The present use of Sepia in medicine is due to Hahnemann. Some among the ancient physicians (Dioscorides, Plinius, and Marcellus, says Teste) used either the flesh, the eggs, or even the only bone which constitutes the skeleton of this animal, for "leucorrhoea, gonorrhoea, catarrh of the bladder, gravel, spasms of the bladder, baldness, freckles and certain kinds of tetters "—which is sufficiently remarkable in the light of the provings. Sep. is one of the remedies of the Chronic Diseases, and was proved by Goullon, von Gersdorff, Gross, Hartlaub, and Wahle. Sep. is predominantly, but by no means exclusively, a woman's remedy. It affects the generative organs of both sexes, and a large number of the symptoms occurring in other organs have some relation thereto. Teste describes the type to where Sep. is suited as follows: Young people of both sexes, or, rather, persons between pubescence and the critical period of life; of delicate constitutions, with pure white skins, or skins having a rosy tinge; blonde or red hair; nervous or lymphatico-nervous temperaments; exceedingly excitable and anxious for emotions; and, lastly, particularly such as are disposed to sexual excitement, or have been exhausted by sexual excesses. Hering gives these types: (1) Persons of dark hair, rigid fibre, but mild and easy disposition. (2) Women during pregnancy, in childbed and while nursing. (3) Children who take cold readily when the weather changes. (4) Scrofulous persons. (5) Men who have been addicted to drinking and sexual excesses. (6) Pot-bellied mothers, yellow saddle across nose, irritable, faint from least exertion, leuco-phlegmatic constitutions. Bähr gives: "Sanguine, excitable temperaments inclined to congestions." Farrington adds that the Sep. patient is sensitive to all impressions, and that the dark hair is not by any means a necessity. He gives a more complete description: Puffed, flabby persons (less frequently emaciated) with yellow or dirty yellow brown blotched skin; inclined to sweat, especially about genitals, axillae, and back; hot flushes; headache in morning; awaken stiff and tired; subject to disease of sexual organs; the general attitude is never one of strength and healthful ease, but of lax connective tissue, languor, easily produced paresis. Sep. acts on the vital forces as well as on organic tissues. The sphincters are weakened and all non-striated muscles. Sep. disturbs the circulation, causing flushes and other irregularities—throbbings all over; hands hot and feet cold, or vice versâ. The flushes run upward and end in sweat with faint, weak feeling. Epistaxis may occur either from a blow, from being in a warm room, or from suppressed menses. The upward direction of the Sep. symptoms is one of its keynotes. The pains of the head shoot upward; and so do the pains in anus, rectum, and vagina. Also coldness as well as the flushes travels from below up. On the other hand night-sweat proceeds from above downward. The head pains proceed from within out. Sep. is one of the remedies which have the "ball" sensation in inner parts. There is vertigo with sensation of something "rolling round" in the head. There is sensation of a ball in inner parts generally; but the most notable one is sensation of a ball in rectum. It may be described as an apple or a potato, and it is not relieved by stool. I have cured both constipation and diarrhoea when that symptom was present. The upward stitches in rectum and vagina, when present, are equally good indications for Sep. in cases of haemorrhoids, prolapse of rectum, and for prolapse or induration of uterus and cervix. As with Murex the chief incidence of Sep. is on the female sexual organs, though with Sep. the menses are generally scanty, as with Murex they are the reverse. Sep. causes engorgement of the uterus going on to induration. There is either prolapse or retroversion. Yellowish green leucorrhoea somewhat offensive. The bearing-down pains of Sep. are of great intensity. They are felt in abdomen and back; and sometimes even seem to interfere with breathing. The bearing down is < standing or walking. The bearing down extends into thighs. There is a constant sense of pressing into vagina, which compels the patient to cross the limbs to prevent prolapse. Connected with the uterine symptoms are: hysteria, erethism, palpitation, orgasm of blood, faintness. The sensation of "goneness" and emptiness, which is one of the characteristics of Sep., is sometimes connected with the pelvic bearing down. The empty sensation is felt in the epigastrium and throughout the abdomen. It is analogous to the great relaxing effect of Sep. on connective tissues. This sinking is common in pregnancy; and Sep. corresponds to many of the troublesome affections of the pregnant state, as—"morning sickness, vomiting of food and bile in morning; of milky fluid; strains so that blood comes up." "The thought of food sickens her; with sense of great weight in anus." Tendency to abortion is met by Sep.; Hering is reported to have said: "All women prone to abortion should take Sep. and Zinc." But Sep. meets many cases of dyspepsia not originating in uterine disorders. It has cured dyspepsia from injury by overlifting. Portal stasis is part of the Sep. action. There is fulness, soreness, and stitches in liver region; as well as stitches in left hypochondrium. The whole urinary tract is irritated, and catarrh of bladder and urethra may be, set up. There is frequent strong urging to urinate. Stitches along the urethra. The relaxed sphincters of Sep. favour enuresis, and the type which it cures is well defined: "The bed is wet almost as soon as the child goes to sleep, always during the first sleep." It meets the enuresis of light-complexioned boys and onanists. In cases of irritable bladder, although the desire is urgent, the discharge of urine may be difficult, and the patient may have to wait a long time. Gonorrhoea after the acute stage has subsided. Gleet and gonorrhoeal warts have been cured with it. Hering gives, "condylomata completely surrounding head of penis." I have cured a crop of small velvety warts completely encircling the mouth of the prepuce. Thuja had failed in the case. In reference to warts, I cured with Sep. 3x trit. a large horn-like wart on the abdomen of a woman. It was as large as a crown-piece but shaped like a bean, and raised a quarter of an inch from the surface. The skin symptoms of Sep. are among its most characteristic features. The skin is delicate, the least injury tends to ulceration. Itching which often changes to burning when scratched. Soreness of skin, humid places on bends of knees. Chloasma. Painful eruption on tip of nose. Herpetic eruption on lips and about mouth. Ringworm-like eruptions every spring on different parts of body. Ringworm on face. Herpes circinatus. Roundness and yellowness of the spots. The nettle-rash of Sep. appears ongoing into open air. It is > in warm room. The itching of Sep. may be desperate, especially when it affects the genitals and anus. The action of Sep. on connective tissues is again exemplified in the selection of the finger-joints as a seat of ulceration. The sweat is pungent in odour, offensive in axillae and soles of feet, causing soreness. The skin and the eyes are near akin, and Sep. causes all kinds of inflammation of eyes and lids, with impaired vision, black spots, green halo, fiery redness. The eye-symptoms are < by rubbing; < pressing lids together; < morning and evening; > bathing in cold water. Sep. is a chilly remedy from lack of vital heat, "chills, so easily"; this is especially the case in chronic diseases. Sep. is often required in chronic nasal catarrh. Nash had a case in which the discharge was thick, bland, and copious. Puls. relieved the catarrh but increased the menstrual flow too much. Sep. cured both. Sep. is also useful where colds inflame the tonsils and tend to cause suppuration. The characteristic sensations in the throat are: Dryness; pressure as if neck-cloth too tight; plug sensation; stinging; stitching pains on swallowing; contraction of throat without swallowing; sensation of plug when swallowing with feeling of constriction. There are some peculiarities about the mental state of Sep. which must be borne in mind: (1) Anxiety: with fear, flushes of heat over face and head; about real or imaginary evils; towards evening. (2) Great sadness and weeping; dread of being alone, of men, of meeting friends; with uterine troubles. (3) Indifferent: even to one's family one's occupation; to one's nearest and dearest. (4) Greedy, miserly. (5) Indolent. The Sep. patient weeps when asked about her symptoms. She is very sensitive, and must not be found fault with. Faints easily" is a note of the Sep. weakness: after getting wet from extremes of heat and cold; riding in a carriage; kneeling at church. Lorbacher (quoted H. M., xxxi. 142) refers to three important indications for Sep. not generally known: (1) Prodromal symptoms of apoplexy; (2) whooping-cough that drag., on interminably; (3) hypostatic pleuritis. The symptoms of Sep. corresponding to the first are: Stiffness of back of neck; staggering vertigo (< exercising in open air); anxiousness and a feeling of fear of severe sickness; intermitting heart beats; torpor and sleepiness. Lorbacher gives this case: A thick-set farmer, 50, inclined to hypochondriasis, troubled from time to time with piles, without being an habitual drinker was addicted to "nips," Gradually abdominal prominence developed; stiffness of neck; vertigo; occasional throbbing headache; slight transient loss of consciousness; anxiety; fear of apoplexy; piles less pronounced and less frequently troublesome than usual. Venesection, performed several times, only partially relieved. Abstinence from alcohol had no decided influence. Sep. 12x was given, four drops twice daily at first, then every other day, and later at increasing intervals. In two months the symptoms were reduced, and gradually passed away. The man lived eight years after this, and had no apoplexy, though he did not give up his "nips." Sep. is indicated in whooping-cough when it has lasted eight weeks or longer, and the paroxysms, though reduced in number and virulence, do not disappear, and occur especially before midnight. The patients are reduced in strength, dyspeptic, irritable, tearful, easily angered or apathetic. Kunkel reports (quoted H. M., xxix. 670) this case of pulmonary affection: A boy, 14, had been under treatment five weeks for cough and hoarseness. Hoarseness < evening; during the day cough with purulent sputa. Slept well but dreamed when he lay on left side. Emaciated. Phos. 10x produced little change. It was now ascertained that there was remarkable tightness of the chest on breathing, with inclination to take a deep breath; this was > in open air, on motion, while at work; < while in the house and at rest. Though the weather was bad he had constant desire to be out of doors. Sep. 10x made a rapid cure. Boenninghausen recommended Sep. in cases of cough, either with or without expectoration, with bloody, blood-streaked, purulent, yellow greenish or stinking sputa, and especially in consumption. Nash mentions a case of cholera infantum which he cured with Sep. on the indication "always < after taking milk." In moisture oozing from the anus he compares it with Ant. c., which has the first place. Sep., says Bähr (i. 359), "affords considerable help in a certain condition of the system which we have so far only noticed in females. After the exacerbation of a chronic gastric catarrh has lasted a few days with intolerable burning pains, the renal region, more particularly the left side, becomes painful, a violent burning pain is felt in this region, and a quantity of saturated, highly-coloured urine is discharged, which deposits copious quantities of urates, or else a clear urine with copious sandy sediment, coated with uric acid. After the discharge the pains generally abate, and only return if the stomach has not been restored to its normal condition." Peculiar Sensations of Sep. are: As if every object were in motion. As if suspended in air. Vertigo as if intoxicated. As if brain crushed. As if head would burst. As if waves of pain rolling up and beating against frontal bone. As if something rolling around in head, with vertigo. Stitches as from needles in head. As if roots of hair were sore; as if cut short near roots. As if eyes would fall out. As of a weight over eyes. As if eyes were gone and a cool wind blew out of sockets. Eyes as if bruised. As if a grain of sand in eye. As if lids too heavy to open. Eyes as if balls of fire. As if lids too tight and did not cover eyeballs. Hollow molar tooth as if swollen and elongated. Gums, as if burned; as if beginning to suppurate. Tongue and cavity of mouth as if scalded. As of plug in throat. Throat as if raw. As if something twisting in stomach and rising to throat. As if viscera turning inside out. As if stomach sore internally. As if something remained lodged in stomach. As if stomach were being scraped. As if a strap as wide as her hand drawn tightly round her waist. Liver as if bursting. As if everything in abdomen turning around. As of a load in abdomen. As if intestines were drawn into a lump. As of something adherent in abdomen. As of something alive in abdomen. Weight or ball in anus. As if bladder full and contents would fall out over pubes. As if drops came out of bladder. As if bladder and urinary organs would be pressed out. As of everything would issue through vulva. As if everything would fall out of uterus. Uterus as if clutched. As if vulva enlarged. As if something heavy would force itself from vagina. As from a weight in sides. As if ribs were broken and sharp points were sticking in flesh. As if cough came from stomach and abdomen. Chest as if hollow; as if sore. Throat as if filled with phlegm. As if breasts were enlarged. As if heart stood still. Back as if she could not turn or raise herself, or as if she had been in a wrong position, almost as if parts had gone to sleep. Sudden pain in back as if struck by a hammer. Pain in back as from subcutaneous ulceration. As if something were going to break in back. As if limbs would refuse to act. As if shoulder dislocated. Feet as if asleep. Right hip-joint as if bruised. Lower limbs as if beaten. As of a mouse running in lower limbs. As if bones of legs were decaying. As if she could feel every muscle and fibre of her right side from shoulder to feet. As of a ball in inner parts. As of an icy hand between scapulae. As if she would suffocate. As if feet stood in cold water up to ankles. As of hot water poured over one. "Stiffness" is a prominent feature of Sep.: stiffness of limbs < after sleep; stiffness of uterine region. A peculiar symptom of Sep. is: "Involuntary jerking of head backward and forward, especially forenoons when sitting." This may occur in hysteria. Open fontanelles in children is an indication for Sep. The symptoms are < by touch (except pain in back, which is > by touch). Pressure >. (Pressing eyelids together <.) Binding head tightly >. Loosening clothes >. Rubbing; and scratching <. < jar; mis-step; slightest blow; overlifting. Many symptoms are both < and > by rest and motion. < Moving arms. Lying on side, and on right side >. Lying on left side <. Lying on back <. Sitting < many symptoms. Faint sitting erect or kneeling. (< Kneeling is characteristic.) Sitting with legs crossed >. Stooping <. Standing <. Hard motion > headache. A short walk fatigues much. Going upstairs <. Dancing and running = no shortness of breath. < Mental labour. < From sexual excesses. < Afternoon and evening. ("Dyspnoea in evening" is characteristic.) < From cold air or during east wind. < In sultry, moist weather. < Before a thunderstorm. < By laundry work. (Sep. is the "washerwoman's remedy."—H. C. Allen.) Stormy weather = suffocating feeling. < After sleep (stiffness of legs). < On failing to sleep or in first sleep. > In open air. (Also—warmth of natural bodily heat; very sensitive to cold air.) Cold water > eyes and teeth. > Warmth of bed or hot applications. Cough < in church. < During and immediately after eating. Milk, fat food, acids <. While eating pulsation in pit of stomach, the more he eats the < it becomes. Empty feeling ceases at supper. < From coitus. I have confirmed the experience of Dr. Swallow, who found the fresh preparation of Sep. (which I prescribe as Sep. fr.) to possess a wider range than the ordinary preparation and to act as an "organ remedy" in a great variety of uterine affections not definitely indicated by the pathogenesis. I have used it in attenuations from the 5th to 30th.]