Baptisia Tinctoria

[WILD INDIGO. NAT. OKDER, LEGUMINOS^.]

A native of the United States and Canada, frequenting dry soils; very bushy stem, growing about two feet high ; bluish-green foliage. It blooms in July and August, bearing at the ends of its branches clusters of from six to twelve flowers of bright yellow color. It pro- duces a pod of the size of a pea, mostly one-seeded. It is smooth, branching ; the leaves are subsessile ; the leaflets are small, roundish ob-ovate, acute at the base, very obtuse at the apex ; the stipules are setaceous, dropping off yearly; the racemes are loose, terminal; legumes subglobous ; the leaflets are about seven lines long and four to six lines wide, emarginate ; the petiole is from one to two lines long.

The petals are six lines long and yellow. (Wood).

A large number of species of baptisia are found in this country ; baptisia tinctoria is the only variety with whose medicinal properties we are acquainted. Of this, we make an alcoholic tincture from the fresh plant or from the bark of the root.

Our knowledge of the medicinal virtues of the plant is derived from provings and from clinical experience.

The following is the substance of a proving made with it by Dr. W. H. Burt.

On October 12, Dr. Burt, in the enjoyment of good health, took between the hours of 10 A. M. and bed-time seventy drops of the tincture with the following results: Within two hours after the first dose he experienced a feeling of tightness across the forehead, with pain over the right eye. In five hours there was every few minutes a severe pain in the cardiac portion of the stomach, with shooting pain in the bowels and an increase of the symptoms before mentioned.

All of these became constantly worse ; and to them were added, by 8 P. M., constant pain in the region of the gall bladder, aggravated by walking, dull pain in the epigastrium, in the right groin and in the legs. During the night following, these symptoms kept him very restless ; he had anxious dreams ; rumbling in the bowels, and in the morning he found his tongue coated yellow along the centre.

On October 13th, he took one hundred and five drops between 7 A. M. and 9 p. M. The symptoms described increased in severity during the day.

There was a mushy stool in the morning ; later : a dull pain in the small of the back, severe pain in the liver and stomach ; numbness all over the body; increased urinary secre- tion (five ounces). Although no medicine was taken during the next twenty-four hours, the symptoms continued ; there was however a decided decrease in the amount of urine voided, passing in all twenty-six ounces, to forty ounces on the preceding day.

BAPTISIA TINCTORIA. 541

On October 15th, Dr. Burt took two hundred and fifty drops of the mother tincture. During the night he was very restless and was troubled with dreams, which became absolutely frightful. The pain in the stomach and abdomen increased as the day advanced, extending into the groin, testicle and foot of the right side.

In the morn- ing of October 16th, Dr. Burt, feeling then quite well, injected ten drops of the tincture under the skin of the left arm over the biceps. Within ten minutes the feel- ing of tightness of the skin of the forehead, previously experienced, became very painful, and was accompanied by a feeling of numbness of the forehead and face; in fifteen minutes he felt as if he would vomit, but had no nausea ; there was also shoot- ing pain in the left kidney and in the left side of the umbilicus.

In thirty minutes: feeling as if the forehead would be pressed in ; slight pain in the right hypochondriac region.

Between 2 P. M. and night, the prover took three hundred and twenty-six drops. The effects were an increase in severity of symptoms formerly experienced, with a sensation of heat in the stomach and liver ; weakness and trembling during the day. Increase of the urinary secretion, and an impossibility to move or walk, on account of the aggravation of pain caused by it.

The same restlessness during the night fol- lowed, with no change in the symptoms. The tongue was coated yellow along the center, and there wr.s a flat taste in the mouth. A dose of three hundred and fifty drops of the tincture aggravated all the symptoms. Chewing thirty grains of the green bark of the root produced intense burning distress in the epigastrium, colic in the umbilical and in the hypogastric region and a desire to vomit, without nausea.

On October 18th, Dr. Burt took two doses of baptisia of forty and fifty-five grains respectively, watching their effects during the ten days following. These were as follows : The previously well-defined headache continued, being much aggravated by motion and accompanied by frequent sharp pains in the temple. Upon taking the second and larger dose the eyes felt as if they were pressed into the head, with great confusion of sight; he could not place anything without looking at it a few seconds; everything seemed to be moving ; there was also partial paralysis of the eyelids, with difficulty in keeping them open.

The tongue was coated yellow, and there was a flat, bitter taste in the mouth. The fauces and tonsils became very much congested, with an inclination to swallow ; pain at the root of the tongue upon swallowing. There was also soreness in the teeth and gums, with oozing of blood from the gums, when pressed upon with the finger. The abdominal distress continued, with rumb- ling in the bowels, occasional desire to vomit and, at first, mushy stools, which after two days became natural.

Gradually he suffered less with pains, but had much backache, trembling and aching of the legs and general weariness. By October 28th, the prover had recovered his usual health ; but re-produced decided symptoms by taking two smaller doses of baptisia (four and six grains.)

October 29th, the two last doses of the drug, namely ten and fourteen grains respectively, were taken, followed by a return of violent drug-effects, including the nightly restlessness and the harrassing dreams.

During the whole proving the re-action of the urine was decidedly acid.

Here the record of this proving ends. Made with comparatively large doses, it produces a group of symptoms unmistakably clear. You find that from the very beginning the drug shows a marked effect upon the abdominal viscera, viz., stomach, liver, gall-bladder, intestines, and upon the kidneys. It produces a yellow coating of

542 BAPTISIA TINCTORIA.

the tongue, flat, bitter taste in the mouth ; pain in the stomach and in various abdominal regions, accompanied by rumbling in the bowels and aggravated by motion. These effects continue all through the proving. You will also notice a well-marked effect upon the nervous system. There is the peculiar pain in the head, temples and eyes, which has been described ; we find drawing pains in various parts of the body, aggravated by motion ; there is the restless sleep and the frightful dreams, — developing in the very beginning of the experi- ment, growing in intensity as the drug-effects become more and more defined, and decreasing as the amounts taken are lessened and the power of the drug force is wearing itself out. •

We should not overlook the effects experienced from the second and large dose of baptisia taken on October 18th, which indicate a probability that experiments, pushed still farther as to the size of the dose and length of proving, would reveal a power of the drug, which would, surprise its warmest friends. The great confusion of sight ; the partial paralysis of the eyelids ; the feeling of intense pressure upon them, even as if they were being pressed into the head ; later, soreness of the gums and teeth, with bleeding of the former from pressure, indicate that peculiar power to prostrate and to disorganize, which has made a tendency to putrescence so valuable an indication of baptisia in the sickroom.

A proving by Dr. C. Wesselhoeft [New Eng. Med. Gazette, 1 870), made with the fifth dilution, gives: a state of extreme dullness, drowsiness, sleepiness (constant, and not relieved by sleeping all night) and weakness of memory. There is also an aching pain in the occiput, from ear to ear, and from the vertex to the nape of the neck.

Dr. E. A. Wallace took at three different times doses of respectively ten, twenty and thirty drops of the one hundreth dilution of baptisia.

The prover experienced severe frontal headache, with pressure at the root of the nose or with fulness and tightness of the whole head; heavy pain at the base of the brain; stiffness and lame- ness of the muscles of the neck ; soreness of the eyes and lameness upon moving them; sore throat; burning and prickling of the left side of the face and head; pres- sure at the stomach, with copious belching up of flatus ; tightness and lameness of the chest, especially on the left side.

Numbness of the left hand and forearm with prick- ling, running into the shoulder and into the fingers, at times causing twitching of the hand and arm, with an increase of the numbness on motion. Weariness, numbness, paralysis of the left side. Pains in both hips with numbness. Wandering pains in all the limbs, with a feeling of stiffness and soreness all over.

Five or six weeks after the conclusion of the proving livid spots appeared all over the body and limbs, varying from the size of a pea to a three-cent piece ; they were irregular in shape, not elevated and without sensation. The prover had never experienced anything like it before.

BAPTISIA TINCTORIA. 543

Dr. Hale calls attention to the following points :

1. All the symptoms, even the paralysis, appeared within a few hours after taking the drug, and disappeared before the expiration of twelve hours.

2. The appearance, six weeks after, of livid spots all over the body, without any special discomfort. While it may be doubted if these were the result of the proving, there are some peculiarities in the nature of baptisia, which render it more than possible.

3. From the ten -drop dose he had numbness and prickling ; from the twenty drops a sensation of paralysis, with numbness and prick- ling; and, finally, from the thirty drops actual, but transitory, paralysis occurred. These symptoms and the mode of their appear- ance, denote something more than a catarrhal or rheumatic attack. Only a sudden and profound impression on the central nervous system could induce such effects.

Many members of our school look upon a proving made with so high a potency with distrust. While experiments made with larger doses of the crude material are, for obvious reasons, preferable, we must not forget that there are certain persons who are so suscept- ible to the action of the drugs, that very minute doses will produce decided effects upon their organism, even in health. I contend that these cases are very rare exceptions to the general rule, and it is evidently the part of wisdom to be cautious in the acceptance of experiments made with high dilutions ; but let us not overlook the fact that clinical experience has repeatedly verified symptoms which were first obtained by experiments with high attenuations.

CEPHALIC GROUP.

An examination of the proving shows among other head symptoms the following ; Tightness across the forehead with pain over the right eye. Dull, pressive pain in the forehead ; sharp pain in both temples ; feeling as if the forehead would be pressed in. Dull, hard headache, worse by moving.

Feeling as if the skin of the forehead would be pulled to the back part of the head, with a numbness of the head and face. Vertigo; dullness; swimming sensation in the head like that often experienced before the operation of an emetic. Severe frontal headache with pressure at the root of the nose ; heavy pain in the occiput. Peculiar feeling of the head which is never felt except during the presence of a fever ; excitement of the brain, such as precedes delirium.

The vessels of the head are full ; the head feels too large. Heavy ache in the head day and night, causing a sensa-

54.4 BAPTISIA TINCTORIA.

tion of wildness ; noise increases the headache. Vertigo. Aching pain in the occiput from ear to ear, and from the vertex to the nape of the neck.

A careless glance at the above array of symptoms might lead to the impression that in baptisia we have a panacea for headaches. In the common forms of headaches the remedy is of little importance. In those distressing headaches, however, which precede or accompany fevers of various types, with a sense of general indisposition, lassitude, coated tongue, etc., and which in themselves form a most unpleasant feature of those diseases, the wild indigo will do excellent service. If prescribed in the very earliest stage of such a disease, the remedy will not only relieve the headache, but shorten the disease itself, and really forestall a long and tedious illness.

In fall of 1872, Mr. B., aged thirty-four, requested me to prescribe for the follow- ing symptoms: Severe pain in the forehead, especially over the right eye, and at the same time a dull, heavy ache all through the head, with slight vertigo. This pain had existed for several days, and was getting worse constantly. His family physician had failed to relieve it.

The patient insisted that, but for the headache, he would be well ; upon close examination he admitted that he had suffered from extreme exhaustion, pain in the back and limbs, slight chilliness, loss of appetite and bad taste in the mouth. Prescribed five drops of the tincture of baptisia, to be dissolved in a glassful of water, a dessert- spoonful to be taken every hour.

Mr. B. was evidently coming down with a fall fever. The remedy relieved the headache and caused the fever to abort.

NERVOUS GROUP.

You have not forgotten the nervous symptoms recorded by Burt and Wallace; as you review them, the question arises whether or not they are due to a direct action of the drug upon the nervous system and nerve centres. When we take into consideration all we know of this agent, giving close attention to a proper interpretation of clinical experience with it, we are led to believe that the remedy affects the nervous system by virtue of its depressing effect upon the general organism. Hence I do not think that the drug will ever prove of great benefit in purely nervous diseases, least of all in true paralysis. But when nervous disturbances arise in consequence of a vitiated state of the system, as after a long and exhaustive illness, we should study the symptoms of this drug carefully, with a view of prescribing it, even though the nervous lesion should be painful and serious.

NEURALGIA OF THE BOWELS.— C. P. Hart, (American Ob- server, 1874, p. 166,) gives an interesting case of neuralgia of the bowels, m which baptisia proved curative:

G. B., of V., was a prisoner for eight months in Andersonville. He was so broken down by camp dysentery, insufficient nourishment and exposure, that he has been

BAPTISIA TINCTORIA. 545

almost a constant martyr to neuralgia of the bowels. The attacks were generally superinduced, or at least preceded, by exposure to either heat or cold. Previous treatment having failed to benefit him, the only relief obtained was by living north in the summer and south in the winter. As it frequent happens in these cases, the disease was found to be distinctly intermittent, the paroxysms occurring just after midnight.

The feeling was described as one of extreme uneasiness rather than pain, being of a pressive and drawing character. The sensation was compared to that of something "crawling about" in the abdomen. At other times there was active abdominal congestion, as evinced by a constant throbbing in the epigastric and umbilical regions. The paroxysms were frequently accompanied or followed by vomiting, purging and great prostration, showing more or less congestion of the portal sytem and an hypenemic condition of the stomach and bowels.

The pulse, which at first was generally accelerated, now became slow and weak and at times almost imper- ceptible. The symptoms led me to prescribe baptisia, which proved to be the true specific. I gave the 3d dilution, fifteen or twenty drops in a glassful of water, in table-spoonful doses every half hour until the paroxysms were arrested. No other medicine was given, except a dose or two of lachesis30 for burning in the abdomen.

The paroxysms soon became milder and shorter, and the attacks less and less fre- quent, until finally they disappeared altogether.

The remarks previously made are applicable to this case. The disease was the outgrowth of a depressed, scorbutic state of the whole system, originating in the squalor and in the privations of Anderson- ville prison, containing in itself conditions and causes which few remedies would meet so promptly as baptisia.

INFLAMMATORY GROUP.

On October 18th, Dr. Burt recorded : The tonsils very much con- gested, with frequent inclination to swallow, which produced pain at the roots of the tongue. And again, on the following day: Tonsils and soft palate very much congested. Tonsils and palate look very red,, but are not very painful.

The symptoms, in themselves, are suggestive rather than positive indications for the use of baptisia in inflammatory conditions of the mouth and throat. Clinical experience, ever enlarging old boundaries and developing new facts, has demonstrated that in the wild indio-o we have a good remedy in the following diseases :

STOMATITIS.— Dr. Walker (Am. Rom. Observer, 1866, p. 224,) reports to have cured with it several cases of acute stomatitis at a time when diphtheria was prevalent. The patients were feverish; the mouth hot and red, and on the mucous membrane of the buccal cavity were numerous canker spots and superficial ulcerations, sur- rounded by red areolae. The breath was fetid and there was present in every case profuse salivation.

INFLAMMATION OF THE FAUCES has been cured by bapt.

J. H., thirty-three years old, took a severe cold^nd had a sore throat with enlarge- ment of both tonsils, greatly inflamed and a somewhat elongated uvula. On the right side of the fauces was a lump which had the appearance of an incipient abcess ; there was another swelling on the left side. His mouth was continually filled with a

VOL. I. — 34.

546 BAPTISIA TINCTORIA.

thick, viscid saliva which he could not swallow or expectorate, and was obliged to let run from his mouth. There was rigidity of the muscles of the jaw, extreme pain in the articulation and the lower portion of the zygoma, ; the effort to swallow produced violent pain. He was very nervous, tossing about from side to side. Belladonna, mercurius vivus and mere, biniodatus produced no favorable change, while one-grain doses of the first decimal trituration of baptisia relieved the case at once, curing the patient in two doses.

(Dr. George F. Butman, New Eng. Med.

Gazette, May, 1870.)

OKBITAL GROUP.

We find among the symptoms of baptisia, soreness of the eyeballs and a lameness on moving them ; the eyes feel as if they were being- pressed into the head, with great confusion of sight ; bloated feeling of the eyes ; the eyes occasionally glistened ; there is a disposition to have the eyes half closed ; soreness in the front part of the head upon moving the eyes or turning them upward ; soreness of the eyeballs with burning and slight lachrymation; congestion of the vessels of the eye ; they look red and inflamed. 1

OPHTHALMIA of a scrofulous or catarrhal origin. Dr. Carroll Dunham mentions the case of a lady, who had used a hair-wash, which contained the tincture of the wild indigo and in whose case general catarrhal symptoms were produced. He writes : "Her eyes began to smart and to feel as though she had been ex- posed to wood-smoke.

They felt full of dust; the conjunctiva of the globe was injected ; there was a discharge of muco-purulent mat- ter from the eye this morning. Fluent coryza, the discharge being thin, not acrid ; a sore spot, feeling raw, internally on the left side of the pharynx ; these symptoms are aggravated by exposure to damp, cold air. Headache, with a pressure backward in the entire frontal region ; severe pain from the right side of the occiput to the right frontal protuberance. She feels ill, in an indefinable way; feels weak ; half depressed in spirits and half apprehensive of some coming evil.

She feels as though some unknown but irresistible in- fluence had possession of her and she were about to be ill or to meet with some misfortune."

BUCCAL GROUP.

APHTHiE. — In aphthae baptisia has been used to a considerable extent. Dr. Wm. L. Thompson claims to have confirmed the follow- ing symptoms : aphthse of the mouth, particularly those cases of long standing, which extend from the mouth through the alimentary canal, with watery discharges from the bowels ; aphthous diarrhoea. Derangements of the mucous surface generally, vomiting and purg- ing ; sore mouth of nursing infants and sore mouth of consumptives.

The words in italics are important; for to me they seem to furnish

BAPTISIA TINCTORIA. 547

an indication for the class of cases to which the remedy is especially adapted, viz., cases where the vegetative functions have become utterly demoralized.

I was called to a house whose inmates had been troubled, for a year past, with recurrent paroxysms of fever, which were more or less severe, and attacked, one by one, all the members of the household, The location was bad; the people were poor, untidy and shiftless. The patient was an infant, a little more than a year old, suffering with the usual symptoms of aphthse in addition to the following : The face was stupid in expression and earthy in color; there was a profuse flow of ropy saliva, the child ate but little; it tossed about constantly; its bowels were loose, the passages watery and of foul odor ; there was a low fever and the general appearance of the little sufferer bore the impress of a typhoid state. I prescribed aconite and baptisia; but upon again seeing the child, I discontinued the former, giving baptisia1 internally and ten drops of the tincture to a gill of water for topical use, continuing this treatment for nearly ten days, at the end of which time the child was discharged, and had a clear, hearty look in its face, which boded well for the future.

DIPHTHERIA In diphtheria baptisia has been found a valua- ble remedy. Eclectic writers eulogize it very highly. Dr. Goss, a well-known practitioner of that school (Eclectic Medical Journal, August, 1877,) recommends light doses of baptisia, alternated with the iodide of arsenic, giving several instances in which this treatment was followed with excellent results.

Dr. A. M. Cushing writes [Am.

Hoi?i. Observer, Vol. iii, p 224) : Miss D., aged fifteen years, tall, slender and pale, has never menstruated. She has hot skin, quick pulse, pain in the head and a very offensive breath. There are diphtheritic patches on the fauces and on both tonsils, the uvula is red and swollen.

I gave baptisia3, a few globules in half a glass of water, one teaspoonful every hour. On the second day she was about the same ; her breath was still very offensive. The remedy was continued ; the patient improved daily and was dismissed cured on the seventh day.

Dr. Scudder, the well-known eclectic author, speaking of baptisia, says: "The indications for its use are clear — fulness of mucous tissues, especially of the throat, with bluish discoloration. In a majority of cases the breath will be fetid." {Eel. Med.

Jour., Janu- ary, 1872). This bluish appearance of the mucous membrane is quite peculiar to wild indigo and if you add this symptom, with its profuse salivation and its excessive fetor, to the symptoms experi- enced by Dr. Burt, you can see why it has proved so excellent a remedy in ulcerated and in mercurial sore mouth.

CHYLO-POIETIC GROUP.

Baptisia has caused a yellow coating along the center of the tongue ; tongue coated yellow, followed by a brown coating in the center, the edges being red and shining ; the tongue feels thick and swollen ; numb, pricking sensation in the tongue. Flat taste in the mouth and loss of appetite. Dull pain in the epigastric region, fre- quently recurring and aggravated by turning over or moving ; con-

548 BAPTISIA TINCTORTA.

stant pain in the epigastric and hypochondriac region, aggravated by motion.

We have already noted the peculiar effect of baptisia upon the mucuous membrane of the mouth. When this condition extends all through the alimentary canal, causing

GASTRIC DISTURBANCES AND DIARRHOEA, the drug is possessed of valuable curative powers. I would also use it in those gastric disturbances which accompany bilious and typhoid fevers. Dr. Coe (Hale's New Remedies, 2d edition) says that he found it very serviceable in certain forms of

DYSPEPSIA, accompanied with irritability of the stomach, acid eructations, griping pains and looseness of the bowels, with frequent small and offensive stools. In the treatment of

DYSENTERY baptisia plays an important role. It does not cor- respond to the first stage, but may prove invaluable at a later date.

Dr. C. M. Conant (Am.

Hommopatliist, January, 1878,) gives the following indications which I copy in full; "Stools: Pure blood; bloody mucus ; dark, thin, fecal ; frequent, profuse as from a violent drastric carthartic, Aggravation: in the hot weather, in autumn. Before stool: violent colic in the hypogastric region. During and after stool: terrible tenesmus.

Accompaniments: dry, brown tongue ; afternoon fever of a typhoid type ; hepatic symptoms ; sleeplessness or restlessness ; unrefreshing sleep, full of troublesome dreams." Dr. Conant adds : " We have very often seen the 1st centesimal in wTater, cure promptly and permanently, leaving no ill effect, while the 10° (Tafel and the 100° (Fincke) have almost always failed us." I can testify to a similar experience. In using baptisia higher than the 1st or 3d dilution I have been disappointed, while the low attenu- ations and the tincture have acted promptly in my own hands and in the hands of many of my professional friends.

That baptisia exerts a marked effect upon the liver, is clearly demonstrated in the proving. What its exact relation to that organ is, we do not yet know.

FEVER GROUP.

Baptisia is best indicated in that type of fever, which is character- ized by an extreme depression of vitality; in that stage where the system is just ready to yield to the poison, which has tainted the very fountain of life, causing extreme fetor and absolute foulness of the excretions, a low continuous fever, dry parched mouth, sluggish or thread-like pulse, stupid expression of the countenance ; bluish

BAPTISIA TIKVTOKIA. 540

and at times half-rotten gums, with sordes on the teeth, an utter care- lessness as to the issue of the disease and, often, muttering delirium. When you have a full, bounding pulse ; dry hot skin ; a bright, glistening c ,e; very high temperature of the body; anxious tossing about or extreme restlessness ; when you have everv appearance of the wildest arterial excitement, aconite is your remedy.

If the patient complains of being very tired ; has a pale or crim- son looking countenance ; is nervous, drowsy and feverish, with cold hands and feet and complains of his head aching and of its being too big, gelsemium will probably cure.

Let us examine the types of fever in which the wild indigo has been used to advantage and study from the record of clinical experi- ence the conditions under which you will find it especially useful. Baptisia is eminently adapted to the treatment of

TYPHOID FEVER or of fevers which have assumed a typhoid state. Our English brethren attribute a very wide range of action to baptisia, looking upon it as almost sure to abort typhoid fever in its first stage, if given in the very beginning of the disease. Says Dr. Hughes in the British Jour, of Horn., "The patient has a hot, dry skin and a quick, full pulse ; the tongue is thickly covered with a whitey-brown fur ; the head aches and there is at least nocturnal delirium ; the appetite is absent and thirst is great ; the urine is high- colored and the bowels generally constipated. * * * The result of my own experience in its use has been, that in the great majority of cases it cuts short the fever in its first stage, freeing the patient from all the dangers of the second.

I have never yet been disap- pointed in it, and its curative action is often exceedingly rapid." That Dr. Hughes does not stand alone in his views among English physicians is shown in the fact, that in a discussion, which followed the reading of the paper, the most exaggerated statements were made as to the remarkable cures performed by baptisia during the early stage of the fever, " cutting it short," to use the language of Dr. Dunn "almost with the rapidity of lightning."

I would caution you against such blind enthusiasm. A do not doubt that baptisia has often cut short attacks of typhoid fever ; but it could do so only because it was homceopathic to that particular and individual case. I care little what the stage of a disease may be, baptisia will act curatively, if the symptoms indicate it ; and under no other consideration. If baptisia shortens the course of a typhoid fever, it can do so only, if the drug force is homoeopathic to the

550 BAPTISIA TINCTORIA. .

morbific force which produces the disease and its symptoms; and if such a case were not treated and cured by baptisia in the first stage, it would soon develop symptoms which would call for it so distinctly, that any one would detect that homoepathicity to the case, upon whose existence alone depends its power to cure. Let us banish the hope of curing upon general principles, and realize at once that our success as physicians depends upon our power to individualize.

The gastric fever, spoken of by some writers, is but a lighter form of typhoid fever, and is now frequently designated by the terms of nervous fever and abortive typhoid fever. In this type the symptoms of gastric and catarrhal irritation of the alimentary canal are usually present with considerable clearness.

Dr. J. Harmar Smith of England [Brit. Horn.

Jour., 1865), relates the case of a clerk, of pale and sickly appearance, but of usually good health, who was obliged to eat food only half cooked. He was taken with languor, nausea, eructations, great debility. Later, vomiting set in of matters tinged with bile, continuing for several days. The pulse became small and compressible; the tongue dry and baked; and there was great restlessness and irritability of temper.

Owing to excitement, the vomiting returned with increased violence ; diarrhoea set in ; the tongue was dry and covered with a thick, brown crust; and delirium of a mild, muttering sort supervened. Up to that time he had taken mercurius, ipceacuanha, kreosotum, belladonna, and at last arsenicum, which latter remedy relieved the vomiting somewhat, without produ- cing a marked general improvement. At this juncture baptisia was given. Of its effect, Dr.

Smith, in summing up the case speaks as follows : An immediate improve- ment followed the exhibition of baptisia, and in a week from the day on which it was first given the patient was justly pronounced out of danger. There was in this case considerable reason to believe that the disease was prevented from passing from the gastric into the typhoid phase by the remedy in question. Some of the existing symptoms were also at once ameliorated. There had been a succession of restless nights, which had reached their climax on that, previous to the day #n which the baptisa was commenced, but it appeared to set aside at once that morbid irritability of the nervous system which prevented sleep. * * * Nor was there any renewal of the retching and vomiting.

The appetite for food also, which had been absent from the first, was at once excited. The pulse, which had been variable, but generally rapid and always weak since the development of fever, rapidly diminished in fre- quency and increased in strength.

Dr. C. C. Smith, of Stanford, Conn., was called to see a patient, who presented these symptoms: Excessive drowsiness; pulse 120 and thready; the lips parched and cracked; the tongue-heavily furred; great thirst; he could not give a direct answer to a simple question, without wandering away from it or falling into a deep sleep in the middle of a sentence ; low, muttering delirium at night, with a desire to get out of bed.

Prescribed baptisa1, four drops in half a tumblerful of water, a dessert- spoonful every hour. After taking medicine all night, a gentle perspiration set in toward morning, the pulse came down and the patient fell asleep. He had passed through the night frequently small amounts of fetid urine.

Dr. Jahr in his Experience of Forty Years Practice says : " This remedy can hardly be dispensed with during the whole course of the disease ; with but few exceptions it covers the entire case of poisoning by the typhoid cryptogami. It is the analogue of arsenic, nitric acid and muriatic acid, and corresponds with them, in some of its features, almost precisely. It has been denied by some who profess

BAPTISIA TINCTORIA. 551

to have emyloyed the baptisia in the treatment of typhoids, that it produces any of the curative actions attributed to it. This statement cannot be true ; and undoubtedly if there was the failure just men- tioned, it could be traced to want of proper understanding as to the amount to be given and the time to give it. Anything above the second decimal in the treatment of typhoid or any of the blood diseases, when the danger arises from the destruction of the san- guineous fluid by de-fibrinating it, is entirely useless."

Dr. Bull furnishes the following symptom as one particularly char- acteristic of baptisia: " She cannot go to sleep because she cannot get herself together. Her head feels as though it were scattered about, and she tosses about the bed to get the pieces together." This peculiar symptom has been verified in many instances. Some- times the patient thinks that his legs and arms belong to some- body else, and that, consequently, there are strangers in bed with him.

BRAIN DISEASES are sometimes characterized by typhoid symptoms, which demand the exhibition of baptisia ; this is of especial frequency in brain troubles of children. The indications for the remedy do not bear repetition. The same remark will apply to

TYPHOID PNEUMONIA, in the treatment of which disease wild indigo may be a most valuable adjuvant. The expectoration looks grumous or like prune juice.

• HECTIC FEVER. — The slow, hectic fever which accompanies pulmonary consumption is said to be much relieved by the use of baptisia. I have prescribed the lower dilutions in a few such cases and derived considerable benefit from their use.

URINARY AND SEXUAL GROUP.

I am not aware that the drug has produced any remarkable urinary symptoms, or has been found of much value in the treatment of urinary affections, unless you include here the temporary urinary derangements which are so commonlv found in fevers.

The effects of baptisia upon the sexual organs are not very valuable. We find recorded, painful stitches in the urethra ; ulcerous excoria- tions on the glans, resembling chancre, with a pus-like secretion j copious perspiration of the genitals. Baptisia has been used in

GONORRHOEA, where there was an acrid, irritating discharge, with severe, stitching pains in the urethra. In

LEUCORRHCEA it may be found of service when the discharge itself is acrid and fetid; when we have ulceration of the os uteri and

552 BARYTA CARBONIC A.

of the vagina, and when there is clear evidence of general depravity of the system. It has also been used with fair success in

UTERINE ULCERATION, characterized by an acrid, smarting, irritaring discharge, fetid in its nature, and marked by the same low state of the vegetative sphere.

Hale, in his treatise on abortion, tells us that baptisia causes abor- tion by producing extreme relaxation of the muscular fibre. Ooe also bears testimony to the same effect, cautioning against its use during the period of gestation. We may bear this in mind and pre- scribe the remedy in

THREATENED ABORTION, when the general symptoms of the case favor its selection, as may be the case in certain fevers.

MENTAL GROUP AND SLEEP.

The provings made, developed disinclination to think ; restlessness ; extreme dullness ; lack of interest in what is going on. Utter list- lessness is one of the most reliable characteristics of the remedy. The sleep is disturbed by dreams which often become frightful. This, and constant restlessness during sleep, are symptoms of nearly con- stant occurrence in typhoid fever.

We make the tincture of the green root, and dilutions from the mother tincture as usual. Baptism represents the active principle of the plant and is freely used, Erom it triturations are made. Dr. Scudder claims to have found an infusion more prompt in its action than either the tincture or the baptisin.

It should be made by pour- ing boiling water upon the part of the plant used, permitting it to remain upon it in an an air-tight vessel for thirty minutes, after which it should be poured off and filtered through cloth.

BARYTA CARBON 10 A.

[CARBONATE OF BARYTA.]

This agent is recommended for scrofulous swelling, induration and suppuration of glands, chronic sore throat ; it is said to be a good medicine for old people suffering from loss of mental vigor and of physical energy.

Pereira relates the following case of poisoning with this agent, which shows the narcotic character of the poison : A young woman swallowed half a teacupful of the powdered carbonate ; in two hours she had dimness of sight, double vision, ringing in the ears, pain in the head and throbbing in the temples ; a sensation of weight at the

BARYTA CARBONICA. 553

epigastrium, distention of the stomach and palpitation. Subsequently she had pains in the legs and knees and cramps in the calves. A day or two after, the cramps became more severe.

These symptoms, slightly modified, continued for a long time. They show that the first action of baryta is upon the brain, whence it extends to the peripheral nerves. I look upon this case of poison- ing as a beautiful proving of the carbonate of baryta, which may reveal to us a most positive and specific remedy in a case of

HYSTERIA or an acute irritation of the cerebral and ganglionic nerves, characterized by such symptoms. To accidental or intentional cases of poisoning we are indebted for some of the best provings in our materia medica.

Wibmer distinguishes between local and constitutional effects of the drug. The former consist in the inflammation of the stomach and its accompanying symptoms, pain, vomiting, etc. ; the latter comprise the effects caused upon the system by absorption of the poison, namely : the effects upon the brain and spine, characterized by general weakness, stupor, paralysis of the motor apparatus, slow, feeble, pulse and death.

Dr. T. S. Hoyne gives the following characteristics (U.

S. Med. and Surg. Journal, July, 1873): Mental or physical weakness. Fear or dread of the presence of others.

Imagines himself criticized or laughed at, which causes great unhappiness. Suddenly overwhelmed with apprehension of evil; cries out that his family or. friends are ill, which causes great distress. Anxious about the most trivial affairs. Forgets what was just said, just done, or what he was going to do or get.

Sensation as if the brain was loose — seems to move to and fro on motion of the body; feels stupefied as if benumbed. Right side of the head feels burning hot; in reality it is cold to touch. Formi- cation of the scalp; sensation as if the hair stood on end. Loosing hair from the crown of the head.

Cannot bear to look at one object for any length of time ; sparks before the eyes in the dark. Sounds in the ears, as echoes, cracklings, reports, etc. Diseased condition in the region of the posterior nares, especially if the patient be troubled with frequent epistaxis. Formation of scabs in the posterior nares and behind the base of the uvula.

Chronic induration of the tonsils. Prevents suppuration in tonsillitis. The throat looks pale, is sore, with putrid breath. Sore throat, etc., with difficulty in moving the lower jaw.

Painful swelling of the submaxillary gland. The pass- age of food to the stomach is painful, as if it passed over a sore spot.

554 BARYTA CARBONIC A.

Sore feeling at the stomach, even when at rest. Diarrhoea, with pain in the small of the back. When convalescing from pneumonia, sen- sation as if the lungs were full of smoke — she smells pine smoke. The soles of the feet are painful when walking, on account of callos- ities (calc).

Fetid sweat of the feet (sil.). Scarlet fever with enlargement and induration of the glands of the neck, and much pain in the ears and head. Fatty tumors, especially of hard drinkers. Constantly weak and weary ; wishes to lean on something, to sit or lie down, and still feels weak and weary.

Very well adapted to persons who take cold easily, resulting in sore throat. Perspiration on one side, as, one hand, one foot, one side of face, etc. Suitable to scrofulous children who do not grow. Especially suitable to dwarfish women with scanty menstruation and troublesome weight about the pubes in any position.

CEREBRO-SPINAL GROUP.

In their large manual Noack and Trincks offer the following remarks concerning the clinical scope and character of the carbonate of baryta: "Baryta is especially suitable for the affections of infancy, and more particularly still for those of old age, when there is mental or physical weakness. Marasmus senilis, childish and thoughtless manners (in old people), want of clear recollection, sopor, sleep full of internal uneasiness, with groaning and murmuring, immovable pupils ; dim, somewhat reddened eyes ; circumscribed, dark redness of the cheeks ; cold hands with blue spots ; weak, somewhat acceler- ated pulse, frequent micturition, constipation; stoojring posture when sitting; inability to speak a word or to stretch forth the tongue." In

PARALYSIS of old age many of these symptoms are found.

APOPLEXY. — In apoplexy, also, of old people, baryta carb. has proved itself valuable, more particularly in persons who have been addicted to the use of strong drink.

The following cases furnish the indications :

An old toper, after taking a severe cold, was attacked with apoplexy. Symptoms : Loss of speech ; paralysis of the tongue ; the mouth is drawn to one side ; loss of vol- untary motion in the right hand ; consciousness did not seem to have left him. Baryta cured him in thirty hours. (Gross in Archiv xv., I, 103.)

An old man, sixty-four years old, had an attack of apoplexy. He presented the following symptoms on the third day : He sits stooping forward, as if the muscles had lost their tenacity ; he cannot speak one word intelligibly, or protrude the tongue. Cannot think clearly ; behaves in a childish, thoughtless manner. He is very sleepy; sleep is uneasy, with groaning and mumbling.

The pupils are immovable ; the eyes look weak ; slightly reddened. Circumscribed, dark redness on the cheeks. Cold hands spotted blue. Feeble, slightly hurried pulse.

Somewhat hurried urination. Constipation. Three doses of baryta acet., 1st and 2d, cured the man. (Messer- schmid in Hufeland 's Journal.^

BARYTA CARBONIC A. 555

NERVOUS GROUP.

Baryta has produced some symptoms in the nervous system, although its action, so far as our provings are concerned, is never very strongly marked by any characteristic changes. Among these effects we may record the following, which have likewise disappeared under the curative action of the agent: Painful drawing in the small of the back, as if a heavy body were moving downward. Tensive pain in the small of the back, worse in the evening, so that the patient can neither rise from his seat nor bend himself backward.

Stiffness in the nape of the neck when awakening from a siesta. Glandular swelling in the nape of the neck and occiput. When the arm is lying upon the table it goes to. sleep. Intensely painful drawing in the hollow of the bones of the right arm.

Numbness in the lingers as if asleep. Tearing from above downward in the right buttock, periodically increasing and decreasing. Tearing and tension in the bones of the lower extremities down to the heel.

These various symptoms point to the use of baryta in neurotic and rheumatic conditions of a non-inflammatory character, especially when grafted upon a scrofulous diathesis.

ASTHMA. — Eaue recommends the remedy in asthma, especially in old people, fat and with light hair ; aggravation in wet weather and warm air ; frequent, copious urination and paralysis of the tongue.

SPECIAL SENSES.

Under the eye symptoms of baryta we may record the following : Soreness and weariness of the eyes, with pressure. Pressure deep in the eyes, which grows worse by looking at one point, or upward and sideways. Agglutination of the 'eyelids. Everything seems as if in a fog. Black spots before the eyes. Sparks before the eyes in the dark.

We employ the baryta in scrofulous inflammations of the eyes and eye-lids, and in amblyopia of old people.

■ Baryta carb. has caused drawing, stitching, tearing, and boring pain in the ears ; otalgia. Eruption on the ears. Eoaring and buz- zing in the ears ; hardness of hearing.

A girl, aged twenty-four years; for three days, every evening from between seven and eight until she goes to bed, hears a ticking in the right ear, with a roaring like the sea, in the head, at each inspiration. Baryta carb.3000 given in the morning cured at once.

Baryta has also caused an increased sensitiveness of the sense of smell, dryness of the nose, and fluent coryza.

556 BARYTA CARBONICA.

INFLAMMATORY GROUP.

TONSILLITIS In the treatment of tonsillitis this remedy has established quite a reputation, and while a few practitioners deny- that it prevents suppuration, the great bulk of testimony seems much in favor of its power to arrest the disease, even in the later stages. The experience of the writer substantiates this ; for he has not only found the drug to act with remarkable promptness in severe attacks of the disease, but he has treated with the remedy a number of cases of persons of a strumous diathesis, where a common cold would be sufficient to bring on violent attacks, invariably terminating in suppuration.

In the cases which I bear in mind, the carbonate of baryta prevented this ; and in two of them removed the tendency to constant recurrence of the trouble. The right side seems more particularly affected ; the very tendency to the disease and to suppu- ration is an indication of the remedy. In

CHRONIC ENLARGEMENT OF THE TONSIL, especially in children of fair complexion, of scrofulous taint, after an attack of quinsy or as a sequela of scarlatina, this remedy is of great value.

STOMATITIS PUERPERALIS.— Dr. Helmuth reports a case of stomatitis puerperalis cured by baryta carb., when many other reme- dial agents had failed. The chief symptom that directed the writer's attention to this medicine was the absolute and complete anorexia. (U. S. Jour, of Horn., Aug., 1860.)

THORACIC GROUP.

COUGHS. — Baryta has cured coughs, with pressure on the chest ; tickling and dry cough. Also loose cough with saltish, starch-like expectoration.

A young man of strumous habit and prone to take cold easily, had suffered for many weeks with tickling in the larynx and cough. He expectorated considerable mucus, and nearly all the time he suffered from coryza. After trying several reme- dies that appeared to be indicated, with little effect, baryta carb., in the sixth attenua- tion, was prescribed with good result ; the cough ceased, and the catarrhal symptoms disappeared. This remedy has often proven satisfactory in the treatment of sore throat and cold in the head in persons of scrofulous diathesis and very impressible to cold.

(Dr. Small in U. S. Med. and Surg, yournal, July, 1 871.)

We have often found baryta carbonica to act nicely in coughs, where there existed a catarrhal state of the whole mucous membrane with a profuse discharge of thick, yellow mucus ; soreness in the nose, sensitiveness of smell and formation of scabs in the posterior nares and behind the base of the uvula.

In difficulties of the heart you may find it to your advantage to consult baryta. The drug has no very marked effect upon the

BARYTA CARBONIC A. 557

organ, but in violent palpitation of the heart, with shooting and stitching pains, with loss of sexual desire, tendency to catch cold easily, the remedy frequently acts well ; this is especially the case in persons of advanced years.

CHYLO-POIETIC GROUP.

CAEDIALGIA In this direction the pro vers of baryta have re- corded a series of symptoms, among which the following point to its use in the milder forms of cardialgia : " Inclination to vomit, a kind of uneasiness with qualmishness. Pain in the stomach. Heaviness of the stomach, with nausea when fasting, passing off: after breakfast.

Pressure at the stomach as from a stone, relieved by eructations. The prover feels a soreness in the stomach for several days, even when fasting." Dr. Hoyne has cured a few cases of dyspepsia, character- ized by sourish eructations, a few hours after dinner, and by symp- toms just given.

SEXUAL GROUP.

This group is not strongly marked. It is wTell known that baryta causes a loss of sexual desire, especially in topers. Berjeau recom- mends it in syphilitic troubles, when there are present numbness of the sexual organs ; sweat of the scrotum ; loss of memory ; great sensibility to cold, palpitation of the heart, etc.

LEUOOEEHQ3A it has been given successfully, when accom- panied by the following : discharge of a little bloody mucus from the vagina, with anxious beating of the heart, uneasiness in the body, pain in the back, and weakness even unto fainting. Leucorrhoea be- fore the menses. Anxiety for one's family. Vertigo.

Brain feels as if loose. Excoriation at the anus. Urine frequent and abundant. Pain and stiffness in the sacrum and nape of the neck, with drawing and shooting in legs.

Most suitable to scrofulous and emaciated people. (Dr. F. E.

Moore, Med. Investigator, Nov., 1873.)

SKIN DISEASES. — Baryta is a valuable remedy in the treat- ment of certain skin diseases. The indications are mainly constitu- tional. It is adapted to the scrofulous diathesis, to young children and to aged people ; to the phlegmatic temperament, to persons of a dwarfish stature, to those who take cold easily and suffer, in conse- quence, from inflammation and enlargement of the tonsils, and who have fatty tumors about the neck. It is an efficient remedy in

AFFECTIONS OF THE SCALP, with moist crusts and falling out of the hair. In

558 BARYTA MURIATICA.

SCARLATINA it may be prescribed, when the condition of the throat suggests baryta.

FATTY TUMORS— Dr. Hoyne, finally, recommends it highly in the treatment of fatty tumors. He uses the following language: " There is one affection in which we may confidently predict a cure with this agent, and that is fiatty tumors, no matter upon what part of the body they occur. These tumors are quite frequent in persons addicted to strong drink, and it has been my good fortune to treat quite a number of cases.

I have uniformly used baryta200, and have not yet failed to cure a case." ( U. 8. Med. and Surg. Jour., viii., 425.)