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.