I have often prescribed this remedy for children suffering under intermittent or remitting, and even typhoid fever, in the summer season, when there were not present any well defined symptoms of worms, and yet the fever would soon abate, and in due time worms appear in the fecal evacuations. It often arrests entirely intermittent fever, when worms are present, and are the probable cause of the fever.

I give either the crude salt in from one-fourth to one-half grain doses, or a trituration of one grain to four of sugar, giving in the latter case, from one to two grains of the trituration. Give one dose at bed-time, or in an urgent case at any other time, but never repeat the dose under thirty-six hours, and in an ordinary case, under forty-eight hours.

This is the medicine par excellence for worms. It may be repeated once a week, when there is a tendency in the patient to the development of worm symptoms, or, in other words, the breeding of worms. The idea held out by some that it is hurtful, or unimportant to remove the worms, in itself considered, is simply nonsense, and worse, for children are sometimes sacrificed to this idea.

Earache—Otalgia.

This may arise from various causes, but a common one is sudden cold. If it arises from cold, and there is general fever, or if the ear is red, or the side of the head and ear hot, Bell. and Baptisia should be given in alternation, every hour, or in a violent case, more frequently. These remedies will soon relieve such cases. Cloths wrung out of hot water should be laid over the ear, or the side of the head steamed, or it may be laid into water quite warm, with good effect.

Where the disease is a chronic affection, and the patient is subject to frequent attacks of pain in the ear, especially on a change of the weather, from dry to moist, Mercurius is the proper remedy, especially if it is worse at night, when warm in bed.

If it arises from a shock or blow, Arn. is to be used. In scrofulous persons, whether there is ulceration or not, Phosphorus and Pulsatilla are the remedies.

Children and even adults, not unfrequently suffer from earache, without any known cause sufficient to account for it. On examination into the ear you will often find either the cavity filled or nearly so, with a hard black substance, (the inspissated "earwax") almost as hard as horn, or else the ear will be quite empty, and the sides of the cavity dry and red, though perhaps not properly in a state of inflammation.

The natural condition of the cavity as it can be seen by straining the ear outwards and backwards a little in a strong sun light, is moist, the surface covered slightly with a yellowish, greasy, soft substance (the cerumen) "earwax." When this is wanting or in excess, or its character changed, it is evidence of disease, and pain is likely to occur. The

TREATMENT

for this condition is to remove the accumulation when that exists, as the first step. But this must be first softened by pouring some warm oil, pure olive oil, or good pure sperm oil, into the ear, and repeat it two or three times a day for several days, until it is so far softened as to be easily removed with the probe end of common small tweezers, having a spoon-bowl point.

When there is dryness, moisten the surface with oil. In either case, it is best, for a while, to protect the delicate surface from the air, by putting oiled wool into the external ear.

If the ear was filled, give Mercurius once a day until there appears a natural secretion. If dry, use Belladonna.

Toothache.

It is difficult to determine the cause of toothache, and more difficult to select the remedy. It often depends upon decay of the tooth, and exposure of the nerve to air, and contact with food or drinks, or even saliva, which irritate and produce pain.

Pulsatilla will as often relieve such cases as any other remedy, yet if it has been aggravated by a recent cold, Bell. and Nux V. may be better. If the nerve is not exposed, and there is a disposition to a return of the pain on exposure to cold air, or a change of weather, the pain being of a rheumatic character, give Rhus and Macrotin in alternation. These will relieve many cases. For decayed teeth, the pain being dull aching, with soreness, use Chamomilla. The body of the tooth, that is the dentine, sometimes becomes very sensitive when there is no decay or cavity, the pain being experienced when some hard substance hits, or the air or water, either cold or hot, comes in contact with the tooth. The temporary pain will generally yield to Arnica, and in most instances, the daily use of Arnica at the first decimal dilution, applied to the surface, and upon the jaws, will effect a cure.

The chloride of Zinc applied to the surface of such teeth for a few moments will destroy the sensitiveness of the dentine.

Teeth that are ulcerated at the roots, or have ulcerated gums around them, the teeth being decayed, should be extracted at once, for, besides the pain and inconvenience they cause, they are a very prolific source of disturbance to the digestive organs, from the positive poison generated by the decaying process.

If people will use soft brushes upon the teeth with soap and water, followed by rinsing with simple water only, after each meal, brushing both inside and out and crossways, so as to clean between them, they will be saved much pain and decay, and disease of other parts, arising from foul and diseased teeth.

Teething of Children.

Affections arising from teething of children, are often of a serious character. The most prominent of which is Diarrhoea. Fever frequently accompanies the diarrhoea, and convulsions occasionally occur. Aconite and Chamomilla should be used in alternation, every one or two hours, according to the violence of the fever, and if convulsions occur, or are threatened, as will be known by twitching, starting, and screaming, use Nux and Bell. These may be given in rotation with the others, following the remedies, one after the other, every hour. I have relieved the most alarming cases in a day by this method of procedure, that had not yielded to either of the single remedies for several days, given as directed in the books; the patient growing worse continually. If the gums over the teeth look white and the teeth, (one or more,) are near the surface, the gums should, by all means, be cut. Press the point of a lancet or penknife down upon the top of the gum, until the tooth is plainly felt, and be sure to make the cut as wide as the tooth. Rub the gums with Arnicated water once or twice a day. Pulsatilla should be given at night and Chamomilla in the morning, during the whole summer while the child is teething, as a prophylactic against the fever and diarrhoea that is likely to occur. It will generally save all trouble.

If the diarrhoea is profuse, watery and light colored or brown, give Phos. acid and Veratrum alternately, as often as the discharges occur. For the restlessness of infants at night, Coffea is the specific.

Apthae—Thrush.

This is a disease peculiar to nursing children. The mouth becomes sore, and the tongue, lips, and fauces are covered with a white crust, looking like milk curds, which, when removed, leaves the surface red, inflamed and very tender. It sooner or later, extends to the stomach and bowels, producing severe and dangerous diarrhoea.

TREATMENT.

Of all the medicines known to our Materia Medica, none, according to my experience, will in the least, compare with the Eupatorium aromaticum. It is almost, if not quite certain to relieve speedily in all cases. I say this, not only from my own experience and observation, but from the testimony of several other Homoeopathic Physicians, who have, within the last year, used it.

It should be given at the first or second dilution, once in four or six hours, and three or four drops of the tincture put into a teaspoonful of water, and the mouth occasionally washed with the mixture.

In summer, where agues prevail, and the child is feverish and restless, China will aid in the cure, to be given once in six hours between the doses of the Eupatorium. If the diarrhoea is obstinate, the discharges colored, and the child is sick at the stomach, give Podophyllin with the other remedies.

Inflammation of the Eyes—Ophthalmia.

For common Ophthalmia, in the early stages, while there is more or less fever and headache, with flushed face, bloodshot eyes and throbbing of the temporal arteries, Bell. and Aconite should be used alternately every two hours, and a wash made with ten drops of tincture of Aconite to one gill of pure water, applied to the eyes as hot as the patient can bear. This application should be repeated every two hours, in a violent case, until the eyes are easy, and then about twice a day until all inflammation and redness pass off. This will relieve a large proportion of cases in from one to four days.

If, however, the case continues obstinate for a longer time, or has been of a week or more standing before the treatment is commenced, in the place of Bell., or after using it one or two days, use Hydrastus with the Aconite, giving them alternately at intervals of two to six hours, according to the stage of the case—more frequently as the symptoms are more urgent, using washes prepared of each separately, as directed for Aconite, except that the Hydrastus wash may be twice as strong; and apply each about half as often as the same medicine is taken internally. The wash should, in all cases of acute inflammation of the eyes, be as hot as it can be borne. Let it be put into the eyes so as to come directly in contact with the inflamed surface.

Simple hot water applied to inflamed eyes for hours together, allowing short intervals between the applications, will often cure most painful cases.

Never apply cold to inflamed eyes. It always aggravates. When the inflammation is in a scrofulous person, especially in infants, it assumes a purulent character, and may leave the cornea in clouded (nebulous) condition, and the sight more or less obliterated. For this condition use Conium first, and apply it in tinct., half water, to the eyes every four hours.

Wounds and Bruises.

On this subject, I must necessarily be very brief. When a wound is inflicted, the first and most important thing to be done is to arrest the flow of blood. Every one should know how to do this. The bleeding is to be stopped, and the wounded vessels to be secured, so that no further flow can take place.

First, then, to stop the bleeding, pressure is to be made upon the artery leading to the wound. If the wound is in the leg or foot, pressure is to be made, either on the vessel above and near the wound, or, where that cannot be easily found and compressed, make firm pressure with the thumb or some hard substance, in the groin, about two and a half inches at one side of the center of the pelvis, (wounded side) just below the lower margin of the belly, towards the inner side of the thigh, where the great artery (Femoral artery) can be felt pulsating. By pressing firmly upon this artery, the blood is arrested in its flow into the limb, and of course the bleeding from the wound soon ceases. If the wound is in the arm or hand, pressure is to be made, either just above the wound, or on the inside of the arm, about one-third of the way from the shoulder to the elbow, where the artery (Brachial) can be felt. To secure the parts from further bleeding, the wounded artery must be taken up and tied. Let it be seized by forceps, or the point of a needle may be thrust into it, and the vessel stretched out a little, a thread put round it and tied; cut off one end of the tie, and let the other hang out of the wound, until it comes out by the vessel sloughing off. Bring the lips of the wound together, and if it is large, put in stitches enough to hold them, and put on an adhesive plaster, compress of cloths, and bandages to keep it from straining the stitches, and protect it from the air. The Arnica plaster, made by JOHN HALL, of Cleveland, is the best adhesive plaster of which I have any knowledge. Give the patient Aconite once in two hours, for a day after the accident.

Slight Cuts about the joints, especially the knee, are dangerous, from their liability to affect the ligaments, inflame, and produce Lockjaw. Therefore, such wounds, ever so slight, are of great importance. They should be at once closed up, whether they bleed or not, and covered with an adhesive plaster, (Arnica plaster is the best) a bandage, and the knee should not be bent, even when walking or sitting, until the wound is healed. It is best to apply a splint from the hip to the heel, and bandage the limb to it, so as to prevent bending of the joint.

Bruises are to be treated with Arnica, applied to the part affected, by putting twenty drops of the tincture into a gill of water, if the skin is not ruptured, or three drops into the same if it is, and bathing freely. The Arnica is to be taken internally at a higher dilution. Keep the parts covered with cloths and wet in Arnica water.

If a blow is received upon the head, by a fall, or in any other way, producing a "stunning" effect, (concussion of the brain) so that the patient appears lifeless for a time, and delirious when he begins to come to, there is great danger of inflammation of the brain, and death from the re-action, or in some cases, the shock is so great that the patient will never revive unless he has the proper aid.

Arnica is the great remedy to bring on reaction, arouse the patient, and prevent dangerous inflammation or congestion of the brain.

When a patient is "stunned" by a blow or fall, he should be conveyed soon as possible, to some quiet place, and as little noise as practicable made about him, and the room kept darkened. Arnica 3d should be given immediately, and the nostrils wet with strongly arnicated water.

If fever arise after he comes to, Aconite should be given with Arnica, and if the head aches, or becomes hot, Bell. is to be used. This will prevent or arrest all symptoms of inflammation.

Torn and Mangled wounds should not be handled much. If they bleed, the blood must be stopped as in any other case. If they are dirty, warm water may be gently applied to cleanse them. The wound should be covered with some soft cloths, and kept constantly wet in Arnicated water of the strength of four drops of the tincture to a pint of water.

Piles—Hemorrhoids.

One important matter in all cases of habitual piles, is, to keep the bowels regular. Much can be done for this purpose by diet and regimen. On rising from bed in the morning drink freely, from a gill to half a pint of cold water, at least half an hour before breakfast; use such diet as is easily digested, and drink no alcoholic beverages. To relieve the bowels when costive, take a dose of Nux Vomica at night, and Podophyllin in the morning. This may be repeated from day to day until the proper effect is produced.

To relieve from a severe attack of Piles, use Bell. and Podophyllin in alternation every four hours, and apply to the tumors when inflamed, cloths wrung out of hot water, or sit in hot water for a time.

A poultice made of fine-cut Tobacco wet in hot water and crowded firmly up against the pile-tumors, secured by a T bandage, will relieve the most desperate cases for the time, and is attended with no danger or disagreeable symptoms except in rare cases, when it produces sickness at the stomach, which soon subsides on the poultice being removed. Oil of Arnica is an excellent application for inflamed Piles.

A most important point in the management of Piles, and one often neglected, is to replace the prolapsed tumors. The tumors will be protruded from within the anus by the act of evacuating, and if left in that condition, will be pressed upon by the external parts, chafed and inflamed. In all such cases, the patient should take particular pains to return the tumors into the rectum; and to aid in that process a little oil may be applied when they will be easily pushed back, and the sphincter of the bowel will close below them, preventing any chafing, and the consequent inflammation.

For Bleeding Piles, Ipecac and Bell. are very efficient remedies. They may be alternated every half hour, or oftener if the bleeding is severe, or at longer intervals when it is only slight.

Hamamelis V., (Witch Hazel,) will in nearly all cases arrest the bleeding at once. It should be applied to the parts and taken internally at the same time. Drop doses to be put on the tongue once in fifteen or twenty minutes.

An infusion of the Hamamelis may be taken internally in doses of half a teaspoonful, and the same injected into the bowel with excellent effect.

The most effectual way, and the best for obtaining permanent relief from Piles when the tumors have become hard, and remain all the time so as to pass out of the anus at every evacuation, being constantly more or less tender and painful, and often becoming inflamed, is to have them taken off. But never let that be done with a knife. The bleeding would, in such a case, be very excessive, and most likely fatal. The history of knife operations for the excision of Pile tumors is written in blood, and the tombstone stands as a monument of condemnation of the practice. No trustworthy surgeon will at this day attempt it.

But however dangerous may be the knife operation, there is no danger at all to be apprehended from removing the tumors by a ligature. To accomplish this, take a soft cork about three-fourths of an inch in diameter, and one inch long—make a hole through the center from end to end, about one-eighth of an inch in diameter—cut crucial grooves in the top of the cork about an eighth of an inch deep, bevel down the lower end nearly to an edge, make a cord of saddler's silk, three fold twisted together and waxed, about eight or ten inches long, double this in the middle and pass the loop down through the cork out at the sharp end, the two loose ends of the string being out at the grooved end. Make a strong hickory stick about three-sixteenths of an inch in diameter, and just long enough to pass across the square end of the cork. Now have the patient protrude the Pile tumors as far out as possible, being placed on his knees with the head bent to the floor, pressing out firmly as if to evacuate the bowels. Let the tumors be dried as much as possible by gently pressing a soft, dry cloth to them; then let the loop of the string projecting from the flattened end of the cork, be pushed on over the largest tumor, and held down at its base, while an assistant places the stick in one of the grooves, ties the two ends of the cord firmly down over the stick, or toggle, by a square bow knot; then turn the stick round once, twice, or more, until the pressure upon the tumor is sufficient to strangulate it perfectly, and prevent the string from slipping off. Care should be taken to keep the cord down to the base of the tumor while it is being tied and tightened, as in many cases the base is much the larger part of the tumor, and the cord tends to slip up. After the ligature is applied and tightened, apply arnicated water to the parts, and a large, warm poultice of superfine slippery elm bark, wet so as not to be too soft and slippery, on the face of which Arnica may be put. Keep it on with a T bandage. The patient must be put to bed and kept quiet until the ligature and tumor come off, which will be in about six or seven days, sometimes sooner. Once a day the "toggle" must be turned part, or the whole of a circle or more, to tighten the cord as the patient can bear. This will be very painful from beginning to end of the ligating, but any, even the most sensitive, patient can bear it. The patient must have quite warm hip baths two, three, or more, times a day, or as often as the pain is severe, the poultice being replaced after each bath, and kept constantly on.

If there are several tumors protruding, apply ligatures to two of the largest, when these are removed, the others will disappear.

Injections of mucillage of slippery elm should be carefully used to move the bowels daily, or at least once in two days. Let the diet be of corn or oat meal mush, or rice. As the tumor gradually sloughs off, the surface heals, so that, though the base where the ligature was applied, may have been an inch or more across it, there will not be a raw surface of over an eighth of an inch in diameter, to which Calendula Cerate should be applied. The patient must keep quiet for a few days longer. Though this is a painful operation, it is not in the slightest degree dangerous. I have effected complete and permanent cures by this mode in numerous instances.

Sea-Sickness.

Nux Vomica should be used once in about four hours, for twelve hours before sailing, as a preventive to sea-sickness.

If, however, symptoms, such as dizziness or blur before the eyes, and headache, begin to come on, a dose of Nux should be taken, followed in an hour with Pulsatilla.

If the nausea comes on, Ipecac and Arsenicum should be taken alternately between the paroxysms of vomiting, should that symptom appear.

If practicable, the patient should lay still upon the back until the sickness passes off. I have removed sea-sickness immediately in several instances with Pulsatilla alone, and the last time I had an opportunity to prescribe for this affection I gave Podophyllin. It removed all the symptoms in a few minutes. That is the only time I ever tried it, but from the provings I am satisfied it is one of the best remedies.

Asiatic Cholera.

I was practicing in Cincinnati during the prevalence of Cholera in the years 1849, and 1850, and in Northern Ohio in 1854, and had abundant opportunity to observe and treat it. The disease generally begins with a diarrhoea, which may continue for several days, or only a few hours before other symptoms set in, such as vomiting, then cramping in the stomach and muscles of the legs, arms, hands and feet, followed by cold sweats, great prostration, restlessness, excessive and burning thirst, drinks being immediately rejected. These symptoms continue, the patient sinking rapidly into collapse, when the skin looks blue and shriveled, the eyes sunken, the surface covered with a cold, clammy sweat, the extremities, nose, ears, tongue and breath cold, the voice hollow and unnatural. This condition continues from two to eight or ten hours, the patient regularly failing, sometimes becoming delirious before he dies.

In some cases the vomiting and diarrhoea set in simultaneously, and the other symptoms follow, as above described, in rapid succession. In others the cramping may be the first symptom, the others following it.

In a large proportion of cases, the disease takes the course first described above, the diarrhoea, called the premonitory symptoms, or sometimes cholerine, coming on several hours, if not a day or more, before any other symptoms.

The diarrhoea is not usually painful, hence the patient may not be alarmed so as to attend to it until the more dangerous symptoms appear. It begins in some cases with pain and some griping, the discharges rather consistent, having a bilious appearance, so that the patient supposes it to be an ordinary bilious diarrhoea, which is not dangerous, his fears being thus quieted. But however the diarrhoea begins, it becomes sooner or later, copious, watery, and light colored, (rice water) painless but rapidly prostrating.

TREATMENT.

In the early stages of the diarrhoea, Veratrum, taken about twice as often as the evacuations occur, will frequently arrest it in a few hours, especially if the patient lies down and keeps quiet. But if not, and it increases in frequency, or becomes more copious, or any sickness is felt at the stomach, the patient should, at once, be laid upon a bed and strong tincture of Camphor should be given in drop doses, once in five minutes, for one hour or more, and as the symptoms abate, once in ten, fifteen or twenty minutes, for six or eight hours.

A teaspoonful of the Camphor tincture may be put into a tumbler of cold water, ice water if at hand, and the water agitated until it becomes clear, giving a teaspoonful of this camphorated cold water as a dose, stirring the water each time. I think this is better than to give the pure tincture. After the patient becomes quiet and easy, Veratrum should be given in alternation with Camphor, a dose in four to six hours for several days, or oftener if he feels any symptoms like a threatened return of the disease. These two medicines serve as prophylactics (preventives) of Cholera.

If, however, the disease continues in spite of the Camphor and Veratrum, in the first instance, or later, (as the Camphor may be given in many cases with success in the advance stage,) you must resort to other remedies.

If vomiting comes on with burning in the stomach give Ipecac and Arsenicum in alternation as often as the vomiting occurs, and if the diarrhoea continues give Veratrum between the doses of the other two, in a violent case, as often as every ten to fifteen minutes, and at longer intervals when the disease is slow in its progress. If the vomiting and diarrhoea, or either, occur with a kind of explosion, the vomiting ceasing suddenly for the time, after the first gush, or the discharges from the bowels are involuntary, Secale is the specific remedy.

For the cramping, Cuprum and Veratrum are the remedies to be given alternately.

If, however, the cramping comes on as the first symptom, which is sometimes the case, the patient being suddenly seized with it before any other alarming symptoms occur, Camphor is the great remedy, and in this case it may be given in doses of double or treble the quantity before directed.

If he sinks into the collapse and lies quiet, indifferent to everything, the pulse sinking, or he is pulseless, Carbo Veg. will sometimes arouse and restore him, hopeless as the case appears. It should be given once in half an hour until the pulse begins to rise. If, however, instead of being quiet he is restless and thirsty, give Arsenicum in alternation with Carbo Veg., repeating the dose as above directed. In some cases, after all the active symptoms cease, the patient will become quiet and drop to sleep, and instead of the pulse rising, as it will if he is recovering, it sinks, or does not appear if he has been pulseless, and the breathing becomes irregular and feeble—he is sinking. If aroused, he sinks back into the stupor in a few moments as before. Laurocerasus is a specific for this condition. It should be given once an hour until he is aroused.

If, however, besides the stupor, the head is hot, the face red, the breathing oppressed, the pulse slow and sluggish, Opium is to be used, and may be given in alternation with Laurocerasus.

For the irritation of the brain, and furious delirium that sometimes sets in after the cessation of cholera symptoms, Secale and Belladonna in alternation will prove specific.

Let the patient have warm or cold drink as he prefers, and let his covering be light or plentiful as is most agreeable. As soon as he gets easy, and the vomiting and purging cease, and his pulse begins to return, keep him quiet as possible, let the room be darkened and everything still, so that he may go to sleep, which he is inclined to do, this being the surest restorer. I am quite sure I have known several patients carried off by a return of the disease, after it had been effectually arrested, in consequence of sleep being prevented by the rejoicing officiousness and congratulations of friends, disturbing and preventing that early and quiet slumber which nature so much needs, and must have, or hopelessly sink. The diet for two or three days after recovery, should be a little oat meal gruel or rice.

Small Pox—Variola.

This disease begins with pain in the head and back, chilly sensations, followed by a high fever, so similar in all respects to a severe attack of Bilious or "winter" fever, that it is difficult or impossible to distinguish it with certainty, as Small Pox. The fact of the prevalence of the disease at the time, and the exposure of the patient, may lead the Physician and friends to suspect Small Pox. There is one very striking symptom of Small Pox, however, that exists from the beginning, which, though it may be present in fever simply, is not uniformly so. This is a severe and constant aching pain in the small of the back. The headache is also constant.

The Small Pox is of two varieties or degrees, distinct and confluent. The distinct is when the pustules are separated from each other, each one a distinct elevation, with more or less space between them not affected by the eruption.

The confluent is where the pustules spread out from their sides and run together, covering the whole surface as one sore.

It may be distinct on some parts, as on the body, and confluent on others, as the arms, face, and parts most exposed to the air.

In the Distinct variety the fever continues without abatement until the eruption appears, when it entirely subsides, and that quite suddenly. The eruption comes out about the third day of the attack, sometimes not discoverable until the end of the third or beginning of the fourth day. The eruption is at first very slight, beginning with small red pimples on the forehead, upper part of the cheeks, neck and upper part of the breast, extending by degrees to the arms, and other parts of the body and limbs. About the end of the fourth or forepart of the fifth day, the eruption is complete.

There is a symptom, not mentioned in the books, which will often determine the disease before the occurrence of any eruption. It is the appearance of hard shot-like pimples, to be felt under the skin in the palms of the hands, while there is, as yet, no trace of eruption to be seen upon the surface.

On the eighth or ninth day, the eruptions become vessicular, have flattened tops, and contain a limpid fluid. The parts continue to swell, the eruptions to enlarge, and become filled with purulent matter, having a dark color at the top, up to about the fourteenth or fifteenth day, when they begin to flat down, to dry up, and some of the scabs become loose. At this time, some fever arises, often quite severe, with headache and other inflammatory symptoms. If the eruption is very severe, fever will be of corresponding violence, and lighter or wanting when the eruption is mild. This fever rarely lasts more than twenty-four hours, from which time the patient rapidly recovers.

In the Confluent variety, all the symptoms are more violent, the fever continuing after the eruption begins. The pustules burst early, and run into each other, covering nearly or quite the whole skin; the surface swells and turns black or dark brown, the lungs are more or less irritated, producing cough, and not unfrequently the stomach is nauseated, and vomiting ensues.

If the patient survives the irritation up to the fifteenth or sixteenth day, when the secondary fever sets in, he is liable to be taken off by an affection of the brain or lungs, during this fever. If he recovers, his whole surface, especially that part exposed to air, is deeply pitted.

TREATMENT.

As it is not often known for a certainty, in the early febrile stage, that it is the small pox, the treatment will be first adopted that would be proper for a like fever arising from other causes. But in all my observations in this disease, and they extend to several hundred cases, I have not found in a single instance, any of the ordinary fever remedies, such as Aconite and Bell., which would be applicable for such symptoms in an ordinary case, to do any good in small pox. They are directed, however, for these symptoms by the authorities, in the febrile stage of the small pox; but I am quite sure they are not the proper remedies.

From the great similarity, the almost absolute identity of small pox headache and backache, with the same symptoms developed by the Macrotys racem. as well as the nausea and restlessness produced by the drug, I was led several years ago to the conclusion that this, or the Macrotin was valuable in small pox. Not only so, but during the prevalence of small pox in Cincinnati, to an extraordinary degree in the winter of 1849-50, I treated about one hundred cases, including both sexes, and all ages, from infants a few weeks old, to very old persons, giving the Macrotin to all, and had the good fortune to see all my patients recover. Since that time I have prescribed it for every case successfully.

Having then, been entirely successful in so many cases, with this medicine, I am not inclined at this time to give any other the preference. I must admit, however, that though my patients all recovered, I was not able to greatly abridge the duration of the disease, nor to prevent the development of all the stages in their proper order, as is claimed by M. TESTE, for his use of Mercurius cor. and Causticum. I was satisfied with so far modifying the symptoms, as to enable my patients to live through, and come out well in the end. I would then direct, if small pox is suspected, the patient having been exposed to contract it, or from the peculiarity of the symptoms, in the early stage, or when the disease is discovered after the eruption, to give Macrotin at the first trituration, in one grain doses, once in two hours, while the fever, headache and backache continue, after which, during the whole course of the disease, give it three times a day. This will prevent the development of a dangerous secondary fever, as well as irritation of the lungs, stomach or bowels. In addition to this medicine I give the patients daily, from half an ounce to two ounces of pure (unrancid) Olive oil. This serves to prevent the development of pustules in the throat, lungs and stomach; is more or less nutritious, and keeps the bowels in a healthy condition. Wash the surface once a day in weak soap suds, following it with a bath of milk and water, and keep cloths moistened with warm milk and water, constantly upon all parts that are exposed to the air, lubricating the surface with Olive oil after the bath of milk and water. This keeps the surface quite comfortable.

The best diet is corn or oat meal mush and molasses, to be taken in small quantities. Cold water is the proper drink, though it should not be very cold.

The room should, at all times, be well ventillated, but in cold or cool weather, sufficient fire must be kept up, to keep the room warm and dry. A temperature of about 65 deg. is the best. Hardly any thing can be worse for a small pox patient than to be in a cold or damp room, and to breathe cold air. Uniform temperature is important.

If the eruption is tardy about appearing, or after it is out, a recession takes place, the Alcoholic Vapor bath will soon bring it out. (See Rheumatism **p. 30).

Occasionally the feet and limbs below the knees, will swell prodigiously, and become extremely painful, causing the principal suffering. For this, wrap the feet and legs in cloths wet in a strong solution of Epsom salts, quite warm, and cover with flannels so as to keep them warm. This will afford immediate relief, and reduce the swelling in a day or two. The finely pulverized Epsom salts, dry, sprinkled on the pustules, will very often prevent pitting. It is the safest and surest remedy of which I have any knowledge.

Varioloid

is small pox modified by vaccination. It is to be treated as a mild case of small pox. The Macrotin has been used with apparent success as a prophylactic (preventive) to small pox, taken three times daily.

Painful Urination, Incontinence of Urine,

Involuntary Urination.

Where the discharge of urine produces smarting and burning of the urethra, Cantharis is the remedy. Where there seems to be an over secretion of acrid urine, producing inflammation of the neck of the bladder, known by pain in the glans penis, Copaiva, and Apis mel. are the remedies. If there appears to be a partial palsy of the neck of the bladder, the discharge taking place in sleep, Podophyllin is the surest remedy. I have cured some bad cases by the use of these three remedies, given in rotation three or four hours apart.

Injections of a solution of borax into the bladder, have, in several cases, been sufficient to effect a perfect cure, without any other remedy. This may be used in connection with the other remedies. For painful urination with a distressed feeling in the neck of the bladder, causing a constant disposition to evacuate urine, the Althoea Officinalis is a certain remedy; it acts like a charm. It is an important remedy for inflammation of the bladder. A good mode of using it is in form of a warm infusion in doses of a table spoonful every half hour or hour, according to the urgency of the symptoms. The Althoea Rosa (Hollyhock) may be used as a substitute, though it is not as good. Every family should cultivate the Althoea Officinalis (Marsh Mallow), so that the fresh green root, which is the best, can be procured at any time. I have been able to relieve patients with it, especially females, when all other remedies seemed unavailing. It is particularly useful for urinary difficulties of pregnant females.

Neuralgia.

Aconite and Bell. are two important remedies in this affection. If given low, and applied directly along the course of the affected nerves, at full strength of the tincture, they will almost always effect a cure. The proper way to use them is to give them internally at the second dilution, at intervals of fifteen to thirty minutes, when the pain is severe and nearly constant, and apply Aconite tincture as hot as practicable over the course of the nerve, by means of wet cloths, for an hour or two hours, and if the pain has not subsided use Bell. locally in the same manner.

If the Neuralgia is periodical, coming on at regular intervals, Arsenicum and China are the remedies, and they should be used externally as directed for the others, both at the first dilution, and given internally at intervals, in proportion to the violence of the symptoms, the Arsen. at the 3d and the China at the first dilution. If the patient has used alcoholic drinks to excess, Nux is to be used in place of Arsenicum.

Periodical Neuralgia generally requires the same treatment as ague. In females when there is uterine disease, Pulsatilla and Macrotin are the remedies to be used, as directed above.

Jaundice.

This disease depends upon derangement of the liver. The skin and whites of the eyes become yellow; the patient grows weak, loses his appetite, is dull and sluggish in all his actions, melancholly and discouraged in his moods.

TREATMENT.

Mercurius and Podophyllin given in alternation, each twice a day, will nearly always effect a cure. If the patient is costive, Nux should be taken at night, until his bowels become regular.

Bathing the surface daily, or oftener, is a very important measure in the treatment of this affection. As often as once in two or three days, an alkaline bath should be taken. If the patient has fever every day, or once in two days, ever so slight, China should be used with Podophyllin. If he has been drugged with Mercury in any form, in large doses, even six months or a year before, give Hydrastin in place of Mercurius.

Itch.

I shall say but little about this very common and very obstinate affection. Everybody has a "cure for itch" yet nobody cures it short of the use of Sulphur in some form. Though the attenuations of Sulphur may sometimes cure itch, it must be acknowledged that such cures are so rare in this country, and the time requisite to accomplish it is so long, as a general rule, that few will trust them.

The most successful remedy, and the one that will always cure quickly, if at all, is Hepar Sulphurus Potassium, the common Hepar Sulphur (sulphuret of Potassa) of the shops. To succeed with it most certainly, let the patient be thoroughly bathed with warm soap suds, quite strong, in a room at the temperature of 90 to 100 deg., continuing the bathing and rubbing for an hour or more, then dry off the surface with soft cloths, and apply the Hepar sul. with water, at the strength of thirty drops of the strong alcoholic solution, with a gill of water, wetting every eruption on the whole surface and let it dry on. This causes some smarting, but it is effectual; it kills the acarus, (itch animalcule) and in a few days the sores heal, the itching all subsides immediately. If every pustule has not been touched, those left may continue to itch, in which case, a second application is necessary. Hepar Sul. should be given internally at the third dilution, for a month, once a day, after the baths. Avoid greasy food. For the

Scald Head

of children, where there is a discharge of yellow and watery pus from the sores, and the eruption extends to the ears or face, like the disease called the crusta lactea (milk crust), the same washes as for itch, are the most effectual, while at the same time, and for a month or two, the child should have Hepar Sul. 5th at night, and Petroleum 3d in the morning. Daily ablutions of the head with warm soap suds, and keeping it covered, are absolutely essential.

Carbuncle.

This affection, though it somewhat resembles a common boil, and is by some writers considered only such, in an overgrown state, is, nevertheless, far from being identical with it.

While a boil is only a sanitive effort of nature to eliminate the cause of a morbid process, and tends to a spontaneous, healthy termination, the carbuncle, on the contrary, is the very essence of disease; its constant tendency being towards the dissemination of diseased action, causing destruction of the parts affected. It, in fact, appears like a parasite, living by the destruction of surrounding tissues, literally absorbing them and "thriving on death." It begins with a red, livid color, slight aching and burning pains, the part swells and is elevated some like a boil, except that it does not "point," but has a broad base rising like a cone and flattened at the top. It feels soft and spongy, and will appear to fluctuate, but if punctured, blood only flows. The pain and burning increases rapidly, and sooner or later several openings appear upon the top, varying from three or four to half a dozen or more, looking like the holes in a sponge, out of which issues a fluid like thin gruel. Instead of becoming easier after the suppuration begins, as is the case with a boil, the burning increases to an alarming and unbearable extent; cold chills, loss of appetite, great depression of spirits, general nervous and muscular debility come on. The tumor continues to discharge, turns purple; gangrene beginning in the carbuncle extends to other parts and death follows.

The disease is nearly always confined to quite feeble persons and those past the meridian of life; but I have seen it on younger though feeble patients. It is generally located on the back, occasionally on the head, where it is very dangerous from its liability to affect the brain.

TREATMENT.

If treated very early, strong tincture of Arnica applied to the surface of the carbuncle, by cloths wet and laid over the tumor, will often arrest it so that the swelling will not be developed to the suppurative stage. However, to reap any benefit from Arnica, it must be applied while the pain is not severe, and the parts only feel bruised and tender to pressure, like a common bruise.

After the ulceration occurs, Arsenicum is the great remedy to be relied on. It should be given at the second or third attenuation as often as every three hours, when the pain is severe, and applied to the surface of the carbuncle freely by cloths laid over it, wet in the first dilution, or by sprinkling the first trituration of the oxyde (1-10) freely upon the open surfaces, so that it may penetrate into the open mouths or orifices. Over this powder apply an emolient poultice, or soft cloths wet in water hot as can be endured. This will soon allay or greatly lessen the pain. It should be repeated as often as any of the burning pain peculiar to the carbuncle returns, until the tumor suppurates in a tolerably healthy manner; then lessen the strength of the Ars. applications, and continue them until it has the appearance of a healthy abscess, when only simple dressings are necessary. Some may suppose such strong applications injurious, but I can assure them from abundant experience, that there is not the slightest danger. The carbuncle should never be punctured or cut into. Such operations always make them worse, and induce a more rapid approach to gangrene.

The patient should have nourishing food, and good native wine may be taken in moderate quantities, by a very feeble person, with decided advantage.

Though the knife operations for the removal of carbuncle are always injurious, the chemical effect of Potash is frequently most beneficial. I have, in repeated instances, applied to the ulcerated surface, caustic potash freely, allowing the dissolved caustic to penetrate to the very "core" by running into the orifices. At first it would produce some smarting, but the pain is different from that of the carbuncle, and the change is agreeable rather than otherwise. Soon after the application all pain ceases, and the tumor, under the use of a poultice, begins to slough off in a few days, leaving a raw surface, disposed to heal kindly. Occasionally, however, the healing process is tardy, when Arsenicum, at the third, applied and taken internally, will soon effect a cure.

I have occasionally used Hepar Sul. with good effect in the latter stage.

Felon—Whitlow.

For this disease, in the early stage, when the sensation is that of sharp, sticking pain, feeling as though a brier or thistle was in the finger, immerse the part in water as hot as possible, into which put common salt as long as it will dissolve; hold it in this hot salt bath for an hour or more at a time, and when removed, apply finely pulverized salt, wet in Spirits of Turpentine; bind on the salt with several thicknesses, and keep it constantly wet with the sp'ts turpt. for twenty-four hours, when, if all symptoms of felon are gone, no further treatment is necessary. As a general rule, the hot bath should be repeated three times a day, especially if the symptoms have existed for several days and there is much pain or swelling, and the dressings should be kept on as above directed for several days, more or less, until all symptoms disappear.

I am quite confident that a large majority, if not all, of the cases if thus treated at any time before pus is formed, will be discussed and cured. If pus has begun to form before the treatment is commenced, this will not cure the felon, but it is good treatment, especially the hot bath, as it will greatly lessen the pain.

By holding it in hot water for an hour or two each day, the suppurative process will be hastened, and as soon as the pus can be felt at any point, fluctuating, puncture and let it out; then continue the hot bath, with Calendula (Marygold) flowers in the water, keeping the part all the time warm and moist.

For the restless and nervous irritability that frequently occurs, especially in females, Aconite is the best remedy. It should be given, one drop of the tincture to a gill of water, in teaspoonful doses, once in one or two hours, and the same applied to the sore.



DISEASES OF FEMALES

Suppression of the Menses, (Amenorrhoea.)

For sudden suppression from taking cold, as by wetting the feet, there being headache, more or less fever, the pulse frequent and variable, pains in the small of the back and cramp like pains in the pelvic region, give, in alternation, Aconite and Pulsatilla, as often as every fifteen or twenty minutes in a violent case, and at longer intervals as the patient begins to get easy. Putting the feet into hot water, or taking a hot Sitz bath is very useful. If the patient is sick at the stomach, as is often the case, give lukewarm water freely and let her vomit; after which let her drink freely of water as hot as it can be safely swallowed, adding milk and sugar to make it palatable. The good effects that are often attributed to and experienced from the use of various hot teas in this affection, are, in my opinion, attributable more to the hot fluid alone than to any specific medicinal virtue in the substance of which tea is made. At all events, very hot drink with nothing but water, milk and sugar, is equally efficacious, and my medicine (a few grains of sugar of milk) put into the hot water, seasoned as above, has often obtained great credit, when the hot water was alone worthy. Rubbing the loins and abdomen briskly downwards with the hands of a healthy and vigorous nurse, will often excite the menstrual flow after a sudden suppression. If the head is hot, the face full and red, and the arteries of the neck and temples beat violently, give Bell. with Pulsatilla, and if the lungs are oppressed, use also Bryonia, giving the three in rotation. If, after the menstrual flow begins, there is still much pain in the pelvic region, give Caulophyllin, which will immediately afford relief.

Apis mel. is very servicable in suppressed menses of several days, or even weeks duration, where there is fever, redness of the face, and pain in the head, and pains in the hips extending to the limbs, especially if there is any tendency to bloating of the abdomen and swelling of the limbs or feet. It acts promptly and efficiently.

If the suppression has been caused by sudden fright or any strong mental emotion, Veratrum should be given in connection with the two former medicines. Should there be great fullness of the vessels of the head, or bleeding at the nose, Bryonia with Pulsatilla are to be used. Bell. is also useful in this case if the pain in the head is throbbing, especially if any delirium is present.

For suppression in young females, of several months duration, I have used, with much success, Podophyllin and Macrotin, one at night, the other in the morning, giving them for two or three weeks before the proper time for a return, and a day or two prior to the time, give also Pulsatilla, and give the three in rotation, a dose every six hours.

This practice has been successful with me in cases of long standing and apparently obstinate character. Where there is other disease, as an affection of the liver, lungs or stomach, this must be treated and cured, or the menses will not probably return. Great care should be exercised to keep the patient's feet and limbs warm, as upon this may depend her future health.

Dysmenorrhoea.—Painful Menstruation.

For this disorder, I know of no one remedy so valuable as the Caulophyllin, but Pulsatilla in many cases is efficacious, and as they do not prevent each other's action, I prescribe them in alternation, giving a dose every half hour, for a short time during the paroxysm, or until the pain abates to some extent, then every hour.

If there is pain in the head, sickness at the stomach, a kind of sick headache, as is often the case, with painful menstruation, Macrotin should be used with the others; Ipecac is the Specific for an excessive flow of the menses with great pain, especially if the stomach is nauseated. It should be given as low as the first dilution, and the tincture, in water, in the proportion of thirty drops to half a pint, injected into the vagina quite warm.

The application of extract of Belladonna to the neck of the uterus will often produce immediate and perfect relief. After the patient is relieved from the painful paroxysm, she should be treated so as to prevent a return of the pains at the next monthly period. Pulsatilla, Caulophyllin and Podophyllin are the three medicines that are most certain to effect this object. They are to be given, one medicine each day, a dose at night for three weeks, then morning, noon and night, until the time for the return of the menses, when they should be used oftener if there is pain. If the patient is inclined to be costive, Nux should be given at night for a few days before the menstrual period, in place of Pulsatilla.

Menorrhagia—Profuse Menses—Flowing.

For this affection, Ipecac and Hamamelis are the specifics. They should be taken alternately, at intervals of from half an hour to two hours apart, according to the urgency of the symptoms, and the Hamamelis injected into the vagina. These will nearly always arrest the flooding immediately. Secale should be used either alone or with the above medicines, if there are bearing down pains like labor pains, and sickness at the stomach in spite of the Ipecac. Ipecac alone is often sufficient.

Nursing Sore Mouth.

Sore mouth of nursing women, as the name of the disease indicates, is peculiar to women who are suckling children. It is an inflammation of the mouth, tongue and fauces, which sometimes comes on during pregnancy, several months or but a few days before the birth of the child. It generally, however, makes its first appearance when the child is a few weeks old, and sometimes not till after the lapse of several months. In some cases the tongue and inside of the mouth ulcerate, and the irritation extends to the stomach and bowels, producing distressing and dangerous inflammation of these parts, with severe and obstinate diarrhoea.

For the sore mouth, before diarrhoea begins, give Eupatorium Aro. and Hydrastin, in alternation, a dose once in three hours, and wash the mouth with the same, each time. After the diarrhoea occurs, use Podophyllin with the other medicines, giving them in rotation, three hours apart. It is best to give a dose of Podophyllin night and morning.

I have treated very bad cases of this disease that had been running for more than a year, and been treated with the ordinary remedies directed in the Homoeopathic authorities without any permanent benefit, curing them perfectly in ten days with Podophyllin and Leptandrin, giving them in alternation at the 1st attenuation in half grain doses, at intervals of from four to eight hours according to the frequency of the evacuations. These two remedies are almost certain to arrest Chronic Dysentery where there is ulceration of the lower portion of the rectum, a peculiar distress felt at the stomach just before stool, with sudden rush of the evacuations and inability to control the inclination even for a few minutes, with a feeling of faintness after the stool.

Leptandrin is the specific for the Dysentery that often succeeds cholera, and these two, Pod. and Lept., are almost certain to relieve the "Mexican Diarrhoea," as well as that connected with the fevers along the Mississippi river.

Mammary Abscess,

(Ague in the breast—Inflamed breast.)

This is a disease peculiar to nursing women. The first symptom is a slight pain or soreness in some part of the "breast," which continues to increase for a day or two, when a chill, more or less severe, sets in, followed by high fever and quick pulse, headache and great restlessness. The gland swells and becomes very painful. This is generally a disease of rather slow progress, running eight or ten days and sometimes two or three weeks before abscess forms and "points" to the surface.

TREATMENT.

Phosphorus is to be taken internally, and the first dilution put in water, twenty drops to one gill, and applied to the surface by means of cloths wet in the mixture, as hot as it can be borne, and laid over the whole breast. If this is done and the medicine given internally every hour, as early as the first and frequently as late as the second or third day, it is quite sure to remove the disease and prevent an abscess. It is best to use it even much later. In fact it often succeeds as late as the fifth or sixth day, and if it does not prevent the abscess, it so far palliates the severe symptoms as to render the pain but slight and keep the patient comfortable.

An application of the Tincture of Cantharides diluted with water and applied to the breast by cloths wet in it, to the extent of producing considerable redness and even eruptions, and the second dilution of the same taken in drop doses every three hours, has proved successful in subduing the inflammation after Phos. had failed, and it was supposed an abscess would form in spite of any treatment.

I recently succeeded in giving perfect relief with Apis Mel. internally, applying it externally after the pain and swelling was very great. I am of opinion that the Apis is a valuable remedy.

After abscess forms as soon as the pus can be felt at any point, soft and fluctuating under the skin, puncture and let it out, then poultice it for a few days until it heals, giving Phosphorus and applying it to the sore. In puncturing, always be very particular to have the lancet or knife enter so that the edge will look towards the point of the nipple, so as not to cut across the milk ducts, which all run toward that point, and if cut off will close up so that the milk which may be secreted at any future time cannot get out, and swelling, pain and severe inflammation, abscess and ulceration will be the consequence; whereas, if the cut is made lengthwise of the ducts, very few, if any will be cut off, and all future danger will be avoided. Apply an elm poultice from the beginning to the end of treatment. For malignant ulcers of the breasts, the Cornus Sericea is a most potent remedy. It is to be taken internally at the first dilution, and applied in strong infusion or diluted Tr. of the bark to the sore.

Sore Nipples.

This affection of nursing women frequently comes on before the birth of the child, but generally does not make its appearance until after the suckling has continued for a week or more. It seems in some cases to be connected with the aphthae (sore mouth) of the child, or at least to be aggravated by contact with the sore mouth; on the other hand it sometimes seems as though the sore nipples produced the sore mouth of the child.

TREATMENT.

I treat both the nipple and the child's mouth with the same remedy Eupatorium aro., applied at the strength of 6 drops of the tincture, to a teaspoonful of water, the application being made by a soft cloth, wet and laid over the nipple; give drop doses of the same strength internally every three hours, which will, in nearly all cases effect a cure in one or two days. The child's mouth should be wet with the same each time just before nursing. The oil from the pit of the butter nut, (Juglan's Cinerea,) obtained by heating the pit and pressing out the oil, applied to the nipple, will generally cure it after 3 or 4 applications about six hours apart. The child may take hold when the oil is on, without danger. This remedy is sufficient in nearly all cases.

Leucorrhoea and Prolapsus Uteri—Whites, Female Weakness.

The disease depends in all cases upon inflammation of the uterus, or vagina, or both.

The inflammation may be simply in the neck of the uterus extending to the posterior surface of the vagina, or the latter may not be affected; or it may extend to the whole internal surface of the uterus, producing swelling of that organ, both the fundus and neck.

The swelling may be confined mostly to the fundus, causing it to be too large for the space it ordinarily fills, hence there will be more or less displacement of the womb, and crowding upon other parts, as the bladder or rectum. In some cases, the swelling is more on one side than on the other, so that it will be crowded over to the opposite side. These displacements are often called prolapsus uteri, or "falling of the womb," carrying the idea that the difficulty depends upon a morbid relaxation of the ligaments that support the organ. Not one case in a hundred is of this latter character, but nearly, if not all, depend upon the inflammation and swelling above mentioned. How futile then, not to say hurtful, must be all instruments for, and all attempts at replacing and supporting it by force! All such mechanical meddling is injurious, and should, with all the "supporters," be condemned and discarded.

They may afford temporary relief, but this is at the expense of future health. Cure the disease, relieve the inflammation, and nature will replace the organ. Leucorrhoea is always present where there is ulceration of the neck of the womb, and this ulcerated condition exists to a greater or less extent, in many cases where it is not suspected by the patient. It is vastly more prevalent than is generally supposed. The symptoms are numerous. Among the more prominent are a sense of weight and bearing down in the pelvis, pains extending down the limbs, aching and weakness of the small of the back, headache, more or less gastric disturbance, dyspepsia, the food souring on the stomach. There is often, especially when there are ulcers on the parts, a distressing sense of heat or a smarting sensation. The menstrual function is frequently deranged, the bowels costive, the urethra, by being pressed, becomes irritable and burns and smarts whenever the urine is evacuated. The sleep is disturbed and unrefreshing, and the whole nervous system is unstrung.

The discharge from the diseased surfaces, in an ordinary case without ulceration, is of a mucous or muco-purulent character, not unlike an ordinary catarrhal secretion. When ulceration exists it is dark, fetid or bloody, or sanious and purulent, sometimes it is acrid, excoriating the parts.

TREATMENT.

Inflammation or ulceration, either acute or chronic, in these parts does not differ essentially in its characteristics from the same affection in other mucous surfaces.

The proper treatment for a catarrh of other mucous surfaces will be applicable to these, though there is no doubt but that some medicines are more specifically adapted to these than to other organs.

In the early stage of the complaint, while the inflammation is acute, or sub-acute, the discharge thin or white, Copaiva and Macrotin are to be given once in 6 hours alternately. During the same time let injections into the vagina of warm soap and water be used twice a day, to cleanse the parts of the secretion, followed in half an hour by a wash of warm water, into which tr. of Macrotys has been put in proportion of 40 drops to half a pint. The application should be made with an 8 ounce or at least 6 ounce curved pipe syringe, so as to throw it with considerable force. If there is a burning sensation, use the washes quite warm, until the heat of the parts is allayed. Avoid the use of cold injections as long as any inflammation exists. If the bearing down is present with burning in the parts, Bell. is to be used in rotation with the two former remedies. If the sensation is that of smarting, Cantharis is to be used in place of Bell.

Where the disease comes on soon after child-birth, Podophyllin is the Specific. It is to be given at the first attenuation three times daily in half gr. doses of the trituration. In this case let the parts be freely washed daily with a solution of borax, quite warm. In the chronic form of the disease, especially where barrenness exists, Macrotin, Podophyllin and Hydrastin, given morning, noon and night, in the order named, will, in nearly all cases, afford relief.

For females who have never borne children, give Phos. acid, 2d and Eryrgium Aquaticum 1, night and morning for a week, and then give them at the 3d dilution until the symptoms subside. If there are headache and derangement of the stomach, Macrotin and Podophyllin should be used, each once a day, between the latter remedies. When the discharge is colored and the pains darting, cutting or smarting, indicating ulceration, or if ulceration is discovered by examination, use Macrotin and Hydrastin internally, injecting the latter upon the affected parts freely. The ulcerated surfaces should be well washed off every day with soap and water, or a solution of borax, and the medicine (Hydrastin) in form of infusion, used half an hour after the other wash. If the neck of the womb looks dark, and is ulcerated, or is hard and painful to the touch, especially on probing the cavity, Cornus Sericea must be used both as a wash to the parts, and at the first dilution internally, using them twice a day. This remedy will often cure malignant cases.

It takes a long time in some instances to cure a chronic case, but if persevered in, these remedies will not be likely to fail.[2]

[2] NOTE.—The late Prof. Morrow was remarkably successful, and became justly celebrated for curing hard cases of Leucorrhoea ulceration and "Prolapsus uteri."

Almost his entire reliance in their treatment were the Macrotys and Caulophyllum, given internally and by injection upon the parts. He gave the Macrotys in the form of tincture every day to the extent of producing specific head symptoms when he discontinued it till the next day, using the Caulophyllum in the meantime in small doses. He rarely if ever failed.

Morning Sickness of Pregnant Females.

The most efficient and certain remedy for this symptom is Macrotin. It should be taken at the first attenuation, a dose before rising in the morning, and one every six hours during the day, as long as the sickness is troublesome. It will generally relieve in a few days. If the stomach is sour use Pulsatilla with the Macrotin.

As a preparation for labor, a dose (one grain) of Macrotin at the first attenuation given in the morning, and the same of Caulophyllin at evening, is of great service.

Whatever others may think or say in relation to any preparatory treatment for labor, I have reason to know as well as anything in medicine be known, that patients treated as here directed, pass through labor much quicker, frequently in one-fourth the usual time. Their sufferings are comparatively trifling, and the length of time for recovery to ordinary health after labor is abridged from three-fourths to nine-tenths that of former labors. I am quite confident that the medicines produced this difference.

For irregularity of labor pains, and for distressing after pains, the Caulophyllin is specific.

During labor it should be given at the 2d attentuation in about half grain doses, every half hour, until the pains are regular. Two or three doses at most, and generally one will suffice.

For the after pains it may be given in alternation with Ipecac or Aconite if there is flooding, or with Pulsatilla when the flooding is not troublesome, a dose once in half an hour, until the pains are checked.

For Rigidity of the soft parts and severe, retarded and long protracted labor, where the pains are strong and irregular, and great pain and exhaustion is experienced on account of the unyielding condition of the parts, Lobelia Inflata given in drop doses of the tr. in water, once in twenty minutes, in alternation with Caulophyllin as above directed, will in a short time produce the proper condition of the parts, while they render the pains stronger, regular and progressive.

In urgent cases I have given the medicines every 5 or 10 minutes, with decided benefit.

A Useful Hint to Mothers.

Children push beans, peas, corn, &c., into the nose and ear, causing much alarm. To remove such a body take a syringe that works tightly, put the end of the pipe against the bean, shot, or other substance, draw back the piston so as to suck up the article firmly as the pipe is withdrawn from the cavity.

LOCAL APPLICATIONS.

That medicines act locally, that is, manifest their symptoms by peculiar derangement or disturbance of some particular part of the system, more prominently than of any other part, for the time, no one will deny. That each one has some particular locality or tissue upon which its action is more perceptible than anywhere else, is equally undeniable, and that the prominent symptoms are often external and local, is also true. Yet, with these truths clearly demonstrated, there are those of our school who discard the external or local application of all remedies except Arnica.

Why this is done, is difficult to determine, unless we can believe that such physicians suppose it to be heresy to make use of any remedy in a different manner from what was recommended by the "Father of Homoeopathy," and abjure all possibility of improvement in our practice.

That nearly if not all medicines, may be applied externally with advantage, when there are local manifestations similar to those produced by the drugs, there can be no doubt in the mind of any sensible man. That they will act favorably when so used is reasonable, as a matter of theory, and that they do, as a matter of fact, has been proven to my mind, by abundant experience in their use. Therefore, I hesitate not to recommend the practice to others. Medicines must act either by combination with the affected part, or by Catalysis, changing the molecular action of the living tissues. In either case, they must come directly in contact with the part to be affected. This must be done through the circulation, when taken internally, or it may be done by direct application of the remedy to the diseased tissue, when that is so situated as to be reached. The difference is greatly in favor of the latter mode when that is practicable, from the greater certainty of its results. This assertion is based, not upon vague hypothesis, but upon actual practice.

Entertaining these views, however heretical they may be pronounced, I shall proceed to mention some of the remedies I have learned to use thus, and the cases for which they are prescribed. I would remark that, in selecting a remedy, it must be done with as much certainty of its homoeopathic relation to the local or general symptoms for external as for internal use. I have found, however, that much lower attenuations are requisite and admissible.

ARNICA is highly applicable to bruises, and is valuable also when applied to lacerated or mangled surfaces, to the surface of the limb where a bone is fractured, also about the joint when it has been dislocated. It is to be used in the form of Arnicated water, by putting one or two drops to a gill of water for application where the skin is ruptured or the surface raw, and ten to twenty drops to the gill, upon parts where the skin is sound. It is useful also, for boils, and carbuncles in the early stage, the strong tincture to be applied when the surface is sound, and (to boils) when the surface is open, one drop to a gill of water.

Aconite

Is applicable to inflamed eyes, in the early stage, where the disease is in the conjunctiva, (that portion which lines the lids and covers the front of the ball), especially if there is a sense of scratching, as though some foreign substance is in the eye, great intolerance of light, chilly sensations, with more or less fever, and quick pulse. Put three or four drops to a gill of warm water, and apply it freely.

It is also very valuable for Neuralgia, applied strong and warm, along the course, or at the origin of the affected nerve. In neuralgia of the face, apply it upon the side of the face, also just behind and below the ear of the affected side.

It is of much value as a remedy for neuralgic affections of the womb. I have relieved the most distressing symptoms of neuralgia of the womb, in a few minutes, by injecting warm water containing twenty to forty drops of tr. Aconite to the pint. By repeating this application at every paroxysm, patients recover rapidly, each succeeding attack being lighter, and the interval between being longer, until they cease entirely. It may be used with much benefit in the same manner, for Hysteritis, as well as recent cases of Leucorrhoea. It is the most valuable remedy applied to the Eye for a wound of that organ.

In Gonorrhoea, it is more valuable as a local remedy, than most of those now in use. It will frequently cure alone. In this case, it is to be used with an equal part of the tr. and warm water.

Belladonna

has great power as a local remedy in Erysipelas, to be applied with water in proportion of ten drops of the tr. to a gill of warm water. It is also of much value applied to the surface of inflamed breasts; also injected when there is inflammation of the uterus, with pressing pains as though the bowels would be pressed out. Very valuable in parturition where there is rigidity of the os uteri, with fullness of the head and throbbing of the temples. It has the specific power to relax circular fibres without affecting the longitudinal.

Calendula,

is applied to wounds, incised and lacerated, promoting healing by the first intention. It is a valuable application for wounds in scrofulous persons, which tend to suppurate rather than heal by the first intention. It is also useful in old sores.

The Calendula Cerate is one of the best of dressings for any abraded surface.

Conium

is valuable as a palliative upon cancerous tumors. As a curative remedy it is useful in chronic ophthalmia, especially the purulent of children; useful also for indurated swellings.

Thuya

is a specific when locally used for Sycosis, also for fungoid cancerous tumors. I have cured well-marked cases of Fungus Haematodes with the tinct. Thuya applied to the surface of the tumor.

The Thuja Cerate is a valuable application for malignant ulcers.

Cornus Sericea

will often cure malignant ulcers both of the breast and uterus, used as a wash.

Arsenicum

acts favorably on cancers, and is a specific when applied to the surface of carbuncle.

Ipecac

acts very beneficially when applied to the surface where there is high fever, with nausea and vomiting. Half an ounce of tr. Ipecac to two quarts of tepid water, applied with a sponge to the whole surface, acts like magic in yellow fever, allaying the nausea, producing free and health-restoring perspiration.

Rhus Tox,

applied, with water at the strength of thirty drops of the tr. to a gill, to parts affected with Rheumatism, acts very beneficially. It is also a most valuable application at half the above strength upon parts affected with Erysipelas, when the surface is swollen, and there are vessicles filled with fluid like a blister in burns.

It is also useful for sores that exist as the chronic effects of burns when the proper treatment had not been used in the beginning, and the healing process was never perfected.

Rhus Cerate is a very useful application to irritable ulcers.

Hepar Sulphur

is a specific for Itch and Scald Head, applied in form of a wash with twenty to thirty drops of tr. Hepar Sul. to a gill of water. Also for ill-conditioned scrofulous ulcers, generally.

Cuprum Aceticum.

(Acetate of Copper Verdigris) applied to Cancerous ulcers of the face, Lupus or Noli-me-tangere, in the early stage, will in most cases effect a perfect cure, especially if for a week previously the part has been wet daily with tr. Thuja. The best mode of applying the acetate is to mix the impalpable powder, as prepared for paint, with some substance to form a cerate, as equal parts of bees-wax and mutton suet, with 1-50 to 1-100 part of the pure acetate as found in the bottom of the can, when prepared in oil for paint; heat all together and stir until cool. This forms a good plaster for covering and shielding the sore while its medicinal property is in the Cuprum Aceticum diluted as above. It is quite useful for any ill conditioned ulcer.

Acetic Acid

is a most efficient remedy applied to old irritable varicose ulcers on the limbs of females who have suffered from Phlegmasia Dolens, (milk leg.)

It may be applied as a wash to the part once or twice a day at the strength of 1-20th of the acid with water, or in the form of good cider vinegar.

The manufactured vinegar of the cities does not usually contain acetic acid.

ARUM TRIPHYLLUM is a specific to allay the inflammation and excessive pain in scrofulous swellings of the neck, (Kings Evil.) The pure drug in powder, wet with warm water, or the green root bruised so as to form a poultice, is to be applied over the swelling. It soon discusses the swelling, or if pus has already formed, allays the the pain, and brings the pus to the surface, and if continued, disposes it to heal rapidly.

BAPTISIA TINCTORIA applied as a poultice either in the powdered drug, or with some other substance wet with the infusion or tr., arrests gangrene in a short time. It is especially useful for threatened or actual gangrene arising from lacerated wounds or scalds with wounds, as in accidents connected with the explosion of steam boilers; when we often have scalds and lacerations in the same wound.

HYDRASTUS CANADENSIS used as a gargler in a putrid state of the throat in malignant Scarlet fever, arrests the destructive process at once.

It is also a most excellent application for inflamed eyes in the second or sub-acute stage.

* * * * *

PROPHYLACTICS.

(Preventives of Disease.)

TO PREVENT SCARLET FEVER

Give Belladonna at the 3d attenuation, three to six pellets, according to the age of the child, every morning, during the prevalence of the epidemic. This is for the common or mild form of the disease. If the prevailing epidemic is of the malignant kind, producing fatal ulcerations of the throat, give Bell. once in two days and Mercurius Corrosivus at the 3d attenuation on the alternate day.

While Bell. is a very certain preventive of the common eruptive Scarlatina, it is not as certain to prevent the malignant form. Though it renders the latter much more mild, the Merc. Cor. is necessary to ward it off entirely, or so modify as to divest it of the dangerous features.

TO PREVENT YELLOW FEVER

Take Aconite, Belladonna and Macrotin, 1st in rotation one dose a day. If there is any headache, or pains occur in other parts of the body, or a languid feeling, take a dose twice or three times a day in rotation.

TO PREVENT BILIOUS FEVER OR AGUE

Take Podophyllin, Baptisia and Gelseminum 1st in rotation, one dose at night, and if symptoms of fever, as headache and loss of appetite, or bad taste in the mouth in the morning appear, take a dose three times a day, and refrain entirely from food for one or two days.

TO PREVENT TYPHOID FEVER

When exposed, as in nursing the sick, take Baptisia 2d, and Macrotin 2d, a dose three times a day.

TO PREVENT SMALL-POX

Use Macrotin 1st night and morning, and if nursing or exposed frequently, use it every four hours.

TO PREVENT CHOLERA.

Camphor (pellets medicated with the pure tincture) Veratrum 3d, and Arsenicum 3d, should be taken in rotation—a dose morning, noon and night, in the order named; so as to take a dose of each every twenty-four hours. If any sense of weakness or trembling comes on, use the Camphor oftener; if pain or uneasiness in the bowels threatening diarrhoea, use the Veratrum, and for increased thirst with uneasiness at the stomach Arsenicum more frequently.

TO PREVENT DIARRHOEA

Where it is prevailing as an epidemic, Ipecac at night, and Veratrum in the morning will often suffice. For teething children give Ipecac and Chamomilla in the same manner.

TO PREVENT DYSENTERY

In hot weather when bilious diseases prevail, use Mercurius 3d, Podophyllin 2d, and Leptandrin 1st in rotation, giving one dose a day.

In the winter, or when Typhoid fevers prevail, use Mercurius and Rhus tox. alternately a dose every day.

TO PREVENT ITCH.

A dose of Sulphur, or rubbing a little flour of sulphur on the hands, will generally suffice.

TO PREVENT COLDS

Keep the arms, hands and chest well clothed and warm. Affecting the head as catarrh, or the pelvic regions keep the feet and ankles warm and dry. Affecting joints and muscles as Rheumatism—protect the Spine (back) from colds and currents of air.

After an accidental exposure as by getting the feet wet, or being caught in a shower, drink bountifully of cold water, and take a dose of Nux; followed in an hour by Aconite, if any chilliness is felt, or Copaiva if the head is "stuffed up."

In winter and spring when the weather is mild, but there is snow, or the ground is damp, more clothes are necessary than when it is freezing hard and the air is dry.

* * * * *

PREPARATION OF MEDICINE.

As it often becomes necessary for the practitioner to make more or less of his own dilutions and attenuations, some brief instructions especially to new beginners, may not come amiss.

Medicine is prepared by mixing it with distilled water, or purified 98 per cent. Alcohol; or if solid and dry, by reducing it to powder and triturating (rubbing) it in a mortar with pure sugar or Sugar of Milk. The liquid is called dilution, the powder trituration. The attenuations are mostly made at the decimal (1-10,) or centecimal (1-100) ratio and numbered 1, 2, 3, &c., by putting ten drops of the liquid with ninety drops of Alcohol, or ten grains of the powder with ninety grains of Sugar for the 1st, and ten grains or drops of the 1st with ninety more of Alcohol or Sugar, as the case may be, for the 2nd, and so on to any desirable extent.

If the centecimal attenuation is adopted, one grain or drop is used instead of ten, as in the decimal.

I prefer the decimal to the centecimal ratio. Not that there can possibly be any difference in the action of the medicines, at the same attenuation, whether it was brought to that state through a series of 1-10, or 1-100; the 3d at the 1-100 ratio of dilution being precisely the same as the 6th at 1-10. My preference for the decimal ratio is based upon the greater convenience and accuracy of measuring larger quantities.

Accuracy is very desirable, but the practice of guessing at the amount as pursued by some, is anything but accurate. When one makes his dilutions by putting the fluid into a vial and "pouring it all out," guessing that he has a drop left which is to medicate the ninety-nine drops of Alcohol or water, he may put in by guess, I am inclined to guess that he knows nothing, accurately as to what dilution he is making. (See Hull's Laura, introduction, also Jahr & Possart's Pharmacopoeia and Posology.) For if the vial is small and quite smooth there may not be a drop left, or if it is rough, there may be several drops.

Yet some physicians make their dilutions thus, and insist upon the superiority of the centecimal over the decimal attenuations.

Whatever ratio is adopted, should be accurately followed. Have true scales for weighing solids, and a graduated measure marked from ten drops up to one hundred for liquids; then always weigh or measure accurately the medicine, as well as the substance with which it is to be attenuated.

The measure and mortar, after using them for one medicine, can be cleaned preparatory for another, with scalding water, rinsing them with purified Alcohol, then drying.

Never smoke or chew Tobacco in any place, but if you are such a slave to habit, that you must do it despite your good sense and better judgment, never do either, or have tobacco or any other odoriferous substance about your person when you are preparing medicines, or they are exposed to the air. Keep the medicines excluded from the light and air as far as practicable.

Triturate the powders thoroughly for an hour or more upon each, and shake the dilution from fifty to one hundred times, more for the higher attenuations.

It is better to medicate pellets in large bottles, filling them half or two-thirds full, put in just liquid enough to wet every one, but not so as to dissolve any. Shake them until all are equally wet, and let them stand for four or five days, if practicable, shaking them up two or three times a day until all are dry.



INDEX.

Administration of Remedies, 11

Ague, 22

Ague, preventive treatment of, 153

Asthma, 57

Aphthae, 90

Asiatic Cholera, 104

Amenorrhoea, 129

Ague in the breast, 135

Attenuation of medicines, 151

Bathing, 12

Bilious Fever, 26 Preventive treatment of, 153

Bronchitis, 51

Burns and Scalds, 64

Bilious Colic, 19

Brain Fever, 70

Bee stings, 75

Bite of Rattlesnake, 77

Bruises, 95

Cholera Case, 3

Colic, 18

Colic, Bilious, 19

Cholera Morbus, 21

Cholera, Asiatic, 104 Preventive treatment of, 153

Chill Fever, 22

Continued Fever, 28

Catarrhal Fever, 28

Cough, 52

Colds, 57

Colds, Preventive treatment of, 154

Croup, 55

Constipation, 62

Chilblains, 69

Convulsions of Children, 72

Crusta Lactea, 122

Carbuncle, 122

Diarrhoea, 14 Preventive treatment of, 154

Dysentery, 16 Preventive treatment of, 154

Diet, Rules for, 13

Dyspepsia, 58

Diseases of Females, 129

Dysmenorrhoea, 131

Enteritis, 53

Erysipelas, 62

Epistaxis, 81

Earache, 84

Foreign Substances in the Ear or Nose, 144

Fevers, 22 Intermittent, 22 Chill, 22

Fits of Children, 72

Felon, 126

Flowing, 132

Female weakness, 198

Gastritis, 54

Hooping Cough, 58

Heartburn, 62

Hoarseness, 70

Headache, 78 Sick, 80

Introduction, 5

Intermittent Fever, Ague, 22

Inflammation of the Lungs, 49

Inflammation of the Brain, 70

Inflammation of the Bowels, 53

Inflamed Eyes, 91

Incontinence of Urine, 117

Involuntary urination (nightly), 117

Itch, 120

Itch, preventive treatment of, 154

Inflamed Breast, 135

Inflammation of the Uterus, 140

Jaundice, 120

Local application of Remedies, 145

Leucorrhoea, 138

Mammary Abscess, 135

Menorrhagia, 132

Measles, 73

Mumps, 74

Morning sickness of pregnant females, 143

Nursing Sore-mouth, 133

Nosebleed, 81

Neuralgia, 118

Nightly urination of Children, 117

Otalgia, 84

Ophthalmia, 91

Preparation of medicine, 155

Pleurisy, 48

Prolapsus Uteri, 138

Pneumonia, 49

Piles, 97

Painful urination, 117

Painful menstruation, 131

Profuse menstruation, 132

Preventives of Disease, 151

Quinsy, 53

Rheumatism, 30

Rheumatic Fever, 29

Remitting Fever, 27

Rattlesnake bite, 77

Scarlet Fever, 35 Preventive treatment of, 151

Sore Throat, 52

Scalds, 64

Stings of Insects, 75

Sick Headache, 79

Sore-mouth of Children, 90

Sea Sickness, 103

Small-Pox, 110 Preventive treatment of, 153

Scald Head, 122

Suppression of the menses, 129

Sore Nipples, 139

Table of Remedies, 3

Traveler's Case, 3

Typhoid Fever, 31

Tonsillitis, 53

Toothache, 86

Teething of children, 88

Thrush, 90

Ulceration of the Uterus, 140

Urination painful, 117

Urination, Involuntary, 110

Variola, 117

Varioloid, 117

Worms, 82

Wounds, 93

Whitlow, 126

Yellow Fever, 38 Preventive treatment of, 153



APPENDIX

ON THE USE OF GELSEMINUM SEMP. IN FEVERS. BY J. S. DOUGLAS, A. M., M. D., Prof. of Mat. Med. and Special Pathology, in the Western Homoepathic College, Cleveland; author of "Treatment of Intermittents," &c.

Such has been the general result of the treatment of the fevers of this country, that most Homoeopathic physicians deny the possibility of breaking up a fever when once established.

Those who labor under this impression, will be soon convinced of the error by properly employing the Gelseminum semper virens, or yellow Jasmine. Having proved this drug repeatedly on myself and seven or eight others, it was impossible to avoid the conviction that it would be homoeopathic to the ordinary fevers of this country.

The pathogenetic symptoms, almost uniformly experienced, are the following, the dose being from one to five drops:

Within a few minutes, sometimes within two or three, a marked depression of pulse, which becomes 10, 15 or 20 beats less in the minute, if quiet, but greatly disturbed by movement. Chilliness, especially along the back, pressive pain of the head, most generally of the temples, sometimes in the occiput, at others, over the head. The chilliness is soon followed by a glow of heat and prickling of the skin, and quickly succeeded by perspiration which is sometimes profuse and disposed to be persistent, continuing from twelve to twenty-four hours. As soon as the re-action takes place after the chill, the pulse rises as much above the normal standard, as it was before depressed below it. With these symptoms is a puffy, swollen look and feeling of the eye-lids, slimy and disagreeable or bitter taste in the mouth, languid feeling of the back and limbs, and sleepiness.

As example affords the best illustration, we will give one to illustrate the usual action of this drug in fevers:

P. W., aged 21, sanguine temperament, had been complaining of languor, and want of appetite for three weeks. For a week has been unable to attend to business. Took a cathartic, and was, of course, worse. For the last thirty-six hours had been seriously sick. June 30, 1858, had the following symptoms: Pulse rather full, but weak and vascillating, about 100 per minute. Tongue red and dry; hands tremulous when extending them; tongue trembles when protruded; the mind wanders; he reaches after imaginary objects; lips dry and parched; he is uneasy, restless. Now this, all will recognize as a case which had been long in coming on, and was fairly established, and was not likely to be broken up by ordinary means. He took one drop of Gelseminum tincture to be repeated every hour, if needed. The next morning he reported that he had been in a perspiration ever since fifteen minutes after taking the first dose, had slept quietly during the night, the tongue and lips were moist, mind clear, pulse 80, and steady. The next day I found him dressed and down stairs, with good appetite and free from disease. I could give sixty cases of equally prompt results from this precious drug, in fevers which make their attack rather suddenly, whether from cold or otherwise, and attended with chilliness, pain in the limbs, head and back, variously disordered taste of the mouth, with great restlessness. The almost uniform effect, in these cases is, a cessation of the chills, within from two to five minutes, quickly followed by a glow of heat and prickling of the surface; and within from five to twenty minutes, perspiration with progressive abatement of all the pains and restlessness. The patient falls asleep, and after a longer or shorter time, wakes with a consciousness that his disease is broken up—and this proves to be the truth. Like all other drugs, the dose must be various, generally one drop repeated every half hour, till the desired effect is produced repeated afterwards as occasion may require.

In simple cases of fever, I regard it as the remedy, not only, but the only remedy required. There are, of course, many cases of fever, with local complications, as inflammation of the liver, &c., &c., where other remedies will be necessary. Half a drop, or even a quarter, is often sufficient. The largest I have yet given is five drops, and this in only one case.

Several Homoeopathic physicians to whom I have recommended it, have made equally favorable reports of it.

My experience has been, that not a few of our Western fevers, especially if neglected beyond the incipient stages, are accompanied by such gastric and bilious disorder, as to require Mercurius, China, or Podophyllin, after the general febrile symptoms are removed by Gels. But at an early stage, the Gels. alone will prevent the development of these complications.

The drug seems to me to act specifically and energetically, not only upon the circulatory system, but equally so upon the nervous system, allaying nervous irritability more effectually in fevers, than Coff., Cham., Bell., Nux, or any other drug we possess. As it acts very quickly, the first dose may be soon repeated and increased, if no effect is observed.

- Transcriber's note: Inconsistent punctuation in headings in this book are as in the original. -

THE END