Gummi Gutti

A gum-resin which we obtain from the gamboge-plant, a native of Ceylon and the Indian Archipelago. The gamboge of commerce is the Siam gamboge which is the only kind that comes to us. The only accounts which we possess of the method of obtaining Siam gamboge, is that given to Koenig by a Catholic priest residing at Cochin China. According to this statement, when the leaves or branchlets are broken, a yellow, milky juice issues drop by drop

GUMMI GUTTM. 155

(hence the origin of the term gumnii gutta? applied to gamboge), and is received either on the leaves of the tree, or in cocoa-nut shells, and, from thence, is transferred into large flat earthen vessels, where it is allowed to harden during the summer season, and is afterward enveloped with leaves.

Fine gamboge is brittle and odorless; it has very little taste at first, but, after some time, it causes a sensation of acidity in the throat. Its fractured surface is opaque, reddish-yellow, with a glim- mering lustre.

Gamboge is an active irritant drastic. In large doses it causes nausea, vomiting, griping pains in the bowels, watery stools, and increased discharge of urine ; and, if the drag acts with uncommon violence, the pulse may fall. A man killed himself with one drachm of the poison. It caused horrible vomiting and purging, followed by syncope and death.

In fatal cases of poisoning with gamboge, the symptoms generalby are : violent vomiting and purging, abdominal pain and tenderness, cold extremities, and sinking pulse. A post- mortem examination shows inflammation, ulceration and mortifica- tion of the intestines.

Gamboge is of use in derangements of the bowels, varying from a profuse watery diarrhoea, with colic, tenesmus, burning pain in the bowels and vomiting, to a dysentery. Its main usefulness is, how- ever, manifested in diarrhcea, of thin, yellow and frequent stools, with a quick and violent expulsion of the passages,

Mr. D., aged thirty-six years. Thin, yellow', watery stool, coming out all at once. Aggravation in the morning and forenoon. Before and during stool, some pain and urging. After stool, great relief. Cured by two doses of gummi guttas200. (Dr. Conant in Am. Horn., Oct. 1877.)

Mrs, B., aged thirty years. Thin, watery diarrhcea, discharged all at once, pre- ceded by urging. Aggravation in the morning, after breakfast. After stool she feels great relief, and thinks she is well ; but is soon seized again with urging and stool. Cured by one dose of gummi guttse500. [Ibid.)

A child, had been sick four weeks of lienteria, until it was emaciated to a skeleton. The bowels refused to hold anything; the discharges from the bowels were very fetid and came away with a gush, nearly all of the stool at a time. Often gurgling sounds were heard, as if water were passing from a bunghole. Gummi guttse200 cured promptly. (Dr. G. N. Brigham in the A?n. Horn., Oct., 1878.)

In cases of poisoning, Hahnemann recommends the carbonate of potash. It may be necessary to use large quantities of demulcents and if inflammatory symptoms appear, aconite will counteract them.

156 HAMAMELIS VIRGINIANA.

HAMAMELIS VIKGIJ^IAlSrA.

[witch-hazel, natural order, hamamelace^.]

A very common plant in this country, growing from ten to twenty feet high, with large, smooth, alternate, oval leaves. In its external appearance it resembles the hazlenut bush, except the blossoms which differ entirely from those of the latter. The fruit ripens every second year. The plant grows on hills, mountains, stony banks and near streams. We use the bark and leaves of this tree, from which we prepare a dark-green tincture.

It is conceded that Ham am el is affects, above everything else, the venous system. Dr. Preston arrived at this conclusion from a thorough clinical study of the remedy at a time when no provings of the drug existed ; nor have experiments made upon the healthy given evidence to the contrary. In haemorrhages of a passive nature from various parts of the body the witch-hazel is one of our best medicines ; and we are justified, in part at least, in our belief, that the power to cure these conditions depends upon its direct effect upon the structure of the vessels, when we remember the fact, that in inflammatory states of these vessels Hamamelis acts curatively and with surprising promptness.

Its power to arrest bleeding cannot be due to tannin, which is one of its constituents, for the dilutions, given internally, have also produced promptly curative effects.

You will find witch-hazel a reliable remedy in the treatment of the following diseases :

EPISTAXIS or haemorrhage from the nose. Dr. Preston ex- perienced, after taking one drop of the third decimal dilution, the following symptom : epistaxis, with a feeling of tightness of the bridge of the nose, and considerable crowding pressure in the fore- head between the eyes, with a benumbed sensation over the whole os frontis.

Our periodical literature furnishes many cases in point. They all teach the value of the remedy, given internally as well as in form of a wash for the nostril. The haemorrhage must be passive, and may vary from a slow oozing of blood, exhausting only because of its long-continuance, to a pretty free flow. I have often used it in the nose-bleed of persons who have been for a long time subject to nasal catarrh.

HAEMOPTYSIS or bleeding from the lungs; when the blood

HAMAMELIS VIRGINIAN A. 157

comes into the mouth without an effort, like a warm current; labored respiration; when attempting to assume. the recumbent position breathing becomes almost impossible ; tickling cough, with a taste of blood in the morning on waking ; sometimes taste of sul- phur in the mouth. (Lilienthal's Therapeutics.)

Dr. William E. Payne reports a case of pulmonary haemorrhage which promptly yielded to hamamclis. The details of the case may be read in the fourth number of the U. S. Jour, of Horn.

The doctor states that, on his arrival, he found the patient, a lady, lying upon the sofa, calm, with a napkin in hand nearly saturated with apparently pure venous blood, aud spitting about a teaspoonful at intervals of one or two minutes. The blood came into the mouth without any effort. She described it as issuing from about two inches below the right clavicle, in a warm current, making apparently a tortuous course, and at the same time there was a sensation in that region as from the presence of a hard body.

Pulse somewhat accelerated, about 85 per minute. No other symptoms were noticeable. The doctor prescribed four drops of the tincture to half a tumbler of water, of which mixture he gave a table-spoonful. The blood im- mediately ceased to flow, after the haemorrhage had lasted nine hours and a numher of remedies had been tried in vain.

The medicine, however, was continued for several days, at lengthening intervals. The following remark is appended to the doctor's report: "I never have used Hamamelis successfully, in cases of blood- spitting, where the blood was of a light red color, fluid, frothy in appearance, and raised by much cough. Nor have I used it successfully in uterine hemorrhages, except when the blood flowed steadily, was venous in its character, and without uterine pains."

HEMORRHAGE FKOM THE BOWELS, under which we may class dysentery, and the haemorrhage from the bowels which may take place during typhoid fever. In the former you have the usual symptoms of the disease with the addition of the truly hsemorrhagic nature of the discharge from the bowels, which is dark; in the latter the remedy is indicated by the same dark, black, viscous, tar-like bloody stools.

A patient who had been sick with typhoid fever two weeks, had an attack of diarrhoea, dark and fetid, running into hecmorrhagic discharges, large, of black, grumous, fetid blood, under which the patient sank rapidly, was pale and excited, slightly delirious, fearful of death. Gave Rhus tox., in the 6th dilution, for five or six hours, without benefit. I then used Hamamelis 3d, in solution, once in two hours, and also by injection. After the second injection there were no more move- ments for six days, when an enema was given ; the patient recovered rapidly.

(Dr. Seward in the IJakn. Monthly, April, 1873.)

HAEMORRHAGE FROM THE UTERUS, of a passive nature, constant, dark in color, unaccompanied by pains in the womb.

Mrs. P , February, 13, 1872. After eight weeks' absence of menses there set

in painless flowing (dark, then brighter) for three weeks. This evening, a fainting fit. The mouth of the uterus was dilated, but there was no sign of an ovum. The blood comes every quarter of an hour, in warm gushes, liquid, and with irregular contractile uterine movements, Headache all day, dull and heavy — around the head and on the vertex, worse by moving, but kept moving about all day.

The eyes look injected and contracted : she appears as if she had been weeping. Twitching of corners of the mouth and of the hands, when asleep. Two doses of hamamelis,

15S HAMAMELIS VI KG IN I A Is A.

200th dilution, arrested the flow, until renewed by motion of the patient, to be stopped again. The remedy was continued ; during the next day there was some flow, and thumping headache in the forehead and vertex. She had to lie still, with eyes shut, to get any relief at all ; head rather high. The back of the head and neck were cold and painful ; relieved by heated, dry flannel.

The blood appears slimy. February 19th The symptoms have nearly disappeared. Strength and spirits are good.

She continued the hamamelis three times daily, despite directions to omit, until yesterday ; causing evident continuance of a flow, which to-day is nearly gone. Yesterday it was " very dark and thick." Has omitted the medicine the past day. The symptoms are nearly gone. Strength and spirits good.

Discharged. (Dr. J. C.

Morgan in the Med. Investigatoi-, June, 1872.)

Iii the haemorrhages from wounds, haemorrhoids and bleeding surfaces generally hamamelis is used with excellent success. In

INFLAMMATION OF THE VEINS, in any part of the body, hamamelis has shown itself a most useful remedy. We are still in the dark as to the exact manner in which the remedy affects the tissues which compose the structure of the vessels ; but we know- that it cures both inflammation (phlebitis, phlegmasia alba dolens, etc.,) and enlargements of the veins (varicose veins, varicocele, etc.)

The following cases will illustrate the curative action of the remedy.

Mr. H. B., fifty years of age, small of stature, of bilious temperament, and accus- tomed to severe manual labor, was attacked with a severe and protracted illness, in October, 1856. About the first of February, 1857, I made him a visit, in company with his physician.

He was then able to be dressed, but not to leave his room. He had frequent attacks of suffocative and painful cough. There were fulness and swelling of the epigastric region, which was very sensitive to pressure. In the same region, and extending to the liver, was a constant burning pain, of which he com- plained much and often.

He had a similar pain which he located in the rectum, ex- tending from the anus superiorly, several inches. He ascribed it to "blind piles." I diagnosed phlebitis, in the hepatic, and perhaps, haemorrhoidal vessels and advised hamamelis. He got the third centesimal attenuation, three or four doses a day. In a fortnight, he had perceptibly improved, was anxious to go out of doors in three weeks, and returned to his usual laborious employment in early spring.

This he has continued to do, often pushing loads in a hand-cart, large enough for a mule, up to the present time. To this there is one exception, which I think it worth while, on account of its interesting character, to record in detail : In August last, he was taken ill at church, and was obliged to leave the service and go home. His physician was called, who found him in a state of high fever, and suffering intense pain in the right groin. There was a moderate swelling below Poupart's ligament, but too sensitive to allow of a thorough examination by taxis.

From what I learned then and subse- quently, the doctor diagnosed " strangulated femoral hernia." Among the symptoms confirming the diagnosis, was fetid, almost fecal, vomiting. By request I visited him. He had high fever, flushed face, was soporous, and delirious. He was moaning, but would lie quiet except when we examined his groin.

Then he would resist us, and beg to be left to himself; but we could not rouse him to arty consciousness. The tumor exhibited no tendency to turn upward over Poupart's ligamen ; this was fatal to the diagnosis of hernia. I diagnosed inflammation of the femoral vein, and advised hamamelis. Wishing to learn the value of his own prescription, the doctor did not change it till ten o'clock p.

M. Then, finding his patient continually grow- ing worse, as he had from the beginning of the attack, he gave him hamamelis. The next morning there was no delirium, little fever, and pain and soreness in the groin. But from the groin nearly to the knee, the skin over the track of the femoral vessels, about one inch in width, was red, sore and painful.

On the day following, the foot become much swollen, bluish-red and very painful. There was much cedema,

IIAMAMEL1S VIEG1NIANA. 159

especially after the inflammation subsided a little. Hamamelis was continued; in about two weeks from the beginning of the attack, the man went about his usual business. (Dr. Starkey.)

J. A. B. consulted (February, 1871,) Dr. J.

C. Morgan for advice concerning a varicose tumor or enlargement of the left spermatic vein, first noticed after violent physical exercise in a gymnasium four years previous. Since that time it had con- stantly increased in size, soon making it necessary to support it by means of a suspensory bandage. It also gave rise to dull, aching pains in the groin, sometimes extending into the back, very much aggravated by horseback riding.

Having been treated unsuccessfully with hydropathy, iodide, etc., for nearly three years, the patient had concluded to submit to surgical interference, but was advised to try hamamelis for one month. To this the patient assented, taking of the mother tincture drop-doses, morning, noon and night and applying a solution topically by means of a bandage. There was no improvement at the end of the month and the patient returned home, without submitting to an operation. On the first of May the use of the remedy was re- commenced, taking drop-doses of a solution of equal parts of the tincture aiid water.

By the first of June the bandage, constantly worn for three years previous, was removed and the patient seemed radically cured. [Am. your, of Horn. Mat. Med., October, 1871.)

Dr. Ussher [Bom. World, December, 1875,) reports the case of a young lady, who had a tumor beneath the tongue, of the size of a filbert nut, soft and full of fluid, giving a gelatinous feel ; the capsule seemed veiy tough and the enlargement had the appearance of a huge vein. The case was cured with hamamelis, first decimal dilution.

Hamamelis has also been used in various inflammatory conditions of the eye, characterized by venous congestion, great conjunctival vascularity, ciliary neuralgia, photophobia and lachrymation. Dr. Hart says [Am. Observer, September, 1877,) "This remedy, used locally as well as internally, has been successfully employed in traumatic conjunctivitis, keratitis and iritis, caused by burns, splinters, blows, etc., also in ulceration of the cornea, and in internal haemorrhages, especially when of traumatic origin."

Sometime since, a sweetmeat manufacturer rushed in to see me immediately, after a drop of boiling sugar had flown into his eye. The agony he suffered was distressing to witness. He rolled on the carpet in uncontrollable anguish. I mixed half a drachm of the tincture of hamamelis with an ounce of water, and put a few drops into the eye.

This relieved the pain in a short time, and I sent him home, with instruc- tions to apply the collyrium every hour or two until quite easy. The next morning he called, and though the conjunctiva was much conjested, he was free from pain. The eye was well in three days. My patient told me he had on two former occa- sions met with a similar accident, but did not recover from either of them under three weeks.

(Dr. J. L. Newton in the Monthly Horn.

Review, August, 1871.)

Pro vers of hamamelis experienced pretty well-marked effects upon the sexual organism. Dr. Burt suffered severely from pains in the testicles, which were at times excrutiating ; in others, unconscious seminal emissions took place, and in the case of two women (see Allen's Encyclopedia) violent uterine haemorrhage was produced.

Clinical experience has failed to prove the witch-hazel of much value in derangements of the generative organs. It is true, its use has been advocated in gonorrhoea and other similar difficulties, but

160 HAMAMELIS VIRGINIANA.

with the exception of disorders previously mentioned, you will find other remedies far more reliable. In

DYSMENORRACEA, however, it may he given, when we find "severe pains through the lumbar and hypogastric region, and down the legs ; fulness of brain and bowels, with severe pain through the whole head, causing stupor and dull sleep ; blood very dark and pro- fuse; ovaritis after a flow, with diffused agonizing soreness over the abdomen ; worse at the time of the menses, which are irregular ; retention of urine." (Lilienthal's Therapeutics.)

Miss. B., aged twenty years, blonde; large blue eyes ; brown hair; leuco-phleg- matic temperament, mental and motor, active. From her fourteenth year she has slept from eight to nine o'clock A. M. in a natural but heavy sleep, from which she could not be awakened.

For a few hours subseqnent to this she would be languid and irritable, then lively and pleasant, but not very fond of company. In other respects her health was pretty good. Menses did not appear until she was sixteen. The menstrual nisus was very irregular and preceded by pain in the back ; cold feet and hands; sensitive to cold; constipation, leucorrhoea and irritation of the vagina; mental depression.

She would, during the menstual period, continue from two to three days in the sleepy, trance-like condition, insensible to everything, but would partake moderately of liquids. When she became conscious she had no recollection of anything that had transpired during the two or three days of sleep. She was then weak, nervous, and sluggish. In a few days she would recover her usual buoyancy and health, but the late sleep in the morning with the accompanying symptoms con- tinued from one nisus to the other, to give place to the days of prolonged sleep.

After five years of unsuccessful treatment she recieved hamamelis, 6th decimal, every four hours, previous to the appearance of the menses, and an occasional dose of sepia6. She menstruated in three days after commencing the use of hamamelis with- out pain or sleep, and to date enjoys good health and is free from all her abnormal symptoms. She continued the use of the hamamelis at long intervals for several months. (Dr.

A. M. Cowan in the U. S.

Med. Investigator, May, 1876.)

Hamamelis has long been a favorite domestic remedy for the topical treatment o,f sores, wounds, ulcerated surface, etc. It could not have held its place in popular regard so firmly, did it not possess real virture. Medical men also employ it much as they would arnica, using both, Pond's extract and the officinal preparations.

SORE NIPPLES are greatly benefited by the use of the topical application of a dilution of the tincture in water or of a glycerole.

BED SORES are similarly and successfully treated.

WOUNDS. — In the treatment of wounds its enthusiastic friends claim for it superior merit, ranking it with arnica, particularly in incised, lacerated or contused wounds.

A lad, aged thirteen years, was kicked in the head by a mule, laying open the scalp from the centre of his forehead, extending over the right temple to the top of his head, making a very large and frightful wound. Applied hamamelis, and two weeks after, the scar was scarcely perceivable. (Dr. C. W. Hamisfar in Horn. Observer.)

A young man, cutting grass, barefooted, accidentally stepped back upon his scvlhe, nearly severing the toes from his foot. I was immediately called to the case, applied the hamamelis, which speedily arrested the bleeding, removed all pain and soreness,

HELLEBORUS NIGER. 161

causing the wound to heal by the first intention, and in a short time the young man's foot and toes were as good as belore the injury. [Ibid.)

Dr. Hamisfar advises the use of one part of the fluid extract to four parts of water ; compresses are to be applied to the wound and kept thoroughly saturated for several days ; then it is to be applied three times a day until union has taken place.

HELLEBORUS 2S"IGER

[BLACK HELLEBORE. NATURAL ORDER, RANUNCULACE^l.]

This is a perennial plant, flowering from December till March, hence its name Christmas rose. Few plants are more elegant; the large, concave flowers, white with a tinge of blush-color, are finely contrasted with the ample, dark, shining foliage. The roots are perennial, creeping, very black externally, with numerous long, simple, perpendicular fibres. It grows on rocky and woody mountains.

In looking at the beautiful flower you will find that the calyx is composed of five large, roundish, concave sepals, at first white, with a blush of a pale rose color deepening by age and finally assuming a greenish tint, after the impregnation of the seed. Petals tubular and two-lipped ; filaments numerous and supporting yellow anthers. Leaves pedate, large, composed of five, six or more leaflets, of a deep-green color, smooth ; leaflets ovate-lanceolate, smooth, shining, coriaceous, with the distal half of each slightly serrated ; flowerstalk a scape, six or eight inches in length, erect, round, variegated with red, and supporting one or two flowers. Boot blackish with numerous fibres.

From this root we obtain a brownish straw-yellow tincture.

The following case of poisoning is related in Ferrari's Journal Universal: Two persons took a decoction of this joot in cider; three-quarters of an hour after taking it, alarming symptoms were developed, without exciting suspicion of the real cause. One of the men, therefore, took another dose, when vomiting, delirium, horrible convulsions, accompanied with immediate coldness supervened, and death at last ensued. On dissection, sixteen hours afterward, the appearances in each were found precisely similar, except that in the one who took the largest quantity, they were more strongly marked; the lungs were gorged with blood ; the mucous membrane of the stomach was considerably inflamed, of a blackish-brown color, and reduced almost to a gangrenous state ; the oesophagus and intestines were natural.

VOL. II. IO.

162 HELLEBORUS NIGER.

This case shows that black hellebore is an acrid poison, excessive doses of which cause vomiting, and inflame the lining membrane of the stomach.

Another case of poisoning is reported by Morgagni : A man who appeared to be nearly fifty years old, being in the hospital on account of melancholia, was about to depart, when he took some extract of black hellebore by which he was considerably purged. In the beginning of the night, seven or eight hours after taking the drug, he was attacked by vomiting and pains in the abdomen, which were allayed by warm broth ; about the fifth hour of the night those symptoms returned and were again relieved.

He lay down an hour afterward, having vomited two or three spoonfuls of a greenish matter. So quietly did he rest that none of the patients in the nearest beds heard him ; but at the eighth hour they were attracted to his bedside by a peculiar noise from his mouth, and found him dead. He had taken about forty drops of the extract, a quantity which had been administered to others with impunity. He had, however, neglected to drink copiously of whey, a precaution which it was customary to recommend.

After death, the -sxtremities were relaxed, muscles flabby; the stomach, oesophagus and intestines were found inflamed, though not violently in any part ; the whole of the cerebrum was found softened and shrivelled.

In this case, purging was the first effect of hellebore ; this was followed by vomiting and pains of the abdomen, again followed by vomiting of two or three spoonfuls of a greenish matter. The whole of the intestinal canal was found inflamed except the larger bowels. The cerebral changes cannot be considered reliable, since the man was under treatment for melancholia, and the brain may have been previously diseased.

Another interesting case is reported by Tahrenhorst in Bust's Magazine. A young man of nineteen years swallowed a table-spoonful of the powdered hellebore by mistake. Soon after, he was attacked with copious vomiting. Two hours after, when the doctor was called, the patient had vomited sixty times, the whole body was covered with a cold, clammy sweat, the face was pale and the features looked distorted, the pulse was small and tremulous, the abdomen dis- tended, but not very painful when touched.

The patient had frequent twitchings of the muscles of the legs, and complained par- ticularly of a violent burning in the stomach and fauces, which he compared to the burning caused by a streak of fire. After drinking copious quantities of milk and an infusion of althea with opium, and after applying mustard poultices to the abdomen, he soon recovered from the effects of the poison.

This case reveals, to some extent, curative powers that may be of

HELLEBORUS NIGER. 163

use to us in sudden attacks of cholera, where the inflammatory and nervous symptoms, such as violent vomiting and burning pains in the epigastric region, diarrhoea, twitchings of the muscles, sinking of the pulse, coldness of the skin and clammy sweat, manifest them- selves conjointly. This case may likewise suggest the propriety of using the black hellebore in violent forms of gastrodynia or neurosis of the stomach, where precisely such a group of symptoms may occur.

These cases of poisoning demonstrate the irritant properties of the black hellebore ; long-continued provings upon the healthy develop peculiar effects of the drug which show that it acts very decidedly upon the kidneys and upon the serous membranes, causing dropsical effusions in various parts of the body ; to the homoeopathic physician the results of these provings are of far greater interest in this case than the information gleaned from cases of poisoning.

Hellebore is particularly adapted to diseases of childhood.

CEPHALIC GROUP.

According to Hahnemann, hellebore depresses the sensorium, so that, with perfectly sound eyes, the patient sees imperfectly; with sound hearing, the patient hears imperfectly ; with a sound organ of taste, he has no taste or appetite for any thing ; he recollects past things imperfectly, seems to be absent-minded, has no refreshing sleep, wants to work without having the ability to do so. This impaired state of cerebral innervation may be of use to us in the application of hellebore to various diseases to which the brain is liable.

The headache of hellebore, although usually dull, is exceedingly severe, extends from the occiput to the vertex, compels the patient to seek relief in constantly seeking a new position for the head. There is heat and heaviness in the head, with coldness of the hands ; stoop- ing and sitting up aggravates the pain ; the patient feels best when lying quiet and with closed eyes.

As far as we may infer from the provings which have been instituted, helleborus niger affects the brain in a very marked manner, inducing engorgement of the cerebral vessels, and depres- sing the vital energies of the serous membranes of the brain in a manner that may lead to effusions into the ventricles.

HYDKOOEPHALUS. — Hellebore is one of our most important remedies in hydrocephalus arising from a diseased condition of the serous membranes, especially in children of a scrofulous diathesis ; the disease may develop very gradually ; if the result of metastasis,

164 HELLEBORUS NIGER.

the symptoms appear suddenly. Hartmann describes the hellebore patient as follows : The fever is not very active, the pulse feeble, not rapid, soft and irregular ; breathing is difficult, interrupted by occasional deep sighs. The patient lies in profound apathy, cannot sit up alone, carries his trembling hauds to the head in an automatic fashion ; as he is raised up the head falls back ; frequent rubbing of the nose ; the eyes are half-open, the pupils enlarged, the eyeballs turned outward or upward, the eyelids in convulsive motion; the forehead is wrinkled and covered with cold sweat ; there is no appe- tite, but a constant craving for drink, which is taken voraciously and in large quantities, the act of drinking being preceded and fol- lowed by a chewing motion of the jaw.

The patient is easily vexed, especially if attempts are made to coax him ; he strikes about. The countenance is pale and bloated. A drowsy stupor is more fre- quently present than consciousness and wakefulness. Frequent startings with crying and screaming; the nostrils are dirty and dry; the lower jaw is dropping.

(Diseases of Children, p. 393.)

A girl, two and a half years old, had all the symptoms of a serious brain-difficulty and presented the following symptoms on the sixteenth day of her illness : For a week past she has only lain on her back, seemingly asleep, the eyes half-open, pupils con- tracted, the cornea and albuginea lustreless, dull, as if covered with dust, the canthi filled with dried mucus, the eyeballs squinting inward, surrounded with blue margins, countenance pale, emaciated ; nose pointed, the nostrils covered with dry scabs, the lips cracked, dry ; the body emaciated, covered with loose, dry skin.

The pit of the stomach sunken in ; the legs spread apart, the thighs drawn upward after an attempt to change the position ; groaning, anxious, piteous weeping. The countenance dis- torted with pain ; the head, thoroughly powerless, sinks backward; she opens the eyes widely, with enlarged pupils ; oscillations of the iris ; light makes no impression. She drinks ravenously, bites the spoon without rousing from her stupor ; distortion of the face ; chewing motion with the jaws ; reaches with her hands toward the head ; spasms in the muscles of the back ; grinding of the teeth ; constipation ; unconscious voiding of urine; partial perspiration on the hairy scalp; pulse accelerated, soft, intermitting.

Prescribed tincture of hellebore niger, two drops every two hours, day and night, for six days, at last every three to six hours. On the third day the lustre of her eyes reappeared, screaming out less frequent ; she notices objects about her, and from the sixth day of treatment improvement went on so constantly, that she received no other medicine. (Knorre in Allg. Horn.

Zeitg., xix., 39.)

CHTLO-POIETIC GROUP.

We have seen that hellebore may effect powerful disturbances in the stomach and bowels. It causes : bitter taste in the throat ; dry and slimy taste in the mouth, with violent thirst; confluence of a watery saliva in the mouth ; nausea, vomiting of green bile and purging, with great pain ; burning as from a hot iron in the stomach and oesophagus ; white, jelly-like discharges from the bowels several times a day; also hard and scanty stool with violent cutting in the rectum.

ELLEBORUS NIGER. 165

GASTRODYNIA. — We have seen that these symptoms justify the use of hellebore in gastrodynia and the milder forms of

CHOLERA ASIATIC A, with excessive restlessness and anxiety.

URINARY GROUP.

The first effect of large doses of hellebore is to suppress the urinary secretions, the secondary effect or the symptom of organic reaction is emission of increased quantities of watery urine. This symptom is valuable in dropsy, where the urinary secretions are very much diminished, and are dark, like coffee-grounds.

Hellebore may also prove valuable in a type of

CYSTITIS, which develops very gradually until, at its climax, it is characterized by the most violent symptoms, constant urging to urinate, with violent spasms, and emission of very small amounts of urine ; tendency to nausea, vomiting ; loss of appetite ; tympanitic abdomen.

SEXUAL GROUP.

Hellebore depresses or extinguishes the sexual instinct, a valuable indication in disorders where hellebore is indicated.

In women it may cause menstrual suppression, and is therefore indicated in amenorrhoea with oedema or ascites.

THORACIC GROUP.

HYDRO THORAX. — Hellebore causes a good many of the symp- toms which characterize hydrothorax, and oedema of the lungs. We have: hurried breathing; slow and deep breathing; contraction of the chest ; he had to gasp for air with his mouth wide open, unable to breathe.

Hellebore is particularly useful in dropsy of the chest, and perhaps of the pericardium, if the disease is an after-disease developing itself in the wake of measles or scarlatina. In hydrothorax of this kind, the patient may soon become oedematous in various parts of his body ; he may be troubled with dry and racking cough, orthopncea, dimin- ished secretion of urine, etc.

EXANTHEMATOUS GROUP.

Hellebore has caused eruptions, vesicles and ulcerations of the skin. In some instances the skin peels off in large patches. We see it even stated in the Oxford Magazine of 1779, that various indi- viduals who had eaten of the helleborus fcetidus, the stinking helle-

166 HELLEBORUS NIGER.

bore, a species endowed with powers analogous to those of the black hellebore, lost not only the epidermis, but their hair and nails a? well. Hence the drug may be considered of possible value in similar conditions, provided particular and well-defined constitutional symp- toms establish its homceopathicity.

In certain forms of dropsy hellebore may become a most important remedy. This is particularly true in post-scarlatinal dropsy of scrof- ulous, tuberculous, strumous individuals or of dropsy which appears after any one of the eruptive diseases, no matter where it is situated.

In the case of a boy, eight years old, born of scrofulous parents, a general anasarca developed after an attack of scarlet fever, which had readily yielded to proper treatment. The urinary secretions were partially suppressed. Every few hours the boy vomited up quantities of watery mucus. After beginning the use of hellebore, the urinary1 secretions were soon restored and the dropsical symptoms disappeared completely in a fortnight.

FEVER GROUP.

LUTESCENT TYPHUS.— Hartmann recommends hellebore for lutescent typhus, with internal burning heat at night, chilliness and cold hands, stupefying sensation in the head, drowsiness, numb- ness of the extremities, small pulse.

INTERMITTENT QUARTAN.— Hellebore has also been recom- mended for intermittent quartan, with obstinate swelling of the spleen and liver, scanty emissions of dark, coffee-colored urine.

MENTAL GROUP.

PUERPERAL MANIA— Hellebore has long been a favorite remedy for various mental derangements, more particularly for puerperal mania and mania from menstrual suppression.

A case is reported in HufelancVs Journal where a girl became deranged in consequence of menstrual suppression, jumping over chairs and tables ; she was speedily restored by the internal use of hellebore.

MELANCHOLIA. — The mental state caused by hellebore is fre- quently one of utter despondency. Hence it acts curatively in melancholia, where the patient is very retired, thinks of sad themes and is utterly unable to bear the sight of a smiling face or to hear laughter or light conversation. He prefers solitude, thinks of death and its terrors. Homesickness.

HEL0NIAS. 1G7

HELONTAS.

[FALSE UNICORN OE BLAZING STAR. NATURAL ORDER, MELANTHACEyE.]

This plant is a native of this country, and is found in low grounds, woods and meadow lands, particularly in the western states. It is a perennial plant, from one to two and a half feet high. Its stem is furrowed. The leaves are lanceolate ; the radical leaves are broader, and are arranged in a whorl.

The flowers are small, green- ish-white, very numerous, in long, terminal, spicate racemes, which are slender on the barren plants. The fertile plants are taller, more erect but with fewer flowers. The seeds are inclosed in a three- furrowed capsule, oblong, tapering to the base, opening at the top. The root is from one inch to one and a half inch in length, about one-eighth of an inch in diameter, and terminates abruptly at the end, which gives it a bulbous appearance.

It is fibrous, of dark brown color externally, rough and uneven. "The roots have a faint, peculiar and pleasant odor, when bruised, and a peculiar, bitter, somewhat aloetic taste, not so powerful in the dried root as in the fresh." (King.) The botanical name of the plant is, chamtelirium luteum.

The root is the officinal part. From it we prepare the tincture and triturations. Helonin represents its active principle.

Our provings are not very complete. The following is a synopsis of the proving :

Discouraged ; gloomy ; irritable ; dull.

168 lIELOlSriAS.

Profuse uterine haemorrhage ( ?). Irritation of the external labia and pudendum, which were puffed, hot, red and burned and itched terribly ; thin, transparent exfoliations on the skin ; the mucous membrane of the labia was red, swollen and covered with a white curdy deposit, like aphthae.

Clinical experience has demonstrated the usefulness of helonias in various derangements of the urinary and generative organs. Among them we may mention the following :

ALBUMINURIA.— Depression of spirits ; restlessness ; burning and aching in the lumbar region ; urine pale-yellow ; palpitation ; unrefreshing sleep ; after scarlatina or as one of the complications of pregnancy; uterine derangements.

UELONTAS. 1G9

DIABETES. — The indications are very much like those given under albuminuria* The general depression is more marked; the melancholy mood of the patient still more profound ; there is more lameness and pain in the back ; gastric disturbances, as foreshadowed in the proving, show themselves and complete impotence or well- marked uterine atony are apt to prevail.

Many practitioners attribute to helonias a remarkable effect upon the sexual organs of women. Primarily it stimulates the sexual in- stinct, this. is followed by a decided depression, such as impotence in men and complete loss of sexual power and sterility in women.

LEUCORRHCEA dark and offensive, with soreness and pressure in the uterine region and the usual characteristic symptoms.

PROLAPSUS UTERI with aching through the hips and drag- ging pain in the sacral region ; consciousness of a womb ; leu- corrhoea ; anaemia ; soreness in the uterus, irritation in the vagina, pruritus, despotidency, general debility, etc. A patient of Dr. Hale, to whom the helonias had been given for uterine atony, experienced the most distressing itching of the external sexual organs, with an aphthous inflammation of the lower third of the vagina, without experiencing any sexual excitement. Hence it might be to our ad- vantage to consult the drug in the treatment of vaginitis.

CHLOROSIS has been successfully treated with it, when depend- ing upon a condition of the sexual organs, which was characterized by the customary constitutional symptoms of helonias.

Helonias has caused and may cure headache, which is relieved by motion or mental exertion, but returns as soon

170 HYDRASTIS CANADENSIS.

as the patient is quiet. For further particulars consult the patho- genetic symptoms, previously given.

The remedy may he found useful in the following :

DIARRHOEA with gastric derangements, burning in the bowels and the usual constitutional symptoms.

DROPSY — (Anasarca) arising from states to which the remedy is homoeopathic, such as : kidney difficulties, chlorosis, uterine de- rangements, etc.