Angustura Vera

[BRAZILEAN CALIPCEA OFFICINALIS. NAT. ORDER, OCHNE.E.]

Not the bark of the trifoliata as was formerly supposed. The cal- ipoea is a shrub seldom exceeding an altitude of twenty feet, whereas the angustura is a stately tree of from sixty to eighty feet high. Of the bark we make a tincture of a dark yellowish-brown color.

In his introductory notes to angustura, Hahnemann mentions the case of four persons, each of whom took from ten to twelve grains of the extract of angustura, and were seized with rigidity of the muscles of the body, like tetanic spasm ; one of them suddenly fell ' down, without, however, losing his consciousness ; lockjaw. Accord* '

ANGUSTUKA VERA. 32 7

ing to Noack and Trinks, this agent may be of use in paralytic rheumatism, in lockjaw with convulsions of the back, in tetanic convulsions, and in spinal irritation characterized by spasms of the extremities, oppression on the chest, violent palpitation of the heart, feeling of heat in the face.

Possibly these indications are not reliable, and may have to be attributed to the bark of the strychnos nux vomica, which, for a long- time, was suppposed to be the angustura vera, the bark of the bon- pland-trifol. The true angustura bark has been successfully given in spring inter 'mitte 'tits, probably empirically, on account of its supposed tonic and astringent properties, which assimilate it some- what to Peruvian bark. It has also been given in intermittent neuralgia of the face.

Dr. Marcy, of New York, reports a case of this kind, where the symptoms were : acute pain in both cheeks, occasion- ally darting through the eyeballs and temples, aggravated by stoop- ing, stepping and by mental excitement ; debility and depression of spirits ; frequent chilly sensations and occasional attacks of nausea and looseness of the bowTels. Four doses of the first dilution were prescribed daily, and at the expiration of six days all unpleasant symptoms had disappeared.

It is also recommended in diarrhoea, more particularly diarrhoea of a chronic nature, accompanied by general debility, loss of flesh, mucus and bilious derangements, as indicated by acidity, coated tongue, pappy or unpleasant taste, loss of appetite ; it is often given in cases where china seems indicated, but proves unsuccessful.

TETANUS. — As already stated, angustura has been used in the treatment of tetanus. The following is related by Dr. Hering in the Arcliivo f d. Horn. Heilkunst, vii. 1-89 :

The negroes are liable to have injuries followed by tetanus, which is treated by mercury until they are salivated ; if salivation is pro- duced they recover. I was called to a negro woman suffering from this malady, in whom salivation could not be produced, although she was under the care of a physician of large experience in this class of. diseases. The woman had violent paroxysms of lockjaw, and spasms of the muscles of the back, causing opisthotonos. I gave her a minute dose of angustura.

A paroxysm occurred within a few min- utes, followed by improvement ; she was soon completely cured and, to the great surprise of all, without salivation.

A lady ran a pin into her foot ; two weeks after she was taken with tetanic pains striking from the point injured back to the heel, then up the limb and back ; she had also darting spasmodic pains in her neck. A messenger came, saying shooting pains

328 ANTIMONIUM CRUDUM.

had gone into her face. On my arrival I found darting pains from the nape of the neck to the jaws, both sides; jaws stiff, not closed, but the pains began to be terrific. Prescribed angustura3 every thirty minutes until relieved. In an hour the pains abated and she gradually recovered. (Dr. Hubbard, Med. Investigator, April, 1870.)

Hale, in his Heart Repertory recommends it for cardiac debility, hypertrophy with dilatation. Spasmodic affections of the heart, giving the following indications for its use : Great oppression of the chest, and violent palpitation of the heart (when going up-stairs) ; also when sitting or stooping, accompanied by a painful sensation as if the heart were contracted ; also in the evening in bed, better when sitting up. Painful thrust or shock in the region of the heart. Stitches in the chest.

Tightness in the chest, and pressure in the left side of the chest when walking fast. Affections of the motor nerves tending to paralysis. Spasms. Also, disorders of the nerves of sensation.

ENURESIS. — The following symptoms indicate its use in enuresis : Tenesmus of the bladder, followed by profuse emission of white urine ; tenesmus after micturition. One is obliged to urinate frequently, although but a few dark yellow drops are emitted each time, causing a burning pain ; orange-colored urine, soon be- coming turbid. (Dr. Edmundson, Halm. Monthly, Oct., 1876.)

ASTTIMOSTlTTM CEUDUM.

[CKUDE ANTIMOMY.]

Antimony is the basis of several important medicinal preparations. Metallic antimony, formerly known under the name of stibium, is no longer used in medicine. The antimonial preparations which homoeopathic physicians make use of, are : the black sulphuret of antimony, also termed crystallized tersulphuret of antimony, or crude antimony ; antimonial wine and tartarized antimony. In order to distinguish the metallic antimony from the tersulphuret, the term " regulus antimonii " has been applied to the former.

The black sulphuret of antimony was known in the most ancient times. It was used by the Asiatic and Greek ladies as a pigment for the eyebrows. The pigment was composed of the black sulphuret, lead and zinc, and was used for the purpose of giving prominence and expression to the whites of the eyes. The term stibium is derived from the Greek verb, stibo, which means " to crush." The nr.me of the pigment was platuophthalmon, literally, large-eyed — an

ANTIMONIUM CRUDUM. 329

ointment for the eyelids. The practice of using this pigment for such purposes is alluded to in the 23d chapter of Ezekiel, 40th verse, and likewise in II. Kings, 9th chapter and 30th verse, where the expression, " and she painted her face," is shown by the celebrated Oriental scholar Gesenius to refer to the practice of painting the eyebrows and lashes.

In former ages the sulphuret of antimony was only used externally for sore eyes, ulcers, etc.; physicians dared not use it internally on account of its supposed poisonous qualities. Basil Valentine is supposed to be the first who gave it internally. Experiments upon animals led him to believe that it acted favorably upon the repro- ductive system, and he therefore administered it to the monks of his cloister as a stimulant of the digestive functions, in case of weak digestion or dyspepsia.

Paracelsus and his disciples spread the use of antimonial preparations in a manner which led to great abuses of this agent, and induced the parliament of France to forbid its em- ployment as a therapeutic agent during a period of one hundred years. In the year 1666 this edict was revoked at the request of the medical faculty of Paris, one hundred and two members of which gave their assent to the use of antimonial preparations. The name of antimony dates from the period when the abuse of this drug led to so many disastrous consequences among the people and the inmates of cloisters.

Antimony is a compound of anti, against, and monachus, a monk, an agent used against monks. The black sulphuret of anti- mony, or the tersulphnret, is found native in various parts of the world, more particularly in Hungary, Germany, France, England, and likewise on the island of Borneo, from which quantities of the crude ore are imported as ballast. According to Pereira, from six to eight hundred tons have been imported in the course of a year.

The tersulphuret is separated from its siliceous gangue by melting it in iron crucibles or pots, the bottoms of which are perforated by a number of holes, and which are placed over other receiving vessels in holes dug in the ground. The liquid sulphuret runs into the inferior vessel, and the unmolten silicate remains behind. This process of separating the sulphuret from the gangue is slightly modified in dif- ferent countries.

The sulphuret thus obtained is found in commerce in large loaves or cakes, consisting of shining, lead-colored crystals agglomerated into roundish masses. The native sulphuret is generally found adulterated with small quantities of lead, copper, iron and arsenic ;

330 ANTIMONTUM CRUDUM.

hence, for homoeopathic purposes it is best to prepare it one's self. For this purpose we reduce thirteen parts of pure metallic antimony to a fine powder, and mix it carefully with five parts of the washed flowers of sulphur; we insert this mass by degrees into a red-hot crucible, and melt it by adding half a part of dried salt. After being kept liquid for half an hour, we allow the mass to cool, sepa- rate the portion which adheres to the bottom of the crucible by a stroke of the hammer — this portion being found to bo pure metallic antimony — and reduce the remainder to an impalpable powder, which is to be washed with distilled water, and to be used for triturations.

PHYSIOLOGICAL ACTION OF ANTEMONY.

Antimony seems to affect principally the gastro-intestinal mucous membrane, and the mucous membrane of the urinary bladder. According to the statement of Trousseau and Pidoux the effects of antimony, as observed on the hospital-patients under their care, are most strikingly perceived in the pulse, the respiration and the urinary secretions. They state that, under the use of large doses of antimony, when given to patients affected with non-febrile affections, such as sciatica, chronic rheumatism, chronic catarrh, nocturnal bone-pains, etc., the pulse went down from seventy-two to forty-four beats in the minute ; in many cases the first effect of antimony upon the circulation was to cause an extraordinary irregularity in the beats of the pulse, without any diminution in their frequency ; this irregularity sometimes preceded the previously-mentioned decrease in the number of beats.

The number of inspirations was likewise considerably diminished. From sixteen, twenty and even twenty-four inspirations, the number went down to six ; this extraordinary decrease would have justified the most serious apprehensions concerning the safety of the patients if their whole appearance, their unimpaired physical and intellectual energies, had not indicated a state of well-being. From these re- markable effects we may certainly infer that, although antimony possesses the power of depressing the action of the heart and lungs, two great centres of organic life, yet it does not seem to make any great inroads upon the cerebral centres ; for, if it did, this remark- able depression of the pulse and the respiratory movements, would undoubtedly be accompanied by symptoms of great constitutional derangement.

A striking effect of the antimonial preparations is to increase the

ANTIMONIUM I i:i Dl'M. 331

urinary secretions. This effect is more particularly perceived if the drug excites neither diarrhoea nor vomiting. The urine is watery ; after giving the golden or yellow sulphuret of antimony (another antimonial preparation), a thin, gold-colored urine was secreted which deposited a scarcely perceptible cloud. In one case the urine se- creted by a healthy person, deposited, twenty-four hours after the emission, small, red, hard little corpuscles.

This symptom might lead us to infer that antimony may prove useful in gravel and urinary calculi.

In endeavoring to define the therapeutic sphere of antimony, we shall find it impossible to solve this problem by such symptoms as we find recorded in Hahnemann's Chronic Diseases, where antimony occupies a position as an antipsoric. In reading over the patho- genesis of antimony the fact seems to impress itself upon our minds that, in order to do justice to this interesting agent, we have to grasp the totality of the impression which antimony makes upon the tissues. The lono- continued use of antimonv causes an inflammatorv irrita- tion of the intestinal mucous membrane, similar to what appears upon the skin when antimonial washes and ointments are applied to it.

It is likewise to be observed that the symptoms of gastric de- rangements which antimony causes, incline to be inveterate, and that a continual tendency to looseness of the bowels is very frequently the result of antimonial action. Keeping this disorganizing or disin- tegrating action of antimony upon the intestinal membrane, in our mind's eve, and considering moreover that individuals of a cachectic habit of body are especially subject to diarrhceic discharges, we may consider this coincidence as prima facie evidence of the affinity existing between antimonial action and this habitual tendency to looseness of the bowels in persons whose reproductive system is tainted with decay.

Hence, if we see a patient with a sallow and haggard countenance, dull and sunken eyes, dirty grayish coating on the tongue, unpleasant, foul, pappy taste in the mouth, fetid odor from the mouth, dryness of the mouth and throat, thirst, or constant secretion of unpleasant, tenacious phlegm in the throat, rising of foul, sweetish or insipid water from the stomach ; loss of appetite ; want of tone in the stomach ; bloating of the stomach after eating ; fulness and distention of the bowels ; frequent tendency to emission of foul-smelling flatulence ; tendency to diarrhoea, the evacuations consisting of foul-smelling mucus, or alternate tendency to diarrhoea and constipation ; constant feeling of weakness in the bowels ; fre-

332 ANTIMONIUM CRUDUM.

quent desire to urinate, the urine being in most instances turbid, and having a foul odor ; and perhaps weak and retarded or short breath- ing and corresponding weakness of the circulation ; if these and similar symptoms present themselves to our view, they at once con- vey to our minds the general impression that we have an antimonial group of symptoms to deal with.

The intestinal mucous lining seems to be that portion of the mucous expanse which perceives the action of antimony with most readiness and intensity. Hence, it is in affections of this membrane, when characterized by symptoms of debility and decay, that anti- mony may render good borvioe. We may avail ourselves of this agent in

CHRONIC DIARIiHCEA, of a watery consistence, or of a gray- ish, decomposed, rather foul-smelling mucus ; the stools may be mixed with undigested food ; a feeling of weakness is felt in the bowels such as is induced by the action of a cathartic ; and this feel-' ing of weakness may be accompanied by a sensation of heat which is diffused through the bowels, pinching pains in the small intestines, distention and hardness of the abdomen, emission of moist and fetid flatulence.

A diarrhoeic condition of this kind must inevitably be accom- panied by dyspeptic symptoms. Patients whose bowels exhibit these signs of weakness are suffering with anorexia or loss of appetite; the lining membrane of the mouth is dry, hence they complain of thirst ; after eating, the stomach feels oppressed and distended ; the epigas- tric region may feel sore ; the patient may complain of foul and bitter risings from the stomach ; the food regurgitates after eating ; the taste in the mouth is altered, and the tongue is covered with a thick, grayish slime or mucus.

These symptoms denote a condition which former pathologists were in the habit of designating by the term "gastricism," or saburral derangements of the primae vise. The doctrine was that the delicate vessels in the canals in which the functions of nutrition are supposed to be carried on, were filled with impurities termed saburrge, and it was therfore a matter of impor- tance to the patient that the organism should be cleansed of these crudities by cathartics or drastics. Antimony was often administered for such symptoms, but in such massive doses, or in combination with so many other ingredients, opium and so forth, that the good effects of the drug were either interfered with by the presence of these heterogeneous elements, or else that the medicinal effects of

ANTIMONIUM CBUDUM. 333

tlie drug were amalgamated with the natural disturbance, thus be- getting a monstrous compound which required other direct and antidotal treatment and often entailed incurable infirmities upon the sufferer.

It is not necessary that diarrhoea, or a tendency to diarrhoea, should always be present in this gastric condition ; the opposite condition, viz., constipation, with heat in the bowels and a deep- seated soreness throughout the mucous expanse of the small intestines may take the place of the diarrhoeic element. We know that a large dose of antimony may cause vomiting and purging, with decided symptoms of gastroenteritis; hence the symptoms of the organic reaction which would follow the continued use of comparatively small doses of the drug, must necessarily assume the opposite form, viz., constipation, with distention of the abdominal walls, engorge- ment and consequently heat and dryness of the mucous lining of the the bowels. In the gastric group which I have endeavored to delin- eate, constipation, with heat, deep-seated soreness and distention of the bowels, is therefore just as much an indication for antimony as the opposite diarrhoeic condition.

Having alluded to the general effects of a massive dose of anti- mony upon the intestinal mucous lining, we may take this oppor- tunity of recommending it for a form of

G ASTRO-ENTERITIS characterized by similar symptoms. It is not such a form of gastro-enteritis as would indicate aconite. In the form where antimony is indicated, the skin shows a tendency to be- come cold and to cover itself with a clammy perspiration ; the pulse, instead of assuming the full, hard, quick and bounding character of an inflammatory type, becomes weaker and emptier ; the patient dis- charges mucus mixed with blood, and complains of griping and cutting pains in the small intestines.

It is well-known that the intestinal mucous lining of children is liable to characteristic derangements. If this great focus of the reproductive system exhibits such symptoms of decay as I have depicted, and if these symptoms of decay are accompanied by irregular appetite, alternate anorexia (loss of appetite) and bulimia (h ordinate craving for food), and by frequent emissions of urine, more particularly during sleep, at night, we have in antimony an • excellent remedy for a diseased condition of the intestinal lining which frequently leads to the formation of those troublesome para- sites, worms.

334 ANTIMONIUM CRUDUM.

Considering that the intestinal mucous lining is so powerfully in- fluenced by the action of antimony, it stands to reason that the skin, an organ that is in such close dependence upon the condition of the assimilative sphere, must likewise be subject to the disturbing action of this agent. Indeed, even if we did not know it by our provings, yet we have a right to infer that in all cutaneous disorders which purely and simply result from such diseased conditions of the intes- tinal mucous membrane as antimony is homoeopathic to, this medi- cine will exercise a curative influence. Such disorders are not measles, scarlatina, purple rash and the like, but a variety of vesicular, papulous and herpetic eruptions, some of which it may not be inappropriate to mention :

1. Papulous eruptions, little pimples or blotches, and sometimes scurfs, with an inflamed base, leaving brownish spots.

STROPHULUS, white gum, milk spots, dental rash, red gum or gown of children which sometimes becomes very troublesome during teething, consisting of red or sometimes whitish pimples surrounded by a reddish halo, on the face, neck and arms.

STROPHULUS VOLATIOUS, an eruption consisting of burn- ing, red spots, gradually peeling off and changing to a brown color ; the Germans designate this eruption by the term of wild fire, a fiery redness principally affecting parts of the face, head, neck.

LICHEN SIMPLEX, consisting of red pimples on the face or arms, thence spreading all over ;

LICHEN AG-RIUS composed of clusters of pimples, surrounded by a red halo ; the cuticle gradually grows hard and thick and cracks.

LICHEN LIVIDUS, in which form the papulae or little blotches look dark red, or livid, without any fever.

LICHEN URTICATUS, consisting of blotches and wheals like nettle-rash, and accompanied by fever.

Besides these forms of lichen we have a species of urticaria under the skin, generally caused by poisonous crabs and oysters.

SCABIES PURULENTA or HUMIDA, of an inveterate char- acter, particularly in scrofulus and arthritic individuals ;

PUSTULES ON THE HAIRY SCALP, terminating in the formation of yellowish crusts ;

A.NTIMONIUM CRUDUM. 335

PSYDRACIA or spurious itch, a form of itch consisting of small, irregular pustules pouring out a thin, watery fluid, and forming laminated crusts ;

ECTHYMATOUS ERUPTIONS, especially a form of ecthyma termed " ecthyma cachecticum," a pustulous eruption showing itself on persons whose reproductive system has suffered a great deal from want and care, may require the use of antimony.

Lastly, we may give this drug in certain eruptions, such as :

BOILS of an unhealthy character, secreting an uuhealthy, thin, offensive pus.

ACNE ROSACEA, gutta rosacea, copper-nose, bottle-nose, grog- blossoms, an eruption consisting of suppurating tubercles with shining redness, imparting a rough and irregular appearance to the skin. The eruption generally first breaks out at the tip of the nose, whence it spreads over the sides of the nose and cheeks.

SYCOSIS MENTI, mentagra or barber's itch, an eruption on the bearded portion of the face and scalp, and consisting, according to Bateman, of inflamed, but not very hard tubercles, and usually clus- tering together in irregular patches, may likewise be advantageously treated with antimony.

In general, antimony is adapted to cutaneous disorders in indi- viduals of impoverished constitutions, whose skin is cold, unhealthy- looking, deficient in elasticity and subject to the breaking out of sores that secrete an unhealthy, thin, badly-smelling pus. This con- dition of the skin is accompanied with universal signs of decline in the vegetative sphere. The abdominal mucous surfaces show signs of decay such as we have endeavored to picture in previous para- graphs. We may here remark that, because a cutaneous disorder is accompanied by symptoms of gastric derangement, this coincidence is not necessarily an indication for antimony.

In order that anti- mony may meet the case, the gastric derangement must not only be characterized by such phenomena as I have described, but the cuta- neous disorder must be incidental to the morbid condition of the vegetative system. In many eruptions, whether vesicular, papulous,

336 ANTIMONIUM CRUDUM.

pustulous, etc., the gastric symptoms are incidental to the cutaneous disorder. In many forms of strophulus, lichen, eczema, ecthyma, herpes, and tubercles, the accompanying febrile excitement may require the use of aconite which will often calm the gastric disorder and effect a drying up and scaling off of the eruption.

9, 1 87 1, Master , has been subject to nettlerash for fifteen months, all over

SORENESS OF THE EYELIDS of a chronic, scrofulous char- acter, especially when accompanied by general abnormal symptoms of the vegetative system, may require the use of antimony.

SORENESS OF THE EARS, external as well as deep-seated, when in relation with gastric symptoms, especially in scrofulous and arthritic individuals, may likewise be benefited by the use of anti- mony.

TINEA CAPITIS, when depending upon or accompanied by such symptoms of gastric derangement as indicate antimony, should be treated with this agent. This species of tinea generally forms thick, coherent, dirty-looking crusts, or isolated crusts covering unhealthy- looking sores.

We have stated that large doses of antimony will cause vomiting and diarrhoea, or will increase the urinary secretions in case the emetic or cathartic action does not develop itself. It is by massive doses of a drug that its primary effects upon the tissues are deter- mined ; small doses indicate more fully and accurately the manner in which the organism reacts against the drug. We have seen, for instance, that a massive dose of aconite will depress the pulse and animal temperature ; this may be considered as the primary effect of the poison, which, if eventually overcome by the organic vital force, will be replaced by an opposite condition, heat and dryness of the skin, and increased frequency, fulness and strength of the pulse. Under the effects of a massive dose of the poison, the organic reaction sets in slowly at a late period, if at all ; under the effects of a comparatively small dose of the poison, the organic reaction may

ANTIMONIUM CRUDUM. 337

set in speedily, sometimes so rapidly that the primary effects of the drug are hardly perceived. Comparatively small doses of aconite, for instance, may at once develop the symptoms of organic reaction, heat and dryness of the skin, and fulness and rapidity of the pulse, without any marked previous diminution of the temperature or of the volume and frequency of the pulse. In applying this doctrine to antimony, we shall find that comparatively small doses of this drug may develop symptoms of organic reaction without any previous symptoms of primary action.

Instead of diarrhoea we shall have more or less constipation, accompanied peril aps by bloating of the bowels, and instead of vomiting we may have a loss of tone in the stomach, giving rise to loss of appetite, or even complete anorexia, a perfect indifference to food. The other symptoms of gastric derangement may remain the same. We may add that the urine and circulation would likewise be found correspondingly altered ; instead of a thin, watery urine we might have a urine evincing slight symptoms of a feverish condition of the system, darker in color, of a more offensive odor, and perhaps depositing some sediment.

The pulse would, most probably, be slightly irritated.

Formerly it was believed that the action of antimonials depended upon their solubility in the fluids of the stomach. This doctrine is now emphatically exploded. Metallic antimony, which is in- soluble in the stomach, acts as energetically as the soluble antimonial salt," tartar emetic. Trousseau and Pidoux have determined by direct experiment that "antimonial preparations, if injected into the rectum, veins, or subjected to absorption in any part of the system, will excite vomiting more certainly than they do if intro- duced directly into the stomach " ; which proves, according to the opinion of these observers, that "vomiting is the effect of some special modification of the nervous system rather than of the local irritation produced by the drug." Homoeopathic practitioners may well rejoice at this more enlightened and refined mode of accounting for the action of drugs, a powerful rebuke to Liebig and his followers, who have undertaken the hopeless task of explaining the phenomena of vital action and reaction by the laws which govern inorganic matter.

VOL. I. — 21.

oo

38 ANTIMONIUM CBUDUM.

One of the workmen was attacked as follows : after having been exposed to the vapors for a long time, oppression on the chest and slight headache ; the oppression gradually increased to violent stitches across the chest, darting toward the shoulders and back ; these were accompanied by a dry, painful, shrill cough. The headache likewise increased to a stitching and burning distress in the occiput and nape of the neck. When coughing, the patient raised with difficulty ; a rattling and wheezing in the air-passages were heard during the res- piration.

At night the patient was distressed by a painful uneasiness which soon increased to complete loss of sleep. An occasional short nap was invariably interrupted by a most distressing sweat which was always followed by great exhaustion. A complete prostration of the organism was a marked symptom of the effects of the poison. The appetite was impaired, the abdomen distended, and the patient was' troubled with frequent attacks of a pinching diarrhoea, especially after eating, when the food would pass off undigested.

The patient had difficulty in passing urine, which was attended with urging and pain at the neck of the bladder and a painful burning in the urethra, from which a few drops of a liquid mucus were occasionally discharged. The urine had a dark, orange or reddish color. A few pustules broke out on the scrotum, resembling small-pox pustules ; pains were felt in the scrotum, the sexual instinct was weakened and gradually became extinct even to complete impotence; seminal dis- charges and erections had entirely ceased.

Incipient atrophy of the penis and testicles accompanied this loss of power.

This group of symptoms illustrates in a very characteristic man- ner the disorganizing action of antimony upon what physiologists designate as the vegetative or reproductive sphere. First, in this group of symptoms we have the acute bronchial irritation and colli- quative sweats with the sticking-burning pain in the head, and more especially in the occiput ; next, we notice the impaired appetite and the diarrhoea and lienteria ; thirdly, observe the urinary difficulties, the urging and pain at the neck of the bladder, and the burning in the urethra with discharges of mucus from this canal ; next the small- pox-shaped pustules on the scrotum, and lastly the impotence and atrophy of the sexual organs.

In another case the same symptoms were observed, together with rheumatic tearing pains in the limbs, and the pustulous eruption first breaking out on the neck, afterward on the trunk and very characteristically on the sexual organs.

In a number of other cases antimony produced the same effects. In one case the patient complained of stitches darting toward the occiput, with pain in the forehead and in the region of the root of the nose ; he likewise complained of a violent distress in the small

ANTIMONIUM CRUDUM. 339

of the back ; the other symptoms were the same as in the other cases.

The important facts which are communicated to us in these cases, lead us to some exceedingly interesting applications of antimony as a therapeutic agent. We are undoubtedly entitled to its use in

CHRONIC HEADACHES, of the character delineated in these groups of toxical symptoms ; the patient complains* of stitches flying through the head, or of a burning distress in the region of the cere- bellum ; such headaches are always complicated with profound gastric disturbances, loss of appetite, diarrhoea and a general prostra- tion of the vital reaction; they may have a mercurial-syphilitic origin. Antimony has been used by old-school physicians for syphilitic bone- pains in the skull, syphilitic nodes about the skull, and hypertrophy of the pericranium ; and in all these affections massive, alterative doses were resorted to. If the drug is indicated in these syphilitic affections by the constitutional symptoms, comparatively small doses will be sufficient. In

DIARRHOEA AND LIENTERIA, to which I have already directed your attention ; I mean the diarrhoea of cachectic indi- viduals, with discharges of foul slime, bile and undigested food, an impaired appetite, coated tongue.

Plenck asserts that antimony, when inconsiderately taken, may produce vomiting, copious stools, intolerable griping pains, anxiety, agitation, haemorrhage from the bowels, convulsions, inflammation of the stomach and intestines, erosions, gangrene, death.

We know, moreover, that antimony will induce copious and fetid ptyalj,sm, foul taste, coated tongue, foul risings from the stomach, anorexia, oppression after eating, emission of fetid flatulence, enuresis. Hence we may recommend antimony in gastro-enterilis, sabarral derangements or gastricism, weakness of the bowels and diges- tive system, and worm affections.

These derangements of the gastric functions may be accompanied by febrile symptoms ; hence it may be necessary to resort to anti- mony in some chronic forms of gastric or mucous fever of an erethic type. In the inflammatory type of these fevers antimony would be out of place.

If antimony is possessed of the power of depressing the vegetative functions of the organism by disorganizing the intestinal mucous tissue and the lymphatic system, we may reasonably infer that it may prove useful in certain forms of

340 ANTIMONIUM CEUDUM.

MARASMUS, characterized bv such sisrns of derangement in the digestive system as we have indicated. The unhealthy state of the skin, tendency to sores, depression of cutaneous temperature and a sensation of heat diffused over the inner surfaces ; anorexia, diarrhceic discharges consisting of disorganized lymph and mucus, or alternate diarrhoea and constipation, and other signs of vegetative decay, must of course justify the use of this agent. In

CATARRH OP THE BLADDER, with burning in the urethra, discharge of mucus ; it may arise as a spontaneous symptom of deficient innervation in the lymphatics of the urinary organs.

IMPOTENCE and atrophy of the testicles as a symptom of gen- eral prostration of the reproductive sphere, with loss of appetite, diarrhoea, night-sweats, rheumatic or arthritic pains. In

CHLOROSIS with gastric complications, great depression, consti- pation, etc.

APHONIA, depending upon a loss of muscular power of the

ANTIMONIUM CKUDUM. 34]

<

organs of speech and upon depressed vitality of the laryngeal mucous membrane. The attacks are usually spasmodic, are brought on by becoming heated on exertion and are relieved by rest.

German writers have reported several cases of

342 ANT1M0NIUM TARTARICUM.

complicated with deep-seated gastric disturbances, with prostration and debilitating sweats, we may prescribe antimony with a well- grounded hope of affording relief to the patient.

The inflammatory sphere of this drug is very limited ; we may use it, as we said before, in some cases of chronic arthritis and rheumatism, provided the accompanying gastric disturbances justify its employment; when concretions have formed in the joints it may favor their absorption. Understand me well, Gentlemen, antimony is not a remedy for gouty concretions ; the co-existence of gastric symptoms has to justify its use ; it will prove of little avail, unless the gouty diathesis is symptomatic of deep-seated gastric irri- tation, with tendency to prostration and debilitating sweats.

ANTIMONII ET POTASS^E TAKTKAS.

[antimonium tartaric um, tartrate of antimony and potash,

tartar emetic.]

The term Stibium is more especially applied to this salt by homoe- opathic physicians. We obtain it by boiling equal equivalents of cream of tartar and teroxyde of antimony in four times their weight of water.

Tartar emetic was first accurately described by the Dutch chemist Hadrian de Mynsicht in the year 1631. Old-school physicians have always regarded it as one of their most valuable sedatives, and more recently it has been lauded to the skies by Rasori and his followers as a most powerful antiphlogistic.

One of the most energetic experimentizers with tarter emetic is Magendie. Dogs without number have been sacrificed by this remarkable man for the purpose of ascertaining the effects of poisons upon the animal economy.

Magendie infers from his experiments, that tartar emetic occasions death when swallowed, not by inflaming the stomach, but by means of a general inflammatory state of the whole system subsequent to its absorption. In one case six or eight grains were dissolved in

ANTIMONIUM TARTARICUM. 343

water, and injected into the vein of a dog; the animal was attacked with vomiting and purging, and died within an hour. Post-mortem appearances : redness of the whole villous coat of the stomach and intestines ; also the lungs were of an orange-red, or violet color throughout, destitute of crepitation, gorged with blood, dense like the spleen, and here and there even hepatized.

Kayer and Bonnet killed rabbits with tartar emetic, without being able to discover any inflammatory symptoms after death. They have observed the symptoms of inflammation in the tract of the intestinal mucous membrane, and even these were found entirely wanting in all cases where the poison, destroyed life suddenly. Doctor Camp- bell likewise found no traces of inflammation in the lungs. He killed a cat by applying five grains of tartar emetic to a wound made for that purpose, and discovered no signs of inflammation in the pulmonary tissue.

It is barely possible, as Trousseau and Pidoux suggest, that Magendie may have mistaken a purely mechanical stagnation of blood in the vessels for actual inflammation. The specific power which Magendie supposed tartar emetic to possess of causing pulmonary engorgements, is doubted by most, and denied by many leading, physiological therapeutists. So far as I know, there is not a single fact on record going to show that tartar emetic is en- dowed with any specific power of inflaming the lungs in the human subject.

Pereira very justly argues that " in cases of poisoning by this substance, no mention is made of difficulty of breathing, cough, pain or other symptom which could lead to the suspicion that the lungs were suffering.

In this case the thoracic viscera remained sound. A case of this

344 ANTIMONIUM TARTARICUM.

kind simulates a sudden attack of gastroenteritis or even cholera ; in violent attacks of this kind, where the capillary network, ramified over the intestinal mucous lining, is intensely irritated by the poison, and the cerebro-spinal axis receives a violent counter shock in con- sequence, tartar emetic may prove an invaluable curative agent. It has even been administered with great success in cases of furious delirium tremens where such symptoms as this case exhibits consti- tute characteristic indications.

Another case is reported by Orfila where the narcotic effects of the poison are distinctly seen :

In this case the symptoms seem to be the result of a deep inroad upon the nervous system. We infer this from the great prostration of the patient, from the cramps in the calves, and from the peculiar alteration in the pulse. This case again shows that in attacks simu- lating gastro-enteritis and cholera, tartar emetic may be homoe- opathically indicated, even if the nervous character of the attack is a prominent feature in the case before us.

A case of this kind is not altogether a fair illustration of the effects of a small dose of tartar emetic ; for it may be presumed that the reactive energies of the organism must have been generally pros-

ANTIMONIUM TARTARICUM. 345

trated ; nevertheless it may afford us an approximate proof that small doses of a drug, in highly sensitive organisms, may produce great effects generally, and that small doses of tartar emetic may do so in particular.

Another case is reported in the London Lancet, where a still smaller dose was administered to a stout, active, well-built man for ii cold. He took fifteen drops of antimonial wine at bed-time in order to perspire. The nausea which ensued was excessive, and the prostration extreme ; the patient was unable to leave his room for three or four days ; there was no purging, but colicky pain, griping, faintness and general exhaustion.

These symptoms do not point to cholera or gastro-enteritis ; but they lead us to infer that tartar emetic may be an eminently useful agent in gastrodynia.

In Frank's Magazine another case of poisoning by tartar emetic is reported where the symptoms resemble gastro-enteritis of a violent kind:

Twenty to twenty-five grains of tartar emetic were taken by mistake ; in a few minutes there was insufferable feeling of warmth in the epigastrium, then violent pains in the forehead like clavus hystericus and some dizziness ; in half an hour moisture on the fore- head and nape of the neck ; vomiting for twenty or thirty minutes ; the headache, dizziness and redness of the face increased ; after taking a dose of castor oil, the burning feeling in the stomach and small intestines increased to such a degree that he became very rest- less ; the pulse weak, 80; tongue white, throat dry, taste unpleasant; inclination to sleep ; next day his mouth was very sensitive, the gums bleed, with a slight spongy appearance like scurvy, lasting two days.

This is a most interesting case which reveals therapeutic powers of a peculiar order. The symptoms in this case resemble those of the fatal case reported by Reeamier. They show that tartar emetic may serve us in gastrodynia, in cholera-morbus and gastro-enteritis when the nervous symptoms, prostration, dizziness, pain in the head, are prominent indications. Even in nervous headache, with the sen- sation as if a nail were sticking in the brain, tartar emetic may be found indicated, provided the constitutional symptoms, more partic- ularly the symptoms of gastric disturbance, and the general prostra- tion correspond. *

We likewese learn that tartar emetic is adapted to stomacace with bleeding and sponginess of the gums. Considering that tartar

346 ANTIMONIUM TARTARICUM.

emetic causes profuse salivation, we may consider this agent as ex- ceedingly qualified to arrest mercurial ptyalism.

Beside these toxical effects we have provings by Dr. Jankovich:

Pie prepared a solution of twelve grains of tartar emetic in three ounces of water, of which he took a spoonful every hour. After the first spoonful he was attacked with dizziness and nausea ; after the second dose he experienced a shuddering over the whole body, cold sweat, nausea, retching, disposition to vomit; after the third dose violent precordial anguish ; two paroxysms of vomiting of quantities of mucus and bile, rumbling in the bowels without pain or discharge ; the skin was continually covered with profuse sweat; there was a copious flow of saliva; the prover felt somewhat thirsty, and had to drink small quantities of water.

He felt so weak that he was unable to rise from the sofa. After the fourth spoonful he had frequent attacks of nausea, vomiting, and a discharge from the bowels. The fifth dose was followed by such a perfect listlessness and indifference to everything that death itself seemed an indifferent event at this period. The pulse was considerably retarded.

He had now taken one-fourth of the medicine, four grains, but was seized with such an aversion to the drug that he was unable to continue his proving. He took some broth ; the nausea, rumbling in the bowels, apathy and sweat continued all night, but in the morning he was quite well again.

These provings would seem to show that the nerves of the stomach experience the first shock of the poison, especially when administered in moderately small doses, and that the alvine derange- ments set in subsequently to the nausea and vomiting. Very large doses may at once develop cathartic effects without any symptoms of nausea. Years ago, when traveling in Texas, I once swallowed, inadvertently, a teaspoonful of tartar emetic; it could not have been less than twenty grains.

The effect was tremendous ; no nausea or vomiting, but watery discharges from the bowels which seemed to be propelled or expelled with a tremendous force, taking their point of departure from the pharynx, and continuing with a rolling noise down the oesophagus and through the whole intestinal tract, as if the bowels would be torn out. These discharges lasted off and on for a whole day. The probability is that the tartar emetic was adulterated with magnesia, else the effect might have proven more obstinate and lasting.

The characteristic effects of the drug may likewise be elicited by means of endermic applications. These endermic effects are pro- cured with more certainty by first boiling the emetic in water and precipitating it by the addition of alcohol, after which it may be combined with lard into an ointment. If the tartar emetic is rubbed up with the lard without having been previously boiled in water and afterward precipitated from the watery solution by means of alcohol, the vomiting and diarrhoea may not take place, and the irritating

. ANTIMONIIM TARTARICUM. 347

action of the poison may be confined to the epidermis, where pas- tilles make their appearance which resemble in all respects the ordinary small-pox pustules.

The application of tartar emetic ointment to the epidermis has very frequently occasioned disastrous consequences.

Dr. Krebs has frequently seen urinary difficulties arise from the use of the ointment in whooping cough.

A scrofulus child, of two years, had the ointment applied to the scalp, in consequence of which the occipital portion of the scalp was transformed into a black, fetid, gangrened mass. The gangrened portion of the scalp gradually sloughed off, and the child recovered.

A young lady was attacked with intense praecordial anguish and utter inability to move in consequence of the application of the ointment to the epigastric region. The first effect of the ointment was a syncope of two hours' duration, which wa's followed by an anguish in the praecordia lasting six hours.

Dr. Bertini relates that, twenty hours after the application of a

348 ANTIMONIUM TARTARICUM.-

In the London Lancet the case of an Essex farmer is reported who took tartar emetic in half-grain doses every three hours, while suffer- ing under acute pneumonia. A pustular eruption made its ap- pearance over the whole body, which was mistaken by his friends for small-pox.

Frank, in his magazine, reports the case of a man suffering with pneumonia, who took ten grains of tartar emetic in solution in thirty- four hours ; about twenty-four hours after the last dose an eruption appeared which resembled in the closest particulars that produced by a tartar emetic ointment ; it consisted of pimples and vescicles which increased rapidly in size and filled with pus in two days ; they were surrounded with a red base and resembled closely matured pustules of small-pox or smaller pustules of cow-pox. * They were exceedingly painful, but most of them dried up in a few days, and formed crusts ; a few became larger than the others, and then resembled the pus- tules of ecthyma. The eruption commenced on the inner surface of the right forearm, then spread over the whole back, where the pustules were both isolated, grouped and confluent. Neither vomit- ing, purging or perspiration was caused by the drug. The pneumonia was rapidly cured, together with a fever and ague, and consequent dropsy with which the patient was also troubled.

CEPHALIC GROUP.

In my judgment the signs of cerebral irritations do not indicate tartar emetic, unless they can be traced to some deep-seated, primary irritation of the nervous plexuses upon which the functions of the stomach and small intestines depend. According to Dierbach and other observers, tartar emetic, when introduced into the stomach, first acts upon the coeliac plexus through the mucous lining of the stomach, whence the impression is communicated to the cardiac

ANTIMONIUM TARTARICUM. 349

APOPLECTIC HEADACHE, with ineffectual retching, collapse of pulse, coldness of the extremities, these indications can only be deemed reliable in case the comatose condition of the patient can be traced to a primary irritation of the coeliac plexus through the mucous lining of the stomach.

It is fair, moreover, to observe that in the fatal case, reported by Dr. Kecamier, the brain exhibited decided symptoms of disorganiza- tion. The dura mater was found ossified about an inch and a half in diameter; the arachnoid membrane was found thicker and uni- formly red ; signs of recent inflammation were found on that portion of the membrane which covers the anterior lobes of the brain ; exudation of a serous liquid, tinged red, particularly at the base of the skull ; the substance of the brain was softer than usual ; the left ventricle contained four or five spoonfuls of a transparent and color- less serum ; the right ventricle contained less of a similar fluid.

It seems improbable that this disorganized condition of the brain and its membranes can have been exclusively the result of the tartar emetic : there must have been previous disease and a condition of cerebral weakness induced by previous inflammation or injuries of some kind. Under these circumstances it seems impossible to de- cide how far the existing symptoms, revealed by the post-mortem examination, were the result of primary or sympathetic poisoning.

METASTATIC HYDKOOEPHALUS, where it is recommended by Noack and Trinks both internally, and externally as an ointment applied to the head. Success can only be expected in this treatment in case the hydrocephalus arises from the spontaneous suppression of small-pox.

NERVOUS GROUP.

350 ANTIMONIUM TARTARICUM.

but she preserved a state of irritability of the stomach which never ceased entirely, and could only be moderated by the habitual use of milk and mucilaginous substances.

A girl, aged fourteen, had suffered for five weeks with chorea in an extreme de- gree, which had resisted all the usual narcotic remedies; she was emaciated to a skeleton, and suffered the most frightful tonic, but more especially clonic cramps, which persisted night and day, almost without cessation. Tartar emetic was given in half-grain doses every three hours; not the least nausea or vomiting was caused, but obstinate constipation was relieved ; in twenty-four hours the cramps were lessened, and ceased entirely in two days ; the remedy was continued for ten days, when the patient was perfectly well and blooming.

A boy, aged eight, had suffered with chorea for six weeks ; he was not even free from it during sleep; he had just had chicken-pox and had taken cold; tartar emetic ointment applied to the spine cured him quickly.

A girl, aged twelve, who had grown very rapidly, and had been subject every autumn for five years to an eruption on the face and forehead, was attacked with St. Vitus' dance after the eruption was suppressed ; she had already suffered for seven months, and almost every remedy had been tried without success. Tartar emetic ointment was then rubbed upon the nape and upon the inside of both arms ; improve- ment commenced within eight days after the tartar emetic pustules appeared, and she was well in four weeks ; the cure was still permanent at the end of a year and a half.

A boy, aged twelve, who had suffered for a long time with St. Vitus' dance, and the most wonderful convulsions occurring every morning at nine o'clock, was cured by the application of tartar emetic ointment to the pit of the stomach, where he always felt premonitions of the approaching attacks.

It is perfectly proper to administer the homoeopathic agent by the skin, if it should seem most conducive to the end intended. This does not justify the indiscriminate application of salves or washes to sores or eruptions, for the purpose of drying them up or driving them in. No reasonable practitioner will make himself guilty of the insane proceeding of arresting a discharge or drying up a chronic sore, that had become necessary to the preservation of health or even life. Even in these cases an agent which is truly homoeopathic to the cutaneous disorder may be applied externally at the same time

ANT1M0NIUM TA11TARICUM. 351

as we administer it internally. Hahnemann himself has set us an example of such treatment. He has cured chronic syphilitic and scrofulous sores by the external use of corrosive sublimate washes ; we have cured glandular swellings, goitres and polypi by applying to them the iodide of mercury; we apply the tincture of iodine to buboes, condylomata ; we treat vesicular scabies with the sulphur ointment. All such external applications are perfectly justifiable in homoeopathic practice, as long as we are satisfied that the remedial agent is in true homoeopathic rapport with the disease.

In many cases the external use of the drug may not only be advantageous, but absolutely necessary to a cure. In the cases of chorea which I have extracted from Frank's Magazine, it is more than probable that the ointment was applied as a revulsive or counter-irritant agent, but it is likewise certain that its admirable curative effects depended upon its homoeopathicity to the existing disease.

Similar symptoms were observed in the case of a child ten years old, to whom one grain of tartar emetic had been given. Half an hour after taking the drug, the child experienced a spasmodic diffi- culty of swallowing, and severe pain in the throat. Leeches calmed the spasm ; vomiting had to be arrested by means of twenty grains of ipecacuanha. We therefore recommend tartar emetic in parox- ysmal dysphagia characterized by inability to vomit, spasmodic con- striction of the oesophagus and throat, pain in the throat, congestion of the cervical and cerebral vessels.

BUCCAL AND FACIAL GKOUPS.

Among the poisonous effects of tartar emetic we distinguish very frequently a profuse flow of saliva which is sometimes fetid and ichorous. Hence we are prompted to prescribe this drug for

352 ANTIMONIUM TAETARICUM.

MERCURIAL PTYALISM, to which it is rendered homoeopathic

by the sponginess and bleeding of the gums, which constitute symptoms of tartar emetic action. These effects justify the use of tartar emetic in the

STOMACACE which may befall cachectic or strumous children or full-grown people. This stomacace or scorbutic inflammation may sometimes assume the form of a fully-developed

ANGINA DIPHTHERIOA, with ptyalism, swelling and redness of the soft palate and pharynx which are studded with vesicles and lined with a tenacious mucus. An angina of this kind may meet its homoeopathic type in tartar emetic, if the gastric symptoms likewise point to its use. The voice may be somewhat altered, in some cases weaker and rougher than in its normal state. Trousseau and Pidoux attribute the angina occasioned by tartar emetic to its mechanical action upon the lining membrane of the throat.

If this supposition be correct, tartar emetic may not prove a very efficient agent in angina, except perhaps in the angina of cachectic or scorbutic indi- viduals, where it develops itself as a condition incidental to such a state of gastricism as I have described before.

CHYLO-POIETIC GROUP.

IRRITABILITY OF THE STOMACH which may be induced by over-eating or over-stimulation by strong drinks. In

Acute paroxysms of gastrodynia to which tartar emetic is homoe- opathic, are characterized by extreme prostration, cold sweats, feeble pulse, colicky pains in the bowels, or crampy, burning distress in the stomach and duodenum, retching and nausea.

ANTIMONIUM TARTARICUM. 353

)v. .hall have occasion to refer repeatedly to the prize-essay of Dr. Hirschel, since it contains very thorough investigations of drug indi- cations. In regard to tartar emetic the author says: "Here also the material alterations take the front rank, and the nervous symp- toms are only complications and sequels. The tartar emetic enters more deeply in the metamorphosis and has a wider range, from mere congestion and catarrhal swellings to inflammation, mortifica- tion (softening, ulceration, necrosis) and alteration of the tissues.

Cardialgia, potatorum and arthriticorum, haemorrhoids, venosa ac- companied y affections of the mucous membranes ; the scrofulous and arthrit\ constitution, lymphatic, bilious persons, with phleg- matic, melancholic temperament ; persons of sedentary habits, inclined to catarrh and rheumatism, correspond especially to its application. ^Etiological momenta are : indigestion, catching colds and dyscrasias. Special indications : preponderating nausea and vom- iting, especially after eating or drinking, of mucus, bile, food, blood (especially in drunkards), or also empty retching, with all the symp- toms of gastricism, oven diarrhoea ; pressure on the stomach, relieved momentarily by vomiving ; hunger, cutting pains in the pit of the stomach, as from flatulence ; sensation of heat, congestion, inflam- mation, burning in the stomach ; metallic, bitter, salty, flat, soft taste ; nausea after every meal ; eructations of gas and of the food ; acidity, relief from vomiting.

Accompanying symptoms are : con- gestions to the head, vertigo, sleepiness, catarrh of the respiratory mucous membrane, hepatic affections, rheumatism^ sweats." In

GrASTKITIS tartar emetic will sometimes prove available. In fatal cases of poisoning by tartar emetic the stomach has been found filled with a thick bloody mucus ; the mucous membrane of the stomach has been found intensely inflamed and corroded throughout its whole extent, especially at the fundus of the stomach ; at the same time it looked spongy and might be readily detached from the muscular coat. The duodenum has been found similarly affected. The lining membrane of the remainder of the intestinal tract had a grayish appearance and was found more or less spongy.

A patient attacked with this severe form of gastritis would exhibit symptoms like the following: severe retching and vomiting, crampy, burning- distress, bloating in the epigastrium with excessive sensitiveness to contact, violent thirst, coldness of the skin, with cold sweat, and thin, hurried pulse, expression of agony in the features.

A severe form of gastritis may be superinduced by the metastatic

VOL. I. — 22.

354 ANTIMONTUM TARTAKICUM.

transfer of the small-pox eruption to the coats of the stomach. Tar- tar emetic may be required in such a case.

According to his observations, fatal doses of tartar emetic cause hypertrophy of the intestinal follicles and change the mucous mem- brane to a pale, dry, pultaceous mass. It is therefore evident that in true inflammatory conditions of the intestinal mucous membrane tartar emetic is not applicable as an homoeopathic agent, but that it may prove of decided advantage in degenerations of this organ which set in with violent diarrhoea, consisting of watery and mucous dis- charges, attended with extreme prostration, depression of the pulse and of vital heat.

A strong man, twenty-five or thirty years old, has been sick for eighteen hours.

ANTIMONIUM TARTARICUM. 355

URINARY GROUP.

We have seen that an ointment may induce dysuria, perhaps only in cachectic individuals.

SEXUAL GROUP.

We have seen that antimony causes pustules on the sexual organs, hence tartar emetic has been supposed to be useful for

PUSTULES ON THE VULVA; these indications, however, should be received cautiously, since eminent observers think it probable that these pustules are due to the inadvertent application of the ointment to these parts rather than to the dynamic action of the drug. . The external and internal use of tartar emetic has cured

CHRONIC INFLAMMATION OF THE UTERUS. We are not able to give reliable indications, neither do we think the remedy can be of particular service in the treatment of this disease.

CATARRHAL GROUP.

Tartar emetic has been used for

INFLUENZA. Hirschel gives the following group of symptoms as characteristics of the epidemic influenza of 1834, in Germany:

Rheumatic pains in the limbs and extremities ; stitches in the chest ; oppression on the chest, relieved by expectoration ; irritation inducing cough, with moist serous-albuminous expectoration ; rack- ing cough, especially at night, causing frontal headache and racking the chest ; aphthae around the mouth ; thick, Avhite or bilious coating of the tongue, with hawking up of mucus; nausea, vomiting, pasty or bitter taste, anorexia, not much thirst, empty feeling in the stomach ; pressure, stitches, bloating of the hypochondria, especially of the region of the liver ; diarrhoeic stools, consisting of mucus, not copious; oppressive frontal headache, with vertigo, stupefaction, dulness of

356 ANTIMONIUM TARTARICUM.

the head, slight delirium, weary feeling as from want of sleep, yet there was no sleep ; apathy alternating with nocturnal restlessness ; exhausted feeling in the limbs, as if proceeding from the back ; stiff neck ; pulse small, nervous ; chilly creepings, with copious sweats.

To act with promptness the medicine should be given in the lower attenuations. In

WHOOPING COUGH with tickling in the throat, choking and vomiting of food and phlegm ; croupy symptoms ; gasping for breath before the paroxysm ; diarrhoea ; great exhaustion ; clonic spasms ; profuse secretion of phlegm, which the patient cannot raise in spite of persistent and exhausting coughing, causing constant rattling, difficult respiration and great exhaustion.

CROUP may demand the exhibition of this remedy, when the disease is of the catarrhal type and presents the characteristic symp- toms of the drug. There will be weakness of the voice, which may amount to aphonia ; hoarseness ; oppressed breathing ; coldness of the body, especially of the face, which is of a bluish color ; cold, clammy perspiration ; seeming danger of paralysis of the lung.

A strong boy, six years of age, had croup and received aconite and spongia, and later spongia and hepar, without getting relief. During the second evening he was in

ANTIMONIUM TARTARIC UM. 357

•

PULMONARY GROUP.

PNEUMONIA Tartar emetic is extensively used in pneumonia by physicians of all schools, upon a variety of hypotheses, from tolerably small doses to the enormous ^doses of Rasori and his follow- ers, doses which range from 32 to 144 grains of the crude article. Homoeopathic physicians differ very much in their opinion of the value of this agent in pulmonary inflammation. It cannot be denied that the remedy is of the greatest service in that condition where extensive oedema exists and pulmonary paralysis is threatened.

It is also in place when there is a copious secretion of phlegm, with much rattling and difficult expectoration, extreme prostration, ten- dency to coma, gastric complications, especially if the patient is advanced in years.

It is a mistake to presume that tartaric emetic is a frequently in- dicated remedy, or a remedy of large range in pneumonia; its importance, however, in its limited and peculiar sphere of usefulness cannot be overestimated.

A young woman, aged eighten years, became overheated on July 3d, and exposed herself to a draught. The same day she had a chill, stitching pains in the right side, dry and laborious cough, dyspnoea, etc., all of which increased during the following

358 ANT1M0NIUM TARTARICUM.

We have used tartar emetic with apparently favorable results in cases of cough, induced in accordance with Virchow's hypothesis, by the detachment and deposition, through the general current of the circulation, of little clots of purulent matter, inducing secondary irritation, inflammation and suppuration of the mucous surfaces. In a case of scrofulus periostitis, where the whole substance of the thigh seemed converted into one abscess, the lungs became involved either by nervous agency or in accordance with Virchow's theory ; the patient was continually troubled with a hacking cough, and frequently raised pus and blood. The cough was exceedingly pain- ful. Tartar emetic controlled these symptoms very speedily.

EEYER GROUP.

YELLOW EEVEE for : nausea, vomiting, sense of sinking at the stomach as if the patient would die, prostration, white fur on the tongue, profuse cold perspiration, rapid and weak pulse, drowsiness and disposition to go to stool.

APIUM VIRUS. 250

EXANTIIEUATOUS GROUP.

VARIOLA, especially where gastric difficulties exist or where catarrhal or pulmonary complications have arisen, with characteristic symptoms. It may also be of use in

ECTHYMA with large, full pustules with red areola, showing a tendency to form malignant ulcers and leaving deep scars.

MENTAL GROUP.

Tartar emetic may induce apathy and precordial anguish ; these conditions are of value as a part of the totality of symptoms.

APIUM VIRUS.

The poison of the honey-bee, apis mellifica. This remedy is of peculiar interest to our school, because we have not only developed the entire knowledge of its medicinal power, but, so far, other schools have refused to profit from our labors.

It has always been known that the sting of the bee is not only painful, but absolutely dangerous to many persons. No attempt was made to utilize this knowledge until homoeopathy had become a recognized fact, when Brauns, a veterinary surgeon, in 1835, com- menced to use the alcoholic dilution of the poison, at first to antidote

360 APIUM VIKUS.

The sting of the bee produces frequently, but in exceptional cases only, serious and even fatal consequences. It is believed that the sting of an fnfuriated bee is usually followed by serious symptoms. But little annoyance is experienced from their sting in the winter ; during the hot months of summer the effect is much more marked. Then, the " part rapidly swells up, becomes more or less hot and red, with intense pain and considerable burning, tingling and itching." (Hughes.) Some persons are especially sensitive to the poison.

The writer is forced to take pains to avoid the insect, because to him the sting of the bee is not merely painful in an ordinary sense, but is at once followed by aching of the whole body, dimness of vision ; severe, congestive headache ; general malaise, accompanied by chilli- ness and followed by a depression of the whole system, which usually lasts for several days, leaving behind it irritation of the skin and a marked increase of the urinary secretion.

The poison is fatal to the bee itself. A bee stung by another may die at once ; or it may loose the use of its wings, fall down and remain in that condition until death ; or it may crawl away, dragging behind it one or both hind legs ; its abdomen or second joint is bent upon itself or sideways ; but in all cases a stung bee looses power of motion within one hour and death takes place within the second hour.

Permit me to call your attention to well authenticated instances, where the sting of one or more bees produced serious or fatal conse- quences upon man or beast. These cases are taken from Hering's American Provings.

APIUM VlltUS. 361

The following case occurred near Philadelphia:

362 APIUM VIRUS.

The following cases show the effects of the poison of the bee upon man :

Dr. Mueller relates the following : During very hot summers ani- mal poisons seem to develop the same virulence which characterizes them in the warmer climates. A woman was stung by a bee near the temple, in June, 1834, the sting remaining in the flesh; she immediately felt pain in her teeth, trembling and swelling of the lips and tongue ; difficulty of breathing, choking, goneness, followed by perspiration and a rash, covering the whole body ; then shuddering ; copious evacuations of dark brown, green and white stools and pain in the sides ; the rash disappeared ; she passed a quiet night, and, on the day following, the symptoms were much less violent, and disap- peared altogether after taking a mixture of liqu. amnion, caust., and liqu. anod. min. Hoffm. *

APIUM VIRUS. 363

The above cases show that the poison of the bee acts promptly, and in certain cases with terrible rapidity. Introduced into the system, much as the poison of venomous snakes, it is absorbed with great readiness and carried with ease throughout the organism. We find that the cellular tissue is strongly affected by the poison, causing symptoms of local and of general dropsy; the mucous membrane becomes violently inflamed, giving rise to inflammation in the eyes, nose, mouth, larynx, trachea, stomach, intestines and bladder.

The kidneys secrete an unusually large amount of urine ; the sexual organs of women, the ovaries more particularly, are violently affected ; the brain is invaded, as shown by the headache, vertigo and general prostration. The skin presents prominent symptoms. We find a general rash, characterized by stinging, itching, burning ; or petechise or pale, large blotches. Some of these effects have not been brought out in the cases given ; but they have been fully developed in provings made by Humphreys, Bishop and others.

CEPHALIC GROUP.

364 APIUM VIRUS.

You will find Apis an excellent remedy in

HYDKOOEPHALUS with the following symptoms: convulsions ; high fever ; delirium ; sopor, interrupted by piercing shrieks ; boring of the head into the pillow ; copious perspiration about the head, which smells of nrask ; inability to hold up the head ; squinting ; dilatation of the pupil ; grating of the teeth ; retching ; vomiting ; hard and collapsed abdomen ; frequent, scanty urination of milky urine ; trembling of the limbs ; symptoms of paralysis on one side with twitching on the other side of the body ; painful turning out- ward of the big toes of both feet; slow, irregular, uneven, hard pulse.

In 1857, a boy, four years old, a son of German parents, was given up by the attending alloeopathic physician as a case of hopeless hydrocephalus.

He had been blistered with cantharides from the nape of the neck to the lumbar region, two days previous, since which time he had passed no water, and had given no evidence of seeing, hearing or feeling.

The case certainly seemed a hopeless one. Nevertheless, a few pellets of Apis mel.30 were dissolved in half a tumblerful of water, with directions to give the child a few drops of the solution every two hours, even if it was not swallowed.

CEREBROSPINAL MENINGITIS, Apis is said to be an efficient remedy. We have prescribed it in but one case, where the remedy

.APIUM VIRUS. 365

" The direct pathogenesis of apis presents neither the convulsions nor the spots which characterize cerebro-spinal meningitis ; but it has the violent headache, and all the paralytic symptoms which result from the serous or other exudation of the advanced stage of this disease. While its acknowledged value in acute hydrocephalus, in arachnitis and in the secondary or exudative stage of what is called ( meningitis basilaris of children/ will entitle it to a careful study in this connection.

" The apis seems to produce serous rather, than plastic exudations ; but when indicated by its dynamic, subjective symptoms, it will always do good, and we can see when the remedy is called for, during the life of our patients, by means of these dynamic symptoms ; wThile if we were to rely upon the demonstration of the exact pathological condition (the nature of the exudation as serous or pseudo-mem- branous,) we should be obliged to postpone prescribing till after we had made a post-mortem examination of the subject.

INFLAMMATORY GROUP.

From the above you will infer that we may use apis in inflamma-

366 APIUM VIRUS.

tory conditions of the organs of vision. It has, indeed, been success- fully prescribed for

CONJUNCTIVITIS, accompanied by some of the symptoms just given ; also in

BLEPHARITIS ; its main use, however, has been in

SCROFULOUS OPHTHALMIA, where, in our own experience, the remedy acts finely, when the indications given by Raue are present, namely: eyelids swollen, inflamed and turned inside out, granulated ; eyelashes fallen out ; conjunctivas injected ; chemosis ; cornea grayish, smoky, opaque ; pain burning, stinging.

You remember that in instances of poisoning from the sting of the bee, a well-marked swelling or infiltration of the upper lids took place ; in one instance the upper lids hung down like little sacks ; hence

(EDEMATOUS SWELLING of the eylids may find its remedy in apis.

The following cure of

OPHTHALMIA, reported by Dr. Humphreys, is found in Met- calfs Provings, page 201 :

A woman of fifty, of dark complexion, bilious temperament, had suffered from ophthalmia for three years and had been, with little benefit, under the care of several oculists. Her eyelids were swelled, dark red, everted, denuded of the lashes; gran- ulations along the edges; the conjunctivae reddened and full of dark vessels; the cornea dark and smoky; vision very indistinct ; eyes intolerant of light, running and agglutinated. Apis80, every three or four days, changed the entire aspect of the case. The eyelids were relieved entirely, the conjunctiva lost its dark vessels, the cornea became clear, vision improved, and she left almost entirely well.

GLOSSITIS may find a remedy in apis, especially when there is a great deal of burning and stinging pain in the throat, with red, in- flamed, raw state of the mucous membrane of the mouth.

The throat shows unmistakeable marks of inflammation from the effects of the poison. You have all the symptoms of violent inflam- matory action, namely : swelling, redness ; burning, stinging pain ; sensation of fulness and constriction in the throat ; swelling of the glands of the throat ; accumulation of mucus in the throat, com- pelling hawking and coughing, without ability to raise much.

APIUM VIRUS. 3 07

3G8 APIUM VIRUS.

and others recommend the remedy highly in the treatment of this affection. In

BRONCHITIS it has been successfully used when, according to Marcy and Hunt, there exists a "chronic tendency to inflammation of the upper part of the alimentary and respiratory organs, popularly comprised under the name of bronchitis. It is characterized by re- currence of the troubles after every cold, particularly exposure to wet ; highly inflamed or mottled appearance of the fauces and con- tiguous parts ; constant discharge of a tough, clear, stringy phlegm, which produces a tendency to hawk frequently ; hoarseness and huskiness of the voice, and returning after every cold. In a case of a minister who complained of a cold, sore throat, great hoarseness, pain from talking, apis3, a few doses, restored him so thoroughly that he was able to fulfil his clerical duties only two days afterward. Many months afterward a similar attack was cured by the same remedy."

APIUM VIRUS. 369

DIARRH(EA, when the stools are light yellow, soft, and the patient has blue and cold hands, worse in the morning, some pain and weakness in the bowels and possibly other symptoms char- acteristic of apis, you may find it to the advantage of your patient to prescribe the drug.

Apis has been recommended in

PERITONITIS may demand the exhibition of apis. We will find sharp and sudden paroxysms of burning, stinging pain ; tender- ness of the abdomen to the touch ; scanty, milky and even sup- pressed urination ; swelling of the limbs and feet ; great prostration ; fear of death.

VOL. I. — 23.

370 APIUM VIRUS.

CYSTITIS We use apis in the treatment of cystitis with fre- quent desire to urinate, passing only a few drops ; burning, stinging pain during urination ; the urine is red, hot and even bloody. Said to be of service after the use of cantharides.

PARENCHYMATOUS NEPHRITIS, albuminuria or chronic Bright's disease, you will find a very similar set of symptoms.

Albuminuria is one of the sequelae of scarlatina and of diphtheria. As such it has often been our duty to preseribe for the disease, in all the stages of the development, and we have invariably found apis one of the most reliable and prompt remedies.

APIUM VIRUS. 371

When you bear in mind the fact that a deficient secretion of urine is one of the most important conditions which characterize dropsy, and that a re-establishment of an abundant flow of urine is of the utmost importance in such complaints, you can readily see that apis must be a remedy of the utmost importance in the treatment of

372 APIUM VIRUS.

The power of the bee-poison to cure dropsy seems to have been known to the Indians.

At this stage of the case a strolling Indian woman, one of the few survivors of the Narragansett tribe, suggested to the family the use of the honey-bee every night and morning. She enclosed the bees in a covered tin pail, and placed them in a heated oven until they were killed, and then, after powdering them, administered one in syrup every night and morning. After the lapse of about twenty-four hours the skin became less hot and softer, the respiration less difficult and more free, the pulse slower and more developed, and there was a decided increase in the quantity of urine. From this time the symptoms continued steadily to improve, the dropsical effusion diminished day by day, until at the expiration of a few weeks, the patient was entirely cured.

APIUM VIRUS. 373

FEVER GROUP.

TYPHUS AND TYPHOID FEVER, when there is present the following condition : apathy, unconsciousness, stupor with murmuring delirium, hardness of hearing, inability to talk and to put out the tongue, which is cracked sore and ulcerated, or covered with vesicles ; difficulty in swallowing, great soreness and bloating of the abdomen ; constipation, or frequent, painful, foul, bloody and involuntary dis-

374 APIUM VIRUS.

charges from the bowels ; unconscious flow of urine ; dry burning skin, or partial clammy sweats; trembling and jerking of the limbs; white miliary eruption on the chest and abdomen ; greatest weakness and sliding down in bed ; frequently changing, weak and intermit- ting pulse. (Wolf.)

CHTLO-POIETIC GROUP.

These symptoms are of importance only when taken into consid- eration as a part of a general group, where they may afford us additional indications for the selection of the proper remedy.

SEXUAL GROUP.

DYSMENORRHEA. — We may use apis in dysmenorrhea or painful menstruation, when the case is of the congestive type ; vio- lent, labor-like, bearing-down pains, followed by discharge of scanty, dark, bloody mucus ; stinging pains in the ovaries ; scanty, dark urine ; wax-colored skin.

AMENORRHCEA, characterized by congestion to the head; de- lirium ; tendency to dropsy, dyspnoea ; mental depression ; irri- tability.

APIUM VIRUS. 375

Drs. Marcy and Hunt (Theory and Practice, vol. ii, p. 707,) recom- mend apis in

MASTITIS or inflammation of the mammae, and even in

CANCER OF THE BREAST, apis has been employed. As in other local disturbances mentioned, we are justified in using the remedy only when the concomitant symptoms point to it with dis- tinctness. If in mastitis there is considerable enlargement of the breast, with a burning, stinging pain, apis may act very favorably. But even here, and by all means in scirrhous affections of the organ, possible ovarian complications, disturbances of the urinary apparatus, tendency to dropsy, etc., are really the only justification for the use of the drug in the affections mentioned.

376 APIUM VIRUS.

though rarely, the general practitioner is called upon to treat such a case ; it will be well to remember that apis has produced such a con- dition and may consequently cure it.

Several years ago we treated a young girl of sixteen years of age, who had been under the care of several prominent allceopathic physicians, who considered the liver the cause of all the trouble, and who had given the patient large doses of calomel and iron. We took charge of the case under very discouraging circumstances. There was excessive tenderness in the hepatic region; great irritability of the stomach which made the very idea of eating painful; there was much retching and vomiting; excessive thirst all day and feverish erethism each night ; the patient had intense headaches, driving her wild ; constant restlessness ; ©edematous swelling of the lower lids; bloating of the limbs ; difficult and scanty urination; constant watery, yellow- ish, offensive diarrhoea ; and at her monthly periods (during which the discharge itself was merely nominal), the poor girl suffered unspeakable torment.

After she had taken china, arsenic, pulsatilla and other remedies that seemed indicated, we concluded to resort to apis, which would have been given sooner, had there not been an entire absence of appreciable ovarian irritation and, with all the pain she suffered, of the burning and stinging so characteristic of the remedy. She took apis for nearly four weeks with constant improvement. The cedematous conditions disappeared as she voided urine in increasingly large quantities ; her complexion lost that deathly, wax-like appearance which it had so long borne and, generally speaking, she gained rapidly, without, however, improving perceptibly in other respects, namely, the pain in the hepatic region, the irritation of the stomach, the nightly fever and thirst, and headache.

She menstruated twice while taking the apis and suffered far less than she had done previously. At that time we concluded to return to the class of reme- dies previously given. China and ars. album were once more taken and acted promptly, and a few months later we had the pleasure of discharging our patient per- manently cured. In this case the apis, while by no means able to reach the cause of the disease, removed, however, a set of symptoms which seemed to stand in the way of a cure ; and the same remedies which had been at first unsuccessfully given, acted to my perfect satisfaction at a later period of the course of treatment.

The climacteric period of womanhood is frequently characterized by a set of symptoms not unlike those described under the head of chlorosis, and, in fact, the very name might be justly applied to a condition of such great similarity. You will be apt to find at such times, in addition to the condition above described, a tendency to skin troubles, often merely a dryness and scaling off of the skin, or an irritation which approaches urticaria.

APIUM VIRUS. 377

There is a less clearly-marked waxy, anaemic appearance of the countenance, though the face may look pale or flushed ; but urinary difficulties, ovarian irritations, menstrual derangements and drop- sical symptoms are often present, in which case apis may be the very remedy which your patient needs.

EXANTHEMATOUS GROUP.

The symptoms enumerated do not, by any means, comprise all those recorded by the various provers ; but they suffice to give you a fair idea of the close homoeopathicity of apis to many of the diffi- culties which come under this group.

SCARLATINA, that dreaded disease of childhood, very often finds its remedy in apis. No candid practitioner can refuse the testimony in its favor. It is to be exceedingly regretted that, as is ever the case with a valuable new remedy, everything possible and impossible was claimed for it by its friends ; for, in the very nature of things, disappointment had to follow. We have heard apis eulo- gized as a specific for scarlet fever by men who were by far too well read and too experienced practitioners to entertain, seriously, the very possibility of a specific.

Apis cannot take the place of aconite, belladonna, lachesis, etc., any more than those drugs can fill the place of apis. We can readily see that the pathogenetic symptoms of apis bear a close resemblance to the symptoms of scarlet fever. Apis causes the appearance of a rash which is a fair picture of the scarlet rash, and in many cases of scarlet fever we find that peculiar burning and stinging pain, which reminds us, invariably, of apis. As the disease progresses, the throat presents often the ©edema- tous condition of the apis-throat, which differs so much from the intensely-congested state which indicates belladonna, and from that

378 APIUM VIEUS.

bluish, passive congestion, which calls for lachesis ; further on we have scanty, milky urination or entire suppression, followed by local or general dropsy. Wolf does not exaggerate when he says: Apis is indicated in ordinary as well as in those grave cases where the blood is thoroughly poisoned by the virus and the whole nervous system is under its pari ay zing influence ; the fever assumes a typhoid char- acter, the tongue is of deep red color, and covered with blisters, which become converted into sores and ulcers, with stinging pains ; the nose discharges a thick, white, bloody, fetid mucus ; the tonsils are swollen and hard, and the swallowing difficult ; the whole abdo- men is sore to the touch ; the discharges from the bowels are diarrhoeaic, slimy and bloody ; the urine is scanty, and of a dirty red color ; micturition sometimes painful ; the breathing is accelerated and labored ; there is loss of consciousness, delirium, sopor, convul- sions, trembling of the limbs ; the skin is either burning hot all over or gradually growing cool ; or hot in some and cool in other places ; the fever rises constantly, and the pulse changes frequently in char- acter ; dropsical symptoms during desquamation.

A few days after, a sister of the above-mentioned sickened with scarlatina ; she was twelve years of age, and on the second day of the fever the rash extended gen- erally over the body. She took apis only; the throat did not become much affected; she did not suffer from one alarming symptom, and made a good reovery.

A boy, aged eight, came under treatment about this time for renal anasarca, conse-

AFIUM VIRUS. 379

MOKBILLI or measles often call for apis. Kaue gives the follow- ing indications : " Confluent eruption and cedematous swelling of the skin ; greatly inflamed eyes ; croupy cough ; violent cough similar to whooping cough ; catarrh of the bowels, with diarrhoea ; prostra- tion, muttering and delirium."

SMALL-POX. — In small-pox or variola (chicken-pox) you may give it, if there is a generally inflamed state of the skin ; if the pain is burning or stinging ; if the throat is inflamed and if urinary and other derangements exist, which call for apis.

The sequelae of eruptive diseases, for which apis may be success- fully prescribed, have been mentioned under their respective groups and need not be repeated.

ERYSIPELAS, especially of the scalp, has been favorably affected by apis. You will find in such cases a tendency to metastasis

380 APIUM VIRUS.

to the face ; you will have the peculiar pain so often mentioned, namely: burning and stinging ; there will be oedematous conditions and other symptoms characteristic of the drug.

The erysipelas was occasioned by taking cold, the patient, a lady of seventeen years, having stood for some time at the open door in the damp night air. She felt a slight chill, which, more severe, returned once or twice during the night, and was followed by high fever. By next morning the affection appeared on the right side of the nose, and within four days spread over both cheeks, eyelids, the right ear, fore- bead and part of the hairy scalp, upper lip and a part of the chin.

That the case, ab initio, was a severe one, was manifest from the intensity of the general (fever, headache, gastric disturbances) and local symptoms (veiy numerous bulla?, quickly uniting into one large blister on the cheeks, forehead and chin, intense con- junctivitis of the right eye). However, the remedy very soon held decided control over the trouble, and though it spread over both sides of the face, the several success- ive eruptions had a dead appearance at the very outset, and the disease ran through its course within six days I have to add that the patient had never suffered from ery- sipelas before.

APIUM VIRUS. 381

It would be a wearisome task were we to enumerate all the possi- ble conditions, or forms of skin disease, in the treatment of which the use of apis may be justifiable. Whenever there is much of a burning and stinging pain, examine the concomitant symptoms closely and unless they counter-indicate apis, you may find it to your advantage to prescribe it.

In Marcy and Hunt's Theory and Practice, Vol. ii, page 884, the following case is given :

382 APOCYtfUM ANDROS^MIFOLIUM.

days, after which there was a slight return of the symptoms. Under the use of a few globules of apis200, the disease gradually disappeared.

SLEEP AND MENTAL GROUP.

APOOYKUM AJSTDEOS^EMIFOLIUM.

DOG'S BAKE. KATUKAL OKDEK, APOCYNACEtE.

The root is perennial, large, bitter. The flowers have a peculiar,

APOCYNUM ANDROSiE.UIFOLIUM. 383

It grows in all parts of the United States, along the highway, in the corners of fences, where its fruit, furnished with long and downy pappus, makes it a conspicuous object. We use the tincture of the root.

Dr. Henry says (Philadelphia Journal of Homwopathy, Vol. hi, page 369) : "This plant has been used greatly by the common people, especially by the blacks of the south. We are told it acts as an emetic, and diaphoretic ; in large doses it promptly induces emesis, causing scarcely any previous nausea. It is a mild diuretic, most active sudorific and cathartic ; it seems to resemble the action of bryonia ; it has been used in all forms of bilious diseases by the country people of this state (South Carolina), in the marsh fevers of the rice plantations, yellow fever, lues veneria, syphilis, gonorrhoea, colds and inflammations of the bowels and lungs, and constipation from chronic liver complaint, dyspepsia ; it seems to exert a specific action over the abdominal viscera ; it is given to increase the secre- tion of milk, and is curative in diarrhoea, dysentery, rheumatism."

To obtain medicinal effects, Dr. Henry experimented with doses ranging from fifty to eighteen hundred drops.

Permit me to give, in Dr. Henry's own language, the symptoms produced on his three pro vers :

We each took fifty drops, fasting in the morning ; symptoms felt by two of us, cramps in the bottoms of the feet ; the third had violent heat in the bottom of the feet with profuse sweating all over. May 15th, each took 100 drops; all felt the cramps and burning in the bottom of the feet, most in my right foot with great pain in the joint of the left big toe ; heat in the right leg and knee. One of the ladies with myself complained of great fulness and pain in the head, cannot describe it ; next morning the bowels of all were costive. 16th — 150 drops; same symptoms; tingling pains in my toes, sharp pains in the middle, trembling of the body of two provers, most delightful taste in the mouth of each ; everything smells like honey to me; all complain of pains in different parts of the body, much pain in my knee and right shoulder.

The ladies complain of pain in all the teeth of the lower jaw, left side. 17th — 200 drops. I am the only one that felt the cramps in the bottom of the feet; all other symptoms as on the 16th; pains and stiffness in the back of the head and neck ; dull, heavy pain when breathing, seems to go from above down- ward. 1 8th. — 250 drops. Bilious, painful diarrhoea, felt by myself and one of the ladies. 19th. — 300 drops. Heaviness of the body, with great desire to sleep, flying

384 APOCYNUM ANDIiOSJEMIFOLIUM.

pains all over the system, pain in the head and back of the neck, swollen sensation of the face and body, violent itching of the body and face. 20th Took 350 drops. All the above symptoms. Profuse flow of clear urine, pulsating pain in the back of the head and between the right hand and elbow ; constipation of two, diarrhoea of the third, with much pain and rumbling; only two evacuations, but large, giving much relief. 21st. — 400 drops.

Much pain all over the head, stiffness of the neck; pain on turning to the left side, itching and burning of the face, much lassitude, fre- quent passing of clear urine. 22d. — 450 drops ; all symptoms felt, great sneezing, twitching of the face, most violent pain in all the joints, great itching and irritation in the left nostril. 23d. — 500 drops. Violent pain in the left zygoma, chilliness, lassitude, heat of the head and neck; cannot sleep at night; violent dreams; sleep not refreshing, pain in the left groin of a shooting character. 24th. — 550 drops; profuse menses, lasting eight days, with violent pressing pain; symptoms as before. 25th. — 600 drops ; some flying pains in the stomach ; fulness and pain in the right side ; feeling as if something would pass the bowels; slight nausea; increase of all above symptoms, with great pain in the left side of the head ; pain above each wrist-joint. 26th. — 650 drops.

Some efforts to vomit, without pain ; pain increases in the back of the neck, extending in front ; pains worse about the wrist ; four bilious evacuations, two in one prover and constipation in the other ; it seems every alternate day there is constipa- tion and diarrhoea. 27th. — 1800 drops; all sick, vomiting, purging; great prostra- tion, great trembling of the body. All the provers seem well when beginning the remedy ; all sick and prostrated when sleeping. One of the ladies was troubled with leucorrhcea before taking the medicine; she is now well and has not had the least return ; all have improved in flesh up to this time.

GASTRIC AND BILIOUS DERANGEMENTS, or in diseases (fevers, for instance,) characterized by such disturbances. In

GOUT, also, it should act with tolerable certainty. The urinary symptoms would lead us to think, that in dropsy, particularly if ac- companied by bilious and gastric troubles, it might be prescribed advantageously. The effect upon one prover, curing a leucorrhoeal discharge, might indicate some special effect upon the genital organs; this seems all the more possible, when we remember that several of the Indian tribes, according to Professor Lee, look upon it as a spe- cific for syphilitic affections.

APOCYNUM CANNAMNUM. 385

APOCVNUM CANNABLNTTM.

INDIAN HEMP. NATURAL ORDER, APOCYNACEiE.

The remedy is not frequently used by alloeopathic practitioners, but has grown into some importance in the hands of homoeopathic and eclectic physicians.

Provings made with the drug are merely suggestive.

Dr. Peters, one of the provers, took half a wine glass full of a (probably weak) decoction, three times a day.

VC1-. 1.— £4.

386 APOCYNUM CANNABINUM.

and night were a continuation of the sixth ; on the eighth day the stomach and chest symptoms had diminished, but the urinary secretion had increased in quantity and was much lighter in color than in health. On the evening of the eighth day we ex- perienced an unusual heaviness of the head, V7ith aching pains in the small of the back and limbs. There was no tenderness of the region of the kidneys on pressure, but a slight soreness of the parts when bringing the muscles into action, indicating the muscles as the seat of the pains. From the ninth day the symptoms continued very gradually to decline until the thirteenth day, after which no further abnormal phenomena were observed."

Dr. Marsden {Am. Horn. Observer, February, 1865,) says: "Some years since, when engaged in making the first decimal trituration of the bark of the root of this plant, I observed that the Schneiderian membrane became affected very similarly to what is experienced, when suffering from a very bad cold in the head.

I have been subject to severe attacks of coryza from my childhood and am quite familiar with its symptoms, and immediately noticed the very close resemblance between these and those produced by inhaling the pulverized apocynum. * * * I did not until quite lately meet with similar effects from its internal exhibition. About the middle of November last I had a lady under my care, * * * to whom I gave a small tea- spoonful of the decoction of the plant. Toward the evening of the third day after she began the medicine, she complained of dryness and stiffness in the nose, chilli- 'ness and general malaise.

She asked me if these symptoms could be produced by the medicine she was taking, as she had not exposed herself in any way by which she could take cold, and that she had never taken cold in the head, but always in the throat and breast. She discontinued the medicine when she went to bed, was some- what feverish during the early part of the night, but in the morning all the symptoms had disappeared, She resumed the medicine, the symptoms returned in the after- noon, and in the evening she finally discontinued it.

Apocynum has caused, among others, the following symptoms upon the healthy :

Bewildered state of the mind.

Headache. Unusual heaviness of the head, with aching pains in the small of the back and limbs.

Irritation of the left eye, as if sand were in the eye, at- tended with heat and redness. Lasted several hours, then disap- peared suddenly.

Without any signs of cold, he would awaken in the morn- ing with the nostrils and throat filled with thick, yellow mucus, as if he had had a severe catarrh for at least seven or ten days, and which had skipped its first stage and commenced in the second.

Mouth — Dryness on waking. Increased secretion of mucus and saliva.

Decided distention of the abdomen, especially after

APOCYNUM CANNABINUM. 387

dinner, sense of fulness in the upper abdomen. Some flatulence and slight uneasiness in the bowels.

Acted like a gentle cathartic, without produc- ing any griping. Evacuations exceedingly scanty.

Neck and Back. — Slight soreness in the region of the kidneys, when bringing the muscles into action.

Lower Extremities. — Hard aching in both knees.

General restlessness on going to bed. Transient debility.

Desire for sleep, but inability to sleep.

On going to bed unusual heat of the skin. Sweat.

The pathogenesis of apocynum lacks that variety of profound drug-effects which usually characterize a drug of great sphere of action. Indeed, practically speaking, the main value of the remedy lies in its power to stimulate the action of the kidneys and to pro- duce the copious secretion of urine, which has led to its frequent use in the treatment of dropsical effusions in any part of the body. The catarrhal symptoms, which apocynum has produced upon pro vers, have led to its employment in corresponding pathological states ; and clinical experience has demonstrated its value in bleeding from the lungs and from the uterus, both metrorrhagic aud menorrhagic. In the treatment, then, of

388 APOCYNUM CANNABINUM.

diseases, renal difficulties and sequelae of certain fevers, particularly of the exanthematous type, belong here and may demand the exhi- bition of apocynum. The following symptoms indicate this drug : Anxious expression of the countenance ; dryness of the tongue; great thirst ; irritability of the stomach, which rejects everything ; feeling of faintness and goneness at the pit of the stomach ; muddy appear- ance of the urine which is voided in small quantities; total suppres- sion of urine; oppression on the chest ; great difficulty of breathing, so he cannot lie down or dare not make the slightest exertion ; feeble action of the heart ; irregularity and great weakness of the pulse ; dryness and scaly appearance of the skin ; great anxiety.

A married lady, thirty-five years old, was laboring under organic disease of the heart, complicated with distressing general dropsy. For fourteen days and nights the patient had occupied a sitting posture, supporting herself on the edge of a couch with her hands, on which sores had formed. She had been unable to sleep during this period longer than five minutes at a time ; the dropsy involved the face, chest, abdomen, vulva and the upper and lower extremities. The urinary secretion was almost entirely absent.

She took apis, arsenic, china, digitalis, lachesis, rhus, eupa- tor. purpureum, colchicum, hellebor., veratrum and gelsemium without benefit. Dur- ing eight weeks from the commencement of treatment, she was tapped four times ; the result being the withdrawal of about thirty quarts of water, in addition to which an incredibly large quantity was discharged through openings made in the lower extremi- ties by means of a bistouri.

Your attention has been called to the production by apocynum of

APOCYNUM CANNABINUM. 389

HEMORRHAGE FROM THE UTERUS.— Should the drug be carefully proved by women, it is probable that we would discover pathogenetic symptoms, which would not only confirm our clinical experience, but would furnish us indications for a still broader field of usefulness.

390 APOCYNUM CANNABINUM.

Apocynum has caused : short, dry cough, scanty expectoration of white mucus, etc.

COUGHS. — In coughs, characterized by the above symptoms, with heat of the fauces and dryness of the throat, the remedy may be found of value.

ARGENTUM METALLICUM. 391

I had a very severe haemorrhage from the lungs some eleven years ago, raising more or less twelve or fourteen times during four or five days. It was then some four months before I could talk aloud, but by leaving the city and coming up among the New Hampshire hills, I have kept along and attended to a good deal of business in spite of a few slight attacks until last fall. 1 was then taken without any warning a few days after returning from a journey to New York and Philadelphia, the blood almost pouring out to the amount of half a pint; this was about 8 A.

M. At io another attack, in which I raised somethimg more than a half pint ; at 6 and 9 p. M. two more attacks, each time about half a pint. I had taken aconite, hamamelis, china, etc., with only temporary relief.

After the fourth attack I told my wife that I could not live through many more turns, and to prepare some of the apocynum can- nabinum1 and have it ready to give if I should have another attack. About 6 o'clock next morning it commenced as furious as ever. I took the apocynum every few minutes : it began to check it at once, and by the time I had raised half the usual quantity it had ceased entirely, with no return since. I continued to take it occasion- ally for a few days until I began to feel the vital powers returning. * * * I seemed to feel the effect of the apocynum in one minute after taking the first dose, and I think it had wonderful power at that time.

AEGEWTLTM METALLICUM.

[metallic silver.]

Of the finest silver foil we make triturations, either in the decimal or centesimal scale, running them up to the fourth, or, better still, to the sixth trituration, from which the alcoholic preparations are obtained in the usual manner.

We have interesting provings of this agent by Hahnemann, and subsequently by Huber. According to this experimenter, metallic silver acts upon: 1, articulations ; 2, bones ; 3, cartilages, particu- larly cartilaginous surfaces, cartilages of the ears, Eustachian trumpet, tarsal cartilages, cartilages of the nose, false ribs ; 4, muscles, ten- dons and ligaments, particularly those in the neighborhood of joints ; 5, certain glandular organs (salivary glands, testicles) ; 6, heart.

CEREBROSPINAL GROUP.

Pressure and tearing pain in the region of the right and left tem- poral bone, increased by contact Giddiness and stupefaction of the head. Spasmodic jerking of the right temporal muscle, the occipito- frontalis muscle, also the muscles of the side of the neck and cervical region.

o

92 ARGENTUM METALLICUM.

Dr. Peters thinks that "it may prove homoeopathic to some of the head affections which attend epilepsy ; at least Huber noticed com- plete dizziness on entering a room after a walk ; while slumbering, he was seized with dizziness, so that it seemed as if his head was falling out of bed ; also, while dozing in the afternoon, a violent electric shock, which proceeded first from the left, then from the right hip, disturbing his sleep ; another shock, more violent, was afterward felt in the left arm."

INFLAMMATORY GROUP.

The following symptom seems to point to silver as a medicine which may prove of use in combating some of the chronic effects of mercury or of the strumous miasm upon the throat ; " The region of the submaxillary glands is swollen ; this causes a rigidity of the neck, and produces a tension in the parts when moved ; deglutition is, at the same time, rendered difficult, as if there were an internal swelling of the throat ; he is obliged to force every mouthful of food down his throat." This condition may be described as a mercurial rheumatism.

ORBITAL GROUP.

Argentum foliatum causes : red and thick eyelids ; the eyes, how- ever, do not suppurate. Frequent and fine stitches with itching, which provokes scratching, in the left canthus, etc.

Occasionally we find a case of scrofulous inflammation of the eye or eyelids, which is benefited by the remedy under consideration. The following case is typical :

Was called in to see a child, about four weeks after its birth, which was suffering

ARGENTUM METALLICUM. 393

NASAL GROUP.

AUDITORY GROUP.

Here we have, violent itching of the lobules ; sensation as if an insect with many feet were digging those feet into the depressions of the concha.

CHTLO-POIETIC GROUP.

In this range the symptoms are not very numerous or marked. Provers have experienced a painful sense of hunger, a sort of bulimia, for which silver may be recommended.

URINARY GROUP.

SEXUAL GROUP.

CHRONIC ORCHITIS.— Silver causes a contusive and digging pain in the testicles ; hence it is recommended by Huber for chronic orchitis.

394 ARGENTUM NITRICUM.

THORACIC GROUP.

IRRITABLE HEART — The following symptom deserves our attention : Spasmodic startings of the heart, not painful, but giving rise to the idea of apoplexy. This condition may be described as irritable heart.

MENTAL GROUP.

HYSTERIA. — In some forms of hysteria and hypochondria, silver may rouse the depressed spirits, acting similarly to gold.

AEGE^TUM NITEIOUM. I

[nitrate of silver.]

Old -school practitioners use it externally as an escharotic, dry or in solution, five grains or one drachm to an ounce of water ; it is applied to sores, injected into fistulous ulcers ; or it is used as a wash in cases of aphthae in the mouth, or for scorbutic gums. One-fourth to one-half of a grain in an ounce of rose-water is applied to the eye in subacute ophthalmia.

The nitrate of silver has been extensively used by alloeppathic physicians in the following affections :

Croup ; chronic laryngitis (follicular ulceration and inflammation) from two to four scruples in an ounce of water ; erysipelas ; burns ; bed-sores (first washing the parts with chloride of soda or soap-suds) ; gonorrhoea and leucorrhoea ; chronic cystitis; typhus abdominalis; inflammation, ulceration or induration of os tincae; fissured nipples; fissure of the rectum; incontinence of urine; scald-head; small-pox; it is also used as an ingredient of hair-dye, and when thus used caused meningitis and terrible headache.

AEGENTUM N1T1UCUM. 395

Why such enormous doses should be given in order to cure epi- lepsy is a mystery to me. If the salts of silver are homoeopathic to the disease, a small dose will prove sufficient for a cure.

The following case of epilepsy is reported in the third volume of the Transactions of the London College of Physicians : A man, aged forty-six, had epileptic fits from his infancy, and, to save his tongue from severe injury, carried a silver crown-piece in his pocket, to be placed between his teeth so soon as a fit was about to come on. On March 12, 1771, he accidentally swallowed the piece of silver. In September, 1772, he was seized with fever, for which emetics were ordered; active vomiting caused the ejection of the coin, nearly twenty months after it had been swallowed, and down to July 6, 1773, the date of the published article, he had no return of fits. The coin was blackened and corroded on the edge, and there can be no doubt that a portion of the coin had acted dynamically upon the abnormal condition of the nervous system, and had effected a cure not only in accordance with our law similia similibus, but likewise by means of a very small dose.

Very few drugs have been abused by old-school physicians more than the nitrate of silver. Mercury, opium and the nitrate of silver

396 ARGENTUM N1TRICUM.

are the three grand poisons with which our alloeopathic brethren would have poisoned the very life-springs of humanity, if it had been in their power to effect such a result. In Asiatic cholera the nitrate has been given in doses of ten, twenty, thirty and more grains to arrest the vomiting and purging ; and even in other diseases, where a high state of irritability of the stomach was present, enormous doses of the nitrate of silver have been resorted to, to blunt the excessive sensitiveness of this viscus.

The first sensation after the immediate strangling is a sense of numbness, which is quickly followed by a heat and smarting throughout the entire ramifications of the air-cells ; this is soon followed by an expectoration of deep-yellow, or even reddish -yellow mucus which an ignorant patient may mistake for a salutary action of the medicine, but which is, in reality, a manifestation of the irri- tating action of the poison upon the lining membrane. Will the counter-irritation, thus set up, absorb the natural morbid irritation of the part ?

It may in those cases where a little aconite, spongia or hepar in our hands would have cured the disease speedily and thoroughly ; or where the nitrate itself was homoeopathic to the dis- ease : for, as I shall show you by and by, the nitrate of silver if taken internally, develops a group of symptoms in the bronchial tubes which clearly indicate some specific inflammatory action. Moreover we have the statement of Schloepfer who experimented with it by introducing it into the healthy trachea of animals, and who found that the nitrate causes inflammation of the windpipe and pneumonia, passing rapidly on to hepatization of the lungs.

Even in the strength of ten grains to the ounce, it causes inflammation, swelling and abundant discharge of a thick, deep-yellow mucus in a very few hours ; this gradually grows lighter, until it has recovered the bland and transparent aspect of mucus which is secreted by the mucous

ARGENTUM NITRIC UA1. 397

follicles in their normal state. If the application is too often repeated, the epithelium is destroyed, the mucous membrane presents an attenuated and shining appearance, or else the mucous glands, in a state of hypertrophy, project like small pea-like elevations, studding the entire mucous surface. Dr. Green designates our practice as the "fabric of a vision" ; it can only appear so to those who are infatu- ated with the illusion that a natural irritation can be counter-irri- tated ; that is, neutralized or absorbed by an artificial irritation, whereas this result can only be achieved, provided the artificial irritation is specifically similar to, or in homoeopathic rapport with, the natural disease.

Whenever this specific relation or rapport exists between the medicinal agent and the natural disease, a very small quantity of the medicine, given internally, will reach the affected tissue more certainly through the conducting power of the sympa- thetic system than by means of any local application whatever. And even, if it should be deemed advisable to make a local application, the application can be made to the skin, or under the cuticle, whence the drug will be absorbed and conducted to the part upon which it is designed to act.

In the hands of wise and skillful practitioners, the nitrate of silver may sometimes prove an available and even necessary means of local treatment. A fungus may shoot up from a wound while the process of healing is going on, the growth of which may not only be arrested, but which may be effectually removed by the cauterizing action of lunar caustic. Or a salutary reaction may be excited in a torpid ulcer in otherwise healthy conditions of the organism. Warts have been removed by the local application of the nitrate, without any inconvenience to the constitution.

But the indiscriminate applica- tion of the nitrate of silver to the inflamed mucous membrane of the uterus, urethra, bladder, nose, eyes, throat or larynx must result in serious and often irreparable injury to the patient.

We have several cases of poisoning by this salt which, in view of the decisive provings we possess of this drug, it seems hardly neces- sary to expatiate upon. The following is a summary of the post- mortem appearances produced by a long-continued use of large medicinal or by poisonous doses of this agent.

The plexus choroideus and the veins of the fourth ventricle pre- sented a lead-colored appearance. (In the case of a woman, aged thirty years, who died in the Salpetriere, and who had taken for a long while the nitrate for epilepsy, and who finally died of tuberculous

398 ARGENTUM NITRICUM.

Nitrate of silver is so readily decomposed that it is not safe to make triturations of it; a watery solution is preferred, first in the proportion of five to ninety-five, and preparing a second attenuation from this first solution in the proportion of twenty to eighty, in order to obtain the decimal scale of potencies. The original salt, as well as the potencies, should be kept in dark vials provided with ground-glass stoppers.

Let us review Dr. Mueller's splendid provings of this drug under their respective categories.

CEREBROSPINAL GROUP.

ARGENTUM NITRICUM. 30'.)

oral increase of the temperature of the body; extremely troublesome itching, creeping and crawling of the hairy scalp, with sensation as if the roots of the hairs were pulled up ; she had to scratch all the time ; this kind of congestive headache may result from various causes ; from the action of the mercurial or syphilitic poison ; from rheumatic exposure, but principally from these causes combined.

NEURALGIA in the infraorbital region that we desire to invite attention. The nitrate of silver may prove homoeopathic to it, more especially if the indication is completed by the presence of the fol- lowing symptoms which the Doctor experienced at the same time that he complained of the neuralgia. "The action of the heart be- came somewhat irregular; at times the beats of the heart would intermit, and were accompanied with a peculiarly disagreeable sen-

400 ARGENTUM NITRICUM.

sation in the chest; when directing his attention to it more intently, he experienced the irregularity more fully, but scarcely any during exercise in the open air. Together with these functional irregulari- ties of the heart, he complained of a continual sensation of fulness in the pit of the stomach ; but there was no alteration in his spirits, no attacks of precordial anguish, no impediment to his movements. The palpitation was worse only when he indulged in unusual muscu- lar exertions, such as jumping, ascending the stairs without inter- ruption; violent emotions likewise increased it; in an horizontal position, for instance, in the evening when in bed, the above-men- tioned disagreeable sensations in the chest were most marked.

His sleep was scarcely ever interrupted by palpitation of the heart." These symptoms all diminished in intensity about the end of winter, and ceased entirely after summer had set in. A professional friend was unable to discover any of the physical signs of heart disease.

In spite of the most rigid diet and the continued use of the nitrate during a period of two weeks, the Doctor was unable to discover any alteration in the quality of the pulse, nor did a thermometer applied to the back part of the tongue show any signs of a change in the functions of the assimilative sphere of the organism.

According to Dr. Gray's observations the nitrate of silver is indi- cated in disturbances of the brain, and the consequent derangements in the system generally, which have arisen from moral causes.

" Epilepsies produced by moral causes (such as very impassioned lay-preaching) are promptly and durably cured by a few small doses of this drug, whilst those proceeding from abdominal irritation, inde- pendently of moral causes, are at best but poorly palliated by very large and frequently-repeated doses. The same observation must, I am persuaded, hold good with respect to gastric disturbances ; those only will be really cured by it which have arisen during too great or too long-continued mental exertion.

ARGENT UM NITRIC UM. 401

"The bodily symptoms being similar to those produced by this drug, I should regard it as an indispensable remedy when there are the following moral conditions :

"1. A crowd of impulses, to wit: to move, to be busy, which, without any distinct purpose to effect, keeps the patient in continued motion ; a state of unrest which gives the appearance of hurry and discontent to all his conduct.

" 3. Errors and defects of perception. The erroneous perceptions in which I have seen nitrate useful have been : (a) As to time ; the patiently constantly fearing he should be too late, and supposing that one or two hours had elapsed, when not more than a quarter or an eighth of the supposed time had passed, and this all the while, night and day, for many weeks together ; and (b) errors as to the velocity of gait, the patient supposing that he was walking very rapidly when he was in fact moving but very slowly indeed.

" Moreover, I should regard the nitrate as the remedy (other indi- cations existing for its use) in all severe commotions of the system arising from too great acuteness of the perceptive organs ; e. g., cer- tain forms of epilepsia and chorea.

" It is, I think, probable that silver will be found as strictly adapted to the cure of morbid perceptions, and their concomitant disturbances in the digestive, motor and genital apparatus, as gold is to the re- moval of morbid affections, and their consensual motory and genital diseases. However the reader may regard the foregoing speculations of Mueller, he cannot, if he be a thorough student of Hahnemann, permit them to have the slightest weight with him in the choice or rejection of the nitrate of silver as a remedy for a case in hand ; they are beyond the limits of possible testimony, and for all known pur- poses of the homoeopathic art would be useless, even if demonstrably true, because we have no possible means of knowing when the pneumo-gastric nerve or the abdominal ganglia are the essential seat of disease."

In addition to these indications we should not overlook the sthenic character of the epilepsy to which the nitrate is homcepathic. Our provings show that it causes engorgements of the cerebral

VOL. I. — 25.

402 ARGENTUM NITRKJUM.

vessels, and that, for this reason, it is adapted to the cure of those forms of epilepsy where Kruger resorts to cupping and cold effusions (see Horn's Archive, 1823,) and Kopp (see Memorabilia, Vol. hi,) observes that is only useful in cases where the attacks seem to depend upon irregularities in the circulation through the cerebral vessels.

Krahmer has a theory on the subject which shows how utterly the phenomena and functions of the vital reaction are disregarded by the chemico-physiological therapeutists. He denies that the nitrate of silver acts upon the nervous system and the cerebral functions, and asserts that "in his numerous experiments and investigations of this subject, he has never met with a single fact which places this in- fluence beyond doubt. The preparations of silver enter into the circulation and the substance of organs as albuminates, oppose the organic metamorphosis with more energy than the normal constitu- ents of the organs, diminish the receptivity of the blood for oxygen, and, in this way, diminish the mass of the material required for the process of decomposition ; in one word, these preparations depress the vegetative functions" For this reason Dr. Krahmer ranks the nitrate of silver on a level with sanguineous depletions, and only recommends it for epilepsy of an inflammatory type, in the case of robust individuals with active congestions about the brain, and where the attacks are excited by violent commotions of the nervous system.

The chemico-physiological therapeutists study the phenomena of disease and drug-action in the sphere of matter exclusively. The effects of drugs are determined solely by microscopic examination, by the thermometer, by measurement and by chemical analysis. The manner in which the vital forces react against the physical and chemical changes which drugs seek to impress upon the tissues, and the characteristic signs by which this reaction is made manifest to the senses, and by which the contemplating reason is enabled to interpret its essential nature and its bearing upon the pathological disturbances of the functions and correspondingly abnormal meta- morphoses of tissue, seems to be utterly ignored by these otherwise useful and industrious workmen in the great laboratory of Nature. A truly rational study of the effects of the nitrate or other salts of silver would show that, if the vegetative activity of the organism is primarily depressed by their chemical or physical agency, the living brain at once comes to the rescue, endeavoring to counterbalance

ARGENTUM NITIilCUM. 403

this depression by exciting the circulatory system to an increased activity which will be more strikingly perceived in robust and plethoric individuals, and, in the case of silver, happens to take place more prominently in the cerebral vessels. From these phenomena of sanguineous reaction in the brain we draw the conclusion, which indeed seems irresistible, that the salts of silver act upon the brain either directly or indirectly by a process of reflex action from the ganglionic centres. Practically the relation is immaterial, for the nitrate of silver will not cure epilepsy unless the indications for its use are embraced in their integrality, in the sphere of the brain as well as in that of the abdominal ganglia. The symptomatic appearances and their dependence upon each other under the physiological unity of the organism, have to determine our selection of the appropriate remedial agent in this, as well as in all other instances.

Homoeopathic physicians have found ^ to 10Joq of a grain sufficient to effect a cure in cases where the nitrate fulfils all the requirements of the law of specific homoeopathy. For immediate purposes tritura- tions with sugar of milk may be allowable, provided they are made with as little exposure to the light and air as possible ; otherwise a watery solution is preferable, from which alcoholic attenuations may be derived in accordance with the rules laid down.

Kopp has given the nitrate with perfect success for other spas- modic affections, when a correlation seemed to exist between the spasm, and an abnormal crowding of the blood-vessels. Some of these cases which we find reported in his Memorabilia, are both in- teresting and instructive.

A woman of forty-six years, whose menses had been very profuse for the last year and had made their appearance every three weeks, had been attacked with violent spasms of the right side of the face and neck, of the tongue, of the right upper and right lower extremity, and of the muscles of the right side of the trunk, during which she lost her consciousness and frothed at the mouth. Immediately after the paroxysm her memory was either much impaired or entirely gone, her face was drawn to one side, she experienced a drawing and creeping in the right arm and leg, and very fre- quently complained of headache and fever, which had been attended with vomiting for some time past; during the trismus she bit her tongue until it bled ; the epilepti- form spasms emanated from the brain; there was no hereditary disposition, but the spasms seemed to be in relation with the menses ; they either set in shortly before or during the menses, and generally on waking from sleep. After having tried a number of remedies in vain, she took the nitrate of silver, one grain made into twenty pills, first one pill every two hours, and afterward one-thirtieth of a grain six times a day. The spasms ceased very soon, the health of the patient improved more and more, and at the expiration of a year, during which period she continued to take the remedy at intervals, she was quite well.

A girl of nineteen years, who had always enjoyed good health, and looked healthy, had moved to a different section of the country, in consequence of which, as it

404 ARGENTUM NITRICUM.

»

appears, her menses came on every few days ; for the last three months, had lost a quantity of blood, had cold feet continually, and was occasionally attacked with a slight haemorrhage from the lungs, although her chest seemed perfectly sound, and the blood was often expectorated without any cough. The consequences of these losses were nervous paroxysms, spasms and fainting fits. Such an attack was accom- panied by loss of consciousness, chills, cold extremities, suppression of pulse, palpita- tion of the heart, nausea, retching, vomiting, screaming, spasmodic laughter, convulsive movements of the limbs. She took the nitrate in pills, one-twelfth of a grain to a pill; the nervous symptoms ceased at once; after the fifth pill the haemor- rhage was arrested, and after having taken two grains in all, she was perfectly restored.

CHOREA In chorea this agent has likewise been given with

good effect ; it will probably prove curative only in cases where the disease can be traced to cerebral disturbances.

FACIAL GROUP.

The face looks sunken, pale, sickly ; it has an appearance of old age. This change may occur as a symptom of the mercurial cachexia ; or in cachectic individuals who are afflicted with chronic syphilis or both combined.

ORBITAL GROUP.

CHRONIC CONJUNCTIVITIS.— The nitrate of silver seems to develop all the characteristic signs of chronic conjunctivitis, with redness of the canthi and eyeballs, agglutination of the lids, pressure as from a grain of sand, and heat in the eyes ; the eyes are filled with mucns which dries up in the lashes.

In the case of cachectic individuals, afflicted with chronic con- junctivitis of this description, the nitrate of silver will be found useful, if administered in small doses.

CATARRHAL OPHTHALMIA is often very promptly relieved by the internal use of this remedy.

OPACITY OF THE CORNEA.— We find that this salt pro-

ARGENTUM NITRICUM. 405

DISORGANIZATIONS OF THE CONJUNCTIVA, when it looks puckered, hypertrophied in consequence of interlamellar exu- dations, higher attenuations of the nitrate may likewise be of much avail.

As an external application to sore and inflamed eyes, this agent has been abused by alloeopathic physicians from time immemorial. In cases where the ophthalmic affection seems purely local, and the general constitution in no wise involved, this external application of the nitrate, by means of a camel's-hair pencil, is justifiable.

PURULENT OPHTHALMIA— Dr. Dudgeon is of the opinion that in the purulent ophthalmia of children, the external use of the nitrate should not be dispensed with.

In reference to the external use oi the nitrate in purulent ophthalmia, Dr. Krahmer presents the following statement: "At the commencement of the disease, powerful solutions of the nitrate should only be applied, if the disease is a local affection, and\ the morbid process is confined to the conjunctiva ; its application, is especially efficacious if the conjunctivitis is caused by the syphilitic or the gonorrheal virus. If the ophthalmia is at the outset the localized expression of a constitutional affection, even if there should be a doubt on the subject, a gently antiphlogistic treatment, com- bined with frequent and careful cleansing of the eyes, is preferable.

This treatment is assisted by the simultaneous application of weak solutions of the nitrate, if the conjunctiva is the only organ involved in the disease. As the disease progresses, the nitrate becomes an invaluable remedy which cannot be replaced by any other; more especially, if we desire to touch the granulations which cannot be removed by any other means, or in case ulceration or perforation of the cornea should have set in, if the cornea is interstitially distended or hypertrophied and studded with granulations.

The local action consists principally in the rapid removal of the mechanical irritation which impedes the healing of the ulcers, and favors the increased bulging of the eyeball. For this reason it seems unnecessary to touch at the same time the ulcerated surface." The Doctor prefers touching the eye to injecting a powerful solution, more especially in that form of prolapsus of the eyeball which is designated by the term "melon." He never touched the prolapsed portion of the eye;

40 G ARGENTUM NITRICUM.

moreover he deems it indispensable to acquaint the nurse with the danger which is involved in changing the position of the child from the back to the side or stomach, or in making a hasty move- ment, in pressing upon the eye while cleansing it, or while the child is nursing, or in the continual cries of the child, or even in the act of coughing or vomiting, etc.

In eighty-six cases the eyes were touched one hundred and twenty- seven times by everting the lower lid, and rapidly and lightly passing the rounded extremity of a stick of the nitrate over it, after which the same part is quickly painted with a little olive oil by means of a camers-hair brush ; one touch was sufficient only in four cases ; generally it had to be repeated from three to five times, sometimes even from six to eight times ; but it was repeated only in case all in- flammatory reaction had ceased.

In the Berlin hospital, the disease is treated and cured even in the most violent grades by means of a solution of from one to six grains of the nitrate to an ounce of water. From one to three drops are dropped into the eyes very cautiously twice or three times a day ; at the same time the eyes are carefully cleansed of the secreted matter by washing them as often as may be required.

AUDITORY GROUP.

The nitrate of silver causes ringing in the ears, with hard hearing ; whizzing and a feeling of obstruction, with hard hearing in the left ear. Painful stoppage of the ears, with headache.

In affections of the ears, such as deafness and fetid otorrhoea, this agent is applied externally by some alloeopathic physicians to the inner lining membrane, touching even the tympanum. In otherwise perfectly sound conditions of the system, this proceeding may be proper, provided the remedy itself is appropriate to the case.

NASAL GROUP.

Violent itching in the nose, he had to rub it until it bled ; ulcer- ated scurfs in the nose ; coryza, with chilliness, sickly look, lachry- mation, sneezing, stupefying headache ; she had to lie down. In

ARGENTUM NITRICUM. 407

structure throughout, and by its invigorating effects cures those more serious difficulties, of which the catarrh is, after all, but an ex- pression. The dull, heavy pain in the head which usually exists in these conditions, is also readily relieved by the prompt exhibition of the remedy, especially when we have flatulency, gastric disturb- ances, etc.

This conditition may occur as a symptom of chronic hydrargyria, or as a catarrhal attack in persons who have taken too much mercury, and where this medicine, although indicated, might prove unavailable.

OZiENA. — In ozsena, not only when of a syphilitic, but likewise when of a scrofulous nature, it may be necessary to touch the ulcer- ated surface with the nitrate.

DENTAL GROUP.

Nitrate of silver causes inflamed and loose gums, and white inden- tations, readily bleeding ; the prover, who had never had a tooth- ache, was troubled with it all the time during the proving, a grumbling and digging pain, especially when chewing, eating sour things, or putting cold water in the mouth.

Krahmer found that some of the dogs upon whom he experimented with the nitrate of silver by injecting it into the veins, were attacked with bleeding of the gums. We therefore recommend this agent for such a

TOOTHACHE as is described in our provings, and for

STOMAOACE with much bleeding of the gums, whether of a mercurial or scorbutic nature.

PHARYNGEAL GROUP.

Ptyalism ; tongue painful as if burnt, sore feeling of the fauces as if scalded ; dark redness of the fauces and uvula ; ulcerative pain in right side of the throat ; sensation as if a splinter were lodged in the throat, when swallowing, eructating, breathing, stretching and mov- ing the neck ; sometimes an undulating jerking and throbbing were felt in the throat, continuing for several days. Throat full of mucus, tenacious or watery, obliging him to hawk all the time. Balls of soapy mucus accumulate in the larynx, occasioning slight turns of cough, by means of which they are expelled.

Dr. Mueller remarks that "these pharmatoxical affections of the mouth, fauces and throat are not acute, phlegmonous, sthenic inflam- mations, but chronic, asthenic, adynamic, such as occur at times in

408 ARGENTUM NITRICTJM.

the shape of an exceptional irritation, in cachectic individuals affected with some chronic disease, or as a secondary specific manifestation of some deep-seated affection; such pharmatoxical affections are generally seated in the mucous membranes, resulting in disorganiza- tions of structure, hypertrophy or thickening of the mucous mem- brane, granulations, exudations."

These remarks show in what forms of sore throat, chronic or acute, the nitrate of silver is indicated according to our law of cure. Positive experimentation does not justify the horrible abuses which old-school practitioners render themselves guilty of by their deter- gent practice. A nitrate of silver solution will wash off any kind of inflamed surface in their hands ; whereas, as Dr. Mueller shows, its legitimate sphere of action is the chronic sore throat of cachectic individuals who secrete a foul mucus in the throat, whose throats are easily invaded by torpid inflammatory irritations, resulting in tedious suppurative and ulcerative processes and disorganizations of the lining membrane.

OHEONIC ANGINA of this character may be entailed upon a patient in consequence of scarlet fever or even measles. Argentum nitricum may be given internally, and a mild gargle of the same salt may likewise be resorted to.

CHYLO-POIETIC GROUP.

In this direction, the provings furnish us a number of valuable symptoms: Bitter, astringent, chalky taste; most of the gastric derangements are accompanied by eructations ; vomiting of glassy mucus in the morning ; she had two paroxysms of this kind of vomiting, after which she felt the whole afternoon a desire to vomit, a tremulous weakness, and a sensation in the head as if it were in a vice; cardialgia with internal chilliness; cardialgia with violent gnaw- ing pain; cardialgia, griping and burning in the stomach; cardialgia after yawning, a sensation is experienced in the stomach as if it would burst; wind presses upward, but the oesophagus feels spasmodically closed, hence an ineffectual effort to eructate, with excessive strangu- lation, pressing pain in the stomach, fainting sort of nausea, flow of water in the mouth and inability to stir ; the paroxysm ceases after a quarter of an hour, amidst frequent and violent belching of wind; troublesome feeling of malaise in the region of the stomach, relieved by pressure; the patients frequently press the clenched fists into. the rtomach; feeling of emptiness in the stomach, desire for piquant food or drinks, insatiable hunger, depression of spirits, watery urine.

ARGENTUM KITRICUM. 409

OARDIALGIA Little need be added to these symptoms in the way of explanatory remarks. They show that the nitrate of silver must be possessed of excellent curative powers in the treatment of certain forms of cardialgia or gastralgia. According to Dr.

Mueller, the gastralgia for which the nitrate of silver is successfully used, is characterized by the following symptoms: it is particularly suitable to delicate nervous women, when the affection arises from depressing causes, nightly watching, etc.; a troublesome feeling of malaise in the region of the stomach, relieved by pressure; the patients frequently press their clenched fists into the region of the stomach; feeling of emptiness in the stomach; desire for piquant food and drinks, insa- tiable hunger, depression of spirits, water-colored urine.

Autenrieth recommends the nitrate for the vomiting of an insipid fluid, and for the cardialgia of young people from the period of pubescence to the age of a fully matured manhood, if the affection has been occasioned by the violent suppression of the itch or of some other exanthem. The affection is characterized by loss of appetite, bitter taste, continual sensation of pressure which frequently increases to a violent attack of cardialgia after the use of food, and by torpid stool.

At first the vomiting takes place only in the morning ; but, as it gets worse, it likewise occurs in the day-time more or less fre- quently after a meal. The ejected fluid has a sour reaction. In the case of women, the affection is complicated with derangements of the menstrual functions, leucorrhoea, hysteric complaints ; men are afflicted with oppression of the chest, cough, expectoration of small fibrous balls, or of black masses. The affection of the chest very frequently terminates in pulmonary phthisis of an atonic character.

Kopp regards the nitrate of silver as one of the most reliable remedies for inveterate cardialgia. A number of interesting cures of this distressing affection are mentioned in his Memorabilia. The symptoms are comprised in the following summary: Burning, malaise in the pit of the stomach, contractive rising from the pit of the stomach to the throat ; violent shivering in the back, nausea, , eructations, loss of appetite. Disposition to vomit, acrid burning in the throat, expulsion of water with retching, distress in the region of the stomach.

Pressure in the pit of the stomach, pain in the region of the spleen, vomiting of black blood. Pulling and contracting sensation in the region of the stomach with griping, ascending from the epigastrium to the throat ; when this reached its acme, the patient lost her senses, was unable to talk, hear, see, stir; the face became

410 ARGENTUM NITRICUM.

flushed and she became delirious; pulse accelerated during the attack, but not intermitting ; sometimes the hands would twitch convul- sively; the attack came on four, five, and even ten times a day, and could be prevented by taking a little food during the precursory symptoms.

Argentum nitricum is often of the greatest use in that type of gastralgia, which is based upon a more or less well-defined inflam- matory or cancerous condition of the stomach.

VOMITING OF WATER— Mueller likewise recommends the nitrate for vomiting of water or waterbrash consequent upon sup- pressed itch ; for chronic affections of the stomach, whether assuming the form of a neurosis or consensual gastrosis; chronic gastritis; scirrhus of the stomach.

NERVOUS DYSPEPSIA.— Johnson has directed attention to the good effects of the nitrate in allaying an excessive irritability of the stomach, more especially in nervous dyspepsia and the complaints incidental to this affection.

Krahmer recommends it for affections of the stomach consisting in or resulting from a stasis or passive engorgement of the mucous lining, and having still retained the character of hyperemia. These

ARGENTUM NITRIC UM. 411

cbemico-physiological indications are strictly conformable to the employment of the nitrate in conformity to the homoeopathic law; for this salt determines a state of hypersemia which is not inflammation, and is the concomitant anatomico-pathological condition of an abnor- mal irritability of the nerves of the stomach, for which Johnson has already recommended the nitrate as a leading remedy.

MILIARY AFFECTIONS. — Autenrieth likewise recommends the nitrate for miliary affections of the stomach complicated with metas- tatic itch. In the case of women the affection sets in in consequence of debilitating influences, frequent and difficult labor, haemorrhages, constant nursing, grief, care, etc. ; it proceeds from the previously described cardialgia, and is characterized by loss of appetite, thirst, saltish or else smarting taste, as if the patient had pepper in her mouth. The tongue looks clean, red ; the epigastric region feels as if it were constricted by an iron belt ; constipation alternates with diarrhoea ; the circulation of the blood is irregular, there are frequent congestions to the head, chest, or sexual organs ; metrorrhagia alter- nates with bleeding of the nose ; not unfrequently febrile symptoms are observed which terminate in copious and sour sweats, attended with miliaria.

It is not only to nervous affections of the stomach and duodenum, but also to nervous pains in the bowels, that argentum nitricum is homoeopathic. Among the abdominal symptoms, we may record the following as the most characteristic: stitches in the liver; sensation of fulness in the liver ; affection of the liver, ending in fatal dropsy; pains in abdomen as if sore, accompanied with great hunger, abating after eating, with trembling instead of the hunger; stitches dart through the abdomen like electric sparks, especially during a sudden transition from rest to motion, on left side; coldness in abdomen, which is painful ; sensation as of a ball ascending from the abdomen to the throat.

The last symptom may often be considered a symptom of hysteria and may likewise usher in an attack of epilepsy.

412 AKGENTUM NITRICUM.

gratification, were likewise present during the attack. The patient was afflicted with piles.

The symptoms show that these paroxysms of enteralgia may some times be accompanied by, or perhaps depend upon, liver-com- plaint. In one case, the continued use of the nitrate by an epileptic woman terminated in disorganization of the liver with fatal dropsy. If the liver is involved, the attack may be characterized by diarrhoea and vomiting, swelling of the bowels, excessive sensitiveness in the right hypochondrium, haggard appearance.

The alvine secretions are considerably disturbed by this agent. We distinguish the following symptoms : Colic followed by sixteen green mucous stools in one night; very fetid, with much flatulence ; costiveness, dry and firm stool ; itching of the anus, he has to rub until he becomes sore ; discharge of taenia.

DIARRHCEA These symptoms justify the use of the nitrate in

diarrhoea of a bilious character, when the attacks are preceded by colic, accompanied with chilliness along the back and extremities, debility, pale and haggard appearance.

If positive experimentation upon the healthy is of any value, we cannot possibly approve of the indiscriminate use which alloeopathic physicians make of the nitrate of silver in all sorts of discharges from the bowels ; no matter what the disease is, so long as there is a discharge of some sort from the bowels, some sign of abnormal secretion of the intestinal mucous membrane, the nitrate of silver is thrown up the bowels or forced down the throat as a universal sore- henling panacea. We believe that this gross mode of practicing upon the sick will be condemned, at no very distant day, by all en- lightened practitioners.

In regard to the cathartic action of the nitrate of silver, Krahmer offers the following statements which, in many respects, are inter- esting to an homoeopathic practitioner: "Our predecessors, Angelus Sala, de la Bos, Boerhaave, Fred. Hoffmann, Cappe, Portal and others, were convinced of the drastic nature of the nitrate, and erected upon this belief their theory of the anti-dropsical and anti-

ARGENTUM NITRICUM. 413

epileptic effects of tliis salt. On the contrary, Lombard (Rust's Magazine, Vol. xvi,) states that of twenty-four patients who took the nitrate, only five were attacked with diarrhoea, which continued only in one case, disappeared in three patients even while the drug was continued, and in one did not set in until after the drug had been discontinued. Graves, Boudin (Gaz. Med. de Paris), Kalt (Organon fuer die Gesammte Heilhunde), Hirsch, Reuf and others, found the nitrate efficacious for diarrlma, even when of a typhoid character, and for dysentery arising from teething.

Dr. Krahmer accounts for these diversified statements by the different quantities in which the nitrate was prescribed. Sala, for instance, gave from four to six grains, Lombard only half a grain to one grain, and Hirsch only one-twentieth to one-tenth of a grain. (An illustration of the homoeopathic law).

His own provings show that small doses do not alter the alvine discharges, but that large doses hasten them. The Doctor is of the opinion that the nitrate does not act directly upon the peristaltic motion ; either it acts indirectly in consequence of large doses of the nitrate coagulating the intestinal mucus, by which means the bowels become more sensitive to the irritating action of their contents, or else the nitrate deprives the blood, which is circu- lating within the walls of the intestinal canal, of water, by which means the chyle and the feces are kept in a state of fluidity, a chemical explanation of the same sort as any other, accounting for the phenomena of the living organism by the same laws which govern the combinations and elementary changes of inert matter.

414 ARGENTTJM NITRICTJM.

HELMINTHIASIS, with irritation at the nose and anus, bulimia, paroxysms of gagging and vomiting of water and mucus, emaciation, chilliness followed by nightly fever, nitrate may prove very useful.

The itching at the anus, when caused by worms, or when arising from a strumous habit, may yield to this agent.

Taenia solium may require the internal exhibition of the nitrate.

Hartmann reports the case of a lady who, besides being afflicted with profuse, ir- regular menstruation, had paroxysms of pain in the bowels, liver and stomach, with nausea, retching and vomiting of tenacious phlegm and a jaundiced complexion; she took the nitrate, second trituration, a powder three times a day, for a week ; during this time, fragments of a tape worm were expelled in large quantitities, after which the patient gradually recovered her health.

URTNARY GROUP. .

In this range we may mention the following symptoms : Frequent emmission of pale urine; emission of a few drops of urine, after which the urethra feels as if swollen; burning during urination; sen- sation as if a drop were running along the urethra from behind for- ward; cutting, from the posterior portion of the urethra to the anus, when emitting the last drop of urine; ulcerative soreness when urinating; ulcerative soreness in the middle of the urethra, as from a splinter; the urethra feels swollen, hard and knotty; inflammation and violent pain of the urethra, priapism, chordee, bloody urine, fever.

The two last-mentioned symptoms in this group are the results of strong injections into a urethra irritated by the gonorrhoeal virus. I look upon the method of burning the delicate membrane of the urethra with nitrate of silver injections as a most abominable abuse of an agent which may be productive of much good iu the hands of a humane and rational physician.

GONORRHEAL URETHRITIS.— If argentum nitricum is in specific rapport with gonorrhoeal urethritis, the medicine may be given internally, and a mild injection may be thrown up at intervals.

We may observe that, if gonorrhoea can be considered a local dis- ease, we can adduce the testimony of positive experimentation to show that the nitrate of silver, as a local agent, acts homoeopathic to the morbid irritation.

AKGENTUM NITHICUA1. 415

An inflammatory irritation of the urethral mucous membrane might undoubtedly be induced by other irritating substances, but this inflammation, so far from resulting in a diminution and gradual cessation of the natural disease, would, on the contrary, produce a permanent complication and consequent aggravation of the symp- toms. We know that in thousands of cases the irritation induced by the nitrate, has extinguished or devoured, as Trousseau and Pidoux term it, the natural disease. Hence we infer that nitrate -possesses a specific influence over the gonorrhceal disease, or, as we term it, acts homoeopathically to it.

The quantity of nitrate which is used in these injections, is from four to twenty grains, according to the judgment of the physician, the nature of the case, and the knowledge which he may have of the patient's constitution. Five grains to an ounce of water is generally sufficient, provided the injection is repeated at suitable intervals. Hundreds of cases are cured by this sort of treatment, both in hos- pital and private practice, year after year. The so-called anti- phlogistic treatment and emollient fomentations are often required in connection with the nitrate.

In the place of leeches, the tincture of aconite answers our purpose much better. Injections are one of the methods by means of which the gonorrhceal virus may be ex- tinguished, and the patient's health may consequently be restored. He may have to pass through a temporary aggravation of the symp- toms, violent pain in the urethra, and even in the testicles and all along the spermatic cord, horrid burning during the emission of urine and difficulty in voiding it; but these symptoms are soon superceded by a copious discharge of healthy-looking pus, which gradually becomes transformed into urethral mucus until the secre- tion ceases altogether, sometimes in a few daj-s, and at other times in one or two weeks.

The treatment of gonorrhoea by means of injections of the nitrate of silver is not the only method of removing this loathsome disease. We shall hereafter show that copaiva, cnbebs, cannabis, the nitrate of potash are likewise specifically adapted to the treatment of certain forms of this disease.

41G ARGENTUM NITRICUM.

URINARY GROUP.

A mere glance at the symptoms of the urinary group shows at once that the nitrate must be useful in

CHRONIC URETHRITIS, as a sequela of acute gonorrhoea. The higher attenuations of this agent have been found more efficient in this disease than the lower.

Hahnemann has recommended this salt for diabetes; others for irritable bladder, with an excessive flow of urine.

SEXUAL GROUP.

In this group we note the following symptoms : deficient sexual desire ; atrophy of the genital organs ; chancrous ulcers on the pre- puce, flat, with a tallowy base ; enlargement and hardness of the right testicle.

SELF-ABUSE. — Some of these symptoms may occur as the con- sequence of self-abuse.

CHANCRE. — The development of a chancrous ulcer by the nitrate of silver shows that this agent is homoeopathic to some forms of chancre, more particularly to the flat, superficial chancre, which shows a tendency to spread on the surface rather than to penetrate into the substance of parts.

ENLARGEMENT OF A TESTICLE.— Enlargement and indu- ration of a testicle, in consequence of suppressed gonorrhoea, may likewise yield to the internal use of the nitrate.

If homoeopathic to these affections, it may be used internally with benefit, although the external use is not at all inconsistent with rational homoeopathic treatment. Many homoeopathic physicians cauterize the ulcerated os and cervix of the womb at stated intervals, four, five, six times, until the ulcers have assumed a healthy appear- ance and bid fair to heal. In chronic blenorrhoea of the vagina, more especially if traceable to a gonorrhoeal taint, an injection of two grains of this salt to six ounces of water, may prove highly use- ful. If necessary the quantity may be increased to three, four, and even six grains.

ARGENTUM NITRIC UM. 417

Argontum causes excessive menstrual flow, and is indicated in metrorrhagia and menorrliagia with much pain in the back and pel- vis, particularly in women of excitable, moody, nervous temperament. There is in such cases little or no sexual desire ; the patient is anxious, impatient; we have confusion of ideas; dizzy headache; morning vertigo ; cardialgia ; belching of wind ; great flatulency.

THORACIC GROUP.

Among the recorded symptoms, the following deserve special attention : dry, almost burning titillation in the throat, occasioning a cough ; hoarseness and violent titillation in the larynx ; suffoca- tive cough, for several days at noon ; aching-tensive pain in the chest, in various parts of the chest, of the size of half a dollar.

NERVOUS DYSPEPSIA— Argentum nitricum has caused violent palpitation of the heart, with faintish nausea, three parox- ysms in one afternoon. The symptoms may occur as parts of a group denoting an irritation of the pneumogastric nerve, which affects the digestive apparatus as well as the heart. We may desig- nate a pathological condition, where such a group of symptoms occurs paroxysmally, as a case of nervous dyspepsia.

ANGINA PECTORIS AND ASTHMA— The peculiar influence which the nitrate of silver seems to exercise over the functions of the heart, has induced Kopp to prescribe it in cases which seem like angina pectoris and asthma. In angina pectoris, or the so-called Asthma Dolorificum Koppii, this eminent practitioner prescribed the nitrate on the supposition that it stimulated the nervous energies of the heart. Kopp regarded this angina as a purely nervous, inde- pendently existing disorder, whereas modern investigations have shown that, in a majority of cases, it is a diseased condition of the process of innervation which leads to a degeneration of the substance of the heart, and a passive dilatation of its cavities.

In sthenosis of the orifice of the heart, which is sometimes very considerable, the angina is wanting. Nevertheless it may be affirmed, upon the authority of observers whose testimony seems unimpeachable, that the nitrate is useful in certain forms of angina pectoris which, according to Krahmer, emanate from a disturbance of the gastric functions, derangement or excessive irritability of the stomach — an indication

VOL. I. — 26.

418 AKGENTUM NITRICUM.

which seems somewhat justified by our last-mentioned symptom ; although the same author admits that, " however certain it may be that the attacks of angina pectoris are excited in most cases by a derangement of the gastric organs, yet experience teaches that, in some cases at least, the cause of the disease must be traced to an affection of the spinal cord and brain. Here, too, the nitrate of silver may prove useful by limiting and retarding the abnormally in- creased metamorphosis of the cord, but hardly in so short a space of time or after exhibiting a few eighths or quarters of a grain." He says that, in some cases, even Kopp has given one and more grains daily for weeks.

Kegarding the curative influence of the nitrate in asthma, Krahmer thinks that this influence is limited to such forms of this disease as are excited sympathetically by gastric disturbances. According to this author, "true asthma, where periodical paroxysms of violent dif- ficulties and anxiety of breathing set in, while the substance of the lungs is perfectly sound, in consequence of an essential affection of the nerves of respiration or their origin in the brain, is of an exceed- ingly rare occurrence ; and that, leaving the habitual dyspnoea which is caused by an aneurism of the arch of the aorta, or by a medullary degeneration of the oesophagus or some other tumor pressing upon the recurrent nerves, out of count, most paroxysms of dyspnoea can be traced to an organic ulceration of a portion of the pulmonary parenchyma, which unfits it for the business of respiration."

In all such cases of sympathetic asthma, Kopp gives one-twentieth, one-tenth or even one-fifth of a grain, only for a short time.

Asthma, however, like angina pectoris, may result from a diseased condition of the brain or spinal cord, and argentum may render essential service in such cases.

EXANTHEMATIC GROUP.

In the course of this lecture we have taken many opportunities of mentioning the cases where the nitrate of silver may and perhaps ought to be used by homoeopathic practitioners as an external agent. Sores of a malignant nature, more especially chancrous ulcerations, may have to be touched with it, by which means they are often converted into a common sore, or one more readily impressed by some specifically appropriate agent. The nitrate seems to be essen- tially inimical to the mercurial and the syphilitic virus, and, in otherwise sound constitutions which naturally repel these taints, — not in constitutions of a decidedly scrofulous or cachectic habit,

AKGENTUM niteicum. 419

that are unable to scarcely offer any resistance to such deleterious influences — a timely cauterization with the nitrate may extinguish the malignant type of the ulcer. These cauterizations should not be resorted to indiscriminately, lest the constitution itself should become vitiated by the destructive processes of a secondary or tertiary syphilitic disease.

Mitscherlich offers the following explanatory statements concern- ing the manner in which the cauterizing process affects the tissues : "After touching the parts, certain vital phenomena take place, different according to the different tissues where the cauterization took place. The cauterization of a thick epidermis does not cause any pain, but if the skin is very thin, a slight burning is experienced. This cauterization does not cause any perceptible inflammation ; the white skin turns brown and even black ; it does not separate until after the lapse of some days, sometimes even a week or a fortnight, and is replaced by a deeper layer of the epidermis.

If the skin is denuded of the epidermis, or if the parts are ulcerated, the nitrate may touch the sensitive nerves, and a pretty severe pain may be experienced, but only for a short time. If the atmospheric air has access to the cauterized surface, the water evaporates, and a dry and brown scurf forms, whose thickness varies according as the action of the cautery penetrates the tissues to a less or greater depth. After the scurf has become detached, we see a red surface like that of a sore which secretes a small quantity of a thickish substance, and is surrounded by a pretty intense inflammation.

The inflamma- tion which is excited by the process of cauterization, is more or less intense in different parts, according as the vitality of the part is more or less readily affected."

420 ARGENTUM NITRICUM.

and a portion of the integuments had been lost ; the lower extremity of the cut nerve had become involved in the cicatrix, and formed a small swelling. Below the wound the nerve had lost the power of conveying sensation, but in the swelling the most violent pains were felt if the part was touched ever so lightly, for instance, if the stocking rubbed against it ; these pains extended to the dorsum of the foot. After touching the swelling several times very thoroughly with the nitrate of silver, the pain was entirely removed, but the power of conveying sensations did not return.

ULCERATED NIPPLES— The cauterization of ulcerated nip- pies in the case of nursing females, and of fistulous ulcers, is some- times exceedingly useful and indeed necessary to a cure. After touching the nipple, which should be done carefully and gently, it must be washed with tepid milk and water.

MENTAL GROUP.

This agent causes apathy, hypochondria. In the affections with which it is in specific curative rapport, such a depression of the spirits is often present.

There are conditions of the nervous system, usually depending upon great excesses and characterized by serious mental disturbances, which not only embitter the life of the patient and unfit him for association with others, but by the excessive anxiety, worry, imagina- tions and impulses which he is utterly unable to control, drive him to despair and to suicide. In such cases argentum nitricum is often a savior. Dr. von Grauvogi was the first to insist upon the great curative power of the drug in such cases.

ARGENTUM NITBICUM. 421

The pain, caused by the local application of the nitrate, may be diminished or arrested by washing the parts with a solution of com- mon salt.

422 ARISTO LOCHIA VIRGINIANA.

To diminish the slate-colored tint of the skin, dilute nitric acid may be used externally as well as internally ; the continued use of these agents is said to have removed the discoloration.

AEISTOLOOHIA VIRGESTIAKA.

[aristolochia OFFICINALIS, ARISTOLOCHIA SERPENTARIA, VIRGINIAN SNAKE-ROOT. NATURAL ORDER, ARISTOTOCHIACE.E.]

This drug has, been proved by Professor Jcerg and his disciples in a very careful manner. The doses employed were a watery infusion containing the strength of two to four scruples. The effects obtained were not very marked. It caused slight frontal headache, in one instance terminating quite suddenly in two sudden stitches darting through the whole head; warmth in the head.

The headache is sometimes accompanied by a painfulness in the nape of the neck which ends in drowsiness ; loss of appetite ; nausea, retching, and vomiting which continues until every particle of the drug has been expelled ; increased secretion of saliva ; feeling of oppression and embarrassment in the cardiac region; the stomach not only feels full, but distended ; costiveness, with expulsion of hard, tenacious feces. After the proving had been discontinued, Professor Joerg was attacked, contrary to habit, and without any perceptible cause, with diarrhoea, which he feels disposed to regard as an after-effect of the serpentaria ; itching at the anus, with increased development of haemorrhoids ; rumbling of the bowels ; uneasiness and pain in the umbilical region ; increased secretion of a watery urine ; oppression on the chest ; frightful dreams ; the beats of the pulse are stronger, harder and more frequent.

From these few provings it is plain that serpentaria tends to induce a congestion of the cerebral vessels and of the thoracic organs ; it likewise induces some symptoms of gastric irritation which may com- mend it in dyspepsia ; congestion of the abdominal organs, with con- stipation, and subsequent diarrhoea; an increased secretion of urine, and an excitement of the circulation.

ARNICA MONTANA. 423