The history of this remedy is of more than usual interest to the homoeopathic physician. Its chemical nature is to this day shrouded in uncertainty, and many physicians deny its very existence. By some practitioners it is considered inert and absolutely useless, while others attribute to it remarkable curative powers. Its introduction into the materia medica is due to Hahnemann, who attributed to this substance the caustic properties of quicklime. Noack and Trincks state, that it is of value in affections of scrofu- lous and weakly constitution of women. Organisms which have be- come debilitated in consequence of long grief are especially suitable for the administration of the drug. Excessive waste of tissue is a strong indication for the remedy. We will consider the use of causticum under our various groups, with the preliminary statement that in all of the diseases, in whose treatment causticum is suggested, the characteristic mental and moral symptoms of the remedy should be carefully considered. An anxious, solicitous, apprehensive mood is somewhat peculiar to the remedy. We find utter despondency, extreme fearfulness, dissatis- faction, excessive irritability, a tendency to be easily vexed, vehement manners, an inclination to be offended upon slight provocation, an indisposition to work, weakness of memory, absence of mind and other similar symptoms recorded by the provers. NERVOUS GROUP. Causticum has caused : startings of the left arm ; after slightly exerting the left (weak) arm, it is convulsively jerked up and down ; twitchings in the outer side of the elbow-joint, when leaning the arm on something ; small, tremulous twitchings in the right forearm while writing ; spasmodic sensation in the hands ; involuntary con- traction of the fingers ; trembling and shaking of the extremities ; jactitation of the muscles of the left thigh, above the knee ; con- tractive sensation in the right calf, both when at r*est and in motion ; jactitation of the muscles and slight jerking in different parts of the body ; continual twitching in the right side of the body ; general tremor ; unsteadiness of the limbs, causing a staggering to and fro, as if intoxicated, without any vertigo, etc. CHOKEA. — These symptoms point with tolerable certainty to chorea. It seems to affect the right side in preference to the left. 672 CAUSTICUM. Jahr, in his work on Nervous Diseases, speaks of it as highly efficient in grave cases and where the choreic symptoms follow a retrocedent eruption of the head. Raue, in his work on Pathology and Therapeutics, mentions a case from Gross, in a young girl, presenting the following : The child laid down on her stomach, when one of her knees was firmly inserted into the hollow of the other knee, and her feet drawn upward upon the buttocks. In this position her body commenced jerking for- ward and backward, simulating the movements which are exercised during coition ; at the same time the muscles of her face became contorted, similar to risus sardonicus. After the attack the child would be exhausted; but during the intervals she showed no particular symptoms ; the spells were worse in the morning. Cured by causticum. Causticum has caused decided paralytic symptoms ; hence it has been recommended in the treatment of that formidable difficulty. PARALYSIS of the tongue, face, hemiplegia, apoplectic paralysis, brought about by exposure or suppression of an eruption, accompa- nied by shifting, tearing, rheumatic pains and the mental and moral condition already described, has been cured by causticum. Ella D., affected with partial hemiplegia. While at work beside her mother, the latter noticed that the patient's mouth laughed only on one side, and reproved her for making faces. Upon going to the mirror, she noticed, for the first time, that the face was somewhat swollen, and contracted only on one side ; the eye of the affected side was weeping, and the tongue could not be protruded in the middle line. The menses, which were nearly established, had failed to make their appearance for eight weeks; but otherwise the patient was in perfect health. Causticum relieved all the symptoms in a few days. (Dr. Anna Munroe in New Eng. Med. Gazette, April, 1875.) EPILEPSY. — In epilepsy causticum may prove a most important remedy. In his Chronic Diseases, Hahnemann furnishes provings which describe in a truly graphic manner the varied symptoms which characterize this condition. Raue furnishes the following excellent summing up of its indications (Pathology and Therapeutics, 510). Before the attach. — Imbecility of mind ; heat of the head, followed by sweat all over ; great pressure in the pit of the stomach, extend- ing all over the chest and hindering breathing. During the spell. — Sometimes bleeding of the nose ; very red face ; biting of the tongue. Afterward. — Soporous condition ; headache ; noise in the head ; exhaustion. During the intervals. — On the scalp and glabella small, round, soft lumps ; sweats easily on the head ; stoppage of the nose ; tongue coated wliite on both sides; sour or sweetish, badly tasting eructation, like ink or rotten wood ; pain in the small of the back and constant coldness of the shoulders and joints of the feet ; great restlessness which urges him to run away. Causes. — Suppressed itch; protracted intermittent ; softening of the brain. Worse during new moon ; drinking cold water as soon as the pressure in the stomach commences prevents the attack. CAUSTICUM. 673 NEURALGIA, more especially on the right side and of the face, accompanied by chilliness, urinary and menstrual derangements, de- pression of mind and with nightly aggravations may be relieved by oausticum. SPECIAL SENSES. Oausticum produces many decided effects upon the eye. We have among others : aching in the eye, going off when touching the eye ; pressure in the orbits and behind the eyes ; pressure in the eyes, as if sand were in them ; itching over and in the eyes, and of the eye- lids ; heat and smarting in the eyes ; burning in the eyes, without redness ; dryness of the eyes ; agglutination of the lids ; lachryma- tion ; visible jerking of the lids and of the eyebrows ; weakness of sight ; momentary obscuration of sight when blowing the nos3 ; obscuration of sight, as if a gauze were drawn over the eyes ; dim- sighted ness, as if a thick fog were before the eyes ; when looking at an object too long, the objects before him began to waver and be- came confused. In AMBLYOPIA, or weakness, dullness, dimness of sight, it is a val- uable drug, when it seems as if one were looking through a fog or as if a veil were suddenly placed over the eye ; or when there is an appearance of black thread before the eyes. If these symptoms appear suddenly, disappearing after a while only to return agai^ the causticum is apt to relieve. FISTULA LAOHRYMALIS has been cured by it. Mr. Clifton {Monthly Homoeopathic Reviezv, July, 1868) mentions a case in which sulphur, silicea and lycopodium had been given without benefit, when four doses of causticum, four globules of the 30th each, were given every other night, fol- lowed by an interval of a week without medicine. This plan was pursued for three months, when, being nearly well, the patient left off treatment. He came back worse in six weeks. The same treatment was again adopted, and within two months the fistula was cured and remained so. In scrofulous and rheumatic diseases of the eye it may be well to bear in mind causticum, especially when the patient shows indica- tions of a disturbance in the vegetative sphere, a great waste of tissue, constipation and despondency, with nervous irritation, twitching of the lids and of the muscles of the body. OTITIS may find its remedy in causticum, when there is hardness of hearing, whizzing, buzzing and ringing in the ears, and when every step taken seems to re-echo in the ears. TOOTHACHE may yield to the internal application of causticum when there is a tendency to neuralgia affecting the whole side of the VOL. I. — 42. 674 CAUSTICUM. face, with sensitiveness to pressure. The pain is usually throbbing, beating, stinging and very severe. The teeth feel elongated ; the gums are tender and swollen. Going into the open air aggravates the pain. Caused by exposure. CHYLO-POIETTC GKOUP. Causticum has caused pain in the abdomen; inflated abdomen with internal pressure ; pain, as if the abdomen were being drawn together with a rope, when breathing ; pinching belly-ache, with paleness of the face ; pinching around the navel, pinching and cut- ting in the right side of the abdomen, as if diarrhoea would come on ; violent pinching and cutting in the whole abdomen, with fermenta- tion ; cutting pain in the bowels, with emission of flatulence ; swelling of the umbilicus with pain all around, when touching it ; incarcerated flatulence. COLIC. — These symptoms indicate its use in colic, with much rumbling in the bowels and a great deal of shifting, darting, annoy- ing pain. It is of particular use in persons of a constipated habit and in cases of long standing. CONSTIPATION. — The pro vers record a variety of symptoms under the head "Stool" While in a few instances we have recorded soft, diarrhoeic stools, we find that the drug is more strictly homoe- opathic to constipation. We read : frequent and unsuccessful effort to pass stool, accompanied with a good deal of pain, anxiety and redness of the face ; frequent desire to pass stool without expelling anything but flatulence ; tenesmus ; the rectum is painfully and spas- modically contracted, which prevents stool being passed ; hard, firm stool ; the stool was expelled in pieces ; after this there was a con- traction at the rectum, and now the stool expelled was soft and of the size of a goose-quill. Stitches in the rectum during stool ; burn- ing in the anus after stool, with prostration ; anxiety after stool. Pressure in the rectum the whole day ; a pressing pain frequently and suddenly darts through the rectum ; a feeling as if feces were lodged in it, which should come away ; spasms in the rectum which make walking impossible ; stitches in the lower part of the rectum ; excessive itching of the rectum, anus and pudendum ; violent burn- ing at the anus during stool, with soreness of and oozing of humor from the rectum. Large painful varices of the rectum, hindering stool, greatly increased in soreness by walking. Pain and strong pulsations in the perineum. The symptoms given you do not only afford us a perfect y \cture CAUST1CUM. 675 '•of severe cases of acute and chronic constipation, but point out other and very painful affections of the intestinal tract, for which causti- cum may prove of great use. I refer to HEMORRHOIDAL TUMORS, exceedingly painful and usually the legitimate sequence of a long-continued constipated habit and to FISTULA IN ANO, indicated by the symptoms enumerated. Mr. Clifton, in an article in the Monthly Horn. Review, July, 1868, says: In constipation of children, especially if there is nocturnal enuresis; a dry, unhealthy skin, every injury of which suppurates; dryness of the rectum, with great contraction of the sphincter ani ; pain in the rectum during stool, inducing children to restrain evacuation of the bowels for many days together, 1 have used it successfully. In internal haemorrhoids, with constipation and shooting pains up the rectum, it is use- ful. One lady, who had been under my care two months, and during that time had taken sulphur, mix and graphites, suffered so much shooting pain in the rectum when walking, as frequently to compel her to seek relief by resting on a doorstep, was quite cured after taking causticum for a fortnight. For many years now she has had no return of the pain. I have seen one case of fistula in ano completely cured by causticum, and another was much improved by its use. In the former, the patient, aged forty years, had suffered from haemorrhoids for some years. For years pre- viously to my seeing him he had been operated on for their relief by Mr. Ashton. On examining him I found a complete fistula, discharging dirty pus and flatus. My diagnosis being somewhat alarming, he again consulted Mr. Ashton, who assured him that the knife alone would cure him. As there was no immediate necessity for operating he placed himself under my care. The treatment I adopted consisted in syringing the rectum with warm water twice daily, especially after stool, and injecting a weak calendula lotion through the fistula. I also gave him sulphur30 twice a day for a week. A careful study of the case led me to select causticum. I gave him the 12th dilution twice a day for a week, then the 30th, then the 3d, omiting medicine for two or three days between each dilution. Pursuing this course of treatment for three months the fistula was completely cured. Causticum causes a taste in the mouth, as if the stomach were seriously deranged, bitter, greasy, foul; fitful appetite, thirst; diminished taste; aversion to sweet things; white coating on the tongue. These may be of use to you in making up the totality of indications for the remedy. INFLAMMATORY GROUP. Causticum is not a remedy which produces a true inflammation of .any of the structures of the body. But it causes some conditions which we may, as a matter of convenience, study under this head ; among them the effects of the drug upon the vocal organs is prom- inent. Causticum has caused dryness in the larynx ; burning and rough- ness in the throat with hoarseness ; rawness in the chest ; hoarseness for many days ; she was unable to utter a word ; the muscles of the larynx cannot be used ; in spite of all efforts he is unable to utter a loud word ; catarrh with cough and rawness of the throat ; hawking up of mucus ; cough with tickling in the throat and roughness with- out any discharge^ violent, long-continued cough at night; shortness 076 CAUSTICUM. of breath previous to a fit of cough commencing ; soreness of the chest when coughing ; cough with rattling in the chest, as if there were much mucus ; difficult and deep inspirations ; oppression of the chest, with hoarseness and roughness of the throat ; violent stitches in the chest.