mucus in the mouth, heat of the throat, want of appetite, loss of taste, nausea, much water in the mouth, vomiting, colics, pres- sure at the stomach, tension in the abdomen, constipation, agitated sleep, want of disposi- tion for intellectual labour, general relaxa- tion, shootings in the limbs, discontent, querulous disposition, and internal agitation. Case I.—Mrs. B. had for some years been suffering from her stomach, which refused almost, every thing: the matters vomited were bitter and sour. The patient became daily thinner, and looked worse, and indeed had altogether the appearance of being very ill. Six doses of nux vomica in solution were administered, and to her great astonishment she found herself so much relieved that she not only digested her food, but speedily recovered her plumpness and her strength. Case 11.—Mrs. S. had been an invalid for B 2(i a year. She could not eat any thing without vomiting immediately, and if the vomitings did not occur naturally, it was necessary to stimulate them, from a feeling as if the sto- mach would burst. Sometimes vomiting took place immediately after eating, at others not for several hours. The matters discharged were sour and bitter: at times the patient vomited first water and a glairy matter, and afterwards the food she had taken. The mo- tions were difficult and hard. The flatulence did not escape, but caused pricking pains on each side. The least pressure upon the region of the stomach was painful. The slightest motion appeared likely to produce suffocation, because the cramp in the stomach rose to the neck, and caused contractions. There were frequent cramps in the calves of the legs, especially at night, loss of strength and substance, complexion disordered. Nux vomica was given in dilution, a dose every hour: four sufficed to cure her. Cramp of the stomach, connected with this derangement, is curable by the same means. This disease is very common, usually without fever, long and intermittent, attack- ing chiefly women, and appearing sometimes to be hereditary. In the beginning, it is merely a pressure, a very disagreeable con- striction and pinching in the region affected, 27 especially at the pit of the stomach and the left side, and sometimes in the back. After- wards, the pains become very sensible, tear- ing, burning, insupportable, and are felt even in the gullet. In their highest degree of intensity, they are dreadful, accompanied by constriction, twisting, anxiety, oppression, dartings in the breast and back. The attack remains at first for some minutes, then for a quarter of an hour, an hour, and even for half a day, and it often ends by vomiting. The pain usually disappears when the sto- mach is empty or contains only light and mild food, and it returns after a repast. It is increased in an erect position: the leaning forward or being bent, and even pressure mitigates it. Sometimes the region of the stomach is rather hard and swollen, more commonly it is contracted, very seldom is it sensible or tense. A disposition to vomit is commonly observed, but it is not always fol- lowed by vomiting. The latter produces a brief alleviation. Cramps of the stomach are more or less obstinate according to their cause; and they sometimes resist for a long time the best directed treatment. They often disappear for several weeks, and return again at regular periods. The usual causes of this disease, are errors of regimen often and long reiterated, 28 irregularity of eating and drinking, abuse ot spirituous liquors and coffee, vexation, anger, frequent chills, especially of the feet. The remedies to be opposed to this disease, are nux, ignatia, pulsatilla, and crude coffee. The complete cure sometimes requires the use of antipsorics; but it is then necessary that an able physician should direct their administration. Nux vomica, 30th, particularly suits per- sons who are addicted to the use of coffee and spirituous liquors, especially when we observe in them the following symptoms: constriction, pressure, tightening, cramps in the stomach, with a sensation as if the dress compressed the body in that region, a sensa- tion which may be compared also to that produced by much flatulence in the left side, under the ribs, a tightening of the chest, which in many cases extends between the shoulders and the loins, nausea especially during the attack, much water in the mouth, returns of sour bitter liquid, with or without burning in the pharynx, palpitations of the heart with anxiety, acid or putrid taste, constipation, swelling of the abdomen by flatulence, sometimes head-ache on one side, sometimes also pressive pain in the forehead. If the remedy has diminished the symptoms, without making them entirely disappear, a 20 second dose must be given at the end of three or four days, and afterwards a third one. Sometimes this state of the stomach is con- nected with hepatic affection and is similarly remedied. Case.—Mr. B., aged twenty-eight, of good constitution and bilious-sanguine tempera- ment, was seized suddenly on the 19th of July, 1836, with a violent constrictive pain in the epigastrium, and vomiting, consequent upon great mental affliction. His stomach rejected all food both solid and liquid almost immediately. The epigastric pain was in- cessant and not increased by pressure. The tongue was in its natural state, the patient having neither thirst nor appetite. The circulation was in no way disordered, but there was suborbital cephalalgia and general uneasiness. The skin had a very marked icteric complexion. On the morning of the 20th of July, all these symptoms had been in operation for twelve hours. Three globules of nux vomica of the twenty-fourth dilution, dissolved in two spoonfuls of water were then administer- ed. The same evening the pain was greatly relieved, the vomitings had ceased, and the patient took some broth without experiencing anv inconvenience. The following morning b2 30 there was no symptom of gastralgia remain- ing, nor has it reappeared since. In this case, mix vomica effected a speedy and desirable cure, because it was exactly in accordance with the occasional cause, name- ly, with the mental distress and temperament of the patient, with his moral condition, and also with the cephalalgia, epigastric pain, vo- mitings, and even with the icteric complexion of the skin. Sometimes this state is connected with he- morrhoidal and menstrual affection, and may be similarly treated with advantage. Indeed, spasms in the stomach, resulting either from plethora and sanguine congestions in the ab- domen, or simply from increased sensibility of the nerves of the stomach may be treated with nux vomica. The former case is met with more frequently than the latter, and then the spasm of the stomach is found to be connected either with hemorrhoids or irregu- lar menstruation, in such a manner that the customary sanguine congestions towards the hemorrhoidal or uterine vessels are disor- dered. Case.—A lady, aged twenty-four, had been suffering for seven years from pains in the stomach; during the whole of which time she had taken nothing but cold milk, as other 31 aliment produced the most violent pains in the stomach, spasms, nausea and vomiting. In addition, she laboured under a flow of blood towards the head, pressive head-ache, dimness of sight, hemorrhoids, general cold- ness of the body, especially of the hands, feet, suppression of the menses during five years, great irritability, and meagreness of habit. Eight doses of nux, 8th, 3, one daily before bedtime, and four of bryony, 8th, 3, sufficed to diminish the disease to such an extent, that the patient after fourteen days of this treatment, was able to eat roast fowl and roast beef, without experiencing any pain or heaviness at the stomach. Sometimes this state is connected with affections of the head. Spasm in the stomach, with nausea and eructation, acid and bitter vomitings, anxiety and oppression of the chest, palpitation of the ' heart, contraction of the abdomen, blind he- morrhoids, bilious temperament, may often be cured by calcar. carbon. A female, aged twenty-eight, experienced frequent frontal head-ache, followed by bi- lious vomitings, pressure at the stomach as if caused by a stone, pain in the right hypochon- drium, becoming pressive and shooting upon stooping, motions unfrequent, difficult and hard, menstruation painful, continuing for 32 eight or ten days, followed by hemorrhoidal tumours, weakness, perspiration and agitated sleep, was cured in eight days by two doses of coccul., 6th, gl. 1. Pulsatilla is particularly suitable when a repast is composed of aliments which are fat, and when it presents the following symp- toms: taste bitter, salt or putrid mucus in the mouth, roughness in the throat, bilious returns, want of appetite, repugnance to warm food, fulness of the stomach, swelling of the abdomen, tension below the last ribs, borborygmi, constipation, or at least slow, difficult and scanty evacuation, shivering depression, shooting in the limbs, and ill hu- mour. Case.—A patient experienced a sensation of tightness above the navel as if the in- testines were inflated. At times, there was a round lump as large as a fist, hard and prominent, the bowels painful at the slightest touch, very painful pricking pains on°each side of the abdomen, feet cold, head burning, febrile irritation, frequent tendency to sick- ness, followed at times by vomiting. This disease, which attacked the patient more especially in the evening, arose in the first instance from cold. In cases of this sort, pulsatilla is an actual 33 specific; the exhibition of it is generally fol- lowed by sleep, and the patient awakes per- fectly cured. The attack may return, but at all events the intervals are long. Some persons who are very irritable, ex- tremely sensible, and subject to spasmodic and nervous accidents, are often attacked, from causes slight in appearance, with a vomiting of viscous and whitish mucus, usu- ally preceded by vertigo and pains in the abdomen, followed by diarrhoea. Pulsatilla, 18th, and coccukts, 24th, are successfully employed in these cases. The derangement of the stomach may have been caused by anger preceding a repast. The following are the circumstances which present themselves in this case: heat and redness in the face, painful head-ache, red- ness of the eyes with burning, general excite- ment of the nervous system, great sensibility, loss of appetite, continued bitter taste in the mouth, bilious eructations, vomiting of green and bilious matters, colics, depression, agi- tated sleep, frequent awaking. Chamomilla, 12th, and, if that be not sufficient, pulsatilla, 18th, are then the best remedies. Bryonia alba, 18th, is applicable to cases in which the emotion still remains, and in which the sensation of cold is joined to the preceding symptoms. If the anger have been 34 accompanied by great fear, aconite, 24th, is the specific. When the nervous system is very irritable, and the sensibility increased, good effects are obtained from chamomilla, 12th, especially when the patient complains of pressure in the region of the stomach, of painful swelling at the pit of the stomach and of the left side, of asthma and of anxiety. It should also be observed, that a little coffee usually mitigates this kind of pain; while it is injurious in others which yield to the use of nux vomica. Chamomilla has no effect in persons who have used much camomile tea: it must then be replaced by ignatia, pidsalilla and coffee. Arnica, 6th, is administered if the de- rangement of the stomach arise from a gene- ral and continued excitement of the nervous system caused by distress of mind, watching, excess in pleasure, fatigue of the body, and if it be accompanied by the following symp- toms: vertigo, pain in the head, especially above the orbits, stupefaction, heat in the head, dryness of the tongue, sour or bitter taste in the mouth, desire for acids, tongue loaded with a yellowish matter, taste of what has been eaten, fulness at the pit of the sto- mach, nausea, flatulence, weight in all the members, disagreeable heat, agitated sleep, frequent awaking, starting during sleep, 35 anxious and distressing dreams. We may also give nux vomica, 30th, and chamomilla, 12th, if there be no circumstance which con- tra-indicates their use. We observe in the spring, particularly in persons who dwell in humid places, near stagnant waters, marshes, &c, a particular derangement of the stomach, of which the following are the characters: loss of appetite, continual satiety, a heaviness and fulness of the abdomen, eructations, depression, weak- ness, vertigo, dull head-ache, sometimes heats, alternating with shiverings, turbid and cloudy urine, sensibility to external impres- sions, agitated sleep, ill humour. This state is, in many cases, the forerunner of fever, which may be prevented by china, 24th. When in these affections there is some inflammatory tendency, belladonna is inva- luable. Case I.—In this case, the female was pregnant: and spasms occurred frequently, each time with increased intensity. There occurred violent spasmodic pain in the pit of the stomach, and left hypochondrium, with vomiting; general soreness of the abdomen, violent pressure downwards towards the pel- vis, with frequent desire to micturate; face red, swollen and heated; eyes fixed, pupils 3(5 dilated; partial loss of consciousness; occa- sional movements and moaning produced by the violence of the pain. A few doses of bellad. 5th, effectually removed the disease. Case II.—A man had been suffering for forty-eight hours under hiccough and vomit- ing. The sensibility of the stomach was so great as to reject even a spoonful of water. Opium and lavements were inadequate to remove the symptoms or the constipation. The face was red and burning, and the body bathed in a cold perspiration. Belladonna, 10th, was immediately administered. At the end of three hours, the vomiting had ceased, but the hiccough still remained and continued even during sleep. In order to free himself from this distressing symptom, the patient had, during his attendant's absence, drank a few cups of strong camomile tea. But as the camomile counteracted the action of the belladonna, all these symptoms reappeared during the night, the hiccough in particular more violently than before. There was then administered a cup of coffee, as an antidote to the camomile; and a few hours after a homoeopathic dose of belladonna. By the evening, all the symptoms had ceased, and they never recurred. 37 Case III.—A female had been long suf- fering from spasms in the stomach, with fre- quent nausea and vomiting, after eating or drinking, from which she was relieved only by partial or total abstinence. At the same time with the spasms in the stomach, she ex- perienced shooting pains in the chest and vicinity of the heart, and frequently so vio- lent a constriction of the chest as to impede respiration. During the attack, she experi- enced anxiety, heat, head-ache, perspiration and pains in the back. This disease which had for months baffled the resources of allo- pathic treatment, yielded in a few days to two doses of belladonna, followed by a few doses of nux vomica. AVhen burning pain accompanies these affections, arsenicum album is successfully employed. Case I.—An unmarried female, aged forty- five, an invalid since puberty, suffered from various diseases, such as painful and irregu- lar menstruation, leucorrhcea, hemorrhoids, induration of the liver, spasms in the sto- mach, alternation of constipation and diar- rhoea, arthritic shootings, especially in the head, &c. She had been continually taking medicines chiefly of a heating and drastic nature. Suddenly she was seized with ex- o 38 treme pains and fever. The pains were felt chiefly in the pit of the stomach, in the hepa- tic and hypogastric regions, and in the loins: the other parts of the bowels were sore, and there was constant vomiting, extreme thirst, inexpressible anxiety and agitation. After the vomiting and pain had ceased in the pit of the stomach and the region of the loins, they increased in the hypogastriuin and haunches, in which parts the pains were burning and severe. The hypogastrium was unable to endure the slightest touch, and was swollen, hard, distended and hot. Shootings existed in the rectum, heat in the tumefied hoemorrhoidal swellings, motions liquid, with tenesmus, sharp burning pains, especially in the lower part of the pelvis, fever, dryness of the mouth, inclination to vomit, thirst, sleep- lessness, anxiety, agitation and palpitations of the heart.—Jlrs. 30th, (3 doses) acted instantaneously upon the affection, by pro- ducing a marked homoeopathic aggravation, but without any sensible improvement. After a few days, there was a sudden ces- sation of pain, and a discharge of several glassfuls of thick pus from the bowels: this discharge ceased gradually at the end of six or eight days, and the patient speedily re- covered. 39 Case II.—An aged female, who had often suffered from spasms in the stomach, had not for several months passed a single day free from pains in the epigastrium and back. These pains gradually increased, and were succeeded by vomitings occurring several times in the day, so that the sufferer could take nothing without vomiting immediately, or at the end of a few hours, with increase of pain. She sometimes even vomited when the stomach was empty. At the same time, she lost substance visibly; and finally weak- ness and incessant pain confined her to bed. The pain was constrictive and burning; the pit of the stomach distended and painful to the touch, with constipation; the tongue clean, throat dry, thirst, sleeplessness. A few doses of ars. 30th, administered at long intervals, obviated for a long time this chro- nic gastritis, which was doubtless accompa- nied by a tendency to the production of scirrhus. Case III.—Inflammation of the stomach was cured by ars., 10th, gl. 1; twelve hours after which was administered coloc. 10th, gl. 1: and the same again sixteen hours afterwards. The patient, who was sixty years of age, complained of extreme burning pain in the pit of the stomach, so great that 40 he could not even endure the contact of the clothes, and his stomach rejected immedi- ately every thing that he took; pulse small and quick; the patient extremely restless. The cure was rapid, without any other appli- cation. Chronic Indigestion.—In a case of con- tinual swelling of the epigastrium arising from wind, difficulty of breathing in the morning, but more especially after meals, eructation, sensation of sickness, occasional vomiting, continual pressure, periodical heat in the stomach, and constriction of the abdo- men, were almost instantly relieved by two or three doses of sulphur. Tinct. sulph. not diluted, gl. 1, repeated every eighth day has cured many severe cases of heart-burn in young persons. One case of this was so serious that the patient began to lose substance, as he could take nothing but a little broth. Two doses cured him: acids had been found useless. A female, between thirty and forty, had for twelve years been suffering from nausea and vomiting, immediately after breakfasting, and very often after dinner. Besides this, she complained of shooting and tightness of the chest, with a dry cough, darting pain in the forehead, stupifying vertigo, cold in the hands and feet, and pains in the abdomen. 41 Fifteen days use of the tincture of sulph. and ipecacuanha stopped the sickness: ars. and con. removed the cough and all other symp- toms. Affections of the stomach arising from lead require the employment of its proper anti- dote. Mr. N., a house-painter, aged thirty, of sanguine temperament, after mixing colours for some days for a great number of work- men, was seized with colic, to which he paid little attention. At the end of three days, however, he fell into such a state of disease and suffering, that he exhibited the following symptoms:—dull, obtuse pain extending from the middle of the stomach to the epigastrium, not increased by pressure, dry tongue, vomit- ing of mucus and bile, obstinate constipa- tion, pulse contracted and quick, respiration difficult, face pale, with convulsive move- ments of the extremities. Opium being an antidote to lead, and one of the best homoeopathic remedies in cases of constipation, four globules, 12th, were dis- solved in four spoonfuls of water, to be taken every hour, and the same at night. Next morning, the patient was generally more easy; but the pain and vomiting remained the same. Jllumine, 30th, 5, were administered in three spoonsful of water, to be taken c2 42 every hour, when the vomiting ceased. On the third day, as the colic and constipation still remained, opium, 4th, one drop, in a spoonful of water was prescribed. The relief was very marked, and the patient himself observed that the medicine seemed to grapple with the disease. As the constipation, how- ever, still continued, three other tea-spoons- ful, with tincture of opium, were administer- ed during the day, increasing each dose one drop, so that the last dose consisted of four drops. After a difficult evacuation, compos- ed of a small quantity of hardened matter, the patient enjoyed a comfortable sleep, and awoke convalescent on the following morn- ing, being the fourth day. DYSPEPSIA AND HEPATIC AFFECTIONS. I think it necessary to remark, "and my long experience convinces me," that there are no cases in which the homoeopathic treatment is more singularly beneficial than in affections of the liver, stomach and bowels. 43 Case I.—A lady in delicate health, who had suffered from dyspepsia for several years, and latterly from disease of the liver, was labouring under the following symp- toms:—frequent giddiness, dull pain with pressure in the forehead, face flushed, sleepi- ness even after breakfast, tongue yellow, thirst, acid eructations, weight in the sto- mach much increased after eating, acute pain in the region of the liver augmented upon pressure, dull pain in the loins, bowels constipated, no relief without purgatives lat- terly of the most drastic kind, feet cold, pulse quick and hard, nervous system highly excitable. The acute pain in the liver with inflamma- tion, and the condition of the pulse indicated the use of aconit. 30th, which was repeated three times a day for three or four days, when the pulse became subdued, and the liver much less painful. Bryon. 30th, was ordered every night for a week, and subsequently every alternate night for another fortnight. During the ac- tion of the bryony, the symptoms gradually diminished; the bowels became regular, and at the end of several months no medicine was required, and digestion had so much improv- ed, that she recovered her strength and former healthy appearance. 44 Case II.—A solicitor, whose avocation confined him much to his office, was annoved with stomach complaint to such extent that he could scarcely eat the most digestible food without producing great uncomfortable- ness both mental and bodily. He complain- ed of heaviness in the head, pain in the temples, sleepiness after dinner, appetite bad, bitter taste in the mouth, cough with oppres- sion of the chest, palpitation of the heart, distention of the stomach after eating, so as to require the clothes to be loosened, consti- pation sometimes alternating with diarrhoea, spirits depressed, at other times irritable. Thuya, 10th, was given daily, and suc- ceeded by pulsatilla, 6th. Under this treat- ment, the improvement was gradual and per- manent. Case III.—A gentleman complained of head-ache, particularly in the occiput, stiff- ness in the nape of the neck, tongue dry and furred, appetite bad, flatulence, pain in the stomach much greater when fasting, bowels irregular. Although these symptoms had continued many months, they yielded under the influ- ence o(baryt. carb., 6th, every second morn- ing, followed bv a few doses of staphisagria, 10th. 45 Case IV.—A lady had for many years suffered most severely from a stomach affec- tion, which had latterly increased to such an extent that all food was immediately reject- ed, even fluids not being always retained; the pain in the stomach most distressing, much increased upon pressure, distention of the stomach and bowels, eructations, and se- vere dull pain between the shoulders and in right side, copious secretion of aqueous fluid from the mouth, violent fits of coughing both day and night, more particularly on lying down and after taking nourishment. During one of these attacks, she ejected a large quantity of black blood, twelve or fourteen ounces at least; pulse quick, small, hard. Aconite, 6th, dissolved in water, was given every ten or fifteen minutes, until the pulse became soft and less frequent, when bryony, 10th, followed by nux, 10th, daily, removed the pain and vomiting. This patient had long suffered from disease of the liver, and had consulted several of the most eminent men of the present day with no relief. 40 OBSTRUCTION IN THE INTESTINAL CANAL. This is a morbid state of which the princi- pal symptom is a superabundant secretion of mucus, in consequence of weakness of the digestive organs. This affection, the result of a sedentary life, of a moist and unhealthy atmosphere, of painful emotions, or some other malady, attacks especially infants, wo- men and old men, and occurs chiefly in au- tumn. The secretion may have its principal seat in the stomach, or in the intestinal ca- nal; but this produces little difference in the symptoms, which are generally the following: —want of appetite, thirst, sweetish nauseous taste, abundant secretion of viscous saliva, a white, thick coating on the tongue, much mucus about the teeth, paleness of the face, depression, fulness at the pit of the stomach, swelling of the abdomen, sometimes vomiting of mucus; when the evil reaches a great de- gree of intensity, it is frequently accompa- nied by diarrhoea or colic. Nux vomica, 30th, is the most effica- cious remedy against this affection, especially when it has for its predominant symptoms cramps in the stomach, much water of an 47 acid taste in the mouth, vomiting of mucus of an acid odour, slowness of the movements of the intestinal canal. We employ, nearly with the same success, veratrum album, 12th, chiefly when the mat- ters vomited contain bile as well as mucus, or when these have a greenish yellow colour and a bitter taste. Tartar emetic is indicated when vomiting is joined to a disposition to mucous evacua- tions. Rheum, 9th, is used when there is softness and fulness of the abdomen, frequent alvine evacuations of brown matter, mixed with mucus, and tensive sensation at the pit and in the region of the stomach. Pulsatilla, 12th, is employed in irritable and delicate persons, if accompanied by shi- vering, frequent vomiting of mucus, and mu- cous evacuations. Anlimonium crudum, 9th, is used when we observe great weakness and extraordinary slowness of digestion. Ferrum and china are also employed with success, especially when the disease arises from the abuse of laxatives. Ipecacuanha, 3d, is especially efficacious in almost all cases of obstruction, and may be administered in repeated doses. Many patients suffering under affections of 48 the abdomen, experience pains in the stomach and liver, jaundice, abdominal obstructions, hemorrhoidal tumours, &c. These affections are of frequent occurrence, especially in per- sons from forty to fifty years of age, and of sedentary habits. In such cases, nux ad- ministered daily or every two days, is always found more useful than any other means; though, at times, the symptoms have required other remedies, such as calcar., bryon., sulph., lycopod., sepia, graphit., silic, carb. veget., phosph. * Case I.—One of the patients, who was always obliged to remain in a sitting posi- tion, was reduced by the affection almost to despair. The chief symptoms were obstruc- tion of the liver, jaundice, hemorrhoids, constipation, flatus, puffing of the abdomen, severe pains on the right side of the chest, continuing for several hours and extending to the middle of the thorax and to the hips, impeding and frequently preventing respira- tion, ceasing for some time and again com- mencing more powerfully than before, both by night and day. During the spasmodic attacks, the pulse was beating one hundred * Nux alternated with sulphur, will be found to be the best remedy in such cases. 49 and twenty times in a minute, the face be- came red and the head confused, terminating in oppressive head-ache. This condition had existed for four years, without any remedy affording relief. Aeon., nux, coloc., ars., carbo an. and veget., and phosph. performed a perfect cure in less than six weeks. Case II.—A young man, who had been hypochondriacal for some years, and had become weak and emaciated, complained of hemorrhoidal affections, frequent colic, con- stipation, wind, spasms of the abdomen and chest, with loss of sleep. He had become restless, timid, morose and often very irrita- ble. A few doses of nux, phosphorus and nux again, combined with anacardium, re- moved the principal symptoms; the evacua- tions became regular, the appetite and diges- tion improved, the spasms ceased, the sys- tem gained strength, physically as well as morally. Case III.—A female had been suffering for five years under almost daily darting pains on the right lower region of the abdo- men, which extended as far as the loins and back; there were hemorrhoids, frequent tenesmus, constipation, flatulence, swelling of the bowels, legs and feet, accompanied D 50 with pain, coldness of the hands and feet, character susceptible, morose and depressed. Three months exhibited a cure by the use of sulphur, nux, coloc, phosph., nux and phosph. again. CONSTIPATION. This is a very common disease. Its se- verity varies with the causes which produce it. Sometimes it is an accessory of other affections, or the consequence, as already observed, of some organic change in the in- testines. The most common constipations, which continue during several days without being accompanied with any other accident, have generally for their cause the too scanty se- cretion of the liquids necessary in digestion, or a particular weakness of the intestines. They attack chiefly women and old men, and are occasioned by a sedentary life, a dry kind of nourishment, advanced pregnancy, the abuse of remedies, or a predisposition resulting from previous constipations. Constipation is always accompanied more or less with other affections of the abdomen; the difficulty, however, of discovering them renders it necessary for the practitioner to 52 undertake a careful examination of the pa- tient. Frequently we find the patient suffer- ing also from a sensation of fulness or op- pression at the stomach and epigastric region after eating, and that for several hours; fre- quently also there exists a ravenous appetite followed by nausea, temporary heat in the face and a pressive pain in the head. In these cases, high dilutions are preferable to low, because they speedily remove the dis- ease without producing accessory symptoms. The treatment is regulated according to the causes of the affection. Opium, 6th, is very salutary in case of a simple constipation, which does not originate from an internal disposition or a malady of long duration, but from external circumstan- ces, particularly from those which have a de- bilitating influence upon the nervous system, and when that constipation, without being truly painful, presents the following symp- toms: desire to relieve the bowels, with sen- sation as if the intestines were obstructed, and there existed impossibility of evacuation, beating in the abdomen, pressure at the sto- mach, want of appetite, thirst, dryness of the mouth. Case.—For a patient, having a sallow com- plexion, loss of appetite, tendency to vomit, 53 flatulence, pressure at the stomach, constipa- tion, dry cough, was prescribed tincture of nux vomica, one drop night and morning, advising him to increase the dose one drop every day. An improvement was speedily manifest without any crisis. At the end of fifteen days, he had quite recovered; the cough left him in a short time. Constipation constitutes very frequently a separate disease, often produced by abuse of coffee. Out of many cases, one was very remark- able. During six days, no motion, giddiness, stupor, intoxicating heaviness in the head, especially in the morning, great heat and redness of the face, dryness of the mouth, acid and bitter taste, heart-burn, nausea, especially in the morning, loss of appetite, flatulence, pressure at the stomach, swelling of the stomach after eating, shooting pain in the abdomen, tenesmus, pain in the rectum and loins, oppressive constrictive pain in the chest, sleep disturbed at night, great lassitude and drowsiness in the morning, restlessness, great general depression. A few doses of pure tincture of nux vomica removed these symptoms entirely.* * A few drops of the tincture of lycopodium repeat- ed twice a day, will relieve such cases when nux has been ?iven in vain. d2 54 The following cases occurred lately in my own practice. Case I.—An elderly man had, for up- wards of twenty years, suffered from consti- pation, accompanied by severe head-aches, to such an extent that he was compelled every few days to absent himself from business, having fulness in the stomach after eating, tongue dry and loaded, &c. He could exist only by taking, every second day, a dose of some aperient medicine, which relieved his head for the day only; the pain returning as regularly as possible the following day. The stomach had become so weakened by repeat- ed purgatives, that it was unable to digest even the best food; and they had produced a distressing disease of the lower intestines. He complained likewise of dull pain in the region of the liver, which was much increas- ed upon pressure. Sulphur, in five weeks, enabled the bowels to act daily, and the head- ache entirely subsided. Case II.—An old naval officer, was placed in early life, on the West India stations, where he had yellow fever several times, and with difficulty escaped with life, leaving on one occasion only eight or ten on board his vessel. These attacks produced disease of 55 the liver, and consequently confirmed consti- pation, which had existed upwards of thirty years when I saw him. He informed me that, during that time, he had never obtained relief from the bowels without aperient medi- cines: taking them regularly every second day, they had become as necessary to his existence as food. Accompanying this state of stomach and bowels, were most distressing head-aches, and great depression of the ner- vous system. Though introduced to me, he did not expect anything like permanent re- lief. Nevertheless, after continuing for two months the medicines I prescribed, the bow- els became regular and acted daily; and, upon seeing him many months afterwards, he told me that, during that time, he had not taken or required one dose of aperient medi- cine. The remedies were nux, 30th, bryon. 30th, and verat. 12th, every second or third day in succession. Case III.—A gentleman had long suffered from an eruptive disease covering great part of the body. At the same time, he com- plained of dyspeptic symptoms, such as acid and bitter eructations, fulness of the stomach and bowels after eating, with pain in the region of the liver and consequent constipa- tion. [ prescribed verat. for the skin dis- 50 ease, to which it yielded. At the same time, the stomachic symptoms subsided, and the constipation gave way; so that, at the end of two months, although he had not taken pur- gative medicines of any kind, as previously in the habit of doing, at least weekly, he assured me his health was in a much better state than for many years before. Case IV.—A medical man, who had lived in the country where he was accustomed to horse exercise and active life, upon his set- tling in town, where he had now resided nearly twenty years, soon became affected with derangement of the digestive organs— such as nausea, giddiness, weight and pain in the head, loss of appetite, distension of the stomach after eating, with acid flatulence, loaded tongue, pain in the liver, general falling away, and palpitation of the heart, to such an extent that in bed the clothes were often lifted up. This continued for several years, when the bowels became obstinately constipated, requiring purgatives, tonics, alkalines and alteratives continually. He informed me that a week never passed with- out medicine—seldom a day without either soda or a purgative. All these means were discontinued; and, by the use of calcarea car- bonica, and subsequently carbo vegetabilis, 57 the dyspeptic symptoms subsided, and the constipation was removed. Upwards of three years have elapsed with no return of the complaint. Case V.—Colonel P. had resided many years in a warm climate, and during the greater part of that time, had laboured under irregularity and derangement of the bowels, which terminated in confirmed constipation. Having lived freely, he had two or three attacks of inflammation of the liver, which produced induration and evident enlarge- ment. He had frequent fits of vomiting, with acid and bitter eructations, weight and ful- ness of the stomach and bowels, particularly after eating, restless nights, head-ache, tongue loaded, dryness and thirst, kidneys much affected, and was altogether much emaciated. Bryonia, veratrum and opium were given in succession, when all the symptoms gradually yielded; and in from three to four months, the patient was convalescent. Constipation in Women.—In this case, exercise, especially in the open air, absti- nence from coffee and heating drinks, and the use of fruit are necessary and assist the action of nux, 8th, which is in most cases the requisite treatment. If this only improves 58 the condition without curing it entirely, we may administer ignat. 6th, gl. 2, after which nux, 10th, again. In some cases, bryony, 6th, gl. 2, opium, 2nd, gl. 2, and veratrum will answer. When the constipation is obstinate, it will be advisable to assist these remedies with lavements. If all these fail, we must then have recourse to plumb., alum., platin., sepia, and especially the two last. Bryony is still more important in cases of lying-in women, when constipation arises very frequently from inflammatory irritation of the abdominal organs, to which this remedy is strikingly adapted. We may in the same manner treat the constipation which usually occurs in the first days after delivery, if it do not speedily dis- appear of itself. Case.—A lady, the wife of a professional man, had suffered from constipation for up- wards of twenty years, and during the last four or five years, had been obliged to take aperient medicine daily. In such a way, indeed, had purgatives been administered, both as to quantity and quality, that they had produced ulceration of the lower intestines, discharging blood, pus and mucus, in quanti- ties that became alarming. She had long suffered from torpid, if not diseased, state of 59 liver, and great weakness both mental and bodily, &c. She was much reduced and fast hastening to the grave, when I was consult- ed. Six doses of nux and bryonia entirely removed the constipated state of bowels, and the general health rapidly improved. Occa- sional doses of nitric acid restored the ul- cerated bowels to health, and the discharge gradually ceased. Nearly five years have since passed with no return of the disease; and though not a single purgative has been since taken, the general health is better than at any previous period of life. Constipation in Children.—The first point necessary is to regulate the regimen of the child and the nurse. Care must also be taken that the child be not too much confined by its clothes. The constipation of new-born children has usually for its cause food which does not agree with their age, especially when they are not suckled, or when, besides the milk of their nurse, they receive more solid food. It may be prevented by adding to that milk, in cases when it is not sufficient, only very light substances, such as cow's milk mixed with water, pigeon or chicken soup, water gruel slightly boiled, &c. If the patient be in good health, a lave- 00 ment of warm, milk, water gruel, with or without castor oil, is frequently sufficient: should it fail, another lavement of honey water will be certain to produce the effect. If the mother is not accustomed to coffee, two or three spoonsful may be administered to the child. When these dietetic precautions are not sufficient, we must have recourse to internal remedies. For this purpose, nux, 10th, is appropriate, especially when the mother has been accustomed to coffee, in which case it is a specific. But it is also efficacious in other cases, for instance, when constipation is pro- duced by undigested food, or when the alvine excretions are so hard that the child cannot void them without great straining, pain and blood. Next to this stands opium, 2nd, which is indicated when the peristaltic movement of the intestinal canal is, so to speak, de- stroyed, when there exists no inclination to obtain relief, and the abdomen gradually swells. Advantage has sometimes been de- rived from a higher dilution than that just mentioned. Next to these two remedies, bryon. 10th, 1 and 2, veratr. 10th, 1, are most effective. The first operates in a manner very similar to nux vomica, and frequently succeeds when 01 the other has failed, and vice versa. With respect to veratrum it is most efficient in cases where the rectum appears deprived of all action. When the disease is very obstinate, tinc- ture of sulphur, or lycopodium, 10th, are very successful. Cole, carb., and zinc, are equally valuable: the latter is one of the best reme- dies in constipation in children. COLIC. Colic is a pain generally pinching, tearing, tensive, without any symptom of inflamma- tion, without fixity or continuity, rarely burning, which affects the interior of the ab- domen, especially the region of the umbilicus, tends almost always from above downwards, and has often for an accessory a swelling of the abdomen. The stomach being exempt from suffering, or that being only accidental, if that viscus contains no impurities, the patient scarcely ever vomits; and if that does occur, he ejects only the matters contained in the stomach, mixed with a little bile. There E G2 is sometimes accidental constipation, more frequently a little diarrhoea, rarely any fever. In children, after evacuation of urine, more considerable than ordinary, we often remark much agitation and impatience, con- tinual crying, sudden screams, contortions which disfigure the countenance during sleep, sleeplessness and cramps. They draw up the limbs, bend them, and are incapable of lactation. The treatment of colic is regulated princi- pally by the causes which have produced it. In children, it is usually caused by cold, or by worms: in adults by severe cold, by ex- cess in eating and drinking, but often also by a particular disposition to flatulence and to hemorrhoids. Chamomilla, 12th, or pulsatilla, 15th, cures colic produced by a cold, when it presents the following symptoms: violent, cutting, tearing pains in the bowels, causing agitation which allows the patient no rest, a sensation as if the abdomen were entirely empty, with continual commotion in the intestines, dark circles around the eyes, frequent collection of saliva in the mouth, violent and tearing pain below the navel, pains in the loins, nausea, inclination to vomit, diarrhoea, eva- cuations green, watery and mixed with mu- cus. G3 Nux vomica, 24th, for adults, 30th, for children, causes the prompt disappearance of a colic characterized as follows: constipation, sensation of a heavy weight in the abdomen, extraordinary heat, considerable tension of the part, with anxious, short and painful respiration, fulness of the abdomen and un- der the ribs, shooting, pinching, compressing pains, as if the intestines were pressed, vio- lent and confusing pain in the head, the ab- domen painful to the touch, loss of conscious- ness, the extremities cold at the moment when the affection is most violent. Windy colics, which have their seat in the lower part of the abdomen, yield to the same remedy in cases in which the air, seeking a passage, produces pressure, as if by a sharp or cutting instrument, towards the bladder and rectum, a pressure which is acutely felt at every step, but which repose, the sitting or the lying position cause quickly to disap- pear. Mercury, 10th, for adults, 12th, for chil- dren, and cina, are successfully employed against colics caused by worms, the symp- toms of which are great inclination to vomit, collection of saliva in the mouth, twisting in the bowels, with sensation of hardness around the umbilicus, convulsive twitchings in the muscles of the abdomen, frequent hiccough, Gl disgust for food, continual desire to relieve the bowels, the abdomen hard and swollen, tensive and burning pain, eructations, gene- ral weakness, diarrhoea, evacuation of mucus, with pains in the bowels, especially towards midnight. The symptoms of colic produced by excess of nourishment or by unhealthy food are: nausea, weight, with a feeling of extension and of painful tension in the abdomen, tear- ing, pinching, and cutting pain, increased by touch, white saliva foaming from the mouth, pains above the navel, diarrhoea, evacuations green, or of a citron colour, with violent pain in the stomach, countenance pale, dark cir- cles round the eyes, slight convulsions of the limbs, bending of the body, pressive and ten- sive head-ache. Half a cup of strong coffee would have the effect, in persons who do not make habitual use of that beverage, of evacua- ting the superabundant or unhealthy aliments contained in the stomach and intestines. When this means has produced the desired result, it should, after some hours, be follow- ed by pulsatilla, 18th. Pulsatilla, 12th, is the best remedy against hemorrhoidal colics, of which the usual symp- toms are the following:—beating at the pit of the stomach, a painful feeling of constriction as if it were too full, borborygmi in the abdo- 05 men, the escape of flatulence prevented, heat and swelling of the abdomen, general heat with swelling of the veins of the hands and forehead, insupportableness by the patient of all vestments, greater suffering when in bed, movement procuring some relief, pains in the loins, an almost entire incapability of dress- ing, pain in the abdomen as if a blow had been received, agitation, anxiety, sleepless- ness. Colocynth, 30th, is very efficacious against various kinds of colics, especially when they cannot be ascribed to a known cause. But it is more particularly indicated by pains in the abdomen, violent and continual, or ceasing only to re-appear with greater intensity, and leaving in the parts that have been affected a pain of tearing which produces at every step a sensation as if the intestines were freely suspended, which obliges the patient to walk very slowly and with extreme caution, the pain experienced in the umbilical region sensible chiefly at a point of small extent, recurring only at intervals of from five to ten minutes or even longer, commencing always by slight shootings from the ribs to the centre which gradually augment, becoming constric- tive, pressing, tearing, dragging, and reach such a degree of violence that the patient utters loud cries, the anxiety and pain allow- k2 66 ing him no rest, and compelling him to writhe with the agony. Colics with which some women are attack- ed at the commencement of the catamenia, usually disappear when it has occurred; but the affection may, in certain circumstances, continue and become very distressing. Nux vomica, 30th, is then often employed with success, especially when the disease is cha- racterized by a twisting in the abdomen, with some nausea, a poignant spasmodic pain in the pelvis chiefly about the ischium, which becomes remittent, pressive, or shoot- ing, with constriction in the region of the bladder. Coffee, 3d, causes the disappearance of the following symptoms: pains in the abdomen, violent and spasmodic, which affect even the chest, bending of the body with convulsions of the limbs, grinding of the teeth, general cold, crampoid stiffening, loss of respiration, sighing, fulness of the abdomen, with pres- sure. Pulsatilla, 18th, may be employed in the same circumstances when they are accompa- nied by violent and pressive pain of the ab- domen and loins, and by an evident shooting from the trunk to the thighs, which ceases when seated, and to which are joined a pain- 07 Jul pressure on the rectum, and pains in the back. Frequent colics may produce a disposition to be attacked by them from the slightest causes, and may even become the origin of organic changes.* HEMORRHOIDS. This disease, which is very common, has for its cause an impediment to the circulation in the vessels of the abdomen, and has al- most always for its precursor a long series of affections of the digestive organs. It attacks chiefly men of middle age and women after the suppression of the catamenia, and it is characterized by obstinate constipation, by congestions in the head and chest, vertigo, palpitation of the heart, pains in the back, tenesmus, itching in the peringeum and in the rectum, excrescences about the anus, colics, &c. It re-appears at fixed or indefinite pe- * In colica flatulenta, carl. veg. and lye. are mostly to be relied upon. 08 riods, and has commonly for its result a more or less considerable excretion of mucus or blood. During pregnancy, we generally find some disorder in the alvine secretions and hemor- rhoidal effusions. Two or three weeks after delivery, every motion is accompanied by lancinating pain in the rectum. In a short time, the evacuations occur every three or five days, the excretions being dry and hard. After long and inefficient efforts, no relief is obtained, or at most but of a small quantity of matter; the pain in the rectum reaches the greatest degree of suffering, with anxious perspiration of the face, and tendency to syn- cope; with the evacuation a discharge either of pure blood, or sanguinolent mucus; after which the heat and shooting pains in the rec- tum, remain for some time. The anus itself forms a round, hard, livid tumour. There are continual pains in the loins, extending towards the back, especially during move- ment. Hemorrhoids may be divided into two large classes, internal and external, and each of these classes maybe subdivided into fluent and dry. The patient ought above all things to ob- serve a severe regimen, to take much exer- cise in the open air, to keep the feet warm, 09 and to avoid coffee, wine, spirits, and mental excitement. In the first place, however, it will be well to point out the principal remedies most likely to be successful in the disease of which we treat. Most of the antipsoric remedies may be beneficially used, amongst which we recognise arsenicum, antimonium crudum, calcarea, graphites, mercurius, phosphorus, sulphur. These may be alternated with aconite, ar- nica, nux, pulsatilla, fyc. used as intercurrent medicines. Arsenic.—In cases of large, burning, ulcer- ated external hemorrhoids. Antimony.—In fluent hemorrhoids, with excretion of black blood, and burning and pricking sensation. Calcarea.—Expulsion of hemorrhoids dur- ing evacuation, spasmodic contractions of the rectum. Graphites.—Painful hemorrhoids secreting a mucous liquid. Mercurius.—Inflammation accompanied with tearing pain round the margin of the anus, evacuations acrid and bloody, excoriat- ing the extremity of the rectum. Phosphorus.—Itching hemorrhoidal tu- mours, with small ulcers allowing the dis- 70 charge of a great quantity of blood. Flow of mucus from the anus, which remains open. Sulphur.—Hemorrhoidal colics followed by discharge of blood, expulsion of hemor- rhoids, descent of the rectum. Aconitum.—Extensive hemorrhage from hemorrhoidal tumours; hemorrhoidal fever, violent inflammation of the tubercles, which are hard, bright and ready to burst. Arnica.—Hemorrhoidal tumours caused by external violence. Nux.—Constipation, pressure on the rec- tum, tenesmus before and after evacuations, discharge of blood-stained mucus: dry he- morrhoids, painful during evacuation. Pulsatilla.—Excretion of yellowish mucus, hemorrhoidal tumours, with smarting and soreness. I would here direct attention to the fact that, with the exception of arnica, apsoric medicines cannot alone cure hemorrhoids produced by external violence, such as long riding, or wearing bandages which exercise constant pressure on the part. In all other cases, we should have recourse to antipsorics, alternately with apsorics, according to the indications. When besides a disagreeable itching, he- morrhoidal excrescences occasion a continual and violent burning, accompanied by diar- 71 rhoeal evacuations, we employ with success capsicum annuum, 15th: arsenicum album, 30th, possesses the property of dispelling this burning in the rectum and the neighbouring parts.* Case 1.—A female, aged twenty-two, mo- ther of six children, of a venous-arterial con- stitution, had been for two years suffering from blind hemorrhoids, arising principally from a sedentary life, and the habitual use of very strong coffee. She one day found three tumours at the anus, as large as nuts, which produced great throbbing and burning pain, and prevented her sitting down. The pain extended half way up the rectum, accompa- nied with febrile symptoms, heaviness of the head, vertigo, loss of appetite and consti- pation. An allopathist prescribed twenty leeches, hip baths and emollient lavements. This treatment was continued for eighteen days, during which the patient had ninety leeches and thirty-six hip baths. Instead of the disease, however, being in any way alle- viated, the symptoms increased to an extraor- dinary degree, the patient suffering excessive pain, which no narcotic could relieve. The * The best remedies in herpetic hemorrhoids are cole. kali, and lycop. 72 medical attendants declared that no resource was left but to extirpate the tumours, which they asserted was necessary on account of the formation of cancerous ulcers. This was the advice of many eminent practitioners who were called in consultation. The friends, being alarmed, determined to try the homoe- opathic treatment. The following was her condition:— Local Affection.—The patient tossing about in bed, and complaining of burning, shooting and throbbing pains in the anus and its vi- cinity, which she described as similar to those that might be produced by a red-hot iron. Outside the anus and extending inwards were three tumours as large as nuts, inflamed, and having on their internal surfaces some excres- cences of a very painful nature that bled at the slightest touch. The whole internal sur- face of the anus was ulcerated, and secreted an ichorous liquid. Sympathetic Affections.—Weight and pres- sure at the occiput; loss of appetite, tongue dry, chapped and hot; violent thirst, consti- pation; ardor urinse, loss of sleep, skin dry and hot, and dread of death. Ars. 10th, 3, was prescribed, suspending all other remedies. This selection was determined by the shoot- 73 ing and burning pains, the ichorous discharge and the moral symptoms. After the powder had been taken half an hour, the patient slept undisturbed for three hours, when she no longer suffered the violent pains. A second dose of arsenic, 10th, 2, was pre- scribed. The following day the patient ex- perienced only a slight sensibility at the anus when seated. She had had a copious evacu- ation. The tumours had diminished during the night in size, redness and sensibility; the ichorous discharge from the anus had ceased, as well as the ardor urinae. The patient was now left three days with- out medicine, at the end of which time was administered, in consequence of the consti- pation and loss of appetite, nux, 10th, 3. From this time, there was a general improve- ment, and the patient was enabled to leave her bed. Sepia, nux vomica and sulphur had thus in a very short period entirely removed an affection that had been regarded as incu- rable. In suppression of hemorrhoidal flux, for several months; continual vertigo, occasion- ally so severe as to prostrate the patient to a state of insensibility, dull pain in the head, as if intoxicated; violent, pressive and stu- pifying head-ache; loss of memory, alvine F 74 evacuations, infrequent and hard. A few doses of calc. carb. 5th, effected a cure. Sulphur, 30th, effects the most perfect and the most durable cure, when the disease pre- sents the following symptoms: continual de- sire to obtain evacuation even after diarrhoeal or sanguinolent dejections, a darting pain of excoriation in the rectum and neighbouring parts, with itching, burning, and humidity of the excrescences, which cause a constricting fulness in the rectum, and often even the descent of that viscus, violent and darting pains in the loins, and tension as if the skin and the muscles were shortened. In hemorrhoids, especially termed blind, with constipation and shooting pains in the rectum, accompanied by various affections of a hemorrhoidal nature, or consequent on the suppression of sanguine congestions, or ha- bitual hemorrhages, congestion towards the head, continual pressive pain at the occiput, vertigo, flow of blood to the heart, great exci- tability of the whole vascular system, pulsa- tion throughout the body, with anxiety, oppression, disordered digestion and consti- pation, sulphur is successful. Case.—A man, aged thirty-two, of strong constitution and arterio-venous temperament, was attacked, (after riding for a very con- 75 siderable distance, and indulging much in heating liquors,) by blind hemorrhoids which at first only produced constipation, itching, and throbbing at the anus. His medical attendant prescribed cold hip baths, cold lavements and leeches. These dangerous applications diminished the heat, itching and throbbing, but had no effect on the hemor- rhoidal tumours or the constipation. The bite of a leech produced an abscess, followed by anal fistula, which was operated upon by an eminent surgeon. But the wound would not heal; the hemorrhoids protruded at every evacuation; and the patient's state was worse than before, he was in the following state: IjOcoI Affection.—The patient complained of heat, fulness and throbbing at the part. The hemorrhoidal tumours protruded at every evacuation, discharging and causing heat. The incision made by the operator six weeks before was not yet closed. Tumours as large as nuts were apparent externally when the patient sought evacuation, their internal surface was livid, and covered with excrescences. Sympathetic Affections.—Weight and ful- ness of the head, face red, covered with tu- mours, appetite good but soon satiated, fre- quent eructations, pressure and tension of the two hypochondria impeding inspiration, 70 scanty evacuations with copious expulsion of flatus, sleep restless, disturbed by dreams, depression, anger, discontent, peevishness, indifference towards his wife and children, of whom however, in health, he was remarkably fond, gloomy thoughts, propensity to commit suicide. Here there was clearly a well developed case of hypochondria resulting from hyperve- nosity of the abdomen. For this reason, in order to act effectually on the venous system, and render the organization accessible to treatment, sulph. 4th, gtt. 1, in a drachm of water was administered. Never is it more necessary to begin by rousing the suscepti- bility of the organization than in cases of exaltation of abdominal venosity, or what is called hypochondria. Every morning for eight days, the patient took one drop in a glass of water, without any evident effect, except that during the first four days, the wound occasioned by the operation was per- fectly healed. After eight days the moral state, the abundance of flatus, and the ten- sion of the hypochondria induced the pre- scription of conium, 10th, 3. Three hours afterwards, a considerable aggravation occur- red. The moral symptoms especially were carried to such an extent, that a cup of coffee was administered. This antidote had very 77 little effect, for the symptoms remained equally severe during two days. On the third day, however, there was an improve- ment; the tensive pressure of the hypochon- dria, and especially the moral condition were sensibly ameliorated. It became clear that the moral affection was closely connected in this patient with that of the abdomen; for, in proportion as the pains in the hypochondria reappeared, the disposition of the mind chang- ed also. He was left for eight days under the operation of conium, administering only a little milk and water each day, in order to satisfy his desire of taking something. The conclusion of this period was followed by constipation and loss of appetite, which led to the prescription of nux, 10th, 3; but the nux vomica had no effect, although it was the first dilution. Recourse was then had to fachesis, 10th, 2, which was more successful; although it did not agree perfectly with the moral state, it accorded well with the primi- tive affection, its action being remarkably powerful upon the function of the venous system, or rather of the nervous system that influences it. Three doses were then admi- nistered, one every third day; an exhibition peculiar to lachesis, which requires to be repeated till the development of a manifest action, which we must be especially careful f2 78 not to disturb, even when it appears alter the first dose. There is not in fact any medicine likely to do so much mischief as lachesis: it is one of the best polychrests we possess, but at the same time, one of the most dangerous when improperly applied, or repeated too frequently. In repeating a dose of lachesis, great attention must be paid to the moral condition, the sleep and the appetite: if all be right in this respect, we may repeat the dose with confidence, although fresh symp- toms have been exhibited. After these three doses of lachesis, nothing was administered for fifteen days, in order to leave sufficient time for their action to exhaust itself. It was then found that the symptoms for staphys. and natr. carb. were indicated, which was prescribed in dose 10th, 3. These remedies concluded the treatment, and the patient was perfectly cured after two months application of the homoeopathic system, without recurring to a course of mineral water which his medi- cal attendant had advised. Experience has proved that nux vomica, 24th, is peculiarly efficacious against this disease, especially when it is caused by the use of heating drinks, such as wine, spirits, strong beer and coffee, by the influence of sedentary habits and of prolonged study, by the hardness of the foecal matter, worms, 79 pregnancy, swelling of the abdominal viscera, organic injuries of the rectum and neighbour- ing parts. When it has for symptoms con- siderable excrescences which are the seat of burning and shooting pains, a sense of strang- ling in the rectum, narrowness of that vis- cus, joined to dull and darting pains felt by shocks in the loins and hip-bones; a pain as of cracking in the loins on the slightest move- ment, which causes the patient to cry out, and does not permit him to remain erect or to walk except in a bent position, a flow of pure and clear blood after alvine evacu- ations, or accompanied by desire of evacu- ation. Case.—Mr. S., aged thirty, of strong con- stitution and very corpulent, had for some years been afflicted with a hemorrhoidal af- fection, characterized by swelling and thick- ening of the hemorrhoidal veins accompanied with constipation and strangury. The use of leeches applied to the part almost every month afforded the patient a temporary relief, but the disease grew worse and each time it became necessary to apply the leeches at shorter intervals. He exhibited the follow- ing symptoms: vertigo, confusion of ideas, throbbing pains in the temples as if nails were being driven in, face pale and puffed, 80 contraction and slight convulsive movement of the eye-lids, singing in the ears, tongue whitish, the patient having a sensation as if it were contracted, thirst and desire for cooling drinks. In the morning, vomiting of slimy acid matter, mucus in the mouth. Six hours after dinner, rejection of food taken, either wholly or partially, with sensation of weight in the occiput, numbness of the right arm, especially of the third and fourth fingers, (these symptoms disappeared when every thing was thrown off' the stomach,) indiges- tion, acid eructations, flatulence, constipa- tion, continual desire to micturate, urine voided by drops with sensation of heat at the prostate gland, occasionally bloody, palpita- tions of the heart or cocliac arteries after repose; sensation of oppression at the chest, compelling the patient to take long inspira- tions, numbness in the shoulders, arms and legs, starting and nightmare at the com- mencement of sleep; lassitude, weakness, feeling of languor in the stomach, constant drowsiness, great want of prolonged sleep, yawning, sensation of cold, restlessness, ner- vous depression. Nux vomica, 30th, was prescribed, and a second dose three days afterwards, from which he received great benefit; afterwards sulphur, graphites, silicea, 30th, re-established 81 his health at the end of two months, and also removed the excessive obesity resulting un- doubtedly from a morbific cause. Case II.—A female, aged twenty-eight, of arterio-lymphatic temperament, in whom from the age of seventeen, menstruation had always been attended by violent abdominal spasms, and almost incessant vomiting of bile and mucus during the first days. These symptoms she attributed to a fall sometime previous. She was in the following state:— Local Affection.—The patient complained of violent burning and throbbing pains, with fulness, at the rectum, hemorrhoidal tumours appeared at each evacuation, no relief was obtained oftener than once in eight days, with much pain. Sympathetic Affections.—Pressive pain in the forehead and occiput, coryza, loss of ap- petite, clammy taste in the mouth, leucor- rhoea, a few days before and after the cata- menia, contusive pains in the limbs, excessive sensibility to external impressions, extreme excitability of the whole nervous system, ten- dency to anger and ill-humour, sleep broken by alarming dreams. All these symptoms indicated nux, which was administered (10th, 3.) The first dose speedily produced a good effect; the appetite 82 improved, sleep became tranquil, and the leucorrhoea soon disappeared. It may be said that these phenomena would have occur- red of their own accord simply under the influence of diet; but to meet this objection it must here be stated that the patient had frequently subjected herself to a much more severe regimen without obtaining any suc- cessful result. At the end of fifteen days as there were still remains of head-ache, and the hemorrhoidal tumour occasionally protruded, sepia, 10th, 3, was administered. Three weeks afterwards, in order to remove the pimples from the face, and destroy the predo- minant venosity, was prescribed sulph. 8th, 3, which produced the desired effect. In these cases a distinction is made be- tween local and sympathetic affections, and this method will save students a vast deal of trouble in the examination of the patient and the selection of the remedy. In combining the primitive affection with the moral state, and guided by the combined appearance of the symptoms, selecting the best homoeopa- thic remedy, it is almost impossible to go wrong. There are cases in which we find no organ or system specially affected, and con- sequently we cannot distinguish between the local and sympathetic affection, though both are in existence. In such a case, a beginner 83 should administer sulphur and belladonna, alternately at suitable intervals until the suf- ferings are relieved or the symptoms appear more marked, guided by which we can easily discover the proper remedy. Salphur may also be administered at intervals of two, four, six, or eight days, according to the suscepti- bility of the patient. The selection of dilu- tions may be regulated in the same way. A susceptible patient is often acted upon as strongly by a very small dose as another not easily affected will be by the strongest. Pe- culiarity of constitution can alone decide the point, and hence so many opinions upon this important subject. In this matter all de- pends upon the extent of the patient's suscep- tibility, and this is the reason why hypochon- driacs are frequently so long before they experience any effect. Case.—In the case of a young female, at the end of her sixth accouchement, after two attacks of intermittent fever, the inflamma- tion of the hemorrhoidal tumours extended between the ninth and the thirteenth day, gradually to the following extent: the orifice of the anus swollen in a round and thick bunch, divided by furrows into three unequal parts, one being the size of a small egg, the others of a nutmeg. The tumours were of a 84 bluish red, hard, hot, shining and extremely painful when touched. The patient suffered extreme pain in the part, as if it were exco- riated, accompanied by violent pricking and shooting pains. The latter occurred from time to time in paroxysms, and produced involuntary exclamations. The patient was unable to sit, turned herself with difficulty, and always with increased pain. Muriatic acid, 3d, gutta, 2, cured her in ten days. Case.—A lad aged thirteen, who was in other respects in good health, had for several years been suffering incessantly from hemor- rhoids, in the cure of which all allopathic treatment had been found ineffectual. The affection was manifested by the following symptoms: infrequent evacuations, extremely painful, every third or fourth day; several tumours appearing at each motion with con- siderable loss of blood, in addition, they bled frequently during the day. Nux v&mica and ignatia (several doses) produced regularity of evacuations, so that they occurred every day and completely free from pain. Nitric acid, 15th, administered at short intervals during several weeks successively, stopped the flow of blood, the tumours gradually appeared less frequently and finally ceased altogether. The same success has been ob- 85 tained by administering daily a tea-spoonful of ammon. carbonic. 10th, gl. 3, dissolved in six ounces of water. Before antipsorics were known, says Hart- mann, I always regarded bryony (4th, and 6th,) as an invaluable remedy in cases of he- morrhoidal tumours, and even at the present time, I by no means reject it, although nu- merous antipsorics are more efficacious in these affections. Its salutary influence is remarkably observable when the patient com- plains of burning pain in the lower part of the rectum, after evacuation, and when pain leaves him slowly. Its indication is still more certain when the patient suffers from fulness on the left side of the loins, and this fulness degenerates during movement into lancinating pressive pain, relieved only by rest, and announced by too great a flow of blood. A description of pain in the stomach, of frequent occurrence in persons suffering from hemorrhoids, after the apparition of tumours at the anus, may here be mentioned. It is also frequently met with in pregnant women, who during their pregnancy have been sub- ject to varicose veins of the legs, which after delivery, cause considerable pain, and are often accompanied by head-ache, diminished by rest and increased by motion. 80 Case.—A woman aged forty-eight, and the mother of several children, had been afflicted since her last accouchement with hemorrhoid- al tumours. These tumours bled several times in the year, with good effect. Suddenly however moral causes occurred to aggravate the affection which then presented the follow- ing condition. Itching and heat at the anus, shooting pains in the rectum; frequent tenesmus, sensation of fulness in the abdomen; six small tumours of different sizes, round and oval shape, of a bright red, extremely painful, inability to sit down, evacuations accompanied with much pain. Compresses steeped in decoction of camo- mile, were applied to the parts, and admi- nistered internally a small portion of the ca- momile extract. At the end of twenty-four hours, all the symptoms were diminished, and on the fourth day all trace of disease had vanished. S7 ENTERITIS, OR INFLAMMATION OF THE INTESTINAL CANAL. Aconite possesses virtues both powerful and prompt in salutary operation when em- ployed in inflammation of the intestines, bladder, lungs, &c. In enteritis the effica- ciousness and speedy operation of its curative effects, seem to be developed in direct pro- portion to the intensity of the inflammatory symptoms, the violence and extent of the fever, the power and acuteness of the pains, tensive darting or shooting, for the more intense the symptoms are, the delirium, and respiration short and difficult, the fewer ner- vous symptoms present themselves, aconite, 10th, becomes more energetic and indispen- sable. Case.—In the month of September, 1838, a young person aged fourteen, having taken cold after being much heated, had been seiz- ed with very severe enteritis. In spite of all the allopathic means which had been used, such as leeches, of which eighty-seven were applied during the first six days, fomenta- tions, emollient cataplasms, liniments with oil of henbane and tincture of opium, emol- 8W lient and slightly laxative lavements, bathing of the lower extremities, emulsions and calo- mel, finally joined with opium, the disease instead of decreasing, increased daily up to the seventh, at which time the patient was all but dead. Aconite, 8th, 3, was prescribed to be repeated every three hours during the night. The next morning, the eighth of the disease, the young patient was much better. For the first time since the commencement of the disease, she had slept for quarters and half hours at a time during the night; the constant vomiting accompanying the taking of food, had ceased; the pains in the lower part of the abdomen, which had been pre- viously incessant, had almost entirely depart- ed; the abdomen was but little sensitive to the touch, less swollen, and distended; the fever, previously incessant, was fast subsid- ing, and this complete change occurred with- out any crisis by perspiration. The patient again took a few doses of aconite during the day. The following morning she was per- fectly free from danger. This homoeopathic case astonished her friends not a little. Still I could not per- suade myself that it was attributable to the administering of aconite in such small doses. I rather thought it ought to be considered as a consequent effect of the antiphlogistic 89 treatment previously adopted, although this hypothesis was weakened by the absence of any crisis, and a crisis of some kind will generally occur in inflammatory diseases of this nature. The entire recovery of the patient was long: she was very weak, and was unable to walk without assistance before the expiration of three weeks. During the fourth week, she exposed herself carelessly to cold air, and that brought on the same disease again. In- cessant pains in the umbilical region, increas- ed by the slightest pressure, painful eructa- tions, frequent vomiting of a yellowish-green matter, constipation, pulse small, quick and hard, general heat, thirst, continued agitation and anxiety, sufficiently announced a case of enteritis. The parents of the patient re- quested that recourse should be had to ho- moeopathy: aconite, 8th, 3, was administered. A quarter of an hour had scarcely transpired before the patient fell into a quiet sleep that lasted more than three hours; upon awaken- ing she felt herself relieved; she no longer complained of any of the previous symptoms, but wished to leave her bed, which however she was not allowed to do till the following day. Affections of this kind when treated allo- pathically, continue generally from seven to g2 90 nine days before there is any vast improve- ment. I was therefore not a little astonished at so prompt a cure by a single dose of aconite, without any exhibition internal or external of allopathic remedies. A careful perusal of the annexed case will convince the reader that, in certain cases, nigella sativa, has an incontestible advantage over aconite. A female aged twenty-seven years, the mother of three children, who had enjoyed uninterrupted good health with the exception of measles and scarlet fever when young, was attacked with violent enteritis, which during four days baffled copious bleedings, and the usual remedies. The state of the patient was as follows: violent febrile action at night, head confused, diminution of sensibility, ten- dency to ill-humour, indifference, great anx- iety alternately with a sensation of heat and tension, inability to preserve an upright posi- tion, trembling, disordered vision, difficulty in moving the eyes, sensation of paralysis in the eye-lids, violent buzzing in the ears, dryness of the nose, with sensation of cold, sinking of the features, face of a red colour, lips pale and trembling, tongue red, dry and furred, with difficulty of moving it, speech muttering and unintelligible, as in cases of paralysis, rancid taste in the mouth, no se- 91 action of saliva, loss of appetite, sensation of fulness, without any desire to vomit, pressure at the stomach with tensive pain, palpitation in the region of the stomach, contraction of the abdomen, pressure at the anus, respira- tion slow, deep and noisy, gaping, moaning, deep and pressive pain in the chest, occa- sional cough, palpitations of the heart, swell- ing of the abdomen, tension and extreme sensibility of the part when touched, and violent darting pains when leant upon, swell- ing in a direction toward the inguinal region, shooting with pricking pains, on the slightest touch, decrease of urinary secretion, occa- sionally accompanied with heat, borborygmi in the hypogastrium, ulcerative pains, immo- bility of the legs, sensation of curvature in the loins, occasionally violent burning heat followed by cold, great agitation, loss of sleep, frequent sighing, moaning, indolence, with great irritability of the nervous system. The symptoms of enteritis were clearly developed, and the disease was so advanced that slight hopes remained of cure. Less re- liance was to be placed on aconite, than upon those remedies adopted to oppose nervous symptoms. Neither nux vomica nor bryony appearing suitable, nigella, 6th, gl. 1, was administered. At first, it did not appear to produce any favourable effect; at the end of 92 one hour, all the symptoms were increased: delirium, with extreme heat at the back part of the head, continual jactitation, cries, respi- ration short and quick, unquenchable thirst with burning heat, violent pains in the abdo- men towards the loins, sharp cutting gnawing pains in the intestines, involuntary move- ments in bed, requiring the patient to be held down. At the end of two hours, these affections diminished, the head was relieved, accompanied by repose, tranquillity and gene- ral improvement. Towards evening, increase of symptoms, but in a slight degree and for a shorter period, soon succeeded by drowsiness and tolerably quiet sleep, disturbed only by agitating dreams, involuntary startings and inarticulate words. The patient passed a quiet night. The following morning, with the exception of shooting and tensive pains in the abdomen, and excessive weakness, the patient was tolerably well, and complained only of dull pressive head-ache in the fore- head, with rather sharp pains in the occiput, thirst, and dislike to food. A second globule was administered, which produced a very short aggravation of the symptoms, especially of the head-ache, whilst the tensive and dart- ing pain in the abdomen was succeeded by shooting pains. The febrile exacerbation of the evening was also less violent; nux, 10th, 93 gl. 1, was administered. The next morning, the patient said she had slept well and sound- ly, and that she felt tolerably strong; all the pains in the head had departed, when she felt only a sensation of vacuity; there was no sensation of heat or cold, respiration free, ordinary tone of voice, very slight thirst, tongue moist, a little white at the edges, but no redness, natural taste, desire for food, sensation of emptiness in the stomach, occa- sional eructations without pain, plentiful evacuations, hard and of a dark colour, de- parture of pains and swelling of the abdomen, only in sitting up in bed shooting pains with tension in the coecal region. On the sixth day, the patient was free from any irregu- larity excepting ordinarily, in the evening, a shooting and pressive head-ache at the back part of the head. Strength however soon returned under the influence of a generous diet, the appetite was restored, the patient had two evacuations daily, and slept well during the night. From this time, the cure was complete.* * Enteritis has been successfully treated where there has been violent cutting pain in the umbilical region, painfully distended abdomen, hard, corded pulse, hot, dry skin, thirst and hurried respiration, with aeon, and bell.—where the above symptoms were accompanied with constipation and stercoraceous 91 DIARRHCEA. This is a prompt and repeated evacuation of humours secreted in a defective manner, and in too great,abundance, with or without a mixture of foecal matter. It is often only a slight indisposition, without danger; but ft may also be accompanied by pains and fever, may degenerate into another malady, and may have very serious consequences if it is not suitably treated. Its most common cause is cold or intemperance in eating or drinking. Its accessory symptoms are the partial or total loss of appetite, cardialgia, swelling and tension of the abdomen, borborygmi, dryness and coldness of the skin, thirst, scanty secretion of the kidneys, depression, irregu- larity and intermittent arterial pulsations, cutting and tearing pain, frequently in one part, sometimes in another, with an inclina- tion to vomit, which disappears to return again at the end of a few minutes. Long and violent diarrhoeas cause burning in the rec- vomiting, aeon, and opium have been successful,— where the stomach is irritable, attended with nausea and vomiting, aeon., ant. crud., ant. tart, and coloc, generally produce relief. 95 turn, tenesmus, great weaknes, alterations in the features and even faintings. Dulcamara, 24th, is an infallible remedy against aqueous diarrhoeas which arise from cold, and are not accompanied either with pains in the abdomen or any other accessory indisposition. To diarrhoea arising from cold must be op- posed china, 12th, when the evacuations are of an acrid and clear liquid, without mixture of foecal matter, are preceded by violent colics, by spasmodic and pressive pains in the intestines, eructations, borborygmi, and by a sensation of weakness in the abdomen. Case.—A man aged eighty one, in full possession of his intellectual faculties, though of a delicate constitution, generally healthy and of regular habits, was seized in the au- tumn of 1836, without any perceptible cause, with a serious disease; after a few days, during which the disease had continued to increase, I was called in to prescribe. For the last two days, and especially at night, a very copious diarrhoea, watery and mucous; the patient voided what little food he took undigested; he had frequent vo- mitings of mucus, water and aliments, with sour and bitter taste; however small the quantity of liquids or solids, he instantly 90 experienced painful pressure in the abdomen, and especially at the region of the stomach, with oppression at the chest, followed bv eructations which gave some relief. No ap- petite, constant feeling of fulness, and an insurmountable antipathy to what he was previously most fond of. Sleep broken, ex- haustion amounting almost to syncope, pulse quick and rather hard; anxiety, restlessness and agitation. Nothing was so well suited to this indi- vidual case of disease as bark. Everv thing indicated it, his physical as well as his moral condition. Bark in solution was consequently administered, at ten in the morning. The next day, the patient's condition was altered considerably for the better. No diar- rhoea, nor vomiting; the patient had enjoyed a good night's rest; his appetite was somewhat better; he speedily recovered his usual tone of body and mind; and in a few days he was restored to as perfect health as was compati- ble with his age. A lady, advanced in years, had been for some weeks suffering severely from continu- ed diarrhoea. She had taken all possible domestic medicines, and even applied to several allopathic physicians. She was then very pale, thin and weak. She could eat but little, and almost instantly voided the food 97 undigested; thirst extreme. Six doses of china, 11th, one every three hours, having produced no effect, one drop of tinct. ralan- hix, was administered night and morning. At the end of four days, the complaint had subsided; but the remedy was continued, since which time she has had no relapse. If the cold is caused by night air, and pro- duces a pinching at the pit of the stomach, borborygmi, a feeling of relaxation as if eva- cuation were about to take place, a cutting and tearing pain with pressure in the abdo- men, which is cold, nausea, shivering, sudden and frequent desire to evacuate, at first without result, and afterwards with excre- tions, frequent, aqueous and green, with dis- position to fainting, it is desirable to admi- nister mercury, 12th. If diarrhoea arises from errors of regimen, and manifests itself by loss of appetite, with sensation of dryness, &c, of slight burning of the tongue without thirst, a bitter and saltish taste in the mouth, eructations foetid, hic- cough, nausea, and vomiting, fulness of the abdomen, colic, much flatulence, commotion of the intestines, urgent desire to relieve the bowels, inquietude, with frequent evacu- ations, pulsatilla, 12th, is the best remedy. Chamomilla, 12th, is employed successfully against diarrhoeas which arise from anger, h 98 accompanied by bitter taste in the mouth, eructations, a sensation of fulness at the pit of the stomach, pressive pain in the head, general weakness, frequent evacuations of green, aqueous, acrid and foetid matter. Pains in the abdomen violent, tearing, which leave no rest to the patient, and oblige him to twist himself, a sensation as if the ab- domen were entirely empty, with continual movement of the intestines, blue circles round the eyes, nausea, vomiting, evacuations watery, mucous and foetid, are symptoms requiring the employment of chamomilla, 12th. Those which result from fear, anxiety, and generally from strong emotions, yield readily to opium, 6th. Case.—A man aged forty, previously in the enjoyment of good health, was seized suddenly during the night with violent colic and continued diarrhoea; next dav, things remained in the same state; and in the even- ing I was sent for. I found the patient in bed, very weak, his breath affected when speaking, and he complained of alternations of cold and heat. Evacuations occurred very frequently, preceded by pains in the abdo- men; they were discharged with violence and were altogether aqueous; at the same time 99 there was much flatus in the abdomen, with nausea and excessive thirst. Had cholera existed in the vicinity, the patient might have been thought to be slightly affected with it. From the general appearance of his face, it was evident that the abdominal nervous sys- tem was considerably affected. Half a grain of arsenic was pounded with two scruples of sugar, and divided into fifteen powders, one to be taken every hour as long as the exhaust- ing diarrhoea continued. At the same time a slight emulsion of almonds was prescribed as a beverage in very small draughts. From the moment he took the arsenic, he had only six diarrhecal evacuations. He fell asleep, but not into a sound sleep before midnight, and had no evacuation during the night. In the morning, he had slept well, and, though verv weak, felt more easy; the skin was moist, and thirst less violent. The same remedy was continued, but more slowly, recommending him to discontinue it if the diarrlvra did not return; and he continued to improve. With the exception of the weak- ness and anorexia, the patient recovered ra- pidly. A few doses of the sixth of a grain of nux vomica cured him completely. Diarrhoea in Women.—As this complaint frequently arises from cold, it is advisable to keep the stomach warm, in order to aid the 100 action of dulcam. 8th, which is a specific in such cases. If the diarrhoea arises from the stomach being overcharged, or from fat food, prescribe pulsat. 6th, and sometimes anti- mon. cr. 10th, gl. 1. If it be accompanied by pains in the stomach, and the excretions be watery, it will be necessary to recur to chamomilla, 4th, gl. 2. When there is tenesmus and frequent evacuations, small in quantity, mucous and bloody, it may almost always be removed by mere. sol. 4th, some- times also by sulph. 10th, which is remarka- bly useful in obstinate and habitual diarrhoeas. In certain cases phosph. and petrol, deserve preference. If the complexion be very yel- low and sallow, lycop. 10th, may be success- fully used. The following case proves the necessity of carefully observing the characteristic symp- toms of a disease before the application of the remedy. My own wife, says a homoeopathic practitioner, who was very subject to diar- rhoea arising from cold, complained in the morning of violent griping pains, tendency to vomiting and looseness. As I had frequently cured her in similar cases with dulcamara, I did not hesitate to administer it; but finding no improvement in her condition in the space of an hour, I administered veratrum album without any more beneficial effect. Another 101 hour elapsed, when by careful observation 1 found that the diarrhoea was accompanied by tenesmus. I then gave her mere, solub. Five minutes afterwards she fell asleep, and awoke in half an hour free from all pain and diarrhoea. The sleep convinced me that I had selected the proper remedy, as it is always consequent upon the administration of good specifics. Whenever the patient falls into a sleep or even a state of dozing immediately after tak- ing the remedy prescribed, we may safely prognosticate a cure; it does not however fol- low that sleep must necessarily precede the removal of disease. In dysenteric diarrhoea, sharp, shooting and griping pains in the abdomen; violent pain in the back and loins; pressure at the stomach after eating; eight or ten evacuations daily; ejection of a small quantity of white mucus, followed by tenesmus; constant but ineffectual attempts to evacuate; alternations of cold and heat; the former especially; thirst, &c; was removed by belladonna. The patient, a female, at other times quiet and good-tempered, was very irritable and con- tinually crying. In chronic diarrhoea with eruption of itch- ing pimples on the body, and leucorrhoea, emetic tart, was successful. h2 102 Diarrhccain Children.—An infant, thirteen weeks old, had been crying incessantly for days, suffering from green diarrhoea, some- times mucous, and at others watery. The family attendant administered an infusion of camomile and opium in fennel water from time to time, because the child refused all food and even fluids. For the last two or three days, he dosed with the eyes half open; the veins of the head were full of blood; at times he awoke starting from his sleep, cried violently and exhibited extreme restlessness. The medical attendant finding him very weak, began to doubt if he would live through the night. After a few doses of coff. 3d, 1, belladonna, 10th, 2, and one of nux vomica, 10th, 1, employed as an antidote to the opium, matters returned in three days to their primitive state. The diarrhoea, rest- lessness, and griping were speedily remov- ed by a single dose of senna, 2nd, 3. The child recovered its health ten days after- wards. Ipecacuanha is useful in serous diarrhoea in children, accompanied by vomiting of a green or white mucus, with griping pains in the ab- domen. In those acute diarrhoeas in children de- scribed as relaxation of the stomach and the intestinal canal, the diarrhoea is established 103 without any perceptible cause. Evacuations copious and more or less frequent, according to the intensity of the disease, consisting of aqueous mucous matter, sometimes greenish, and at others greyish, of foetid smell. At the same time, slight fever, heat in the palms of the hands and soles of the feet, incessant thirst, loss of appetite, rapid wasting of the bodv, constant agitation, moaning and weep- ing, paleness and dryness of the skin without turgescence, abdomen very sensitive, puffed, clastic, occasional vomiting, urine small in quantity and colourless, sleep comatose or light, eyes half closed. The patient remains in this state from three to five days. A few doses of calc. acet. gl. 1, suppressed the incessant and copious evacuations, and the child, which was previously almost a skeleton, soon became florid and ruddy. In another case, in addition to chalk, mere. sol. was administered with good effect. In the most acute form of this disease, especially when attended by violent pains in the abdomen, colocynthis is undoubtedly the first and best remedy. In children towards the fourth month, those green diarrhoeas, attributed to acidity in the primse vise, or to dentition, are often observed. The disease appears to depend upon some particular anomaly of the biliary 101 secretion, the causes of which are unknown. The evacuations are more or less frequent, of a vegetable green, sometimes watery, at other times and more generally mucous, frothy, like the white of an egg, and occasionally mixed with sanguinolent mucus. The chil- dren cry very frequently, from griping pains, abdomen swollen, with loss of substance. In such cases, mercury has been found an inva- luable specific. Sometimes diarrhoeas occur in children of more advanced age, that suc- cessfully resist various modes of treatment for a long time. Suddenly aphthae appear, and in a few days mercury removes both the diarrhoea and the sores. Generally speaking, diarrhoea in children depends upon a sub- inflammatory state of the mucous intestinal membrane.* Ferrum carbonicum is useful in diarrhoea, especially in children. When the disease has existed for some time, after eating or drinking there are speedy aqueous evacu- ations without pain or effort, containing al- most always a certain quantity of undigested food, accompanied with paleness of the face, loss of substance, hardness and swelling of the abdomen, without flatulence, sometimes * In diarrhoea of children, with a very bad smell, rheum has been found particularly useful. 105 voracious appetite, and at others total loss, thirst, &c. In chronic dysenteric diarrhoea in children accompanied with violent griping pains, great thirst, loss of substance and slow fever, arsen. alb. is very efficient. In cases of neglected diarrhoea in children during their first dentition, when they void a brown liquid five or six times every day, become extremely thin and yellow, and there is loss of appetite, with enlargement of the abdomen, ars. 10th, gl. 1. is frequently suc- cessful. In one case, a single dose was suffi- cient; in other cases, the 'dose was repeated every three days; but in no case more than four times. Dulcamara is useful in diarrhoeas with which children are attacked during dentition, and to which are often joined fever and loss of appetite. DYSENTERY. Mercury is the principal remedy in this disease, and has been found extremely effica- cious in two epidemics. The disease was 10G mostly simple dysentery, commencing with shivering and cold, with alternations of heat, with pain in the abdomen and watery evacu- ations as in ordinary diarrhoea: but very soon the fever increased with cold, heat, thirst, head-ache, and general depression, and the evacuations assumed a dysenteric character. In the midst of extreme pains, occurring at very short intervals, with violent tenesmus, pain and burning heat, there were evacu- ations of small quantities of blood and mucus. The tongue was more or less furred and dry, with loss of appetite and pains in the limbs. In many cases, especially in children, the discharges were accompanied with masses of dark green mucus, which occurred more or less frequently every quarter of an hour, with tenesmus. Many patients required only one dose of mercury pidv. 3d, gl. 1. Others re- quired several doses. The wonderfully prompt operation of sub- limate in autumnal dysentery in adults, has frequently been witnessed. A few doses of the sixth dilution were sufficient to stop the most violent attacks. In colics and diar- rhoeas, the proper homoeopathic remedies such as colocynth, aloes, and rheum, have been no less successful. A man was suffering severely as follows:— The affection commenced with cold and heat, 107 anxiety, diarrhoea, spasms in the abdomen, violent pain in the loins, tenesmus, and void- ing of a small quantity of blood. The reme- dies applied, antiphlogistics, did not diminish the disease; on the contrary, the anxiety, tenesmus and thirst increased; every ten mi- nutes the patient vomited sanguineous mucus mixed with blood. On the third day, he took sublimate, 16th, which in a few days entirely removed the symptoms. In dysentery in a child eighteen months old, who had previously suffered from humid tetter, the dysentery had baffled allopathic treatment. The child, which was previously strong and healthy, grew pale and thin at the end of three weeks, and ejected sanguineous mucus without particular suffering several times a day. A few doses of baryta effected its speedy removal. A female, aged twenty-three, of phlegmatic temperament, was seized, in consequence of eating unripe fruit and other errors in regi- men, with discharge of blood, to which she at first paid no attention. The skin was dry; there were sharp, shooting pains in the abdo- men; thirst, bitter taste in the mouth, tenes- mus, bilious evacuations streaked with blood. A very small dose of tartar, emetic, removed it in three or four days. In the beginning of July, an epidemic 108 dysentery broke out, consisting of three pe- riods. First Stage.—Attack: some were seized with giddiness, scarcely able to stand, heavi- ness of the head, griping pains in the abdo- men; others with colic, nausea, pricking in various parts of the stomach. A patient complained of compression of the brain, and violent head-ache, especially about the fore- head, shooting pains and fulness of the orbits, especially when he held down his head.— Progress: after twelve or even twenty-four hours, painful tenesmus, useless attempts, or evacuation very small in quantity, of a frothy mucous matter, mixed at times with blood, during which the patient suffered severely from a feeling as if the intestines were com- pressed. Colic and pain in the abdomen, bending the patient almost double. Frothy evacuations of a yellowish colour, similar to saffron. Desire to evacuate every five or ten minutes, accompanied by painful tenes- mus, pulse small and depressed, face sunk, weakness and trembling of the limbs, with anxiety. Second Stage.—Two or three days after the commencement of the disease, all the symptoms that affected the head and abdo- men grew worse, accompanied by a sensation of burning and pricking at the stomach, 109 with vomiting, especially during evacuations. These were blackish and foetid; a few mo- ments afterwards, violent eructations, inces- sant hiccough, painful spasms and cramp of the abdomen, inclination to evacuate, some- times ineffectual, at others followed by a dis- charge of mucous matter, and blood, frequent discharge of soft, puriform substances tinged with blood, described by the patient as if he had voided a mass of substances, attended with insupportable pain. Tongue dry and rough, thirst, desire for iced water, painful lassitude, general spasm, cramp in the calves of the legs, trembling and weakness amount- ing to paralysis of the legs, cold shivering of the back, sensible coldness of the hands and feet, and soon after, heat of the forehead and head; fever accompanied by dryness of the skin, depression and suffering as in approach- ing death. Loss of strength, the eyes sunken and surrounded by livid circles. Great fall- ing away, and occasionally death. Third Period.—Evacuations of blackish, aqueous matter, eighty to one hundred daily; loss of substance and emaciation, general coldness and colliquative sweats, delirium, insatiable thirst, strong desire for ice, burn- ing heat of the mouth and stomach (pyrosis), tongue dry, chapped and blackish, teeth black, breath cadaverous, face hippocratic, constant 110 groaning, violent suspirations and hiccoughs. Afterwards tranquillity, cessation of several symptoms, apparent improvement in the con- dition of the patient; death. The remedies deemed advisable in accord- ance with the homoeopathic treatment were, in the first period, camomile of the tenth dilution, colocynth. and corrosive sublimate of the thirteenth. Camomile taken in the form of globules (one or two every half hour) always exercised a salutary but temporary influence during the first period of the dis- ease; for which reason the patient was never left solely to its effects, but there were admi- nistered eight or twelve hours afterwards, two globules of colocynth, and the patient was left for twenty-four hours to its action. At the end of this time, there was a sensible improvement, and health was re-established at the end of a few days. In a case where two globules of colocynth were given imme- diately on the commencement of the disease, a complete cure was performed in twenty- four hours. In an epidemic, corrosive sub- limate was administered, but it was discon- tinued, no proof of its action having been witnessed. In the second stage, colocynth was found again efficacious; beneficial effects were also experienced from rhus toxicodendron and sul- Ill phuric acid. Rhus of the thirteenth dilution produced successful results, especially when the disease began, from improper allopathic treatment, to degenerate into typhus fever. In the last stage arsenic of the thirteenth dilution appeared to be effective. Case I.—A labouring man aged twenty, of a strong constitution, had been for two days suffering under heaviness of the head, and acute pain in the forehead. On the morning of July 30, he was seized with violent colic, and griping in the abdomen. His efforts were incessant, but ineffectual, to relieve the bowels, with tenesmus. In the evening, the following was the pathological state: vertigo similar to that produced by drinking, painful heaviness of the head, as if pressed in a vice, sudden shooting pains in the eyes, flatulence, violent colic as if the intestines were being cut, forcing the patient into a bending posi- tion, useless efforts and tenesmus, evacu- ations of frothy matter mixed with blood and mucus, weakness of the legs, pulse slow and small, excessive thirst, paleness of the face, slight shivering, sensation of cold. Camomile of the tenth dilution repeated every three hours; colocynth, the following morning. Finding that after six hours, the morbid phe- nomena were relieved, fresh doses were ab- 112 stained from. The following day, the patient was quite recovered and able to attend to his work. Case II.—A man aged twenty-five, was seized on the 23d of July, with vertigo and head-ache, accompanied with griping pains and copious evacuations. On the fifth day of the disease were observed the following phe- nomena: Suborbital cephalalgia, as if the head would split, acute pains in various parts of the abdomen, flatulence, tenesmus, nausea during evacuation, discharge of whitish frothy mucus every half hour, mixed with streaks of blood, and accompanied by violent pains in the abdomen and sacrum, the patient feeling as if voiding his intestines. General weak- ness of all the limbs, sensation of paralysis, depression, eyes and face sunk, pulse small and slow. After employing colocynth, repeat- ed during the first two days, with rhus and sulphuric acid, the patient recovered on the eighth day. One of his sisters, his eldest brother, and two of his daughters were similarly attacked with dysentery, accompanied by fever. The two daughters were also suffering from worms: nevertheless these four persons were cured by the use of aconite, camomile, rhus 113 and sulphuric acid: the case, however, of the elder brother exhibited an instance of the danger of bleeding and leeches in this epi- demic. Case III.—A little girl aged eight years, of weak constitution, was seized with dysen- tery and exhibited the following symptoms. Pain over the right eye-lid, violent colic in the epigastrium, evacuations with pain in the abdomen, sometimes of mucous blood-stained matter with ascaridcs, at others of bright clear blood These evacuations were attend- ed with intolerable pain, thirst, general cold- ness, paleness, loss of substance, fever in the afternoon, ceasing towards evening. Subli- mate was administered, and two days after, colocynth: no improvement; on the contrary, the patient was worse. Rhus was prescribed, and a cure was effected in the fourth day of the treatment, after three doses, being the fifteenth from the commencement of the attack. Case IV.—A young girl, aged sixteen, of rather strong constitution, was first seized with dysentery. On the fourteenth day of the disease, after she had gone through all the stages, it appeared to have degenerated into hectic fever. The following were the i2 114 phenomena observed. Dysenteric evacu- ations, constant ejection of liquid matter and food, thirst excessive, tongue dry. Dull pain in the loins, hiccough, cough, accompanied with expulsion of bronchial mucus, remittent fever, pulse frequent and weak, slight shiver- ing at night, foetid, clammy perspiration in the morning; during the remainder of the day skin dry and rough. Sensation of internal heat, extreme thinness or rather emaciation. Pulsatilla repeated during three days. The sixth day arsenic and nitric acid alternately every six days. I had the satisfaction of finding that the young patient recovered com- pletely in eighteen days. SPORADIC CHOLERA. A female was suffering under this disease: continual vomiting, first of aliments, after- wards of a greenish liquid, with frequent diarrhoea, more and more liquid and colour- less, violent cutting and shooting pains in the abdomen, cramp in the legs, suppression of the urinary secretion, rapid decrease of 115 strength. Colocynth, 6th, gt. 1, repeated every two or three hours, effected its speedy removal. Veratrum also is successful in sporadic cholera. A child six months old, of weak constitu- tion, had been for three days suffering from vomiting and diarrhoea, and was extremely weakened. Six doses of veratrum album, 12th, were administered, one every two or three hours. Still no improvement in his condition. His body was cold as ice, and thirst insatiable. The case was critical. Cupr. metallic, 30th, was prescribed, and a tea-spoonful was administered every ten or fifteen minutes, till these symptoms disap- peared. The child was saved, and in a few days completely recovered. ASIATIC CHOLERA. It will not be amiss, if I put before the eyes of my readers, the advice given by Hahnemann, for the treatment of cholera. It is sufficiently simple, concise and easy of ap- plication, to be readily understood by every 116 person. These instructions were given ex- actly as follows.—First, therefore, 1 refer to the precautions the medical man should take for his own safety. Directly epidemic cholera breaks out, eve- ry medical man should procure the following solution. Put an ounce of camphor in twelve ounces of pure spirits of wine, and shake it till it is completely dissolved. Before enter- ing the patient's room, take two drops of this solution as a preservative, and repeat the same precaution on entering every patient's room to prevent infection from the mephitic air confined there. Before entering the room, it will be well to wait a few seconds in the ante-chamber, a precaution rendered necessary by the fatigue the medical man suffers from his numerous avocations. If he visit his patient in a state of perspiration, he is much more likely to receive the contagion. Great attention also must be paid to diet, that is to say, he should never suffer either hunger or thirst, and never overload the sto- mach with food or liquid; with respect to the choice of food he should take only that which possesses undoubted nutritive qualities, with- out any exciting properties. But in this he must, like his patient, be guided by circum- stances, as it would not be discreet to discon- tinue, whilst the epidemic is raging, the use 117 of wine, tea, coffee, or any other heating arti- cle which he had been daily in the habit of using. It may be as well to add that the medical man should be fully imbued with the importance of his functions at these difficult times, banish all fear from his mind, be pre- pared by reflection for all occurrences, and possess great presence of mind. Directly a patient is seized with cholera, administer one or two drops of the solution of camphor before mentioned, on sugar or in pure water. Repeat the dose every five mi- nutes, whatever the intensity of the disease, the camphor should in all cases be adminis- tered during the first hour after the com- mencement of the attack. As long as the patient feels any benefit from the use of the camphor it should be continued, and if the disease yields to this application no other will be necessary. When this, however, is not the case, we must be guided in our treat- ment by what the symptoms require. If there is vomiting, or only tendency that way, or if the vomitings are accompanied by ex- cruciating pain, agitation and icy coldness, the patient should take one or two globules of arsenic. If this produces a good effect without complete cure, the dose should be renewed every two or three hours, according to the strength of the patient. 118 If the symptoms enumerated above are ac- companied by cramps, recourse must be had, not to arsenic, but to cuprum, of which two globules may be administered, and the dose repeated every two hours if necessary. The cholera, however, may assume another form, its characteristic symptom being fre- quently violent diarrhoea. In this case vera- trum album must be given, and in this stage of the disease, ice may be beneficially used. Hahnemann expressly says allow the pa- tient as much as he chooses. Sometimes a period occurs when the pa- tient falls into asphyxia. We must be care- ful, however, not to treat him as if dead, though he may appear to be so, much less consign him to the undertaker. We must administer a few drops of carbo vegetabilis in water, and at the same time rub the whole of the body with ice. But if the patient, when actually in as- phyxia, has not been previously treated ho- moeopathically, the whole external surface of the body must be rubbed with camphor, and a few drops in a glass of water be poured into his mouth, even if he is unable to swal- low. Persons not suffering under acute cholera, and who, though not confined to their beds, are affected with cholerine, and experience 119 alternately weakness, palpitation, anxiety, cramp in the calves of the legs, cold, uneasi- ness, sickness, diarrhoea, should take every day, or oftener if need be, one or two globules of phosphorus to preserve them from infec- tion. Persons who are quite free both from cholera and cholerine, will do well to submit to preservative treatment, for which purpose they should take every eight days a globule of veratrum album, if diarrhoea be the chief characteristic of the disease, and a globule of cuprum, if the general symptoms are vomit- ing and cramp. CHOLERINE. During the second invasion of the cholera at Berlin, Rome, Marseilles, &c. an epidemic broke out which attacked young children chiefly, adults not however being exempt from it. Although this epidemic did not present all the symptoms, nor yet all the intensity of cholera, still the character of the disease was the same, and this will be evi- dent from the following cases. This resem- blance induced a recurrence to those reme- 120 dies which had frequently been found effica- cious in cases of cholera, and the result was satisfactory. The diarrhoeal evacuations of the patients were whitish, liquid and occasionally blood- stained, resembling the juice of meat, a cha- racteristic with the exception perhaps of the blood, of most choleratic evacuations; they were frequently accompanied with tenesmus and colic; the patients suffered from nausea and sickness; some exhibited a bluish dis- coloration round the eyes, nose and mouth. The limbs had lost a great portion of their natural heat. But of all these symptoms, the most singular was the considerable loss of substance, and that in a few days; the skin became flaccid, by the disappearance of the subjacent fat, and lost its elasticity, as in old men. Whatever the symptoms were, it is certain that in many respects they were simi- lar to those of cholera, and also very analo- gous to those of epidemic dysentery. The major part of the patients had been unsuccess- fully treated in the usual manner. Case I.—A child, aged eleven months, of good constitution, and previously enjoying excellent health, had been for six days suf- fering under violent colics, with very copious diarrhoeal evacuations of a whitish colour, 121 very abundant, at times mixed with blood, extreme sleeplessness, face pale, eyes sunk, tongue dry and furred, sores on the sides of the nose, with obstruction of the nostrils, extreme thirst, loss of appetite, violent colic, with tenesmus causing the child to cry in- cessantly. The patient free from fever, the skin cold, extreme weakness and loss of substance, dis- pirited and exhausted. On the 28th of August, nux vomica, tenth dilution, was prescribed in four ounces of distilled water, three spoonsful every day. The next morning, 29th, the patient had only three evacuations, more cohesive and free from blood. Again was administered a tea- spoonful of the mixture; and, on the follow- ing day, the child was able to sleep, and had recovered his playfulness and appetite. On the 1st of September, the patient was a second time seized with frequent blood- stained evacuations, accompanied with con- vulsions of the limbs and very violent tenes- mus, each evacuation preceded by cries and griping pains in the abdomen. On the second of September, prescribed veratrum, third dilution, in four ounces of distilled water, two spoonsful to be taken during the day. On the third, the diarrhoea and colic K 122 were sensibly diminished, and on the fifth the patient was perfectly recovered. Case II.—A child, aged five months, in the enjoyment of general good health, and strong for her age, was seized with very co- pious diarrhoea towards the end of the month of August. For nine days, she had been treated in the usual way; opiates and gums were administered both by the mouth and in lavements. On the first of September, she was as follows:— Face very pale, eyes sunk and wandering, pupils dilated, features distorted, tongue dry and white, thirst, loss of appetite, fre- quent vomitings, violent colic and copious evacuations, discharge of foecal matter almost every minute, loss of substance, skin dry and hot. No sleep for several nights, difficulty of breathing. As an internal remedy, nux vomica was prescribed, tenth dilution, in four ounces of distilled water, a spoonful every hour. At the same time, were applied to the stomach flannels soaked in warm water. On the fol- lowing day the child was much better, and on the third of September entirely cured. 123 WORMS Most frequently attack women and chil- dren, are engendered by bad food, moist and unhealthy air, and by everything which fa- vours the collection of mucus in the intesti- nal canal. Their existence is often unknown; and on the other hand, we attribute to them many affections which arise from other causes. The kinds of worms most common are as- carides, lumbrici and taenia or tape-worm. The ascarides resemble the worms of cheese, but some of them attain nearly the length of the finger. They are particularly common in children, to whom they cause a disagreeable itching in the intestinal canal and of the nose, frequent and pressing desire to relieve the bowels, with some other symp- toms. The lumbrici have the form of earth- worms. They are white, have, at the point of the head, a circle surrounded with a little wart, unite in different parts of the intestines, on the parietes of which they cause, by mov- ing and sucking, an irritation which produces pinching and pain, particularly in the region of the umbilicus. The usual signs of their 121 presence are the following: nausea, much aqueous saliva or other liquid in the mouth, foetid breath, countenance puffed and pale, bluish or brownish arches below the eyes, dilatation of the pupils, sleep disturbed, ab- domen distended and tense. The tape-worm is flat, whitish, often very long, and composed of a great number of articulations. It is somewhat difficult to discover its existence. It sometimes occa- sions extraordinary sensations of pressure, of cold and of undulatory movement in the abdomen, acute pain, cramp, epileptic and convulsive movements; often none of these symptoms are observable. The only certain sign of its presence is the appearance of some portions which are naturally detached from its body, and are replaced by a new growth. The greater part of the means employed against these three kinds of worms have at most, for their result, the separation of a por- tion of them, without destroying the morbid principle which produces them. When the lumbrici or the ascarides live in the intestines in children without producing any serious effects, they do not require interference of art. But if we observe signs or a real altera- tion in health, it becomes necessary to oppose to each particular case the means which it requires. We can most frequently employ 125 against ascaridcs, aconite, nux, mercury, ig- natia, valerian," and against lumbrici, nux, china, belladonna, mercury.} Stramonium, 9th, will remove colics pro- duced by worms. Cicuta virosa, 30th, is salutary in fevers caused by worms and ac- companied by cramps with violent pains in the bowels.—Tincture of sulphur, 30th, causes the disappearance of the itching, which arises from the same cause.—Filix mas, 11th, ad ministered from time to time, always allays the irritation, which is sometimes painful, produced by the tape-worm.J * Spigelm is also an important remedy in asca- rides, also spongia tosta, this remedy has been known to procure the evacuation of more than a yard of lasnia. t Lumbrici are frequently evacuated after the ad- ministration of arsenic, and in a few instances after arnica and belladonna. t Homoeopathy possesses no particular specifics against worms. Any remedy in the Materia Medica may become applicable, says Dr. Hart, if the symp- toms only correspond. k 2 ON HOMCEOPATHIC DIET AND REGIMEN. BY P. CURIE, M. D., &c. &c. COMMON PRACTICE IN THIS RESPECT. In none of the medical schools which have preceded that of Hahnemann, have the rules for the adoption of regimen been fixed upon a sound and invariable basis. Each school has formed these rules upon its peculiar views of the nature of disease, and thus, while some prescribe an extremely low diet, others order, or permit the use of, the most nourishing aliments and stimulating wines. The object of the former is to subdue that irritation, which they consider to be the generating principle of the disease, by an almost total abstinence from food,—whilst the latter attempt to counteract, by stimu- lants, that debility which, in their opinion, is often the foundation of the malady. 128 The examination of the doctrines and rules of each school, will demonstrate the existence of these contradictions and uncertainties; and I do not hesitate to affirm, that this will con- tinue until the homoeopathic law is adopted, which, by giving a fixed and sure basis to therapeutics, will, at the same time, destroy all uncertainty regarding regimen. Homoeopathic Rules of Diet and Regimen. The object to be attained by attention to regimen in the treatment of disease, is to place the patient in a condition the most favourable for the action of the remedy; and, to accomplish this, the two following rules are considered essential. 1st. To prohibit the use of every descrip- tion of aliment which possesses medicinal properties^ or which might destroy or modify the action of the medicines administered. 2d. To regulate the quantity of such ali- ments as are allowed to the patient, in order that the daily waste of the constitution may be supplied, without overcharging the diges- tive powers. The homoeopathic physician prohibits his patients from using spirituous liquors, spices, acids, strong tea and coffee, and aromatic 129 substances. He also excludes from their regimen, every aliment which his experience informs him is of difficult digestion, and in general all fat meats and the flesh of animals which are too young; as well as all fruits of bad quality, or which are not perfectly ripe. He moreover recommends them not to reside in marshy districts, nor in dark and damp streets, in which there is no free circulation of air. For similar reasons, he advises them to avoid public meetings, and large parties, where the temperature of the air is either too elevated, or vitiated by the number of persons breathing it. The aliments to be preferred, are such as the patient digests with the greatest facility; and, in this, experience alone can guide him. The physician can neither predicate those which will be agreeable to him, nor those to which he has a dislike. The patient is allow- ed to drink pure water, weak beer, or a very small quantity of wine mixed with water. Wine undiluted, as well as tea and coffee, are allowed only to patients who have been long accustomed to their use, and who would suffer from privation of them. The physi- cian must decide in what cases they ought to be entirely prohibited, or be only partially permitted; but, even when it is necessary to allow them, they ought to be taken in much 130 smaller quantities and much weaker than usual. It is also strongly recommended to the homoeopathic patient to avoid every thing which is calculated to excite strong emotions, and all excesses either of labour or pleasure. Exercise is likewise a very important ele- ment in the homoeopathic regimen. It is indispensable that patients afflicted with a chronic disease, should not lead too sedentary a life. They ought to take exercise daily in the open air, to as great an extent as their strength will permit; and if they are unable to walk, they ought to be taken out in a car- riage, although this mode of exercise is less salutary than walking. If the patient is too ill to partake of either of these modes of ex- ercise, the air of his apartments ought to be frequently changed, and the greatest atten- tion paid to cleanliness therein. Hot baths are not permitted in homoeo- pathic treatment; but sponging with cold or slightly tepid water is recommended in pre- ference. These, of brief Duration in Acute Diseases. The regimen here pointed out is more espe- cially adapted to the treatment of chronic diseases. But it is also suitable in acute 131 complaints; although, in the latter, it is sub- ject to many particular modifications which cannot be detailed in a work like the present. I will only observe here, that rigorous atten- tion to diet in acute disorders, is rarely of long duration in homoeopathic practice. In no case is the patient restricted from taking food, except in cases where he has a positive disinclination to it; and whenever the desire for food returns, he is allowed by degrees to indulge it. Besides, the duration of acute diseases being infinitely shorter by the ho- moeopathic mode of treatment than by that of the old school, the duration of dietetic restric- tions is also shorter, and consequently the inconveniences arising from long abstinence from food are avoided. Such Rules Accessory, not Curative. From the preceding observations, an opin- ion may be formed of the rationale of the homoeopathic regimen. It will be remarked, that we consider it only as accessory, and not curative; and that, consequently, there is a wide difference betwixt the homoeopathic school and that which has been called the expectant—that which looks to the efforts of nature for every thing, and proclaims diet, 132 water, and exercise, to be sovereign reme- dies. No doubt, diet, water, and exercise, arc excellent things. Unquestionably, for him who has too constantly remained within doors, it may be well to prescribe exercise. To another, who has gorged himself with the delicacies of the table, it may be proper to recommend moderation in eating, and to dic- tate such a diet as will give the alimentary system time to recover from the effects of repletion. And, to him, who has indulged in an excess of wine, it may be wise to prescribe water: to deprive him for a time of that in which he has indulged to excess, is easily understood, and it may alone be sufficient to re-establish the health, which the abuse of it had deranged. We should not have mentioned the expect- ant school at all,—as it enjoys credit only with those who are absurdly credulous,—had it not been that we have always been repre- sented as ranging ourselves under its banner. Those who have seen the success of the ho- moeopathic treatment could not well deny it; but they have preferred attributing this suc- cess to the regimen, and not to the principle, and to that curative virtue of homoeopathic doses which we proclaim. Their arguments appear to us to be quite unfounded. It is 133 easily seen that our regimen is infinitely less severe than that which is commanded by cer- tain other medical schools; for we always allow to our patients a quantity of substantial nourishment in accordance with their appetite and digestive powers. It is true that, even in this objection, our system of diet is, so far, well understood; but its excellence is dependant on this, that it does not injure the constitution of the pa- tient, and more especially on its favouring the most simple and beneficent therapeutic which has ever existed. But, on this point, it has justly been asked,—if Homoeopathy has really performed so many wonderful cures by its dietetic prescriptions alone, are not the routine practitioners criminal if they continue to torment their patients with bleed- ings, leeches, cupping, setons, artificial ul- cers, hot irons, disgusting draughts, pills and other kinds of dangerous and repugnant me- dicines? Assuredly, if the homoeopathic regimen contributes to the preservation of health, it has no more power than any other system in destroying disease. And those who advance the opinion, that it is the strict attention to diet exacted by the homoeopathic physician which alone produces a cure, ought to feel the absurdity of supposing examples of such L 134 diseases as cholera, typhus, or bilious fever, being cured by such means;—and, as regards chronic disorders, no one has effected their cure by a regulated diet alone. We know, on the contrary, that by adhering for a long time to a low diet, the organs of digestion are weakened, the susceptibility of the ner- vous system increased, and that thus new disorders may be produced. All this is so true, that it is only those of the routine phy- sicians who have very naturally lost confi- dence in their art, who have adopted this do- nothing practice. The argument of our opponents is the less reasonable, even allowing it to be possible to cure by regimen alone; for, in that case, of what use are the long and difficult studies of the medical practitioner? and why does he devote his time to them if they lead to nothing better than to a simple diet? This would be placing a very low value upon the labours of those who have devoted their lives to the advancement of a science which they consider one of the most important: it would be placing that science itself in a low rank, and it would leave little hope to those who expect to derive from it some alleviation of their sufferings.