Hura Assacu Oassacu

THIS plant inhabits the equatorial regions of South- Ameri- ca, the provinces of Para, Jlio-Negro, and the neighborhood of the Amazon, where it is very frequent. It resembles the hura crepitans ; its leaves are alternate, somewhat cordate, rounded, glabrous, serrate ; rolled up and stipulate while young. The petiole is provided at its top with two large glands. Flowers monoechous ; the male flowers having a short, urceolate perianth, and covered with a scaly bract ; they form elongated, peduncled, terminal husks.

The fe- male flowers, which are twice as long as those of the hura crepitans, have their perianth resting against the ovary, which is surmounted by a long and infundibiliform style, terminated by a stellate stigma ; they are solitary and placed near the male flowers. It is from this tree that the Indians draw the milky juice called Assacu by the Brazilians.

A man affected with lepra, and who had sought refuge in the solitary regions of the Amazone, took, by the advice of an Indian whom he met there, a considerable quantity of a juice known under the name of Assacu, flowing from the

66 BRAZILIAN PATHOGENESI3.

trunk of a tree, which has been described by Willdenow, under the name of hura braziliensis. He was cured ; and the president of the province of Para, informed the imperial government of it. Since then, this juice has been very generally used by leprous patients without, however, curing them.

The first and third provers of this drug, on a voyage to Brazil, in 1842, had both been attacked with the lepra. Under homeeopathic treatment they seemed both to have got well, though one might have inferred from the gravity of their symptoms, that they had been palliated rather than cured. The frightful symptoms of compression of the spinal marrow, which supervened in the case of one of the provers, point to the Assacii. as a powerful remedy for various forms of myelitis. The symptoms of nervous excitement, the twitching, the irritability of the temperament exhibited by all the provers, favor the doctrine that the lepra is a particular lesion of the nervous system.

If the exanthems and the insensibility of the skin characteristic of the lepra, have been less marked in our provings, it is undoubtedly because these phenomena belong to some chronic form which a continued use of the drug and a real poisoning are alone capable of producing.

These four provings have been instituted with a single drop of the fifth attenuation. It is our rule to avoid repeating the dose lest the chronological succession of the symptoms which we regard as important, should be disturbed. We do not believe that repeated doses can do much good, arid if a prover should not experience any effects from one dose, we should prefer dropping this proving, and resort to some other drug, to which his organism should be more sensible.

First prover : Aug. Joly, 29 years of age, bilious-nervous temperament, healthy constitution.

First day. — Took one drop of the 5th attenuation at ten o'clock at night.

lo One hour after, itching at the ribs and sternum, at the biceps and the posterior parts of the right arm. Doughy mouth, in the morning, on waking. Dreams about a ball,

HURA BRAZILIENSIS. 67

about houses in process of erection. In the morning, itching at the arms, legs, outer parts of the tibia. 5» The upper and lower eyelids are inflamed and blueish. Itching at the right arm, at the lower and inner portion of the humerus, owing to a little pimple which is forming. Taste of blood in the mouth.

Whizzing in the ears, especially the right. Clusters of miliary pimples on the back, arms, legs and chest. 10. Irritated by the least contrariety. Desire to vomit, sick stomach.

Rheumatic pain at the left arm. He looks weary as if he had been carousing all night, though he slept well all night. Pinching at the right side of the tongue. 15. Laricination in the canal of the urethra.

Prickling around the eyes, and especially around the right one. Sensation as if small pimples would break out on the inside of the eyelids. Nervous beating in the eyelids. Rheu- matic pain at the sacrum, especially when stooping. 20* Con- tusive pain at the lumbar region.

Miliary eruption in the joints.

Second day Dry mouth in the morning. Acute pain in the lumbar region and at the sacrum, as from a fall. Smoky taste of the water which is drank at breakfast. 25» Pain in the ilio-femoral articulation.

Pain all along the left thigh. Sneezing, and frequent blowing, as when a catarrh is about setting in, followed by involuntary discharge from the nose of a lemon-colored mucus, with tickling. Constant pain in the lower part of the lumbar regions, worse when stooping or sitting down. Lancinating pain at the top of the head. 30i Slight desire to vomit at eleven o'clock in the morning.

Dizziness. He dreams that he was swimming in a river with ,warm and dark-green water ; afterwards that he was on a plantation in Brazil, where men drew water from a yellow pond. Moist, intermittent heat, mounting every fifteen minutes from the feet to the face. Prickling at the right eye. 35» Sense of heat mounting to the clavicles.

(At a quarter of ten o'clock :) Dry nose, he cannot blow it ; with itching at the interior of the nose.

Third day. — In the morning, the pain at the sacrum had disappeared. (At ten o'clock and a half:) The pain at the sacrum returns worse, after moving a box. Burning at the

68 BRAZILIAN PATHOGENESIS.

right index-finger, a red spot extending from the nail to the second phalanx. Numbness ; almost amounting to insensi- bility. 40« (At half past twelve :) Pain as from a splinter under the thumb-nail. In the evening, tickling under the arms and along the dorsal spine. 'No sleep at night, frequent waking, feverish agitation.

Fourth day. — Heat in the hands, in the morning. At two o'clock, a small vesicular pimple on the back of the left hand ; for four hours. 45. Stiffness in the trapezoid muscle, near its attachment at the occiput. Pain at the left fore-arm as from a blow. Small vesicular pimples, and itching at the ribs, arms, and at every prominent process of the bones.

Fifth day In the morning, the pimples on the arms have almost disappeared ; there remains only a little itching at the sternum. Heat at the tips of the right fingers. 50» Sen- sation as if a small portion of the nail of the right index- finger had become detached. At half past six in the evening, heat and passing sweat.

At half past seven in the evening, sensation of burning, smarting on the left side of the chin, in the beard, as from an incipient tetter. Sensation under the masseter muscle, as from a recent blow on the parotid. At eight o'clock in the evening, the spot becomes sensible to contact ; a small swelling is observed extending below the zygomatic arch. 55« Sensation at the supinator muscle of the forearm, as from an incipient tetter. Small pimples on the inner surface of the lower lip.

Stiffness of the trape- zoid muscle and the neck. Prickling as from dust, at the border of the lower lid of the right eye. 60. Itching at the back, legs, arms, at the same time.

Sixth day. — Fleshy excrescenses on the inner surface of the lips. At four o'clock, weariness in the legs, in going up- stairs. At eight o'clock in the evening, painful stiffness of the neck. The pain in the masseter muscle, which had already decreased in the morning, disappeared entirely in the the evening. Weight in the testicles in walking, at five o'clock in the evening. 65* Taste of blood in the throat before breakfast.

Seventh day. — Itching at the right lower eyelid, as if a

HURA BRAZ1LIENSIS. 69

pirnple would appear. At three o'clock, sensation as of dust in the left eye. Sense of weight at the eyes, as if they had been strained.

Eighth day. — No sleep all night. 70» Pressive pain at the cranium. Heat in the» nails of the left hand.

Ninth day. — Straining sensation in the upper part of the sacrum, preventing him from standing erect, at noon. Taste of blood in the throat before breakfast. Sputa mixed with blood. 75» Sense of giving way in the knee-joint, in going down-stairs, at two o'clock. At four o'clock, pain in the renal region, which keeps increasing ; it decreases at five o'clock. Prickling in the left eye, and intolerable itching, with nervous irritation which spreads to the heart, but passes off soon.

Tenth day. — Prickling in the left eye as from dust. Smarting sensation in the beard as from a pimple, at each hair, at nine o'clock. 80t Burning sensation at the inner canthus of the right eye, at half past nine in the evening. The carunculae lachrymales look inflamed.

Eleventh day. — Itching at the anterior surface of the tibia, at night, and smarting sensation as from a tetter. Appear- ance of a small red circle, with a small dark-red pimple in the middle ; followed by peeling off. Itching at the hairy scalp, especially behind and in the mastoid process, as from a tet- ter. 85« Sensation as if he had torn off a hang-nail, or as from a splinter in the ring-finger of the left hand. At ten o'clock, smarting at the bend of the right elbow, on the outside.

Twelfth day. — Tickling at the left arm, with small vesicu- lar pimples. Itching in the beard, with small pimples which form a crust under the chin. Itching and small crusty pim- ples on the hairy scalp. 90« Constrictive sensation at the anus ; at half past five o'clock.

Thirteenth day. — Painful sensation at the upper and late- ral portions of the sacrum, as if strained or bruised. Clus- ters of small miliary pimples at the bend of the elbow, with redness around the pimples after scratching them. The pimples cease to be vesicular ; other pimples appear on the

70 BRAZILIAN PATHOGENESIS.

insteps. Prickling sensation in the eyes all day, with red- ness and smarting at the border of the lids. 95. Sensa- tion as if there were dust or foreign bodies in the eyes. The right eye is more sensible than the left. Weariness in the legs, after noon. Pain in the left knee as from a sprain, with lancinations below the pain,

Fourteenth day. — Contractive sensation below, and at the right side of the coccyx. 100. Rheumatic pain at the left side of the neck, the splenius, complexus and trapezoides muscles.

Fifteenth day Rheumatic pain at the neck, with diffi- culty of turning the head to the left side, in the morning. Pain in the head like a weight on the skull, extending to the mastoid processes. Sense of loathing with nausea, Oppression at the stomach when standing erect. 105.

Pale face, with rings around the eyes and redness at the margin of the eyelids. Pains in the head like a beating in the sides and at the vertex, reverberating in the mastoid processes, and extending to the sterno-mastoid muscles. Sense of constriction in the upper part of the throat. Yel- lowish, heavy and frothy expectoration, ever since he took his drug.

The affective sphere is very active. HO. Painful stiffness of the neck, which prevents one from turn- ing the head to the left side. Sensation, in closing the eyes, as though the eyelids were cold.

Pain from the occi- put to the vertex, with 'beating, and acute pains.

Sixteenth day Horrid pain in the sacro-lumbar region, at the articulation of the last lumbar vertebra and sacrum, when attempting to raise a weight. Pain as when straining a ligament ; numb pain in the left thigh, along the course of the sciatic nerve. 115. Inability to stoop without ex- periencing acute pains in the sacro-lumbar region ; he is obliged to lie down.

Fainting when trying to sit down, caused by the violence of the pain at the sacrum ; sense of tearing. Nervous spasms, convulsions, cramps in the calves and toes during the fainting spell. Sense of shud- dering at the rectum. Tickling like worms creeping along in the rectum. 120.

In spite of the pains, he slept pretty

HUKA BRAZILIENSIS. 71

well in the night, from the fifteenth to the sixteenth. De- sire to urinate, every half hour. He urinates a long time. Watery urine, with a greenish tint.

Cramp in the right middle, and ring-finger. 125- Pulse interrupted for two minutes, ringing in the ears, roaring in the head, beating in the temples. During and after the fainting-spell disposition to love everybody, especially those around you. He often thinks of death, but he is not afraid of dying; he even feels as though he would die without regret. He reproaches himself with everything bad he has done, even the lease trifles, and considers nimself very guilty for having done them.

During the nervous attacks, he thinks of his salva- tion. The sense of smell is very acute, he eren smells persons at a distance.

Seventeenth day. — 13ft. The pain at the sacrum seems to decrease, but he fs not yet able ta rise from bed, nor stir about in it, he has to remain lying on the back. He has an appetite, but eats little. A sort of painful glandular swelling behind the masseter muscle, below the right ear. Dul'ness of the head, in front. Sense of oppression at the forehead.

Eighteenth day, — 135- Frequent waking at night. He wakes earlier than usual. Doughy mouth, in trie morning. Foul, bloody sputa, of the color of chocolate with milk.

The pain at the sacrum is feebler, it seems to have spread over a larger space, rises a little towards the dorsal and lumbar muscles, and to the dorsal vertebrae. f|0- The heao?, above the eyebrows, is still somewhat dull. Weakness in the finger-joints and wrists. The gland at the neck con- tinues painful, with lancinations. Taste of blood in the throat.

Flushes of heat. 145- The breathing is painfuf, as if there were a sore in the lumbar region.

Nineteenth day. — Deep and long sleep. Nosebleed, in the morning. Pimple at the forehead. Weight above the eyes, he is unable to read* long. 150- Sense of weariness in the arms, though lying down. The pain at the sacrum decreases ; sometimes, however, it rises again to the cervi- cal vertebrae. Prickling in the eyes. A cluster of pimples breaks out at the wrist, on the external and inferior surface

72 BRAZILIAN PATHOGENES1S.

of the radius ; they are vesicular, (like those which he had after his return from Brazil.) Bloating sensation in the eyes. 155. Throbbing at the sacrum, without pain. Pale face, eyes sunken, with redness around the eyelids.

Twentieth day No stool from the sixteenth to the twen- tieth day. Hard and difficult stool. The pain at the sa- crum is much less, though he still feels a violent throbbing in this region, but painless. 160- Rose at eight o'clock, his legs were weak and his head felt heavy ; he laid down again an hour after, with very cold feet.

He feels a pain at the iliac bones, though not all the time. There are fever pimples on the arm, and the remaining pimples contain a little water which spirts out when pressed. Sensation in the glutei muscles as if bruised. Full and slow painless beatings in the sacro-lumbar region.

Twenty-first day. — 165- Restless night, dreams about crime, dead bodies, children with their heads half cut off, and of others whose heads were being cut. Pain in the glutei muscles as if bruised, now on the right, then on the left side. Pain as if bruised at the sacrum, with heat mounting to the face, at nine o'clock in the morning, shortly after rising. Cramp in the toes. Beatings in the left temple. 170- Painful stitch and beating sensation between the shoulder- blades.

Twenty-second day. — Lascivious dream with emission. Heat mounting to the face, with oppression of the chest. Acute pain in one of the right toes. Weight at the sacrum, but less bruising in the glutei muscles ; weakness in the knee-joints, with cracking, either in going up or down-stairs, 175- Sensation as if a warm liquid were flowing from a sore in the lumbar region. Heat mounting to the face, at seven o'clock in the evening. Weakness of the legs in going up or down-stairs.

Twenty-third day. — Restless night, heat and sweat all night. Dream about work, vast business. 180- Dizziness at two o'clock, waves before the eyes ; the sight becomes dim when writing. Sparks and zigzag movements before the eyes, when walking or sitting. Weak legs. Weight in the

HURA BRAZILIENSIS. 73

upper lids. Frontal headache. 185. Pressure at the fore- head, with damp coldness at the feet and hands. The head- ache extends to eyebrows and eyes.

Short-lasting oppres- sion at the throat, in the region of the tonsils. The eyes are red, with blue dark margins ; face pale, yellow, dull. Less pain in the renal region ; but he is unable to stand any length of time without experiencing an uneasiness in the stomach which extends to the chest with oppression. 190. Sclerotica red, inflamed, and the capillaries injected.

Beat- ing pressure at the sclerotica. Weakness of the knee-joint, when walking or going up and down-stairs. Hiccough four hours after eating.

Twenty-fourth day. — Restless sleep. 195. Slight prick- ling pain at the sacro-lumbar articulation, in going up-stairs. Sense of oppression at the chest.

Twenty-fifth day. — Pressure at the forehead. Heat in the sacro-lumbar region; sense of oppression at the chest, and rush of blood to the larynx, with suffocative oppression ; taste of blood and tearing in the chest.

Twenty-sixth day — Restless sleep. 200- Throbbing and weakness in the sacro-lumbar region. Nausea while riding in a carriage, before breakfast. Sense of heat in the renal region, after a long ride in a carriage. Slight aching pain at the forehead and vertex.

Twenty -seventh day- — Restless sleep. 205. Beatings in the lumbar region, with slight pullings or shudderings. Weakness in the lumbar region. Weakness in the knee- joint; sense as if sprained, after a walk.

Twenty-eighth day. — Restless sleep, with dreams about work, wild beast devouring meat in a public slaughter-house. Sense of heat with throbbing and fatigue in the lumbar re- gion and above the iliac bones. 210- Paleness, cold hands and feet, with weakness all over while the pains last.

Twenty-ninth day. — Dream about revolution, gun-shots, de- molition of some public edifice ; he walked among the ruins. Sense of well-being, in the morning on rising. Doughy mouth every morning, with sputa that has the color of choco- late with cream, and foetid smell. Spits blood in the morning

74 BRAZILIAN PATHOGENESIS.

that seems to come deep out of the throat. 215. Swelling of the left lower gums, over the molar teeth, outside, with toothache in this region. Small pimples on the right knee, with smarting as from a tetter and painful itching when touch- ing them ; they emit a fluid when pressed upon ; itching at the tibiae.

Thirtieth day The swelling of the gums continues, but the toothache is less. The cheek threatens to swell. Taste of blood in the mouth and throat, very marked, with scratch- ing or tearing sensation when drawing breath. 220.

Head- ache at two o'clock, as from a nail in the vertex, with vio- lent toothache, swelling of the gums, after a walk. Beatings in the left side of the face, extending up to the eye. The feet, and mostly tbe whole body are constantly damp and cold, with weakness. Uneasiness at the stomach.

His breakfast does not seem to sit well on his stomach ; he eats with a good appetite, however (from the twenty-fourth day).

Thirty-first day. — Restless night. Intolerable erections, sexual dreams, with emissions. 225. Large pimples on the legs, around the root of each hair. In the evening, large pimples, swollen, like mosquito-bites, with violent itching, and raw feeling when touched.

Thirty-second day. — Weakness, with painful stitch in the lumbar region. Uneasiness in the stomach, every day after the noon-meal. Violent headache on the left side.

Thirty-third day. — 230. Sense of tearing and spraining in back when sitting (for one minute). Spitting of blood, with sense of rawness in the throat and the respiratory passages, after talking. Contractive sensation on the skin of the fore- head. Pimples all over the body, similar to those above de- scribed ; suffocative sensation rising to the larynx.

Thirty-fourth day. — Taste of blood in the mouth during an embrace. 235. General emaciation. Inability to in- cline forward ; he can only walk by reclining the trunk back- wards ; when inclining forward ever so little, he feels a pull- ing in the lumbar region and is obliged to straighten himself.

Thirty-fifth day. — Uneasiness at the stomach from the noon-meal until four in the afternoon. Irritable mood.

fcURA

Thirty-eighth day. — Frequent desire to urinate. 240. Clear urine, after a return of the pain in the sacro-lumbaf region. Tearing sensation in the renal region ; acute pain, with faint feeling and pale face.

Forty-sixth day. — Cold sweat at night.

Fifty-fifth day. — Pale, sickly face; rings around the eyes, Red lips. 245. Emaciation. Weakness in the sacrd-* lumbar region. Dimness of sight, and prickling in the -eye- lids. (From this period, he gradually gets better.)

Second prover : Chr. Dieudonne Joly, twenty-four yeard old, sanguine-nervous temperament, robust constitution.

At eight o'clock in the evening, took one dose of assacii of the fifth attenuation.

First day. — Contraction of the papillae on the tongue, im- mediately. 250. Heaviness of the head. Acute pain in the right kidney while walking, with urging to urinate, at nine o'clock in the evening; for two minutes.

Second day. — In the morning, while walking, pain as if sprained in the left coxo-femoral articulation, for some mo- merits. Prickling at the margin of the eyelids, in the day- time. Face looks weary, with rings around the eyes. 255. Lancinations in the left index and thumb. Dull lancinations in the right hand. Itching at the left side and calf. Stitch in the right index-finger at eight o'clock in the evening. Feeling as of sand in the left eye, at ten o'clock.

Third eZay.— 260. Nocturnal emission. Sneezing at noon, as when a catarrh is about setting in. At two o'clock, dark redness and almost complete insensibility of the sides of the neck in the region of the sterno-cleido-mastoideus-muscles ; he pricks the parts and does not feel any pain until one hour after.

Fourth day. — No sleep at night, and drowsy in the day- time. Livid complexion at noon. 265. At nine o'clock in the evening, itching at the left eyelids.

Fifth day. — "Violent nosebleed, at seven o'clock in the morning. Stinging in the ball of the right thumb. Slight pain in the medius of the left hand.

Sixth day. — Itching at the margin of the left eyelids.

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270* At noon, pimple at the right lower part of the lower jaw. At ten o'clock in the evening, in bed, smarting and itching of the puncta lachrymalis and the left lower eyelid.

Seventh day. — At two o'clock: Aching pain like a stitch in the side, under the right lower ribs, for one minute,

Tenth day.-^M three o'clock in the afternoon, slight colic, and nausea. Dull and heavy head, with weak legs.

Eleventh day.— '275. At eleven o'clock, hypochondria, sad- ness, despair ; he imagines that he is abandoned by his family.

Twelfth day.— Fatigue, and weakness of sight.

Thirteenth day. — Eyes red, with weak sight, he reads with difficulty. The upper and lower limbs feel weak.

Fourteenth day. — Eyes weary, sight weak. 280- Short, dull, painful lancinations in the pectoral muscles, rather in- ternal, without impeding the breathing.

Fifteenth day. — Weariness of the eyes, pressure at the superior portion of the orbits. Headache. At nine o'clock in the evening, lancinating pain in the biceps and triceps muscles of the arm, similar pain between the shoulder-blade and the spinal column, in the trapezoid muscle. The throat feels dry and irritated, compelling one to cough. 285* Dryness of the glottis ; causing a cough as from a cold,

Sixteenth day.— -Itching at the margin of the eyelids.

Seventeenth day. — -Sense of stoppage in the ears ; after- wards as if air-bubbles were passing through the left ear (for two or three seconds). Small smarting pimples on the lower part of the right leg.

Twenty-third day. — Diarrhoea.

Twenty-seventh day. — 290- Nocturnal emission. Weight at the frontal muscle. Heat about the head. Painful stitch in the ileo-coecal region, recurring several times when walk- ing or moving about. Slight nausea.

Thirtieth day. — 295- Pain as from weariness in the outer portion of the left crural muscle when pressing upon it.

Thirty-first day>-~- This pain is very marked and continues all day.

HURA BRAZILIENSIS. 77

Thirty-second day. — Violent headache in the left side of the head.

Thirty-third day. — Headache in the side of the head.

Thirty-fourth day. — In the evening, slight pain in the lum- bar muscles as from weariness.

Thirty-fifth day. — 300. The weariness in the loins conti- nues in the morning. At 9 o'clock in the evening, slight pain as from weariness, with an acute lancination in the lumbar region, for one second.

Thirty-sixth day. — At noon, long-lasting lancinating pain under the left big toe. A good appetite for some days past.

Thirty-seventh day. — 305- Hard, scanty and difficult stool. Absence of mind. Not disposed to work. Peevish. Red eyelids. 310- Lazy, weary. Constant yawning.

Thirty-eighth day. — Hungry, two hours after a copious meal. Tightness at the stomach, in the evening.

Thirty-ninth day At five o'clock in the morning, violent sensation of hunger, with tensive and pressive pain at the stomach ; when lying, the pain extends to the umbilical re- gion. 315- The pain during a walk continues ; pressure after eating ; painful sensation of hunger. Acute pain at the stomach, with constant hunger. Frequent desire to uri- nate.

The urine deposits a white sediment. At noon, pres- sive pain at the stomach, before and after eating. 320- Acute pain, like a stitch, at the anterior surface of the right lung, which hinders breathing. Absence of mind, he makes many mistakes, mistakes one month for another, for several days. He mistakes the street twice.

During the last days of the proving, frequent urination with whitish deposit.

Third prover : Mme Al. j. 26 years old, sanguine tempera- ment, good constitution.

First day. — Took one dose of the 5th attenuation, at 10 o'clock in the evening.

In the morning on waking, doughy taste in the mouth, and great drowsiness. 325. She dreams about death, burial. Small painful pimples on the left side of the tongue. Burn- ing at the stomach. Stiffness at the nape of the neck. Weakness of the legs and arms. 330. Nausea at two

78 BRAZILIAN PATHOGENESIS.

o'clock. Fever: face of a scarlet-red, hands burning-hot. Depression of spirits, has no desire to do any thing, nothing pleases him. White spots on the tongue. Frequent desire to urinate. 335. Feeling of weariness all over. Sense of pain with heat at the sacrum.

Second day. — Lancinating pain, zig-zag, in the uterus, at half past six in the morning. Slight leucorrhoea. Dry cough. 340. Pain in the groin, compressive sensation as during parturition. Lanciriation from the lumbar region to the coccyx.

Third day Restless night, frequent waking. On waking, sense of weariness, as if strained. Acute pain in the palm of the left hand, proceeding from the index, and describing a circle extending to the carpal articulation of the thumb. 345.

Very weary, especially the left leg. At half past 12, third night, writhing colic. Violent diarrhoea at one o'clock, with pains similar to those which she had experienced on her return from a voyage to Brazil. Fetid stool, with white little worms. 350.

The diarrhoea continues and is suc- ceeded by a great weakness of the chest. Violet-colored cheeks. Heat in the cheeks and temples. Red forehead.

Small miliary vesicles on the right cheek, on the middle of the forehead and on the left cheek. 355- Listless, she attends to things as if she took no sort of interest in them.

Fifth day. — Dreams about a church-yard ; she placed torches on the graves. On waking, her face is bloated and scarlet-red. Blotches on the right cheek, similar to those which she had after her return from a voyage to Brazil (at this time an enormous crusty tetter commenced in this way). Intolerable heat at the chest, at two o'clock, violent pain and burning sensation at. the sternum.

Sixth day. — 360- Restless sleep. Nervousness, impa- tience, at half past 12. Dry heat in the hands.

Seventh day. — Small vesicular pimple at the right wrist- joint. Marked feeling of heaviness from the parietal bone to the lower attachment of the stemo-mastoideus muscle, at the upper side of the sternum. 365- At two o'clock: the

BRAZILIENSIS.

weight, at times, descends to the forehead, with heat. Small pimple on the right wrist, red at its base, containing a fluicl.

Eighth day. — No sleep. Twisting pain in the left side, or lancinations around the pelvis ; the pain passes off soon and extorts cries from her, at 9 o'clock in the morning. Burn- ing all over.

Ninth day. — 370. Twisting pain at the scapulo-humeral articulation. Acute pain under the breast. Half past twelve : the pain at the scapulo-humeral articulation recurs from time to time with great violence.

Five o'clock in the evening: the pain is constant but less, always of the same kind. Half past nine : miliary eruption in the face. 375. Small red pimples on the right cheek, smarting on the right cheek, the eruption first showed itself at 7 o'clock in the morning. Mi- liary eruption on the shoulders, with itching, in the evening.

Red vesicular pimples, they break when pressed upon, and discharge a smart stream of water.

Tenth day. — Dulness of the head, in the morning, on ris- ing. Red face, the little pimples are less apparent. 380- Pain at the stomach, as from hunger, though she is not hun- gry. She swallows her saliva. She has to eat to quiet her pain.

Eleventh day. — Headache, slight beating at the forehead, during a considerable portion of the night. The headache continues with a heaviness in the forehead, in the morning.

Twelfth day. — 385- Small pimples on the back, with itching. Nosebleed, at 8 o clock. Hard stool for 8 days. Nosebleed, at 10 o'clock.

Thirteenth day. — 300- Restless night, dream about a sea- voyage. Heaviness of the head, nosebleed on rising. Head- ache, heaviness with beating in the forehead, all day. Red pimples on the shoulders, with pricking when touched. Lan- cination and pricking in the left little finger, three or Tour different times.

Fourteenth day. — 395- Hot and red face. Itching red pimples on the shoulders.

Fifteenth day. — Sense as of crumbs in the eyes. Sclerotica

80 BRAZILIAN PATHOGEXESIS.

red, with margins around the eyes, red eyelids, red face. Red pimples on the sides of the hips, smarting.

Sixteenth day. — 400. Sharp pain, followed by an acute lancinating pain about the heart.

Seventeenth day. — A.t eight o'clock in the morning, sharp, lancinating pain, by fits and starts, at the right side of the sacrum, more or less violent. Ten o'clock in the evening; wry neck on the right side.

Eightee?ith day. — While slumbering, sensation as if she were hanging three feet from the ground. Sensation as if she would fall into a ditch. 405- Coldness and heat, al- ternating at night.

Nineteenth day. — Acute pain at the left hip, at 9 o'clock in the morning. The pain recurs at 9 o'clock in the evening, and continues for several days at the same hour. Pain at the uterus as if compressed. Pain at the heart, which is at times very sharp, almost unbearable. 410- The breathing is arrested ; this pain makes her very uneasy. Lancinating pain in the head.

Twentieth day. — Pain at the left knee, as if sprained.

Twenty-first day. — Writhing colic, and diarrhoea, five times in the day.

Twenty-second day. — Restless night. 415- In the even- ing, pain at the loins and on each side of the ovary. Vio- lent lancinations with prickling, afterwards lancinating pain in the vagina ; appearance of the menses, but very slight.

Twenty-third day. — Pain in the uterus as if a sharp in- strument were thrust in. Lancinating pain above the left breast. Pain at the right little toe, like an intermittent throbbing, with intolerable prickling, at half past 10 o'clock in the evening.

Twenty-fourth day. — 420- Sleep disturbed by a violent itching caused by small pimples on the shoulders. In the morning, the pain of the little toe returns, but it does not last as long as the day previous. Pain in the renal region, with sense of weariness in the region of the sacrum, Cold and heavy pain at the left hip. Painful pricking in the wrist and along the left hand, between the middle and ring-finger.

HURA BRAZILIENSIS. 81

Twenty -fifth day. — 425- Prickings and stitch above the left breast, hindering breathing, whether walking or sitting. Acute pain when drawing breath.

Twenty-sixth day. — Sense as if sprained in the left knee and cracking when walking.

Twenty-eighth day. — Restless night. Desire to cry. 430- Fever, inability to close her hand. Sad, vexing thoughts.

Twenty-ninth day. — Sensation as if floating in the air. No sleep. Starting in bed. 435- Sensation as if she were falling to the ground. Lancinating pain under the heart ; it continues, more or less feeble. Bad digestion, the stomach feels yet full since supper.

Thirtieth day. — Restless night, starting during sleep. Sense of weariness in the lumbar region, all night. 440- Pain at the sacrum as from a recent blow, this pain increases until four o'clock in the evening. Pressure at the sacrum, with weariness in the left thigh. Heaviness at the sacrum, when sitting. Sensation as if worms were crawling in the pos- terior and external portion of the sacrum.

Thirty-first day The pain at the sacrum obliges her to keep bent ; this pain shifts up and down from the sacrum to the left thigh, and is accompanied by chattering of the teeth, which interrupts the speech, and by cold hands and feet. 445. Quickly -passing tingling and twisting pain in the right leg, at three o'clock in the evening, when lying. Twisting pain extending from the sacrum into the left leg, and oblig- ing her to lie down.

Every paroxysm of pain excites a nervous laugh, with moanings like those of a sick child. Sensation as if dogs had bitten her where the pain is felt. Sensation as if she had a plaster at the region of the kidneys. 450. The pain descends along the vastus externus muscle.

Mottled face, in the beginning of the proving it became red, now it is sometimes pale. She cannot walk, without fearing to fall. No solicitude for the future, generally speaking; tears with ennui ; she thinks of death without fearing it. The pain at the sacrum is worse when sitting, and obliges her to lie down.

Thirty-second day. — 455- Sleep during the the night, but

82 BRAZILIAN PATHOGENESIS.

•the pain in the renal region returns as soon as she rises from bed. The pain is seated in the sacro-lumbar articulation ; it extends to the glutei muscles with sensation as though she were gnawed by dogs. At times the right thumb feels numb.

Thirty-third day. — Pain in the vertebral column. Sense of luxation, with pain in the glutei muscles, of the same na- ture as the day previous.

Thirty-fourth day. — 460- Twisting sensation in the groin. Nosebleed, when lying. Vesicular pimples all over, with red spots as if the skin had been rubbed. Large blotches on the legs like mosquito-bit.es. Sensation in the renal region and buttocks as if gnawed by dogs. 465. Continual sneez- ing for two hours,

Thirty-seventh day. — -Sensation in the thighs, as if bitten by dogs. The pimples increase during an increase of tem- perature, and leave large red spots in the renal region and on the hips. Since she had the pains in the sacrum, she is unable to sleep or rest on the stomach.

Thirty-eighth day. — Uneasiness, sometimes she cries in the street. 470- Acute headache, like a circle which rolls quickly over the forehead. Dizziness. Profuse nose- bleed from both nostrils. The nosebleed is preceded by a smell of blood. Red face, with little pimples between the skin and flesh. 475- Heat at the face. Sensation as if the skin of the face were stretched too much. Frequent emission of watery urine. Sense of coldness in the right- thigh.

Fortieth day. — 480- Dreams about dead bodies, assassins, decayed oxen, yellow water. Continual nosebleed, especially in the morning. The pains in the renal region decrease.

Forty-third day. — Nervous twitching at the left lower eyelid.

Forty-fifth day. — Flow of sad thoughts ; she imagines she will lose somebody who is dear to her. 485- She cries every moment, and, for several days past imagines she is see- ing the dead person before her eyes.

Fifty-eighth day. — Painful sensibility of the whole right half of the head, especially when touching it. Lancinations

HURA BRAZILIENSIS. 83

in the jaws, pain at the right arm. Impatience, anger ; she bites her hands, arid gets mad because her ideas flow too slowly.

Fourth prover : Mile E. R. 17 years, sanguine tempera- ment, good constitution. 490- At 8 o'clock in the morn- ing, the ball of the thumb of each hand is painful. 9 o'clock : her feelings are excited and she cries a good deal. 10 o'clock : numbness of the right index, every minute. Half past 10 : cold and clammy feet, followed by heat for three hours. Half past 11 : short lancinations in the last two left molares, lower jaw; numbness in the bend of the right arm. 495.

Lancination in the right index-finger, and especially in the articulation of the last phalanx. Sensation of a small ball under the left breast; at the same time, lancination under the left shoulder, for 5 minutes. At noon, large red spot on the lower part of the left cheek. Half past 12 : heat at the face, for half an hour.

Half past 12 : small pimples on the left cheek, above the nose and near the lower lip ; they are red, with a small white point in the middle. 500- At two o'clock, beating in the right index-finger. At half past 2, lancination in the gums. At a quarter past four ; pain in the gums corresponding to the left eye, with heat in the face. Burning in the left cheek, weight at the eyes, lanci- nating pains in the ears.

Pain at the outer ankle, as from a blow. 505- Frontal headache, at half past 9 in the evening. Cold sweat on the face. Pressure in the orbits, as from a violent headache. The teeth and gums are painful when pressing the teeth against each other ; the pain extends to the nose.

Toothache on the left side.

Second day. — 510. Half past seven, white-coated tongue. Slight pain shifting from the left ear, where it commenced, to the left orbit. Small pimple at the inside of the left elbow, causing a smart itching.

Half past 7, lancinations in the right side, every second. Cold feet, 515- Eight o'clock, pain as if the right arm had been stretched a long time, contusive pain at the back of the right hand, especially at the middle-finger. Lancinations in the gums on the right side. Itching at the forehead.

Small pimples at the fore-

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HURA BRAZILIENSIS. 85

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HURA BRA2ILIENSIS, 87

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Sixteenth day. — 785- At noon, beating at the right middle and index-finger.

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stretched. 820- Impatient; she wants to break every

Thirty-fourth day. — 855- The eyes are bloated and small- er. Painful pimples when touched, on the left cheek and at the eyebrows.

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ARRANGEMENT OF THE SYMPTOMS ACCORDING TO HAHNEMANN.

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HURA HJTAZILIEN-SI3. 95

96 BRAZILIAN PATKOGENESIS.

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100 BRAZILIAN PATHOGENES1S.

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