The Science of Therapeutics - Classical Homeopathy Online

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 1 of 653This is a digital copy of a book that was preserved for generatioto make the world's books discoverable online.It has survived long enough for the copyright to expire and the bto copyright or whose legal copyright term has expired. Whether aare our gateways to the past, representing a wealth of history, cMarks, notations and other maiginalia present in the original volpublisher to a library and finally to you.Usage guidelinesGoogle is proud to partner with libraries to digitize public domapublic and we are merely their custodians. Nevertheless, this worprevent abuse by commercial parties, including placing technicalWe also ask that you:+ Make non-commercial use of the files We designed Google Book Sepersonal, non-commercial purposes.+ Refrain fivm automated querying Do not send automated queries otranslation, optical character recognition or other areas where ause of public domain materials for these purposes and may be able+ Maintain attributionTht GoogXt "watermark" you see on each fileadditional materials through Google Book Search. Please do not re+ Keep it legal Whatever your use, remember that you are responsibecause we believe a book is in the public domain for users in thcountries. Whether a book is still in copyright varies from countany specific book is allowed. Please do not assume that a book'sanywhere in the world. Copyright infringement liabili^ can be quiAbout Google Book SearchGoogle's mission is to organize the world's information and to madiscover the world's books while helping authors and publishers rat |http: //books .google .com/IIBOSTON UNIVERSITYpp«Benlad byhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 2 of 653^Q-%tV^A^ ^ -^^\fBOSTON UNIVERSITY^tUai of ^dirine.Prcaenied by^■^^^-^V >^.THE SCIENCK^^,THEEAPEUTfJSB^^ACOOBDIHO TOTHE PRINCIPLES OF HOM(EOPATHY,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 3 of 653BTBERNHARD BJEHR, M. D.TBASflLATBD AHD BXBIOHBD WITH BUMBBOUB ADDITIONSKAFKA AKD OTHER SOURCES^BTCHARLES J. HEMPEL, M. Do»oVOLUME IL C?^32MBW TOBEtBOERICKE & TAFEL, No. 146 GRAND STREET.1875.Entered aooording to Act of Ck>ngresi, In the year 1860, bjjBOERIGKE ft TAFEL,Tn the Clerk's OflBee of the DiBtrlct Goort of the Soathem I>l8trCONTENTS OF THE SECOND YOLUME.SETClIfTV SEGTIOir.Diseases of the Seziial Organs lA. DiaeoMM of the Male Sexual OrganB 1http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 4 of 6531. Urethritis. Gonorrhoda, Oatarrli of the Urethra, BlexmorrhcBa of the Urethral Lining Membrane.^ 12. Orchitis, Inflammation of the Testes 188. BpermatorrhoQa ~ 16B. Dieeaeee of the FemdU Sexual Organe 201. Vaginitis, Catarrh of the Sexnal Mucous Lining. FluorAlbus, Leucorrhoda, Whites... 202. Metritis, Inflammation of the Womb 278. Metritis paeri>eralis. Puerperal Fever, Inflammation ofthe Uterus during Confinement 844. Oophoritis, Qyaritis. Inflammation of the Ovaries 455. Menstrual Anomalies 47a. Derangements attendant upon the appearance ofthe Menses 53b. Amenorrhoea, Suppression or Delay of the Menses 55c. MenstiTiatio Nimia, Profuse Menses 57d. Dysmenorrhoea, Scanty Menses 60e. Difficult Menstruation, Ailments accompanying theMenses. 616. Metrorrhagia. Uterino Hemorrhage 667. Carcinoma Uteri. Cancer of the Womb « 818. Various Morbid Cond.clons in the Sexual System of theFemale 879. Vaginodynia, Neuralgia of the Vagina i.. 9210. Mastitis, Inflammation of the Breasts 9511. Mastodynia 9912. Carcinoma Mammas. Cancer of the Breasts 100EIGHTH!«•http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 5 of 653Diseases of the Hespiratory Organs 107A, DiseoMee of the Larynx and Trachea 1071. Laryngotraoheitis Catarrhalis acuta. Acute Laryngo-tracheal Catanh 1072. Laryngotracheitis Crouposa. Croup, Membranous Croup 1128. Laryngotracheitis Chronica. Chronic LaryngotrachealCatarrh 129(V)VI Contents of the Second Volume.Pftgti. (Edema Glottidis, Laryngitis Sabmaoosa, (Edema of theGlottis- ^ 1876. Spasmus Glottidis, Spasm of the Glottis 1406. Ulcers of the Larynx^ Helcosis sea ulcera laryngis 145B. IHieoiM of the Lungt 1491. Hypenemia of the Lungs. Congestion, Plethora of theLungs 150S. Pneumorrhagiay Pulmonary Hemorrhage ~ 1548. Bronchitis Acuta, Acute Bronchitis 1644. Influenza, Grippe ~ 1825. Tussis Gonvulsiva, Pertussis, Whooping-Cough 1086. Bronchitis Chronica, Chronic Bronchitis, Chronic Pulmooiaryor Bronchial Catarrh 3107. Brondiiectasia, Dilatation of the Bronchia ~ 2848. Emphysema Pulmonum, Emphysema of the Lungs 2850. Pneumonia, Inflammation of the Lungs 24310. Gangrsani^ Pulmonum, Gangrene of the Lungs 80811. (Edema Pulmonum, Hydrops Pulmonum, (Edema of theLungs, Dropsy of the Lungs 807http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 6 of 65312. Asthma ,,, * 811O. DUeoMi of ih6 Diaphragm 8211. Diaphragmitis, Inflammation of the Diaphragm 8222. Singultus, Hiccup 8288. Hernia of the Diaphragm 824D. DiieoM of ^ Pleura 8251. Pleuritis, Pleurisji Inflammation of the Pleura 8252. Hydrothoraz, Drqpsy of the Chest 8428. Pneumothorax , 848NIKfTH itllCTIOli.Diseases of the Organs of CironlatioiL 846A. DiMOMiof the Heart , 8461. Carditis, PericarditiSi Endocarditis, Myocarditis. Inflammation of the He^rt, Pericardium, Endocardium, Substanceof the Heart 8472. Hypertrophia Cordis, Hypertrophy of the Heart 8798. Dilatatio Cordis, Dilatation of the Heart 8814. Adlpositas Cordis, Patty Degeneration of the Heart 8826. Anomalies, Abnormal Conditions of the Oriflces of theHeart, Valvular Diseases 888a. Insufficiency of the Miti'al Valve 888b. Stenosis of the left Auriculo-ventricular Orifloe 889c. Insufficiency of the Aortic Valves 804d* Stenosis of the Aortic Orifice 8966. Defects of the Oriflces and Valves of the RightHeart 8996. Palpitation of tl|e Heart 8997. Stenocardia^ Angina Pectoris 405Contents of the Second Volume. VIIhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 7 of 653TENTH SiEVElOJi.Pag«DeraBgementB of Single Systems 410A JHteoiss of ihs BoTiet^ Mu$eU$^ AfUmiiaUant 4101. Ostitifl, Periostitis, Pott's Disease. Inflammation of theBones and Periosteum 4102. Bhadiitis, Rickets 4168. Enchondroma, PsdariJirocaoe, Spina Yentosa 4904. Psoitis, Inflammation of the Psoas-muscle 4215. Lumbago ~ 4286. Progressiye Muscular Paralysis 4247. Inflammation of Joints 426a. Coxalgia, Coxarthrocace, Inflammation of the Hip-Joint ~~ m 427h, Gonarthrocace, Tumor Albus Genu, Gonitis, Inflammationof the Knee-joint 480c. Inflammation of the Tarsus 483J3, DiHa$et of the Arteriei^ Veiniy Lymphatici and LyftphaHo Olan1. Diseases of the Arteries 489sSa jjiseases ot cne veins* •••••••••••••••••••••••••••••••••••••a. Phlebitis, Inflammation of the Veins ...••• ••• 486b. Phlebectasia, Varices, Dilatation of the Veins . ••••8. Diseases of the Lymphatic Vessels and Glands .•••••••« •••a. Lymphangioitis and Lymphadenitis Acuta 44Si .b. Lymphadenitis Chronica, Chronic Inflammation ofLymphatic Glands - 446(7. Ditsattedof the Nsrvei 4471. Ischias 4472. Neuralgia Intercostalis. Intercostal Neuralgia 460D. DinoM of the Skin 4521. Erythema ^ 468http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 8 of 6532. Erysipelas ^ 4558. Roseola, Rubeola 4654. Urticaria, Nettlerash - 4666. Miliaria, Rash -. 4686. Pityriasis, Dandruff, Dandriff ^ 4707. Psoriasis, Scaly Tetter ^ 4728. Ichthyosis, Fish-skin, Porcupine Disease 4780. Lichen, Strophulus, Tooth-Rash •...••- 47410. Prurigo 47611. Acne, Stone-pock • •, 47812. Sycosis, Mentagra...^ ^ 48018. Aone Rosacea, Gutta Rosaoea, Copper-nose, Bottle-nose... 48214. Lupus, Wolf; Jacob's Ulcer 48815. Herpes, Tetter 486a. Herpes Facialis 487b. Herpes Pmputialis 487C Herpes Zoster, Zona, Shingles 488d. Herpes Iris and Circinnatus - 490vm Contents of the Second Volume.Pag«16. Eczema 40017. Impetigo ^ , 49718. Ecthyma, Rupia 49919. Pemphygus 501SN). Furuncle, Oarbunde, Anthrax * 50881. Seborrhcaa 50522. Fayufi^ Honey-comb Tetter, 8cald-head - 60628. Bcabiesy Itch. ^ 507IXlSTIIBr TH SECTIOKT.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 9 of 653Constitutional Diseases .« 518A Acute and Chronic Contagiout Dueates ^ 5131. Morbim, Measles 5182. Boarlatina, Scarlet-fever 5228. Yariola, Bmall-pox 5824. Syphilis 542a. Primary Chancre 548% b. Secondary Syphilis 548c Tertiary Syphilis 551B. Epidemic and Endemic Infectioue Dieea*e9 5681. Intermittent Fever, Fever and Ague 5082. Typhus ., 5768. Febris Icterodes, Yellow Fever 6034. Cholera Asiatica 618(7. ConstUutiondl Diseaaee without Definite Infection 6341. Chlorosis, Green-sickness 6242. Bheumatism 630a. Acute Articular Rheumatism 680b. Acute Muscular Rheumatism 6S2c. Chronic Articular Rheumatism 6838. Arthritis, Gout 6404. Dropsy 6155. Scorbutus, 8cui*vy 6496. ScrofUlosis 6527. Tuberculosis 6588. Constitutional Plethora, Polyamia, Uypersemia 6819. Ansmia, OligsBmia. Deficiency or rather Paleness of theBlood 68710. Congenital AuBBmia 70111. Consecutive Anamia 709http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 10 of 65312. Secondary AnsBmia 71118. Marasmus, Tabes 71114. Obesiias, Adiposis, Polysarcia, Obesity 71415. Ursemia 72016. Pyeamia. Purulent Decomposition of the Blood 72817. SepticsBmia. Putrid Decomposition of the Blood 7o218. Gastromalacia, Softening of the Stomach ^ 787' 19. Goitre, Bronchocele, Derbyshire Keck - 748cP .O,'[%V ''.'rSEVENTH SECTI^Difloases of the Sexual Organs.,0 "^ ' A. DISEASES OF THE MALE SEXUAL ORGANS.1. VrethriUs.GcnorrJuBa^ Catarrh of the Urethra^ BlennorrhxBa of the UrethralMucous Lining.If we liave not made a distinction between virulent and nonvirulent gonorrhcBa, it is because the last-named disease is so vand indefinite and, moreover, of such rare occurrence, that a barallusion to the same will sufELce for all practical purposes.IStiology. The non-virulent blennorrhoea is caused by the irrihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 11 of 653tation produced by foreign bodies in the urethra (calculi, etc.);it may be caiised by excessive sexual intercourse, intercourse duing the menstrual flow, irritating drugs, etc., although not frequently by the latter; it may likewise have a catarrhal originand, finally, may constitute a symptom of other inflammations,more especially of the bladder and prostate gland. In a case ofblennorrhoea we should never be too hasty in not attributing it tthe contact with an infectious virus. Gonorrhoea proper or an infectious blennorrhoea of the urethra, is always occasioned by inftious contact; and, although we cannot deny the possibility thatgonorrhoea may result without sexual intercourse, yet in the majoity of cases it may be boldly asserted that an impure coition iscause of the disease. Of course, the patienta make every possibleeftbrt to conceal the origin of their trouble. What conditions aninfluences have to co-operate in order to produce an infection, idiflElcult to determine : all we know is, that the same woman wilinfect one person without infecting the other. The degree of sexuexcitement may possibly constitute an additional cause of infectiat all events it is remarkable that novices are almost always cau1 (1)2 Diseases of the Male Sexual Organs.Regarding the natare of the gonorrhoea! contaginm, opinionsstill differ. Some deny the specific natare of the contaginm , plit in the same category as the secretion of epidemic blepharophthmitis ; they assert that gonorrhoea is caused by contact with thesecretion caused by an intense catarrhal inflammation of the vagiThis view is not entirely unfounded, and is more particularly supported by the circumstance that gonorrhoea does not superinduceconstitutional diseases. Others attribute to the gonorrhoea! viruspecific character, and the power of producing constitutional maldies, concerning whose essential actuality and nature, we shall oBome farther remarks in the following paragraphs. The gonorrhoealvirus has even been supposed to be identical with the chancropoison; this opinion has, however, been abandoned. We cannotafford time or space to enter upon a more extensive discussion ofthese points, to which we shall, however, refer somewhat more fulin the next paragraph. [Jahr's recent work on Venereal Diseases,translated and edited with numerous notes and additions by Chs.J. Hempel, M. D., and published by W. Badde, No. 550 Pearl St.,New York, is the best work on this important subject now extant,in the literature of our School; no physician who desires to havefull and accurate knowledge of the various opinions now prevalentregarding the nature of the gonorrhoeal virus and the syphiliticcontaginm, or of the manifold disorders which they are capable ofproducing, from the simplest blennorrhoea to the most terrible diorganization, or of their homoeopathic treatment as conducted inaccordance with strictly and unimpeachably scientific principles,can do without this work. H.]Symptoms tMtd Course. The time between the first communicationof the gonorrhoeal disease and its actual manifestatiois from three to eight days, very seldom either less or more, altthe patients are very apt to indicate a longer period. Usually, hever, this is an intentional deception, but may likewise be an erfor the reason that the disease sometimes sets in so mildly thathttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 12 of 653may have existed for some days without having been noticed. Theduration of the stage of incubation may likewise differ, in consequence of differences inherent in the degree of infectiousnessthe secretion, as has already been noticed when speaking of blennorrhoea of the eyes. The affection commences with a titillating,painless, sometimes even voluptuous sensation in the urethra, frowhich a small quantity of a transparent, slimy secretion is discharged by which the orifice is glued together in the morning. AtUrethritis. 8this stage the visible portion of the urethral mucons membrane isalready redder and swollen. The peculiar titillation is followedan increased desire to urinate and increased erections, sometimesalso by nocturnal emissions' In a few days the titillation changeto a pain, the urging to urinate becomes more frequent, the painurinating becomes intolerable, and the urine of which only a fewdrops are emitted, becomes scalding hot, so that it seems like fiIf the urine is emitted in larger quantity, the pains during theemission are less severe, but so much more violent immediatelyafter. The concentrated urine, moreover, causes an increased painon which account the first discharge of urine early in the morninis the most distressing. The orifice of the urethra now begins toswell quite perceptibly, the lips look very red. The secretion stremains scanty, looks yellow or greenish-yellow, is thick, stiffethe linen with yellow or greenish-yellow stains, and, in the mornis easily squeezed out in an increased quantity. The sensitivenesof the urethra to pressure now extends to the fossa navicularis.The erections, especially at night, become more frequent and continuous, causing the patient great pain in consequence of the string of the exceedingly sensitive urethra; emissions now occur verrarely. Shortly after this, the purulent secretion increases in qtity, but preserves its greenish-yellow color. The parts stainedthe discharge, the glans and prepuce, swell ; the smegma is secremore abundantly, excoriations and small superficial ulcers showthemselves. The inflammatory irritation of the prepuce easily results in phimosis or paraphimosis. The further extension of thedisease is evident from the fact that the urethra now is sensitivits whole length. It is only in a few cases that the gonorrhoearemains confined to the anterior portion of the urethra. This socalled inflammatory stage seldom lasts less than eight days, geneally a fortnight. General febrile symptoms are seldom present;what might be considered as such, is owing to the mental excitement of the patient and to the intensity of the pain. Towards theend of this first stage the discharge generally becomes very copibut its color changes more and more to that of a whitish mucus,and assumes a more fluid consistence. At the same time the painsat urinating abate almost entirely, leaving at most only a disagrable feeling, the erections become less frequent and painful ; onthe other hand, the nocturnal emissions are apt to be more frequeand to be followed by slight exacerbations. The white secretionleaves gray and stiff stains on the linen, with a yellowish point4 Diseases of the Male Sexual Organs.the centre. In favorable cases the whole disease is terminated inhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 13 of 653five to seven weeks amid a gradual abatement of all the symptoms.Such a simple and favorable course does not by any means constitute the rule; generally we meet with one or more complicationIn the first stage, we not unfrequently meet with a considerableinflammation, on which account a gonorrhoea of this kind has beentermed erythematous, with distinct febrile motions. The inflammatory stage may be protracted beyond the above-named period.In the next place we sometimes observe inflamed spots in the neigborhood of the urethra, elongated or rounded infiltrations whichsometimes terminate in abscesses, but are not always of great importance. The extension of the inflammation along the wholecourse of the urethra is apt to superinduce a simple congestive oeven inflammatory affection of the prostate gland, rarely of thebladder. An inflammation of the prostate gland involves danger,because it may result in a more or less complete retention of urior terminate in suppuration. Orchitis will be spoken of more fullby and by. Inflammatory swellings of the inguinal glands, socalled gonorrhoeal buboes, are very common. They are of no special importance, and disappear of themselves as soon as the inflamatory stage has run its course.Isolated deviations from this picture of gonorrhoea, exert littleno influence upon its general course. The so-called dry gonorrhoeconsists in a short-lasting suspension of the purulent secretion,is most commonly accompanied by an exacerbation of the inflammatory symptoms. It not unfrequently happens that at the commencement of the disease streaks of blood are mixed up with thepus, which does not influence the further course of the disease.so-called torpid gonorrhoea which has the peculiar characteristicbeing totally or partially without any inflammatory symptoms, isof rare occurrence and mostly attacks individuals who have had thdisease more than once. It cannot be denied that repeated attacksof gonorrhoea and the cauterizing action of the injections used ding the treatment of such attacks, diminish the disposition to cotract an inflammatory gonorrhoea.One of the most painful complications is chordae by which is understood the curving of the penis downwards during an erection.It arises when the corpora cavernosa have become involved in theinflammation and the consequent infiltration of these bodies doesnot permit the interstitial swelling of these parts during an ereUrethritis. 5tion. This trouble is so much more serious as this condition of tcorpora cavernosa may remain a permanent disorganization.One of the most ordinary consequences of gonorrhoea, which is socommon, that it may almost be considered the rule, is gleet, a chnic urethritis or secondary gonorrhoea. It arises gradually fromacute form, the discharge becoming more and more scanty, clearerand thinner, and continuing all the time, sometimes for years, unless arrested by medical interference. It often defies all treatmA discharge of this kind would be of comparatively trifling importance if we knew to a certainty whether it is infectious or not,latter supposition having undoubtedly the larger amount of probahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 14 of 653bility in its favor. The treacherous stains on the linen are, ofa source of great anxiety to the sufferers, and it is not to be wdered if they desire to be freed from their distress. Finally, exbations will occur during gleet, which, if they do not result inattack of acute gonorrhoea, cause some pain at urinating and anincreased, whitish discharge. Such exacerbations sometimes set inafter slight colds, after drinking beer or wine, or even after coGleet is no guarantee against a fresh infection, but this may absit instead of rendering it more inveterate.Among the sequelse which may involve the bladder, prostategland, etc., we note more especially strictures of the urethra. Ocause of stricture may be a contracting cicatrix in the urethra,which case the bougie is alone capable of affording help. Or thestricture may depend upon infiltration and subse juent callous hypertrophy of the tissue surrounding the urethra, in which case itsometimes felt externally like a hard, elongated swelling.We shall devote a few lines to the so-called gonorrhoeal diseaseand gonorrhoea! metastases. Hahnemann speaks of two kinds ofgonorrhoea, a benign kind which may be regarded as a local diseasof the urethra, and another kind depending upon the sycosic contagium. Ilartmann observes, that the two kinds cannot well be distinguished in a given case. It can scarcely be supposed that condlomata constitute a distinct phenomenon in gonorrhoea, which mayrun its course as completely and rapidly with, as without them. Iblennorhoeic condylomata constituted a specific product, ophthalmblennorhoea ought to be a result of the sycosic miasm, since condlomatous growths likewise occur in the former disease. Be this asit may, it is of very little consequence whether there are two kiof gonorrhoea, for in practice we cannot make this distinction evif we would. It is an established fact, that the gonorrhoea! bear6 Diseases of the Male Sexual Organs.resemblance to the syphilitic contagium, by which is meant that tformer does not develop, as a more or less regular consequence, aconstitutional malady, and that it acts like the contagium of theophthalmic blennorhoea and similarly to the contagium of smallscarlatina, etc. Or shall we consider these contagia as syphiliticause their respective diseases sbmetimes leave severe constitutiderangements behind them? In our opinion, a gonorrhoeal epidemicdisease neither exists, nor is it at all possible. At all events,intense gonorrhceal infection, including, of course, the absurd min which it is often treated^ gives rise to a constitutional diseis wrong to hold the gonorrhoea responsible for it, any more thanthat it may have acted as the exciting cause or the spark that mahave ignited the accumulated combustible material. This view issupported by a number of analogies, whereas the other view requirfor its proof a mass of speculative hypotheses. Let the partisansthis doctrine be invited to point to a case of gonorrhoeal constitional disease. If such a thing did at all exist, it certainly cabe difficult to pick out a dozen cases among the tens of thousandthat have been treated for gonorrhoea. And then it would be incumbent upon them to show that in those cases the gonorrhoea wasa simple blennorrhoea and not caused by a syphilitic ulcer. Hartmann has not made this distinction, nor is it probable that Hahnemann did so.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 15 of 653Gonorrhoeal metastasis, is likewise a theory of very questionableauthenticity. Orchitis is certainly not to be regarded as such ametastasis and, as regards gonorrhoeal rheumatism, which is admitted even by the most obstinate sceptics, we are not quite surewhether the medicines which the patient took, have not more to dowith it than the gonorrhoea. Under homoeopathic treatment wehave never yet met with a single case of pretended metastasis.Treatment. Hartmann's views in respect to the treatment ofgonorrhoea differ from our own in many respects.According to Hartmann, Hahnemann gives the following instructions for the treatment of gonorrhoea: "Sycosic gonorrhoea is curmost certainly and radically by the internal use of Thuya^ whichhomoeopathic to this disease, giving one dose of a few pellets of80th potency, which, if no improvement has taken place in twenty,thirty or forty days, is to be followed by an equally small dosethe I2th potency of Nitric add which must be permitted to act foran equally long period. The miasm of the other benign kinds ofgonorrhoea does not seem to infect the general organism, and to rUrethritis. 7main localized in the nrinary organs. This kind of gonorrhoea yieto a single drop of the fresh jnice of parsley (succns Petroselinprovided the frequent urging to urinate indicates this drug, or tdrop of an alcoholic solution of Copaiva, unless the intense inflmation and the debilitating treatment have roused the latent psorwhich hitherto had been slumbering in the organism of the patientin which case it often happens that a lingering gonorrhoea is excinto action which will only yield to an antipsoric treatment." Hamann replies to these statements in the following words: ^^Thesimple gonorrhoea yields only in a few cases to the tincture of pley or to the alcoholic solution of Copaiva: nor have I been ablecure sycosic gonorrhoea with nothing but Thuya ; in general thiskind of gonorrhoea cannot well be separated from the benign form,unless condylomata are present, or the patient knows positively tthe woman who infected him, had sycosis. The same remark applies to figwarts. Quite recently I treated a case of sycosic conlomata which would not yield to Thuya, but got well in ten daysafter a single dose of Kitric acid 1 ; in another case I effectedwith two doses of Oinnaharia; in other cases other mercurial preparations were required." At a later period he adds: ^^In manycases of gonorrhoea all three remedies proposed by Hahnemann, andeven many others, have to be used for a cure." — ^'^I know now thgonorrhoea which sets in with great violence at first, is much moeasily managed, if Thuya is used at once at the commencement.Nevertheless, I admit that I am as yet unable to distinguish sycogonorrhoea from any other form unless condylomata are present.Gonorrhoea attended with condylomata is in most cases a secondaryaffection, as may be inferred from the fact that it disappears sitaneously with the sycosic disease against which the treatment hato be directed."The idea of a so-called gonorrhoeal disease is very plainly enunciate in the preceding paragraph. It is evident that the doctrinea sycosic miasm owes its origin to the difficulty of explaining thttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 16 of 653quently peculiar and chronic course of gonorrhoea; but it is wronundertake to explain that which requires to be explained by resoring to an explanation which is itself unintelligible. If any. oneconsider a statement of this kind as disrespectful to Hahnemann,him consider that it is much better to admit defects than to wilfclose one's eyes to them. How many cures has any homoeopathicphysician made in accordance with Hahnemann's precepts ? A normal gonorrhoea runs a course of five to seven weeks. How can we8 Diseases of the Male Sexual Organs.talk about cures if we are to let remedies act for forty or eightdays? If a gonorrhsea disappears under Hahnemann's treatment,what has Thuya or Nitric acid to do with the cure?We boldly assert that most ht>moeopathic physicians employ othermeans and methods in order to secure the cure of gonorrhoea. Kthe gonorrhoea disappears in the fourth week, we are entitled toconsider this a cure. It will scarcely ever yield in a shorter peof time. Hartmann admits that this disease cannot be cured bymeans of a strict comparison of the symptoms, and that we cannotget along without resorting to a certain empiricism. "We fully agwith him in this opinion ; hence the reader must not expect to fithe use of each of the following remedies accounted for by an enumeration of the symptoms.For the first stage of an uncomplicated gonorrhoea there is nobetter simile and no more efficient remedy than Mercurius sclvbilThis drug has the whole group of symptoms ; tickling in the urethra when touching it at urinating, the tickling is of a voluptuosort, attended with violently excited sexual desire; greenishpurulent secretion from the urethra, with traces of blood ; inflamation of the prepuce and glans with balanorrhoea; breaking out olittle sores ; urging to urinate, with frequent and painful emissetc. The choice of Mercurius is therefore in strict accord with hmoeopathic principles, but does not depend, as Hartmann fancies,upon the resemblance of the gonorrhoeal to the chancre-virus, fordoes not exist. If Hartmann states that he has cured but few caseof gonoiThoea with Mercurius, we do not find this strange; Mercurius is not sufficient to a cure, and even if it were, it would nthe disease at once, for it cannot be cut short by internal treatLet it suffice to state that most homoeopathic physicians prefercurius as long as the inflammatory symptoms continue. Some ofthe above-mentioned complications likewise require Mercurius. Weallude more particularly to inflammatory infiltrations of the protate and to the parts adjoining the urethra. It is surprising thasuch infiltrations scarcely ever occur if the gonorrhoea is treatwith Mercurius from the beginning. If chordae sets in, Mercuriusis indicated by the cause producing the chordae. Gonorrhoeal buboes likewise require Mercurius. The doses should not be too smalwe have always had more success with the second trituration thanwith the higher attenuations ; one or two grains every morning ore\&en every other morning are quite sufficient ; it may not be adable to continue the use of this drug longer than ten days or a fnight.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 17 of 653Urethritis. 9Hepar sulphuris is the best remedy to give after Mercarius. Thesymptoms referring to the disease are not very characteristic, buthe saccess obtained in very many cases, is remarkably striking.This medicine is given as soon as the discharge assumes a whitishcolor and the pains abate quite considerably. This usually takesplace about the ninth or tenth day. Under the persevering use ofthis remedy, the discharge will either cease entirely in the fourweek, or else become so trifling, that the pain will almost ceasewill a secondary discharge remain, except in a very few cases, Mecnrius and Hepar sulphuris are tolerably sure remedies for an uncomplicated gonorrhcea of moderate intensity. The various deviations from the average course of the disease will require a few ational remedies.For the excessive sexual excitement during the inflammatory period of gonorrhoea, with almost unceasing painful erections, especially at night, violent urging to urinate, with inability to voimore than a few drops, discharge of blood, or if there is no discharge as in dry gonorrhoea, Cantharides will be found excellent.This remedy should not be given too strong ; even the third tritution may still cause an homoeopathic aggravation.If the gonorrhoea sets in without any marked inflammatory symptoms; if the discharge is copious, rather white than yellow, andcausing a superficial inflammation of the glans and prepuce, Cannobis is preferable to Mercurius at the outset. Marked sexual excitement argues against, rather than in favor of the remedy. Inthe subsequent course of the disease where Hepar has been advisedCannabis sometimes has a very good curative effect. This medicineshould be given in the lowest attenuations.The true torpid gonorrhoea which is more particularly met within individuals that have been infected several times, requires focure Thuya, Acidum nitr.. Sulphur and likewise Hepar sulphuris,and in general, the remedies recommended for secondary gonorrhoeaAs we said before, gonorrhoeal buboes are best treated with Mercurius; but after they have passed into a chronic-inflammatory codition. Clematis erecta or Kali iodatum should be employed.Chordae does not require any special treatment: it is best actedupon by Mercurius. If the erections are frequent and continuous,Cantharides may relieve them. An admixture of blood in the discharge is not an alarming symptom, and is met by most of the pre*viously-named remedies.10 Diseases of the Male Sexual Organs.If the bladder becomes involved in the inflammation^ ^he medicines indicated for cystitis, will have to be used.Secondary gonorrhoea constitutes, so to speak, a separate affection ; it is one of the most obstinate plagues both to the physicand patient, and its removal is so much more difficult as it presa great uniformity of symptoms which greatly interferes with theselection of the suitable homoeopathic agent. The published caseshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 18 of 653shed very little light regarding the preference that should be gito one or the other remedy; it is, indeed, very difficult to distgui^ between a cure eftected by the action of Nature and that ofthe remedy.According to the experience of most physicians Thuya ocddentcdisis the best remedy. It should not be given as long as inflammatorsymptoms are present; nevertheless, it is recommended by many,and even by Hahnemann, at the outset of gonorrhoea. In the acutestage Hartmann only derived benefit from Thuya if condylomatawere present ; on the contrary, in secondary gonoiThoea, he foundvery efficacious, which many other practitioners confirm by theirown experience. Although the presence of condylomata & a goodindication, yet Thuya likewise acts well if no condylomata arepresent.Nitri aoidum competes with Thuya, but will scarcely ever proveuseful, except in the secondary form of gonorrhoea. As a rule itseems to act best in cases where Thuya had proved useless.Petroleum has been recommended in former times, but is nowvery generally abandoned on account of its inefficiency in this dease. It has likewise been recommended in the acute form, moreparticularly if the neck of the bladder is very much involved. Cagicum may likewise prove useful under such circumstances.Sulphur sometimes has a good efiect if all the other remedieshave proved fruitless; nevertheless it cannot be depended upon focertain. In strictures occasioned by chronic-inflammatory infiltrtions it is an important remedy. Clematis erecta and Nitri ac. shhowever, be tried first for this trouble. Strictures depending upthe presence of cicatrices in the urethra, are beyond the reach ointernal treatment and have to be managed by surgical means, thebougie, etc.The following remedies have likewise either been used or recommended. In acute gonorrhoea : Balsam, copaivcBy Tussilago petasitPetroselinum; the last-named remedy deserves the most attention,Urethritis. 11altbongh it is not used maeh by practitioners generally. In gleetCulebce^ Agnus castus^ Mezereum^ lodium^ Phosphori dddum.[In several inveterate cases of gonorrhoea, where injections hadbeen used for several months without the least benefit, a cure waeffected by Eafka by means of the internal use of Matico 1, a Pervian plant known in Peru as the Yerba del soldado, (the soldier'sweed or herb.) H.]It cannot be denied that Homoeopathy cannot boast of any verybrilliant results in the treatment of gonorrhoea. It is only excetionally that a real gonorrhoea yields in a few days to internalhomoeopathic treatment ; it generally takes weeks to cure the disease, and even then the gradual transformation of the disease inta gleetish discharge cannot be avoided. Have we not yet discoverethe right remedies ? Or do we not make a proper use of the remedies we have ? In this condition of things it certainly behoovehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 19 of 653us to ascertain how gonorrhoea is treated by physicians of otherSchools. The most common method now in vogue is a vigorouscauterization of the urethra with Nitrate of silver, zinc, etc. Neven the most inveterate doubter can deny that a gonorrhoea issometimes cut short by such a proceeding ; on the other hand, itcertain that a cure does not always take place in this way, thattreatment is attended with severe pain, and that it is not withoudanger as regards the supervention of strictures. This last circustance is of course flatly deified by the partisans of this checkor aborting method. Astringent injections after the inflammatorystAge is passed, frequently lead to good results, nor are their sdary effects attended with the danger involved in the formermethod; nevertheless they are not absolutely reliable, and it ofthappens that the gonorrhoea breaks out again after a suppressionof several days. Large quantities of Copaiva and Cubebs sometimes suppress the discharge for a few days, but it frequently returns again with a renewed fierceness and changes to a mostobstinate gleet. In addition to these disappointments the gastrointestinal canal is sometimes very much weakened by these drugs.Moreover it is our conviction that these two drugs are the mostfrequent cause of gonorrhoeal orchitis and of the peculiar gonorrhoeal rheumatism, neither of whicjh conditions has ever occurredto us under a stdct homoeopathic treatment.Upon the whole, we are willing to admit that these severe methods of treatment are now and then crowned with brilliant successbut on the other hand we believe that they do not counterbalance12 Diseases of the Male Sexual Organs.the dangers incident to this treatment ; we believe that a gonorrhcea treated in this manner, without being cured, becomes exceedingly inveterate. Hence we prefer, under all circumstances, theslower but safer homoeopathic treatment, were it for no betterreason than that it never does any positive harm. It might beworth while to ascertain how often a strict homoeopathic treatmenof gonorrhoea has resulted in orchitis, strictures, cystitis, etccases will be few indeed. Another advantage of the homoeopathictreatment of gonorrhoea, which is readily perceived and appreciatby the patients, is the circumstance that they need not impose upthemselves distressing inconveniences. It is well, however, thatthe attention of the patient should be directed at the very commencement of the treatment to the difference between the allopathic and the homoeopathic methods.The patient's mode of living constitutes an important part in thetreatment of gonorrhoea. The views of physiciians differ greatlythis respect. Some doctors torment their patients half to death btheir pedantic dogmatism in regulating the diet and general modeof living. Abundant experience has satisfied us that so muchpedantic care is uncalled-for. The patient may take exercise, butshould avoid all severe exertions and remain as much as possiblea recumbent posture. Every patient should wear from the start agood suspensory which we do not, however, regard as a preventiveagainst orchitis. The usual diet may be pursued with the followinexceptions : The patient must abstain from fat food, eat meat moderately, avoid spices, spirits, wine and beer, and likewise coffeing the first period of the treatment ; during the subsequent trehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 20 of 653ment coffee may be drank without hesitation. In order to avoidthe nocturnal erections, the supper should be very light and eatein good season; after supper all beverages should be abstainedfrom. Balanitis and phimosis are best prevented by frequentlywashing the penis with tepid water ; if the glans is covered by tprepuce, the water should be injected under the prepuce. Physicians should never omit to direct their patients' attention to thdanger of gonorrhoea! virus getting into their eyes. By systematially drinking cold water, the urine becomes much less concentrateMy patients drink a glassful every hour. The night-urine is especially irritating; on this account the patients should drink twothree glasses of water on rising in the morning, and should thenwait forty or fifty minutes before urinating ; during this periodlarger portion of the water will have passed into the bladder. ByUrethritis. 18pnrsning this course we have always got along tolerably well, andour patients enjoy the advantage of being able to attend to theirusual avocations. That even severe exercise may not always havean injurious eftect upon gonorrhoea, has become evident to usby the example of dozens of soldiers who, in order not to be sentto the hospital by their regimental physician, were treated by ussecretly and who attended to their military duties all the time,even those who served in the artillery. "We have never seen anyinjurious consequences result from this management. As a matterof course, the presence of important complications during the couof gonorrhoea will require corresponding modifications in all thearrangements. In recent cases of secondary gonorrhoea, the use ofcold water, as above recommended, should likewise be resorted to;in cases of long standing it has no effect. The injections whichHahnemann likewise concedes as proper, have sometimes, but notalways, a favorable effect. Excellent injections are prepared ofdaret diluted with water, to which small quantities of Tannin maybe added. We have never obtained equally favorable results withweak solutions of Nitrate of Silver, Muriate of Gold, Sublimate,Thuya; nor have we done any better with lime-water, or solutionsof Zinc, Copper, or Lead.9. OrehltimInflammation of the Testes.Now and then this affection is met with as the result of mechanicinjuries, but most frequently originates in gonorrhoea. It not onsupervenes during the course of acute urethritis, but it may likeset in suddenly during gleet, generally without any apparent exciing cause. Severe exertion or the discontinuance of the use of supensories are said to sometimes cause the disease, but this is noestablished fact. The excessive use of beer or wine is a much moractive cause of the disease, probably because the inflammation isvery much increased by such stimulants. Both Cubebs and Copaivahold the same relation to gonorrhoea. They have a specific effectupon the urethra, and it is easily conceivable that, instead of eing a cure when given in large quantities, they aggravate the inflammatory symptoms and, owing to the specific action which theylikewise exert upon the testicles, communicate the inflammation tthese organs. This point has not yet been substantiated by provhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 21 of 653ings on the healthy. At any rate it is strange that the exhibitioof these two drugs should be so frequently and speedily followed14 Diseases of the Male Sexual Organs.orchitis which is scarcely ever observed under strictly homoeopattreatment unless the patient should commit some gross indiscretioIt might be well to inquire into this circumstance ; the result msuggest additional reasons for preferring the homoeopathic treatment of gonorrhoea. That orchitis takes place in consequence ofthe spread of the urethral inflammation through the seminal vesicles to the vas deferens and the epididymis, is distinctly shownthe painfulness of the former organs. A gonorrhoeal metastasis isout of the question, because the gonorrhoea! discharge dther continues side by side with the orchitis, or only disappears after torchitis is fully developed, not before, in the same manner as acatarrh disappears during the supervention of a more serious disease of the respiratory organs.Symptoms. Orchitis seldom sets in suddenly. Ordinarily itcommences with slight drawing pains in the spermatic cord whichis sensitive to contact. At the same time the patient experiencesviolent tearing pains in the thigh of the affected side. The weigof the testicles at first is troublesome,, then becomes painful afinally intolerable. In one or two days the epididymis becomespainful to pressure, swells with more or less rapidity, and shortafter is succeeded by an inflammatory effusion into the tunica prpria, in consequence of which the testicle very soon enlarges tosize of a fist. The pains now become agonizing; the patient has tconfine himself to a horizontal posture with the testicle properlsupported. The pain is a burning-tearing pain, most frequentlywith remissions after the fashion of rheumatic pains. The generalcondition of the patient does not suffer much, only in violent cathere is fever or even vomiting. The discharge usually disappearsafter the orchitis is fully developed, and does not re-appear untinflammation has run its course; only in a few cases it does notappear after the subsidence of orchitis.The inflammation in its acute form does not often last beyondthe tenth day, sometimes the improvement commences on the fourthday. This, however, is not very rapid, since it sometimes takesweeks before the testicle resumes its former size ; very frequentan obstinate swelling of the testicles remains.Tr€€Ument. Most physicians prescribe in the first place Jfircurius sol. or vivus, especially if the orchitis had its origin iattack of gonorrhoea. We give the first trituration and continueit until the inflammation begins to abate. For orchitis arising fchronic urethritis, Clematis erecta is preferable. This medicineOrchitis. 15good service after Mercurios, even better than Pulsatilla which,however, has more decided symptoms referring to such a case. Itis veiy difficult, in a case of this kind, to select a remedy inance with the symptoms, for the reason that the symptoms of thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 22 of 653different drugs are so very much alike. Beside the abovedrugs, we likewise recommend Addum nUr.j especially if the patient is tainted with syphilis and has taken a good deal of MercuThe subsequent enlargement of the testicle, if of recent origin,quires in the first place ClenuUiSy likewise locUum; Hartmann alsproposes Staphysagria^ and, if the enlargement had lasted sometimAurvm met and Sulphur. Udocynthis has helped us out very promptlyin two cases of violent rheumatic pains in the thighs which emanated from the testicle and had remained behind after an orchitisIf the orchitis does not originate in gonorrhoea, a few other medicines deserve attention. If caused by a contusion of the testiclArnica has to be given, afterwards Conium or Pulsatilla^ to whichHartmann adds Calendula offidnalia. If it is caused by a cold ormetastasis of parotitis, Bhus tox.j Belladonna j Bryonia have togiven together with the above-named drugs. [We have subduedthe most intense phlegmonous inflammation of the testes consequenupon sudden suppression of gonorrhoea by means of the 18th attenuation of Aconite; the first tablespoonful of a solution of a fewules in half a tumbler of water, produced an almost instantaneousrelief from the most agonizing distress. In rheumatic orchitis thlower attenuations of Aconite act more specifically, or in otherwords are more specifically adapted to the pathological process.In a case of terrible orchitis caused by suppression of the gonorrhoeal discharge, with swelling and inflammation of the spermaticcord of the affected side, high fever, flushed cheeks, glisteningintolerable restlessness. Belladonna given internally and appliedtemally, in the proportion of fifteen to twenty drops of the fluiextract to half a cupful of water, controlled the inflammation answelling, after other remedies had been tried in vain. H.]These remedies are likewise to be used in chronic primary swellings of the testes. Some of these swellings are, indeed, past allcure, especially those having a tubercular origin; in some cases,however, even of long standing, the result of our treatment is, ideed very etriking.External applications generally are of very little use in orchitiNeither warm nor cold fomentations are easily born, nor have theyany good effect, not even palliative. Of course the testicle shou16 Diseases of the Male Sexual Organs.be supported so that the spermatic cord is not pulled upon. A suspensory should be worn even some time after the disease is cured.Strapping the testicle with strips of adhesive plaster so as to ea slight compression, frequently exerts a strikingly beneficial ifluence. Those who have recovered from the disease, will have tobehave with great discretion in order to avoid relapses which areapt to take place.8. Spenaatorrbcea.By this heading we, strictly speaking, comprehend a flow of semenwithout any sexual excitement. However, in order to avoid thenecessity of resorting to a number of sub-divisions, we have clastogether in this chapter abnormal nocturnal emissions as well ashttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 23 of 653various other morbid derangements of the male sexual organs; anadditional motive for this arrangement is the circumstance that ttreatment of most of these conditions is the same.The functions of the male sexual organs vary in accordance withtemperament, mode of life, constitution, etc., to such an extentit is often difficult to decide whether these difierences are ofbid nature or belong to the normal standard. This can only be determined by the manner in which the male sexual sphere is generally affected by the local phenomena ; whether the organs are notabnormally disturbed, or whether the procreative powers are impaired or even suspended.The etiology of these various abnormal conditions of the sexualsphere is pretty much the same. Debilitating constitutional diseases, or acute diseases during the period of convalescence are ato cause a so-called irritablid weakness in the sexual sphere, whin the former case is permanent and in the latter case only temporary. This fact is most strikingly witnessed in diabetes and tubeculosis. In the last-named condition the excessive irritability othe sexual organs contributes to hasten the general decay. Asecond cause are cardiac and nervous diseases, which may, howeverlikewise result from the sexual weakness. Hypochondria is a frequent cause, and still a more frequent consequence of sexual weakness. The most common cause of sexual weakness is the vice ofonanism, which is too much overlooked by physicians. Yet it iscertain that thousands might, by a timely warning, be saved fromunspeakable mental and physical disease.Excessive nocturnal emissions generally take place between theyears of 20 and 25, and exceptionally at an ealier age, even 16.Spermatorrhoea. 17They are of a morbid nature if they occur almost regularly without rousing one from sleep, and if they do not occur often, yetleave for days a sensation of languor and debility, and of mentaldepression. They are likewise abnormal if they occur several timein one night or week. Moreover every emission that takes place inthe waking state, with or without any special cause, at stool forinstance, is to be regarded as abnormal. The consequences of suchabnormal losses very soon show themselves : Paleness of the facewith dark margins around the eyes ; insufficient sleep ; drowsinewith inability to sleep ; dulness of the head ; aching, pressingin the head ; vertigo ; irritable, sensitive temper ; aversion toto work, and, after a while, a deranged appetite and digestion,deficient assimilation.Spermatorrhoea, properly speaking, consists in a loss of semen atevery emission of urine, at stool, without any cause or after themost trifling erections. The pernicious consequences of this sortof spermatorrhoea manifest themselves much more speedily thanafter nocturnal emissions, most probably because spermatorrhoeanever occurs in organisms whose physiological functions had beencarried on in a normal manner.Irritable weakness of the sexual organs is sometimes the cause,but more frequently the consequence of both the previouslyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 24 of 653tioned anomalies. The sexual excitement occurs too easily and toovehemently, without possessing sufficient energy and consistencethe act of coition. The ejaculation of the semen takes place toosoon, or even not at all, or the introduction of the penis into tvagina is prevented, by a premature cessation of the erection. Thsexual weakness may be characterized by all sorts of abnormalmanifestations in the sexual sphere. The mental disposition exerta powerful influence in this direction. Hypochondriacs are particularly disposed to irritable weakness which, under abnormal mentainfluences, sometimes attains to such a degree of intensity thatseems to amount to complete impotence.Complete impotence, by which is meant an entire suspension ofthe ability to perform the sexual act, is upon the whole a very rand frequently only temporary disorder, except when dependingupon debilitating incurable constitutional diseases, such as diabor tuberculosis, or when depending upon the loss of one testicle.An excess of sexual excitement (satyriasis) besides taking placeat the copimencement of gonorrhoea, as we have already stated,may likewise occur in consequence of debilitating conditions, fir18 Diseases of the Male Sexual Organs.as a passing increase and subsequently to be succeeded by a decreof excitability. It is frequently met with in the case of personswho have been addicted to the vice of onanism^ or among wornrou^s; very rarely without such a cause, and then mostly as asymptom of some deep-seated disease of the brain.In treating most of these forms of sexual weakness, the diet, modof life and psychical agencies exert an important influence ; henwe place them in the front rank.We cannot lay it down as a rule that these morbid conditionsrequire either a lean or a strengthening diet. Some are afflictedwith weakness of the sexual organs, more especially with excessivpollutions, because they live too well ; it is a mistake to suppothat this waste is repaired by a nourishing diet, since it is welknown that some persons are living in circundstances which precluthe possibility of indulging in good living. Hence it becomes amatter of interest to inquire whether a lean or a rich diet is thmore suitable. All such patients must be cautioned against goingto sleep with a full bladder or a full stomach, either in the dayor at night. Certain beverages, such as spirits and hopbestrictly avoided. Beer-drinkers are very apt to deny the debiltating influence of hop-beer on the genital organs ; that this inence exists, must be evident to all who are acquainted with theeffects of Lupulin. It is well known that drunkenness, either paror total, causes an irritable weakness of the sexual organs. Cofland in some even tobacco, have to be interdicted ; among the secondary effects of coffee we notice a depressing excitability andtability of the nervous system. In general all stronglystimulatingfood is hurtful. As regards bodily exercise, it is cethat bodily fatigue diminishes sexual excitement and brings it baagain to a normal standard ; muscular exercise has also the ad vatage of preventing the mind from dwelling upon erotic subjectsViewed from this point, walking is not the best kind of exercise,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 25 of 653for the reason that it leaves the mind free to revel in all kindsfancies ; onanists are very apt to be fond of walking. Severe menlabor is sometimes preferable to bodily exercise, especially in tcase of hypochondriacs and onanists. This leads us to a consideration of psychical influences as a means of cure. Every physicianknows that the evil consequences of nocturnal emissions, and evento some extent, of self-abuse, are more imaginary than real, lumbers are made hypochondriacs by reading books that fill them withfear and trembling at the excesses they may have been guilty of \Spermatorrhcea. 19former days. Encouraging advice does them more good than medicine. Self-abuse is prevented much more certainly by comfortingencouragement than by picturing the consequences of such a crimein the most frightful colors. In dealing with sexual weakness, itis in the first place necessary to depress the fancy, and in theplace to strengthen the will. On this account, reading novels ishurtful, and cold-water treatment has such an excellent eflfect.We deem a special enumeration of the medicines, referring tothis subject, inappropriate; the multiplicity of the phenomenawould leave too many gaps. The symptoms being all confined toone set of organs, they can easily be compared with the symptomsin the Materia Medica. It is only because the chapter entitled" Male genital organs " is so replete with symptoms and remediesthat we furnish in the next paragraph a list of the remedies whospractical value has been verified by experience, and we classifyin accordance with the difl^erent divisions adopted for the symptof the disease.For excessive emissions, with increased irritability : CantharideNux voraica^ Camphora^ Phosphorus ; with diminished irritabilityConium maculatum^ Phosphori aeidum^ Clematis erecta^ Digitalis pupurea^ China.For spermatorrhcea: Phosphori acidurrij Calcarea carbonica^ Comum^ Cantharides. Among all these remedies Digitalis, and moreparticularly Digitalin^ has the best effect. A few doses of the ttrituration of this medicine are generally sufficient to effect aplete cure or at least a marked improvement. The medicine shouldbe given in the morning ; in the evening it is very apt to disturthe night's sleep. [Gelsemin^ given for a period of time, has curBpermatorrhoea. Stillingin is likewise an excellent remedy for bonocturnal emissions and spermatorrhoea. H. 7.]Irritable weakness requires besides the remedies mentionedfor spermatorrhcea and nocturnal emissions, the following medicinCaladium seguinuw^ Selenium^ Nitri axndum^ Agaricus rnuscarius^ aif the weakness borders on impotence, Agnus castus^ Cannabis,Baryta^ Capsicum annuum^ Lycopodium, Natrum muriaticum.Satyriasis requires particularly Cantharides and Phosphorus^ thelatter more particularly, if the affection is caused by disturbanof the central nervous system.The consequences of self-abuse are so varied that we cannot inthis place indicate all the remedies that may have to be employedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 26 of 653against them. Moreover we have made it a point to allude to this20Diseases of the Female Sexual Organs.vice in treating of the various functional derangements of the diferent organs. As far as the sexual organs and their functions arinvolved, we may have to resort to Phosphori acidum^ Nux vomica ^China^ Calcarea carbonica.Among the external agents that may prove useful in the treatment of these affections, cold water occupies the first rank. Insome forms of irritable weakness cold ablutions of the sexual orgor sitz-baths are sufficient ; but where the whole nervous systeminvolved, a rigorous and systematic water-cure treatment is prefeable ; it not only helps to invigorate the constitution, but liketo give exercise and tone to the mental energy, which is impairedby nothing more than by abuse of the sexual organs.B. DISEASES OF THE FEMALE SEXUAL ORGANS.1. Vaginitis, Catarrh of the Sexual Mucoius Uning.Fluor AlbuSj Leucorrhxa^ Whites.Catarrh of the female sexual organs may be distinguished assimple and virulent catarrh.The virulent catarrh or gonorrhoea of the female is caused, likegoncr.'hoea of the male, by contact with gonorrhoeal matter, andnever develops itself from an intensified simple catarrh. Simplecatarrh is one of the most common derangements of the female sex.It originates in a variety of causes. In the first place we havemention as exciting causes such as act directly upon the sexual ogans : excessive coition, self-abuse, miscarriage, and to some exconfinements which, if occurring in too rapid succession, almostalways cause leucorrhoea. Ascarides likewise cause catarrhal discharges from the vagina, by crawling from the anus into the lastnamed organ ; pessaries should likewise be mentioned. The maincauses, however, are not local, but have a constitutional originmenstrual disturbances, a sedentary mode of life, abuse of coffeechlorosis, scrofulosis, tuberculosis, and the various defects inhin our modern systems of education, which have already beenalluded to in the chapter on hysteria. A vaginal catarrh is scarcever owing to a mere cold, except perhaps at the time of the menses, at which period the tendency to this derangement is mostmarked. With reference to age, the trouble occurs most frequentlyVaginitis, Catarrh of the Sexual Mucous Lining. 21http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 27 of 653between the first commencement and the cessation of the menbtrualperiod-, it is likewise met with among children, and very oftenamong women who have ceased to menstruate, the less frequently,however, the longer the menses had ceased to make their api)earance. Tumors in the uterine cavity are accompanied by a tolerablyprofuse catarrh as a symptomatic appearance.We transcribe from Kafka the following concise description ofacute vaginal catarrh. The mucous lining of the vagina is attackeby an acute catarrhal inflammation, in which sometimes the labiamajora and minora and the entrance to the vajrina, and at othertimes the whole length of- the vagina, are involved. In bad casesthe inflammation may communicate itself to the cervix uteri, tothe internal cavity of the uterus or to the urethra.The mucous membrane is dark-red, swollen and interstitiallydistended ; the papillee are swollen and form numerous prominenceimparting to the mucous lining a granular appearance. The granulations are at times scattered, at other times confluent, at timoccupying isolated portions of the vagina, at other times the vagin its whole extent. The hypersemia induces a sub-mucous oedemawhich narrows the vaginal space. The secretion of mucus is veryscanty at first, or even entirely suppressed ; afterwards it becomore copious, of a yellow or yellowish-green color and opaque. Nounfrequently we find in the course of the inflammation superficianumerous erosions on the external and internal labia and at theentrance of the vagina.A benign acute catarrh of the vagina is most generally occasionedby local injuries affecting directly the mucous lining of the vagBuch as : excessive sexual intercourse, self-abuse, sudden exposuto the action of cold, foreign bodies in the vagina, such as badlfitting pessaries, or corrosive injections, or else the inflammatprocess in the vagina may simply be a continuation of a similarprocess in the uterus.The symptoms of acute vaginal catarrh are an itching in thevagina with which a burning sensation afterwards becomes associated. Walking, the introduction of the finger, of a speculum, asexual intercourse, are exceedingly painful. If the urethra is involved in the infiammation, the patients experience a violent desto urinate ; in such a case urination causes a burning distress ithe urethra. The yellow secretion stains the linen yellow ; if acit inflames and excoriates the parts adjoining the vulva, and ofteprt^ads a pungent and offensive odor.22 Diseases of the Female Sexual Organs.An examination with the speeulam would show whether thesecretion proceeds from the uterine cavity or the vagina ; but thintroduction of the speculum is not only very painful, but oftencauses hemorrhage.An acute vaginal catarrh lasts from eight days to a fortnight, orelse passes into the chronic form. The prognosis is generally favable.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 28 of 653We recently treated an acute vaginal catarrh in a girl of nineyears. It was caused by sitting on a cold stone. The vagina andvulva were much inflamed, and the purulent and yellow-greenishdischarge exceedingly profuse. The disease was radically cured inabout a week with the Q-erman tincture of Aconite and a few dosesof Iodine. H.]A simple acute catarrh is, upon the whole, a very rare disorder.Inasmuch as, with the exception of slight differences, it is idenas far as intensity is concerned, with the virulent form of catarwe confine our description of the disease to the latter.Female gonorrhoea commences with a feeling of heat and drynessin the vagina, attended with a peculiar titillation and sensitiveto contact. Soon after, the mucous membrane is seen injected, uriation becomes painful (which is never the case in simple catarrh)the external pudendum becomes swollen and inflamed, in consequence of which walking is impeded, and a muco-purulent discharge makes its appearance the same as in gonorrhoea of the maleonly more copious and generally of a bad odor. Some individuals,according as the disease is more or less intense, experience febrmotions, lassitude, depression of strength, drawing pains in thelumbar and sacral regions, dull pains in the pelvis, sensitivenescontact, difficulty of urinating. Upon the mucous membrane, aswell as in the neighborhood of the vagina, we often notice erosioand small flat ulcers. This inflammatory stage lasts, as in the cof the male, from eight days to a fortnight. As the pains abate,the discharge becomes thinner, more milky, and, in favorable caseabates little by little until it ceases entirely in a few weeks.commonly, however, the discharge continues for months, and incase the uterus is considerably involved, the gonorrhoea becomeschronic and exceedingly obstinate. The infectiousness of the discharge does not become extinct until it has lasted a long time.Chronic catarrh very generally arises from the acute form, butin most cases takes place \^'ithout any preliminary acute stage.scanty slimy secretion from the vagina occurs in most females,Vaginitis, Catarrh of the Sexual Mucous Lining. 23either as a constant discharge, or before or after menstruation,even a profuse discharge after several confinements still constita normal secretion ; at any rate the women themselves do not lookupon it as anything unnatural. It is only when the discharge isexcessive, or when it occurs in children, that we are justified iregarding it as a morbid phenomenon. Under the operation of oneof the above-named exciting causes the discharge continues to increase in quantity and to gradually disturb the constitutional eqlibrium. The discharge is at times of a glassy transparency, attimes milky, and less frequently purulent ; it may become so profuse that the patients may not be able to leave their room ; thestains on the linen are generally stiff and grayish, less frequenyellowish ; it often excoriates the external parts and the thighsthis is not owing to the quantity of the secretion, but to its quand perhaps to the sensitiveness of the skin. The discharge isscarcely ever uniformly the same; sometimes it has remissions andeven intermissions, is generally most copious before or after themenses, and frequently even takes their place entirely. If the uthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 29 of 653ine secretion is very tenacious, mucous plugs are easily depositein the cervical canal, and an increased accumulation of mucus takplace in the uterus which causes labor-like pains that cease allonce as soon as the mucus has been expelled. The anatomicalchanges accompanying this condition of things, consist in an intestitial pufiing and swelling of the mucous lining which may resuleven in polypous formations ; the follicles, known as the ovula Nbothi, are likewise altered, their orifices becoming closed by thcontinued secretion ; they are particularly seen at the cervix inshape of small, prominent, transparent vesicles. The ulcers areeither flat, catarrhal erosions, or else the suppurating follicletransformed into more deep-seated rounded ulcers. The erosionsnot unfrequently give rise to the granular ulcers of the cervix,ulcerated surface becoming uneven and very much disposed to bleedMore recently a degree of importance has been attached to thisulcerative process of which it is not possessed in reality. In evchronic catarrh, simular ulcerations take place without the catarbeino: on that account derived from the ulcers, or the constitutisymptoms from the ulcerative process generally. Why should thisbe done in a case of uterine catarrh ? It cannot be denied that tlast-named ulcers give rise to pain, especially during coition, athat they may even cause slight hemorrhages ; but it is questionable whether such accidents impair the general health as much as24 Diseases of the Female Sexual Organs.is supposed. It is much more natural to regard the general irritability and the nervous phenomena as simple consequences of thecatarrhal disease, and to derive the ulcers from the irritation pduced by the act of coition in individuals with a peculiar predisposition for such derangements. On hearing of so many physicianswho make female diseases a speciality and trot around with theirspecula, promising the afflicted a speedy cure, we cannot forbearsuspecting such vagabonds of impure designs. These ulcers of thecervix fare no better than many other modern discoveries in medicine ; at first everything is explain 3d by means of them, untilpeated disappointments satisfy us, that the discovery was no greathing after all.The consequences of catarrh to the general organism vary both inextent and in intensity. Many women who have been afflicted foryears with profuse leucorrhoea preserve an appearance of perfecthealth ; others, on the contrary, are very much affected even byinconsiderable discharge. One of the most common consequences,and, on the other hand, one of the most common causes, are menstrual irregularities, generally scanty menses. Moreover, an unusnervous irritability, backache, aching pains in the small of thehemicrania, hysteric spasms set in. The patient looks sick, withgrayish, dingy complexion and dark margins around the eyes. Ifthe discharge is very profuse, symptoms of aniemia make their appearance. The faculty of conception is not very much, influencedby uterine catarrh, otherwise women afflicted with it, would notconceive so readily. If the mucous lining is considerably puffedup, and the uterine canal closed by plugs of mucus, it is a matteof course that conception must be very much interfered with. Theworst thing that can happen to the patient is the shock to thenervous system caused by a co-existing titillation of the genitalorgans and a violent excitement of the sexual instinct.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 30 of 653Treatment. Whether an acute vaginal catarrh is virulent ornot, can be inferred from the symptoms with tolerable certainty.The non-virulent catarrh scarely ever affects the parts with muchintensity, but usually makes an inroad upon the constitutional webeing, and leaves the urethra unirritated ; at least no pus can bsqueezed out of its orifice.As in the male, so in the female gonorrhosa, Mercurius sduhilis ovivus is the first and most important remedy. The employment ofaconite in this disease, as recommended by Hartmann, simply involves a loss of time. Mercurius has all the symptoms of the inVaginitis, Catarrh of the Sexual Mucous Lining. 25flammatory stage: Itching, smarting and burning in the sexualorgans; increased sexual desire; inflammatory swelling of thevagina and external pudendum, with sensitiveness to contact;whitish, thick, purulent and greenish discharge, of an offensiveodor, causing erosions and ulcerations in the surrounding parts,with painful emission of urine ; tenesmus of the bladder and rectThese phenomena constitute a complete image of the gonorrhoea offemales, for which Mercurius will be found as efficient, a remedyas it is for gonorrhoea of the male.The symptoms which remain after the inflammation is removed,may require a variety of remedies. It is advisable to first findsuitable remedy among those that have been recommended forgonorrhoea of the male. Hepar svlphuris may be required, or elseNitH aeidum or Thuya. Nitri acidum is particularly suitable if thdischarge looks bad, is mixed with blood and has a bad odor;Thuya is more suitable if condylomata are present. For markedurinary difficulties Cannabis and Cantharides may be resorted to.If we are sure that an acute attack of vaginal catarrh is of thenon-virulent kind. Aconite, whatever Hartmann may say in favorof this drug, is scarcely ever required, at any rate much less frquently than Belladonna. As a rule Belladonna is preferable toAconite in all diseases of the mucous membrane ; in this instanceit is likewise more specifically indicated by the symptoms.Regarding -4r7U*ea, Hartmann has the following : "A conditioncharacterized by an increased sensation of warmth, fulness andtension in the internal pudendum, constant titillation, sometimeseven a burning sensation at urinating, slight fever, is sometimesmet with in the case of newly married people. It would be wrongto attribute these symptoms to infection ; they are caused by toogreat a narrowness of the vagina and by the contusion caused byintercourse, as is likewise made evident by the swelling and rednof the external labia, attended with an intense burning pain aturinating, and even retention of urine, owing to the inflammationand swelling of the urethra and of the internal organs. Arnicameets this condition. [Belladonna and even Aconite are often required to control the swelling and inflammation of the labia. H.]If the patient complains of a burning in the vagina and labia,with discharge of a thin, but acrid mucus from the genital organsconstant chilliness, disposition to lie down, sadness, depressionhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 31 of 653spirits, etc., Pulsatilla answers this condition better than anyremedy.26 Diseases of the Female Sexual Organs.Other remedies which are likewise adapted to the acute form ofcatarrh, will be indicated in the subsequent paragraph ; altogeththe transition from the acute to the chronic form of leucorrhoeascarcely noticeable. ^Chronic leucorrhoea is one of the most inveterate derangements,and is much more difficult to cure than an obstinate gleet, althothe use of local remedies is much more practicable in the formerthan in the latter. We merely mention the names of the remedies,since it is impracticable to enumerate the symptoms of each whichin order to effect a cure, will have to be compared with the utmocare with the pathological phenomena ; the large number of drugsbearing upon this aftection, renders the use of a good Repertoryindispensable. The most important and most frequently requiredremedies are : Calcarea carbonica^ Ferrum^ Graphites^ Lycopodium^Natrum imiriaticum^ China^ Sepia^ Kcdi carbonicum^ Mezereum^ Phosphorus^ Platina^ Sabina^ lodium^ Gonium^ Aluminn. "We will endeavor to classify these drugs in accordance with some of the mostimportant indications, referring the reader for more minute symptomatic particulars to the Materia Medica.The most important item to be considered is the appearance ofleucorrhoea at the beginning or during the course of the menses ;this point alone may furnish us a clue to the whole character ofthe discharge. For leucorrhoea previous to the menses the followiremedies are suitable : Calcarea carbonica, Sepia^ Phjosphorus^ Gphites^ Alumina^ Natrum muriaticum; for leucorrhoea setting in inthe place of the menses : Pulsatilla^ Sabina^ Zincum^ China^ Natrmuriaticum ; and subsequently to the menses : Bovista^ lodium^ Sudale. carLy Sepia j Graphites^ Lycopodium.In the case of chlorotic individuals, if fluor albus is the consequence, not the cause of the anaemia, we resort to : Ferrum^ PuisCole, carb.^ and Arsenicum ; if the ansemia is caused by the lossfluids involved in the leucorrhoeal discharge, Ghina^ Ferrum^ Lycpodium^ Natrum muriaticum^ Stannum are required. •The nervous phenomena attendant on the discharge, are mostgenerally found under Ignatia and Platina ; and if selfofthe causes, Zincum^ Nux vomica and Ignatia may be exhibited.In the case of patients of a somewhat advanced age, the followingremedies may be preferable : Kali carb.^ Natrum mur., Mezereum^Lycopodium^ Sepia.In dietetic respects all that is needful to do is to avoid everytthat has a tendency to excite or keep up the discharge; this is eMetritis, Inflammation of the Womb. 27ily neglected if the patient's whole mode of living is chargeablewith the disorder. In such a case marvellous cures are related frhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 32 of 653a visit to these or those springs, whereas a little common sensemight teach that the same results can be obtained with much lesstrouble and expense by pursuing a regular course of proper diet ageneral hygiene at home. It is not our object to single out and rcommend in this place certain springs that are really of use in taffection; all we have to say is, that salt-water bathing is somea sovereign remedy for the most obstinate uterine catarrh, agreeato the indications furnished by the physiological experiments instuted with common salt.Injections of water by means of a good vaginal syringe keep theparts clean and free from soreness and ulcerations ; otherwise thhave no curative effect. But we should not pedantically insist upcold water being used under all circumstances and by everybody;tepid water sometimes has a much more certain palliative effect,ft. Metritis.Inflammation of the Womb.This inflammation may involve the internal lining as well as thesubstance and the external serous coat of the uterus. If the mucous lining alone is invaded, we have the picture of an acute utecatarrh which, however, almost always accompanies both the otherforms, parenchymatous and peri-metritis.The common causes of metritis are, like those of acute catarrh,deleterious influences acting directly upon the uterus, more espeally excessive coition, obstetrical operations or foreign bodiescavity of the uterus; or the causes may be more general, such ascold, or violent emotions ; these influences affect the uterus somore readily at a period when the organ is in a state of congestifor instance at the time of the menses. If the menses suddenlycease at the commencement of inflammation, we have no right toconclude that this suppression is the cause instead of the consequence of the inflammation. Chronic metritis generally arises frothe acute form, or is occasioned by causes similar to those in wha chronic catarrh of the sexual mucous membrane originates.SyfnptomH aiid Course. The disease usually commenceswith a chill which is at once followed by pains in the diseased ogan. If the parenchyma is alone affected, the pains are not veryviolent, aching, boring, throbbing, stitching or lancing, they ar28 Diseases of the Female Sexual Organs.seated deep in the pelvis, are accompanied by a most painful presing downwards resembling feeble labor-pains; they are increased bpressing upon the abdomen, by very active respiratory movements,urging at stool, and erect posture, and they radiate to the smallthe back and thighs. If the serous covering is likewise involved,the pains become more acute, the sensitiveness to contact is greaand extends over a larger surface. The volume of the uterus notbeing sufficiently increased, it cannot be felt through the abdominteguments ; on exploration the uterus is found to be more sensitive, and the cervical portion is softer, more swollen and shortethan in the normal condition. The constitutional symptoms are ofdifferent degrees of intensity. Fever is never entirely absent, bhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 33 of 653is not generally very violent ; the pulse is generally small andhard. The stomach sympathizes most readily in this disease ; lossof appetite, coated tongue, nausea, retching and vomiting are vercommon. The bowels are constipated, the passage of the faeces isattended with tenesmus, urination is impeded and sometimes quiteimpossible. K the disease breaks out during the menses, they ceasimmediately and in their place a discharge sets in as in acute caof the uterus. K the menstrual period happens within the courseof the disease, the menses either remain suspended, or else the fof blood is more copious, sometimes even amounting to an actualhemorrhage. In the further course of the disease the dischargefrom the uterus is apt to become purulent, and if, which is a raroccurrence, abscesses form within the substance of the uterus, clpus is discharged. The disease runs an acute course of about a fonight, when, if no particular complications exist, convalescenceplace; which, however, is frequently incomplete, inasmuch as eithleucorrhoea or swelling of the uterus is apt to remain behind.Among the most important complications we number an inflammation of the peritonaeum which is apt to occur and by which thecourse of the disease is very much protracted and the metritis itself is very much aggravated. In such a case the inflammation assumes the form of diffuse peritonitis, with a very dubious prognoIn a case of this kind, the patient being a robust young woman, npregnant and the attack having occurred between the menstrualperiods, a copious discharge of thin pus from the vagina took plaabout the tenth day, so that it was scarcely possible to keep a scient supply of clean cloths under her. This was of course followby extreme weakness owing to which her recovery was very muchMetritis, Inflammation of the Womb. 29delayed. Previous to this discharge nothing of any sort hadpassed her.Metritis of pregnant females can scarcely ever be recognized withperfect certainty unless the enveloping membrane of the uterus anthe fieritonffium generally become involved. It may be supposed texist if febrile motions, vomiting or retching, meteorism, painfuness of the gravid uterus whether touched or not, set in. Duringthe first months the inflammation extends over the whole organ ;afterwards it becomes localized, and the painful sensitiveness iswise more circumscribed and confined to a definite locality. It ionly exceptionally, that the course of pregnancy is aflfected unfably by the inflammation, and if the latter is vary intense. If mtritis occurs during the period of parturition, labor becomes unuually painful ; and, if abscesses should form, rupture of the utemay easily take place. After confinement metritis generally takesthe form of puerperal metritis, of which we shall treat in the nechapter.Chronic metritis is upon the whole a somewhat obscure condition.It generally remains as a consequence of acute metritis, but maylikewise develop itself spontaneously under the operation of thevarious causes that may give rise to chronic catarrh of the uteru"We discover a more or less considerable general or total swellinof the uterus; enlargement, interstitial distention, hardness andulceration of the vaginal j)ortion, obstinate leucorrhoea, The pahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 34 of 653ordinarily are trifling, consisting of a sensation of pressure anheaviness in the pelvis. During and previous to menstruation thepains increase to such a degree of intensity that they seem likegenuine uterine colic. In higher grades of the disease the mensesbecome entirely suppressed, except that about the period for theiappearance violent pains set in, as if the flow would really takeplace. The constitutional equilibrium is more or less disturbed,so-called hysteric nervous affections almost always make their appearance. If the swelling is considerable, the passage of the feeand urine is very much interfered with, likewise the circulationthe left or right lower extremity. The faculty to conceive is vermuch impaired by both the acute and chronic form of metritis,although the possibility of conception cannot altogether be denieTretitment* We transcribe a few passages from Hartmann'swork: "Having had many opportunities of treating this kind ofinflammation I recommend as a chief and frequently applicableremedy Nux vomica^ which I found useful in the district where I80 Diseases of the Female Sexual Organs.happened to be located, for the additional reason that the womenin my district were in the habit of indulging in the excessive usof coflfee. Other homoeopathic physicians have tested the efficacof Nux in these inflammations. The selection of a drug, however,neither depends upon the seat of the inflammation, nor upon thefact whether the uterus is impregnated or not, or whether the inflammation occurs during pregnancy or confinement. If the medicine was otherwise homoeopathic to the symptoms, I have cured inflammation of the fundus, cervix, anterior or posterior surface othe uterus, with a single dose of Nux. In some cases where thefever was accompanied by a severe chill, followed by intense heatfrequent and tense pulse and violent thirst, I found it necessarybegin the treatment with a few doses of Aconite, Nux vomica isindicated by the following characteristic symptoms: acute pressinpains above the pubic bones, increased by external pressure and aexploration of the internal parts; violent pains in the loins andsmall of the back; constipation or hard stools attended with burning-stinging pains ; painful urination or retention of urine ; stand bruising pain of the abdomen during motion or when coughingand sneezing; increased temperature and swelling of the os tineaswith simultaneous painfulness of the vagina ; exacerbations in thmorning-hours." "We doubt the correctness of these statements.The symptoms of Aconite do ' not point to metritis as an homoeopathic remedy for this inflammation; not even the accompanyingjfever is sufficiently intense to justify the use of Aconite. Ifwe believe that metritis can be cured with a single dose of Nux;at any rate we should not expect, nor do we deem it possible to ca metritis short.** An equally indispensable remedy in these inflammations is Belladonna^ more particularly, if the sensation of heaviness and draging in the abdomen, which frequently increases to a painful beardown, becomes very troublesome and is attended with a stingingburning pain above the pubic bones, pains in the small of the bacas if it would break, stinging pains in the hip-joints which cannbear either motion or contact, (under certain circumstances Chinamay here be indicated after Aconite.) If the inflammation sets inhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 35 of 653after confinement, the lochial secretion is arrested, the placentheres, or is discharged in the shape of an ichorous, fetid liquidviolent burning and a sensation of fulness in the vagina, the employment of Belladonna is called for so much more pressingly."We refrain from commenting upon the last passage, for we holdMetritis, Inflammation of the Womb. 81that if sucli phenomena occur while the placenta remains adheringto the uterus, we have a strictly puerperal disease before us, whdoes not belong in this chapter. Without doubt Belladonna iseminently suitable in cases of violent metritis, and is even prefable to Nux, more especially if the menses were arrested during tcourse of the inflammation. Nor have we a better remedy formetrorrhagia setting in at the time of the menses."A similar affection occasioned by a violent fit of chagrin, especially after confinement, yields most speedily and surely to a sidose of ChamomUla. In such a case the lochial secretion is generamore profuse, and, if it was already white, it again changes to adischarge of quantities of blackish, coagulated blood. Not unfrequently we see metritis set in after the inordinate use of Chamomile-tea, which unreasonable midwives will allow their patients iconfinement in spite of all the warnings of physicians. In suchcases Nuzj Ignatia^ Pulsatilla^ each according to the symptoms ofthe disease, will be found to be the best antidotes. We here refeto what we have said above concerning the one dose of Nux ; moreover we doubt the value of Chamomilla as a remedy in metritis.Mercurius deserves the same encomiums in this disease as inuterine catarrh. It is indicated by violent febrile heat interrupby chills; inclination to abundant perspiration; violent thirst;purulent discharge from the vagina; diarrhoeic discharge withtenesmus. These are symptoms denoting the formation of pus.Knowing as we do that this is apt to set in in the impregnateduterus, Mercurius had better be prescribed first, when the uteruspartially inflamed.Sabina may be given if the menses set in in the form of hemorrhage during the course of the inflammation, attended with laborlike pains that spread to the thighs. This remedy will likewise bfound applicable in other forms of metritis ; we are led to thisclusion because Sabina which is so often employed as a means ofproducing abortion, is apt to cause inflammatory conditions of thuterus.Other suitable remedies will be found in the next chapter onpuerperal fever ; or for the remaining traces of metritis we refereader to the remedies recommended for catarrh of the genitalmucous lining ; or finally, in case the peritoneum should be inteaflFected, the remedies for peritonitis may be consulted. It is awell to watch convalescent patients for a time lest chronic metrishould remain behind.S2 Diseases of the Female Sexual Organs.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 36 of 653For this disease we do not possess any Similia in the rigoroussense of the term; our provings have not as yot disclosed suchpathogenetic virtues in our drugs as can be considered homoeopathto the pathological symptoms. Hence we shall have to select ourremedies in accordance with accessory symptoms. A most importantsymptom is the discharge from the vagina, and next to this thecharacter of the menstrual functions. The most noteworthy remedies in this direction have already been mentioned in the previouchapter. They are : Sepia^ Platina^ Lycopodium, Graphites^ Coniummaculatum^ Arsenicum alburn^ Natrum muriaticum^ and finally Sidphur. Sulphur is especially appropriate if the chronic disease haremained after an acute attack, in which case it is superior to aother remedy.[In bad cases of endometritis Kafka proposes Kreosotum andSecale cornutum. He writes: "If the lochia have a dirtycolorand a fetid odor, and ulcers have broken out on the externapudendum, the question is to check the further spread of the diphtheritic process as soon as possible. At the commencement of thisdisease we resort to Kreosotum 1. in solution every two hours ; athe same time we order injections into the vagina and uterus, usifor this purpose lukewarm water to which from 10 to 15 drops ofKreosote are added. The injections have to be repeated every threor four hours. The diphtheritic exudation soon becomes detachedand the lochia and ulcers of the vagina assume a healthier appearance.In very bad cases of this kind, if the diphtheritic process in thuterus has spread over a large surface, the lochia have a cadaversmell, and the injections bring away whole quantities of disorgangangrened cellular tissue ; if at the same time the patients aremuch prostrated and become ansemic, and the ulcers on the pudendum assume a gangrened appearance, we prescribe Secale cornutum1, in order to induce more powerful contractions and to bring abothe detachment and expulsion of the necrosed cellular tissue. Wewill relate a striking case of this kind from our former practiceIn a case of septic metritis setting in in consequence of a verytedious labor that lasted over 72 hours, the above-described phenmena were all present ; the patient grew weaker from hour to hourshe ceased to answer questions and was pale as death ; yet she haher senses ; the extremities were cool, and the hydrsemia which halready set in, had given rise to oedema round the ankle ; a gangrenous ulcer in the vagina had already destroyed a considerableMetritis, Inflammation of the Womb* 88portion of the nymphse. Without being acquainted with the physiological cflFects of Secale, we proposed the external and interuse of this drug. We gave five grains of the powder every twohours, and ordered injections into the uterus every two hours, ofdecoction of the same substance of the strength of one drachm ofthe powder to on« pound of water. After the sixth powder andthe sixth injection violent labor-like pains set in which broughtaway a black, excessively fetid coagulum that had filled the caviof the uterus and consisted of decaying detritus. The patient whoin the mean while had fainted as if dead, was washed with wineand, after her consciousness had been restored by the inhalationsome diffusible stimulant, she partook of small quantities of Malhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 37 of 653The patient was saved. A good diet gradually restored her strengtand her recovery was soon obtained.Since we have become acquainted with the effects of small doses,we prescribe in the higher grades of endometritis, if the above dscribed phenomena are present, Secale cornutum 1, in solution evehour or two hours, and, by this means, accomplish the same purpose, with this difference, that no such tumultuous reaction takeplace in the uterus, that the contractions lake place slowly withany pain worth mentioning, and that the exudation is not detachedall at once, but gradually. Ergotin 1, has given us the same favoable results.In desperate cases Sabina 1, may be given internally and externally. If during the course of septic endometritis the symptomsof puerperal fever supervene (for a description see next chapter)give Camphora 1, one or two drops on sugar of milk every twohours, at the same time ordering injections of Camphor into theuterus in the proportion of one drachm of the spirits of Camphorto one pound of water, for the purpose of rousing the sinkingvitality of the uterine capillaries and of the general organism,by quickening the movements of the stagnant blood-corpuscles, increasing the chances of a favorable reaction. This result, howeveis a very rare one. However, if we succeed, we then discontinuethe Camphor, and resort to Kreosote in order to keep up the incipimprovement.In order to neutralize the bad effects of the fetid odor of thelochia we resort to the use of disinfectants, such as the ChloridLime, fumigations with vinegar, etc.Parenchymatous metritis and metrophlebitis set in with frequently-recurring chills. These chills are more especially ominou384 Diseases of the Female Sexual Organs.if symptoms of puerperal fever are at the same time present. Insuch cases, which are generally of the worst kind, we at once givCkinin. 1, every two hours. The intention is to prevent the rapidfailing of strength, and at the same time to exert a favorable inence upon the fluids.If this remedy does not cause a satisfactory improvement, weresort to Chininum arsenicosum 1, for the same purpose, more particularly if the chills are attended with rapid sinking of strengand the integuments at the same time show a remiirkable degree ofpallor. H.]3. Metritis pnerperalis.Puerperal Fever ^ Inflammation of the Uterus during ConfinemOur excuse for bringing together in this chapter several morbidconditions that ought to have been separated according to the exigencies of a rigorous pathological classification, is a desire toour remarks on the subject of treatment. Consequently we shallhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 38 of 653discuss in this chapter not only the simple puerperal inflammatioof the tissues of the uterus, but likewise puerperal fever properspeaking, and shall, as far as possible, explain the differencesthese two diseases in the paragraph on the etiological causes.Simple puerperal metritis involves, it is true, most frequently tinternal lining of the uterus (endometritis), but usually likewisextends to the parenchyma, the veins and lymphatic vessels, andvery frequently to the peritonseum, although no specific etiologicause can be assigned for each of these different localizations.rhe disease originates more especially in the circumstances underwhich the act of parturition takes place. The inner lining of theuterus is very easily injured by the process of labor ; the placethe placenta adheres, is like an open sore ; the uterine involutieven in perfectly normal conditions, is attended with signs of loinflammatory action and a general febrile excitement. Hence, evenif the process of parturition takes place ever so normally, we hato carefully weigh every circumstance which the most trifling caumight kindle into an inflammatory affection. If, in addition tothis, we. have the effects of a tedious labor, perhaps an operatidetachment of the placenta, turning, etc., the uterus is so muchmore disposed to become inflamed, and the access of atmosphericair which cannot be kept out, increases this disposition by favorthe decomposition of the uterine secretion. This accounts for theMetritis Puerperalis. 85ease with which trifling causes sometimes exert the most nnfavorable influence upon women in confinement. Among these we placein the front rank emotions whether joyful or depressing ; excessiwarmth of the sick-room and bed-covering, with which a want ofcleanlinees almost always goes hand in hand ; stimulating beveragsuch as chamomile-tea and coftee ; and finally a cold, which, however, occurs much less frequently than is generally supposed, todetriment of lying-in women who are not only deprived of fresh aibut, being kept too warm, are made to perspire, and thus becomesensitive to the least exposure.True puerperal fever, under circumstances of which mention willbe made by and by, develops itself from the uterine infiammation,or else it originates without any such special cause. Various hyptheses have been resorted to in order to explain this perniciousmalady, but all these hypotheses are still unproven. What is certain is that the composition of the blood is altered, that exudattake place with a most decided tendency to suppuration, and thata general dissolution of the blood, as in typhus, is apt to occurseems as though this decomposition of the blood were not depending upon the puerperal condition, but may have existed alreadyprevious to confinement, which is inferred from the circumstancethat fever and various local symptoms are already perceived durinthe last few days or even weeks of pregnancy. That the composition of the blood is altered, is moreover evidenced by the circumstance that only such women are attacked as are constitutionallysickly or are exposed to want and oppressed with care and anxietyIf, as Scanzoni asserts, pulmonary tuberculosis is a protection apuerperal fever, the doctrine of dyscrasias would seem to be confirmed by such a fact.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 39 of 653Puerperal fever sets in under the operation of the same causesthat have been indicated for simple metritis ; two weighty circumstances, hoisvever, have yet to be added. One is the epidemic appearance of the disease, which shows that general atmospheric ortelluric influences are at work in producing the disease, and itseem as though stormy and damp cold weather exerted the greatestinfluence as an exciting cause ; and the other circumstance is thcommunication of the disease by infection. In this respect opinioalthough not by any means agreed, incline to the theory that thedisease is not communicated by a contagium, but, like cholera, bymiasmatic agencies. We do not deem it expedient to discuss thismatter more fully in this place. A number of cases in lying86 Diseases of the Female Sexual Organs.hospitals nndoubtedly originate in this source, although there arexceptions.Si/inptoms and Course. In order to intelligently appreciatethe phenomena characterizing the morbid process of which we arespeaking, it is well to familiarize one's mind with the anatomicachanges that this morbid process develops. The disease alwayscommences in the first days after confinement, at a period when tuterus has not yet completed the process of involution. This retuto a normal condition is checked by the inflammation, on whichaccount the uterus remains larger than in its normal condition, iwalls are soft and flabby. The interstices of the internal liningsometimes puffed up only in part, and covered with a purulentsecretion ; and at other times they are covered with a croupous,membranous exudation, more especially round the portion wherethe placenta was attached. All such exudations incline very stronto gangrenous disorganization, in which case the mucous membraneis transformed into a fetid, dark-colored pulp. The uterine parenchyma scarcely ever remains uninvaded ; sometimes, however, itsinner layer only is interstitially distended and infiltrated. Ifinflammatory process spreads, exudation takes place here and therin the muscular layer, with abscesses or ichorous deposits, the vbecome involved in the inflammation, and likewise the lymphaticvessels, after which a more or less considerable peritoneal exudais scarcely ever absent. In xjonsequence of a further spread of tinflammation of the veins and lymphatic vessels, the femoral vessnot unfrequently become inflamed and closed up, giving rise to thso-called phlegn:asia alba dolens ; or else metastatic abscessesinate in consequence of the inflammation communicating itself toremote parts.Simple puerperal metritis rarely commences before the second,and equally rarely after the eighth day of confinement, almost always with a severe chill followed by burning heat. At the sametime or very soon after, the uterus becomes painful, with or without pressure, and very soon shows a decrease of resisting power.Generally the lochial discharge ceases as soon as the inflammatiosets in. One of the most common symptoms at the very outset isa violent, painful vomiting and retching, and more or less frequediarrhoeic discharges with tenesmus. The fever is very intense; tpulse, if vomiting is present, is at first empty, but seldom lessone hundred, and afterwards full and hard. The patients are torhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 40 of 653mented by a desire for cold water, their features are collapsed fMetritis Puerperalis. 87the commencement of the attack, and, if the vomiting is severe, aexpression of despair is depicted in their countenances. Two orthree days after the breaking out of the disease, flat ulcers areally seen on the external pudendum, which are covered with pusor a croupous exudation. If the disease runs a favorable course,and if no complications develop themselves, it may gradually termnate in recovery in one or two weeks, with a return of the lochiaa decrease of the local pains, and a resumption, on the part of tskin, of its normal functions. The last-mentioned change is frequently attended with the breaking out of a rash and profuse perspiration.But if decomposition of the inflammatory products in the uterustakes place, we are led to suspect the occurrence of such a changby the supervention of severe rigors followed by heat, the pulsecomes more frequent and smaller, and collapse sometimes takesplace with extraordinary rapidity. The vagina now discharges afetid, dark, ichorous fluid, mixed with exudation-shreds, and theulcers on the pudendum assume a suspicious look and become gangrened. At the same time the local pain may disappear entirely,at least it scarcely ever increases in intensity ; a profuse, coltive diarrhoea now breaks out, nor are complications in other orgwanting, such as a copious exudation in the peritoneal cavity.With this series of phenomena simple metritis, under the operatioof the causes described in the paragraph on etiology, passes intotrue puerperal fever, that is, a general decomposition of the blotakes place very speedily. The pulse now becomes very small andfrequent, all pain disappears, the features collapse, assume a caverous appearance, the skin is burning hot and very dry, the tonglooks as in the most violent form of typhus. The diarrhoea becomefoul, bloody or dysenteric, and the vomiting sometimes reappears.Very bad symptoms are a vomiting of the color of verdigris, and aintense meteorism. The secretion from the vagina is either entirearrested, or else exceedingly ichorous and decomposed. Gangrenouserysii)elas of the integuments is a very common attendant on thisdreadful disease.In cases where this putrescence of the uterus sets in as a primaraflfection, not as the result of a process of decomposition in thcourse of simple metritis, the signs of an intense constitutionalease are generally manifest already previous to the period of conment, although the indications may be so vague that it is not always easy to interpret them correctly. The patients have a sickly88 Diseases of the Female Sexual Organs.cachectic appearance, complain of a feeling of languor, frequentshiverings, without much heat. Labor is tedious, the pains are ditressing and feeble, the child is often still-born, the exhaustiolabor out of all proportion, the uterus is sensitive to pressure.after such preliminary symptoms a violent chill and other symptonis of metritis set in suddenly two or three days after confinehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 41 of 653ment, a malignant puerperal fever may be confidently expected,which most commonly terminates in death after a very short periodof time.Phlegmasia alba dolens is one of the most striking and most frequent metastatic inflammations occurring duiing the course of metritis. It is occasioned by the inflammation of one or more of thlarger femoral veins. Amid severe pain, sometimes high up in thelimb, sometimes in the knee or leg, the limb swells very rapidlyfrom above downwards, frequently to an enormous size. The swelling is white, shining, painful, elastic in the lower grades of thease, and at a later stage retaining, like oedema, the imprint offinger. The motion of the limb is either rendered difficult or impossible. If the superficial veins are inflamed, they appear downthe limb like bright-red, painful streaks of great hardness. Thetermination is either in recovery by a return of the circulation,in suppuration of the surrounding cellular tissue and other softparts, whereby life is greatly endangered.In severe attacks of puerperal metritis, the prognosis is alwaysrather unfavorable. Although simple endometritis is of itself aless threatening disease, yet accidental unavoidable circumstancemay transform it at any time into a putrid inflammation, or maycause a fatal termination by an invasion of the peritoneum. Truepuerperal fever is undoubtedly one of the most fatal diseases witwhich we are acquainted.OPreatment.Aconitum is indicated at the commencement of metritis not somuch by the local as by the general constitutional symptoms.*' Belladonna 30 is indicated by the following symptoms: Disappearance of the milk from the breasts, or suspension of the milkysecretion with cord-like indurations; redness radiating towards ofocus, with stitching and tearing pains in the breasts. Short, oppressed breathing; anxiety with oppression; distressing drawing,lancing, labor-like pains deep in the abdomen, with painful presstowards the sexual organs and the anus, and constant urging toBtool which cannot be gratified on account of a contracting spasmMetritis Puerpcralis. 89in the recinm (for which Belladonna is almost a specific); dischaof a coagulated, fetid, black blood, or suppression of the lochiacharge ; meteorism of the abdomen, without eructations or emissioof flatulence, attended with stinging-digging pains in the abdomeaggravated by contact and accompanied by a continual invitationto hack ; b'urning heat of the whole body, especially on the foreand in the palms of the hands, with perspiration on other parts othe body, and violent, sometimes only moderate thirst, and occasional difficulty in swallowing; violent pressing headache, especally in the forehead; turgescence of the veins of the head and cojunctiva, with contraction or dilatation of the pupils, which impto the eyes a glassy appearance; not unfrequently optical illusioare present, such as sparks, luminous vibrations; photopsia, evenamaurosis; headache rendered intolerable by motion and noise andalso by moving the eyes, the patient sometimes loses his senses ahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 42 of 653becomes furiously delirious; sleep is generally restless, not refing. If constipation is present it will disappear, after the useBelladonna, together with the pains in the abdomen. Generallyspeaking. Belladonna deserves particular attention if a puerperalfever assumes the character of typhus, if symptoms of meningitisor encephalitis become apparent, and the affection originates inviolent paroxysm of emotional excitement." This complex of symptoms does not clearly inform us in what particular case BelladonnIB really indicated. We make this remark in order to show howimpracticable such a vast enumeration of all the symptoms of a dris in the treatment of a disease whose symptomatic manifestationsare so exceedingly varied. Hartmaim has omitted the importantsymptom of spasmodic vomiting with which an attack of metritisis so apt to set in. In our opinion Belladonna should be given ifpuerperal metritis sets in with great violence and an intense fevfor symptomatic particulars we refer the reader to our MateriaMedica. An important indication for Belladonna is the meteorismwhich may set in even if no marked symptoms of peritonitis are observed. If peritonitis is present, our chief attention should bedirected towards it. As soon as symptoms of suppuration in theuterus, or of decomposition of the exudation become manifest, othremedies will have to be resorted to.As regards Chamomilla and Pulsatilla, we do not, as Ilartmanndoes, regard them as remedies for puerperal metritis ; if eitherthese remedies is supposed to have cured metritis, all we have toBay is that no metritis was present.40 Diseases of the Female Sexual Organs." Nux vomica will frequently be found curative, for the additionareason that coftee which is made use of by women in confinementin such large quantities and so strong, often occasions the disea(Nux is likewise suitable, if the disease is caused by abuse of Cmomile-tea, provided, however, that the symptoms indicate thisremedy.) The prejudice which is even entertained by people of cultivation, that coffee facilitates the secretion of milk, or evenmilk, cannot be removed by anything physicians may say to thecontrary. If some of the following symptoms are present, the seletion is no longer doubtful : Acute pains in the small of the backloins ; stinging and bruising pain of the abdomen during motion ocontact, or when coughing or sneezing; bitter taste and eructationausea, even vomiting; dryness of the lips and tongue, slimy ordirty-yellow coating on the tongue ; sensation of weight and burning heat in the sexual organs ; suppression of the lochia ; consttion or hard stool, with burning-stinging pains in the rectum; paful urination or retention of urine; dry, parchment-like, burninghot skin, with thirst, desire for cold drinks, full and hard pulsanxiety and oppression reflected in the countenance, constant reslessness ; the secretion of milk is very seldom suspended, rathercreased, causing a turgescence of the breasts, with pressure andsion in the same." We will add that Nux has aflforded aid in theless violent and uncomplicated forms of endometritis, but never ithe more intense forms of this disease. A characteristic symptomfor Nux is the violent inflammatory pain of the swollen veins ofthe rectum, with exquisite sensitiveness to contact." Colocynthis is an important remedy in these fevers when causedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 43 of 653by a fit of indignation or mortification on account of unworthytreatment, beginning and progressing with fainting-fits, attendedwith a febrile heat, hot and dry skin, hard, full and quick pulsesopor alternating with delirium, during which the eyes are keptopen; disposition to escape, heat about the head, stinging in theeyes and forehead, dark-red face, yellowish coating on the tonguebitter taste in the mouth and of everything the patient eats, coland diarrhoea after partaking of the least nourishment, and painthe pit of the stomach when touching this part." These symptomsare not the most characteristic indications for Colocynthis. If tperitoneum is more especially attacked ; if the coat of the uteruis invaded by the infiammation, or if, during the paroxysms of vilent pain, the complexion shows the pallor of death, the featuresbecome distorted, the skin is in part cool, and in part burningMetritis Puerperalis. 41the pulse is quick and there is distressing vomiting with diarrhoColocynth would be much more appropriate. We request thereader to compare what we have said when treating of peritonitis,Veratrum album deserves a preference at the outset of the attack,if the disease sets in suddenly and with great violence; there isfierce vomiting and frequent diarrhoeic stools, the trunk is hot,while the extremities are icy-cold, the face is pale as death andcovered with cold sweat , a particular indication is the presencedelirium from the commencement, attended with an unspeakableanguish. In this respect Veratrum is very similar to Colocynth,and is particularly adapted to attacks that set in with the mosttense vehemence.These remedies, to which we will add Coffta cruda^ Arnica andHyoscyamus for the sake of completeness, are particularly suitedthe lighter grades of metritis, and at the commencement of theseverer forms of the disease. "We now proceed to point out theremedies that have to be resorted to in the further course of thiinflammation and for ensuing complications.Mercurius vivus and solubilis. Simple endometritis is altogethersame process as acute catarrh of the uterus, modified by puerperainfluences. These modifications, however, being no less adapted tthe action of Mercurius than simple catarrh, the similarity of thremedy is not interfered with. The period for its employment isthe appearance of ulcers on the pudendum, hence on the second dayof the diseafie. Without describing the general symptoms whichmanifest themselves as accompaniments of this stage, we will direthe reader's attention to one general indication. As long as theudation in the uterus or peritoneal cavity does not show any dispsition to putrid decomposition, and as long as a simple suppuratiprocess prevails, Mercurius is the appropriate remedy. The condition of the ulcers is the best criterium by which the propriety ousing Mercurius can be determined: as long as these ulcers presertheir healthy color, and do not become ichorous or gangrenous,Mercurius may be given, no matter whether the fever is high oronly slight.Bryonia alba, according to Hartmann, is indicated by a feeling ofemptiness in the breasts, a copious secretion of urine, no supprehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 44 of 653of the lochia, (on the contrary, a re-appearance of a bloody lochdischarge,) no pain in the rectum at stool, sensitiveness of therus, violent fever, with great restlessness and depression of spipaiufulness of the thigh when moving it. In our opinion these in42 Diseases of the Female Sexual Organs,dications are exceekiingly uncertain and insufficient. We consideBryonia indicated, if the fever is not very violent, the peritoneis involved in the inflammation, if no decomposition threatens anno ulcei*a have formed; disposition to sweat, breaking out here athere, but lasting only for a few moments; general languor and inclination to lie quiet; the digestive organs are very much involvin the attack, but there is no vomiting or diarrhcea; meteorism.Compare peritonitis.Rhus toxicodendron is, in some respects, similar to Bryonia. It iparticularly appropriate if simple metritis assumes a typhoid forwithout any symptoms of decomposition being present. The typhoid character may be manifest from the very commencement, butas a rule it does not set in until the disease has fairly enteredits course. The fever is continuous, with a burning heat and dryness of the skin, quick and excited pulse; the sentient sphere ismuch irritated ; the patients complain of violent headache, feeland as if overwhelmed with sleep, or they are more or less delirithe face is intensely red, but the color seems unnatural ; the tois dry and the thirst excessive. These symptoms may cause us tosuspect the approach of puerperal fever. Rhus is likewise suitablif this fever sets in at the outset, or supervenes gradually in tcourse of puerperal metritis. In such a case Rhus is more especially indicated by two circumstances: first by the appearance of mtastatic inflammations of the veins, lymphatic vessels or skin, wa malignant erysipelas or petechise are apt to break out ; and seondly, diarrhoea is very apt to suggest Rhus. If the decompositiois very far advanced, the ulcers are gangrenous, the discharge fr.the vagina has a fetid odor, the following remedies will be founmore suitable. When giving Rhus, we have to see that the reaction is not prostrated and the fever is not completely adynamic.Secale cornutum. No remedy in our whole Materia Medica showssuch a powerful tendency to decomposition of the blood as thisdrug ; nor is any drug possessed of a more intimate and more characteristic relation to the uterus. Hence it is the true puerperalfever, the putrescence of the uterus which invites the exhibitionthis drug ; it is indicated by the following symptoms: The abdomeis distended and not very painful ; the discharge from the vaginabrownish and fetid, the ulcers on the pudendum have a^bad colorand spread rapidly ; the fever consists in a violent burning heatmingled with almost convulsive shiverings, and with a small, almointermittent pulse ; at the same time we notice great anxiety, paMetritis Puerperalis. 48In the pit of the stomach, vomiting of a bad-looking Bubstanee,fetid and decomposed diarrhoeic stools, almost complete suppressiof urine. The skin has a bad appearance, is covered with petechirhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 45 of 653or miliaria, or badly-colored local inflammations become maniftjswhich very speedily terminate in gangrenous disorganization of thinteguments. At times the patients lie in a state of quiet, withbland delirium, and then again the delirium may be of the furiouskind, attended with miarked anxiety and a desire to leave the bedArsenicum album. Hartmann has the following remarks on thisdrug : " The disease may break out in any form whatever, yet itmay exhibit symptoms that may require Arsenic. Such symptomsare: Burning or burning-corrosive pains in the interior of theaffected part, with inability to lie on the affected part, anddecrease of the pains during motion. Again: excessive anguishattended with a general, rapid prostration of strength, excessive debility, sunken eyes, extinct look, sallow, livid complexion, sleeplessness at night, restless tossing about, and a sensation as if a burning-hot water were flowing through the veins ;or the sleep is disturbed by frightful and anxious dreams. TheArsenic-fever is always of a violent kind ; dry and burning heat,intense thirst which is quenched by frequently drinking small quatities of water ; dry and cracked lips, phlyctsena around the mounausea, loathing of food, and sometimes bilious vomiting, withviolent pressing-burning pains in the abdominal viscera, meteorisoppressive pains in the chest, dizziness and l^adache, restlessnedelirium, a small, feeble, intermittent pulse, etc." This picturenot reflect every characteristic feature of the Arsenicpuerperalfever. The position of Arsenic in this disease is bestlearned by comparing this remedy with Secale. Both show undoubted symptoms of decomposition of the blood ; but in the caseof Arsenic the reaction is violent, painful, still active, whereathe case of Secale it is almost extinct. Hence, if both remediesindicated by the symptoms, we may say that the prevalence ofsevere pain would point to Arsenic. This diagnostic distinction iparticularly applicable to existing ulcers and erysipelatous inflmations to which Arsenic is homoeopathic if they are painful, andSecale if they are painless and atonic. For further points of comparison we refer to the Materia Medica.Phosphorus deserves honorable mention in this place. Even acursory perusal of its pathogenesis shows its intimate relation tthe female sexual organs. Its curative influence in puerperal me44 Diseases of the Female Sexual Organs.tritis cannot be determined a priori without further inquiry. Thiinfluence dots not depend upon the local symptoms, but is definedby the general phenomena according to which Phosphorus holds anintermediate rank between Rhus and Arsenicum, to either of whichit bears a good deal of resemblance, and from either of which itlikewise differs a great deal. This can only be decided in everycase by a careful comparison of the symptoms. In one form ofpuerperal fever Phosphorus is preferable to any other remedy, wemean the pysemic form, more particularly if metastatic inflammations take place in the pleural cavity, the lungs, the pericardiuthe femoral veins. The violent fever is mingled with frequent rigthe conjunctiva and skin have a jaundiced appearance, and soonafter we observe the signs of pysemic inflammation in the metastatically-invaded organ. For this reason Phosphorus is likewise thebest remedy in metritis if the disease has assumed the characterhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 46 of 653metro-phlebitis, which it is not always possible to decide with ptive certainty. The symptoms indicating such a change are : Slighsigns of endometritis, or disappearance of the symptoms of thisdisease without any corresponding abatement of the lever, increaspainfulness of the uterus with inflammation of the femoral veins,and particularly the above-described febrile symptoms, burning healternating with frequent feverish shiverings or rigors.The following remedies may likewise be useful, although the indications for their use are not very frequent : Carbo vegetaHHs^ciim^ Platina, Stramqfiium, [See Kafka's remarks on puerperal metritis, page 32 of this work. H.]Many remedies have been recommended for phlegmasia albadolens, although we do not see upon what such a recommendationis founded. We propose: Mercurius vivus^ Phosphorus, Bryonia,Rhus toxicodendron, and Arsenicum. Mercurius corresponds to thewhite swelling of the thigh caused by an inflammation of the lymphatic vessels, the other remedies are indicated in this form ofphlegmasia as well as in that caused by an inflammation of theveins. These few remedies will, in our opinion, prove suflicienteffect a cure. [Bsehr has omitted three important remedies whichare indispensable, if we wish to treat phlegmasia arising from phbitis, as promptly and successfully as such an inflammation can bcured ; they are : Belladonna, Aconite and Hamamelis. H.]Oophoritis, Ovaritis, 454. Ooplioritis, OTaritiB.Inflammation of the Ovaries.This inflamTnation only occurs during the period when tliis organift active, between the age of pubescence and the critical changelite ; or likewise previous to the 24th year, very seldom at anytime. The exciting causes are, upon the whole, obscure : it is cetain, however, that an inflammation of the uterus during the firsweek after confinement is very apt to communicate itself to theovaries. As an idiopathic disease oophoritis is met with amongwomen on the other side of thirty, and among prostitutes who haveintercourse with men during the menstrual flow, or it may be causby a cold ; it is likewise said to occur after medicines that arefor the purpose of producing abortion. Only one ovary is inflamedat a time.Symptoms and Cottrse. We have to distinguish the acuteand chronic form. Acute oophoritis sets in with sudden pains inthe region of the ovaries ; most commonly they are dull and indefnite, stinging and burning, and aggravated by hard pressure. Aswelling at this place cannot be felt, and we only succeed now anthen in discovering a swelling by an exploration per rectum. Thesometimes spreads to the adjoining parts, radiates even to the thwhich feels numb, and is more especially increased by sudden motions, not however so as to enable the patients to aggravate thepain ad libitum. Very generally the uterine mucous lining becomesinvolved in the inflammation which manifests itself with the symptoms of uterine catarrh. Thene is no fever, or it is trifling ; oother hand various nervous derangements set in similar to those ohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 47 of 653hysteria ; even nymphomania and vomiting may occur.Only in very rare cases oophoritis terminates in suppuration ; ifno dispersion takes place, the inflammation becomes chronic. Inthe chronic form the swelling is larger and can even be felt extenally ; the pnins remain, but are inconsiderable and only inclineexacerbate during the menses, during pregnancy and confinement.The menses most generally become irregular, scanty ; leucorrhoeavery commonly present ; in the chronic more than in the acute forsymptoms of hysteria become manifest, more especially an irritablcapricious mood« The prospect of a complete cure is more favorable in the acute than in the chronic form ; in the latter the excause generally never ceases to be present and keep up the morbidprocess.46 Diseases of the Female Sexual Organs.Treatment The scarcity of this disease explains wTiy so fewcases are reported in our publications that can be reliably regaras cases of oophoritis. The aflTection being almost without an exception without any very great importance, we shall confine ourselves to very general indications regarding the use of the properemedies.Belladonna is in many respects the most important remedy in thisdisease. As a rule, this medicine is specially adapted to diseaseglandular organs, more particularly when located in the interiorthe body. Moreover our provings as well as practice have shownthat this medicine bears intimate relations to the female sexualgans. Oophoritis is pointed at by the symptoms, as may easily beseen by reference to the abdominal group. Hence, Belladonna isparticularly adapted to acute oophoritis attended with severe paiExperience has likewise satisfied us that Belladonna is useful inchronic form, provided we do not expect any immediate result.Colocynthis is recommended for inflammatory ovarian aflfections ;the symptoms, however, do not justify this choice ; nor do the paindicating colocynth emanate from the ovary.Conium maculatum. Jahr relates a cure of chronic oophoritisefiected with this drug ; the ovary was very much swollen and hadbeen indurated for a long time. This result and our physiologicalprovings may suffice to recommend this drug.If in addition to these remedies, we mention Bryonia^ Sabina andCantharis^ we have named all the remedies that are of use in acutand, to some extent, in chronic oophoritis. "We must not, howeverforget Apis inellijica which contains in its pathogenesis a numbeof symptoms pointing to affections of the ovaries. It is verylikely that too much has been expected of this remedy, but we areprepared to assert its eflScacy in acute oophoritis from abundantexperience in our own practice. [In acute oophoritis we should noforget to associate Aconite 8 with Apis ; the former remedy maybe exhibited first, and after the inflammatory symptoms are somewhat subdued, Apis may be resorted to, or both may be continuedmore or less at alternate intervals. H.]For chronic oophoritis we recommend : Mercurius, China^ Platinayhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 48 of 653Sepia, likewise Ignatia, Sulphur and Staphysagria. The selectionof the right remedy is often very much interfered with by the existing hysteric difliculties. From Hartmann we take the followingindications : If the affection was caused by disappointments in land consequent dwelling of the fancy upon sexual things, Ignatia^'^ KMenstrual Anomalies. '^ ' ' 47Staphysagria and Acidum phospfioricum ni^ be .exKiMted. Chinamay be added to the two last-mentioned drilgp if bi^an\»the exciting causes. Flatina for a continual trnllatiotji iiv'tjinal sexual organs, compelling the patient to rub^e j^rts/and attended with complete nymphomania ; by pressing ^'th^partei theinflammatory pain changes to a pain as if the parts \ipA b^en 'iptused or bruised, with anxiety and oppression, palpitation of theheart, stitches in the front part of the head, sadness aljbernatiwith excessive mirth. According to Hartmann, Platina in connection with Belladonna is particularly suitable in the case of prostutes. With Aurum metallicum and muriaticum^ Clematis and iodiuM^ we close the list of ovarian remedies ; other morbid conditions of these organs, in so far as they are curable, will yieldabove-mentioned remedies.[In the AUgem. horn. Zeit., May 17th, 1862, we have the reportof a cure of ovarian cyst by Dr. Hirsch of Prague, of which a republication will be found in the 20th number of the British Journof Homoeopathy. The cyst was the result of an inflammation ofthe left ovary, which had been treated alloeopathically. The disorder was completely cured chiefly by the use of the Iodine waterHall, of which the patient took three tablespoonfuls every morninfasting, containing the 48th part of a grain of Iodine. Hall issituated near Linz in Austria ; the leading constituents of thismineral water are Chlorides of Sodium, Potassium, Ammonium,Calcium, Magnesium ; Iodides of Sodium and Magnesium ; Bromide of Magnesium ; Phosphate of Lime ; Carbonate of Lime, Magnesia, and Iron ; Silicic Acid. H.]»5. Menstrual Anomalies*With a view of securing a true definition of menstrual anomalies,we deem it necessary to premise certain observations concerning tnormal condition of the menstrual functions.By menstruation we understand a flow of blood from the femalesexual organs recurring at regular intervals. It is a sign that tfemale organism has attained the faculty of conceiving, and depenupon the following processes : The gradual maturing of an ovulumin the ovaries determines an increased afflux of blood to those ogans. K this congestion has reached its acme, the other organs ofthe sexual system participate in this hypersemia to such an extenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 49 of 653that the blood-vessels become ruptured and a more or less conside48 Diseases of the Female Sexual Organs.able discharge of blood takes place accompanied by a sometimeflmore extensive and at other times more local detachment of theepithelial lining of the sexual organs. While the discharge of bllasts, the matured ovulum enters the Fallopian tubes, which rendeits fecondation possible. A discharge of blood need not necessariaccompany the passage of the ovule into the tubes ; otherwise howcould a woman who is nursing her baby and does not see the leastsign of a menstrual show, conceive again at such a time ? Thatthis happens, is a fact established beyond the possibility of a dAccording to circumstances the menses appear at times sooner,and at other times later. They are influenced by climate; thepearer to theequator,the sooner the menstrual period appears; theare likewise influenced by the mode of living : in cities the menappear sooner than among country-girls; by the mental capacities:the more advanced the mental development, the earlier the menstrual functions make their appearance. The constitution exertsno particular influence; very robust girls sometimes menstruatevery late, whereas feeble ones often menstruate prematurely. According to the^e circumstances the menses may set in between theages of 10 and 20 years ; in our climate they appear in cities between the ages of 14 and 16, and in the country between the agesof 16 and 20 years.rhe quantity of the menstrual blood is likewise variable and cannot be determined a priori ; stout women sometimes lose a smallquantity of blood, whereas feeble and spare-built women lose a grdeal. The quantity is from two to eight ounces.Nor is the duration of the menstrual flow the same in all cases.It generally averages five days, but, without being considered abnormal, may last only two, or may be extended to eight or ninedays. Sometimes the bleeding stops for a short time and then reappears again.The periodicity of the bleeding likewise varies. By far in themajority of cases it returns again every 28th day. In many casesthere is an interval of four weeks between the periods ; in a fewcases we notice an interval of 21 to 80 days. Four weeks may beconsidered the normal length of the interval between each twosuccessive turns.The influence of the menses upon the general health is sometimesconsiderable and at other times none at all. We notice hypersemiaof the vagina and of the external pudendum, sometimes with increased secretion of mucus ; tumefaction of the breasts with painMenstrual Anomalies, 49knotty swelling of single galactiferous ducts. During the menstruflow the nervous system is much more sensitive and excitable,w- hence the following phenomena: chilliness alternating with flahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 50 of 653of heat; headache, hemicrania, vertigo, languor, drowsiness withoany ability to sleep; irritated, whining mood; loss of appetite,palpitation of the heart. In addition to these derangements weoften see a sickly, gray complexion, efllorescences in the face,gins around the eyes ; vomiting or nausea ; altered voice. Thesephenomena usually occur only during the first twenty-four hoursof the flow, after which they cease either suddenly or gradually.The total cessation of the menses takes place indefinitely, somewomen menstruating regularly until the age of 55, whereas otherscease to menstruate when they are 40 years old. These diflferenccdo not depend upon the time of the first appearance of the mensesor upon the vigor of the individual, upon the number of times awoman has conceived, nor even upon other morbid conditions. Thefinal cessation is not bound by any rule, and may take place quitnormally between the ages of 40 and 50 years. It may occur suddenly and completely, or in paroxysms ; some periods, even to thenumber of ten or twelve, being skipped, after which the mensesmay occur again regularly for months, or a sort of hemorrhagemay set in which is again followed by a stoppage of the menses.As a rule the quantity of the menstrual flow is larger as the perof a final cesssation draws near, than in the preceding years.In the previous paragraphs we have only briefly alluded to themost important points. But they show satisfactorily the importancof the menstrual function to the female organism. Hence it is thamenstrual irregularities have at all times excited a lively interamong physicians as well as lay-persons, to such an extent thatthey have been classified under special heads, although, in realithey constitute a symptomatic manifestation of one and the samegeneral or local disease. The question now is, when, in a generalsense, menstruation may be said to be abnormal. The menses areabnormal in the first place if they do not harmonize with one ofthe previously-indicated periods; they are likewise abnormal if,some cause or other, the usual duration of the menstrual flow ingiven case is either shortened or lengthened. A woman who menstruates every 21st day, is not considered sick; but we considerreturn of the menses every 21st day abnormal, if heretofore theyhad occured every 28th day. Finally, whether the menstrual flowis to be considered abnormal, may depend upon the influence which450 Diseases of the Female Sexual Organs.it exerts upon the general organism. A suspension of the mensesin the case of a youitg girl who, after being relieved from the pjudicial influences of school and city-home, goes into the countrand there' regains her blooming health, cannot be regarded as amorbid condition.We now transcribe, with a few additions and variations, the following details from Hartmann, whose treatment of this subjectseems to us excellent. We will fi^rst notice his generaLdieteticrules." Every attention should be given to the mind and feelings of thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 51 of 653young woman; her excited fancy should be controlled, and hernervous sensitiveness and excitable temperament which aito cause disease, should be quieted. For this reason a woman shoube treated with kindness and attention, especially during pregnanand the menstrual period. Every depressing emotion, chagrin,fright, anger, acts prejudicially upon persons in health, much moupon those who are diseased." We refer the reader to our chapteron hysteria and to our subsequent chapter on chlorosis, where weshall show that a premature development of the mental faculties,and more particularly of the fancy, exerts a pernicious influenceupon the constitution of the growing woman generally, and uponthe normal functions of the sexual system in particular."Woman's material mode of living deserves a closer attention.A wrong system has, in this respect, become a second nature toeuch an extent that a physician is expected to allow his patientsindulge in their accustomed violations of a proper diet, on whichaccount we invite him to pay particular attention to the followinpoints in the treatment of temale diseases.1) " Women who lead a sedentary life, should be induced to takemore exercise than usual, and to rouse themselves from their phlematic torpor. This is one of the first requisites of health: freqexercise in the open air, cleanliness, frequent bathing and washiand frequent changes of linen. During the menses, every heatingexercise and every exposure to a cold should be avoided ; likewisheavy farinaceous food, freshly-baked bread; violent emotions, seual intercourse, emetics, purgatives, baths. This caution need nobe carried so far as to compel healthy and robust women to lie dothe first two days and even to give up their accustomed walk. Evethe drinking of mineral water should be discontinued by patientswho are on a visit to springs for their health, unless the disconance of the water should entail greater damage than the use of itMenstrual Anomalies. 51might occasion by its interference with the menses, in which caseis pi*oper to put up with the lesser evil of the two.2) " The physician should see to it that his patient drinks moreliquid than heretofore. Many ladies drink nothing the whole day,except three cups of coffee at breakfast and dinner; if this quanis diminished, as it necessarily has to be under homceopathic trement, some other beverage will have to be substituted, such as cocoa, milk, unspiced chocolate, weak black tea, or roasted rye orbarley. We know, however, from experience that these warm beverages relax the stomach and bowels, hence the patient will haveto drink every day a few glasses of fresh water or very light beeAny other spirituous or spiced, heating beverages, such as wine,punch, and the various liquors, have to be strictly prohibited."We cannot forbear offering a few objections to Hartmann's viewsregarding the use of coffee. As generally prepared and drankby most women, coffee is undoubtedly hurtful ; but this does notapply to properly-prepared coffee that is not too weak and whosearoma is properly preserved. In this shape coffee is a beveragewhose partisans are so numerous because it is the best medicineagainst many of the morbid tendencies engendered by civilization,and which has a particularly beneficial influence on females. Onlhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 52 of 653let them use good coffee of which they cannot drink large quantities, and the use of which should always be associated with freshwater. The so-called substitutes for coffee prove in the end morehurtful than even weak and badly-prepared coffee, except perhapsbeer which, however, cannot well be drank early in the morning.3) "A bad habit that is indulged in by many ladies, is eating atany hour of the day. This practice is decidedly injurious to thesuccess of homceopathic treatment, and should be abolished. Orderis useful in all things and likewise in our meals, and patients sbe given to understand that they must partake every day of a warmdinner at a fixed hour ; breakfast and supper may consist of coldarticles of food.4) " Too much sleep, and sleeping too often within twentyhours, can only be approved of, if the patients are very weak andansemic; during sleep the body has to be kept perfectly unrestraiand easy, without the least inconvenience from the pressure of thordinary clothing ; otherwise sleejJ will not exert the quickeninfluence that is expected from it. Females especially have the badhabit of lying down with a mass of clothes on. This practice notonly prevents the body from getting warm, but interferes with the52 Diseases of the Female Sexual Organs.free circulation of the blood and thus gives rise to other troubladdition to those already existing. Tight lacing is another censuable practice which is often the sole cause of menstrual irregulaties. In such cases we do not advise to abandon the use of corsetentirely, but simply not to lace too tightly. If the patient is ato sit up and were to dispense with her corsets altogether, she wsoon complain of weakness of the back and weakness all over, andwould be more inconvenienced by the use of the many strings withwhich ladies have to fasten their garments, than by wearing looseand easy corsets." In this respect we cannot agree with Hartmann.Corsets, even if laced very loosely, have the disadvantage of supporting the back and occasioning muscular weakness of the back,unless they are worn without interruption. By going without corsets for a time the woman will soon learn to keep her back straigwithout any such artificial support. If corsets are worn too tighthey compel the* wearer to breathe with the upper portion of thethorax, the lower ribs being not allowed freely to expand on accoof the compression exerted upon them. This gives rise to an incomplete respiration, an imperfect introduction of oxygen and adiminution of the elasticity of the pulmonary vesicles. Thus it ithat corsets become a co-operating cause of many of the bloodeases of females. When speaking of chlorosis and tuberculosis, weshall revert to this subject.5) " The physician will have to inquire whether his patient, as iso often the case in the higher walks of life, uses cosmetics forpurpose of giving more color to her face, or making it look palersuch substances as vinegar, tea, decoctions, lime, chalk, roast oshells, etc. The same objection can be raised against most kindsof pomatum and perfumes for the hair which, if it requires morefat, had better be greased with beef-marrow. This is a subject ofgreat importance, if we consider that Lead and Arsenic are usuallemployed in the composition of cosmetics.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 53 of 6536) " Regarding the functions of the bowels, it is of importancethat our female patients should never suppress an urging to stooland that they should at least have one evacuation from the bowelsevery day. Women are much more afflicted with constipation thanmen ; in most cases they are the authors of this exceedingly prejudicial state of the bowels, sometimes on account of neglect, atother times from sheer laziness, again on account of sedentaryhabits, and finally because they are ashamed of satisfying the caof Nature.Menstrual Anomalies. 537) "IVomen should make it a rule to wash their parts, especiallyif affected with leucorrhcsa or other diseases, several times a dwith cold water, and during the menstrual flow with tepid water.More recently the Sitz-haths and the vaginal syringe are now inalmost general use. These are not only excellent means of reliefmany morbid conditions, but likewise excellent means of prevention, and should be found in every lady's bed-chamber. Cold wateris indeed the most reliable nervine at our disposal/'a. Derangements Attendant on the Appearance of the Menses."It must be self-evident that the awakening of the sexual life,whicji is the greatest revolution which the female organism canundergo, is accompanied by phenomena that very often partake ofthe nature of a morbid process. The normal conditions under whichthe menses should first appear, have been explained in a previousparagraph. A premature appearance of the menses always impliesa feeble constitution and powerful sexual instinct. Hence it is othe utmost importance not to accelerate this period because all tailments which sometimes befall young girls at this age, are supposed to originate in the tardy appearance of the catamenial discharge. Of course, where the delay is evidently of a morbid character, Nature should be assisted by such remedial means as. willpromote the menstrual flow.Such morbid phenomena are the more striking, the more sensitiveand delicate the young woman who had been rea^red in the bosomof luxury and ease. Although these ailments may not be very considerable yet their removal often requires the interference of arSometimes a judicious diet is suflicient for this purpose, but incases medicinal agents have to be used. Conditions requiring theassistance of a physician, are characterized by the following symtoms: Congestion of blood to the head, as indicated by heavinessof the head; rush of blood to the chest, with j»alpitation of theheart, and sometimes attended with oppression of breathing ; sensation of warmth and repletion in the abdomen ; feeling of indolethrough the whole body ; occasional flashes of heat and red flushin the face; languid feeling in the legs and feet; pain in the smof the back and pelvic region; drawing in the thighs, frequent uring to urinate. These symptoms may be regarded as menstrual distresses which are very speedily succeeded by an actual appearancethe menses and disappear with them. If these simptoms continuefor a lon

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 54 of 65354 Diseases of the Female Sexual Organs.tient will have to take a good deal of exercise in the open air,more vegetablethan animal diet, more liquids than usual, and spenher time as much as possible in cheerful company." If the above-mentioned symptoms become more severe and continuous ; if the rush of blood is more violent, causing anxiety,pitation of the heart, constant heat, a restless sleep full of drand interrupted by sudden starts ; if the face looks brightthe pathognomonic signs of cerebral hypersemia and congestion ofthe thoracic organs become manifest: we resort to the remediesthat have been indicated for such conditions in their respectivechapters. One of the leading remedies is undoubtedly Pulsatilla^especially if the congestive symptoms of the head and chest areaccompanied by signs of abdominal and uterine congestion, as if astone were oppressing the uterus, and. the patient complains ofchilliness, stretching of the extremities, yawning and other febrsymptoms. Chamornilla and Veratrum may likewise be indicatedby a certain train of symptoms. The above-mentioned dietetic ruleshold not be neglected while these medicines are used. Belladonnamay be added to this group of remedies as one of its most prominent membera. Whsreas Chamomilla is very seldom indicated,Veratrum and Belladonna will often be required, the former if thefunctional activity of the heart is very much impaired, as indicaby paleness of the countenance, great chilliness or constant altenation of chilliness and heat, anxious feelings ; the latter if sof cerebral congestion prevail, with bright redness of the face,gether in individuals of full habit."The so-called anti-psorics here come undoubtedly into play,since this physiological act is transformed into a pathological dturbance only if a constitutional disease prevails whose symptomsare still very obscure and undeveloped. If such a disease evidentexists, it will have to be met by its appropriate remedies, otherwe may resort to Sepia^ ConiuMy Magnesia and Lycopodium." If the young woman has reached the age of pubescence andfeels otherwise quite well, although the menses do not show theleast sign of making their appearance: the physician would commita great wrong if he were to drench the organism with medicines ;his duty will be to leave Nature alone in determining the periodthe appearance of the menses, more particularly if the organismshows signs of being backward in its development. It is only ifthe organism is sufficiently developed and the young woman's agejustifies the expectation that the menses ought to appear, that iMenstrual Anomalies. 55proper to hasten this process by the employment of suitable remedies, more particularly of the anti-psorics. Nevertheless, we docommence the treatment with this class of remedies, but give in tfirst place Pulsatilla and, if the indications are satisfactory,the dose rather frequently, more particularly in cases where thenon-appearance of the menses causes, without any other bodily ailments, an excessive nervous irritability, whining, peevish, timordisposition, paleness of the face and great flabbiness of the mushttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 55 of 653cular tissue. Niix vomica^ on the contrary, will be found approprin j)ersons of an opj)Osite temperament, an irascible, choleric dsition, a full habit, without any decided congestions, redness ofcheeks and tnrgescence of the body. If these remedies, to whichwe shall add a few more by and by, prove fruitless, we recommend as the best remedies: Causticum and Graphites^ more particularly if the appearance of the m.enses only seems delayed in consequence of the insufficient eflbrts of Nature, and the dischargefinally takes place in small quantity and then again ceases; Natrmuriatieum and Kali carbonicum^ if the menses do not appear at aland CaJcarea carhovica^ if there is no show, but the whole appearance of the menses indicates a plethoric habit of body. Sulphur iunder such circumstances one of fhe chief remedies, a few doses owhich ought to be given before any other medicine is resorted to,more especially if a chlorotic state of the blood is indicated bypatient's complexion."Among the remedies corresponding to the morbid phenomenawhich sometimes trouble young girls before the menses first appeawe recommend Sepia and Calcarea for the violent hemicrania whichsometimes attack such persons even at regular periods; Calcareaand Phosphorus for the violent pains in the back which sometimesresemble spinal irritation; for the convulsive symptoms we giveCocciilus and Ignatia; Cuprum is less frequently indicated; forsymptoms of anfemia we recommend Ferrum and sometimes Arseruicum will be found appropriate."b. Suppression or Delay of the Menses, Amenorrhoea." This suppression either takes place during the flow, or in consquence of causes acting previous to the actual appearance. In theformer case a cold may have operated; or cold washing may be thecause; or the feet may have got chilled; or the patient may nothave been sufficiently protected by her clothes; mental or moralemotions, vexations, chagrin, anger, fright, or dancing, sexual i56 Diseases of the Female Sexual Organs.course, dietetic transgressions may have led to the suppression.Most of these causes, if operating shortly before the time when tmenses were to come on, may cause their retention. A gradualsuppression of the catamenia may take place in consequence of deficient nutrition as well as of the abuse of warm beverages and tcontinued influence of depressing emotions. We have already shownthat a change in the mode of living may superinduce a suspensionof the menses in the case of young women, without leading to derangements of the general health." The more sudden the suppression of the menses, the more violentthe changes arising from such an occurrence. Some of the mostprominent symptoms are: violent hemicrania, great anxiety andoppression of breathing, nose-bleed, spitting of blood, congestioof the head, heart and lungs, and the like. In some cases a suppression of this kind gives rise to acute uterine catarrh, metritperitonitis. If a physician is called in time, he will of coursequire what gave rise to the trouble, and will seek to remove theconsequences of fright, mortification, anger, etc., by appropriatspecific remedies. If the physician is not called until some timehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 56 of 653after the morbid symptoms have e^cisted, the aforesaid remedies wno longer be applicable and the constitutional condition generallwill have to be acted upon by corresponding remedies. The remedies mentioned in the preceding chapter under *'a" will often befound indicated."If at the time of the menses they do not appear, and violentabdominal spasms occur, we commend Cocculus as the most suitableremedy, especially if the spasms are accompanied by anxiety andoppression of the chest, moaning and groaning, a paralytic sort,weakness, so that the patient is unable to utter a loud word, andher extremities have lost all powder or are convulsively agitatedand the pulse is scarcely perceptible. Cuprum accticam^ or stillter metallicumy acts very similarly to Cocculus. It is particularapplicable in typical paroxysms of the most violent kind, consistof unbearable abdominal spasms aft'ecting even the chest, causingloathinii:, gagging, and even vomiting, aff*ecting at the same tithe extremities with epileptiform spasms during which the patientutters a piercing cry." The following remedies likewise deserve commendation : Valerianay Platina^ Ignatia^ Belladonna^ Magncs arcticuSy 31ezereicm^Digitalis." If those remedies do not restore the memos, the physician willMenstrual Anomalies. 57then have to resort to the so-called antipsoric remedies, more pacularly Magnesia carbonica and muriatica^ Sulphur^ Sepia^ Zincum^Silicea, Lycopodium^ Graphites^ Addwn nitricum^ which may evenbe employed if the menstrual suppression causes no further troubl"We do not share Hartmann's opinion in this respect. Medicinesshould never be given except where actual morbid manifestationsseem to indicate their use ; the non-appearance of the menses somtimes is a means, on the part of Nature, to increase, or at leasteconomize the strength of the organism."In the treatment of delaying menses we have to follow thesame rules and maxims that have been laid down for menstrualsuppression. A suppression or delay of the menses often causesabdominal spasms and other difficulties for which Pulsatilla is aexcellent remedy. We likewise recommend Cicuta, Terebinthina^Zincum (especially when menstrual suppression is attended with apainful swelling of the breasts); Calcarea carbonica (likewise fomenstrual suppression, attended with marked symptoms of plethora) ; Graphites (when the menses delay too long, and the patiecomplains of hoarseness, headache, bloating of the feet, chillinebearing-down pains in the small of the back) ; Natrum muriaticum(if the menses delay too long and are very scanty); Strontiana (ithe menses delay too long, and afterwards, when appearing, looklike flesh- water and pass off in the shape of coagula) ; Sarsapa(when the menses delay, are too scanty and acrid), etc."These few indications may show that a good Repertory is thebest means of securing the selection of the proper remedy. As regards external applications, we do not approve of them ; their usfulness is questionable, and in many respects they are decidedlyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 57 of 653prejudicial. Hot foot-baths are more particularly hurtful; theyoften exert a very injurious effect upon the brain and heart, notmention the increased susceptibility of the feet to get chilled wthey invariably occasion. If the flow of blood towards the lowerextremities is to be promoted, the most efficient and never hurtfmeans to accomplish this result, is continued and fatiguing walkiDry cupping on the inside of the thighs is the only palliative methat can safely be permitted.c. Menstruatio Nimia^ Profuse Menses.An excess of loss of menstrual blood, a true menorrhagia, doesnot occur as often as it may seem to those who complain of it. Toconstitute menorrhagia, several circumstances have to occur thac58 Diseases of the Female Sexual Organs.require to be carefully diecriminated. The quantity of the discharged blood has to exceed the ordinary loss quite considerably,and then again we have to inquire whether the scantiness of theordinary menstrual flow is not an abnormal diminution in the present case. The menstrual flow is likewise considered too copious,if it continues beyond the ordinary period, although this neod nonecessarily imply that the menses are profuse. The morbid character of the menses is finally and more especially determined by thaccessory symptoms, for a copious flow of the menses cannot beconsidered abnormal as long as the constitutional harmony is in nrespect disturbed by it.All circumstances that cause either permanently or temporarilyan increased flow of blood towards the sexual organs, may be regarded as causes of menorrhagia. A temporary excess of the menstrual flow may be caused by the influences that have been pointeout as the causes of metritis ; a permanent excess is occasionedonanism, novel-reading, a constant dwelling of the fancy uponsexual things, and the habitual use of heating beverages. A fewother important points have to be added. Under certain circumstances a profuse flow of the menstrual blood becomes a real physological necessity tp the body ; for instance, if a larger supplynourishment than the body requires for its normal support, causesa real plethora. This can scarcely be regarded as a morbid condition. A profuse flow is sometimes occasioned by changes in theuterus, such as acute or chronic metritis, and adventitious growtin the uterine cavity. Nursing exerts a very particular influenceAs a rule, nursing women do not menstruate; yet it may happen,even in the case of quite healthy mothers, that the menses reappeagain prematurely, in which case the flow is often very profuse.This is nr)t a normal condition, although it does not inconvenienall women. Of a threatening character and exceedingly prejudicialare menorrhagias that set in when the process of nursing is continued too long. Accidents of this kind occur quite often in thecountry, where the women nurse their children for several yearsfor the purpose of preventing conception, not thinking that bydoing so they inflict permanent injury upon their health. We mustnot forget to record the fact that diseases of other organs, or ogeneral constitution, exert an influence upon the menses. "Withouconsidering the influence of diseases which alter the quality ofblood, such as typhus or scurvy, etc., the influence of hearthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 58 of 653of tuberculous infiltration of the lungs, emphysema, accumulationMenstrual Anomalies. 59of fluid in the pleural cavity cannot be denied ; it is more espeheart-disease that causes menorrhagia, so that the heart had bettbe carefully examined in every case of menorrhagia. Finally thecessation of the menses at the critical age is almost always ushein by profuse losses of blood. Particulars on this subject may befound under the heading : metrorrhagia.The symptoms of profuse menstruation generally may be quiteinconsiderable, being no more than feeble indications of anteniiamost cases, however, profuse menstruation is allied wuth the symptoms of difficult menstruation of which we shall speak hereafter.In treating this anomaly we have in the first place to direct ourattention to the causal indications as far as such a thing is posThese indications are so numerous that we cannot well specify themore particularly in this place. They constitute the cases for whIlanmann recommends the antipsorics. Where menorrhagia occurswithout being dependent upon some more deep-seated disorder, Naxvomica will be found an efficient remedy, more particularly if thnervous system had become very much excited by disturbing mentalinfluences, the patient gets angry at the least remark, shows anirascible and obstinate temper, starts at the least noise, losesbalance on the most trifling occurrence, wants to lie down all thtime, and shows an aversion to open air. Chamomilla is particularindicated, if the blood looks dark, almost black and coagulated,with drawing, griping pains from the small of the back to the pubbones, sometimes accompanied by fainting fits, coldness of the extremities and great thirst. It cannot be denied that the use ofChamomile-tea often has an influence over the quantity of the menstrual discharge. Unfortunately this beverage is generally firstresorted to for such ailments as precede menorrhagia which is undoubtedly made w^orse by the use of this tea. Besides Nuz vomicaIgvatia and China are indicated by such symptoms. The indications for Calcarea carbonica have been furnished by Hahnemannhimself in the following brief but exhaustive remarks : " If themenses appear several days previous to the regular monthly termand to excess, Calcarea is often indispensable, more especially ithe menstrual flow is excessive. But if the menses occur at theregular period, or later, Calcarea will do no good even if they anot scanty." We add that Calcarea will aflbrd much relief in casewhere anaemic phenomena prevail, with disposition to congestionsof the head or chest. Belladonna apparently acts similarly to theformer drug, except that the congestive phenomena for which Bel60 Diseases of the Female Sexual Organs.ladonna is indicated, arise from real plethora ; the menses are tprofuse, not excessively dark-colored and their appearance is accpanied by a pressing downwards, a painful drawing and tearingfrom the uterus to the thighs. Phosphorus is indicated if the menses delay a tolerably long time beyond the natural term, set in pfusely and occasion great debility, weariness and languor, palenehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 59 of 653of the countenance, a sickly appearance, back-ache. It is moreparticularly applicable to the menorrhagia of nursing women. PtaUna for a painful and too frequent return of the menses, a copiouand dark discharge with labor-like pains, more particularly in thcase of sanguine, lively individuals. Sepia has similar characteristic symptoms. Digitalis is indicated if the menorrhagia dependsupon a stasis of the blood caused by heart-disease, if the symptoof passive venous congestion prevail, the face is pale or livid,skin is cold.For further particulars we refer to the chapter on metrorrhagiawhere more medicines will be found mentioned.d. DysTnenorrhoea^ Scanty Menstruation,It is just as difficult to define what is understood by scanty, awe have found it difficult to define what is to be understood byprofuse menstruation. As a change in the mode of living may induce a suppression of the menses, so it may likewise, by exertingmodifying influence upon the internal development of the organismoccasion a diminished flow of the catamenia. This may occuramong women of a more advanced age as well as among youngerpersons, and it would be highly improper to disturb such a changeby medicinal interference.In by far the least frequent cases scanty menstruation is of itsea morbid symptom ; generally it is dependent upon some local aftetion, profuse leucorrhcea, chronic metritis, uterine displacementor it may be owing to constitutional disturbances such as chloroshydrtemia, marasmus, excessive formation of fat, tuberculosis, etThese diflTerent forms of scanty menstruation do not, in reality,require a separate treatment ; it is identical with the treatmentthe constitutional disorder, or else no treatment at all is requibecause the suppression of the menstrual flow may simply bear evidence to the fact that the organism has no blood to spare for suca function. For this reason we deem it unnecessary to indicateremedies for such a condition of things, and refer the reader tochapter on chlorosis and, for various particular points, to the nchapter on difficult menstruation.Menstrual Anomalies. 61e. Ailments accompanyivg the Menses^ Difficult Menstruation.Ailments of Various kinds, sometimes preceding and sometimesaccompanying the menses, are so common, especially among thehigher classes, that, unless they become too troublesome, they arnot complained of to a physician ; on the other hand, their diverfied forms may make them a source of great trouble, or they maycease for a short time in order to reappear with so much more obsnacy some time thereafter.These ailments may very naturally be classified in three categoriEither they arise from material changes in the sexual organs, a bin the uterus, retroversion, anteversion, chronic metritis, etc.,else they are occasioned by an excess of menstrual congestion, orfinall}'^ they may be of a purely nervous kind. Although the firshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 60 of 653category does not properly belong here, yet we call attention toin order that their presence or absence be satisfactorily establiThe congestive ailments are almost exclusively confined to the peorgans, and consist in a variety of pains, sometimes attended witpalpitation of the heart, congestive headache, febrile symptoms.nervous ailments are not restricted to the sexual sphere and verygenerally involve the whole nervous system. Whereas the congestive ailments abate with the appearance of the menses, and disap{entirely on the second day, the nervous symptoms on the contraryare apt to continue during the whole period.In most cases the causes of these ailments are very obscure.Although they most generally accompany scanty menses, yet theyare not unfrequently attendant on profuse menstruation ; moreoveralthough they more commonly affect sensitive, feeble, irritable,delicate and effeminate individuals, yet they are likewise met wiamong women of a robust constitution and who menstruate regularlyThese remarks may show that it would be a futile undertakingto indicate the whole series of symptoms which characterize suchailments. Hence we prefer recording a few of the more importantdifliculties together with their corresponding remedies. We must,however, caution the reader against supposing that the particularcontained in the* subsequent paragraphs are intended to render alfurther reference to the Materia Medica superfluous.It is proper to ascertain whether the ailments occur before, during or after the menstrual flow.For ailments previous to the menses, if the patients menstruatetoo profusely, we recommend : Belladonna^ ChamomUla^ Calcarea^62 Diseases of the Female Sexual Organs.Lycopodiumj Tlatina^ Nux vomica^ and if the menses arc too scantyPulsatilla^ Coccvlus^ Sepia, Alumina, Baryta.Ailments during the menses, if too copious : Nuz vomica, Arsenicum, Phosphorus (the last-named deserving particular consideratioCalcarea carbonica ; if too scanty : Alumina, Pulsatilla, Coniumnuiculatum, Graphites, Sepia, Carbo vegetabilis.Ailments alter the menses, which, however, are not often noticedunless we mean the prejudicial eflfect of a considerable loss ofPlatina, Ferrum, Graphites, Borax.For the colicky pains the seat of which cannot always be tracedwith perfect certainty, whether it is the intestinal canal or thewith scanty menses : Cocculus, Conium, Sepia, Pulsatilla, and witcopious flow : Belladonna, Platina, Nux vomica.For the congestive symptoms in the pelvic organs, if precedingthe appearance of the menses : Belladonna, Bryonia alba, Sabina ;if accompanying the menses: Phosphorus, Veratrum album, Nuzvomica ; if remaining after the menses : China, Platina.For distress at the stomach, if very marked, such as eructations,nausea, vomiting, perverted taste, loss of appetite : Pulsatilla,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 61 of 653cacuanha, Veratrum, lodium.For the toothache which so often accompanies and precedes themenses, and constitutes one of the most t.oublesome torments ofwomen, if setting in previous to the menses : Aconitum, ChamomillBelladonna, Pulsatilla, and more particularly Arsenicum; if durinthe menses : Cole. Carb., Sepia, Phosphorus.For hemicrania which generally is present during a scanty,scarcely ever during a profuse menstrual flow : Sepia, Nuz vomicaPulsatilla.Convulsive symptoms may of course vary, sometimes being purelylocal, at times general, then again tonic and at other times clonthey may even appear like epileptiform spasms so that they seemmuch more threatening than they really are. We may consider itas an established fact that the epileptiform spasms which occur athe time of the menses, never partake of the. dangerous nature ofepilepsy. The most important remedies are : Ignatia amara, Cocculus, Cuprum, Platina, Secale comutum and Causticum.The mental disturbances belonging in this category, mostly partake of the character of exaltation, for which remedies like Platina, Veratrum album, Hyoscyamus, Belladonna, Stramonium, are indicated ; states of depression which occur much less frequently,require Lycopodium or Natrum muriaticum.Menstrual Anomalies. 63We will conclude this chapter by givinjg a general hint bearingupon the selection of a remedy for menstrual difficulties : our cattention should be directed to the conduct of the discharge,whether it appears at the right season or not, whether it is tooscanty or too profuse, or whether it occurs normally. These pointare essentially characteristic ; if the remedy does not meet themcorrespondence with the other phenomena may be ever so perfect,the remedy will not suit the requirements of the case,[Recently a number of drugs have been introduced into the Materia Medica of our School, some of which are being used withgreat success in various diseases, and more particularly in abnormenstruation.Aletris farinosa, or the star-grass, is recommended for the prelinary symptoms of miscarriage, such as dizziness, nausea, headachefulness in the region of the womb, colicky pains.Caulophytlum thalictroides, or the blue cohosh, has been extensivused by homoeopathic physicians for painful menstruation, with ascanty flow of blood, or when the appearance of the menses is preceded by severe spasmodic pains, for which Coccvlus is generallj*recommended. We give the Cohosh as soon as the pains commence,and resume the medicine a few days before the next period. Thiscourse of treatment has a tendency to effect a radical cure.Cimicifuga racemosa, or the black cohosh, is eminently useful invarious forms of menstrual disorder, menostasia, amenorrhoea, dysmenorrhoea, also tendency to miscarriage, menorrhagia. The resihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 62 of 653noid Cimicifugin, first or second trituration, is very commonly uIn the menostasia of young girls it is generally indicated by heaache, hysteric nervousness, pale complexion, debility, loss of apcolicky bearing-down pains in the lower abdomen. In amenorrhoeaor suppression of the menses from some accidental cause, a cold,the characteristic indications are : congestive or neuralgic headfebrile motions, chilly creepings, rheumatic pains in the limbs,ach, uterine spasms. In dysmenorrhoea it seems principally indicaby the prevalence of neuralgic pains, spasmodic pains in the uterregion, disposition to faint, nausea, headache. In menorrhagia ituseful when the flow is of a passive character, the blood is darkcolored, coagulated, the patient complains of neuralgic pains insmall of the back, dizziness, headache, obscured vision, great weness. It will be found admirably adapted to the hemorrhages occurring at the critical age. The doses should not be given too smIf given in sufficiently largo doses, this medicine will often pr64 Diseases of the Female Sexual Organs.miscarriage. It is chiefly indicated by the sudden appearance ofviolent bearing-down pains, together with such accessory symptomsas headache, nausea, fainting feeling, etc. Cimicifuga is used byeclectic physicians for leucorrhoea with much success. It greatlyfacilitates labor, not only by accelerating the process itself, bwise by preventing the harassing and exhausting pains which sooften accompany a tedious labor. Dr. E, M. Hale suggests the useof Cimicifuga as a preventive of difficult labor. In the second etion of his "New Remedies" he relates the following case: A lady,the mother of three children, was in the eighth month of pregnancHer previous labors had been unusually severe, very tedious, painand accompanied by fainting fits, cramps, agonizing pain, etc., bthe birth, and flooding, syncope, and many unpleasant symptomsafter the expulsion of the placenta. She took, for nearly threeweeks, about ten drops of Cimicifuga first decimal dilution,times a day. Labor came on at the proper period, but lasted onlysix hours ; was not painful nor difficult ; there was no floodingfainting and no cramps. She got up in nine days, and had a betterconvalescence than ever before.We know from abundant experience that it is an excellent remedyfor the various ailments incident to the critical age of women. Tannoying flashes of heat to which such women are so often subjectand for which we have been in* the habit of prescribing Sepia, Saguinaria, etc., yield much better to Cimicifuga. "In the irritablcondition of the uterus," writes the London Lancet, "often observin patients for some time after menstruation has ceased, or irregwhen about to cease, and marked by pain more or less periodical ithe lumbar region, Cimicifuga aftbrds rapid relief. In neuralgicpains often met with in such patients, in other localities, it isbeneficial. Females at the period of life we are speaking of, frequently suffer Irom a distressing pain in the upper part of the hrecurring with greater severity at night. These cases are very safactorily met by this remedy. Pains in the mammee also, whetherreferable to uterine disturbance or to pregnancy, are relieved bythe Cimicifuga very speedily."Collinsonia canadensis, stone-root. This remedy is recommended bysome homoeopathic physicians for amenorrhoea, menorrhagia, dyshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 63 of 653menorrhoea, miscarriage, and other disorders of the female organsof generation, such as pruritus and prolapsus uteri. It is not suposed to exert a direct specific action upon these organs, but tothe disorders alluded to by removing the aftections upon whichMenstrual Anomalies. 65tlie disturbances of the sexual organs are depending. These affecare principally piles and constipation. The curative results of Csonia have been mostly obtained by means of comparatively large dGalseminum sempervifeus, yellow jessamine* Dr. Hughes writes, inthe British Journal of Homoeopathy: "I continue to derive themost brilliant results from this drug in dysmenofrrhoea and afterpains, when these are spasmodic and not inflammatory. Its powerover after-pains is so great that the lying-in chamber is well nifreed from one of its greatest bugbears. But it is antipiathic rathan homoeopathic to these conditions, and requires to be given ifull doses, from three to ten drops of the first decimal dilutionDr. Hughes would imply that large doses of Gelseminum are antipathic, and small doses are homoeopathic to spasmodic pains. Ifthis is the Doctor's meaning, his doctrine is incorrect. We havethe testimony of Dr. Douglas of Milwaukie, one of the provers ofGelseminum, that he experienced severe spasmodic pains "a suceessiofn of acute, sudden, darting pains, evidently running alongsingle nerve-branches in almost every part of the body and limbs,sometimes so sudden and acute as to make me start. At one timea quick succession of these acute sudden pains coursed down theoutside and front of the tibia for over half an hour, leaving a lof considerable tenderness marking its track. These pains, whichseemed clearly neuralgic, gave me the palpable indication for itsemployment in this disease. And it has certainly been successful.But while it has fully cured some distressing cases of neuralgia,which Aconite had been fully tried without benefit, there haveoccurred some other cases in which it has failed and Aconitehas succeeded. What is the explanation of this? If we sup'pose that in some cases of this disease there exists a real inflamatory state of the nerve, and in others a mere excess of sen*sitiveness, the explanation is easy ; Aconite cures the first, Geseminum the last." But then Dr. Douglas writes further : "A majority of all cases of neuralgia will be promptly relieved by Gelminum, but it sometimes requires to be given in pretty large doserepeated every half hour till the pain is relieved."Hamamelis virginina has been used with excellent effect in dysmenorrhoea and vicarious menstruation* In Hale's ISew Remedies afew cases are reported where cures were effected with the middlepotencies of the remedy.Hekmias diolca, false Unicom, of which we prepare the resinoid Hekntin^ which is very frequently used in practice, has been prescr566 Diseases of the Female Sexual Organs.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 64 of 653by hoTnoeopathie physicians for prolapsus uteri, a very fine casewhich is reported by Dr. Geo. S. Foster of Meadville, Pa., in HalNew Remedies. It was a case of prolapsus with ulceration of nineyears* standing, and was cured perfectly by means of Helonin, afta number of other remedies had been used either without, or withonly partial succlss. Congestive symptoms are prominently presentin uterine diseases where Helonias is used, in amenorrhcea, menorrhagia, prolapsus, etc.Senecio aureus, life-root, is possessed of fine curative powers ipainful menstruation when the menses occur prematurely and arevery profuse ; the patient suflfers greatly with violent uterineat the time of the menses. "We recommend comparatively largedoses during the attack. EL]6. Metrorrhagia*Uterine Semorrhage.We deem it unnecessary to justify the distinction we have drawnbetween menorrhagia and metrorrhagia ; both difier in their essential characteristics. When speaking of the treatment, we have included among the remedies for ordinary metrorrhagia those thatrefer more specially to metrorrhagia during confinement as well aduring pregnancy.An hemorrhage from the unimpregnated uterus is mostly due tothe same causes as menorrhagia. Every circumstance that haspower to determine an excessive flow of blood to the uterus, maybecome the cause of metrorrhagia. It may likewise occur in consequence of a number of pathological alterations of the uterine sstance and of adventitious growths in the uterine cavity. Hemorrhages of this kind are so common that every loss of blood whichcannot be attributed to the menses, ought to excite a suspicion tit is owing to the presence of material lesions. Metrorrhagia occurs most frequently at the critical age, when it is difiicult totinguish between menorrhagia and Metrorrha^a.Metrorrhagia is generally preceded by preliminary symptoms oflonger or shorter duration, indicating for the most part a violentermination of blood to the pelvic organs, such as: a painful draand pressing in the small of the back towards the sexual organs athighs, sensation of heaviness and fulness, of increased warmth athrobbing in the pelvis, also colicky pains ; frequent desire tourine ; titillation and burning in the sexual organs, accompaniedchilliness, heat ; an accelerated, soft pulse, sometimes with a dMetrorrhagia. 67beat (pulsus dicrotus), palpitation of the heart, swelling and seness of the breasts, leucorrhoea, etc. These symptoms are particuprominent during metrorrhagia at the critical age. The hemorrhageitself often sets in with chilliness, paleness of the face, coldnthe extremities, sometimes without any special phenomena; sometimes it is a mere dribbling of blood, at other times large quantof an usually dark, black blood are.poured out periodically, whicreadily coagulates on account of the fibrin it contains, and formhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 65 of 653coagula of considerable size even while yet in the uterus. In addtion to this loss of blood we notice the most varied symptoms ofconstitutional disturbance, such as : excited temperament, anxietrestlessness, labor-like pains, colic, urinary difficulties, vomiconvulsions, spasmodic laughter and weeping. If the hemorrhagelasts a sufficient length of time, symptoms of ansemia make theirappearance. The importance to the organism of such hemorrhagesshould not be estimated too lightly ; even the most trifling hemorhage may, by its continuance or by an extraordinary increase ofthe loss of blood, permanently impair the patient's health and evthreaten her life.Uterine hemorrhage shortly after the expulsion of the fetus, constitutes one of the most important and dangerous events. Whereit is not caused by injuries of the uterine parenchyma, it almostalways results from deficiency of the uterine contractions. A deficiency of this kind is not always owing to atony of the uterussuch as may result from tedious labor or violent labor-pains, oreven from general debility ; it may likewise depend upon circumstances that render the necessary contractions even after normallabor-pains impossible. Among such circumstances we number atoo rapid labor, partial adhesions of the placenta, and the preseof copious coagula in the uterus. "We have only to do here withhemorrhages depending upon atony and deficient contractions ofthe uterus; these hemorrhages alone are accessible to medicinalinfluences. Hemorrhages of this kind occur immediately after confinement ; they must be expected if the uterus remains large andsoft. Sleep, immediately after confinement, may become the causeor at least the promoter of hemorrhage ; it should not be indulgein. The symptoms of hemorrhage can only escape detection, if theaccident occurs within the womb. The os tincse and the vaginaare so filled with coagula that the blood remains confined withinthe uterine cavity, which again becomes distended by the accumulated fluid. As in every other copious loss of blood, the symptom68 Diseases of the Female Sexual Organs.of aneemia become rapidly manifest, such as pallor of the countenance, chilliness, cold sweat, obscuration of sight, fainting,decrease of the pulse, convulsions ; the uterus, moreover, feelsand increases perceptibly in size. This accident is generally unacompanied by pain.Hemorrhage occurring at a later period of confinement, is generally less copious ; it likewise originates in deficient uterine ctions, or in inflammatory processes, but the prognosis in such cais unfavorable. Hemorrhages of this kind occur more particularlythe case of women who do not nurse their children ; the intense sulation generally caused by the nursing, now reacts npon the uterHemorrhages during pregnancy are sometimes of trifling importance, and at other times more threatening. Some women arein the habit of menstruating several times after conception withodetriment to the fnetus. It has seemed to us as though children bof such mothers at full term, and having otherwise their full development, were less vigorous and disposed to a variety of ailmenHemorrhages during the second half of pregancy, if not dependingupon placenta prsBvia, originate in the same causes as those of thttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 66 of 653first half, of which we shall treat presently ; but they usuallyof a subordinate significance, because they seldom threaten the lor interfere with the further development of the foetus. The mostimportant hemorrhages are those occurring during the first half opregnancy, for the reason that they mostly precede, cause or accopany aMiscarrnige or atiortus. Such hemorrhages happen in oonsequenceof the vessels uniting the ovum to the uterus, being torn, eitherbecause the natural resistance of the uterus against its contentstoo great, or because the resistance of the contents against theof the uterus is too feeble. In this way the uterus is excited topremature contractions which may easily superinduce a lacerationof the vessels for the reason that in the first three months theis on its whole surface connected with the uterus by m^eans of vedelicate blood-vessels. Hence miscarriages take place most easilyduring the first three months of pregnancy. If the afteralready formed, premature contractions likewise lead to the lacertion and detachment of the placental vessel*. This, however, is oless frequent occurrence, because the contractions affect only asmaller portion of the uteitia, and it iff moreover well known ththe normal seat of the placenta is not the locality usually afieeby the ctrntractions, but that they are much more commonly eonMetrorrhagisu 69fined to the lower portion of the uterus. It is all-important thathe circumstances which cause premature contractions of the uterushould be carefully investigated; a miscarriage can only he prevented by keeping all such exciting causes out of the way. Thecauses of miscarriage either proceed from the footus in consequenof its premature death, or from the mother. The death of thefoetus is superinduced by intensely-debilitating diseases of themother, especially a far advanced anaemia ; next by constitutionasyphilis, and finally by violent commotions such as fright. Tojudge by the changes which are sometimes noticed in the foetus, iwould seem as though certain poisonous substances which will benamed by and by, might exert a destructive influence over it. Asproceeding from the mother, we have the various circumstancesthat tend to cause a determination of blood to the uterus, and whhave already been named in the chapter on acute uterine catarrh.Plethoric individuals are much more liable to miscarriage thanansemic women, especially if the former are afflicted with profusmenstruation. In their case the hemorrhage is apt to appear at thtime of the catamenia. Acute febrile afiections and diseases of theart likewise predispose to miscarriage. Mechanical causes actinupon the sexual organs directly, or transmitting their effect upothe uterus by a general concussion of the system, exert a peculiainjurious influence ; so do depressing mental causes when aftectithe uterus unceasingly. It is well known that women who, althoughagain pregnant, continue to nurse their children, become liable tmiscarriage on account of the excited condition of the uterus tramitted to this organ from the excited nipple. Lastly we have tomention various poisons which are sometimes resorted to for thecriminal purpose of producing miscarriage. These are Sahina^CrofmSy Seoale comutum. Sabina is so frequently used as a meansof producing abortion, that the Juniperus Sabina which grows inthe neighborhood of large cities, is usually found pulled to piechttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 67 of 653and deprived of its branches. As regards Secale cornutum, weknow from the history of epidemic ergotism that the women whowere attacked by this disease, generally miscarried. In conclusiowe have to observe that a woman who miscarries once, retains adisposition to miscarry a second time, and that this second miscariage is apt to take place at the same period as the former. Thusit may happen that women miscarry nine or ten times in successionnotwithstanding they had given birth to healthy children heretofore. It almost seems as though the uterus, after the normal funo70 Diseases of the Female Sexual Organs,tion of impregnation has once been interfered with, loees its capto again successfully engage in the process of utero-gestation.Symptoms and Course. We have to examine these pointsmore fully, because upon their correct knowledge and appreciationdepends the possibility of preserving the lives of both mother anchild.In the first three months, hemorrhage is generally the first symptom of incipient miscarriage. As a rule, the hemorrhage at onceassumes the form of metrorrhagia, even if the woman had beenotherwise perfectly healthy, especially if violent external impresions were, the cause of the accident. A mere dribbling of bloodthis time is of much less frequent occurrence. At first the patiedoes not complain of any pain ; after a short lapse of time, it sin very gradually as a dull pain, and increases until it finallysumes the character of real labor-pains ; this is likewise substatiated by the circumstance that, during the paroxysms of pain, thblood is expelled in larger quantity. These phenomena are mistaken by inexperienced women, if they are otherwise afflicted witdifficult and profuse menstruation, for a return of the menses.In the subsequent stages of pregnancy, metrorrhagia only takesplace exceptionally, without a preliminary stage which is determined by the entrance of blood into the uterus whose mouth stillremains closed ; or by the premature contractions of this organ,by the death of the foetus.In the first of these three cases, the patients complain of a dulpain in the pelvis which extends to the back and is increased bymotion, by voiding the urine or by evacuating the bowels. Thesymptoms are frequently associated with slight febrile motions,diarrhoea with tenesmus, urinary difficulties. All these phenomenrarely precede the hemorrhage longer than five days. It commenceswith distinct labor-pains.The premature contractions of the uterus may be allied to thecongestive phenomena just described, but they likewise occur asprimary symptoms. In such a case the patient experiences a peculiar drawing pain from the uterus across the abdomen, and spreading with peculiar violence to the small of the back, at first intmitting for hours, and finally only for a few minutes. The generaorganism does not seem to be affected by this pain. Sometimes thepains intermit even for days ; nevertheless, they return again. Tmore continuous and more violent the pains, the more certainly anthe sooner the hemorrhage will occur.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 68 of 653Metrorrhagia. 71If miscarriage is caused by the death of the foetus, striking precursory symptoms are scarcely ever absent. They sometimes lasteven for weeks. The patients feel faint and weary, complain offeeling feverish, are remarkably pale, and experience a sensationcoldness in the abdomen and lower extremities. The signs of lifethat may have been perceived in the foetus, cease. The patient isvery much depressed in spirits, complains of pains in the stomachincreased nausea and distressing vomiting. While these symptomscontinue, the pains and contractions foreboding the approachingexpulsion of the foetus set in, and the hemorrhage takes place.After the blood has begun to flow the course of the trouble ispretty much the same in every case. If the foetus is separated frthe organism of the mother, it has to be expelled. If the hemorrhage is at all copious, the expulsion can no longer be preventedThe course of the diflaculty now varies according to the differenstates of the uterus. During the first months of pregnancy thelower segment is still very rigid, the os tincse firmly closed ;force or a longer time is required to open the womb, whereas in tsubsequent months the vaginal portion becomes more yielding anddilatable. Hence a miscarriage extends over a longer space of timin the commencement than in the subsequent months of pregnancy ;moreover, the hemorrhage in the former case is more profuse. Asa rule the ovum, up to the third month, is discharged uninjured,sometimes unperceived, whereas, at a subsequent period, the membranes of the ovum are ruptured, and afterwards expelled subsequently to the expulsion of the foetus. The constitutional symptoms are preeminently those of acute aneemia ; even the convulsive phenomena which are not unfrequently present, are onlj^ occasioned by the ansemic condition of the patient, very seldom by thamount of pain involved in the hemorrhage. Primiparoegenerallysuffer most. As soon as the foetus is expelled, the flow of bloodgenerally ceases very soon. But if the placenta has already beenformed, the whole of the foetus is not always expelled, but fragmentB of the ovum remain in the uterus and, by preventing the fulcontraction of this organ, cause the hemorrhage to continue. Thisis so much more dangerous as it is commonly more copious than atthe commencement of miscarriage, the danger being still greater,if we are not able to remove the remnants of the foetus. In thiscase the hemorrhage may likewise be internal, if the foetal remnaclose up the os tincse. Hemorrhages of this kind are always moreor less threatening, and sometimes endanger life. What we have72 Diseases of the Female Sexual Organs.said, shows that miscarriage is least apt to occur in the first tmonths; and that the danger involved in the hemorrhage is greatest, if a placenta has already formed, because remnants of the ovare eiisily retained in the uterus.The whole course of such an accident assumes a peculiar form^if the uterus firmly contracts round the remnants of the ovum. Insuch a case the flow of blood suddenly stops and complete recoverhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 69 of 653seems to have taken place, until the hemorrhage returns, sometimeafter the lapse of weeks, and these hemorrhages follow each otherin such rapid succession that it i% impossible to mistake them fothe menses. A misapprehension of this kind is, moreover, preventeby the ansemic symptoms accompanying this condition. In such acase a rapid cure can only be effected by the artificial removalthe remnants of ovum whose spontaneous expulsion is sometimesdelayed to a remote period. A similar course takes place in therare cases of miscarriage of twins. After the expulsion of one fothe uterus firmly contracts round the other one, and, for a time,trouble seems at an end, until a second hemorrhage brings a way aother foetus.In a case of miscarriage the prognosis has to consider a varietyof circumstances : the possibility to save the life of the foetusdanger to which the life of the mother is exposed by the hemorrhage; the further consequences of the accident, and finally itsfluence upon the faculty of conceiving anew. As far as the preservation of the foetus is concerned, the prognosis is the more unfaable, the more copious the hemorrhage and the sooner it takes plaso that, if a profuse hemorrhage sets in during the first three mof pregnancy, the retention of the foetus can scarcely be hoped fAll morbid processes, especially inflammatory aftections, in otheorgans, and either causing or accompanying the miscarriage, diminish the chances of a successful issue. The indirect consequencesof a miscarriage sometimes tell on the whole future life of the ptient. One of these consequences is a high grade of anaemia, together with the abnormal conditions of the heart, which it oftenoccasions. Chronic uterine aftections are likewise very common;so are leucorrhoea, chronic metritis, displacements and changes ithe normal shape of the uterus. A number of nervous derangements sometimes remain after miscarriage. The influence of suchan accident upon a subsequent conception is often so trifling thamay be said to amount to nothing; many women conceive andabort by turns; as a rule the second miscarriage takes place abouMetrorrhagia. 73the same time as the former, aher women, having once miscarjried, never again go the full term of pregnancy ; at a certain pa hemorrhage again sets in. This is a very common occurrenceafter a miscarriage previous to the fourth month, and is almost arule in the case of a primipara. The general faculty of conceivindoes not seem to become modified by miscarriages.Before passing to the treatment of uterine hemorrhages generally,we will add a few more remarks concerning miscarriage. Miscarriage, both as regards the prophylactic and curative treatment ofeuch an accident, is a morbid process which sometimes defies themost consistent treatment of the so-called Rational School. On thcontrary, the homoeopathic treatment of miscarriage is generallycrowned with the most brilliant success. For this reason we havedeemed it our privilege to lay particular stress upon a morbid prcess whose importance must be self-evident. In our own practicewe can show the records of a number of cases of threatening miscarriage that were successfully prevented by internal treatment,where the full term of pregnancy was secured even after hemorrhage and severe uterine contractions had already set in in somehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 70 of 653them. Quite recently the wife of a most excellent allopathic physcian of this city, who had miscarried nine times in succession inspite of her husband's best efforts to prevent such an accident,successfully carried through her tenth pregnancy by homcuopathictreatment. In the presence of so much brilliant success we have aright to say that we possess the means of preventing miscarriagewith an almost unerring certainty.We will now proceed to mention the different remedies that aremost commonly resorted to in the treatment of miscarriage, andafterwards review this treatment in a connected series.Sabina. We have shown on several previous occasions that theaction of this drug upon the uterus is specifically characterizedcongestion often amounting even to inflammation. This fact shouldnot be lost sight of in cases where Sabina may seem to be indicatIf the metrorrhagia is preceded for some time by a laboring in the abdomen, sensitiveness to pressure, increase of the sepassion, a more copious secretion of mucus from the vagina ; if themorrhage is profuse, painful, and the blood is brightoris discharged in the shape of firm coagula, Sabina is our bestsimile that will certainly help in most cases, for a confirmationwhich fact we can point to our own experience as well as to ourprinted records. This remedy suggests itself more particularly ia74 Diseases of the Female Sexual Organs.the case of robust persons of a plethoric habit, who have menstruat an early age and always were inclined to menstruate profusely."We have already stated in a previous paragraph that the specificaction of Sabina upon the uterus is known even to lay-persons, anthat this knowledge is made available for purposes of criminal abtion even by married women ; the evidence of such a crime has beeon more than one occasion furnished us in our own practice.The relation of Secale cornutum to the uterus is equally constantand characteristic. This relation is not, as Griesselich fancies,pendent upon the action of this drug upon the spinal cord ; it ismediate, but differs greatly from that of Sabina. Secale tends torapidly destroy the organic activity, without occasioning any verstriking signs of reaction which may even be entirely absent. HenSecale is particularly appropriate in metrorrhagia unattended bysymptoms of reaction on the part of the uterus, or the general orism, without any marked pains in the uterus, in the case of individuals of an anaemic or leucophlegmatic habit of body. Secale istherefore indicated in metrorrhagias occurring at the critical agor in chlorotic individuals whose constitutions are broken down bdebilitating diseases; or in post-partum metrorrhagias dependingupon atony of the uterus, or which cause or accompany the miscarriages of ansemic subjects, or which are occasioned by the deaththe foetus. The general character of the hemorrhage will prove abetter guide in the selection of Secale than mere symptomatic indcations, of which we, nevertheless, proceed to point out the mostessential: The blood has a dark color and shows very little or nodisposition to coagulate ; its discharge is either painless, or epain is very vague and undefinable ; it flows in a rather uninterrupted stream ; the hemorrhage is accompanied by great prostration, fainting fits, palpitation of the heart with intermission ohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 71 of 653beats, convulsive movements, cold skin. Secale is likewise indicain the latter stage of hemorrhages that commence with signs ofcongestions, and likewise in hemorrhages occurring during the latter term of confinement.Crocus is an important member of this group of remedies, but differing from either of the above. K Crocus is so often recommendedfor active congestive uterine hemorrhages, we attribute this recomendation to the circumstance that the symptoms of the femalesexual organs have alone been considered. They are: Pressure anda feeling of weight, stitches, pressing towards and in the sexualparts, discharge of a dark, tenacious, even black blood, but withany labor-like pains. K, in addition to these symptoms, we considMetrorrhagia. 75the general languor and loss of strength, the constant chillinessa variety of other symptoms, it seems difficult to regard this seof phenomena as an active congestion. A passive congestion, onthe contrary, is undoubtedly a reliable indication for Crocus, whis more especially confirmed by the quality of the blood. In general, Crocus is adapted to metrorrhagias at the critical age or ware accompanied by affections of the heart or arise from impediments in the portal circulation, in which case varicose swellingsthe veins of the rectum and lower extremities present specific incations for its use. These symptoms likewise point to Crocus incases of miscarriage and post-partum hemorrhages, although in theformer we may seldom meet with the quality of the blood characteristic of Crocus.We take the liberty of presenting these three remedies as prototypes of the different medicines for metrorrhagia, even if by soing we should incur the reproach of a generalizing dogmatism. Thiwould, of course, be unjust, since it is the object of this worklead the reader through general principles to special or individuizing applications, and not to teach the former for the purpose osuperseding the latter.We rank in the Sabina-category the following drugs : Belladonna^Chamomillaj Plaiina^ Nuz vomica, Calcarea carbonica^ Hyoscyamus,Ignaiia arnara, Ferrum^ to which we add these short remarks : Belladonna and Chamoniilla are especially applicable in the hemorrhages of lying-in women, with a general excitement of the circulation. Calcarea, Ferrum, and perhaps Pulsatilla, are adapted tothe hemorrhages of feeble and aneemic subjects, with excited circulation. Hyoscyamus, if symptoms of convulsion accompany thehemorrhage from the start, more especially shortly after confinement. Ignatia and Platina for hemorrhages with excessive irritability of the nervous system and the general sensorium, especiallif the accident was preceded, and probably caused by some violentcommotion of feeling or by sexual excitement, Ignatia being moreappropriate in the former, and Platina in the latter case.The Secale-category does not comprehend many remedies ; at anyrate not one of them shows a complete resemblance to the prototypIpecacuanha^ China^ and under certain circumstances Ferrum^ Plumbum and Arsenicum are the few remedies belonging to this categoryIpecacuanha is generally appropriate only for post-partum hemorhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 72 of 653rhages, or after miscarriage, with cutting, colicky pains aroundumbilicus, pressing towards the uterus and anus, great chilliness76 ^es of the Female Sexual Cthe outside and extreme heat within. China is mostly requiredafter the hemorrhage had lasted already for some time, especiallyafter confinement if the uterine contractions seem to be utterlyhausted, the patient is cold and blue, and a convulsive shock nowand then agitates the frame. The choice of Arsenicum can onlybe determined by the general symptoms, not by the local sexualphenomena. Regarding Plumbum, we transcribe Griesselich's remarks from Ruckert's "Klinischen Erfahrungen": "Among theworst kinds of metrorrhagias we number those that befall femalesat the critical age and who are afflicted with hypertrophy of theuterus. If the patients have been long weighed dow^n by severemental distress, the hemorrhage will prove still more unyielding.Other remedies have often proved futile in such cases. The casesw^here Plumbum afforded help, happened among women of thehigher classes who had attained the age of forty ; they had had fchildren in the first years of their marriage ; the metrorrhagiabecome inveterate, and had assumed a passive character. Generallythe patients had lived well, had partaken of quantities of heatinbeverages, had led a sedentary life and their constitutions had asumed a preeminently venous tendency ; hemorrhoidal tumors hadmade their appearance, constipation, bloating of the bowels aftereating, etc. The metrorrhagia had existed for years, with free intervals of four to six weeks and even longer. During these intervthe patients recovered their strength, but another attack broughtthem down again. The attack was preceded by a sensation ofweight and fulness in the abdomen ; slight labor-like pains fromthe small of the back to the front were experienced, amid whichdark coagula were expelled mingled with fluid blood and serum,without any unpleasant odor ; the discharge was increased by motion ; a profuse discharge was attended with syncope, yawning andstretching, twitchings and by such other signs of anaemia as palption of the heart, a small, intermittent pulse, etc. The hemorrhawas succeeded by a more or less profuse, inodorous and mild leucorrhoea. On exploration the uterus was found to be uniformlydistended. Between the attacks the patients looked sickly, almostchlorotic; the assimilating functions were disturbed, the skin wadry, pale and yellowish, with hepatic spots ; the patients complaof languor, shortness of breath on going up-stairs, had a sad anddesponding mood. The Acetate of Lead, in doses of one quarterof a grain per day, arrested the hemorrhage in several cases andremoved the danger of total destruction which threatened theMetrorrhagia. 77cachectic body, without, however, correcting the constitutional cdition." To these statements we add an important observation :Paul (Archives g^n^rales, Mai, 1800) has had an opportunity ofwatching the effects of Lead upon the female sexual organs in upwards of eighty cases ; his observations lead him to infer that tmetal favors miscarriages and premature births in a most extraordinary degree, and that it very commonly occasions the death ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 73 of 653the foetus.The category of Crocus contains a number of remedies some ofwhich are closely related to Secale. The most important are : Ar^nicaj China, IHgitalis purpurea^ Lycopodium, Kali carbonicum^ Sepia, Kreosotum, Phosphorus, Carbo vegetabilis. Arnica may like^wise be required in active metrorrhagia ; it is particularly adapto post-partum hemorrhages, and is known as an efficient remedyfor excessive and painful after-pains. For particulars concerningDigitalis or rather Digitalin, we refer the reader to our Essay othis drug. There is no question that in metrorrhagias occasionedby blood-stasis depending upon heart^lisease, Digitalis is one offirst remedies. We are not as yet in possession of more special idications. The cure of a dangerous metrorrhagia which is reportedin that Essay, has not yet been interrupted by a similar accidentis now eight years. Sepia deserves special consideration in casesmiscarriage ; it is but seldom indicated in simple metrorrhagia.all events it is one of our most important remedies as a preventiof miscarriage. Whereas Sabina is especially adapted to active,plethoric and robust constitutions. Sepia responds to nervous irrbility associated with a quick circulation ; it is such conditionthe system that so often give the first impulse to miscarriage anare associated with obstruction in the abdominal circulation. Reirecommends Sepial in miscarriage? between the fifth and seventhmonths, if symptoms of abdominal plethora are present ; Kallenbacrelates several cases where Sepia had a good effect, the followinsymptoms being preseilt: rush of bldodf to the head and chest, sesation of weight in the abdomen, swelling of the hemorrhoidal vessels, irritable temper, disposition to syncope. While these symptome prevaily the movements of the fgetus grow^ weaker until theyfinally cease altogether and miscarriage threatens, most probablyprovoked by apoplexy of the foetus consequent upon uterine congestion. Experience has demonstrated the curative virtues of Sepiafr a preventive of miscarriage in so inany cases that it must beowing to indolence if our physicians do not rieport mofe calses o78 Diseases of the Female Sexual Organs.cure than they have done, with carefully and distinctly drawn ontlines. Lycopodium is likewise recommended as a preventive ofmiscarriage, but has not the same practical effect as Sepia. Lycopodium is more particularly suitable for feeble, worn-out individafflicted with bad digestion, chronic gastro-intestinal catarrh,nate fluor albus, symptoms of venous congestion in the extremitieand abdomen, varices on the legs and private parts, hemorrhoids,liver-complaint, splenetic engorgements. Such symptoms are notoften met with in young persons, on which account Lycopodium ispreeminently suitable for middle-aged women. It is of especialvalue in the metrorrhagias of the critical period, if the abovecribed symptoms indicate this drug. According to Hartmann,Kreosotum is suitable if a quantity of dark blood is discharged,succeeded for a few days by an acrid-swelling, bloody ichor causia gnawing-itching and smarting of the parts, after which the flowof blood recommences mingled with coagula. At the same timethe head feels very much distressed. Such symptoms suggest thepresence of malignant disorganizations of the uterus : however,they may likewise occur at the critical age or during confinementwithout any perceptible organic alterations.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 74 of 653It would lead us too far if we were to particularize the symptomatic indications for more remedies ; it may be well, however,classify the remedies we have named, in accordance with the distinctions which we have pointed out as characteristic features ofthe various kinds of metrorrhagia.Hemorrhages of the unimpregnated uterus previous to the critical age, require: Belladonna^ Platina^ Nuz vomica^ Calcarea carbonica^ Hyoscyamus^ Ignatia, Ferrum; very rarely Sabina^ Sepia jPhjosphorus ; hemorrhages at the critical age require : Platina^cah^ China^ Plumbum^ Arsenicum^ Digitalis^ Lycopodium^ Koli carhonicuMy Kreosotum J Carbo veg.y Crocus.^ For post-partum hemorrhages we recommend : Sahina, Belladonnay Chamxrniilla^ Bryonia^ Hyoscyamus, Secede^ TpecacuanhayChinaj Arnica.Hemorrhages during pregnancy require the remedies that willbe presently named for miscarriages.In treating miscarriages we ha^e to keep two things in view,namely the prevention of the hemorrhage by general means, thearrest of the hemorrhage, and the management of the consequencesof hemorrhage in accordance with general principles.It is undoubtedly possible to prevent miscarriage ; the case of tMetrorrhagia. 79Doctor's wife to which allusion was made in a previous paragraph,will be accepted as evidence of such a fact. The nature of theprophylactic treatment is more especially determined by the consttutional symptoms of the patient. If the patient is an anaemic,feeble, pale woman, Pulsatilla^ Ferrumy China have to be prescribin not too frequently repeated doses ; if the anaemia is attendedwith disposition to congestion, Calcarea carbonica is preferable.the woman had miscarried several times, it is best to give the prviously-mentioned remedies about four weeks before the term whenthe miscarriage is expected to take place, but neither too low notoo frequently ; perhaps a few drops every three days, and to continue this treatment until at least four weeks after the term. Weavoid strong attenuations lest the medicine should produce primareffects. The remedies proposed for anaemia should not be continueat the time when the miscarriage is expected ; at such a periodCalcarea^ Sepia or Sabina are preferable each as the patient's pesonality may indicate. Regarding the necessity of absolute rest iorder to prevent a miscarriage, views differ a great deal. It istainly well for the patient to avoid all physical and mental exciment, but careful and slow exercise in the open air cannot do anyhurt, less, at any rate than to constantly be lying down. If thispractice is excusable in the case of weakly, nervous individuals,is certainly inexcusable in the case of plethoric, robust and quipersons. Nov can a scanty, not very nourishing diet be adopted asa rule, for in anaemia we are called upon to improve the compositof the blood by a suitable mode of living ; whereas truly robustwomen are benefitted by a sort of starvation-cure, because they atormented by a voracious appetite during the first months of theihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 75 of 653pregnancy. Of greater importance than all these details is theclothing of pregnant females. As a matter of course every tightfitting garment should be avoided ; if it does not directly interwith the portal circulation, it certainly interferes with the oxytion of the blood in the lungs. This point, generally speaking, inot sufficiently heeded. Moreover, the strictest abstemiousness iindispensable from the moment that conception has become anestablished fact. The use of coffee should likewise be forbiddenthe strictest manner. It is much more difficult to prevent thevomiting which, on account of the extraordinary strain on the abdominal muscles which the vomiting occasions may easily give riseto obstructions of the circulatioa. As yet we have no remedy thatcan be regarded as specific against the vomiting of pregnant fema80 Diseases of the Female Sexual Organs.and it 18 difficult enough in any given case to select a remedy,the reason that all cases look so very much alike. All we can dois to experiment, and to give Belladonna^ lodium^ Veratrum, CupruPulsatilla and Sepia^ the choice of any special remedy, being ofcourse determined by the constitution, the accessory symptoms, etBy employing these prophylactic means we often succeed in carryinthe patient through the full term of pregnancy. Of course wecannot promise success in every case.The treatment of 9^ miscarriage begins with the commencementof the hemorrhage and the uterine contractions. In almost everycase where the appearance of the blood is the first morbid symptoSabina will prove the right remedy, whether pains are present ornot. We have often succeeded in arresting with this remedy anuterine hemorrhage that had already become very copious. Wedoubt whether any other medicine will act more promptly andsatisfactorily at this period. Belladonna ranks next to Sabina. Iis indicated, if the hemorrhage commences with violent colickypains and a sensation in the pelvis as if pressure were made fromabove downwards, and'as if the sexual organs would be pressed outat the same time there is a good deal of vascular excitement.Opium is recommended, if a miscarriage is threatened in consequenof fright.If the hemorrhage is preceded for some time by distinct laborpains, Pulsatilla, Belladonna, Secale cornutum may be tried in orto arrest the contractions if possible. If the patients are feeblwith worn-out constitutions, and the blood has begun to flow, Seccornutum is preferable to Sabina. Crocus is seldom appropriate atthe commencement of the hemorrhage. The cases where the mie^carriage is caused by the premature death of the foetus, may notrequire any medicinal aid previous to the setting in of the hemorrhage, when Secale will most likely prove the most suitable remedIf the above-mentioned remedies do not prevent the miscarriage^and if the os-tinc» dilate more and more, it is advisable not totoo powerful doa©s, and to calmly await the period when the foetuwill be expelled ; for this event can probably only be hastened bmanual interference ; it is moreover very questionable whether atthis period the hemorrhage can be modified by internal treatment.After the expulsion of the foetus most of the above-mentionedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 76 of 653remedies that have been recommended for simple metrorrhagia^come into play, especially : Sabina^ Belladonna^ Crocud^ Secale^caciuinhaj ChamomiUay Chinay Hyoscyamus.Carcinoma Uteri. 81Although we do not believe that a. miscarriage can be preventedby keeping the patient all the time in a horizontal posture, yetposture becomes indispensable as soon as the hemorrhage has commenced. Even after the hemorrhage has been arrested, the patientshould be kept quietly on her back for a couple of days. If a miscarriage has taken place, the patients will have to be treated liwomen in confinement, even with more care, for a return of thehemorrhage, metritis, prolapsus of the uterus are apt to take plaAbove all we have to make sure that no fragments of the foetushave remained in the uterus ; the worst consequences of the miscarriage are sometimes caused by such an oversight.[Besides the medicines recommended by Bsehr for the arrest ofuterine hemorrhage and the prevention of a miscarriage, we oftenmake use of the following with perfect success :Aconitum, if the pulse is full and bounding, the patient experiena sensation of fulness and heaviness in the uterine region, and dof blood have already begun to trickle down. We give the lo'A^erpotencies. In active uterine hemorrhages caused by a sudden concussion, a violent strain, or subsequent to the expulsion of theAconite may likewise help to arrest the hemorrhage. The pulse isfiiU and bounding or else the opposite, the patient complains ofheadache, the cheeks are flushed, the skin is warm and dry or elscold and covered with a clammy perspiration ; the action of theheart is often disturbed, there is a tremulous fluttering of theless frequently tumultuous beating.Erigeron canadense, an alcoholic solution of the oil, often helpsuterine hemorrhage, if the blood is lumpy and dark-colored.Trillium pendulum is likewise much used both in the form ot an alcoholic tincture and watery infusion. Small doses will not answerHamameJis virg. has been used with much success in passive venousand likewise in the more active form of arterial hemorrhage.Hemorrhages brought on by mechanical concussions of the uterineregion, blows, a fall, etc., require the use of AmicUy lower potesometimes in alternation with Aconite. H.]7. Caretnoma Uteri,Cancer of the Uterus.In by far the majority of cases this disease occurs beyond the agof forty, and is very seldom met with in women of a less advancedage. Its origin cannot be accounted for upon well established priciples; feeble as well as robust, married as well as unmarried wohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 77 of 6536S2 Diseases o( the Female Sexual Organs.are attacked by this terrible destroyer. Cancer of the uterns isof the most frequently occurring fomis of carcinoma, and not unfrquently runs its course as a solitary cancer. It is only in rarethat it breaks out in addition to cancerous degenerations of otheorgans.The most ordinary form is medullary cancer, whereas scirrhusand alveolar cancer are very rare; epithelial cancer is a littlefrequent. The medullary cancer usually commences at the vaginalportion of the uterus as a very firm, rugged infiltration, whencespreads to the fundus and to adjoining organs, especially the blader and rectum. The less firmness it possesses, the sooner it becconverted into pus or ichor^ in consequence of which enormous destructions of tissue may take place. Epithelial cancer always commences with cauliflower-excrescences at the os tincfie so that thexcrescences seem to have taken the place of the os, or at any racoalesce with it. The excrescences seem to grow out o£ the papillof the OS ; at first they resemble condylomata and afterwards sprlike a fungus, with marked vascular development. As the fungoidgrowth increases, the elements of epithelial cancer unite with thformer and the mass decays and changes to ichor. It is not certaiwhether these excrescences are really carcinomatous at the outsetat any rate^ the fact, that they have been successfully extirpatethrows doubt on the correctness of the canceivhypothesis.Hartmann relates a form of disease the carcinomatous nature ofwhich is doubtful, we mean the phagedssnic ulcer of the uterus.It likewise emanates irom the vaginal portion, but the ulcerativeprocess is not preceded by the deposition of a firm, pseudolayet* or infiltration ; the uterine tissue surrounding the ulceris sound, or else softened, yellow or reddish-brown* The disorgantion may gradually spread to the walls of the uterus and vagina,tiO the rectum, bladder and peritoneumiCarcinoma of the uterus is frequently mistaken at the commencetnent for menstrual disorder, leucorrhoea or chronic metritis. Thfirst symptoms usually are menstrual derangements, cessation ora more frequent return of the menses, or in the place of the menswe have irregular hemorrhages and leucorrhoea. The mistake ismade the more easily if the patient has not yet reached the critiperiod, so that these changes may be set down as results of a physiological cessation of the catamenial secretion. If the patientpassed through the critical period, a sudden flow of blood takesj^ace, at first resembling the menstrual flow, but soon increasinCarcinoma Uteri. 88a true hemorrhage. In the beginning the patient often complainsonly of a feeling of weight, drawing in the pelvis, a pressing towards the sexual organs, or the pains are excited by bodily motioa concussion, sexual intercourse, touch. An examination showshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 78 of 653the vaginal portion harder than in the normal condition, of unequresistance, swollen, misshapen, rugged and knotty, sensitive to pure and readily bleeding; the lips of the os tincee look pufty annotched, the os is patulous. In the course of the disease pains sin, which are at first vague and occur only now and then, but aftwards become more severe and finally, especially at night, exceedingly violent, pressing, stinging, lancinating, burning, not confto the region of the uterus, but spreading to the small of the baand thighs. Characteristic are the more or less violent burning astinging-boring pains over the pubic bones and in the small of thback, along the hips and thighs, interfering with walking and evesitting; very often a burning pain is continually felt deep in thvis, accompanied by fugitive stitches darting through the uterus.The neighboring lymphatic glands are generally infiltrated andpainful. At the beginning of the trouble a serous or slimy secretion flows from the vagina, having but little smell ; more usuallthe discharge is copious, of a brownish-red, suspicioushavinga horrid smell and excoriating the skin. The bleeding becomes more and more frequent and copious, the blood being mixedwith detached portions of tissue. These hemorrhages consume thestrength of the patient in a very short time. At this stage of thdisease the ichorous dissolution of the carcinoma progresses veryrapidly. An examination reveals the funnel-shaped ulcer and thesoft, readily-bleeding excrescences ; the vagina likewise is oftemuch narrowed by the cancerous infiltration. The patients showthe imprint of the carcinomatous cachexia, together with the symptoms of a high grade of ansemia. The disease generally lasts foryears, calculating from the first manifestation of distinct synipand without allowing for the influence of special circumstances,as confinement, which is one of the most pernicious occurrences tcan happen to a woman afflicted with cancer of the womb. It is inconceivable how it is possible for the organism to bear up for soa time under a destructive malady like cancer, without perishing.Cauliflower-excrescences seldom beget symptoms different fromthose of carcinoma, and the pains are equally intense. On the othhand, however, life is less rapidly destroyed by the former, becathey are not so speedily converted into ichor, and the destructio84 Diseases of the Female Sexual Organs.of tissne does not spread so far. Hemorrhages take place more reaily from cauliflower-excrescences than from carcinoma.Treatment. No more than we reject the possibility of a cureof carcinoma generally, do we believe that carcinoma of the uteruis an incurable disease, although it is difficult to obtain certathis respect. A cure is only possible as long as the carcinoma hanot spread too far, and has not yet become converted into ichor.such a case the diagnosis is still uncertain, for sensitiveness auneven swelling of the os tine® do not constitute carcinoma; evenfetid discharge from the vagina does not settle the diagnosis. Inthe stage of dissolution every attempt at a radical cure is unsucful, and all we can do is to mitigate the patient's distress.A number of remedies have been indicated for carcinoma of theuterus, that have only a partial affinity to this disease, and arfor the most part, suitable only for the various accessory affecthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 79 of 653accompanying the cancerous destroyer. An enumeration of all theseremedies would only lead to confusion ; hence we only mention thothat can be employed against cancer generally. Our first remedy is:Kreosotum. Kurtz recommends this remedy when the followingsymptoms ai^e present : Obstinate leucorrhoea during frequently rcurring metrorrhagias, with aching or pressing pains and a gradually appearing fetid discharge of a serous fluid or a bloody ichoThis is attended with burning or lancinating pains in the small othe back and loins. When standing she experiences a sensation asof a weight in the pelvis ; coition is painful ; all the symptomsworse at the time of the menses. On examination the vagina isfound hot, the interstices of the mucous lining enlarged, the folare hypertrophied, the vaginal portion of the uterus is swollen,the OS tincfiB is garnished with small, wart-shaped or bunchy cauflower-excrescences. Hartmann describes the following group ofsymptoms : Electrical stitches in the vagina, as if proceeding frthe abdomen, causing the patient to start ; voluptuous itching inthe vagina, with burning and swelling of the external and internalabia ; hard nodosities at the cervix uteri ; ulcerative pain durcoition ; the menses appear from four to ten days too soon, and ctinue for days, with discharge of a dark, coagulated blood, painsthe small of the back and subsequent discharge of a pungent andbloody ichor; gnawing, itching and smarting in the parts; themenses stop for hours and days, but afterwards return again in amore fluid form and attended with violent colicky pains. The pres/JCarcinoma Uteri. iO,, 85'Ping downwards and the abdominal spasms contirme aft^i/^e menses, more especially in the groin and pelvic regfap^ bftstedrog fthe uterus and a continual corrosive leucorrhoea ki^ noKwaiuhig.The pains are worse at night. Sensation of fainting on risiftc, ^a peevish and desponding mood, and livid complexion. '"^una ^^\scribes cauliflower-excrescences, Hartmann true carcinoma. C.Oitbformer several cases of cure are reported in our books, of the lanot any, or at least only palliative results. It is certain thatsotum has not answered the expectations that Wahle's recommendation had excited in our minds. A weak local application of Creosote often does more good than the internal use of the drug.Areenicum album has been given with excellent success in carcinoma uteri not so much on account of the specific action of Arsenupon the sexual organs, which is rather inconsiderable and hencedevoid of any marked significance, as on account of the remarkablcorrespondence of Arsenic with the general phenomena of a carcinomatous dyscrasia. Arsenic can only be resorted to after the whohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 80 of 653organism reflects the picture of a cancerous disease. However, itonly palliates the severe pains and the sleeplessness, and perhapmodifies the profuse metrorrhagia, which occurs every now and thein the course of the disease.Nltri acidum is symptomatically indicated in carcinoma uteri, asis in many other inveterate dyscrasic conditions of the organism.The most important symptoms are: Irregular menses, they sometimes remain suspended for weeks and then appear again at shortintervals ; between the menses copious leucorrhoea of a badlyored, brownish appearance and oftensive odor. The patient looksworn, feels nervous and is depressed in spirits. Obstructions inportal circulation, such as hemorrhoids, indicate this drug. Acidnitrieum can, however, only be used as an intercurrent remedy atthe commencement of the disease ; if ichorous dissolution has commenced, this drug is no longer of any use.Graphites. The local symptoms of this drug point to carcinomauteri not any more than those of Arsenic. Out of respect for Wahlwho recommends this drug, we give the symptoms to which, according to Wahle and Hartmann, this drug corresponds: The vagina is hot and painful ; swelling of the lymphatic glands, somewhich are as large as small hazel-nuts ; the neck of the uterus ihard and swollen, on its left side there are three hard little noof various sizes and consisting of several detached tubercles whicause an acute pain and have the appearance as if they might be>>86 Diseases of the Female Sexual Organs,converted into cauliflower-excrescences ; when rising, sensationa heavy weight deep in the abdomen, with an increase of the painsand great weakneaa and trembling of the lower extremitieB ; at thtime of the menses, which appear every six weeks, the pains areworse, shortly previous to, and during the menses; the blood isblack, lumpy and smells very strongly ; constant complaint as iflump of lead were lying in her abdomen, with violent lancinatingstitches in the uterus, darting into the thighs like electric curthe pains are always burning and lancing; frequent lancinatingstitches in the uterus, darting into the thighs ; not much appeticonstipation from two to four days, followed by stool with muchpressing; livid complexion; frequent chilliness, without any subsequent heat or sweat ; feels sad, anxious, desponding ; pulse frquent and hard.Conium maculatum is powerfully related to the female organs, buthas no specific affinity to carcinoma ; the menses are very muchdiminished, nor has it any hemorrhage from the uterus. We donot see why Conium should be so universally recommended for carcinoma uteri ; moreover, there is not a single case on record substantiating the curative virtues of Conium in this disease. It caat most only be used at the beginning, when the diagnosis is stiluncertain.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 81 of 653Nor do we see upon what grounds many other remedies havebeen recommended for carcinoma uteri, Thuya occidentalis for instance, which is recommended simply on account of the wartexcrescences, or lodium^ Carbo aniinali3y Aurum^ SiliceUy Sabina^Sepia may perhaps do some good in this disease.If we expect these medicines will modify the morbid process tosome extent, we shall soon find that their influence is uncertainquestionable. For the hemorrhage which is one of the most dangerous incidental symptoms of uterine cancer, we refer to the remdies that have been recommended for menorrhagia and metrorrhagia.The conduct of the patients, outside of the use of medicines, isof the utmost importance. Their anaemic appearance renders ahighly nutritious diet indispensable, perfect cleanliness is likeneedful to their comfort ; nor should injections of water into thvagina ever be omitted. [The use of disinfectants in this diseaseindispensable ; one of the best disinfecting agents is the Permannate of Potassa to which attention has already been called whenspeaking of stomatitis and scurvy of the gums. BL]Various Morbid Conditions in the Sexual System. 878. Tarious Morbid Conditions In tbe Sexual System of tlieFemale.Climaxis, Critical Age^ Change of Life. The phy Biological involution of the uterus or the cessation of the faculty of conceivingattended in almost every woman with more or less marked derangements which, however, cannot be regarded as morbid conditions anymore than the ailments announcing or accompanying the appearanceof the menses. If the derangements alluded to are disproportionately severe and troublesome, we have of course to regard them asmorbid afiections requiring medicinal aid. A common complaintat the critical age is the flooding. L^efore interfering medicinait is always best to first inquire whether it is a disease. Thistion is best determined by the general health of the patient ; ifis not impaired by the flooding, medical treatment is not calledWe often see robust women lose a quantity of blood at intervals osix to sixteen weeks and longer, but instead of being made sick bsuch losses, they get, on the contrary, rid of all sorts of congesymptoms by which they had been tormented heretofore. Otherwomen, on the contrary, after such flooding exhibit signs of extrdebility and anaemia, which shows that the loss of blood is not anormal physiological phenomenon. The loss of blood may alwaysbe said to be abnormal if it occurs more frequently than the mensThe proper remedies are pointed out in the chapters oiT MenstrualIrregularities and Metrorrhagia.Other abnormal conditions may arise from the disturbances causedby stasis of the blood. As a matter of course, the organism, aftethe naturul cessation of the menstrual flow, has gradually to resthe equilibrium of the circulation, and we seldom meet with awoman in whom this restoration takes -place without any signs ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 82 of 653disturbance. It is most frequently the abdominal organs that suiffirst the liver, next the stomach and kidneys ; piles not unfrequmake their appearance. The principal remedies for these derangements are : Sepia, Belladonna, Lycopodium, Nux vomica and SulphurThe heart, lungs op head are less frequently aftected by these cogestions, for which Hartmann recommends Crocua. As a rule theremedies for these congestions are the same as those recommendedfor hypereemia of the Iffiain, [more especially Aconite, Veratrumand Cirnidfaga raceinosa. For the sudden flashes of heat to whichsuch patients are liable, we recommend beside the remedies that ausually resorted to, such ^as Sepia, Sanguinaria, etc., Veratrum88 Diseases of the Female Sexual Organs.and Cimidfuga. For congestions of the heart, Aconite^ Digitalis aCactus may be required. H.]Prolapsus uteris which is always more or less occasioned by a relaxation of the vaginal mucous lining, can scarcely ever be curedby the exclusive use of internal remedies, and it would be wrongexpect such a result without at fhe same time resorting, to mechaical means. Hartmann recommends as adapted to such conditions :Arnica^ Mercurius^ Nux vomica^ tSepia, Belladonna^ Aurum andCalcarea carbonica; we confess, however, that we have never seenthe least curative effect from any of these remedies. [CimicifiigJSamamelis and Helonias are employed with more or less success,most generally in connection with pessaries and supporters. H.]Sterility depends upon the most diversified conditions of the system. Most commonly it is due to a disharmonious degree of excitability in the man and woman. Generally this want of harmonyis owing to the dissolute life which the man may have led beforehis marriage, and by which he may have reduced his sexual powersbelow the point of normal action. It may likewise be the woman'sfault, if she had indulged in sell-abuse. In such cases medicinesare of very little use, whereas proper hygienic rules may accompla great deal of good. Above all things sexual intercourse shouldbe indulged in very moderately. If the woman is really suftering,her troubles will have to be met by appropriate medicinal treatmeHartmann hts the following brief advice : If the sterility is cauby an excess of sexual passion on the part of the woman, Platinaand Phosphorus are the most promising remedies. If the mensesare suppressed, we give Conium maculatum ; if they are too profuse, Mercurius^ and at the same time too early : Natrum muriaiicum J Calcarea carbonica^ Acidum sulphuricum^ Sulphur; if themenses delay : Graphites arid Consticum ; if they are too scantyAmmonium carbonicum. If husband and wife meet normally, andno conception takes place, Hartmann advises them to take frequentdoses of Sabina or Cannabis. So far as we know, no particular results have been obtained by this treatment, and we doubt very mucwhether the remedies which Hartmann advises can do much good.On the contrary, in our opinion the remedies for menstrual irregularities or for the other morbid conditions of the sexual organs,to be resorted to in treating sterility. This defect can only bemoved, if both husband and wife endeavor to avoid with scrupulouscare every thing that might have a tendency to prevent conceptionP'uritus vidvoij itching of the pudendum, is symptomatic of manyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 83 of 653Vanous Morbid Conditions in the Sexual System. 89more or les8 acute diseases of the sexual organs, likewise at thecommencement of pregnancy, both among young women as well asamong those who are of a more advanced age ; very commonly itprecedes the appearance of the menses for a few days. Under suchcircumstances the trouble is not so very distressing, and does norequire any special treatment. The real pruritus is generally metwith among older females shortly before and after the critical cesation of the menses, more especially if they are unmarried. Intheir case the itching is horrid, deprives them of sleep and causvariety of nervous ailments ; yet an inspection does not reveal aabnormal symptoms, except perhaps a greater dryness of the vaginamucous membrane. The trouble often continues unceasingly formouths. Most commonly, however, such individuals are aftectedwith hemorrhoidal swellings, and the idea suggests itself that thitching may perhaps be caused by an engorged condition of the veiin the vagina. Among the remedies for this inconvenience Caladiunseguinum is the most certain and efficacious, as we are able to afrom personal experience. Moreover, we may derive benefit fromConium maculatunij Lycopodium^ Platina and Sepia, [If the partsare very much swollen and engorged with blood, and the itchingand burning are very great, we have have given with perfect relieAcomte and Belladonna in alternation ; sometimes we have derivedbenefit from the external use of Uamarnelis, If an inspection thra glass reveals the presence of a fine fungoid herpes on the partwe use a weak solution of the Sulphite of Soda as an external application. One of Dr. Dewce's favorite local applications was asolution of Biborate of Soda, Injections of dilute cideralso resorted to. H.]iNeura/gia of the Uterus. Although this affection has been variously alluded to in the different chapters on menstrual irregularties, yet we deem it useful and expedient to transfer the followimore compact picture of this disease from Kafka to our pages:Neuralgia of the uterus consists in a variety of painful sensatioin the uterus, previous to, or at the commencement or during thecourse of the catamenial discharge.As long as these pains are not excessive, we designate this condition as painful or difficult menstruation. If the pains reach a hdegree of intensity, they become colicky, and we describe them asmenstrual colic.K these pains appear between the menstrual periods, they constitute a peculiar form of uterine neuralgia which we shall discupresently.90 Diseases of the Female Sexual Organs.Pains in the uterus before or during the menses attack moreespecially individuals of sensitive or very irritable dispositionas well as women whose uterus had become very irritable partlythrough psychical and partly through external causes. Amoroaahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 84 of 653fancies, the reading of love-stories, slippery conversation, voludreams, etc., are just as frequently the causes of painful menstrtion as a libidinous rubbing of the parts, amorous dallying, onanetc. All these causes keep up a constant irritation in the uterusthe consequences of which are congestion or nervous erethism ofthis organ.Uterine neuralgia between the menstrual periods may be causedby catarrhal metritis, especially after confinement with slow orperfect return of the uterus to its normal condition, chronic inftions, displacements and flexions of the uterus, protracted lactaexcessive coition as in the case of newly married persons or prostitutes.Previous to or during the menstrual period the pains set in eithein a mild form or with much vehemence. In the lormer case thepains are at times tearing, at other times cutting, or drawing, ping, contracting, griping, burning ; they are mostly experiencedthe region above the symphisis pubis, are either fixed or wanderiand are sometimes felt in the uterus, at other times in the vaginor at the entrance of the vagina, in the rectum, bladder, and notunfrequently assume the form of labor-pains.If the pains set in with a great deal of vehemence, they act likecolic ; they are most generally contracting, tearing, griping oring, spread from the umbilical region to the uterus, the vagina,urethra, the anterior surface of the thigh, the small of the backover the entire hypogastriuni, not unfrequently causing a sensatiof burning in the parts where the pain is felt. "When the painsreach the acme of intensity, females with sensitive temperamentsare not unfrequently attacked with nausea or even bilious vomitintheir features look collapsed and the extremities are cold. In otcases, especially if the patients are of a plethoric habit, the cbecome flushed, the temperature of the body is increased, the pulis accelerated, the thirst intense, with a longing for acidulateddrinks." If vaginal blennorrhoea is present, these phenomena frequently denote a condition like catarrhal metritis which not unfrquently becomes aggravated before or during the menstrual flow.In case of chronic engorgements or displacements of the uteruspains are not always present, but the neuralgic affection manifesVarious Morbid Conditions in the Sexual System. 91itself in the form of disagreeable sensations such as weakness, lguor and pressing towards the small of the back or thighs, patulocondition of the vulva with sensation as if the pelvic viscera wopress out. These uncomfortable sensations are sometimes accompanied by frequent but ineffectual urging to stool, frequent desito urinate with scanty emission of urine.The pains are sometimes so trifling that they are not even noticeby the patients. The colicky pains are always very penetratingand distressing, and sometimes last for hours and even days.The pains are often accompanied by other derangements that areof sufficient importance not to be overlooked. At one time it ispain in the temjioral region, on one side of the head, or a presshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 85 of 653pain in the vertex or occiput sometimes increasing to an intoleradegree of intensity ; at other times spasmodic muscular contractiare experienced in the oesophagus or larynx, sometimes taking theshape of globus hystericus, laryngismus or aphonia ; again, symptoms of dyspnoea with oppression of the chest and increased or unrhythmical palpitations of the heart set in; at other times thepatients complain of dyspepsia with accumulation of gas in thebowels, muscular weakness especially of the lower extremities,aggravated by the least exertion ; then again we notice symptomsof reflex-action in the sympathic range taking the form of spasmodic weeping or laughing ; or the spinal nerves are consensuallyaffected giving rise to convulsions. In many cases the sensoriumdisturbed in consequence of reflex-action, resulting in loud andcious delirium and even ecstatic conditions. At the same time themenses are either excessively profuse or very much diminished.The prognosis of uterine neuralgia is generally favorable ; if depending upon structural lesions or displacements of the uterus, idoubtful. In obstinate cases of this kind the age of the patientdetermines the chances of a successful treatment ; if the criticaage is near at hand, a speedy cessation of their troubles may besafely promised all such patients ; experience has taught us thatthe cessation of menstruation the uterine pains disappear.Beside the remedies that we have recommended for the variousforms of menstrual irregularities, more especially for difficultpainful menstruation, we derive particular benefit in these neuraaffections of the uterus from :Aconitum, lower and middle potencies ;Gelseminum, generally if given in tolerably large doses ;Cimicifuga racemosa, likewise to be given in reasonably large dos92 Diseases of the Female Sexual Organs.Magnesia muriatica, lower and middle attenuations ;Hypericum perfoiiatum, lower attenuations.Aconite is generally indicated by a throbbing or peeking pain mthe uterus, sensation of fulness, heat, or a hard aching and seatpain in the uterus, nausea, headache, palpitation of the heart. IAconite does not relieve,Cimicifuga Tnz,j be given, more especially if the symptoms, forwhich this remedy has been recommended when occurring at thecritical age, are present, such as headache at the top of the heachilliness with flashes of heat, etc.Gelseminum, We are not aware that this medicine has been muchused in uterine neuralgic affections of the womb, except in so faas they are symptomatic of menstrual disorders, dysmenorrhoea, etor in so far as they occur in child-birth. The neuralgic pains, twhich both Aconite and Gelseminum are homoeopathic, are mostgenerally, though not necessarily, attended with signs of vasculaengorgement. These two remedies are very often given in alternahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 86 of 653tion with great benefit to the patient.Magnesia muriatica has shown good curative effects in purelyspasmodic affections of the uterus.Hypericum perfoiiatum. Violent tearing in the genital organs,Tvdth desire to urinate ; tension in the region of the uterus asa tight bandage ; the menses delay in such a case.If neuralgia of the uterus is a secondary affection, dependingupon other primary pathological conditions of the uterus, prolapsus, anteversion, retroversion, lateral displacements, flexures,these causes have to be removed before a cure can be thought of.Chronic engorgements, in connection with neuralgia, may requireBelladonna^ Veratrum viride^ Aconite^ Mercurius sd.^ etc. Subcutaneous injections of Morphia and Atropine have relieved the mostobstinate cases of uterine neuralgia. H.]O. Taginodynla.Neuralgia of the Vagina,"We extract from Kafka the following notice of this subject : Themucous membrane of the vagina is neither swollen nor hypersemic,its secretion is not increased, its appearance unaltered. This diis either a local affection of the vagina, or else it is complicauterine neuralgia. It may be caused by lascivious fancies, masturbation, abuse of sexual intercourse which is only partially grfied ; discharge of an acrid, corrosive secretion from the uterusVaginodynia. 98tating pessaries, ascarides in the vagina, dust in the uterus, diments of this organ, etc.The symptoms are in part local, and in part general. Among thelocal symptoms we notice a peculiar itching or tickling of the vagina of various degrees of intensity. If not excessive, this titition of the vagina can be borne ; it does not excite the sexual psion, or at least very triflingly ; it causes a slight sensationin the vagina and an irresistible urging to scratch or rub the iting parts of the vulva or vagina, which generally causes a rednesot the mucous membrane and an increase of the temperature. Inproportion as the warmth of the itching parts increases, they likwise become affected with a striking dryness, which is very troubsome to the patients.In sensitive and excitable women the sexual passion is first excited by the frequent rubbing of the vulva or vagina ; at such atime the eyes glisten, the cheeks look flushed, the head is hot.the rubbing is continued, a pleasurable sensation is excited, whicontinues until a seminal vesicle is detached after which the perfeels exhausted, the face looks pale and a certain moroseness orleuness of temper prevails.An observing physician is not slow to observe these changes inthe looks and mood of his patient. They constitute important phenomena in the case of young girls whose sexual passion could nothttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 87 of 653properly be made the subject of professional inquiry.The titillation in the vagina may become so violent that it mayrouse an irresistible desire for sexual intercourse, and may evento self-abuse. In one case of this kind, an examination showed ththe titillation was excited and kept up by retroversion of the utExcitable, generally sterile women of feeble constitutions, loseseminal fluid during a paroxysm of titillation, without resortingfriction ; others become nymphomaniac and may even go so far asto invite men to sexual converse. Other women experience at thesame time violent pains in the uterus, heat in the vagina, an increased secretion of mucus and a high degree of nervous erethismand hysteric irritability of temper, sometimes extending to the ssorium and resulting in delirium or hallucinations.' Sometimes the titillation and the sexual excitement are entirelabsent, and the vagina is in a condition of hypereesthesia. Coitiis exceedingly painful ; even a digital exploration causes pain,vagina contracting spasmodically around the finger. Such womengenerally remain sterile.94 Diseases of the Female Sexual Organs.These spasmodic contractions may even spread to the urethra andrectum, causing a continual urging to urinate and to evacuate thebowels. Vaginodynia often lasts for years and is very difficult tcure. Cases depending upon displacements of the uterus, are themost obstinate.Treatment. In order to obtain perfect certainty regarding thetrue nature of the disease, an ocular and manual examination ofthe vagina is indispensable.For simple itching, without any simultaneous excitement of thesexual passion, we give Svlphvr and Graphites^ the former if theitching is more of a burning nature, the latter if the itching istended with a smarting sensation in the vagina.The troublesome feeling of dryness in the vagina is relieved byfrictions with the best kind of olive-oil. If this is not sufficithe vagina is cool and pale, we give Ndtrum muricUicum 6 to 80. Ithere is much heat and redness, we give Belladonna 3.K the titillation in the vagina is attended with lascivious desirand there is a good deal of nervous erethism, pain in the uterus,meteorism, torpor of the bowels, JKuz vomica is the remedy. Cannobis indica 3 is likewise excellent under such circumstances, liwise if there is a good deal of urging to urinate, burning duringurination, and the vaginal lining membrane is hot and dry.Calcarea carbonica may be given in alternation with, or after Nuxvomica.Zincum rnety if the titillation occurs during the menstrual flow;Mercurius sol.y if the itching is confined to the labia and the eto the vagina.If symptoms of nymphomania are present, we may give Nuxvomica^ Flatina^ Zincum meL^ also Stramonium and Hyoscyamus.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 88 of 653If the titillation in the vagina arises from dust in the vagina,we may resort to tepid Sitz-baths, also to iiyections of tepid wacastile soap and water, a weak solution of the Sulphite of Soda.For the itching caused by ascarides, s^ Helminthiasis.For painful ness of the vagina during intercourse we give Ferrumacet 8 to 6, also Ferrum muriat. 3 to 6,If the itching is attended with aversion to sexual intercourse,Phosphorus is a good remedy.[Vaginismus must not be confounded with the neuralgic condition of the vagina described in the preceding paragraph. Vaginismus is a spasmodic contraction of the vaginal sphincter which,far as we know, is beyond the reach of internal treatm^it* Dr.Mastitis. 95Thomas, in his recent work entitled : "A Practical Treatise on thDiseases of Women," informs us that this disease was first describy Burns, who advised an operation which .is at present regardedus the only reliable method of cure. This operation has been recently performed by one of our own most brilliant surgeons, WilliTod Ilelmuth, of St. Louis. According to Dr. Thomas the causesof vaginal spasm are : The hysterical diathesis ; excoriations orsures at the vulva ; irritable tumor of the meatus ; chronic metror vaginitis ; pustular or vesicular eruptions on the vulva ; neumata. For a full description of the disease and its surgical treament we refer the reader to Dr. Sims' paper upon " Vaginismus,"communicated to the London Obstetrical Society, Nov. 6th, 1861,or to Sims' work on Uterine Surgery. H.]Inflammation of the Breasts*The mammse constituting exclusively a part of the female organism, we prefer treating of inflammation of the mammse in this plainstead of ranging this disease among the diseases of the thoraciorgans.Mastitis proper only occurs during or immediately after lactationTlie painful, sometimes rather extensive, indurated swellings ofsingle portions of the mammse, which sometimes occur among unmarried females or married women who are not nursing, especiallyabout the time of the menses, are evidently transitory states ofhyperemia which never terminates in suppuration. The cause ofmastitis is always traceable to the impeded excretion of the milkBy some cause or other, soreness or a bad shape of the nipples, tfeeble drawing by the child, one or more lactiferous ducts becomeclosed, the milk in the corresponding mammary lobule becomesstagnant, and an inflammatory process is the result. Another causof obstruction of the milk-ducts is the improper manner in whichsome women wear their clothes, owing to which the breasts eitherbang too loosely or a direct pressure is exerted upon them. The dtrine that mastitis can originate in dietetic transgressions or ais a convenient supposition rather than a scientific fact ; but t80 &r as to assert with Hartmann that mastitis is one of the multhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 89 of 653liarious manifestations of psora, is more than can be proved by abody. What happens with other abscesses, is likewise true in regato abscesses of the mammse : in some cases they heal rapidly, incases they catase vast destructions of tissue. Mastitis is most a96 Diseases of the Female Sexual Organs.to occur soon after confinement or shortly after weaning the chilmastitis occurring at the latter period is less apt to lead to thmation of abscesses.Symptoms. The disease never breaks out all at once. Generally women experience some time previous, a gradually increasingpain both spontaneously or while the child is nursing ; and a sweof one or more mammary lobules, which rapidly increases in extentand induration, develops itself soon after. As a rule the lower olateral lobes are inflamed, very seldom the upper ones, and stillless frequently both mammae. Sooner or later, sometimes in a fewdays, and at other times in some weeks, the painful spot becomesred and more sensitive, and the inflammation is intense, the wholorganism feels the effect of the inflammatory process and shows isympathy by febrile phenomena. Soon the infiltrated tissue showsthe signs of suppuration, the pus being discharged through a smalopening. As soon as the discharge, which is never complete, commences, the pain suddenly ceases and the febrile symptoms abate.The course of the inflammation depends upon a variety of circumstances. If the inflammation is confined to one lobe, the abscmost commonly discharges close to the nipple, empties itself veryrapidly and heals. If several lobes are inflamed, or the inflamedlobe is situated near the base, the suppuration, swelling and paicontinue for a long time ; months and even years may elapse beforthe abscess heals, which discharges through several openings nearthe nipple. This disorder never lasts less than two weeks, and,under corresponding circumstances, may continue for months evenin its acute form.The treatment of mastitis includes above everything else a prophylactic treatment which has to be commenced long before confinement, especially in the case of primiparse. The preservation andproper management of the nipples and of the mamm» generallyshould be a constant subject of our attention. After confinement,if women do not intend to nurse their children, they will have todispense with liquids as much as possible. Nursing women have tokeep the following points constantly in view : the breasts must nbe kept too warm, must not be enclosed in tight clothing, and musby some suitable support, be prevented from dragging down ; everytime after the baby has nursed, the nipple must be washed, but nokept moist between the acts of nursing ; the excessive use of liqwhich women fancy favor the secretion of milk, must be avoided ;the child should be put to the breast as seldom as possible, forMastitis. 97more hungry it is the more vigorously it will draw and the morecompletely the breast will be emptied. At the same time the niphttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 90 of 653ples will not be held so long in the child's mouth, and they willbe exposed so much to the risk of being made sore by the constantnursing. By following these instructions, and more particularly bputting the child to the breast every two hours in the early periafter confinement, mastitis will generally be prevented. By pictuing this disease in its most horrid form, women can generally beinduced to comply with the course recommended by their physicianhis warning counsels in trying to prevent this disease as well asgastric catarrh of children, are generally more potent than all tmedicines of the drug-shops.If the breasts have become hard and painful, the best remedy inthe case of lying-in women is Bryonia^ less frequently Belladonnawhereas the latter medicine is better adapted to women who areweaning their infants. We sometimes succeed in dispersing thestagnation of \h^ milk by gently rubbing the indurated portionwhile the child is nursing. The same good effect is sometimes obtained by causing the milk to be drawn by an older, more vigorouschild. In no event should the infant be all at once kept from thebreast, even if nursing causes pain. It is only if the pain is veacute, and the hardness considerable that the infant should no lobe put to the diseased breast. Belladonna will now have to be administered. As soon as redness has set in, the chances of scatterthe inflammation are very slim ; in some exceptional cases we maysometimes succeed in effecting this result by a few doses of Mercrius. Warm poultices should never be omitted ; they sometimesfavor the dispersion of the abscess as much as in other cases thehasten the process of suppuration. It is best not to apply themuntil pus has begun to form. Hepar siUphuris will sometimes promote the discharge of the pus. A great many authorities teach toopen the abscess at an early i)eriod in order to prevent the furtspread of the inflammation. We doubt whether such a proceedingis justified by corresponding results ; after opening the abscesshave often seen the inflammation spread much more rapidly;in the most tedious cases of mastitis, the abscess had been openein accordance with this suggestion. On the contrary, if the abscewas not opened and the above-mentioned remedies were used, wehave never seen mastitis run a tedious course. This cannot havebeen owing to the mildness of the cases ; a coincidence of this kcannot be supposed probable. Most homoeopathic physicians avoid798 Diseases of the Female Sexual Organs.the lancing of such ahscesses, and yet can boast of excellent resThis shows that their medicines must have an effect which, in succases, our opponents are doubly disposed to dpubt and to deny. Wedo not mean to say that the abscess should not be opened if the pis distinctly seen through the skin ; what we oppose is the openiof an abscess where the tissues situated below the epidermis haveto be divided. In this respect a mammary abscess is to be treatedlike any other abscess. If the tissues through which the abscesshas to discharge, are of a nature to render every effort towardsspontaneous discharge nugatory, they have to be divided with theknife. A case of this kind occurs very rarely under homoeopathictreatment.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 91 of 653After the abscess has commenced to discharge, the course of thedifficulty is quite different under homoeopathic from what it isunder allopathic treatment. In a fortnight at latest the dischargof pus ceases under the use of a few doses of Mercurius^ and thesore heals. K this is not the case, if the hardness and pain continue and the pus is secreted in small quantity ; or if the infiltion keeps spreading, and we are called upon at this juncture totreat the disease, Hepar sulphuris is to be given first. After usthis remedy, the suppuration generally increases and the pain abaPhosphorus deserves a preference if the inflammation frequently rassumes the acute form after an apparent arrest of the inflammatory process ; likewise in the very rare cases of phthisis of themammse. K the breast has become callous, and fistulous canalshave formied, the healing of the sore will prove a very protracteprocess. In such cases Siliceay Svlphuvy Conium and Graphites mayprove the best remedies.[Regarding the use of Aconite in mastitis, Kafka has the following : K the breast swells in consequence of a cold or of a mechanical injury, and a deep-seated pain is experienced in the mammae,we at once give Aconite 3 in solution every hour ; the local hypemia will most speedily be scattered under the influence of this rand, if the pain was owing to a cold, a general transpiration wilspeedily take place, after which the inflammation nius a muchmilder course and often terminates in dispersion without sup^puration.Our poke or the Phytolacca decandra has long been used in domestic practice as a remedy for swelling and inflammation of thebreasts. We refer the reader to Dr. Hale's notes on this subjectthe second edition of his Kew Remedies, pages 794 and further.Mastodynia. 99The medicine should be used internally and applied externally bymeans of a compress soaked with a mixture of a few drops of thetincture in half a tumbler of water, or with a mild infusion ordecoction of the root, H.]11. Mastodynla.[Kafka writes : Painful sensations in the breasts, not having anyeausal connection with pregnancy or with the processes of nursingor weaning, and being most frequently noticed in girls and womenas symptoms of development at the age of pubescence or as parox}'8mB of neuralgia, do not unfrequently become the subject ofmedical treatment.At the period of pubescence, either some time before or duringor after the first appearance of the menses, some girls experiencstitching, drawing or throbbing pains, or a tingling or pricklingsensation in the swelling breasts which appear turgid and tense avery often sensitive to contact. If the girls have already commento menstruate, the painful sensations most commonly make theirappearance before or during the menses. If menstruation has notyet commenced, the pains generally continue until the age of pubescence has been reached. Sometimes the breasts are so sensitivehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 92 of 653that the least touch, the least friction from the underclothes, oleast pressure, are almost unbearable. This sensitiveness extendseither over the whole breast or is confined to the region of thenipples.The sensitiveness lasts for a longer or shorter period accordingthe development of the organism is more or less rapid. We areacquainted with cases of hypersesthesia of the breasts that continued until the patients were married, and spread even to otherparts of the body, particularly to the region of the stomach, uteand pudendum.The breasts are likewise liable to being attacked with pains thatare not connected with the period of pubescence, but depend upon*mechanical, traumatic or constitutional causes. They attack periodically full-grown girls or women, are seated in the mammarygland or nipples, come on in paroxysms, are lancing, tearing, draing or boring ; they are generally worse about the time of themenses, are aggravated by pressure, and, if lasting a certain timresult in the formation of small tubercles in the mammary gland,of a rounded shape, smooth and of the size of hazelnuts.8uch paroxysms of pain scarcely ever occur spoptaneously, and100 Diseases of the Female Sexual Organs.are generally caused by the continued pressure of tight garments,corsets, whalebones, or they are caused by pinching, pulling, consions, blows, etc. Sometimes they aro the result of chlorosis, tuculosis, carcinoma or constitutional syphilis. Their duration isdetermined by the continuance of the exciting causes.In treating these affections the cause has to be removed beforeanything can be expected from internal treatment.For simple hypersesthesia of the breasts Belladonna and Nuxvomica may be given. If the affection can be traced to a delay inthe appearance of the menses, Pulsatilla^ Caidophi/Uum^ Belladonnmay be useful. If the pains are stinging and the patients are atthe same time very nervous, we give Calc. carb. or Nuz vomica. Ifcaused by a blow, contusion, etc. Arnica^ Conium or Sepia may berequired. For tearing pains we give Conium 8 or Baryta carb. 6,and if seated in the nipples, we give Bismuth 6, or Calc. caust.Drawing pains in the mammae require Kreosote 3 to 6, and if seatein the nipples Zinc. met. 6. For boring pains in the mammae wegive Indigo 8 to 6, and if affecting the nipples Spigelia 8 to 6.sensation of prickling in the nipples is relieved by Sabina 3 toIf these pains result from constitutional causes we have to direcour treatment against the latter. If traceable to chlorosis, we gIron persistently, in the case of tuberculous patients Iodine; ifcarcinomatous diathesis is suspected we resort to Conium and Ranabufo; if syphilis is the cause, we give Mercuriv^ jodatus and Cinbans. At the same time the breasts have to be covered with softmaterial, and carefully protected against friction, pressure andcold. H.]!•• Carcinoma ]IIaiitiii»«http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 93 of 653Cancer of the Breasts.Next to the uterus the mammae are most frequently attacked bycancer. Cancer of the mammae is most commonly of a primarynature, hence the beginning of the cancerous disease.The causes of this disease can scarcely ever be determined withcertainty. If a blow or a contusion is generally regarded as thecause of this disease, it is probably because no better cause canfound, not because the disease has ever been known to result immediately from such an injury. The influence of depressing emotions which are so easily und so commonly succeeded by cancerousdegenerations, is a much more evident source of the cancerousCarcinoma Mammae. 101disease. Cancer of the rnammse most commonly occurs betweenthe ages of 40 and 50, about the period which is generally designated as a change of life. Unmarried women or women whohave not had children seem to be more liable to it than marriedwomen with children. Before and after this period, it is proportionally a rare occurrence.The most frequently observed form of carcinoma of the mammaeis scirrhus, next to w^hich we range the encephaloid or medullaryfungus, the alveolar or colloid cancer and the epithelial cancerepithelioma.[Mr. Maurice H. CoUis of Dublin, in his work "The Diagnosisand Treatment of Cancer, and the Tumors analogous to it" 1864,has thrown out epithelioma and colloid growths from the truecancer-group. He regards Colloid as a mere variety of fibroid orrecurrent tumors. Virchow says that " its stroma differs in its ctaining mucus and in its gelatinous nature from the ordinarystroma of cancer," page 526, On Tumors. Mr. Collis says, in rejecting epithelioma from the group of cancerous tumors: "Its superficial origin, its slow progress, its indisposition to infiltrdeeper structures, or to contaminate the glands, the certainty ofcure which follows its timely removal, and the difterent appearanwhen occupying similar localities, are of suflicient importance toutweigh the points of resemblance which it undoubtedly bears tocancer in its advanced and secondary stages. In its early stage iis strictly an hypertrophy, and in this condition it may remain fan indefinite period. Its second stage is one of hypertrophy andulceration combined. This stage also, as far as external or cutaneous epithelioma is concerned, is slow to advance into the thirdor destructive stage, that of infiltration and secondary deposit,page 226. Speaking of Colloid, Virchow writes: "It remains for avery long time local, so that the nearest lymphatic glands oftennot become affected until after the lapse of years, and then agaithe process is for a long time confined to the disease of thelymphatic glands, so that a general outbreak of the disease in alparts of the body does not take place until late, and only in rarinstances." (See his work on Tumors, page 581.) H.]The commencement of the disease is scarcely ever marked bypeculiar morbid phenomena ; the patients generally do not noticehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 94 of 653anything out of the way until a tolerably large tumor is perceivein the breast. It is at first round, smooth, movable, grows withmore or less rapidity, and loses its mobility in proportion as it102 Diseases of the Female Sexual Organs.creases iu size, and its surface becomes more uneven. At first itmost commonly deep-seated and gradually grows towards the surface, is sometimes entirely painless or becomes painful only at ttime of the menses and when receiving some mechanical injury.If the cancer reaches the skin, it coalesces with it, after whichpains are almost constantly felt. At the same time the disorganizing process extends to the deeper tissues, and at an early stageaxillary and other neighboring glands become involved. The patients now conmience to feel constantly or at intervals, and partularly at night, lancinating, boring pains in the affected part wvery soon become unbearable. The assimilative functions begin tosuffer; the patients have a pale yellowish-gray appearance, thespirits are very much depressed. A characteristic sign is the graual effacement and finally the complete retraction of the nipplewhich discharges either spontaneously or on pressure a turbid,serous fluid. At the place where the cancerous growth first becaminterwoven with the skin, the latter by slow degrees loses itshealthy color, and finally breaks. An irregularly-shaped ulcerforms showing a disposition to penetrate to the subjacent tissuesthe edges of the ulcer are infiltrated, have a sickly color and auneven base, and secrete at first a thin, serous and afterwards aichorus, purulent, sanguinolent and most commonly very fetid fluiIf the disease runs a slow course, the incipient ulcer often heala time, but again breaks open at a later period ; if the diseasea rapid course, spongy and readily-bleeding excrescences are aptshoot up from the bottom of the sore. If larger vessels becomenecrosed, hemorrhages take place which are sometimes very profuseat other times trifling. The further course of the disease which,having arrived at this stage, always terminates fatally, dependsupon the extension of the cancer, upon the invasion, by the carcinomatous process, of internal organs, upon the importance of thehemorrhage and upon the loss of fluids in consequence of theichorous discharge. Medullary fungus generally terminates fatallymore speedily th^in schirrus ; the latter may even continue for ybefore the skin ^breaks, whereas . medullary fungus terminates inichorous dissolution in a comparatively short period of time.The duration of the whole disease varies considerably, rangingfrom two to twelve and even more years. The younger the patient,the sooner she will succorab to the disease, and the more suddeuthe cancerous growth, the sooner it will destroy life. The prognois very bud with scarcely an exception.Carcinoma Mammae. 108In many respects the diagnosis is liable to difBculties, becausevarions kinds of benign tumors may occur in the breast. An incipient cancer cannot always be recognized as such, though it maygrow rapidly and be painful ; these two conditions never occur inthe case of benign tumors. At a later period the diagnosis is dehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 95 of 653termined by the retraction of the nipple, the fluid which it discharges, the rugged unevenness and immobility of the swelling, thparticipation of the neighboring glands in the disease, the failiof the whole organism without any increase of the secretory products. Nevertheless there occur many cases of cancer the trueuature of which remains for a long time undetermined and isclearly revealed only after the disease has run a long course.Carcinoma of the mammse is generally considered a surgicaldisease; it is supposed by most authors that internal treatmentcannot reach it. The disease, at least in its incipiency, is conspurely local, and an operation the only cure. It is as yet difficto show what method of treatment is the most successful in thisdisease, but physicians seem to incline more and more to the belithat the extirpation with the knife simply leads to the transferthe disease to more vital organs, without affecting its general dtion. Homceopathic physicians have, for a long time past, rejecteevery extirpation of cancer as injurious or at least unproductivegood results.Unfortunately we are unable to affirm that Homoeopathy isacquainted with a safe method of healing cancer ; at present weare not acquainted with a single undeniable cure of this disease."We are entitled, however, to claim palliative results for our trment ; it never increases the trouble, and delays a fatal terminawere it from no other cause than because it does not rob the patiof her strength.Hartmann mentions a number of remedies for cancer, with amultitude of indications which we do not repeat here because theyhave seemed to us irrelevant. The remedies whicii seem to haveexerted some influence over this disease, are: Belladonna^ Arsenicum^ Carbo animalis and vegetabilis. Clematis erecta^ Conium macuturn^ SepiUy perhaps also Sulphur., Kreosotum, Aurxim muriaticumand Baryta carbonica. Belladonna only alleviates the pains if theare lancing or burning pains, attended mith sub-inflammatorysymptoms, and as long as the carcinoma has not become an opensore. Arsenicum likewise is an excellent palliative against theburning pains of cancerous ulcers, especially when worse at night104 Diseases of the Female Sexual Organs.this remedy likewise diminishes or even suspends for a time thesuppuration and ichorous decomposition. Conium and Clematis,and likewise Baryta can only be used if the tumor has not yetbegun to discharge; the other above-mentioned remedies are principally of use in cases of open cancer.For further symptomatic particulars we refer to Hahnemann'sMateria Medica Pura.Other medicines have been mentioned which, however, do notseem to refer very particularly to carcinoma, such as: NitridciduPulsatilla J Bryonia^ Phosphorus ; Lycopodium, Silicea, Natrum muriaticum would seem more appropriate.Most observers agree that the higher attenuations, if given innot too frequently repeated doses, deserve the preference over thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 96 of 653lower. Their palliative effect is much more certain and persistenwhereas the lower attenuations sometimes do not seem to palliateat all. We do not mean to induce any one to accede to our views ;we would advise, however, if a lower attenuation has not seemedto have any effect to first try a higher one before the medicinechanged.The diet should be as invigorating as possible in order to sustaithe patient's strength; above all the most scrupulous cleanlinesshas to be observed.[The Hydrastis canadensis has been used by the American Indians as a remedy for cancer. It has likewise been experimentedwith by American and English homoeopathic practitioners, but thoresults so far have not been very satisfactory. The medicine maybe given internally 3d to 6th attenuation, and applied externallyin the shape of an ointment or a solution of the resinoid Hytjira"We have used it in some cases of suppurating cancer, with somesuccess ; the destruction was arrested in its course, the pain alceased and the patients declared they felt comfortable. One ofthem was an old lady of nearly 80 years, who is still living.Bflehr's views regarding the propriety of an operation differ sowidely from those of Kafka and leading homoeopaths in our ownmidst that we deem it proper to transcribe them: If the methodical use of appropriate remedies for tumqrs in the breast remainswithout any result ; if in the meanwhile the tumor gains in size,(^ and becomes less movable, and the axillary glands have not yetbecome involved in the carcinomatous degeneration, we at onceadvise to proceed to the extirpation of the tumor. Do not waituntil the schirrous swelling has become interwoven with the tissuCarcinoma Mammae. 105of the fikin, or begins to show signs of a more marked carcinomatoos degeneration. As yet the process may be regarded as localand the extirpation succeeds perfectly in a majority of cases. Ifthese changes, however, have already taken place and if the axillary glands already begin to show signs of cancerous degenerationthe operation is very doubtful and fails in almost all such casesAs soon as the tumor has acquired a stony hardness, the skinover it is no longer movable, and the patients are tormented bysevere nocturnal pains in the swelling, a cure by internal homoeopathic treatment can no longer be thought of. We at least havnever succeeded in performing a cure at this stage of the diseaseEven at this stage the extirpation of the tumor is still feasiblebut a successful result is already very doubtful. The axillary ormesenteric glands may not yet be involved ; but the operation issucceeded by new disorganizations which very speedily terminatefatally in ichorous dissolution. A successful extirpation at thisstage has to be attributed to a fortunate coincidence of favorablcircumstances which cannot be arranged according to a definiteplan. Hence even under these circumstances we are in favor ofextirpation for the reason that it does result in a cure in somewhereas without it the cancerous disorganization progresses in itcourse towards an unavoidable fatal destruction of the tissues.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 97 of 653If the above-described phenomena of cancer of the mammae haveset in and ulceration has perhaps taken place, our treatment mustremain purely symptomatic. All we can do is to appease as muchas possible the nocturnal tormenting pains, to preserve the patieappetite and strength, to stop the hemorrhage that may set in, tocorrect the air impregnated with the pestiferous odor of the foulichor, to arrest the colliquative diarrhcea, etc.The treatment is conducted as advised by Beehr. A few additional remedies are recommended such as China 8 for extremedebility, or China and Phosphorus for the stitching pains. ArseniPhosphorus and the Arsen. of Quinine for the colliquative diarrhoAcidum sulphuricum 1 for hemorrhage at the same time applyingice-water externally, or a solution of the Perchloride of Iron, oeven touching the bleeding vessel with the real cautery.The horrid odor may be neutralized to some extent by coveringthe bottom of the sore with a thick layer of pulverized charcoalwhich absorbs the ichor; we cause the ulcers to be cleansed severtimes a day with tepid water, and we have the sick chamber airedand sprinkled with Chlore or Kreosote-water [or with the Perman106 Diseases of the Female Sexual Organs.ganate of Potash.] As regards the use of caustics of any kind,after the cancer is fully developed, we have never seen them do tleast good, on the contrary they seem to increase the pain and prmote the spread of the ulcer.If the remedies which we use, do not produce the least favorableresult, we give the patient Morphine from motives of humanity, asthe only efficient palliative at our disposal.Professor Franklin of the St. Louis College of Homoeopathyemphatically recommends a speedy extirpation of the canceroustumor and claims for the operation an almost uniform success provided every vestige of the cancer is removed, and not a singlecancer-cell is left behind. E.]EIGHTH SECTION.Diseases of the Respiratory Organs.A. DISEASES OF THE LARYNX AND TRACHEA1. liaryngotraeheitts Catarrhalia Acuta,AciUe Laryngotracheal Catarrh.Next to the catarrh of the Schneiderian membrane, a catarrh ofthe larynx and trachea is one of th^ most frequent diseases ; yethttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 98 of 653the liability of these organs to catarrhal affections cannot be acounted for either by their structure or functions.One of the most common causes of disease is a cold, whether itaffects the organs locally or through the skin. This is the reasowhy such people are most commonly affected as have renderedthemselves, and more especially the skin, very susceptible by theeffeminate mode of living. We often notice that, by keeping theneck too warm, the larynx becomes easily affected with catarrh,whereas such persons fancied that by enveloping their necks inthick cravats or comforters, they were effectually protected agaicatarrh. Since we cannot avoid frequent exposures of the neck tothe air, the susceptibility of the larynx to catarrh increases inportion as the skin of the neck is stimulated to action by an excof warm covering. Why some persons should be affected withlaryngeal catarrh from the least cold, whereas others seem to enja perfect immunity in this respect, cannot be accounted for. Anexcessive use of the organs of voice is one of the causes that bea particular disposition to laryngeal catarrh ; individuals who,accustomed to talking, have had to make long and fatiguingspeeches, or amateur-singers are very apt to contract laryngealdisease. The disposition to such diseases is very much enhanced bthe excessive use of spirits, and more particularly of the commonbeer. We shall afterwards speak of the influence which tubercularinfiltrations of the lungs exert over catarrhal affections of thea07)108 Diseases of the Larynx and Trachea.trachea; we will here state that the development of laryngealcatarrh from the least exposure very properly excites a suspicionthe presence of pulmonary tuberculosis.Secondarily laryngotracheal catarrh may result from nasal catarrhworking down to the larynx, or from bronchial catarrh workingupwards. It may likewise supervene during or in consequence ofthe presence of measles and variola, and other constitutional diseases.Symptomn and Course. The phenomena of laryngotrachealcatarrh vary a great deal according to the intensity of the diseaor the sensitiveness of the individual attacked by it. In mildattacks the disease always commences without fever although usually with a peculiar sensation of languor and heaviness in the extremities. The patients complain of a peculiar tickling, or a sorness and burning in the larynx down to the sternum, which is aggravated by coughing and talking. At the same time the voice isaltered, it is hoarse and has a peculiarly deeper and metallic sothis alteration of the voice increases, according to circumstancecomplete hoarseness or loss of voice. In a few hours already acough supervenes the particular modifications of which will be described in subsequent paragraphs. At first no phlegm is brought uby the cough, afterwards a clear, tenacious, glassy mucus is raiswhich, in a few days, assumes a greenish color, becomes lumpy andhas an unpleasant taste until, in a few days more, the expectoratassumes a globular shape, becomes more copious and has a yellowishttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopathy"Page 99 of 653white color. At the commencen(ient of the catarrh streaks of blooare frequently seen mixed with the mucus ; a copious admixture ofblood occurs very rarely.The higher grades of catarrh which are sometimes described aslaryngitis, always commence with fever which is sometimes veryviolent and continues several days. The pains in the larynx arevery acute, stinging and burning, as from a sore ; aphonia sets iat once, and every attenjpt at talking increases the pain to aneminent degree. The cough becomes exceedingly distressing, painful, sometimes convulsive, with a constrictive sensation of the rglottidis and a real difficulty of performing the act of inspiratThe larynx generally feels sore when pressed upon. In two to fivedays the fever abates, (it scarcely ever lasts longer,) and an extoration of mucus with relief of the cough sets in. In this formcatarrh the general constitution is more or less disturbed; thepatients may even be compelled to keep their beds for some days.Laryngotracheitis Catarrhalis Acuta. 109The laryngotracheitis of children is of particular importance.The children may have seemed quite well during the day, and oftenwake about midnight with a hoarse, barking cough which is sometimes associated with constricted inspirations and anxiety, so that first sight, the little patients seem to have a violent attackcroup ; yet this is evidently contradicted by the fact that on thfollowing day their health seems fully restored. The croupy soundseems to arise from the fact that during their sound sleep in thefirst imrt of the night, when the children breathe with their mouopen as they do in laryngeal catarrh, the vocal cords become verydry and are covered with a dried-up mucus ; on this account thechild's cough in the daytime has no C!t)upy sound, nor if it wakeseveral times in the night. This aftection has been designated ascatarrhal croup. If, which is less fi'equently the ease, this affis associated with a marked inflammatory swelling of tlie laryngemucous membrane, or if, generally, the affection acquires a highegrade of intensity, the croupous sound may be heard for severalnightd in succession, and may be attended with threatening symptoms of dyspnoea. Some children are remarkably liable to anaffection of this kind ; this liability is still increased by thesive quantity of clothing in which the little patients are wrapttheir relatives fcr fear of croup. It is of such children that phcians hoar the report they had had several attacks of croup, andthat they have an attack every spring and fall. There are physicians who encourage this kind of belief wluch is hurtful to boththe parents and their children.We have to add a few words concerning the cough which accompanies this afiection. Many individuals whose laryngeal mucousmembranes are evidently not very susceptible to catarrhal irritations, have no cough in spite of a most severe attack of catarrh,they cough only once or twice a day. Othere, on the contrary, experience even at the onset such a violent and continual irritatioand desire to cough that they cough uninterruptedly, or have violparoxysms of cough which often last four hours and end with anattack of vomiting, or even become associated with a spasm of theglottis. This kind of violent cough is generally peculiar to thecatarrh accompanying measles.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 100 of 653The disease lasts at most nine days, but, if the cough is veryviolent, it rarely ever disappears entirely at the termination ofperiod. As a rule, while decreasing gradually, it continues for stime after, or, if the patients are again enabled to go out, it o110 Diseases of the Larynx and Trachea.disappears of itself as soon as a steady and mild weather sets inMore frequently the hoarseness continues for a longer time, wereonly just enough to interfere with singing, if not with talking.The transition into chronic catarrh is very frequent, and is favoby the circumstance that patients, not minding the trifling disorexpose themselves to renewed attacks of acute catarrh which finalassumes the chronic form. Laryngotracheal catarrh does not endanger life unless other diseases should supervene as grave complcations.Treatment. This morbid process is not sufficiently importantto require a number of remedies. It rray be that a rigid individualization of every case may facilitate the cure, but we cannot idulge in the luxury of furnishing so many details. WhateverHartmann may say to the contrary, we consider a few practicalgeneralizations more adapted to our purpose and shall thereforeconfine ourselves to mentioning the remedies which experience haspointed out as the most valuable and reliable in this disease.Nux vomica is suitable in the milder cases that scarcely ever become the subject of a physician's care ; the patients complain oflittle hoarseness, a burning tickling in the larynx, frequent couwith tickling, scanty expectoration, and especially troublesomeearly in the morning, a weary and languid feeling, chilliness, frheadache. In the more violent cases of catarrh, Nux is only usefuif, after the fever hae begun to abate, the expectoration continuto remain tenacious and hard to raise, and the patient is tormentby a constant titillating hacking cough.Aconitum is useful in catarrhs caused by exposure to a sharp andkeen dry wind. Upon the whole, this remedy does not seem oftenindicated in simple catarrhal affections, except perhaps in the cof children in whom the febrile symptoms assume a different shapefrom what they do in the case of full-grown persons. For catarrhacroup it is undoubtedly the best remedy, which, however, ceases tbe indicated, if the physician is not called till the second or tday of the disease.Belladonna may prove most serviceable in the first few days, if tcatarrh is associated with fever. The following symptoms are characteristic : fever with disposition to perspire and sleep ; violestinging pains in the larynx ; a dry, barking spasmodic cough coming on in paroxysms, exacerbating more particularly in the eveninand beiore midnight; sensation as if dust had been swallowed;feeling of constriction in the larynx; the catarrh is complicatedwith tonsillitis ; aphonia.Laiyngotracheitis Catarrhalis Acuta. Illhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 101 of 653Mercurius acts similarly to Belladonna in this disease. It is suiable at the commenoement of febrile laryngitis, if the followingsymptome are present : chilliness and great sensitiveness to coldmingled with frequent paroxysms of a burning heat ; dry, distressing cough occurring more particularly at night and racking theframe ; the mucous membrane of the mouth and nose is involvedin the catarrh ; soreness of the larynx, hoarseness but no loss ovoice ; disposition to copious perspiration*Next to Aconite, Spongia is the principal remedy in the socatarrhal croup, with distinct symptoms of oedema of the mucouslining of the glottis. The cough is barking, hoarse, hollow, comein paroxysms, especially at night, without expectoration and wheeing inspirations. Spongia is likewise appropriate, if the croupousound of the cough still continues and lumps of a tenacious, yellmucus are expectorated.Hepar sulphuris bears a good deal of resemblance to Spongia. Itshould be given, if mucus commences to be raised, the barkingsound of the cough continues, there is a great deal of hoarsenesssymptoms of ulceration of the larynx begin to make their appearanand a constant rattling of mucus is heard in the larynx. It is ancellent remedy for singers and persons who have to talk a great dHartmann has moreover the following remedies: Arsenicumywhen there is glowing fever-heat with constant thirst, yawning,stretching, a prostrate feeling in the whole body, tearingpains in the head and limbs, oppression of breathing ; in the nigthe pains abate with the appearance of perspiration, and returnagain early in the morning ; constant desire to cough, the coughbeing dry, accompanied by dryness and burning in the larynx.JhdsatiUa : titillation wit^j cough, excited by a sensation of scand roughness in the throat, spasmodic and setting in more especially in the evening and when lying down, better on sitting up, comencing again on lying down, and sometimes increasing to suffocation ; chilliness. Hyoscyamus^ if the cough only occurs at night.Euphrasia^ if the cough continues all day, and fluent coryza ispresent at the same time. He likewise mentions Rhus^ Ignatia^Drosera^ IpecacuanJuiy Bryonia and others, which will be more fuldwelt upon in the chapter on chronic catarrh of the larynx.If patients are very much disposed to relapses, prophylacticmeasures are of the utmost importance; among these the use ofcold water and the abandonment of too much covering around theneck occupy the first rank. If tuberculosis lies at the foundatio112 Diseases of the Larynx and Trachea.of the disease, the treatment will have to be conducted in accordance with other considerationB that will be expounded in the chapter on tuberculosis.8. liaryngotraeheitte Crouposa.Croiipj Membranous Croup.Croup is an inflammation of the larynx and trachea resulting inhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 102 of 653a copious exudation upon the mucous membrane, on which accountit is also described as angina membranacea. It is only in the preent century that the anatomy, cause and course of this disease habeen studied with more particular care. Consequently the literatuof croup has become very extensive; owing to the importance of adisease which so often terminates fatally.Croup is almost exclusively a disease of children between theages of two and seven years, or between the first and seconddentition. It occurs even less frequently before the second thanafter the seventh year; the cases which are said to have occurred among adults are so rare that it is doubtful whether theywere genuine croup. Moreover such cases scarcely ever provefatal, BO that the fact of their being croup cannot be confirmedpost-mortem examinations. According to all statistical tables boyare more frequently attacked than girls ; from 60 to 70 per cent,all cases are boys. As regards the influence of constitution andvarious other points in croup, opinions difler. Rilliet who can imany respects be regarded as an authority in croup, asserts positively that most children who are attacked with croup, are of alymphatic habit. In this respect he differs from a number of physicians who maintain that robust, well-fed children are most liabto croup. Upon close examination we fiiyl however that these twoviews only differ in appearance. A lymphatic constitution is oftedisguised under a full habit, bright complexion, appearance ofmuscular strength; whereas a marked disposition to eczema, togastric catarrhs, to angina with copious exudation and subsequenthypertrophied swellings, distinctly betray a bad foundation. Hencit is not perfectly healthy and vigorous children that are predisposed to croup, which is still more evident from the following prpositions derived from actual experience. Most of the childrenattacked with croup belong to scrofulous and tuberculous familieswhere croup has been a prevailing disease for several generationsMoreover croup is much more frequent in the country where theground is level, than in cities, and here again more frequent inLaryngotracheitis Crouposa. 118lower strata of the population. We shall show afterwards, however, haw in the country so many circumstances combine for thedevelopment of tuberculosis, and how similar circumstances prevaiamong the lower strata of citj-population. In this respect we canaccount for the frequently observed fact that croup is an hereditdisease or that several members of a family are attacked at onceshortly one after the other, or that the same individual is attacseveral times in succession. It cannot be denied that if a childbeen once attacked with croup, it retains an increased dispositioto inflammatory affections of the larynx.True croup is secondarily met' with, although very rarely, asan accompaniment of measles,- typhus, tuberculosis. In a case ofmeasles catarrhal croup is easily confounded with true croup ; thmeasle-catarrh is apt to commence with croupy cough which maycontinue for several days. The croup which is sometimes observedin a case of scarlatina, is something entii^ely different from trcroup; it is a diphtheritic disease the true characteristics of whave already been described in the first volume.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 103 of 653The exciting causes of croup are not always easy to trace. Ifcroup is a very rare disease in warm climates, nor is very frequein mountainous districts, provided the locality is at a consideraaltitude or otherwise well protected: we still are unable to explby these facts why so many cases of croup occur in one and so fewin another year. A northwest or a north wind, or even a sultryand southwest wind with rain, are very apt to bring a good dealof sickness. A district not far from the city of Hanover andsituated in front of a range of mountains extending from northwest to southeast, in consequence of which that district is exposto the winds blowing in a similar direction, is visited every yeafrom March until June by a good many cases of croup and ofsevere pneumonia among adults. The flat country from Hanoverto the North-Sea is similarly circumstanced. The winds blowingin this region of country, must be possessed of a peculiar natureorder to cause extensive epidemics which sometimes snatch awaytwenty and more children in one village. According to the investigations of latter years, which indeed are still incomplete,appears as though the amount of ozone in the air acted an important part as one of the causative influences of croup. This is60 much more probable since the amount of ozone contained in *the air is liable to the greatest variations during the prevalencof abnormal proportions of electricity such as are apt to be caus(8)114 Diseases of the Larynx and Trachea.by a northwest wind. That croup ia caused by a simple cold, ismuch more easily asserted than proven. The same child has manyattacks of violent laryngeal catarrh in the course of the year, bis attacked with croup only during the prevalence of a keen blastfrom the north. The epidemic character of croup likewise showsthat there must be other causes at work in its development beside cold or warm weather. That croup is contagious is only believed by those who regard croup and di]>htheria as identical.SymptomH and Course. For a clearer comprehension of themorbid symptoms we here premise a short description of the postmortem appearances. The mucous membrane shows every possibledegree of hypersemia, from the brightest to the darkest color, buonly if death takes place after the disease had run a short coursif it lasts a more considerable length of time, the color of themembrane is sometimes strikingly pale. The sub-mucous tissue isusually infiltrated, the mucous membrane itself less frequently,though the infiltration is not co/isiderable ; the muscular tissuof the larynx is likewise found swollen and softened. Upon thefree surface of the mucous membrane an exudation of fibrinousplasma takes place, at times only in detached spots, at other timcovering a large portion and even the whole surface of the larynxand trachea, and dipping down to the bronchial tubes. In fewcases only the exudation has the consistence of cream ; usually ibecomes tough and firm, in which case these characteristics aremore marked on the free surface of the membrane than on thesurface adhering to the mucous lining. At times it adheres to thilining loosely, at other times very firmly. The thickness of thismembranous exudation sometimes exceeds one line, sometimes itonly forms a very thin, transparent layer. The formation of ahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 104 of 653firm, compact cylinder is of rare occuiTence ; more commonly theexudation adheres to the mucous lining in the shape of patches ofvarious sizes. Sometimes, side by side with firm membranouspatches, a portion of the exudation is seen converted into pus oreven ichor, or feeble traces of vascularity are observed on the sadhering to the mucous membrane. Very commonly though notregularly, the pharynx is involved in the morbid process, but always only to a limited extent. Less frequently, but not by anymeans very rarely, the exudative process spreads to the bronchiaand the lungs.In a majority of cases, croup is preceded by a preliminary stagewhich is, however, not well defined. The children are less cheerfLaryngotracheitis Crouposa. 115tlian usual, they cough with a somewhat unusual sound, are somewhat hoarse, with a little roughness in the throat, have slight fmotions, etc. These symptoms are so trifling that they are mostcommonly overlooked, if the children are otherwise strong and vigorous. In very rare, or rather in exceptional cases, croup is preceded by a nasal catarrh which, when present, is a tolerably certguarantee against the possible occurrence of croup; in general, ttransition from an ordinary catarrh of the respiratory organs tocroup is not often noticed. The precursory symptoms very seldomprecede the outbreak of the real disease longer than a day.This outbreak generally takes place about midnight. After sleeping quietly for a few hours, the children have a few short turnscough, or sometimes are roused from their sleep by a severe paroxysm. The cough has a sound that is very difficult to describe ; iresembles most nearly the bark of a watch-dog ; it is a hoarse cohaving a metallic ring and is forced out with great vehemence.These peculiar features are so striking, that the very first turncough rouses the family from their sleep by its unusually loud anshrill ring. At the same time the voice becomes husky, loses itsresonance, and seems labored ; the inspirations are somewhat impeded, although not yet to a very high degree, audible, wheezing,and prolonged. This makes the patient restless and anxious. Thefever is scarcely ever very high, but the larynx is very frequentsensitive to contact. Sometimes the child falls asleep again afteshort turn of cough, and it is only the wheezing inspirations thabetray the presence of the terribly threatening danger. In themorning, the little patient may feel quite well, except perhaps alittle weak and languid.Up to this period, croup resembles an ordinary attack of laryngitis so perfectly that it is often impossible to distinguish onethe other. This uncertainty and vagueness of the symptoms maycontinue during the second and even third night, although thecroupy character of the attack becomes more and more marked asthe disease progresses on its course. As a rule, the affection prall its frightful features on the second day, or even at the veryset of the attack. The cough may not become more frequent orviolent, but it is less sonorous, more distressing and wheezing,fills the children with inexpressible agony. As soon as they become aware of the approach of a paroxysm of cough, they raisethemselves in their beds, hold on with spasmodic energy to the pehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 105 of 653son near them, or throw themselves about as if convulsed. The116 Diseases of the Larynx and Trachea.agony is still heightened bj the gradually increasing difficultydrawing breath, which is seldom very marked at the commencement of the attack and is particularly striking during the paroxysms of cough. As the dyspnoea increases, the complexion becomespallid and finally livid, and the face bloats. The pujse increasefrequency and becomes smaller. The little ones seem to suffer morpain than they really do ; the children grasp at their throats anpull at their tongues, not so much because they suffer acute painas because they are so terribly distressed for breath ; at any ratouching the larynx does not seem to cause an increase of sufferiThe cough and the agony of breathing do not last all the time ;between the paroxysms, the patients lie in a state of sopor andutter exhaustion. True intermissions during which the diseaseseems on the point of leaving and the patients appear cheerful anin apparent health, occur very rarely. Intermissions or remissiongenerally take place in the morning ; they seldom last all day, astill less frequently a day and a night, but are interrupted by rnewed attacks of cough and dyspnoea.If at this stage of the disease the pathological disease should ta favorable turn, the improvement may announce itself quite suddenly by the expectoration, within a short period of time, of larquantities of membranous patches or even of the whole of thecylindrical tube at once. This last-mentioned change occurs veryrarely, and even if it does occur, it is not safe to regard the das entirely over until at least two days have elapsed without anytrace of a renewed exudation having been perceived. In other caserecovery takes place by the gradual absorption and liquefaction othe membrane, the cough becomes moister, a mucous rfile is heardin the larynx and trachea, small pieces of membrane and a yellowish tenacious mucus are coughed up, the signs of congestion in thhead and face decrease, the pulse rises and the breathing becomeseasier. Several days may pass while these changes are going on,before all danger is past; this point remains more particularlydoubtful if the children do not bring up any thing and swallow thdetached mucus or membranous patches.If the disease runs an unfavorable course, every symptom steadilyand uniformly increases in intensity, or the increase takes placefits and starts, with remissions such as we have described. Theface now exhibits the pallor of death, the eyes gradually lose thlustre and assume a vague and unmeaning expression. The coughnow loses all resonance, the very power to force out a singleLaryngotracheitis Crouposa. 117turn of cough seems to be lost. At times the membranes in thetrachea are heard to flutter, and their expulsion is momentarilyexpected. The dyspnoea now reaches its climax, the children arealmost driven to frenzy during the paroxysms of cough or the respiration becomes so restricted and superficial that the dyspnoeaapparently does not seem to be as violent as it is in reality. Sohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 106 of 653times the paroxysms become so violent that. the child suddenlyperishes by sufibcation. Between the attacks, the coma becomesmore and more profound, and the brain seems to participate in thestruggle. This phenomenon, however, like the majority of deaths,has to be attributed to the gradual poisoning of the blood by carbonic acid originating in the deficient access of air to the lungThis likewise accounts for the slow death. No immediate asphyxiataking place, this suffocative stage sometimes lasts fortybefore death takes place.There is a form of croup which runs its course without thepeculiar croupy cough. Here the gradually-growing danger is overlooked, because the dyspnoea increases more uniformly and slowly.This may be owing to the glottis not being contracted or at leastin a lesser degree. Sometimes the diagnosis can only be determinewith perfect certainty by the expulsion of membranous patches.This form of crou'p is scarcely less dangerous than the former, oit usually lasts much longer.The duration of croup depends upon a variety of circumstances.If the intensity of all the symptoms increases steadily, death matake place in thirty-six hours by asphyxia. In most cases thepatients die on the fifth or sixth day, seldom later, and exceptionly after the ninth day. This period does not include the preliminary stage, but dates from the first outset of the disease itselThe prognosis is in every case very doubtful. Although homoeopathy is justly entitled to claim more favorable results in its tment of croup than any other method has a right to do, yet evenunder homoeopathic treatment croup is one of the most fatal diseases. Moreover the results of any form of treatment are oftenvery much complicated by another circumstance. Membranouscroup, especially if a cure only takes place after the dyspnoea hcontinued for some time, is very apt to be succeeded by dangerousafter-diseases among which lobular pneumonia, bronchitis and acutoedema of the lungs are the most important. These affections arethe most common complications of croup, owing to which recoveryis often delayed for a long time, or is never complete for the rethat chronic bronchitis, emphysema, etc., remain behind.118 Diseases of the Larynx and Trachea.Before discussing the diagnosis of croup, we will add a few remarks on diphtheritic laryngitis which differs essentially from cEpidemic diphtheria, although more particularly confined to themucous membrane of the mouth and fauces, is likewise very muchinclined to invade the larynx. This occurrence generally showsthat the disease is of a most malignant type. The symptoms ofdiphtheritic croup resemble those of the ordinary form of membranous croup, from which the former differs, however, in flome rspects. The patients begin to show laryngeal symptoms after theaffection of the fauces has existed for some time, and the strenghas begun to fail. The dyspnoea is less intense as in membranouscroup ; the inflammatory swelling is less, and the patients do nodie so much on account of the dyspnoea as on account of the generviolence of the disease. The characteristic sopor of the last staof croup does not occur in diphtheria. These distinctions do notoccur in every case, but in the majority of cases. They are easilhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 107 of 653accounted for by the differences in the character of the exudatiowhich in diphtheria involves the tissue of the mucous lining itseand very speedily results in gangrenous or ichorous dissolution,often attended with considerable loss of substance. If the diphtheritic process invades the larynx, it assumes a very destructivcharacter, sometimes without interfering with the breathing, whercroupous laryngitis unattended with dyspnoea need not necessarilybe a very dangerous disease. In pathological treatises both theseforms of croup are generally described as homogeneous, whereasthey differ essentially in their natures, which explains the factthe views concerning croup are so much at variance in the different w^orks on Pathology.Towards the end of the disease the diagnosis of croup is just aseasy as it is sometimes obscure at the commencement. It is mostapt to be confounded with laryngitis ; indeed, both these forms odisease resemble each other so much that it is very difficult durthe first twenty-four hours to diagnose the true character of theattack, in spite of the most careful investigation of all anamnescircumstances. If we have before us an individual who has hadfrequent attacks of simple laryngitis ; who is otherwise in the ejoyment of bodily vigor and health, and shows symptoms of anincipient or fully developed nasal catarrh : it is almost certainthe idea of croup may be abandoned. The last-mentioned circumstance is of particular importance, for we have never yet seen incipient croup accompanied by a damp nose ; and if the nose doesLaryngotracheitis Crouposa. 119begin to discharge during the last stage of croup, the secretionalways of the ichorous character of a diphtheritic discharge. Inlaryngitis as in croup the dyspncea may at first be very great, ecept that in the former disease the dyspnoea decreases in intensias soon as the children are wide awake and have tasted of a littlnourishment ; nor does it increase after the first attack, althoumay last longer than the first twenty-four hours. If croup prevaias an epidemic, every attack of laryngitis ought to be suspectedfrom the outset; likewise, if in the same family several childrenhad already been attacked with croup. The presence of membranous exudations on the tonsils and in the pharynx, which, however, are not always noticed at the very commencement of theattack, places the diagnosis beyond all doubt. A spasm of theglottis which is but a transitory condition, can only be confoundwith croup at the outset, so much more easily if the spasm is complicated with laryngitis. In a few hours already the true charactof the enemy is sufficiently apparent.Treatment. Since Napoleon's famous concourse of 1807 thepathological and pathologico-anatomical changes occurring in crouhave been investigated so thoroughly and almost exhaustively bysuch a number of physicians that it seems almost impossible thatthe therapeutic management of croup should have been so sadlyneglected. Nevertheless this charge is just. The Old School hasnot a single remedy for croup unless tracheotomy which is the lasdesperate resort, is considered such. If the numerous therapeuticexperiments that have been made during the last fifty-six years ocroup-patients, have failed to lead to the desired result, the meaccording to which the experiments were conducted, must have beenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 108 of 653erroneous. We place this fact in bold relief in order to show wit80 much more force the superiority of the homoeopathic treatmentof croup over any other method. To this eflect we first name someof the more renowned remedial agents that are used in croup. Atthe same time we cannot help expressing our surprise that croupshould drive the scepticism of the Physiological or Rational Schoto such straits ; for it is astonishing what remedies even the leof this School propose in order to avert the fatal blow. Here thehighly praised expectant method is utterly abandoned ; on the contrary, the most diametrically opposed agents are brought into reqsition one after the other in the most rapid succession, so that,out entertaining the least prejudice, we are naturally led to inqwhat has become of the "rationality" of the method.120 Diseases of the Larynx and Trachea.The most important and most extensively used remedies areemetics, topical and general sanguineous depletions, Calomel intenally and the mercurial ointment externally, Antimony, Tartaremetic, Ilepar sulphuris. Alum and finally a number of locally applied substances. At the same time cold and warm compresses,watery vapors, wrappings, etc., are not wanting. Emetics whichare the most important agents in this list, are indebted for theireputation to the apparent success which they have in simplelaryngitis ; we call this success apparent because no true laryng'can be cut short by a simple emetic. No amount of sophisticalargumentation is able to show that an emetic can exert the leastinfluence over an incipient croup. Moreover we cannot overlookthe fact that the effect of an emetic does not end with the act ovomiting, especially if the Sulphate of Copper is used for this ppose, and that our patients are little children. Children who hadan attack of simple laryngitis, often suffer for weeks from theeffects of the Sulphate of Copper or of Tartar emetic. The use ofan emetic is much more excusable if, after the membrane had begun to be formed, the process of expectoration is to be promotedthere is no difficulty in comprehending that the act of vomitingstimulates the disposition to expectorate. An homoeopath willundoubtedly know how to account for the action of Ipecacuanhaor Tartar emetic or even of the Sulphate of Copper upon differentprinciples from those in vogue. In the second stage of croup theSulphate of Copper is now the fashionable emetic; yet this preference is not accounted for upon scientific principles. We know thaCopper has a good effect in the spasmodic closing of the glottis,hence is of advantage in croup. While mentioning this effect ofCopper a knowledge of which has been acquired by the most foolhardy empiricism, we at the same time have to remind our readersthat not one of our allopathic opponents has been able to account for the good eflfects of Copper in croup except by the actvomiting.As regards the sanguineous depletions, be they local or general,we can dispense with the trouble of dwelling upon them anyfurther. It is inconceivable that they are expected to prevent,arrest or diminish the exudation; what is certain is that bleedinrobs the child of the power to develop the necessary reaction agathe disease. Even the croup-tever is not sufficiently intense totify bleeding. As far as Mercury is concerned, the only excuse,we dare not call it indication, for its use is that a quantity ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 109 of 653I>aryngotracheitis Crouposa* 121coagulable lymph is efixised in croup and that Mercury is a powerful antiplastic agent. But this agent alone has never yet removeda case of croup, but has occasioned such violent attacks of stomatitis that the jaws have united by ulceration. The other remedieswill be further dwelt upon by and by, especially the Sulphuret ofLime ; this agent which is a true specific in many cases of croupis only mentioned very cursorily in allopathic works, more like acuriosity than as an useful remedy.The want of internal remedies naturally led physicians to huntup external applications. The croup-membrane was to be destroyed,the subjacent mucous lining to be cauterized and the disease wasto be conquered. Strange fancy, as if we did not know that croupis a special form of inflammation resulting from, or determined bconstitutional susceptibilities. A glance at the results of the cterizing process in diphtheria ought to have discouraged the cauterizers of the croupy membrane. The mucous lining of the larynxlias been washed with the Nitrate of Silver, Muriatic acid. Alum,etc., causing the patient the most agonizing distress. The only avantage derived from such a proceeding may be that the irritatingaction of those agents may cause a violent coughing fit which maypromote the process of expectoration. The inhalations to whichwe shall refer hereafter, are not of very great importancie, northe application of ice or cold water. If we add to these means oftreatment the unavoidable blisters and sinapisms, we have the bespart of the medicinal apparatus of the Old School before us. Inspite of all these appliances, from 70 to 90 per cent, of all undcases of membranous croup perish. This result is certainly notriumph, nor has tracheotomy increased the chances of recovery.In opposition to these failures Homoeopathy can show a mostsuccessful treatment of croup to her opponents without inflictingupon the poor little patients the horrible tortures of Old Schoolpractice. We are not sanguine enough to add credence to those whoprofess to have treated hundreds of cases of croup during a practof thirty or forty years without losing a single patient; but weknow that by fiir the larger number of cases are saved underhomoeopathic treatment ; this is an amount of success to be proudof. We do not fall back upon statistical data which may be calledin doubt on account of diagnostic inaccuracies or uncertainties;single fact among many may prove more convincing to the mostinveterate sceptic than the most scientific statistical exhibit.the beginning of this year epidemic croup broke out on a heathen*122 Diseases of the Larynx and Trachea.about sixteen miles from this city. Several dozens of children haalready fallen victims to the above-described treatment. A younggentleman who happened to visit a merchant of the place, advisedhim to try homoeopathic treatment. The results of this treatmentwere so striking that the house of this merchant was from thatday besieged by persons seeking aid. With the aid of a simpledomestic manual, this merchant succeeded in saving a number ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 110 of 653lives. Is it possible to remain blind to such events? We do notattach implicit faith in the doctrine that vox populi is vox Deibut in such terrible epidemics even a layman has sense enough tosee whether those who are attacked, perish or get well, and whatmethod of treatment is crowned with the latter result.The remedies which homoeopaths use in treating croup, are thefollowing: Aconitum, Hepar sulphuris, Spongia maritima, loiliurriBroinum^ Phosphorus^ Cupj'um and several more. We shall consider these drugs in their respective bearing upon each of the diferent stages of croup, instead of furnishing a detached list ofsymptomatic indications of each drug in particular.If we are called to a case of croup in the night, it is not alwaypossible to at once obtain the conviction that we are dealing wita case of croup; for even the presence of considerable dyspnoeadoes not always imply that the disease before us is croup. In ordto meet this uncertainty the custom has prevailed for a long timealready to at once give Aconite in alternation with some otherremedy. We do not approve of this custom of giving remedies inalternation, but make an exception in favor of croup on account othe uncertainty in our diagnosis. Aconite is excellent in catarrhbut utterly inefficient in membranous croup. If we suspect a caseof membranous croup, we give Aconite 2, and lodimn 2, in alternation every hour. The Iodine had better be prepared fresh in orderthat we may be sure of operating with a reliable attenuation. Thiremedy is not given by all practitioners at the outset of the attbut Hepar sulphuris or Spongia. We have the following reasonsfor our proceeding. lodium exerts a special action on the larynxso constantly, and causes a violent inflammation of the larynx wiso much certainty that this effect may be set down as a pathognomonic and highly characteristic symptom of the action of Iodine. That it is capable of healing far advanced cases of croup, itrue beyond all doubt. Hence there is no reason why a medicinethat embraces in its pathogenetic series all the symptoms of crouand must therefore be adapted to every stage of this disease, shoLaryngotracheitis Crouposa. 123not be given at tlie very commencement of the attack. We consider this medicine much more appropriate than some other medicine that is only suitable in the incipient stages of the diseaseMany other physicians prefer Hepar sulphuris at the outset, if thfollowing symptoms prevail : Marked febrile motions, the respiration is almost entirely unembarrassed, but has a peculiar sound ;dry, metallic cough with disposition to choke, mingled with a shorattling in the trachea, as if mucus would be raised ; or if theseems to continue moist, and the croupy sound is present ; the laynx is painful ; thei-e is hoarseness, but no loss of voice. Sponis even recommended more strongly than Hepar at the first invasion of the disease. Hahnemann himself regards Spongia as themain remedy in croup and directs to resort now and then to anintermediate dose of Aconite or Hepar ; he does not consider Spongia indicated until the respiration has become embarrassed andexudation has commenced. Almost all observers are of the sameopinion.In the first night, it may not matter much which of these rehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 111 of 653medies is given in alternation with Aconite. It is certain thatcatarrhal croup will be modified by a few doses of Aconite withintwelve hours so fully that whenever this favorable change does notake place within this period of time, we may rest assured, thatare dealing with a case of membranous croup and that the selectioof a specific remedy can no longer remain doubtful. This feat isnot so easily accomplished if we take the Materia Medica for ourguide ; moreover, experience has done already a great deal for usin this respect. Experience informs us that Hepar is a suitableremedy on the second day, if mucus begins to accumulate in thewindpipe, there is no increase of hoarseness, no dyspnoea or verylittle of it, and the cough has a uniformly croupy sound ; henceHei>ar is indicated in the milder cases of croup. Spongia is requif the croup shows its malignant features after the lapse of a fehours, the cough has a hollow sound, less resonance, the hoarseness approximates to aphonia, the dyspnoea is more marked. lodiumis to be given if the symptoms steadily increase in intensity, thloss of voice is complete, the dyspnoea has reached the highest dgree of intensity, and the cough has lost a good deal of its ringand shrill sound.As soon as we have become satisfied of the nature of the disease,Aconite is no longer given in alternation with some other drug,even if violent fever should be present. The question now is124 Diseases of the Larynx and Trachea.whether at this stage of the disease two remedies like Spovgia anHepar^ or Hepar or Spongia and lodium^ had not better be continued in alternation. A good deal may be excused in the presenceof such a dangerous malady, and we have not the heart to condemnany one who deems it proper to continue the alternate use of* twodrugs, more particularly in cases where the life of the patient mbe jeopardized if the action of a single drug were allowed to continue for twelve hours and even longer. Alternating drugs doesnot improve our knowledge of their true action ; hence this custoshould be abandoned whenever such a thing is possible.\ In the vast majority of cases the further progress of croup wilbe stayed under the operation of one of the above-mentioned threeremedies ; if this fact is perceived, we have every reason to befied with the treatment, and we must not be anxious to change themedicine until every symptom of the real croup-disease has disappeared. If Hepar and Spongia seem ineffectual, and the diseasesteadily continues to grow worse, we give lodium which we continue at least forty-eight hours unless symptoms of asphyxia manifest themselves before this period is passed. In most cases lodiuwill undoubtedly have a favorable effect. Only we must not indulge in the expectation of cutting the disease short. A result othis kind only occurs in a very small number of cases. Most commonly the pathological process continues to go on under the actioof Iodine^ after which it retrogrades, as is the case in every otinflammation. What is essential is that it should be kept confinewithin proper boundaries. Even if the dyspnoea increases at firstthis is no reason why the use of Iodine should be discontinued.Instead of Iodine, many physicians recommend Brombie ; somesuccessful cures with Bromine are reported, whereas others deny ihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 112 of 653all jx)wer over croup. "We are not yet able to express a decidedopinion on this subject. The symptoms indicating Bromine are thefollowing : Cough having a croupy sound, hoarse, wheezing, distressing cough which does not give one a chance to speak, attendewith sneezing and violent fits of suffocation; spasm of the glottwhence the symptoms of asphyxia; moist respiratory rale, thebreathing is at times wheezing and slow, at other times as if hewould suffocate, and then again hurried, superficial, labored, ditressed, painful and gasping. This combination of symptoms idfurnished by Attomyr, but we would like to ask whether anythingin this group points to Bromine ? Moreover we confess that weconsider a purely symptomatic treatment of croup inadequate, and'^n)' » Ao,Laryngotracheitis Croupf^a. ^ /" 125that, if croup were to be treated according t^^ere\8yra^m8, wewould have to change the medicine as often as the gymptonnfyhangewhich would be productive of a vast deal of harn)#^ v^ jij^acquainted with the effects of the remedies to be employ^^ bi>^ \i4of them is the best adapted to the exigencies of the'^fl'Se, is bdetermined by practical experience. We do not mean'tp rejectBromine, but it is only in mild cases that we would substitute ituse for that of Iodine.If, in spite of all treatment, the symptoms of asphyxia increasemore and more ; if the dyspnoea continues to increase ; if the agand restlessness of the little patient become more distressing, athe symptoms of cerebral congestion more marked, two remediesremain from which aid may be expected, namely Phosphorus andTartar emetic. The former is indicated if the cough has lost allresonance and force, and the mucous r^le has ceased; or moreespecially if the croupous process has invaded the bronchia and tlungs have evidently become hypereemic. Tartar enietic is indicatif the dyspnoea and danger of asphyxia are occasioned by movablepatches of membrane, the cough is indeed feeble and without resonance, but a mucous rale is still distinctly heard in the tracheaHowever it is not advisable to prescribe this remedy in large dosfor the favorable effect of the act of vomiting is very problematwhereas the great deprcbsion caused by the vomiting is sure to folow. Nor is it at all certain whether any emetic at this advancedstage of croup can cause vomiting. Grain doses of the second trituration are sufficiently strong; as regards Phosphorus we would nhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 113 of 653dare give it below the third attenuation.In this place we will call attention to a few remedies that haveno relation to the croupous exudation, but are important in otherrespects. The danger of suffocation depends in many cases upona spasmodic closing rather than upon a mechanical disarrangementor an inflammatory infiltration' of the rima glottidis. A conditiof this kind is pretty certain to exist if the dyspnoea sets in isingle, pretty sharply detached paroxysms, the remissions betweenthe paroxysms are quite considerable and no rSles are heard in thlarynx. If we designate this closing of the glottis as spasmodic,the designation is not entirely correct, because paralysis of themuscular apparatus of the larynx is undoubtedly the chief causeof the asphyxia, \vbereas a spasm of the larynx could not well beaccounted for. If we consider that in the case of children the gltis forms an uniformly narrow chink whose sides incline obliquely>.126 Diseases of the Larynx and Trachea.towarJs each other from without inwards, and from below upwards, it is easily conceivable that, in case the sides are somewrelaxed, they may be forced against each other during the act ofinspiration, in consequence of which the glottis will either be vmuch contracted or even closed. These facts explain how childrenmay die of croup without a membrane being seen after death, andwhy full-grown persons whose glottis is wider and differentlyshaped, scarcely ever succomb to an attack of crouy. We canmeet this paralytic condition by some remedies that are well wortof our consideration : Cuprum^ MoschtiSy Nux mosctiata^ Ipecacuanand Arsenicum. Of all these remedies, Cuprum is undoubtedly themost important ; its effect is in a measure confirmed by the effeof the Sulphate of Copper when administered as an emetic. Arsenicum has shown its favorable effect upon dyspnoea in a most desperate case which terminated in recovery. The other three remedieshave been strongly recommended by other physicians ; we have nopersonal experience to offer in their behalf. If these remedies ato be used, they will have to be given iu alternation with the trspecifics for croup ; the best mode of using them is to interpoladose every few hours.If the stage of asphyxia sets in in spite of this treatment,will not often be the case, — the question then occurs what willto be the further object of the tivatmeut. The glottis is paralyzor its space encroached upon, together with that of the trachea,membranes ; the existing sopor shows that the poisoning by carbonic acid has already made considerable headway; the icy coldness of the skin is evidence that an independent reaction can harbe expected any longer. The only remaining chance of saving thepatient is by promoting the oxygenation of the blood. It wouldbe absurd to prescribe for these apparent symptoms of cerebral cogestions remedies like Opium, Belladonna, Hyoscyamus, etc., whichwill not have the least effect, Nor will the continued use of Phophorus or Tartar emetic, in the absence of all reaction, produceleast result. Under these circumstances trachelotomy alone canhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 114 of 653afford help, and it would be just as criminal to leave the operatundone at this stage, as it would have been criminal to perform iat an earlier period. For a description of this operation we refethe reader to works on Surgery. "We are decidedly optx)8cd to theoperation being performed before the stage of asphyxia has set inthis may be excusable in cases that are not treated horaoeopathioally, for other Schools have no really specific remedies for crouLaryngotracheitis Crouposa. 127•If but few patients are saved by this operation, it is not the faof the operation, but of the period when it is performed. Withoutthe operation all patients die in the stage of asphyxia ; where toperation is performed, only some die, though it be the larger nuber. These results show that the operation is not only justifiablbut eminently necessary and important. However, in order thatall possible advantages may be derived from the operation, it shonot be delayed too long; otherwise the sopor might progress toofar, or recovery might be prevented by an acute emphysema andcedema of the lungs; conditions that may lead to a fatal termination even after the cure of croup is successfully accomplished.[The reader may peruse with profit an article on tracheotomy incroup, by Doctor Talbot, of Boston, in one of the late numbers ofthe New England Medical Ghtzette. H.]If an improvement sets in, we first notice an abatement of thedyspnoea ; it is by changes of this kind that we can measure theprobable chances of our final success. Nevertheless, the medicinewhich induces the favorable turn, had better be continued for somtime longer, but at more extended intervals. To continue the usethe medicine is of importance, for the reason that, after a markeremission of the symptoms, the disease sometimes breaks out againwith renewed violence. The cough sometimes retains for a longtime its hoarse, barking sound; the aphonia likewise often continues for a long time. For the cough we administer Hepar, moreespecially if it is attended with mucous r&le ; if the cough is dPhosphorus is preferable. This agent is likewise most suitable fothe subsequent hoarseness.The so-called torpid croup does not destroy life as rapidly as thpreceding varieties, but is withal a very insidious disease. It itreated with the same remedies as those above mentioned, exceptthat Hepar sulphuris very frequently deserves the preference.If croup results from a gradual working down of the diphtbpritic process from the pharynx to the larynx, it is always moredangerous than the primary form of croup, and, according to thereasons we have advanced when speaking of diphtheritis, requiresto be treated with entirely dift'erent remedies. In diphtheriticBromine may possibly deserve particular attention. We refer thereader to the chapter on diphtheritis. It is this form of croup thas ^ven rise to the belief in the contagiousness of croup ; it dindeed, seem to be a contagious disease. [Some cures have beenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 115 of 653128 Diseases of the Larynx and Trachea.made of diphtheritic croup with Lachesis highly potentized ; andalso with Kali bickromicum. H.]External applications in croup are generally without any effect.Whereas some apply hot water to the neck, and cause watery vapors to be inhaled, or order hot arm-baths ; others, on the contrprefer ice-water or ice itself, and others again resort to the weThis deserves a preference over the other applications, because imost advantageously stimulates the functional activity of the skiUpon the whole, however, it is our belief that the greatest advantage of these auxiliary means consists in diverting the attentionthe family who are generally plunged into extreme agony.Whether the administration of drugs by means of vaporous inhalations is the most useful method, is still a disputed point. Wdo not see whether a medicine introduced into the human bodythrough the respiratory organs, should develop its effects moresurely or more penetratingly than when administered by the mouth.Moreover, this method is sometimes attended with difficulties, unless we do not mind filling the sick-chamber with vapors. This hathe disadvantage that no fresh supply of pure air gets to the lunand that the medicine ceases to be under our control. The dyspnoeis, moreover, easily increased by inhalation. Apparatuses for inhalation cannot be used, because the little patients are exceedinrestless and tossed about by their agonizing distress. At all evethe inhaling process has to be conducted with great care.We have no special remarks to offer on the subject of diet in thidisease. On account of the dyspnoea, which renders deglutition exceedingly diflSicult, the greatest trouble is experienced in givichildren the least quantity of nourishment ; what nourishment isgiven, should be in a liquid form, and very strengthening. If thestrength fails too rapidly, a little good wine proves an excellenstimulant.There is no real prophylactic treatment against croup, except aregular system of hardening children from the moment they areborn, and bringing them up in all respects in accordance with priciples of health. If a child with a suspicious habit of body isattacked with a croupy cough whenever it takes cold, and is generally inclined to have an attack of severe laryngitis, let it bein-doors during a keen North wind, or let it at least be protecteby a sufficient amount of warm clothing. Whether Calcarea carbonica^ Hepar or Phosphorus are capable of exerting a protectiveinfluence against croup, is not yet decided. After a first attackLaryngotracheitis Chronica. 129croup, a dispoaition to be again attacked generally remains. It idoubtful whether even such a disposition can be removed; the constitutional diathesis cannot well be remedied.8. liarjrnsotracbeitts Chronica*Chronic Laryi}gotrachecd Catarrh,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 116 of 653The chronic form of this catarrh is, like the acute, one of themost frequent diseases both with reference to affections of the rspiratory organs specially, and with reference to all other diseacollectively.This disease befalls children only as an exceptional disturbanceif it does occur in childhood, it is almost always a consequencea more malignant acute disease, especially of croup and diphtheriNor are older people frequently attacked by this disease ; hencesay that middle-aged persons between the ages of twenty and fiftyyears are principally liable to such attacks. Sex has an undoubteinfluence over the disease ; for although women are much less exposed to the unfavorable influences which we shall mention by andby, this does not satisfactorily account for the extraordinary prvalence of the disease among the male sex. Regarding a specialdisposition, we refer the reader to what we have said in the firschapter of this section.Chronic laryngotracheal catarrh is seldom a primary, generally asecondary or consecutive aftection. Primarily this form of catarris caused by the same influences as the acute form, a cold, contiued talking, singing, the constant use of spirits, beer, exposuremarked differences of temperature. Secondarily it may representa slow form of acute catarrh, which is the most frequent cause ofthe chronic form, especially if the individual had several acutetacks in succession ; or else it is a continuation of a catarrhaltion of the nose, fauces, buccal cavity ; or it may result from tconstant irritation caused by repeated ulcerations or adventitiougrowths ; or finally it may be a manifestation of some constitutidisease. In this respect it sometimes accompanies syphilis or amercurial dyscrasia ; most commonly, however, it is a symptom ofpulmonary tuberculosis, so that every catarrh whose persistencecannot be accounted for by any known cause, must necessarily excite the suspicion that the lungs are infiltrated with tubercularmatter.In this affection the anatomical changes are so important for aproper understanding of the symptoms, that we premise a short130 Diseases of the Larynx and Trachea.description of these changes. Usually the mucous membrane isdarker than normally, sometimes the dark tinge is quite considerable ; the membrane is more or less thickened and puffed up. It itraversed by a multitude of engorged vessels and studded withswollen follicles imparting to it a granular appearance. It is coered with a tenacious, gray, yellowish or transparent secretion.subjacent tissues, cellular tissues, muscles, ligaments are swollsoftened. If particular circumstances prevail, the mucous membranulcerates at an early stage of the disease, but almost always aftthe disease has lasted some time. Most commonly we observe asimple erosion in the shape of a superficial exfoliation surroundby a more intensely red border, but without any definite form.These erosions may change to more deeply-penetrating ulcers withblown or puffed edges which eat only in exceptional cases throughthe whole thickness of the mucous membrane. Another form ofulceration arises from the inflammation of the follicles ; in whihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 117 of 653case small, deep, rounded ulcers form, which very readily penetrathe mucous membrane and propagate the affection to external organs. We observe moreover fungoid growths of single follicles,even polypi ; cicatrizations and contracting cicatrices, thickeniand callosities of the mucous membrane. Of special importanceare the subsequent changes, especially cicatrices which may leaddangerous accidents.The great differences of the anatomical lesions depending upontheir nature, locality and extent, render it self-evident that itimpossible to draw a true and striking picture of laryngotrachealcatarrh. Hence we shall have to confine ourselves to a delineatioof the leading symptoms. The absence of almost every objectiveaid in establishing our diagnosis, is often seriously felt^ nor icertain whether the laryngoscope has as yet led to striking resulalthough we are willing to admit that this means of investigationhas a bright future before it. The most important symptoms ofthe disease are : pain, alterations of the voice, cough, embarrasre^ration.The pain is scarcely ever very considerable, and if it is describas acute, we may be sure that ulcers have formed. It is scarcelyever continuous, but is excited by talking, singing, running, sudchanges of temperature, and most easily by coughing. Sometimesit is a soreness, at other times the pain is stinging, burning, ging, and inclines to exacerbate towards morning. An annoyingfiensation is the feeling as if there were dust or a foreign bodyiLaryngotracheitis Chronica. 131the throat, or the patients complain of a periodically returningtickling in the larynx.The voice is variously altered. "We may lay it down as a rulethat every persistent change in the voice points to chronic laryncatarrh. The hoarseness runs throughout its whole series of gradations, from simple roughness of voice to complete aphonia. Itscarcely ever continues all the time in the same degree of violenit may even disappear entirely for a while, and then be excitedanew by some unusual exertion in using the organs of voice. Sometimes the hoarseness is only perceived during singing. However,it is not by any means a characteristic symptom of chronic laryngotracheal catarrh. A sudden cracking of the voice or an inabilitto raise the voice beyond a certain pitch, is often met with.Cough is a very common symptom in this affection. Sometimesit amounts to no more than a hawking occasioned by a titillationin the larynx or oppressed breathing ; at other times it tormentsthe patient for days, after which it often intermits for a whilesometimes it breaks out in regular paroxysms which most commonly set in in the morning after rising and abate again after smquantities of mucus have been expectorated. There is nothingcharacteristic in the sound of the cough, except that a rattlingmucus is most generally heard in the trachea or glottis, and thathttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 118 of 653dry titillating cough sometimes prevails by way of exception. Theexpectoration is never very copious except when it is mixed withmucus from the lungs, of a white or grayish color, firmly coherinand globular, sometimes slightly streaked with blood. If it has apurulent appearance, we may almost feel sure that the expectoratidoes not alone proceed from the larynx and trachea.The difficulties of breathing, an oppressed, wheezing respirationand even an asthmatic dyspnoea are occasioned by a swelling andconstriction of the glottis, hence do not show the degree of intebut the seat of the disease. These difficulties are of importancea physician for the additional reason that they excite the most fful apprehensions in the minds of most patients.This disease generally runs a protracted and even obstinatecouree. It is mostly determined by the existing anatomical lesionA simple affection of the mucous membrane is easily cured ; whatrenders the final result doubtful is, when the patients expose thselves to influences that rekindle the disorder as soon as it besto mend. A simple ulcer is likewise within the reach of remedialinfluences, whereas the more deeply-penetrating ulcer and the fun132 Diseases of the Larynx and Trachea.goid exeresccnces of the mucous membrane resist all treatment somuch more obstinately as their diagnosis is more uncertain. It isonly in very rare cases that laryngotracheal catarrh is dangerousto life, not immediately, but in consequence of some pulmonaryaffection that may have been superinduced by the diflSiculties whthe air encounters in passing through the larynx. Laryngealphthisis without tubercles is a very rare occurrence, in which cait most generally depends upon other dyscrasic conditions. Thetubercular laryngeal catarrh will be described when we come tospeak of tuberculosis ; here we will only state that almost all dgerous and obstinate laryngeal catarrhs, especially if attended wemaciation or fever, are caused by tubercular infiltration.Treatment* We deal with an affection that may occur in themost diversified forms, complications and degrees of intensity, awhich on this account alone renders the selection of a large numbof remedies expedient. We could not possibly mention every drugthat may be required for the treatment of this disease, and haveconfined ourselves to an enumeration of the more important remedies, referring the reader to a good Repertory as an indispensabauxiliary, if a remedy is to be chosen for a single symptom of chacteristic value.Tartarus stibiatus and Antimonium crudum. The former is especiallindicated when the acute form passes into the chronic, more particularly in the case of children and old people. There is a freqdesire to cough, attended with an audible rattling of mucus in thair-passages, a thick and white phlegm being brought up after asevere paroxysm of racking cough. Or the cough may set in indetached violent paroxysms accompanied with dyspncea and endingin gagging and forcing up mucus. Both kinds are principally metwith among children and old people. For hoarseness as an isolatedsymptom, Tartarus stibiatus may not be appropriate ; Antimoniumcrudum will be found preferable. The following symptoms indicatehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 119 of 653this remedy : the hoarseness is made worse by excitement and overheating ; disposition of the voice to give out suddenly ; sensatiof roughness in the larynx, and as if a foreign body had lodgedin it.Hepar sulphuris oaloareum is particularly adapted to neglected accatarrh, and is an indispensable remedy for singers and people whhave to talk a good deal, but is likewise suitable in many caseschronic catarrh. The following symptoms are the most essential :the larynx feels painful as if sore and burning, especially whenLaryngotracheitis Chronica. 188patients cough or talk load ; hoarseness sometimes increasing forshort time to aphonia ;• feeling of dryness in the larynx, althouthe presence of mucus is distinctly perceived ; a hoarse titillatcough with scanty expectoration and rattling of mucus in thetrachea ; hard, lumpy, yellow or greenish expectoration, very tenacious and sometimes tinged with blood. Hepar deserves particular attention in cases of chronic catarrh remaining after croupor measles, or in the case of individuals who had taken muchMercury.Spongia bears great resemblance to the former drug both symptomatically as well as in its general indications. It too is indiafter croup and measles, in cases of neglected acute catarrh, incase of singers. It is particularly required for the cough withburning titillation in the larynx, which sets in more particularlnight or after loud talking. The cough has a barking sound, themucus is hard to bring up, tenacious, yellowish, and the attacksapt to be accompanied by dyspnoea emanating from the glottis.lodium is one of the most important remedies in this afiection.Among the general indications for Iodine we distinguish the following : chronic catarrh of scrofulous and mercurialized individuals, or remaining after croup or other acute affections, or complicated with chronic pharyngeal catarrh. Th3 most prominentsymptomatic indications are the following : Disposition to take cand long' duration of the acute stage ; the larynx is painful whepressed upon ; burning, sore pains in the larynx confined to a denite spot, felt especially during cough; embarrassed respiration,wheezing inspirations causing real attacks of dyspnoea especiallynight ; a good deal of hawking, with difficulty of bringing up teacious mucus ; a high degree of hoarseness, even aphonia ; tickliin the larynx, frequently causing paroxysms of cough without expectoration, or else with scanty expectoration of a tenacious mucsometimes mixed with streaks of blood. The general organism isvery much affected by the disease. The presence of ulcers pointsmore particularly to Iodine, which will again be referred to whenwe come to speak of tubercular laryngitis.Manganum is an excellent remedy, although little has been said ofit so far. It corresponds more especially to a catarrh accompanying an incipient, not a fully developed tuberculosis, but likewisforms of catarrh not resulting from a dyscrasic origin, when thefollowing symptoms are present: Slight hoarseness, rather a roughness of the throat, caused by an accumulation of lumps of hardhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 120 of 653184 Diseases of the Larynx and Trachea.mucus in the glottis, and more particularly marked in the morningaccompanied by oppressed breathing, relieved by expectoration, sothat toward noon the voice is perfectly clear ; the cough only lawhile the mucus continues to adhere in the glottis ; worse in theopen air, feels relieved by smoking. This kind of catarrh is verycommon among persons who use their organs of speech a good deal.We beg the reader to contrast Manganum with Selenium which ismuch praised for these symptoms.Mezereum is recommended if the disease has a syphilitic originand the symptoms point to ulceration of the larynx ; among thesesymptoms the livid color of the pharynx and the ulcerated folliclon the posterior wall of this organ ai'e prominent.Phosphorus has been found reliable in the most desperate cases oflaryngotracheal catarrh. A tubercular origin of the affection isindeed a chief indication for Phosphorus, but this remedy likewiscures other forms of catarrh, more especially the chronic hoarsenof preachers or singers. The more important symptoms are : weakness and sensitiveness of the organs of speech, with sensation ofness, burning, roughness, soreness in the larynx and trachea, morespecially after using the voice more than usual ; hoarseness, evnia, particularly under the operation ot exciting emotions ; conswheezing inspirations ; cough excited by the violent tickling andburning in the larynx, painful, with rattling of mucus,* althoughscanty expectoration ; hoarse, dry-sounding cough ; sensation, whcoughing, as if a lump of flesh would detach itself from the throfirm, yellowish expectoration, mingled with pus or streaks of bloIf, in addition to these symptoms, we have the general phenomenaof a consumptive condition of the system, such as : fever, diarrhemaciation, Phosphorus is indicated so much more decidedly. Experience having confirmed its practical value in chronic laryngeacatarrh, this remedy occupies a deservedly high rank among theremedies for this disease.Sulphur. The cases suited to the therapeutic range of this medicine, affect principally persons somewhat advanced in age, althouthey need not be what might be called old people. As a rule. Sulphur is indicated by the following symptoms : Chronic catarrhs ofother portions of the mucous expanse, more especially of the intetinal canal, with signs of sanguineous obstructions in the abdomeenlargement of the liver, hypochondria ; catarrh arising from abuof Mercury ; sensitiveness to the open air and dampness in particular. Among the single symptoms a prominent characteristic inLaryngotracheitis Chronica. 135dicatioQ is the cough which sets in in the evening shortly heforeand after retiring to bed, and is a dry, titillating, distressingor the cough may break out in the morning, and stop during theday, or change to an ordinary moist cough. If tubercles are present, Sulphur has very seldom a good effect, nor does it act favorin recent cases.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 121 of 653Arsenicum album acts in many respects similarly to the precedingremedy. We shall revert to Arsenic when treating of pulmonarycatarrh, to which we refer for the present. Arsenic, too, has gresensitiveness to cold and more particularly to damp air, likewisegreat nervousness. The hoarseness is not often considerable, andsets in at intervals ; it is accompanied by a violent burning sorof the throat. The cough breaks out in paroxysms with almobtcompletely free intervals, most generally about midnight, resembla paroxysm of whooping-cough and is accompanied by distressingdyspnoea. There is scarcely any expectoration, except that a morning-paroxysm of cough results in the hawking up of lumps of graymucus. The constitution feels the influence of the disease. Arsenicum is more especially indicated by the circumstance that theparoxysms of cough are apt to break out when the weatherchanges.Next to Phosphorus, Carbo vegetabilis is the most important remedy in inveterate catarrh, but acts less favorably than Arsenic ithe tubercular form of this disease. Here too, we have extremesensitiveness to the open air, especially damp air. In consequencof loud talking, the hoarseness may increase to loss of voice; thpatient complains of a feeling of great dryness in the throat, wisoreness and a stinging pain, together with a copious secretion otenacious mucus occasioning constant and sometimes very painfulhawking. The cough is wearins:, rough, with mucous rSles, butonly a scanty, greenish or yellowish, lumpy, tenacious expectoration, it sets in more particularly in the morning and is attendedwith dyspnoea.We will now mention a few more remedies in the following cursory series :For the simple protracted chronic catarrh representing an acuteattack : Tartarus stibiatus^ Hepar sidphuris calc.^ Spongia^ Pulsand for the more acute intercurrent exacerbations principally Mercurixis and Belladonna. The latter is sometimes eminently adaptedto a spasmodic nocturnal cough, without expectoration.For catarrh complicated with ulceration, if not too old : lodiurr136 Diseases of the Larynx and Trachea.Hepar sulpL., Manganum^ Silicea^ Calcarea earbonica ; for neglectcatarrh: Phosphorus^ Sulphur j Carbo veg.^ Arsenicum album.For inveterate simple catarrh: Sulphur j Carbo veg.j Silicea^ At*senicum album.For polypous growths: Phosphorus^ Calcarea carb.^ Silicea.For continued hoarseness and chronic catarrhs of singers, preachers, etc. : Manganum^ Phosphorus^ Carbo veg.^ Selenium^ Argentumin older cases ; in recent cases: Hepar sulph,y Spongia.For catarrh caused by Mercury: Hepar sulph.^ lodium^ and if asyphilitic complication exists : Mezereum,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 122 of 653For complete loss of voice, attended with catarrh : AnHmoniumcrudum^ Phosphorus ^ Carbo veg.j lodium; if depending upon disturbed innervation: Cuprum^ Opium^ Caustkum^ Phosphorus., Ignortiaj Sepia.The cure is often promoted and hastened by various dietetic andexternal means. Individuals, for instance, who have been in thehabit of keeping their necks warm, and now take cold from everylittle exposure, may resort every evening to frictions with lardthe neck with the best results ; these will diminish the dispositto take cold. The well known domestic remedy to wear aroundthe neck a rough woollen bandage, is likewise to be commended.The most decided and reliable advantage, however, is obtained frothe use of cold water, either by simply washing the neck with it,by means of wet bandages around the throat. As a matter ofcourse, too warm clothing has to be avoided. There is no betterpalliative for the distressing titillating cough, which is especitormenting at night, than inhaling the vapors of warm water. Weknow from experience that thoroughly practised singers are seldomattacked with permanent hoarseness or pulmonary diseases. Amethodical, cautious, uniform use of the voice in singing, especiif confined to the middle notes, is sometimes a better remedy forchronic hoarseness than any other means of treatment ; if the vocchords are morbidly relaxed, this use of the laryngeal muscleswould be dictated by the principles of the movement-cure. Onlyin a case of tubercular hoarseness an experiment.of this kind migprove hazardous. Talking in the midst of a noisy company, in acarriage, in rail-cars, etc., should be carefully avoided.CEdema Glottidis* 1374. CEdema Olotlidls, liarjmgltbi Sab-miicosa.CSdema, of the Glottis.By this name we understand a sadden infiltration of the sabmncous tissue of the epiglottis, and of the mucous lining of thelarynx extending from the epiglottis to the rima glottidis.(Edema glottidis is more especially a disease of adults, and inmost cases a secondary afiection. Primarily it may result fromsevere bums, by hot food or corrosive substances, but scarcely evlike oommon laryngitis, in consequence of a cold. Secondarily wedo not oitcu notice it in company with dropsical affections, butmost commonly in company with affections that occasion the formatiou of ulcers or suppurating sores on the inner or outer wallsof the larynx, like tuberculosis, typhus, variola, ulcerous larynperichondritis, croup, diphtheria, etc. ; or it may occur in a fecases as a continuation of an ulcerous angina to the larynx, as iscarlatina. Sometimes the disease seems to assume an epidemiccharacter; this may be nothing more than we observe, for instancein epidemic scarlatina, which causes characteristically violent ausually purulent anginas. Considering the manner in which thedisease originates, the most correct explanation seems to be thatsuppurative process in the neighborhood of the glottis causes cedin the same manner in which a chancre causes within a few hoursan excessive oedema of the prepuce. Our statistical tables so farthat the disease attacks men much more frequently than women.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 123 of 653Symptoms. The anatomical changes in oedema of the glottisconsist in a more or less considerable puffy swelling of the mucomembrane, more particularly at and close to the root of the epiglottis. This swelling may become so considerable that the swolleparts protrude behind the root of the tongue like a stuffed pad osausage. Usually the color is not bright-red but pale, and, oncutting into it, the swelling discharges a serous or serofluid.The phenomena of oedema glottidis sometimes develop themselveswith an extraordinary suddenness, and at other times very slowlymoreover they are modified by the locality where they occur. Inthe course of one of the above-mentioned affections, hoarseness,pain and burning in the larynx set in. The hoarseness very speedily increases to complete aphonia accompanied by a cough whichhas all the characteristic signs of croupy cough. These symptomsare accompanied from the outset by a continually increasing dysp138 Diseases of the Larynx and Trachea.noea which, in severe cases, may rise to a fearful height. The inspiration, in consequence of which the puffed-up and infiltratedof the glottis are forced towards each other and towards the rimaglottidis, becomes more and more prolonged, hissing and labored,and the patients very often have a feeling as if a foreign boilymoving around in the larynx. If the infiltration remains moderatein quantity, the respiratory process may go on without life beingin immediate jeopardy ; a condition of this kind may continue unchanged for naany days, although an exacerbation may take placeat any time. However if the respiration is seriously impeded, allthe symptoms, which we have described when speaking of croup ascharacterising a poisoning by carbonic acid, set in and the patiedie in a state of sopor. There is no fever unless it was presentviously; it is only in case the infiltration becomes purulent thathe phenomena peculiar to the formation of an abscess, manifestthemselves; on the bursting of the abscess the inspirations maysuddenly be restored. In such cases an oedematous swelling of theneck in the region of the larynx can almost always be seen.The affection may last from twelve hours to upwards of a week.The most common termination is death by suffocation, and theprognosis is consequently that of inevitable death.It is important to notice the features which distinguish the di&ease from croup with which it is most easily confounded. Manycases of so-called relapses in croup are probably nothing else thoedema glottidis resulting from croup and becoming manifest afterthe croupy process had run its course. The distinguishing characteristics are : In the first place, the swelling itself which, incases, is noticed at the root of the tongue ; the appearance of tdisease subsequently to and during morbid processes which arescarcely ever associated with croup ; the occurrence of the diseaamong adults, whereas croup attacks children almost exclusively ;the peculiar sensation as if a foreign body were moving about inthe larynx.The prospect of a successful treatment is very slim, especially ihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 124 of 653the patient is a child. Our literature does not offer any positivsuccessful cures of this disease, and, since it is one of the rarkind, all we can do is to indicate the remedies which it may benecessary to use in a given case. We are acquainted with only oneremedy which has oedema pf the glottis among its physiologicaleffects ; this remedy is lodium. For particular indications we reto our remarks in the chapter on croup. Another remedy whichCEdema Glottidis. 139offers some resemblance is Phosphorus; in this case, however, theresemblance is limited to a single symptom. If we consider thenature of the pathological process which results in the productioof oedema glottidis, independently of the symptoms superinducedby the mechanical closing of the rima glottidis, we are more particularly led to three remedies that act similarly to the generalease, we mean: Apis mellijicay LachesiSy and Bhus toxicodendron.Lachesis especially has the peculiar serous infiltration of interas well as external parts of the body which sets in without anysymptoms that might properly be called inflammatory, and whichreaches its full development in a few hours. However, since in thdisease we cannot fall back upon experience for a positive knowledge of the curative action of drugs, it would be criminally indicreet to depend exclusively upon internal treatment. In this disemuch sooner than in croup, success may be expected from tracheotomy, for the reason that the trachea is not usually involved ; onthe operation should be performed so soon as the symptoms ofpoisoning by carbonic acid begin to manifest themselves ; otherwithe paralysis of the respiratory organs might have progressed toofar for the operation to be of any use. An incision into the visiswelling has some advantage and cannot do any harm. Compressesas hot as can be borne, may be applied to the throat, whereas colapplications can only prove injurious. We should not forget thatwe have no inflammation to deal with, and it seems absolute follyto treat oedema of the glottis with copious depletions which ategenerally recommended. [The following interesting case of oedemaof the glottis occurred in the practice of Jacob Reed, jr., M. D.this city, as reported by himself:"Marth 16th, 1867, evening. Called to see Miss B., set. 20, whohad for some days ^'had a bad sore throat," and was reported aschoking to death."When seen, the patient was evidently suffering from an acuteoedematous inflammation of the larynx, there being high fever, pain the region of the larynx, difficulty of swallowing and breathivoice almost inaudible, every effort at speaking causing great painspirations prolonged and stridulous, being effected only by vioeffort ; there was but little cough. Frequent spasmodic exacervations of these symptoms rendered suffocation imminent."Ordered inhalations of steam, medicated with Opium, cold packto region of larynx, Aconite and Kali bichrom.; of the Aconite140 Diseases of the Larynx and Trachea.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 125 of 653three drops of the tincture of the root were given in a half glasof water, of which she took a teaspoonful every twenty minutes." This appeared to afford relief which, however, proved but temporary as, upon paying my morning visit, I found the patient muchworse in every respect. The leaden hue of the skin, with the intense anxiety of the countenance, showing that she had to fear thresults of deficient aeration of the blood." This condition of affairs rendering bronchotomy necessary, Ireturned to the office for the necessary instruments and assistanbut in the mean while ordered two drops of the tincture of theAconite root to be given every ten minutes." Upon returning, after the lapse of an hour, the patient was sofar relieved as to render surgical interference unnecessary, and'this the convalescence was steady, although slow and imperfect.There remains, after many months, a cough with hoarseness, owingto constitutional tuberculosis." H.]5. Spasmus Glottidls.Spasm of the Glottis.Spasmodic conditions of the glottis sometimes accompany otheracute or chronic diseases of the larynx as severe complications.this chapter we do not speak of these conditions, but of the purenervous spasm of the glottis which occurs without any materialalterations, and which is described in pathological treatises undthe names of Asthma thymicum Koppii, Asthma M illari. Asthmaperiodicum infantum, or Laryngismus stridulus. All these conditions are essentially alike.Spasm of the glottis affects pre-eminently children of a tenderage; among adults it only occurs as an accompaniment of otherpathological processes; or as an idiopathic disease it may attackfemales of exceedingly irritable nerves. Among children the largenumber of those who are attacked by the disease, are boys ; amongpersons of a more advanced age, the case is exactly the reverse.Ardent discussions have been carried on regarding the real causeof the disease ; a retarded involution of the thymus gland, tuberculosis of the bronchial glands, a rhachitic affection of the occthe non-closure of the ductus Botallii, etc., have been accused athe exciting causes of the disease, until finally pathologists haconcluded that the real cause of this peculiar spasm is as yet unknown. An hereditary disposition cannot be denied in many cases;not unfrequently the children of tuberculous mothers are attackedSpasmus Glottidis. 141by the disease; so are children who are brought up by hand.Among adults, spasm of the glottis is undoubtedly a form of hysteria. Among children the disease occurs almost without an exception in the first year of their existence.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 126 of 653Symptoms and Covrne. The disease consists of paroxysmsseparated from each other by complete intermissions of variousdurations. The first paroxysm mostly occurs at night while thechildren are asleep, very rarely during a vehement crying sfiell.After sleeping quietly for a few hours, they are suddenly rousedfrom sleep with a peculiar cry, as the parents describe it ; or rwith a dif&cult, hissing inspiration of an unusually ringing sounat the same time the faculty of breathing is either entirely suspended, or else the inspirations become rapidly more labored anda few moments quite impossible. The children are lying as if deadat most performing a few anxious movements with the arms ; theface assumes a bluish pallor, the features become pendulous, thecountenance looks bloated, the eyes are distorted and fixed. Thebreathing is entirely suspended. If the attack lasts any length otime, the skin becomes cool and the head is covered with a coldsweat. The pulse is of course very small and accelerated, and mayeven cease entirely. An attack of this kind which naturally enougfills the relatives with indescribable anguish, lasts a few seconseveral minutes, ending with an inspiration entirely like the onewith which the attack commenced, which is followed by normalrespiration, and, if the attack did not last too long, by perfectcovery ; in the opposite case the patients feel anxious and langubut only for a "short time, after which they do not show any signof discomfort, K an older child is attacked, the symptoms varysomewhat ; the child makes great efiforts to overcome the impediment to inspiration, and the loss of consciousness sets in moreslowly. If the attacks return frequently and are very intense,clonic convulsions often supervene.The very first attack may terminate fatally, but this is not oftethe case : as soon as general convulsions set in, the danger incrgreatly, likewise if the attacks follow each other in rapid succeif the patients are not asphyxiated, they perish by inanition.The recurrence of the attacks is not governed by a fixed rule,not even in the case of the same individual. It is very rare thatthe disease is confined to a single attack, but a second attack stimes does not take place until months have elapsed. The firstattack almost always occurs during sleep ; subsequent att142 Diseases of the Larynx and Trachea.take place in the waking state. The more frequently they occur,the more dangerous they hecome. Recovery mostly takes placegradually, with a gradual decrease of the intensity and frequencyof the attacks ; it may drag along for months and may only beapparent, since another attack may break out again after a shortinterval of repose.The prognosis is always more or less uncertain ; neither the vigoof the little patients, nor the weakness of the first attacks isguarantee against sudden death.The diagnosis is not always easily made, more particularly if thespasm sets in in the course of laryngeal catarrh or of some otheraffection of the larynx, or if the patient does not lose his consness, in which case a deceptive croupy cough may set in. The facthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 127 of 653should be kept steadily in view that a spasm of the glottis can obe thought of, if all the other symptoms of a disease of the laryare wanting. A spasm of this kind can never be converted intocroup or catarrh. The sudden dyspncea without a sign of cough,the complete suspension of the respiratory movements, the subsequent complete intermissions constitute safe diagnostic marks inmost cases.As regards treatment, it will have to be directed against the disease as a unit rather than against a single paroxysm which neverlasts long enough to admit of medical aid in every case ; hence ttreatment will have to confine itaelf to a few not altogether unesential arrangements. In the first place the child has to be laida proper manner ; the best posture is to one side, with the headslightly bent forward. A sponge dipped in hot water and appliedto the region of the larynx sometimes renders as effectual aid inthis disease as a warm cataplasm in a case of vesical spasm. Spriling the parts very forcibly with cold water, is likewise a verycient remedy in some cases.For the totality of the pathological process we possess the folloing remedies which of course have to be given at long intervals :ignatia amara has an eminently characteristic symptom, it is thedyspnoea, the difficulty of drawing in breath, whereas the expirations are easy ; such a difficulty is suddenly experienced aboutnight. This remedy is very much praised, if the children suddenlylose their breath, which may be the lowest degree of spasm of theglottis ; we have already stated under hysteria that Ignatia is lwise useful for many nervous complaints of females ; but whetherit will prove a proper remedy for spasm of the glottis, has not ySpasmus Glottidis. 143been verified. It may perhaps prove most appropriate if the spasmoccurs as a symptomatic manifestation in croup, catarrh or whooping-cough-Ipecacuanha has been mentioned as a remedy ; indeed the symptoms justify this recommendation. We should not, however, overlook the fact that asthmatic difficulties do not really occur indisease. Relief is easily afforded if a remedy is given a^ the oubut it does not last, and we cannot recommend a remedy as a speciunless it controls the whole disease. We admit, however, that Ipecacuanha may have an excellent effect, for the time at least, incatarrh accompanying spasm of the glottis.The same remark applies to Belladonna. We refer to the fewcases mentioned in Rtickert which clearly show that Belladonna isonly adapted to spasm of the glottis when occurring as a secondarsymptom in other diseases.Veratnim album and Arsenicum album deserve our attention if, as ioften the case, the disease attacks feeble children with markedsymptoms of cerebral ansemia.Moschus is variously recommended in this disease, but we cannotsee its homojopathicity to it. We are not acquainted with any decided cures that Moschus has effected in this disease, Hartmann'shttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 128 of 653statement to the contrary notwithstanding.Sambucus is represented by Hartmann as one of the leading remedies ; he has noticed its good effect in a striking case which,ever, does not, in our opinion, represent a high degree of spasmuglottidis. According to Hartmann, the following are the more important symptoms : The patient suddenly wakes from his slumberwith his eyes and mouth half open, he has to sit up erect in ordeto catch breath ; he can only make short, hissing inspirations, mgled with paroxysms of suffocation, during which he throws hishands about, and the face and hands look bluish and bloated, withdry heat all over, no thirst, an irregular, small and intermittenpulse ; the patient cries at the approach of a paroxysm. All thisoccurs without cough about midnight. Hartmann commends Menyanthes trifoliata without having seen any curative results fromthis drng. We consider these indications very vague and of littlepractical value.The remedies above named are either appropriate only in a simpleattack of symptomatic spasm of the glottis ; or else they are recommended on account of their marked resemblance to a singleparoxysm; Yeratrum and Arsenicum form exceptions. In our144 Diseases of the Larynx and Trachea.opinion, a Buccessful treatment implies a special consideration othe most trifling accessory circumstances without laying muchstress on the particular paroxysm ; and likewise a careful considtion of the etiological causes. Among these causes rhachiti8,^ adeficient involution or hypertrophy of the thymus gland, swellingof the bronchial glands are undoubtedly the most frequent and mosprobable, and it is with particular reference to these etiologicacauses that we recommend the following remedies :iodium is undoubtedly a very excellent Simile, and is likewiseadapted to all three above-named causal morbid conditions. Withthis remedy alone, given every other day at the fourth or sixth atenuation for four to eight weeks, we have cured five undoubtedcases of spasm of the glottis, which evidenced their malignant nature by the fact that every subsequent attack was more violentthan the preceding one. The patients w^ere children not yet a yeaold, but only one of them showed an enlargement of the thymusgland. Supported by such striking curative results, we cannot beaccused of hazardous speculation if we prefer this remedy to allothers as long as the general organism has not become too muchreduced.Cuprum was already mentioned under croup on account of itspeculiar influence over the rima glottidis. It is particularly appriate if, during the local spasm, general convulsions have supervened and the children have become very much prostrated. Amongthe significant symptoms indicating this remedy, one is particulanoticeable, we mean vomiting after the attack.Plumbum is very closely related to Cuprum in every respect, except that the general strength is still more reduced. The symptomof a spasmodic closing of the rima glottidis are more distinctlymarked in the pathogenesis of this drug than in that of any otherhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 129 of 653We are amazed that Plumbum should not yet have been recommended for this disease which, however, can only be cured by remedies that exert a deeply-penetrating, long-lasting influence ovewhole organism. In this respect, Sulphur may deserve attention,although, we shall take the liberty of doubting the homoeopathiciof its asthmatic symptoms to spasm of the glottis until this facthas been corroborated by experience. [We have cured more thanone spasm of the glottis radically with nothing but the first attuation of Aconite-rooL H.]Several oth'er affections of the larynx have been left out, for treason that they are either not accessible to treatment and are,Ulcers of the Larynx. 145therefore, only of a purely pathological interest to the physicialike laryngostenosifl, for instance; or hecause they occur very rand mostly only as complications, like perichondritis. To devotespecial chapter to hoarseness or aphonia, seemed to us inexpedienfor cases of this kind, if they present a peculiar character, a Rtory is the best guide. Nor have we devoted a special chapter toulceration of the larynx. The therapeutic chapter of this affectiis essentially the same as that of laryngeal catarrh, in which ulof the larynx occur as a complication with but few exceptions.[Ulcers of the larynx are of so many different kinds and differ sgreatly as respects their origin and treatment that we have deemeit expedient to devote a special chapter to this subject. We transcribe the following from Kafka's late work :6. Ulceni of the lArynx,HelcosiSy sen Ulcera Laryngia.All ulcers of the larynx are accompanied by catarrh of the laryngeal mucous membrane; it attends them from the start and remains while they last. A number of morbid processes predisposeto ulceration; if a laryngeal catarrh arises during the existencethe ulcers, we are required to diagnose the ulcers that are peculto the particular disease. It is only when a laryngeal catarrh ispresent that we are justified in inferring the presence of ulcersTJlcers on the epiglottis deprive it of its elasticity, whence laulcers so frequently give rise to the so-called "swallowing wrongThe sputa constitute another criterium for the existence of anulcer in the larynx. The sputa are frequently streaked with bloodcontain blood-disks or pus-globules, and are more particularlycoughed or hawked up after eating or drinking.The ulcers occur most frequently on the posterior wall of thepharynx and on the laryngeal mucous membrane, in front of, andbetween the arytsenoid cartilages.The local symptoms occasioned by the ulcers, do not essentiallydiffer from those of chronic catarrh ; only they are more violentpersistent. They consist in hoarseness even to the degree of aphonia; in continual dyspnoea, with labored, hissing, wheezing, paning respiration, especially after an exertion, such as a good deahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 130 of 653walking, talking, etc. ; in cough which generally sets in in paroysms, is always short and dry, and does not become loose till towards the close of the paroxysm; the sputa are scanty, in smalllamps, not frothy, streaked with blood, purulent; in constant haw10146 Diseases of the Larynx and Trachea.ing occasioned by the accompanying catarrh and the quantity ofmucus accumulating in the fauces; in various painful sensationsand dryness of the throat ; finally in swallowing wrong, as it iscalled, and in the return of liquids during deglutition, if the eglottis is the seat of the ulcer.The following kinds of ulcer are most frequently observed:1) Catarrhal ulcers. They arise in consequence of chronic laryngeal catarrh, commence by the epithelium being detached, are flatirregular, and often run together.2) Aphthous ulcers. They emanate from the diphtheritic process;the raucous lining becomes infiltrated, is rapidly destroyed, andsmall, generally round ulcer arises, which is surrounded with a rareola. They most commonly are present during pulmonary tuberculosis, and likewise occur on the pharyngeal mucous membrane.3) Follicular ulcers. They are a result of the inflammation andulceration of the mucous follicles, and form small, rounded, deeppenetrating ulcers. They generally break out in the pharynx,whence they spread to the larynx. If follicular ulcers in the phaynx are accompanied by constant hoarseness, the existence of suchulcers must likewise be suspected in the larynx.4) T^ibercvlar ulcers. They always accompany tuberculosis. Liketuberculosis they appear in two forms, as tubercular infiltrationas miliary tuberculosis. They are most commonly seated on theposterior wall of the larynx, less frequently on the epiglottis.ing infiltration the infiltrated portion of the mucous membranedies, leaving an ulcerated surface behind. During granular deposition, we first notice small, gray, little tubercles, which form lulcers that not unfrequently run together and give rise to ulcerasurfaces of larger extent. Both these kinds of tubercular ulcersmay spread in width and depth, invade the vocal chords andcartilages, and lead to perforations and destructions.The so-called laryngeal phthisis is only a partial manifestationa general disease. Mo^t frequently it is tuberculosis that leadslaryngeal phthisis. This form of causative relation can only beadopted as long as the phenomena of the laryngeal affection areperceived, while the tubercular process in the lungs is either arrested or has not yet broken out. As a rule, tuberculosis of thelarynx is connected vrith tuberculosis of the lungs or other orgaIn a case of continual hoarseness, we diagnose tubercular ulcers,provided we have become satisfied of the simultaneous existenceof pulmonary tuberculosis. If the destructive process invades thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 131 of 653Ulcers of the Larynx, 147vocal chords, complete aphonia sets in. The painful sensations inthe larynx and the painfulness to contact are seldom very consideable ; the violent cough comes mostly in paroxysms and is frequenaccompanied by vomiting and gagging ; the sputa are often streakewith blood. The presence of emaciation, fever which sets in everyday almost at fixed hours, night-sweats, muscular debility, a cerdegree of ansemia entitle us, if the objective signs are still doto conclude with a high degree of probability that a tubercular dease is developing itself in the lungs ; perfect certainty can ontained if the presence of tubercles in the lungs can be demonstra5) Typhous ulcers. The typhous ulcer arises from a typhous infiltration of the mucous follicles and of the surrounding mucousmembrane by necrosis ; the ulcer is shaggy, irregular and surrounby badly-colored borders. It is the same process as takes place othe intestinal mucous membrane. These ulcers are seated on thesides of the epiglottis, and on the mucous lining in front of, anbetween the ary tsenoid cartilages. They are mostly flat ; but ifdip down to the subjacent tissues, they may expose the cartilageand by necrosis lead to perforation into the oesophagus.The typhous ulcer usually breaks out in the second or third week.Hoarseness or a hoarse cough announce a localization of the typhous process.According to Dr. Maurice Haller the voice of the patient, as soonas the typhous process becomes localyzed in the larynx, is raiseda higher pitch ; this higher pitch of the voice is not lasting, bit continues until the typhous process is terminated. The paroxysmal hoarse cough is mostly dry, the pains are slight.The typhous ulcers are dangerous on account of the frequentlysupervening csdema of the glottis, and on account of the perforation which may even take place during the period of convalescence(perichondritis).As soon as the typhous process becomes extinct, the ulcers in thelarynx disappear.6) Syphilitic ulcers. They almost always break out on the pharyngeal mucous membrane, whence they extend to the epiglottis andthence to the larynx. They are small, shaggy, with raised edgesand a lardy base. If they penetrate to the subjacent tissues, themay cause necrosis of the cartilages. On healing they form cordshaped cicatrices whose contraction causes stenosis of the larynxand aphonia. The syphilitic character of the ulcers is diagnosedby the simultaneously-existing or a previous attack of syphilis.148 Diseases of the Larynx and Trachea.7) Lupous ulcers sometimes spread from the pharyngeal mucouamembrane to the larynx, contracting the larynx and causing stenosis and aphonia.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 132 of 6538) Variolous ulcers arise by the spreading of variola pustules fthe pharynx to the larynx where they change to small ulcers. I'sually this process disappears as soon as the smallpox has rvin itscourse; in severe cases, however, the respiration is interfereo was in croup, and the symptoms of oedema glottidis may set ii/.dyurne, Terminations^ and Prognosis. Catarrhal, aphthous,follicular, typhous and variolous ulcers depend upon the dease which occasions them ; as soon as this disease is cured, theulcers heal likewise. They may easily terminate fatally by thesudden development of oedema of the glottis; or the destructionwhich they occasion, may lead to premature marasmus, or theymay result in death in consequence of pysemia.Syphilitic ulcers can only be healed, if the cartilages have notalready been destroyed, or stenosis has taken place.Tubercular ulcers often run a very protracted course ; they maycause very little destruction, and yet they scarcely ever heal. Ionly if the tubercular process is arrested in its course that theulcers can be healed for a time.Lupous ulcers are generally incurable.Treatfnent. The ulcers are treated with the same remedies asthe diseases from which they result. Catarrhal ulcers requireJlepary Phosphorus^ Iodine^ Spongia^ Pulsatilla. Aphthous ulcersrequire: Sulphur^ Borax ^ MercuriuSj Nitri ac.y also Hydrastis caFollicular ulcers: Alumina^ Plurnbum acetj Argentum nitr , Cuprxisulph. Tubercular ulcers: Oleum jec, aselli^ Calcarea^ China^ IodSulphur^ Stannum^ Silicea ; the treatment is generally unsuccessfSyphilitic ulcers require: Kali bichrom.^ Mezereum^ Phosphoric acand the mercurial preparations: Mercurius jod.^ Mercurius rub.^Cinnabaris, and Mercurius corr.^ also Mercurius sd. Stenosis hasbe treated surgically by tracheotomy. Typhous ulcers require theremedies given for typhus. For variolous ulcers we recommendprincipally Tartar emetic^ also, in form of a gargle, one grain tthree ounces of distilled water.For the excessive cough caused by the ulcers, we recommendSulphate of Atropine^ second attenuation, ten drops in half a tumbler of water, a dessertspoonful every hour or two hours. Cannabiindica 2, given in the same manner, has likewise a soothing effecFor the diet and general management, we refer the reader to theoorresponding diseases. IL]B. DISEASES OF THE LUNGS.The diseases of the lungs are some of the most important ofthe whole body, both on account of their frequency as well as onaccount of the disturbance of the most important function, the oxgenation of the blood. The importance of these diseases has induced pathologists for the last forty years to devote special atttion to them, on which account this chapter may be regarded asthe most complete and thoroughly cultivated in the whole domainhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 133 of 653of Pathology.Pulmonary diseases are of essential importance to a homoeopath,for the reason that he has it in his power to watch them objectivthroughout all their phases and, thus, to become acquainted withthe effects of his drugs beyond the possibility of deception. Thediseases constitute most generally the battle-field upon which thstruggle for supremacy between Homoeopathy and her opponentshas to be fought; a number of publications bearing upon this poinhave already shown that the importance and decisiveness of thisstruggle are fully appreciated.One point of importance has to be carefully kept in view. Wecannot expect that our older Colleagues, who fancy themselves rulin medical Israel, should acquire a thorough knowledge of all modem means of diagnosis ; the thing is much too arduous an undertaking; but no young homoeopath should shun the trouble of availing himself both in his practice and in his reports of cases of tmost refined minutiee of an objective diagnosis. Unfortunately wecannot say that this is the universal rule. It is only by this methat we can convince our opponents with irrefutable arguments ofthe advantages of our System of Therapeutics. They brag of theexactness of their diagnosis and yet they have not as yet derivedthe least advantage from it for their own method of treatment.Here we have a point of attack, provided we prepare ourselves forthe combat with arms that even the most redoubtable hero in diagnosis would stand in fear of, and provided we show at the sametime that we do not study diagnosis as an intellectual entertainment, but as an addition to the science of Therapeutics, as a meato effect a cure of a given case of disease with more positive cetainty. More than one homoeopath has tried to cast a slur on phy(149)ISO Diseases of the Lungs.sical diagnosis as a subject of no importance to Therapeutics, because, as is alleged, we have no physiological pathogenesis to cotrast with the results obtained by means of a physical exploratioof the chest. This, however, is entirely incorrect, for in respeca number of drugs we are acquainted with the material changeswith which the physical symptoms correspond; but even if liiiswere not so, the objective diagnosis would still remain investedwith the highest importance, for the reason that it often interprthe frequently obscure symptoms and traces them to their origin,and likewise because it enables us to determine with reliable certainty the eflfect of the medicine we have administered in a givecase.It is, therefore, our belief that there are not many homoeopathicpractitioners who do not attach great importance to physical diagnosis and declare it a thing of indispensable necessity. Wq shoulnot have been able to refrain at the outset of this Section frompounding, as we have done at the commencement of our chapterson renal and hepatic diseases, the most important points in thediagnosis of diseases of the thoracic viscera, if we had been ablspare the necessary space for such an extensive undertaking. Weshould not only have had to deal with percussion and auscultationhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 134 of 653but likewise with the measurement of the thorax, with spirometry,with the rhythm, frequency and fulness of the respiratory movements, the relation between inspirations and expirations, cough,pectoration, vocalization, etc. Any one who is acquainted withpercussion and auscultation, must know that even the most necessary details in these departments are sufficient to fill a numberpages. Hence we take it for granted that every physician is fullyposted in these branches of medical knowledge, and shall confineourselves to interpolating particulars whenever necessary, whiletreating of the various aftections; by pursuing this course we shbest fulfil the object of this work.1. Hypenemla of tbe Iiimgs.Congestion^ Flethora of the Lungs.Considering the extraordinary quantity of blood which, in comparison with other organs, goes to the lungs; considering the dilability of the pulmonary parenchyma and of its enveloping membrane, we at once not only comprehend the possibility of pulmonarengorgements, but that this possibility is even very great ; if wdevote some space to a consideration of this subject, it is becauHyperaemia of the Lungs. 151all pulmonary hypercemias, primary as well as secondary, are of tgreatest practical importance.Pulmonary hyperemia is of two kinds ; it is an active hyperaemiaor active congestion when caused by an afflux of blood to the lunand a passive congestion when resulting from an obstructed effluxof the blood from the lungs. Active hypenemia presupposes inmost cases an increased activity of the heart, hence constitutesessential symptom of all cardiac anomalies attended with increasefunctional activity of the heart, but may likewise be occasioneda temporary excitation of the heart's action by violent bodily efsuch as running, dancing, singing, lifting, ascending a hill ; orpowerful mental emotions, or by substances which cause a suddenacceleration of the circulation, more particularly spirits, wine,coflFee ; it may likewise occur as a symptom of a general plethorcondition of the system occasioned by the suppression of habitualhemorrhages. Pulmonary hypersemia is less frequently caused byirritants striking the lungs directly ; very cold or very hot airtating gases, rarefied air, etc. Hence lively, sanguine, irritabldividuals between the ages of twenty to thirty-five and forty yeaduring the prevalence of great heat or severe cold, or when residon high mountains, are much more liable to pulmonary hyperjemiathan persons of different temperaments and living under differentinfluences. Various morbid conditions of the lungs, especially tuculosis, engender a strikingly great disposition to pulmonary congestions.Passive congestion is never a primary affection, but always aconsequence of other morbid processes obstructing the return of tblood from the lungs. This result is more especially brought abouby various anomalous conditions of the heart. In the proper placepassive congestion will be discussed more fully when we come tospeak of the different pathological states of the lungs; in thishttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 135 of 653we shall speak of it only so far as may be necessary to discriminbetween the two kinds of congestion, active and passive.Symptoms and Course. The symptoms of pulmonary hyperfieraiavary greatly, according to the condition of the lungs anddegree of engorgement. The lower grades of acute congestion onlycause a sensation of oppression with shorter and more hurriedbreathing, at times passing away rapidly, at other times moreslowly, or having remissions but being otherwise painless. In thehigher grades the breathing suddenly becomes oppressed to an extraordinary degree, so that the patient seems on the point of suf152 Diseases of the Lungs.cation. The respiration is hurried, superficial, noisy; the pulseincreases in frequency and fulness, the face looks flushed. Mostmonly these symptoms are associated with a desire to cough, andthe frothy sputa are tinged with blood. There is no pain if thelungs are otherwise sound, whereas tuberculous individuals ex*perience a great deal of pain. In the highest grades of hypersemithe dyspnoea increases so rapidly and the sanguineous engorgementbecomes so great that the patients die of asphyxia, sometimes sosuddenly that an accident of this kind has been termed pulmonaryapoplexy.The lesser grades of the affection generally terminate sooner orlater in complete recovery, whereas in the higher and more protracted grades of the disease, oedema of the lungs may developitself, which may continue for a long time, even after the hypersemia is entirely removed. It is questionable whether a simplehypersemia can ever pass into pneumonia, notwithstanding thatpneumonia is very commonly initiated by symptoms of hypersemia.Passive hypersemia has almost the same symptoms as the activeform, great oppression of breathing, turgescence of the countenanaccelerated action of the heart. The resemblance is sometimes sogreat that passive hypersemia is treated in the same manner as thactive form, to the great detriment of the patient. In such casescorrect diagnosis can only be determined by the anamnestic circumstances of the disease and a careful exploration of the conditionthe heart ; for passive hypersemia never sets in without being prceded by considerable morbid derangements. Hypostasis of thelungs or, in other words, an accumulation of blood in accordancewith the law of gravitation, is scarcely ever any thing else thanpartial manifestation of other diseases; it occurs almost exclusiamong old people, and is generally destitute of any symptomaticappearances.The prognosis in acute congestion is almost always favorable;congestions caused by violent emotions are the least promising. Afrequent repetition of the attacks is always a very bad sign ; thshow that either the heart is intensely diseased, or else that pumonary tuberculosis is their exciting cause.Treatment. The main remedy for all active congestions of thelungs is undoubtedly Aconite. We are amazed that Hartmannshould have omitted any mention of this remedy. Aconite is particularly appropriate in hypersemia depending upon cardiac affechttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 136 of 653tions, or indicating and accompanying tuberculosis; such indiHypersmia of the Lungs. 15Svidnals have a delicate skin, bright complexion and sanguine temperaments. Even a cursory review of its symptoms will satisfy anyone that Aconite is homoeopatic to acute hypersemia of the lungs.If the disease was caused by a fit of anger, or vehement chagrin,or mortification, Aconite is indicated so much more fully. Belladonna has likewise many symptoms pointing to pulmonary congestion, but it is not so easy to determine the conditions for whichBelladonna is indicated ; they likewise occur less frequently. Bedonna is preferable if not only the lungs, but likewise the cephaorgans are involved in the congestion, and it is less depending ucardiac disease than upon some other affection. Leading symptomsdistinguished from those of Aconite are: turgescence of the cephavessels, with dark redness of the face, bluish redness of the lipglistening eyes ; anguish and restlessness ; a constant dry, hackcough, or else a spasmodic and dry cough. Nux vomica is an excellent remedy for certain kinds of pulmonary congestion, if the following conditions prevail : The attack is occasioned by sedentaryhabits, excessive mental efforts, the use of coffee, ardent spiriin the case of sanguine, robust individuals who are free from cardiac disease; after a copious meal, in the night. The symptomsresemble those of Belladonna more than they do those of Aconite.Digitalis purpurea is, in our opinion, inappropriate in an isolatattack, but is, on the other hand, indicated if the congestions overy frequently or evidently point to tuberculosis. In such affections, however, there is every reason why the medicine should begiven very cautiously. It is not absolutely necessary for the heato be the starting-point of the disease or to be considerably invin the pathological process, for uncomplicated, tubercular hyperemias of the lungs are likewisis most easily relieved by DigitaliBryonia is the next best remedy to this latter drug. In very acutcases which may become dangerous to life by the premature supervention of an acute oedema of the lungs, no time should be lost unecessarily by awaiting the effect of the first-named three remedif they act at all, they will show their curative influence aftervery first dose. If they do not afford speedy relief. Phosphorusshould at once be used, or, in case of cardiac affections : ArsenThese remedies may suflSice ; after all, in most cases the selectof the proper remedial agent depends upon the nature of the casebefore us. "We cannot refrain, however, from calling attention toFerrum and Pulsatilla in the case of ansemic and tuberculous individuals, and likewise to Veratrum album and Sepia. [Veratrum154 Diseases of the Lungs.viride^ if given in comparatively larger doses, has often cured,out the use of any other remedies, hypersemia of the lungs as welas pneumonia. H.]We sometimes have great trouble to persuade such patients todesist from the frequent use of sanguineous depletions. It is truthey afford a momentary relief, but in exchange they help the disease on its. course, and are particularly dangerous to drunkardshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 137 of 653to persons affticted with incipient tuberculosis. There is scarceany affection where it is as necessary to abstain from the use ofcoffee as pulmonary hypersemia, which is caused by the action ofcoffee not only directly, but likewise through an increased excitbility of the functional activity of the heart. Frequent deep andprotracted inspirations are exceedingly useful in regulating theaction of the lungs. Vigorous, but not excessive bodily exerciseuseful rather than otherwise ; the good results of careful ascensof mountains by tuberculous patients afford the best evidence thathis statement is founded upon facts.8. Pneninorrluit^a,Pulmonary Hemorrhage.If we consider the delicacy of the pulmonary tissue and the quantity of blood which is collected in it, we have no difficulty inprehending that one of the pulmonary vessels may readily tear, anmust cause a more or less considerable hemorrhage. For this reasopulmonary hemorrhage is one of the most frequently occurringmorbid phenomena which of itself is not so very important, becausthe bleeding scarcely ever amounts to an excessive quantity, anddoes not threaten life with immediate danger.Etiology. As we stated in the previous chapter, a high degreeof pulmonary hypersemia may easily result in effusion of blood inthe air-passages. The effusion differs in quantity according as taffected lungs are naturally sound or otherwise morbidly affectedThe causes of pulmonary hypercemia are therefore in a certain senthe causes of pulmonary hemorrhage. The main reason, however,why pulmonary hemorrhage is invested with such ominous importance to every layman, is the circumstance that it implies the exience of morbid conditions which result in the destruction of thepulmonary tissue, among which tuberculosis occupies the first ranIt is difficult to explain why the same influences should occasiopulmonary hemorrhage in one individual and not in another. WePneumorrhagta. 155know that sanguine, florid, irritable individuals are more liablehemorrhages than phlegmatic and torpid persons ; but we cannotdecide whether this liability is owing to an accelerated flow ofblood, or to an excessive delicacy of the walls of the vessels. Deases of the vessels themselves, atheromatous degenerations, aneurysms, etc., lead to the most profuse and most threatening hemorrhages. The not unfrequent occurrence of considerable pulmonaryhemorrhages during pregnancy or after a suppression of the mensesis difficult to account for. As regards age, it is selftheage where the pulmonary activity is heightened and where thedevelopment of the pulmonary tissue is most active, is the agewhere pulmonary hemorrhages occur most frequently ; this is theage between the years of fourteen and twenty-five. Whether onesex or the other is more liable, is not certain.SU'fnptoms and Course. Pulmonary hemorrhage either takesplace into the bronchia or into the pulmonary tissue. It is eithecopious or scanty, in accordance with which we have in the firstplace hemoptysis, the evacuation of small quantities of blood tohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 138 of 653gether with the sputa; next: pneumorrhagia, the evacuation oflarge quantities of blood; the formation of clots or sanguir^eousdeposits, by which the tissue of the lungs is not destroyed and tblood is not discharged externally; pulmonary apoplexy duringwhich the blood is likewise eftused into the pulmonary parenchymabut with destruction of the tissue. These distinctions are, however, of very little practical use, and for practical purposes itsufficient to distinguish hemoptysis and hemorrhage, according asa larger or smaller quantity of blood is expelled from the lungs.The formation of circumscribed coagula as well as apoplexy ottertoo many difficulties for a correct diagnosis in order to justifytherapeutic management based upon the latter.Of itself hemoptysis is not a very important disease. It oftenoccurs without any disturbance of the constitutional equilibrium,after violent exertions, in consequence of unimportant catarrhs,often in the case of pregnant females, and sometimes consists ofmere streaks of blood mixed with the mucus, at times in small detached portions of pure blood. As was said before, tuberculousindividuals are most commonly aftected, on which account the chesshould be carefully examined at every ever so trifling hemoptysisSlight pulmonary hemorrhages are not unfrequent accompanimentsof a chronic catarrh of the bronchial mucous membrane, as is soconmionly met with in emphysema of the lungs. If the quantity156 Diseases of the Lungs.of the expelled blood is somewhat more considerable, the hemorrhage is usually preceded by various indefinite phenomena, such apalpitation of the heart, oppression, sensation of heat in the chstitches in the chest, congestions of the head ; these symptoms gerally disappear again after the hemorrhage has set in.Pnelumorrhagia is almost always preceded by a short preliminarystage. For several days previous the patients often feel excited,uncomfortable, oppressed on the chest, hot in the head, disposedfainting fits ; the pulse is somewhat accelerated, the beats of theart are stronger. Real pains in the chest are seldom felt, and,felt, are not attributable to the hemorrhage, but to the morbid cditions that gave rise to it. Shortly before the hemorrhage thesymptoms of a violent pulmonary hypersemia become manifest."While a feeling of increased warmth in the chest is experienced,the respiration becomes at the same time oppressed, after which airritation and urging to cough are felt ; with the first turn ofa frothy, bright-red, pure blood is thrown up in various quantitiwhich is soon succeeded by a larger quantity attended with a couglike vomiting; or else the second hemorrhage may only occur aftera longer paroxysm of cough. The patient has a distinct sensationthat the blood is bubbling up in the chest ; the rfiles can be heeven without the ear being applied to the chest.As soon as the hemorrhage sets in, the hypersemic symptomsabate at once, after which the patient feels very weak and experiences a disposition to faint. The fainting is not so much the resof the quantity of blood lost, but is more commonly owing to themoral impression which every hemoptoe makes even upon the mostrobust individual.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 139 of 653The disease is scarely ever limited to a single attack. After thetrouble seems fully ended, generally in twenty-four hours, less fquently after several days, another attack sets in as suddenly asthe former ; a number of attacks may take place in this manner atindefinitely succeeding periods. In such a case anaemic symptomsmay make their appearance ; in severe cases the patient may evendie of exhaustion.At first sight it may seem as though the diagnosis of pulmonaryhemorrhage could not well be a difiGlcult task. Nevertheless decetions occur nowhere more frequently than in this disease, on whicaccount we shall explain the distinctive signs of pulmonary hemorrhage a little more fully. Nosebleed, especially when the blood idischarged from the posterior nares or during sleep, is easily miPneumorrhagia* 157taken for pulmonarj hemorrliage, because the blood, the largerquantity of which is undoubtedly discharged into the pharynx,likewise gets into the larynx, where it causes a desire to coughw^hich results in the expulsion of blood. At the same time bloodis blown from the nose, and the posterior-superior wall of the phrynx is seen streaked with blood. If these signs are wanting, perhaps the circumstance that after the first bloody expectoration nmore bloody mucus is brought up, may shed light on the nature ofthe attack. The absence of all local symptoms in the lungs is aloinsufficient to justify the supposition that the hemorrhage is nopulmonary, but nasal. It is sometimes equally difficult to discriinate between hemorrhage from the lungs and stomach. In heematemesis the gagging and vomiting likewise easily excites cough ;moreover in hemorrhage from the lungs a quantity of blood, beforeany is coughed up, is sometimes swallowed and vomited up. As arule, the following points may serve as diagnostic signs : In hfetemesis the symptoms of an intense affection of the stomach arealmost always present for some time previous, and these symptomslikewise accompany the attack itself. The blood is always darkred, even black, unless it should emanate from an artery. Thiscould easily be determined by an exact diagnosis ; whereas in pulmonary hemorrhage a bright-red blood is coughed up, although theblood that had first been swallowed and then vomited up, maylikewise be black. A discriminative diagnosis is the most difficuin a case of hsematemesis of tuberculous individuals, or if the psician is called upon to give an opinion derived from the reportdescription of the patient or his attendants. If the stools are tblack for some time, this symptom should not be overlooked. It islikewise important to investigate the circumstance whether theblood was first coughed or vomited up.It is much more difficult and most generally impossible to determine the precise spot in the lungs whence the blood is dischargedIf the blood emanates from the trachea or larynx, the quantity winot be as large, nor will it be as large in bronchial hemorrhagewhen the hemorrhage proceeds from the cavern ; but a perfectlysure diagnosis will always be very difficult, and it is our opinithat this is of very little consequence in a practical point of vThe prognosis is of particular importance to a physician for thereason that pulmonary hemorrhage is supposed to be such a frighthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 140 of 653ful thing in the eyes of lay-people. We have already stated thatthe hemorrhage scarcely ever threatens life with immolate danger.158 Diseases of the Lungs«.Even copious and rapidly recurring hemorrhages destroy life onlyexceptionally. The result is difierent if the importance of thehemorrhage to the general organism is inquired inta The scantyexpectoration of blood which many persons, even without beingaffected with pneumonia, raise during every acute catarrh of therespiratory organs, is of very trifling significance, although itproper that a careful exploration of the chest should be institutwith a view of determining the presence or absence of tuberculardeposits. No more attention need be paid to the slight hemorrhages of pregnant or menostatic females, as long as no tuberculadeposits are at the foundation of the bleeding. Persons afflictedwith cardiac diseases, are very often attacked with pulmonaryhemorrhage which, however, does not imply any particular danger.In general, however, we have to admit that in by far the largermajority of cases pulmonary hemorrhage points to the presence oftubercles in the lungs and to the progress of the tubercular diseand that hence it is justly regarded as a dangerous symptom evenif a physical exploration of the chest does not yet reveal the prence of any alarming disorganization. If the hemorrhage is veryprofuse, a return may indeed be apprehended, for a disposition tothe disease remains, and-oannot even be denied in cases where notubercles exist. The meaning and importance of pulmonary hemorrhage in cardiac affections will be examined more fully when wecome to treat of the affections of the heart.To these paragraphs we have to add a few remarks concerninginternal pulmonary hemorrhage, we mean infarctions and apoplexy,which frequently complicates pneumorrhagia and determines itsmost disastrous sequels.Infarctions in the lungs have their foci. At times there is one,at other times several, varying in size to that of a walnut and elarger. They occur much less frequently near the periphery thanthe base of the lungs. Infarctions occur in the lungs as sharplydefined dark-red or black spots of a granular appearance on theircut surface, without much firmness ; a grumous, black fluid can bsqueezed out of them. The surrounding parts are either (edematousor inflamed. In real apoplexy the infarcted spot is always of morconsiderable size, and the pulmonary parenchyma is partiallydestroyed.Infarctions mostly take place where the pulmonary circulationhad met with considerable obstructions, hence in cardiac affectioless frequently in tuberculosis. Apoplexy arises by the laceratioPneumorrhagia. 159of a larger vessel, either because the vessel is diseased, or inqaence of external violence.Symptoms. {Smaller and detached infarctions may form withhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 141 of 653out any marked disturbances; blood will not often be coughedup in consequence. Infarctions of larger size or greater numberscarcely ever exist without a group of tolerably characteristicsymptoms. The precursory symptoms resemble those of pneumorrhagia, and are scarcely ever wanting. The occurrence of internalhemorrhage is marked by a sudden oppression on the chest, sometimes attended with tolerably acute, but not always definitelylocalized pains. The pulse is always hurried and is always smalland weak. A copious spitting of blood may take place, but it maylikewise be entirely wanting, nor is it generally very considerabNevertheless important general symptoms soon make their appearance, such as fainting, pallor of the countenance, cold sweat ; ithe appearance of such symptoms that justifies the supposition ofinternal hemorrhage, although very little blood is lost externallOnly^ in acute and severe cases death may result very suddenly ;otherwise the final result is determined by other circumstances:whether the extravasation is simply re-absorbed, which it takesweeks to accomplish ; whether a reactive pneumonia or pleuritissets in ; whether the pleura is broken through and hsemathorax isdeveloped; whether the infarction terminates in inflammation,abscess or gangrene; or whether an oedema of the lungs of sufficient importance will result.It is very seldom possible that pulmonary infarctions can bediagnosed with certainty. Their occurrence, most commonly ne^rthe base of the lungs, renders them very seldom accessible to physical diagnosis; and if occurring near the periphery, they frequedevelop uncertain symptoms. A circumscribed dulness not covering the extent of a pulmonary lobe, nor situated in the region whtuberculosis is usually localized or pneumonia exists, if the resatory murmurs are either absent in that locality, or mucous rfileare heard, of course suggests the supposition that infarctions mahave formed. Of more value are the general symptoms, greatdyspnoea and oppression of the chest, with pallor of the countenaand syncope, even sopor, without an opportunity being given toaccount for these symptoms by the presence of other morbid processes, more particularly if these symptoms affect persons afflicwith heart-disease.It is easily conceivable that pulmonary infarctions must modify16( Diseases of the Lungs.the course of pulmonary hemorrhage in a specific manner. Thesymptoms accompanying pulmonary hemorrhage will not suddenlydisappear after the hemorrhage ceases, but the above-describedsequelae and anatomical lesions occasioned by the infarction willnow step into the foreground together with all their characteristphenomena. This circumstance has to be well weighed, lest thehemorrhage should be regarded as resulting from the pneumoniaoccasioned by the infarction, and we should be led to imagine thathose sequelae had only been covered up by the hemorrhage, and inreality represent the primary disease.The treatment has to aim in the first place at arresting the hemorrhage, and after that at removing the subsequently remainingconsequences of the hemorrhage. "We commence with indicating anumber of medicines that have been practically tested in pulmonarhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 142 of 653hemorrhage which is of frequent occurrence, and add to this listfew general considerations of more than ordinary importance.Aconitum : If it were practically possible to draw a line of demacation between active and passive pulmonary hemorrhage, we couldnot mark ofi^ the therapeutic sphere of Aconite more accuratelythan by saying that it is specifically adapted to the active formpulmonary hemorrhage. This would, however, give rise to manyerrors, since many hemorrhages arising from an obstructed circulation, symptomatically resemble almost entirely an active hemorrhage. Hence the selection of the drug should be conducted verycautiously. In all active hemorrhages we meet with marked preliminary congestive symptoms ; even while the hemorrhage is goingon, symptoms of pulmonary hypersemia still continue to exist, andas we stated in the preceding chapter, no remedy is more appropriate for such states of hypereemia than Aconite. Hypersemia notonly causing but likewise maintaining the hemorrhage, Aconite inthis case effects a radical cure, and after its exhibition we somtimes see the hemorrhage arrested with wonderful rapidity. Thefollowing range of symptoms constitutes more particular indicatiofor Aconite : The accident happens to animated individuals with aplethoric habit of body, bright complexion, disposition to palpittion of the heart, incipient tuberculosis ; after a violent fit osion, or severe exertion of the lungs. The blood is raised in smaquantity, associated with a dry cough which is not violent, but tments the patient all the time ; or else the blood is expectorateafter a slight paroxysm of hacking cough, both in larger quantityand of a bright-red color. The patients are very restless, theirPneumorrhagia. 161tenanceB are at first flushed and hot, the pulse and beats of theheart very much excited ; they complain of a burning or stingingpain in the chest. After commencing with the Aconite, the symptoms of febrile excitement very soon abate, after which the hemorrhage likewise cea«es in almost every case. As a rule, it is wellcontinue the use of this drug for some time longer at more extendintervals.Belladoniia has already been mentioned in the previous chapter ;it is one of. the principal remedies for pulmonary hemorrhage, except that its indications are less positively defined. It is partapplicable in the case of robust and plethoric individuals and focongestions towards the head, without any cardiac irregularitiesbeing complained of; also more particularly if the hemorrhage wasthe result of an incipient catarrh. A constant and tormenting desire to cough points to this remedy, the choice of which dependsmuch more than that of Aconite, upon the general symptoms. Intubercular hemorrhage, this remedy has never had the least effectin our hands ; on the contrary, it has been found very efiSicacioin vicarious menstrual hemorrhages and in those of pregnantfemales, or in the hemorrhages occurring: at the critical a,se.Arnio; enjoya a high reputation in pulmonary hemorrha^, whichit deserves much less, however, than Aconite. Hartmann gives thefollowing characteristic indications : The hemorrhage is caused bsome mechanical injury, or by severe bodily exertions ; the expectorated blood is dark-red and lumpy, and is raised without coughhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 143 of 653and without much special effort ; attended with stinging, burningcontractive sensation in the breast, rush of blood, palpitation oheart and striking heat in the chest, loss of strength, faintingA bright-red, frothy blood which is sometimes mixed with mucusand small clots, and which has to be hawked or coughed up, doesnot counter-indicate Arnica. In addition we have to observe thatArnica is particularly suitable for nervous, plethoric, not veryindividuals; the respiration is very much oppressed; during thebleeding, the patient is very much disposed to vomit ; the patienis evidently tuberculous, or the heart may be somewhat affected ;an attack is caused by every slight bodily exertion. Arnica is paticularly suitable for young people.Digitalis purpurea which used to be a favorite remedy for haemoptysis in the hands of allopathic physicians, does not deserve thealight that is put upon it by homoeopathic practitioners. It affodistinguished aid in pulmonary hemorrhage depending upon ob162 Diseases of the Lungs.Btruction of the pulmonary circulation caused by heart disease, ais preeminently indicated if tuberculosis is present at the sameThe most essential indications for this drug which should be usedmuch more frequently by homoeopaths than is the case, are : engorgement of the veins about the head; a pale and livid complexiocoldness of the skin with cold sweats ; irregular pulse and beatiof the heart; extraordinary oppression of breathing apparentlywithout any infiltration ; great anxiety and restlessness or evensoporous condition with disposition to faint.Pulsatilla is recommended by practitioners for the bloody coughexcited by menostasia^ not so much on account of its direct actioupon the bleeding lungs as with reference to the causal indicatiosuppression of the menses. It is likewise an excellent remedy insome forms of pulmonary hemorrhage in the case of phthisickypersons, where the selection depends more, however, upon the restof the symptoms than upon the hemorrhage.Ipecacuanha will not often be found indicated where pulmonarycongestions are evidently present. It is indicated by the followisymptoms : Spasmodic, suffc^cative cough with shortness of breathas in asthma, even unto vomiting ; not too copious hemorrhage, thblood being very dark and mixed with mucus ; pale or bluishcomplexion. In many respects Ipecacuanha acts very similarly toDigitalis, except that Ipecac, has none of the symptoms caused byobstructions in the pulmonary circulation.Ledum palustre has yielded some practical results in pulmonaryhemorrhage. Its local symptoms, however, are so indefinite thatthe homceopathicity of the drug cannot possibly be determined bymeans of them. It is said to be most useful in case of obstructioin the portal circulation.Millefolium is much praised, although we have no very special indications for this drug. We find the following in Hartmann : "Inalmost every variety of hemorrhage, and likewise in pulmonaryhemorrhage. Millefolium is an indispensable remedy, more especialin the case of robust and fleshy persons; the spitting of blood ihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 144 of 653unattended with cough, or the cough is very slight and is causedby the newly accumulating blood ; at the same time there is a bubbling up in the chest, with a sensation as if warm blood were ascing in the throat, gradually increasing in intensity until bloodraised. More recently I have found that a condition of this kindyields to Aconite more promptly than to Millefolium of which wedo not yet possess a sufiicient number of reliable provings." OthPneumorrhagia. 168are of a different opinion; thej recommend Millef. especially inincipient phthisis.Arsenicum album competes with Digitalis in some respects. Wewonld give this remedy only if a high degree of weakness and irritability is associated with an extraordinary degree of cardiac exability, together with all its accessory ailments. It is only inceptional cases that we shall be able to use it in phthisis.Phosphorus which was formerly a favorite remedy for pulmonaryhemorrhage, is used much less by the homoeopathic practitioners othe present day. We infer from its symptoms that only the lessergrades of hemorrhage are suited to its therapeutic range. Uponthe whole no marked results can be expected from it ; hence it rabelow all the other remedies mentioned for pulmonary hemorrhage.K it is to be used, the dose must not be too high, for even thefourth attenuation may still cause real, and therefore inconveniemedicinal aggravations.In addition to these remedies we might complete the list by mentioning a number of others ; but let it suffice if we simply namethe following: Nux vomica and Opium (for the pulmonary hemorrhage of drunkards), DroserUj Hyoscyamus^ CocculuSj Staphysagria.Corresponding with our pathological data, the medicines may beranged as follows:For hemorrhage from active pulmonary congestion: Aconite^Bellad.^ Millef. J Nnxvom.; from passive congestion: Digitalis^ Asenicum ; if caused by mental excitement : Aconite^ Kux vomica^Opium; by exertions: Aconite^ Arnica; by mechanical injuries:Arnica^ Bryonia alba; if depending upon tuberculosis: Acon.^ Am.yPtUsiLj Millef, J Ledum^ Phosphorus; if depending upon heart disease: Aeon., Digit, J Ar sen. ; upon menostasia : Pulsat; upon caBellad,^ Hyoscyam., Mercurius; upon emphysema: Arsen., Digit.^Carboveg,; portal obstructions : Ledum palustre.Regarding the effect of pulmonary hemorrhage upon the organifina, it is the same as that of all other kinds of hemorrhage, ahas to be treated in the same manner ; this effect will never beextensive. The consequences of hemorrhage to the lungs themselves, which are the most to be dreaded, often require differentremedies from those that might perhaps be chosen without regardto the local process. If extensive infarctions have become localiin the pulmonary tissue, and the restoration of health is retardeby them, our first choice may have to be Arnica, afterwards Bryaniaj IXgitalis and finally Phosphorus. Pneumonia depending uponhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 145 of 653164 Diseases of the Lungs.infiirctions, frequently requires, beside the above-mentioned remdies, MercuriuSy and the supervention of oedema of the lungs: ArsenicuMy Tartarus stib., and Phosphorus.Beside attending to the present attack and its consequences, wehave likewise to try to neutralize the evident tendency to pulmonary hemorrhage. Although the general conduct and mode of living of the patient are subjects of the utmost importance in thisparticular, yet we are in possession of a few remedies which arecapable, independently of meeting other functional derangements,of preventing the frequent return of the hemorrhage ; these remedies are: Calc. carb.y Ferrumy Sepia and Siliceay whose specialcations we cannot well enumerate in this place. Carbo veg. andChnium are often likewise adequate to this purpose.The dietetic measures to be adapted in pulmonary hemorrhageand to meet a constitutional tendency to it, will suggest themselwithout any advise from us. All we wish to say is that coffee andall other stimulants, even smoking, must be strictly forbidden.[The following medicines have likewise been found useful in pulmonary hemorrhage; for particulars concerning most of them werefer the reader to Hale's New Remedies, 2d edition.Erigeron oanadense, when the blood is expelled in the shape ofdark coagula; it is likewise recommended for passive venous hemorrhage generally.Hamamelis, recommended for passive venous hemorrhage, althoughit has likewise been found an efficient remedy in active arterialhemorrhage.Seneoio aureus may be given for vicarious hemorrhage when occurring in the place of the menses.Trillium, in tincture or infusion, is an excellent remedy for pulnary as well as uterine hemorrhage.Veratrum viride may afford aid in cases of hemorrhage resultingfrom uncomplicated, but severe pulmonary hypewemia ; the medicine has to be given in larger doses than usual.Soilla maritima is excellent in hemorrhage from neglected catarrhthe blood bubbles up with a pricking sensation at the place whencthe hemorrhage proceeds. H.]8« BronchltlB Acuta.Acute Bronchitis.Concerning the affections of the bronchial mucous membrane, wefind in our pathological treatises, especially if we combine bothBronchitis Acuta. 166http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 146 of 653older and more modern treatises in one Series, such a large numbeof names and corresponding categories, that it is only with difficulty that we succeed in mastering them. If we would adopt sucha complicated course, we should have to devote a number of chapters to what we intend to present in one. We need not hesitate toadopt this course, since every homoeopath is well satisfied of thnecessity to individualize his cases. We shall afterwards, whendecribing the symptoms, have abundant opportunities for showingthe most essential forms of bronchitis.Mttology. Acute bronchitis is one of the most frequent diseases of the human kind generally, and it is next to impossible,decide that a special age or sex is more particularly liable to iWhereas it is not generally a dangerous disease when attackingmiddle-aged persons, it is on the contrary very dangerous to children and old people, and therefore constitutes one of the moat important diseases of these two periods of human existence. It isundeniable that the first years of childhood are peculiarly prediposed to this disease. A predisposition of this kind likewise exiamong persons of a more advanced age, and may almost always beattributed to the following circumstances: An effeminate mode ofKving, without adequate exercise in the open air, and not admittiof a free and easy respiration ; constitutional diseases, even sudo not emaciate and debilitate the system, more especially scrofulosis and tuberculosis; irritability of the mucous membranes inconsequence of frequent attacks of bronchitis; acute and chronicdiseases of the lungs.The exciting causes cannot well be traced with positive certaintyA cold and consequent suppression of the perspiration is undoubtedly one of the most ordinary causes, but not quite as common asis generally supposed. The atmosphere doubtless exerts a powerfulinfluence not only in consquence of rapid changes in the temperature, but principally through the changes in atmospheric electricand, as modern investigations seem to have confirmed, throughconsequent changes in the amount of ozone in the atmosphere. Thisbecomes so much more probable, if we observe that a large numberof cases of bronchitis are not so much caused by a damp and cold,as bv a dry and cold wind, such as prevails in our region of counin the summer-season, when the wind blows from the northwestand north. If the temperature of the wind were the main causeof the trouble, "an east wind would cause bronchitis most easily,which is certainly not the case. An epidemic bronchitis spreading166 Diseases of the Lungs.over a large tract of country and being even considered contagiouthe so-called influenza or grippe, depends upon conditions whichdesignate as miasmatic, but of the true nature of which we are asyet ignorant. Secondary bronchitis develops itself secondarily inpersons afflicted with heart disease, emphysema of the lungs, orduring the presence of acute exanthems, or various intensely acutconstitutional diseases.Symptoms. We may dispense with a description of the anatomicalchanges occurring in bronchitis; all we need do is toremind the reader that hypersemia of the mucous membrane is always accompanied by a more or less marked swelling of the same ;http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 147 of 653this statement is of essential necessity for a comprehension ofvarious phenomena. In order to afford a general view of the disease, we will describe several forms of bronchitis which, howeverare not essentially distinct from each other.a) The lighter form of bronchitis, generally designated as bronchcatarrh, frequently sets in without any fever ; at any rate mostally it is scarcely perceptible ; sometimes no fever at all is pror the fever is at most indicated by a succession of creeping chiThis form of bronchitis scarcely ever exists isolatedly, but is amost always attended with catarrh of the nose and larynx. Afterexperiencing a feeling of malaise for several hours, and a markedsensation of languor, the patients are attacked with a dry andspasmodic cough attended with a raw or sore feeling on the chest;at the same time the breathing is somewhat oppressed and thereis no expectoration at the Outset of the disease. The appetite isless but not gone, the tongue is not always coated ; the patientsare able to remain up, but feel drowsy and often complain ofviolent headache. Very often the cough remains dry for a longtime, but more frequently a tenacious, greenish-yellow scanty expectoration commences already on the second day, which it is verydifficult to hawk up. Auscultation yields no particular results,percussion none at all. At the end of three to nine days, veryrarely at a later period and then only if the patients neglectthemselves, the expectoration becomes more copious, whiter, lumpyand is raised more easily, the normal feeling of health is restorand, while the cough is gradually decreasing, the disease passesThe attack seems so slight, that many patients go about as usual,but, by pursuing this course, expose themselves to relapses whichare very apt to take place and beget a tendency towards the inBronchitis Acuta. ' / 16Tflammatory form of bronchitis or else origiy^te tYt^ coinsequencethat will be more fully described in a subsequeht^ara^aph/;.b) Bronchitis ivflammaioria^ inflammatory or acute h^onc^tisy yhiform of bronchitis which is marked by much more '^iolent\phetr6*^mena, is not by any means a purely simple form of bnmchitis dfi Va higher degree of intensity. It does not ordinarily result fromexisting catarrh of the upper respiratory organs, unless fbq catarrh is suddenly and violently increased by severe neglect; butmost generally it occurs as a primary disease. It generally commences with a violent chill which is distinguished from the chillthat initiates acute inflammations, by the circumstance that it inot followed by as high an increase of temperature and that thereis a frequent recurrence of the chill, especially on motion. Thepatient feels very weary and languid, complains most generally ofa violent headache, exhibits frequent changes of complexion, experiences a rheumatic drawing in the limbs and great restlessnessand is scarcely ever capable of remaining out of bed. Very soonthese general symptoms which do not point out more particularlythe locality of the disease, are followed by a burning, sore painin the chest under the sternum at every deep inspiration, whichis felt more severely when coughing. The cough sets in at thesame time as the pain is felt ; it is more or less violent, sometspasmodic, at first dry but not hoarse, but very soon accompaniedby the above-described expectoration. There is no dyspnoea prophttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 148 of 653erly speaking, but the breathing is more labored, less full andhence somewhat more hurried. The pulse is accelerated, but it isonly in the severer grades of the disease that it exceeds one hunpulsations. In this form of bronchitis the digestive organs arealways involved, the appetite is entirely gone, the bowels areconstipated, there is seldom any vomiting. Percussion does notreveal any abnormal changes, but auscultation reveals a more orless prolonged expiration over the whole chest, less frequently amore prolonged inspiration, accompanied by wheezing. These auscultatory results are very much modified, if bronchitis becomesassociated with a pulmonary emphysema, etc. as a secondary afl^ection. Even in simple bronchitis, when not complicated with tubercles, the expectoration is easily tinged with blood, whereas ring a quantity of pure blood is a rare occurrence and always pointo a more dangerous and more deep-se.ited constitutional disease.All the phenomena, especially the cough, exacerbate in the eveninand about midnight The further course of the disease is governed168 Diseases of the Lungs.by a variety of circumstances. The importance of bronchitis ofany degree in the case of tuberculous patients will be more fullyinquired into when we come to treat of tuberculosis; and whenspeaking of pulmonary emphysema, we shall likewise discuss morefully the acute exacerbations of an existing bronchial catarrh whlikewise assume the form of bronchitis. In favorable cases uncomplicated forms of bronchitis terminate in four or five days, oexceptionally at an earlier period, in simple bronchial catarrh.general symptoms moderate in intensity, the fever abates almostentirely, the expectoration becomes more profuse, more fluid, ofwhitish-gray color and is more easily raised by the cough which inow much less painful. Instead of the dry wheezing, auscultationnow reveals coarse r41es. The patients do not often feel well agabefore the tenth day. If the course of the disease is less favorable, its different phases are either more protracted, or else otmorbid conditions become associated with it. In the former casethe dry, spasmodic, distressing cough may last beyond the seventhor even to the fourteenth day, after which the period of a moreprofuse secretion of mucus lasts equally long. Although this longduration of the disease shows as a rule that it is of a secondarynature, yet a purely primary form of bronchitis may run an equalllong course, an occurrence peculiar to old age. The course of thedisease is still more unfavorable and threatening, if the inflammtion of the bronchia spreads to the more delicate ramifications,if pneumonia and an acute oedema of the lungs supervene. Thelatter may set in with so much rapidity that the patient whom wehad left comparatively comfortable, is found dead on our return.Generally this change develops itself more slowly and is at firstrecognized by a striking and rapid increase of the dyspnoea.The patient's age exerts a greatly modifying influence over thecourse of the disease as well as over its danger to life. Of thebronchitis of children we shall speak hereafter. Among old peopleor only somewhat advanced in age, the danger is quite considerable, and seems to depend more particularly upon the increasedliability of the bronchial mucous lining to swell, upon the profuquantity of the secretion at the same time as the respiratory process becomes feebler, and upon the consequently increased dangerhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 149 of 653of oedema of the lungs. At the same time we should not overlookthe fact that old people are scarcely ever without some degree ofemphysema and that, where no emphysema is present, it is yeryapt to break out in an acute form.Bronchitis Acuta. 16dHence the bronchitis of old people differs greatly from that whicwe have described in the preceding paragraphs. The disease originates in the same manner, only the febrile symptoms seem to be leviolent. With the appearance of the rales in the chest, which aregenerally very prominent, the strength of the patient diminishesinstead of increasing, and dyspnoea rises, to a high degree of insity. The pulse soon becomes smaller and weaker, the skin becomesmoist and cool, the tongae dry and brown, and the sensorium ispowerfully affected by the disease: sopor, delirium and graspingflocks setting in. In this manner the patient may succumb to thedisease in a few days, the increase of the mucous rales and the dcrease and final and total cessation of the expectoration constitthe most ominous signs of approaching dissolution.One of the most common terminations of bronchitis is chronicbronchial catarrh which succeeds the acute form the more rarely,the younger and healthier the individual.c Bronchitis capillaris. We apply this name to an inflammationof the finest bronchial ramifications in the lungs. An inflammatiof this kind frequently sets in as a continuation and still morequently as a sequel of the inflammation of the larger bronchialtubes, and occurs much less frequently as an idiopathic primarydisease. We here give only the symptoms peculiar to capillarybronchitis ; the other forms of bronchitis suggest themselves toreader, if he will simply associate the following description witsimple bronchial catarrh. This affection scarcely ever attacks miaged persons ; it is most apt to occur among children, and very sdom befalls old people.Capillary bronchitis commences like the acute form with thesymptoms of a so-called catarrhal fever; but it is an insidious dease w^hich, when occurring idiopathically, scarcely ever betrayslocal focus by pain. At an early stage the patient is oppressed fbreath, this oppression being determined by the extent of the portion of the lungs that is invaded; with a distressing cough withoany expectoration at first, which, even if it should become verycopious at a subsequent period, can only be raised with a great dof difliculty. The breathing is accelerated, the inspirations beivery much embarrassed and prolonged. Percussion yields noresults; auscultation in this afiection alone at first reveals awi*eezing which is afterwards mingled with fine crepitations andrales. K complicated with inflammation of the larger bronchia,the coarse r41es of the latter are apt to disguise the more delic170 Diseases of the Lungs.rfiles in the finer bronchial ramifications, at any rate, the latheard much more indistinctly,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 150 of 653The constitutional symptoms soon assume a serious and threatening aspect. The fever ordinarily increases, yet the skin is notdry, but inclines to perspire very profusely ; the feet and handsapt to feel cold, and the face looks pale. The pulse soon becomessmall and feeble, and the anxiety and restlessness of the patientgenerally increase in a corresponding ratio; the tongue is notunfrequently brown and dry. The paroxysms of cough sometimesbecome so severe that after each paroxysm the patients seem completely exhausted. In the case of a strong adult the pathologicalprocess seldom reaches a height where the respiration is impededto the extent of inducing poisoning of the blood by carbonic acidThis is most characteristically revealed in the persons attackedthe supervention of cerebral symptoms, such as, sopor, coma, deliium ; in the case of adults these symptoms are of rare occurrencein children and old people they are often met with. The capillarybronchitis of the latter is very much like the above-describedinflammatory bronchitis, except that the typhoid character of thepathological process shows itself in the case of old people at amuch earlier period, is much more intense, and the danger is muchgreater.This form of bronchitis at times runs a very rapid course andthen generally terminates fatally, at other times the course is mprotracted. Robust individuals may recover already in the secondweek, very seldom before this time, whereas a duration of onemonth is a very common thing. Sometimes the aftection continuesunchanged for weeks in all its severity, and the patients sink unthe terrible paroxysms of cough rather than from any other cause.It is always a good sign if a quantity of fine, filiform sputa arexpectorated. This is most easily found out by receiving the sputin water, when these fine threads are most easily distinguished.Among old persons in whom this process resembles almost entirelyan attack of pneumonia notha, death sometimes takes plaoe on thethird day, very rarely after the second week. Independently ofthe circumstance that the disease is of itself a dangerous maladythe simultaneously existing pathological disturbances and the possible and ready occurrence of threatening complications are likewise of great importance. Among the latter the pneumonia whichdevelops itself in the neighborhood of the bronchial inflammationmay result so much more disastrously, as the existing bronchitisBronchitis Acuta. 171aloDe determines a most damaging interference with the respiratoract. Acute cedema of the lungs is equally dangerous. Acuteemphysema is of a less threatening character. The most importantcomplication is the presence of tuberculosis. Many assert thatbronchitis is very often the cause of tubercular deposits ; otherthe contrary, are of opinion that bronchitis only excites the suppurative process in tubercular deposits. This is not the place fofurther discussion of this subject. What is certain is that in tuculous individuals capillary bronchitis is very apt . to pass intchronic form with a long-lasting, dry, paroxysmal cough. Relapsesin capillary bronchitis occur much more easily than in any otherform of this disease.d. Croupous bronchitis is characterized by an exudation on thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 151 of 653free surface of the bronchial mucous membrane, which, in thelarger bronchia, assumes the shape of a tubular lining, and stopsup the smaller bronchial ramifications like a plug. It is most frquently a secondary disease, a result, and an almost always fatalcomplication of a croupous inflammation of the larynx and tracheaor else it may originate as a primary disease. As such the acuteform occurs very rarely, but it does occur sometimes. In such acase it presents the picture of an acute bronchitis, but with aggvated symptoms. The fever is very violent, mingled with chills,the pulse is very frequent, the prostration is disproportion;illyfrom the very beginning. The degree of dyspnoea is determined bythe fact whether the larger bronchia are alone affected or whethethe smaller are involved in the disease. The cough is tormenting,the expectoration difficult, lumpy, tenacious, and, in water, assing the form of fine tubes or arborescent ramifications. If a larportion of the bronchia is involved in this process, cyanosis, oeof the lungs and death by poisoning with carbonic acid are thespeedy terminations of the disease. The chronic form occurs almosexclusively in tuberculous individuals, and will be discussed morfully in the chapter on tuberculosis. Cases that seem idiopathicprimary diseases, are likewise caused by a less extensive and hiddeposition of tubercular matter. The chronic form is distinguisheby the violent cough that accompanies it. In this form of bronchitis the exudation is not secreted in the larger, but in the smbron

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 152 of 653course correspondingly affected. The dyspnoea now increases fromhour to hour and soon reaches a degree of intensity that is in norespect inferior to the worst attack of croup, and becomes stilldistressing in consequence of the unceasing efforts on the part othe children to obtain relief by coughing. Tlie pulse becomes frequent and small, the skin on the extremities and head is coveredwith perspiration, the face is pallid or livid, becomes bluish duan attack of cough, the anxiety and restlessness reach the highesdegree of intensity. If at this stage of the disease there is noprovement by an increase of the expectoration and a relief from tdyspnoea, the disease presents the same picture as in the last stof croup, only the hissing sound caused by the stricture of the gtis is wanting. The children become calmer, pallid and cool, theyare lying in a state of unconsciousness or sopor, the respirationbecomes very superficial, the paroxysms of cough abate more andmore, and the children die comatose. This fatal termination someBronchitis Acuta. 178times takes place already in the first week of the disease, lessquently after the fourteenth day, provided no adventitious influecauses an exacerbation of the disease. Recovery always takes placslowly, the liability to relapses is very great ; the strength doeasily return, and the cough sometimes continues for many weeks.The diagnosis is only difficult in the case of very small childrehere the characteristic cough is almost always entirely absent, igeneral the reaction against the disease is either slight or nonapparent. The prognosis is the more doubtful the younger thepatient. That dentition complicates the prognosis, cannot be takefor granted. The greater liability to the disease at this periodprobably owing to the increased susceptibilities of the infantileorganism.In describing the treatment of bronchitis, we commence with thetreatment of the previously-described forms, in order not to crowtoo much material into one chapter, although influenza and chronicatarrh really belong in this category of disease. These two formhowever, cannot well be treated from the same point of view as asimple acute bronchitis. Let us first consider the leading remedifor the more important forms of bronchitis, to which afterwards,when we come to enumerate the remedies for the diflferent formssingly, the less essential forms can be added. We placeAconitum at the head of the list, not so much because we considerit as one of the more important remedies, but because it seems tohave become a matter of routine to recommend it for incipientcatarrh. We have on several occasions expressed our doubts concerning the propriety of recommending Aconite for catarrh. Acommon catarrhal fever is not the province of Aconite, and if weshould be told that Aconite has moderated this fever in so manycases, we suggest that the improvement might likewise have takenplace spontaneously without Aconite. How many catarrhs commence in the first twenty-four hours with a feeling of anxiety, afrequent pulse and an extraordinary rise of temperature, and yetrun their course afterwards without any fever. This should not beattributed to the action of Aconite. A remittent fever is least sable to this medicine. Where the fever, as is often the case in abronchitis, is continuous, the skin is dry and the heat is not mihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 153 of 653gled with chilly creepings, Aconite is in its place. The symptomatic indications are most fully met with in the incipient bronchof children. K the objection is raised that the diagnosis may bedoubtful at first and that hence Aconite ought to be opposed to t174 Diseases of the Lungs.general febrile symptoms, we meet it with the assertion that mevery attack of bronchitis the fever has at first a catarrhal, noinflammatory type.Belladonna has among its symptoms all those that characterizethe milder as well as the severer forms of bronchitis. In bronchisetting in with a violent fever, it moderates the latter much morcertainly than Aconite. When speaking of Angina we have hadoccasion to remark that we consider Belladonna a very efficientremedy in acute catarrh of the respiratory organs. The single dianostic of a disposition to perspiration while the skin is very hoconstitutes a decidedly characteristic indication. Prominent symptoms, of which we only mention the local symptoms, are the following: A dry, continual, distressing and sometimes spasmodiccough ; short paroxysms of cough, but very violent, especially towards evening; no expectoration, or else a yellowish, tenacious,blood-streaked, scanty expectoration. The respiration is oppresseirregular, and hurried, especially while the patient is sleeping.sation of great fulness in the chest, without any real pain ; detmination of blood to the lungs. This shows that Belladonna isindicated in the lighter as well as in the severer and severest fof catarrh, but ordinarily only in the first three or four days,seldom at a later period.Mercurius corresponds with the whole course of a severe attack ofbronchitis, even better than Belladonna. It is particularly adaptto children and robust adults, but not so much to old people. Theis a violent fever, the temperature is very high, there is greatposition to perspire without obtaining any relief from it ; in codistinction to Belladonna there is a constant alternation of chiland heat, with a remarkable sensitiveness to the most triflingchanges of temperature. If the stomach and the digestive organsare likewise affected, the tongue has a thick yellowish coating,whereas under Belladonna there is only a thin whitish coating inthe middle of the tongue; or if diarrhoea is present, Mercurius iindicated so much more positively. The most prominent and mostimportant local symptoms are: Feeling of dryness, roughness, andsoreness down the middle of the chest, burning in the side; dry,violent and wearing cough, especially in the evening and until minight, with tenacious, yellowish, sometimes blood-tinged expectortion, every paroxysm of cough is preceded by anxious oppression,dyspnoea. Another characteristic which distinguishes Mercuriusfrom Belladonna, is an unquenchable longing for icy cold drinks,although they always make the cough worse.Bronchitis Acuta. 175Bryonia alba will not often be found indicated at the commencement of bronchitis ; if indicated, it will most likely be in thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 154 of 653of old people in whom the catarrhal fever assumes at the outset tform of an adynamic disease. This remedy is most commonly suitable after the fever has been allayed by one of the previously metioned remedies, and the expectoration begins to become looseenough to enable the patient to cough up mucus. The cough isviolent, spasmodic ; it is excited by titillation low down in theby every irritating impression, especially by tobacco-smoke, afteeating, in the afternoon and after midnight ; the expectoration iscanty, yellowish and tinged with blood. "When coughing, there isviolent determination of blood to the head, turgescence of the faParoxysms of oppressed breathing, but no constant dyspnoea.Spongia is characterized by a hollow, barking, dry, seldom moistcough, continuing all day, and likewise all night in longdistressing paroxysms; at the same time labored, crowing, wheezininspirations, sometimes accompanied by rfiles. The remedy is mostappropriate for children, more particularly if the disease set inlaryngitis and gradually extended to the lungs. It Ib an excellenremedy in croupous bronchitis.Veratrum album is not often enough made use of in bronchitis. Itis not suitable in the first stage, but on the passage into the sstage, if mucns is secreted in copious quantities which cannot yebe coughed up. This causes a constant titillation deep in the chewith desire to cough, wheezing and coarse rfiles, but no expectortion, the distressing paroxysms of cough occur principally at nigwith violent determination of blood to the head. The general failing of strength, the increased frequency or even irregularity ofpulse constitute additional indications for Veratrum, which is evdently suitable to old people rather than children.Tartarua stiblatua of all other remedies enjoys the largest spherof action in pulmonary catarrh, and is preeminently characterizedby a profuse secretion of mucus which it is difficult to raise, wor without fever. This range of action is distinctly pointed outby the not very numerous, but significant lung-symptoms of Tartaremetic. Hence both the lighter and severer cases are adapted to tdrug, fine curative results of which are reported in our PeriodicThe lighter cases are not often met with among persons of middleage, more frequently among children and old people. In capillarybronchitis Tartar emetic is sometimes the only remedy from whichhelp may yet be expected, only it must not be given in too small17£ Diseases of the Lungs.doses nor large enough to produce eraesis. Symptoms of incipient poisoning by carbonic acid, such as sopor^ delirium, comawith pallor and bloat of the countenance and an unequal temperature of the body are appropriate indications for Tartar emetic, soedema of the lungs when similar symptoms prevail. Profuse sweatswithout relief, disposition to vomiting and diarrhcea, paroxysmsa rattling cough ending in vomiting, likewise indicate Tartar emeAll this shows that it is really the second stage of the catarrhaprocess which is adapted to the curative action of this drug whicacts very similarly to Veratrum album. These two drugs differprincipally in their phenomena of reaction which are very strikinand active under Veratrum, but very feeble under Tartar emetic.Hence Tartar emetic will often be found useful after Veratrum.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 155 of 653Ipecacuanha bears great resemblance to the two last-mentionedremedies. The most essential symptoms for this remedy are: Loudmucous rfiles in the chest with wheezing respiration, great dyspnmostly in paroxysms especially in the evening and at night, convusive suffocative cough during which the face becomes blue, sometimes ending in vomiting of mucus, or else dry cough in spite ofmucous rSles, spasm of the glottis, convulsive twitchings, unequatemperature of the body, severe gastric ailments and intestinalcatarrh, pallid or bluish and bloated countenance. Ipecac, is liksuitable for a dry, spasmodic cough, but certainly not accordingits physiological symptoms. The remedy is principally adapted tothe bronchial catarrh of children; adults do not seem to be favorably affected by it, and its good effect upon old people is verytionable. The above stated symptoms show that the fine curativevirtues of Ipecac, do not reside in its emetic properties, but inspecific adaptation to the bronchial disease. Allopathic physiciawould soon become convinced of this fact, if they would give theremedy in doses small enough not to cause nausea. It cannot bedenied, however, that the act of vomiting in suffocative catarrhmay exert an expectorant and alleviating influence, and we couldnot find fault with a homoeopath who, from this stand-point, wereto prescribe massive doses of this drug. At any rate we knowfrom experience that a smaller dose than a grain of the secondtrituration does not produce a reliable effect.Nux vomica is recommended for bronchitis, but we must confessthat we have never witnessed any curative results from this drugin the acute form of bronchitis, however much we may value it inthe lessw: degree of laryngotracheitis. We shall scarcely ever diBronchitis Acuta. 177cover a real syinptomatic similarity between Nux and bronchitis;if existing, it will only be found to apply to the more triflingof the disease.Chamomiila may be found suitable for the bronchitis of children,not so mnch of adults ; it is indicated if the larger bronchia arflamed, with an urging to cough, the cough being excited or aggravated, by the least attempt to use one's voice. It is particularlviolent at night, and accompanied by wheezing, and by coarse raleBad cases are not adapted to this medicine.Pulsatilla is only indicated in the lighter forms of inflammationof the large bronchia, if there is no fever or the fever is alreapassed. We shall revert to this remedy again under chronic bronchial catarrh, to which the reader is referred.Rhus toxicodendron seems to us very seldom indicated in simplebronchitis, but may prove of importance in the epidemic forms ofthis disease. On this account we refer the reader to the treatmenof influenza. "We have to recommend this remedy, however, in thefirst stage of the malignant forms of the bronchitis of old peoplAt an early stage already the symptoms resemble those of typhus ;the danger is more particularly determined by the character of thfever which deprives the already exhausted frame of all power ofreaction. Under these circumstances Rhus will be found eminentlyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 156 of 653suitable, since it corresponds very strikingly with the exceedingthreatening constitutional symptoms.Hepar sulphuria oalo. is most nearly related to Spongia in bronchas well as in laryngitis. A characteristic indication for Hepar idry, spasmodic, barking cough with a wheez?ng sound over thewhole thorax without any real mucous rales ; it is a steady coughonly at intervals increasing to frightful paroxysms with danger osuffocation ; it is excited by e\evy attempt to draw a long breatand only results in the expectoration of a yellowish, tenacious mcus. Hence Hepar is an important remedy in croupous bronchitis,likewise in the less acute or even chronic form of the disease ;capillary bronchitis its applicability is questionable. [We do noagree with Bsehr in this statement ; we have used Hepar in thisform of bronchitis with striking benefit, giving the third to thesixth attenuation. H.]iodiunfi may be ranged side by side with Spongia and Hepar.However it is not by any means ahead of these agents, since itaffects the larynx and trachea much more energetically than the12178 Diseases of the Lungs.bronchia. It has no particular symptoms that distinguish it fromother remedies.Bromine has not been sufficiently proved to secure it a prominentplace among the remedies for bronchitis. The recommendations ofthis drug by homoeopathic physicians are too vague and indefiniteto deserve any further notice at our hands. Its practical resultsare exceedingly meagre and indecisive.Baryta oarbonica is not much used in bronchitis, although it deserves some consideration in at least one form of this disease. "allude to the bronchitis of old people during its transition fromacute to the chronic form; there is a constant desire to cough, wloud mucous rales, yet the expectoration is very difficult andscanty. In such cases we have seen this remedy act with decidedbenefit. In bronchitis with threatening symptoms we should neverdepend upon Baryta carbonica,Arsenicum album is scarcely ever indicated in simple bronchitis ;for particulars we refer the reader to the chapters on influenzachronic bronchial catarrh.Phosphorus is not, in our estimation, a remedy for bronchitis unless the disease is complicated with other afi[ections. Hahneinanhimself pronounces Phosphorus not only not suitable, but evenhurtful in this disease ; this statement certainly rests upon praobservations, although it does not seem confirmed by the physiological data of the Materia Medica. In his treatise on PhosphorusSorge does not allude to this agent as a remedy for bronchial diseases. In our further considerations of pulmonary affisctions weshall frequently have occasion to revert to Phosphorus. On thisoccasion we will merely state that if oedema of the lungs or pneumonia should supervene during Che course of bronchitis, Phosphoruhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 157 of 653will be found one of the chief remedies from which help may yetbe expected.Let us now in conclusion consider the above-described forms ofbronchitis in their relation to the remedies we have indicated towhich a large number might be added, if we desired tb present anabsolutely complete list. To those who object to such a cursoryreview of remedies as favoring a tendency to dogmatic systemization, we reply that by this means a knowledge of the remedies ismore easily obtained and an opportunity is afforded for mentionina number of others that had been omitted in the preceding list.In the milder form, the so-called simple bronchial catarrh, no remedy is required, since it most commonly passes off without anyBronchitis Acura. 179medication. Nevertheless, considering how easily this simple formmay prepare the way for the more dangerous forms of bronchitis,it is advisable to get it out of the way as soon as possible. Ifis present, Belladonna should first be given, if not, Nux vomica.[Aconite or Mercurius may be required. H.] In the case of childreBelladonna is principally suitable, to which Chamomilla may bepreferred under certain circumstances, especially if the childrenare very young. As soon as the cough is loose, Tartarus stibiatusPulsatilla may be required, less frequently Bryonia or IpecacuanhThese few remedies will almost always be found sufficient.In the inflammatory bronchitis of adults Belladonna will havealways to be given first; Mercurius if the above-described symptomatic indications prevail, more particularly if gastric derangements or diarrhoea are present. If under the operation of thesedrugs the fever has abated and the cough has become loose, StibiuBryonia^ Bromine^ Hepar sulphuriSy likewise Hyoscyamus or Coniummay be required. Bryonia deserves a preference if the troubleseems disposed to run a very protracted course, in which case Digtalis may have to be resorted to. It is not our object to indicatall the different cough-symptoms ; they can be found in any goodRepertory. If the inflammation spreads to the finer bronchialramifications, Bryonia will still be found most appropriate. Incases with typhoid symptoms and violent fever, Bhus tox, may haveto be given. If the dyspnoea increases to a high degree, Veratrumor Stibium^ or according to some, Ipecacuanfia may be indicated.For a supervening oedema of the lungs Phosphorus and Arsenicumare mostly required ; Tart, stibiatus will seldom be found indicaCarbo veget. may have to be fallen back upon. lodium^ Spongia andBromium may be indicated in capllary bronchitis, also Ammoniummuriat, and carbonicum^ [also Hepar s^dphuris, H.]In the bronchitis of old people we have in the first place to moderate the fever, for which Aconite or even Belladonna will but sedom be found suitable; Bryonia and Rhus tox. may do much better.If there is but little or no fever, Tart, stib, will be found mospropriate. If bronchitis is complicated with emphysema, the wholegroup of symptoms is best met by Arsenicum^ which is likewiseto be resorted to, if the fever should become complicated withdjspnoea. In the case of old people Phosphorus will not often befound suitable for the threatening terminal stages of bronchitishttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 158 of 653Tart, stib, and Veratrum will be much better. We have recomxaendod Baryta for light attacks during the stage without fever.180 Diseases of the Lungs.The bronchitis of children tends greatly to assume the form ofcapillary bronchitis ; for this reason it behooves us to watch anof bronchitis in children with the utmost care. At the commencement of the attack, the symptoms generally point to Aconite^ not,however, with such perfect regularity as to admit of Aconite beinregarded as an invariable specific. Belladonna often competes witAconite in this disease, in the further course of which, even inslight cases, the same remedies may have to be used that suit thecase of adults. In the more dangerous forms Mercurius may generally deserve a preference at the outset ; it is indicated if by nelse than the thick, yellowish coating of the tongue, and the frequent alternation of chills, extreme heat and exhausting sweats.If the symptoms increase in intensity, Spongia is indicated; if tis a violent, dry, suffocative cough, Hepar; if the cough soundsloose, and there are mucous r^les but no expectoration. Ipecacuanfor excessive secretion of mucus, with severe dyspnoea and convulsive phenomena, Tartarus stibiatus may be required, but it will sdom act with as much benefit as Ipecacuanha.Croupous bronchitis as a partial development of laryngeal croupdoes not require any other treatment than the latter. Even ifbronchial croup should break out as a primary disease, which isseldom the case, lodium^ Spongia^ Hepar and perhaps Bromine wouldhave to be used. In subacute and even chronic cases Arsenicum isone of the most efficient remedies to prevent and mitigate theparoxysms of cough, which, considering their violence, must beconsidered a very satisfactory result.In conclusion we call attention to a remedy which, so far as weknow, has never yet been employed in bronchitis. We meanOpium, Latterly we have witnessed good results from Opium^which, doubtless, are not exclusively due to its palliative or naaction. We were led to its use by the description in an EnglishJournal of a chronic case of poisoning with Opium, according towhich a spasmodic and dry cough is one of the most common phenomena of this agent. We have to revert to this remedy more fullywhen we come to treat of influenza and pneumonia. To judge by thephysiological symptoms of Opium as we find them in the MateriaMedica, and considering the energetic action of this drug upon thchildlike organism. Opium must be an excellent remedy in thecapillary bronchitis of children.The general management of the patient occupies a conspicuousplace in this disease. It is unfortunately a widespread custom toBronchitis Acuta. 181endeavor to obtain an increase of cutaneous perspiration even inease of incipient bronchial catarrh, without discriminating by whmeans this object is attained. We cannot encourage a proceedingof this kind. In lighter cases, where this proceeding seems to hahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 159 of 653had little eftect, the question may be asked whether the case wounot have turned out equally favorably without sweat ; the rapidrecovery of patients who do not resort to such means, showsthat exciting a perspiration is not absolutely necessary to a curIn bad cases an artificial perspiration is decidedly injurious. Tobject is obtained more promptly and more safely, if the patientsare kept in their beds with but little covering, and the temperatof the room increased to about fifty degrees P. At the same timewater should be allowed to evaporate in the room, by which meansthe irritating urging to cough is very much diminished. If themere act of sweating were beneficial to the patients, they oughtfeel better in summer. It is well known, however, that the bronchial catarrhs of the hot season are more obstinate and distressithan those of the cold. However, if we are anxious to avoid allconflict with the inveterate habits of the people, perspiration cbe excited by drinking in bed a glass of hot water and sugar witha few drops of lemon-juice in order to make it more palatable ;children may drink a glass of very much diluted warm milk, sweetened with a little sugar. If these simple means do not excite perspiration, other means will not excite any either, or, if they dowill be to the patient's prejudice. There is another powerful reaagainst copious perspiration. It considerably increases the dispotion to take cold, which is anyhow very gi'cat, and causes exacerbations and relapses; rising to void the urine or evacuate the bomay be sufficient to superinduce a fresh cold, nor will the patieafter recovery be able to go out again as soon as they otherwisemight, without apprehending a new attack. An effeminate modeof life which is one of the main causes of catarrh in healthy persons, is likewise the cause of frequent relapses. This remark appto little children in whose case every thing is often done to renthem unfit for the least exposure to open air. The general strengof the patients is the best indication whether they can saf Jy bepermitted to go out of doors; if they feel strong again as usual,little remaining loose cough need not deter them from going out,provided the temperature of the atmosphere and the weather generally are sufficiently inviting. In a case of tubercular bronchiother considerations will have to govern the general management.182 Diseases of the Lungs.In matters of diet, the instinct of the patient may safely be takas a guide. In bad cases the functional activity of the digestiveorgans is completely prostrated, and there is no necessity of fording the use of any kind of food ; whereas in the more unimportancases the choice of food is of very little particular consequenceAll we have to do is to see to it that the nourishment which is itroduced into the stomach, does not cause any catarrhal irritatioof this organ. As soon as the appetite returns, a simple, but nouishing diet is the best. As regards drinks, it may be well not toimplicitly gratify the desire of the patients who have a great loing for cold water. Drinking cold water is apt to excite or increthe cough, whereas it is diminished and moderated by warm beverages. As a matter of course, whatever might irritate the lungs,has to be avoided, such as continued or loud talking, mental exciments, dust, smoke, dry heat, the use of coffee, spirits, etc. Fofurther details we refer to the article on diet in the chapter onmonary tuberculosis.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 160 of 6534. Influenza.Grippe.Influenza is not by any means a simple catarrh of the respiratoryorgans, though the anatomical changes indicate such a condition ;but a peculiar, complicated and combined catarrh which in pointof importance and treatment differs essentially from simple bronchitis. This instance shows most conclusively that it is wrong toundertake to determine the character of a disease by the anatomiclesions it occasions.The etiology of influenza is completely enveloped in obscurity.It is an epidemic disease which may prevail in any season, and isfrequently associated with other epidemic affections. Most commonly it spreads over a large extent of country and attacks anybody, although individuals who are affected with pulmonary diseases, more particularly tuberculous individuals, are most liableits visitations. The most extensive influenza-epidemics have sprefrom east to west. We again call attention to the connection between influenza and the amount of ozone in the atmosphere.Symptoms* If latterly every bronchial catarrh with typhoidsymptoms has been designated as influenza, this appellation is nomore proper than it is proper to refuse this name to larger or smepidemics for no better reason than because they do not come upeither in extent or fatality to the epidemic of 1838. We apply thInfluenza. 183name grippe or influenza to every bronchitis invading a large surface of country and involving with marked symptoms of illnessthe whole organism, more especially the nervous system, attackinga number of individuals in the same epidemic with very i*imilarsymptoms, although these may dili'er ever so much in diflerentepidemics.The phenomena referring to the respiratory organs are altogetherthose of an acute bronchitis, such as we have described in previoparagraphs, and which easily changes to the capillary form; theyare accompanied by catarrh of the nose, larynx and trachea, andare distinguished by the obstinacy and slowness of their course,times being very intense and at other times so completely disguisby the constitutional disturbance that they ar^ easily overlookedInfluenza is generally preceded by a preliminary stage where thelocal symptoms of catarrh of the respiratory organs are still waning, or are but imperfectly developed, whereas the patient complaalready very much of an extreme languor, with nervous excitement,sleeplessness and loss of appetite, without or with only slight fAs the fever increases, the local symptoms become generally moremarked and more intense. At times a coryza is the only prominentsymptom, at other times the mucous lining, from the nose to thefinest bronchial ramifications, is inflamed. At the same time aviolent and constant headache is complained of, which is commonlylocated in the forehead and is marked by all the peculiarities th80 commonly characterize the headache in an incipient typhus. Thiheadache is accompanied by rheumatoid pains in many parts of thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 161 of 653muscular system, accompanied by a degree of debility that almostamounts to paralysis. After a gradual, very seldom sudden increasthe disease reaches its iuU height. The catarrh is at times violeat other times very slight. The fever is intense, but so plainlymittent that the remissions sometimes appear like intermissions.debility is excessive. The headache is agonizing, and is either cplicated with sopor or with violent delirium. The digestion is entirely prostrated ; the tongue is thickly coated white or yellow,times it exhibits a sickly redness with disposition to dryness ;and even diarrhoea are often present; the bowels are confined, dirhoea is less frequent. The symptoms exacerbate in the evening anat night, the patient being very much distressed by the cough whiaggravates the headache a great deal. Thus the more violent attacof influenza simulate an acute typhus, milder cases a sovous gastric fever. Death may take place in the second week amid184 Diseases of the Lungs.symptoms of general exhaustion ; sometimes it takes place at a laperiod in consequence of the peculiar secondary diseases which frquently break out as sequelee of influenza.In the case of sound, robust individuals the disease mostly terminates its course in a fortnight, but always leaving an extremeweakness which may last for weeks. In the case of old people thedanger is always great and recovery takes place very slowly. Anabatement of the fever is always the surest sign of an improvemenThe disease very often leaves very threatening results. If thepatient had tubercles, their suppuration is an almost sure consequence of the bronchial affection, although we do not choose tohold to the opinion of many that influenza is itself capable of cing tubercular deposits. In opposition to this doctrine we mightsay that scattered tubercular deposits very often escape our notiInfluenza is very apt to leave in its track various affections ofthe respiratory organs, such as an obstinate hoarseness or evenloss of voice and a long-lasting bronchial catarrh. The stomachlikewise frequently remains disturbed, nor is a disturbance of thhepatic functions an uncommon event.Thus we see that the prognosis in influenza is uncertain, even ifthe disease sets in favorably at first, and the patient had beenthe habitual enjoyment of good health. If the individual had pulmonary disease, or in the case of decrepit subjects, a fatal termtion is not uncommon. The peculiar nature of the actually existinepidemic may likewise exert a great influence; whereas one epidemic scarcely destroys a single life, another epidemic, on the ctrary, claims a great many victims.The reason why a description of the treatment of influenza is adiflicult task, is the diversity of forms under which the epidemiappears. In influenza, as in other epidemics, remedies whose practical value had been tested by abundant experience, often have tobe abandoned as unreliable, and other remedies have to be substituted in their stead. In influenza one or two remedies sometimesprove specifics in all cases, so that the epidemic might, after Rmacher's example, be conveniently named after the medicine thatacts as its universal curative. To find out these remedies, persehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 162 of 653ing investigations are often indispensable, and we shall, therefoconfine ourselves to indicating the remedies whose practical valuhas been tested in a variety of cases.One of the most dangerous cliffs, on which our treatment so oftenstrauds, is the frequent change of remedies for the purpose of meInfluenza. 185ing this or that symptom. The peculiar nature of the disease sometimes presses the local symptoms of an affection of the respiratoorgans entirely into the background, whereas the symptoms ofcerebral congestion, typhoid symptoms, or the symptoms of gastricor intestinal catarrh appear much more prominent. If, in suchcases, we only direct our attention to the apparently most important complication, we shall often err in the choice of a remedy.is only by weighing every circumstance of the disease that goodresults can be obtained by treatment ; at the same time we are frto add that this task is not often easily accomplished, and thataccomplishment demands a persevering study of the MateriaMedica. As a matter of course, such therapeutic investigationsare very much facilitated by the presence of a prominent complication. In cases of cerebral hyperfieraia, we will, of course, ^ eaother remedies than in cases with prominent symptoms of livercomplaint, or with violent diarrhoBa or gastric catarrh.We repeat : let no one be content with the indications which weadd to each of the following remedies. Guided by existing observations we only point out general landmarks, we do not givedetails.Aconitum is particularly suitable to children in whose case thisdrug often suffices to effect a cure, whereas, in the case of aduother remedies may be required in connection with Aconite. It issuitable if the fever has the inflammatory type, or the bronchialaffection tends to develop pneumonia, and the patient is tormenteby a distressing, violent, dry cough. Aconite will probably neveracquire the rank of a specific adapted to a number of cases.Regarding Belladonna we refer to the preceding chapter. It actswell in cases with violent congestions about the head and furibonor at least active delirium, as long as these symptoms have notassumed the characteristic appearance of adynamia.For particulars concerning Mercurius we likewise refer to the previous chapter. In addition we offer the following remarks. Mercurius is one of those remedies which, according to experience, aall-sufficient as antidotes to some epidemics. Some reporters ofcases even profess to have cut some cases of influenza short withthis remedy. Special consideration is due to the existing coryza,which often is a valuable diagnostic sign in contra-distinct ionthe Arsenic-coryza. Mercurius is, moreover, indicated by violentpains in the joints, angina, a sudden failing of the muscularstrength, profuse sweat having a sour or foul odor and not afford186 Diseases of the Lungs.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 163 of 653ing any relief, thick coating of the tongue, severe gastric catardiarrhoea. We add to these indications the following from ClotarMiiller's treatise on pneumonia: "During epidemic influenza a kinof pneumonia occurs which is easily overlooked, because its subjetive symptoms diflfer but little from the symptoms of the prevailinfluenza. This form of pneumonia ordinarily sets in without muchfever, its symptoms are not very violent and apparently of notmuch importance. Common symptoms are : a tearing and achingpain in the head, especially in the forehead, coryza, a slimy mouand tongue, and dry lips ; among other symptoms we distinguishthe following : Loss of appetite, bad taste in the mouth, dry stourine mixed with a white mucus, a racking and dry cough, painfulness of the whole thorax, afterwards expectoration of frothy mucutearing pains in the joints, disproportionate weakness, tremulousnervousness, aggravation of the symptoms at night, with heat,sleeplessness at night, constant exhalations from the skin, or elcopious and fetid sweat. On exploring the chest, wc generally discover a not very considerable exudation. If overlooked or neglectthe disease runs a very protracted course, sometimes occasions exhausting pulmonary blennorrhoeas, or, if the exudation remainsundissolved, phthisicky symptoms may be developed. These peculiarmorbid conditions are very much abbreviated by MercuriuSj so thata complete restoration of health takes place and, if the patientsotherwise keep comfortably warm, no other remedy is required."Bryonia alba is very closely related to Mercurius and it will befound difficult to discriminate very precisely between their resptive symptomatic indications. Some facts regarding this point havalready been stated in the preceding chapter; in this place we wiadd a few other details. The aftection in the respiratory organsconfined to the larynx, trachea, and bronchial tubes; the noseremains unaffected, whereas coryza is a significant indication foMercurius. The fever is less violent, but more continued ; if theis sweat, it is copious and constant; the tongue is white, but hano thick coating on it, the bowels are constipated. The symptomsexacerbate in the day-time, not at night. The disease has an adynamic character, with deficient reaction, whereas Mercurius has avery decided reaction. Thus Bryonia may be frequently suitableafter Mercurius, but Mercurius is never suitable after Bryonia. Tsupervention of pneumonic symptoms does not contra-indicateBryonia, a supervening aff^ection of the pleura indicates this drvery positively. If influenza attacks tubercular lungs, Bryonia iInfluenza. 187always appropriate, and is always preferable to Mercurius. Bryoniis one of those remedies that is calculated to become a specificepidemic influenza.Rhus toxicodendron is another important remedy in epidemic influenza which often corresponds to the whole character of the disease. Rhus is in its place if the local affection is so disguisedconstitutional disease that we rather seem to deal with typhus coplicated with a bronchial catarrh. The use of this remedy is suggested by great debility, a prostrate condition of the whole orgaism, symptoms of violent reaction, such as a rapid pulse, burningheat, dry skin and tongue, delirium, sopor. Among the local symphttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 164 of 653toms, the most prominent indication is a short, distressing, drycough, mostly at night, and excited by motion and by every littlecold current of air.Of Nux vonfiioa, Hahnemann relates in his preface to Camphorthat a very small dose often removes an attack of influenza in afew hours. We refer to the preceding chapter where we have expressed our doubts regarding the appropriateness of Nux ; we haveto repeat these doubts here in much more emphatic language. Thereare, of course, many who profess to have seen good eftects from ieven in influenza ; but it is not so very easy to speak of curatiresults in this disease with positive certainty ; as far as we ouselves are concerned, we never have been able to obtain any striking curative results with this agent.Phosphorus is of all other remedies most positively indicated ininfluenza by distinct and fixed symptomatic manifestations. It issuitable if, in addition to severe constitutional disturbances, tdisease is chiefly localized in the larynx ; it is likewise approin influenza with tendency to develop pneumonia, or if the influeattacks tuberculous individuals in whose case the medicine has tobe given with great caution ; and finally in cases complicated wisevere intestinal catarrh. Among the secondary diseases, such asaphonia or hoarseness, it is particularly Phosphorus that is charteristically indicated.Arsenicum album is suited to an affection of the upper p)ortion othe respiratory tract, the nose and larynx; it is less suited tochitis, except when it attacks individuals afflicted with emphysema. A violent coryza with copious watery, excoriating secretiona burning pain in the frontal cavities ; dryness and burning in tlarynx and trachea, with hoarseness and a few violent paroxysmsof cough are paramount indications for Arsenic. The constitutiona188 Diseases of the Lungs.Bymptoms are still more characteristic: excessive debility, withrapid pulse, continual restlessness and sleeplessness, regular minight exacerbations. Arsenicum is particularly efficient in caseswhere the conjunctiva is strikingly involved in the catarrhal process and where the disease has an unmistakable tertian type.Opium is only mentioned once in our literature for influenza ; itwas successfully given for paroxysms of a distressing and tightcough, the paroxysms being always followed by yawning. According to our own experience, Opium controls paroxysms of a drycough with congestions to the head and chest, it drives the patieto despair and breaks out particularly in the night. Opium willseldom afford help at the outset of an attack of influenza, but waflbrd speedy and substantial aid if such a cough remains after tdeparture of the fever.Sabadilla is said to have helped in two epidemics, the symptomsof which we transfer from Ruckert's "Klinischen Erfahrungen":"Excessive drowsiness in the day-time; chilliness, especially towards evening ; shudderings with goose-flesh, the chills creepingup from the feet towards the head ; lachrymation, with redness ofthe eyelids ; pressure on the eyes, especially when moving them ohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 165 of 653when looking up. Headache, especially frontal ; sore tongue, thicyellow coating on the tongue, the pain extends as far as the thropainful deglutition ; sensation as if a piece of loose skin wereing in the throat ; bitter taste in the mouth ; complete loss ofpetite, with nausea ; dryness of the mouth without thirst ; constipation with flatulence ; in some, brown frothy diarrhoeic stoowhich floated on the water; yellowish and turbid urine; coughwith vomiting, headache, sharp stitches in the vertex, pain in thregion of the stomach ; cough of a peculiar, muffled kind ; manycough up blood ; painful lameness in the joints, especially the kjoints. All the symptoms get worse in the cold ; they exacerbateabout noon, but worse towards evening; flashes of heat in the facwith chilliness and coldness of the extremities ; the flashes ofin the face are mingled with chilly creepings over the back frombelow upwards at intervals of ten minutes; the skin is dry asparchment ; restless sleep, full of anxious dreams ; the cough appears as soon as one lies down."For the indications for Ipecacuanha and Veratrum album we referto the preceding chapter ; the latter is certainly an important rmedy in influenza. In general the remedies, which we have recommended for simple bronchial catarrh, may likewise be required forinfluenza.Influenza. 189In order not to indulge in too many subjective indications in adisease where practical experience plays a most important part, wtransfer from Hartmann's Therapeutics the passage concerninginfluenza with slight additions of our own, which will aflbrd usan opportunity for briefly mentioning a few important remedies." Smelling of Camphor several times, as soon as the first symptoms of the disease became apparent, had the effect of suppressinthe disease, but a few days later it broke out nevertheless, whicwas not the case in a subsequent epidemic where Camphor wasgiven internally in the first attenuation and proved a sovereignremedy for the disease." Ilahnemauu says in his preface to Camphor : In influenza, if the heat has already set in, Camphor only. serves as a palliative, but as a valuable one, if given in freqbut more and more attenuated doses ; it does not shorten the eonof the disease, which is not very much protracted any way, butmoderates the vehemence of the attack a great deal and conductsit, shorn of its danger, to the end." If the thoracic organs were the chief seat of the inflammation,Nux vomica always did good service if given after Aconite, Mercurius sdubilis or vivus, of which several doses were given everyday, was particularly calculated to cure the disease or even cutshort in its very germ, if the following symptoms prevailed : thebead, throat and chest were- principally aftected ; there was a dand racking cough which afterwards became loose and was attendedwith pleuritic pains; the patient was troubled with profuse sweatwhich did not aflbrd him any relief; there were symptoms of aninflammatory fever, dull pain, not very hard pulse. If the trachewas much irritated, and the irritation almost bordered on inflammation, BO that the intense pain made it impossible to speak, andthe voice was very much altered, Phosphorus was an excellenthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 166 of 653remedy.""Very often the disease broke out in the form of sporadic cholera ; in such a case the catarrhal symptoms were unimportant, butthe prostration was very prominent. Here Veratrum helped in everycase. If an attack of this kind was followed by nervous symptoms, if the patient became delirious, had a wild and staring loocomplained of great sensitiveness of the abdomen, and the pulsewas full and hard, a few doses of Aconite were given with greatbenefit and the rest of the symptoms were removed by Pulsatilla^which ' likewise proved a remedy for the pappy and insipid tastethat sometimes remained for a time, together with a mucous coat190 Diseases of the Lungs.ing on the tongue and loss of appetite." We cannot yield onrassent to this passage. The delirium occurring in influenza, andall the other so-called nervous symptoms, are always of a typhoidtype and do not yield to Aconite, but require much rather Belladonnaj Bryonia^ JRhuSy also Stramonium and Hyoscyafnus; after theexhibition of such remedies symptoms indicating Pulsatilla willnot often remain. ."An exceedingly distressing symptom in this disease was theviolent, pressing frontal headache which, together with the accompanying cough and the loose and slimy expectoration was relievedby Bryonia^ which likewise proved an excellent remedy, if the livwas enlarged and painful on contact, or during a coughing fit ordeep inspiration ; if the cough easily ended in vomiting or causea pain in the epigastric region, in which case Bryonia C(>mpetedwith Nux, or if the pain was felt under the short ribs as if theparts had been bruised so that the patient, when coughing, had topress his hands against them; Bryonia likewise proved eflicient ithe influenza attacked old people with great distress in the chesand coldness of the limbs, in which case the disease often destrolife by paralysis of the lungs; the Bryonia was given in alternatwith Carbo vegetabilis" In such cases Tartar emetic may deserveattention. "If the cough was dry and spasmodic, if the headachebecame unbearable and was aggravated by walking, talking, brightlight and by every least motion ; if the look became staring andthe patients were troubled with fancies whenever they closed theieyes. Belladonna always afforded relief, so that in a few hoursalready this condition which seemed like an incipient meningitis,disappeared."^^Rhus was indicated if the attack had been caused in consequence of the patients getting soaking wet, and they were greatlyoppressed on the chest, anxious, they frequently drew involuntaria long breath, were very restless and had to change their positioquite often.""Sabadilla was given if the attack seemed like an inflammatoryaffection of the thoracic organs, with severe chills and externalcoldness." This indication corresponds but little with what wassaid concerning Sabadilla in a previous paragraph." China relieved the cough that was excited by a rattling underthe sternum as if mucus had accumulated there." This indicahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 167 of 653tion is of very little importance and of no particular value ininfluenza. Independently of the cough which cannot be regarded asInfluenza. 191A characteristic symptom, China will be found suitable if the disease assumes the character of a nervous fever or the appearance opulmonary phthisis."The alcoholic tincture of Sidpkur was prescribed with goodeffect at the termination of the disease, after the fever had abathe stitches in the chest were only felt indistinctly during a deinspiration and a violent coughing fit, and the patient complaineof oppression on the chest as from a heavy weight." In generalSulphur is a valuable remedy for pulmonary affections remainingafter an attack of influenza and not traceable to tubercular infiltration."The spasmodic cough which remained for some time after anattack of influenza and sometimes tormented the patients for hourwas almost always relieved by one or more doses of Hyoscyamus^ insome cases by Belladonna; bat if the coughing fit did not ceaseuntil a mass of frothy mucus with a yellowish purulent nucleus habeen raised, Conium proved the main remedy ; if the cough brokeout after a meal and the food was vomited up in consequence ofthe cough, JPerrum acetieum was found to be the specific remedy."" If the influenza left the patient with a troublesome cough anda gray, sweetish-salt expectoration, wheezing and rattling in thechest. Kali hydriod. proved an admirable remedy." This medicineis likewise excellent for the remaining hoarseness or even aphonibut should not be given in too small doses. lodium itself is of nuse for these symptoms, but may be resorted to in the febrile sta"In cases of a previously-existing disposition to phthisis, whichthe influenza threatened to develop more actively, a few doses ofStannum iu alternation with Carbo veget were often sufficient toprevent the further spread of the tubercular disease." In thesequelse of influenza Carbo veget. is very closely related to Phophorus and Kali hydriodicunL"In some cases the influenza was succeeded by obstinate ophthalmia with ulcers of the cornea and violent photophobia, for whichArsenicum album seemed almost the only efficient remedy ; repeatedoses of Belladonna were likewise useful, but did not effect a pemanent cure."With reference to this long quotation we confess that Hartmann*sindications seem to us rather vague and unprofitable; others may,however, not share our opinion.A number of other remedies that might be mentioned in thisplace, would be directed against the various complications such a19f Diseases of the Lungs.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 168 of 653pleuritis, pneumonia, hsemoptoe, diarrhoea, and more particularlyagainst the sequelce; concerning the former, we refer the readerthe respective chapters on pleuritis, etc. ; the sequelae will geyield to the above-described group of remedial agents.The dietetic management depends a good deal upon the conditionof the digestive organs. If the patient's appetite is good, thereno reason why he should not be permitted the use of nourishingand substantial food. But if the long duration of the disease hascaused great debility, a great deal of caution has to be observedgradually increasing the patient's allowance, because the stomachvery often continues for a long time in a condition of atony. Thesame caution has to be used in allowing patients the enjoyment ofopen air; the sensitiveness of the lungs often becomes excessiveduring an attack of influenza, and it behooves us to ascertain anmoderate this condition of the lungs with proper care and discretThere is no reason of considering influenza contagious as many doand every measure tending to counteract this contagion, is anuseless torture. The only preventive measure which we advise witha good deal of success, consists in avoiding all those exposuresare generally apt to cause catarrhs of the respiratory organs. [Iepidemic influenza our physicians depend a great deal upon Tartaremetic which is regarded by many as a sort of specific for this edemic. We cannot do better than by transcribing Doctor John F.Gray's interesting note on this subject from my Symptomenpublished by W. Radde, New York, in 1848. '*In the first stageof influenza (generally of itself a fugitive state), I think it bmuch the most strictly indicated, and on that account as well asfrom my own observations in many hundreds of cases, by very farthe most efficacious means we can apply. The state against whichI give it, is: lassitude with great sensitiveness to cold, with cfeelings, headache, pasty tongue, inflammation of the throat (tonarches of the palate or pharynx), short turns of nausea, achingsthe bones, especially of the lower extremities, yellowness of theslight hoarseness, more or less fever-heat and sweats.The Antimony often acts as a perfect remedy in the stage of incubation, especially in those cases which would of themselves clothis stage by profuse watery diarrhoea with some vomiting andcramps.*» ^ ^* This stage, of which the angina faucium, the chiUs and the bonethe prominent sufferings, subsides of itself in twenty-four to foand the physician is very apt to be deceived as to the efficacy oTussis Convulsiva, Pertussis. 198The second or bronchial stage of the true influenza having beensuccessfully managed by Phosphorus or Bryonia, with the aid ofAconite or HyoscyamuSy I complete the cure by a return to the Antimony ; that is to say, when the air-passages are loaded with muthe cough being frequent and the exjiectorations copious. 11.]6. Tassls ConTlilslTa, Pertassls.Whooping- Cough.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 169 of 653We understand by this name a peculiar form of catarrh of therespiratory mucous membrane from the nose to the pulmonaryvesicles, where the cough sots in in distinctly detached paroxysmMtioloijym Whooping-cough is an epidemic disease which sometimes occurs in the form of very extensive, and sometimes circumscribed epidemics, in which latter case the few cases of whoopingcough might even be designated as sporadic. So far the real causeof the epidemic has not yet been determined. It cannot be thepeculiar nature of the wind, for the reason that the disease breaout without the least regularity in disconnected portions of counall we know is that the outbreak of an epidemic occurs more frequently in the spring than in the fall, very rarely in the summerA connection with other epidemic affections, especially measles,and likewise with variola and scarlatina cannot well be denied.Whooping-cough frequently precedes or succeeds epidemics of thelast-named diseases, and in rare cases accompanies them.As regards the spread of the disease by contagion, opinions diffea great deal ; a number of observers favor the doctrine of a contgium; on the other hand we should not overlook the fact that during an epidemic all the individuals of one place and the inhabitaof one house are exposed to the same influences. As for ourselveswe have not yet been able to satisfy our minds that whoopingis contagious; yet we are willing to admit that in its highest stof development, this cough may give rise to a product which, whengrafted upon susceptible organisms, may in its turn reproduce thedisease. This is no idle question, as niignt appear at first sighsince it may lead to the adoption ol measures that may prove exceedingly oppressive to a family having a number of children andThe allopathist praises his atrocious lancet and heroic purgativepatbist his Merouriua, Belladonna or Nux, and the patient in eithwonder has been, done for him ; but the disease, if it be a realremoved ; it has only advanced a step beyond the process of incubthe stadium of bronchitis, with its ooiicomitant cough, dyspnoea,pfro»tr»tioii.194 Diseases of the Lungs.living in straightened circumstances. In spite of every isolationhave seen all the children of a family attacked by the epidemic.The immediate causes which determine the outbreak of the disease during an epidemic are the same as those that occasion anordinary catarrh of the respiratory mucous membrane. A specialpredisposition to the disease has not yet been traced ; if it seeestablished fact that girls are more liable to whoopingboys,the same relation holds true in all other spasmodic aflectiwhich attack girls more frequently than boys. Every trifling catamay, under the influence of the epidemic assume the form of whooping-cough. As regards age, children between the second and eighthyear are more commonly liable. Children under one year are seldomattacked by whooping-cough, although we have seen a severe caseof whooping-cough in a child of four weeks. Children upwards ofeight years old are likewise seldom attacked; whereas, during anhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 170 of 653epidemic, adults are frequently attacked by a spasmodic cough inthe place of the light catarrhal cough.SytnjdomH and Course. In the management of whoopingcoughthe fact must not be overlooked that the anatomical changesit occasions are simply those of an ordinary catarrh, to which thchanges which are determined by the not unfrequently-occurringcomplications, have of course to be added. The supposed changesin the vagus are altogether hypothetical, although certain changehave indeed been discovered in a few isolated cases, but not suffciently numerous to enable us to build a reliable theory upon sucpost-mortem phenomena.In the majority of cases whooping-cough commences as an ordinary catarrh of the nose or of the larynx, trachea and bronchialtubes. This introductory catarrh which does not, properly speaking, form a component part of whooping-cough, may break out inall degrees of severity and extent without this circumstance justfying a conclusion regarding the approaching attack. Hence themost proper course would be to regard this preliminary catarrh asconnected with the epidemic only in so far as it furnishes a soila susceptible si)Ot VL\ycm which the whooping-cough miasm can begrafted, and in which it can germinate. This is shown by the casewhere the whooping-cough breaks out without being ushered in bya simply catarrhal stage, or where a simple catarrh exists for webefore it is converted into whooping-cough. At any one period ofthis first stage, in a few days or even after the lapse of weeksa harmlessly-sounding cough sets in, or else an actuallycough becomes more severe, and sooner or later assumes a paroxysmTussis Convulsiva, Pertussis. 195character which constitutes it whooping-cough. After this form ofcough has reached its full development, the simple cough ceasesentirely ; only in a few instances violent paroxysms and simple tof cough occur mingled together. A single paroxysm has the following characteristic symptoms: The children who had hithertobeen bright and cheerful, shortly before the setting in of a parobecome restless and anxious, or, if old enough, they complain oftitillation in the larynx or under the sternum, or of oppressionbreathing; it is very seldom the case that a violent cough sets iwithout any preliminary symptoms, which, after a short lapse oftime, is succeeded by a wheezing and labored inspiration takingturns with the single paroxysms without admitting of a full expirtion for the reason that all the respiratory muscles and more parcularly the glottis are affected by the spasm. While the exertionto cough is constantly increasing and the spasm of the glottis isgradually abating, the children finally succeed in raising or voming up a more or less considerable quantity of a tenacious, whitemucus, which terminates the attack. During the attack the childreexpress great anguish and restlessness; in consequence of the impeded respiration the face and tongue become blue-red, the eyesweep, a watery mucus is discharged from the nose, even blood isspit up sometimes and flows from the nose to the terror of theparents. The vomiting either brings up mere mucus or the contentsof the stomach. Involuntary discharge of stool and urine is a raroccurrence if the children are otherwise robust. After the termintion of the paroxysm the children continue for some time in a stahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 171 of 653of confusion and languor, after which they play again as if nothihad happened. Only in the case of feeble or very small childrenthe paroxysms are succeeded by real attacks of eclampsia, or elseby a state of sopor or even complete catalepsy. In the abovetioned case of the little infant only four weeks old, the catalepcondition was so perfect and lasting that the patient lay for twominutes without pulse or breathing. Under such circumstances theintermissions are not free from morbid symptoms, whereas vigorouschildren seem perfectly sound between the paroxysms.These paroxysms sometimes set in quite frequently and at othertimes at more protracted intervals. Generally their frequencyincreases up to a certain point where the affection remains statiary for some time, after which it gradually decreases in violenceIn the space of twenty-four hours the children may have upwardsof thirty paroxysms of cough ; they occur more frequently in the196 Diseases of the Lungs.night, and at this time likewise last longer and are more intenseA paroxysm lasts seldom longer than three minutes ; if the parentassert that the paroxysms last longer, they are deceived by theanxiety which the mother particularly experiences, to whom aminute may possibly seem a quarter of an hour. The paroxysm isexcited by talking, eating, screaming, or by violent exercise, liwise by a violent fit of passion; the cough may likewise occurwithout any apparent cause, for instance, during sleep.The constitutional state of the little patients is variously aflfby the cough, even if there are no complications. Strong childrenbear this cough for months, without losing flesh, or without theigeneral well-being being interfered with. It may, however, beaccepted as a rule that, if whooping-cough lasts longer than fourweeks, children begin to lose their strength and flesh, and thatloss goes on increasingly in proportion as the cough lasts longerSickly and very small children are speedily and threateninglyaffected by the cough, even if none of the foregoing complicationare present. The children grow pale and languid, they lose theirappetite, but are not often attacked with diarrhoea.The course of the disease is generally for several months ; butwhen we come to speak of the treatment, we shall show that thisperiod is considerably abbreviated in homoeopathic hands.Of particular importance are the complications and sequelwhooping-cough, which alone constitute the dangerous features ofthis disease.The most frequent of these complications are inflammatory affections of the lungs. The catarrh of the respiratory passages, whicwas inconsiderable at first, invades the more delicate ramificatiof the air-passages more and more until a more or less intensebronchitis sets in, which easily assumes the capillary form andbecomes readily associated with pneumonia. This pneumoniaalmost always assumes the lobular form and can scarcely ever bedetermined by auscultation and percussion. The presence of sucha pneumonia is suspected if the bronchitis steadily increases inintensity and the intervals between the paroxysms are no longerhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 172 of 653free from a hacking cough and a constantly increasing dyspnoea.Even if bronchitis sets in violently at the outset, it never chanall at once to capillary bronchitis and pneumonia, — which may, athe same time, serve as a proof that an incipient catarrh, whichhappens to exist before the whooping-cough, does not necessarilyconstitute the preliminary stage of this disease, — but the signsTussis Convulsiva, Pertussis, 197this antoward change do not set in until the cough has lasted fordays and even weeks. In such a case the little patient does notentirely recover from the attacks, he grows languid and feverish,has a short and dry cough, he does not wish to rise from bed, thepulse is hurried, the respiration becomes more and more incomplete, more hurried ; he feels drowsy and tosses about. If thesesymptoms manifest themselves in the later course of the disease,they always augur danger and very commonly lead to a fatal termination.A severe bronchitis as well as lobular pneumonia very commonlylead to a more or less extensive deterioration of the pulmonarycells ; if this deterioration is quite considerable, percussion yan unmistakably dull sound, and auscultation yields bronchialrespiration. But these symptoms must not be attributed to pneumonia, for in such a case their importance would be much less.Cerebral diseases are scarcely ever caused by the direct action owhooping cough ; existing diseases of this kind may become fatallaggravated by the cough. The convulsions which often attacklittle children during the course of whooping-cough, are more correctly attributed to the influence of whooping-cough over the whonervous system, and, on this account, may become lasting. Theapparently violent congestions of the head during the paroxysmsare of very little importance to the brain of a perfectly healthychild, but they prognosticate trouble, if the brain was diseasedbefore the cough set in.Acute heart-disease is seldom one of the complications of whooping-cough. On the other hand, the development of tuberculouspulmonary aflTections is a very common thing. Usually, however,these aftections existed before the cough set in, although manycases occur where the cough 'occasions the deposition of tuberculmatter in individuals predisposed to this disease.Emphysema does not occur as frequently as is generally supposed.A deterioration of the air-cells is very often mistaken for emphysema. Post-mortem examinations have, however, frequently confirmed the fact that emphysema may set in very suddenly.Spasm of the glottis is a tolerably rare occurrence in whoopingcough, at least it does not occur in a high degree of intensity ;does, it is always a very ominous complication which may suddenlyterminate fatally.Beside the complications the frequently occurring sequelae mayprove very dangerous to the patients. Among them we distinguishhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 173 of 653198 Diseases of the Lungs.chronic bronchial catarrh, bronchiectasia, emphysema, deterioratiof single parts of the lungs, with consequent malformation of thethorax, pulmonary tuberculosis, heart-disease, although the lastnamed rarely and then involving mostly the right heart; eclampsiaoccasionally mental derangement, and lastly hernia which is of coparatively frequent occurrence. If the disease lasts a long time,complete marasmus is not an unfrequent occurrence; it is notattended with other morbid conditions^ and seems to result fromthe exhausted condition of the nervous system caused by the exceasive paroxysms of cough.The prognosis is always uncertain. Although the cough doesnot endanger the lives of healthy children, nevertheless, the supvention of one of the above-mentioned complications at any periodduring the course of the disease may occasion death or a lifeinfirmity ; thus it happens that we often see vigorous and healthchildren come out of an attack of epidemic whooping-cough likewretched invalids. "We claim for HomcBopathy the advantage thatsuch pitiable results are scarcely ever witnessed under homceopattreatment, except perhaps in the case of children with deterioratand rickety constitutions.Treatment. We consider the homoeopathic treatment of whooping-cough calculated to demonstrate the value of homoeopathictherapeutics to obstinate sceptics, and deem this a good opportunfor premising a few general remarks.Considering the extraordinary frequency of whooping-cough epidemics and the universality with which children are assailed ; anconsidering moreover the greatness of the danger to which childreare exposed during the prevalence of such epidemics, and the insuficiency of the ordinary mode of treatment, it seems quite naturathat extraordinary efforts should have been made to lay bare thecauses of this disease. It is an established fact that whoopingcough is the result of a noxa diffused through the atmosphere. Buhow is it that this noxa to which every body is exposed, engenderthis peculiar cough only in the case of children ? To adopt thetheory of a specific affection of the vagus, does not harmonize wthis exclusive invasion of the infantile organism whose pnenmogastric nerves are certainly constructed in the same manner asthose of adults ; moreover this theory is not corroborated by thenumerous post-mortem examinations. On such occasions thesenerves were scarcely ever found altered, but most commonly unTussis Convulsiva, Pertussis. 199changecL Thia hypothesis, like all other hypotheses that are notbased upon the evidence of facts, has now been abandoned.Nevertheless since a theory of the pathology of this disease mustnecessarily have an important influence on the treatment, we cannot refrain from recording our views on this subject. During theprevalence of epidemic whooping-cough, violent and obstinatecatarrhs are likewise very common among adults. It cannot wellbe denied that the quality of the mucus secreted at such a time dhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 174 of 653fers from an ordinary catarrhal mucus ; the former is very tenaciand glassy, ropy, firmly adhering to the mucous membrane, whereas ordinary mucus is lumpy and globular, and frequently causingeven in the case of adults a peculiarly spasmodic cough. Kow wewould ask, are there not conditions in the infantile organism sufficient to account for the convulsive nature of the cough ? It isdemonstrable fact that the urging to cough caused by the secretioof mucus, is much less in children than in adults, and so much lethe younger the children are. Whereas an adult expectorates everylittle quantity of mucus by a voluntary attempt to cough, the chidoes not expel the mucus until the urging to cough has reached anextraordinary degree of violence. This fact is evidenced in the cof children who sleep quietly in spite of a rattling respirationmucous rales in the trachea and bronchia that can be heard at adistance. The child only coughs if compelled to do so by the dyspnoea and the urging is very great. This condition will necessarilgive rise to a corresponding reaction, the cough will be so muchmore violent. Moreover the child has not sufficient strength of wto overcome the irritation which induces the cough ; at any rate,this attempt is only noticed among larger children, and thus it ithat a violent struggle arises where an energetic resistance mighhave given rise to a moderate turn of cough. The evidence for thistatement is derived from the circumstance that the older the chidren the less violent the cough. Again, robust children are attacwith less violent paroxysms than nervous children. Finally thespasmodic character of the cough is accounted for by the decisivedisi osition of the infantile organism to convulsive affections ;is likewise confirmed by the fact that among adults only such indviduals are attacked by whooping-cough as exhibit a disposition tspasm, namely females.It is therefore our opinion that the peculiar form of whoopingcough can be explained by the child's evidently feeble reactionagainst the urging to cough, by the insufficient energy to contro200 Diseases of the Lungs.the irritation and urging, and by the disposition to spasmodic aftions generally.These points, if applied to epidemic catarrh which not only causethe secretion of a peculiar mucus, but most probably determinesessential changes in the irritability of the trachea and larynx,sufficient reasons for the paroxysms of cough which otherwisemight appear inexplicable.In this manner a number of symptoms that otherwise wouldseem incomprehensible, can be made intelligible. The continualincrease of the violence of the paroxysms, for instance, for montat a time, cannot be accounted for by referring it to the simpleaction and development of the miasm, since we do not observe asimilar feature in other miasmatic affections, which are generallmost intense at the commencement of their course. The continualincrease of the whooping-cough can be easily accounted for by theincrease of irritability in consequence of the cough, and by thedecreasing amount of resistance. Chorea exhibits a similar featurin its course. Niemeyer advises to abbreviate the paroxysms byexciting the children to make an effort to control the cough. Anhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 175 of 653advice of this kind would seem foolish, if it could not be shownharmonize with the explanation we have furnished. Our theorylikewise accounts for the circumstance that the paroxysms mostlybreak out at night during sleep, or that they are easily excitedin addition to the irritation in the air- passages, another irritis caused by crying or laughing.In making these statements, our aim has been to show that thespasmodic character of whooping-cough is not owing to the peculianature of the miasm, but to that of the organism upon which themiasm acts. We may as well observe in this place that, in our opiion, whooping-cough does not commence until the convulsive stagehas set in, and that the previous simple catarrh is not by anymeans a sign that the miasm has now begun to affect the organism.A glance at the Therapeutics of the Old School is in so far important as a comparison of results is best calculated to place thadvantages of our own treatment in a more conspicuous light.Physicians as well as lay-persons are apt to express the opinionthat there is no remedy for whooping-cough, and that it has to ruits course for months. Wunderlich, who generally tries to enumerate the medicines that may cure a disease and who is not apt tobe in favor of a purely negative treatment, declares that any trement is absolutely powerless in the spasmodic stage and that allTussis Convulsiva, Pertussis. 201that can be done is to moderate the violence of the paroxysms bynarcotics. In the case of children, however, the use of narcoticsattended with a good deal of danger for the reason that they areapt to develop dangerous cerebral congestions^ No class of physicians knows how to appreciate such facts better than homoeopathswho derive the most brilliant results from small doses of such drWe care not to inquire why, we simply state the fact that theordinary treatment of whooping-cough is quite ineffectual; thatboth physicians and lay-persons have lost all faith in it ; thatformer give nothing for the cough, and the latter allow the coughto run its course without giving any medicine at all, and that boparties declare themselves satisfied if the cough gradually disappears in three to five months; that finally under this routinemanagement a number of children succumb to the disease or itsconsequences. Whether Oppolzer's treatment which essentially consists in keeping the children in the same temperature, is as succful as Niemeyer would have us believe, is very questionable to ouminds. We doubt whether a majority of the little patients recoverin the promised space of four to six weeks.In opposition to all this, Homoeopathy can boast of favorable andspeedy results without having to resort to such a rigorous mode oliving as Oppolzer recommends. By means of the treatment whichwe have now been in the habit of pursuing for a number of years^we have succeeded in restoring at least ninety per cent, of our lpatients, provided we had charge of them from the beginning,within the space of five and usually even four weeks, so far thatall convulsive paroxysms ceased entirely, although a slight catarmight have hung on for a short time longer. Yet among the largenumber of children whom we have had under treatment, therehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 176 of 653must have been a good many feeble and sickly ones to whom ourstatement applies nevertheless with equal force. The greatest merhowever. Homoeopathy can boast of is, the freedom from secondarydiseases which do not occur under homoeopathic treatment andgenerally result from whooping-cough when it lasts too long. Themalignant complications likewise, though not entirely excludedunder homoeopathic treatment, yet are comparatively rare occurrences.Before passing to the medicinal treatment of whooping-coaghwe have to oft'er some remarks about the preventive measuresjfecommended for adoption during the prevalence of this epidemicAnd which impose such a heavy burthen upon families. The com202 Diseases of the Lungs,munication of the cough by contagion is at most questionable; weknow from experience that in families where an infected child waskept strictly isolated from the rest of the family^ neverthelesschild after another was gradually attacked by the disease. We areemphatically opposed to all such methods of solitary confinementwhich we would not recommend under any circumstances. The onlysure preventive is the early removal of children from the districwhere the epidemic prevails. Few, however, will consent to such astep previous to the general spread of the disease ; and then a cof locality is of doubtful value, or is of use only in so far aschildren exchange city-air and artificial city-customs for the puair and the more natural mode of living in the country. Anotherpreventive is to guard children against every possible exposure tcatarrhal influences. It is certainly true that a child scarcelyhas whooping-cough without first taking cold; but, on the otherhand, this perfect freedom from exposure cannot possibly be securunless we choose to deprive children of their most necessary nutrment, open air.We have already stated in a previous paragraph that we do notconsider the catarrhal stage an essential ingredient of whoopingcough, although the treatment of this stage is of importance to twhole course of the disease. It may be considered a rule that thesooner and more completely the premonitory catarrh is cured, theshorter and less intense will be the course of the convulsive staHence we have every reason, during the prevalence of epidemicwhooping-cough, to treat the most trifling catarrh with becomingcare and attention. The remedies to be employed for this purposeare the same as those that have been recommended in former sections for catarrh of the nose, larynx, trachea and bronchia, allwhich may come into play, though Belladonna will probably befound the most efficient at the commencement. The much vauntedDrosera is of very doubtful value in th?» as well as in the subsequent stages. At this stage it is of course indispensable to guarchildren against further exposure and consocjuent increase of thecatarrh, for which purpose they had better be kept in the room, ian uniform temperature. In the case of lively and quick childrenthis proceeding is undoubtedly of difficult execution- For a goodportion of our success in the treatment of whooping-cough we areundoubtedly indebted to the comparative certainty wi^^^h which wesucceed in controlling this first stage without impairing the genstrength of the little patient. Even a violent bronchitis at thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 177 of 653Tussis Convulsiva Pertussis. 208oommencement of the disease may not aggravate the symptoms ofthe spasmodic stage, which camiot be asserted of any other treatment.Ab soon as the peculiar paroxysms of cough show that the convulsive stage has set in, an entirely difterent series of drugs hto be selected. We feel some embarrassment in giving a descriptioof the treatment of this stage inasmuch as we are conscious of amarked diflerence in this respect between our own views and thoseof most of our colleagues. Hartmann gives a number of remediesthat may be useful in whooping-cough but are suggested by groupsof symptoms that render a differential diagnosis between one drugand another impossible and nugatory. His symptomatic arrangements are supposed to be in accord with the law of similarity, buthe practical efficiency of the treatment is sadly impaired by sua course. However in order to avoid even the appearance ofpartiality, we shall afterwards mention single remedies and theirmost essential indications.What are, in a case of whooping-cough, the characteristic indications which point most directly and positively to the correctremedy? This is an important inquiry. Is it the particular circumstances which, if the statement of the relatives may be believed, have caused the attack? We cannot accept a theory ofthis kind, notwithstanding that this chapter has been exhaustedby the coarse symptom-coverers among us to the dregs. The samechild has on the same day an attack of cough from laughing,crying, eating and drinking; this alone would require four differremedies. Shall we select a remedy in accordance with the specifisymptoms of each particular paroxysm? In this respect we discover indeed symptomatic differences that ought not to be overlooked ; but in ninety cases out of every hundred the paroxysmsare mostly alike, and only differ from each other slightly in intensity. Hence it is only in exceptional cases that the nature ofthe fiaroxysm will prove a sufficient guide for the selection ofdrug. Can we depend upon the symptoms between the paroxysmsfor light in selecting a remedy ? Here too we shall be disappointed, for where no complications exist, the apyrexia is geneally free from symptoms ; one child may at most feel the immediatconsequences of an attack a little longer than another.In our opinion the simple, uncomplicated whooping-cough ofhealthy children does not present any salient points upon whichthe selection of a remedy could be based. Hence it will always be204 Diseases of the Lungs.exceedingly difficult to select the right remedy from among a larnumber. "We are supported by experience in believing that thenumber of remedies which are adapted to whooping-cough, is verysmall, for the reason that the characteristic effects of the whoocough miasm manifest themselves in almost every case in the sameuniform manner: Excessive irritability of the respiratory mucoushttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 178 of 653membrane with an extreme increase of reflex-action. By removingthis increase, we cure whooping-cough, so that only a simple cataremains which would at most be distinguished by a somewhat moreviolent cough. That this is no hypothesis, but a fact, results frthe decided effect obtained by exciting the energy of larger children; from the favorable influence of powerful external stimuliapplied to various parts of the body as soon as the paroxysmthreatens to set in, for instance the application of a sponge dipin cold water to the pit of the stomach ; from the circumstance tindividuals who are not endowed with a marked degree of reflexaction, are not liable to attacks of whooping-cough, and finallythe abundant confirmations of experience.The remedy of which we make use for the purpose of moderatingreflex-action, is Cuprum metallicum. By continuing the use of Copfor two or three weeks in the sixth attenuation, a few drops morning and night, commencing as soon as the spasmodic character ofthe cough becomes apparent, we have succeeded so well in thetreatment of whooping-cough that we have scarcely ever beenobliged to resort to any other treatment. Many of our colleagues,on reading this statement, will of course accuse us of a crimeagainst Homoeopathy, of an attempt to perpetrate an extreme generalization. In spite of their censure we should have to continueour course, because it leads to success, and success cannot onlyobtained in mild, 'but likewise in malignant epidemics. ThatCuprum is homoeopathic to the disease, may be learned by a mereglance at the Materia Medica. Instead of metallic Copper, Hartmann recommends the Acetate^ which, however, has not yielded usas satisfactory results. After what we have said, we deem adetailed description of the whooping-cough to which Cuprum isadapted, unnecessary. Be the attacks violent or comparativelyslight, whether they occur at night or in the day-tin:e, or whateother dift'erences prevail. Cuprum will not fail us so long as nocomplications exist or the general condition of the organism doesnot greatly deviate from the normal state. Cuprum is really anantidote to the whooping-cough miasm. If the antidotal effect isTussis Convulsiva, Pertussin. ^ % 20Sto be obtained, the use of this remedy n^At no^ b^ discontinued ia few days ; in general, a frequent change dt/emi^ies iti whoopincough can only result in injury to the patienC/ \ / y^We now pass to the other remedies for whooging-CQugK wd expect to satisfy our readers that Cuprum is not r^^rdnd D^^ asthe only remedy for this disease. ' ^, ^ /^>,Belladonna has probably been better tested as a ^medy for"whooping-cough than any other medicine. Experience, Jiowever,has shown that Belladonna does not so much act favorably uponthe spasm as that it limits the catarrh and brings it more speedito a termination. Belladonna occupies the first rank when the disease first breaks out, and at this stage its good efiects are mosdecisive; but to continue its use in the convulsive stage, woulda mere loss of time. It again becomes an important remedy iffever sets in in the course of this stage, the patients become reand after that too quiet, the apyrexia is not free from cough, inshort if the catarrhal symptoms again increase and spread towardshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 179 of 653the bronchia. In most cases, however, all that Belladonna accomplishes is to remove the threatening symptoms, after which thecough again sets in in all its vehemence. The congestive symptomswhich may occur during a paroxysm, should never mislead one toemploy Belladonna on this account.Drosera has been recommended as a specific for whoopingandthe most diversified indications for its use have been enumerated by our earlier writers. Hahnemann says that a globule of thethirtieth potency cures a species of whooping-cough, which probabnever occurs in practice. Many physicians are of Hahnemann'sopinion, although they may not have seen any great results fromthis drug ; others, on the contrary, deny its vaunted efficacy. Tdispute cannot be decided as long as the discussion revolves ^.rounmeaning symptoms. It is certain that Drosera is not made muchuse of at the present time, and scarcely ever against the fullydeveloped convulsive stage.ipecacuanha is one of our best remedies in this disease ; its indtions are tolerably precise and unmistakable. If, instead of theusual tenacious and scanty mucus, a large quantity of simple catarhal mucus accumulates, so that the cough is preceded and accompanied by loud rfiles ; if every paroxysm of cough is attended wivomiting, not at the end, but at the commencement ; if a paroxysmis excited by the ingestion of every trifling quantity of food ordrink: Ipecacuanha deserves a preference over every other remedy.206 Diseases of the Lungs.We shall scarcely ever meet with suitahle indications for Ipecacnanha at the beginning of the attack ; more frequently if the coughad already lasted for some time and had been neglected. We havescarcely ever had occasion to use this drug, if we conducted thetreatment from the start.Tartarus stibiatus has an excessive secretion of mucus in commonwith the former drug, but is preferable if the strength had suffea great deal and the stomach and intestines are affected with catrhal symptoms, so that frequent and tormenting vomiting and diarrhoea set in. This remedy will have to be given for the complications rather than for the cough itself. On this acount we refer treader to the last chapters.Veratrum album acts very similarly to the two last-named remedies. Here, too, we have an excessive secretion of mucus, ralesbetween and during the paroxysms, a marked disposition to vomitwater and mucus, and, at the same time, the patient is troubledwith diarrhoea. In addition we have the symptoms of a catarrhapproximating more and more a malignant bronchitis: anxiety,restlessness, a short and superficial respiration, pains in the caccelerated pulse with disposition to cool perspiration alternatiwith a burning heat, pallid countenance, sopor; the paroxysmsbecome feebler, but the general condition of the system deterioramore and more. Veratrum is calculated to become a specific inepidemic whooping-cough, if an intense intestinal catarrh sets ina complication.Arsenicum album is no real remedy for whooping-cough, but ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 180 of 653great value if the organism has become very much enfeebled bythe long duration of the disease and the violence of the paroxysmThe patients become sensible for some time previous of the approaching paroxysm, become exceedingly restless, seem tormentedby anguish; owing to their great prostration, stool and urine arepassed involuntarily. Arsenicum deserves particular considerationif the pulmonary tissue has become atrophied, or acute emphysemahas set in.Cina. It seems to us absurd that this remedy should be recommended for whooping-cough, if helminthic symptoms either precedeor accompany the attack ; they will hardly influence the nature othe paroxysm. A bettev indication is, if the children become convulsed during a paroxysm, as if they had au attack of eclampsia;another indication is, if a gurgling noise is heard after everyparoxysm from the throat into the abdomen. In some epidemicsTussis Convulsiva, Pertussis. 207other physicians have employed this remedy with a good deal ofsuccess.Conium maculatum is said to he an excellent remedy, if the paroxysms set in principally at night, especially in the case of scrofand ansemic children. Ledum palustre is said to be the right remedy, if every paroxysm is preceded by a convulsive condition whicis again succeeded by an exceedingly violent paroxysm. Numerousrecords of cures by this drug are not to be found in any of ourpublications.We might enumerate a pretty long list of remedies that havebeen used for whooping-cough ; but we not only doubt their specifadaptation to the disease, but cannot refer to any practical demostrations of their efficacy. These remedies are: Arnica^ Hyoscyamus^ Ignatia^ Nux vomica^ Lactuca virosa^ Laurocerasus^ AynJbra^Sepia, Pulsatilla, Carbo vegetabilis, lodium, Spongia, China andothers. Carbo vegetabilis deserves special consideration in caseswhere Arsenic might seem indicated, except that Carbo has a morecopious secretion and expectoration of mucus. China is variouslycommended, but no available indications are given.This list of remedies would have to be increased a good deal, ifwe would include those that may be required to meet existing complications. In this respect we prefer referring the reader to therespective chapters, for it amounts pretty much to the same thingwhether capillary bronchitis or catarrhal pneumonia sets in as acomplication of whooping-cough or as a primary idiopathic diseaseUnless the whooping-cough claims special attention on account ofinherent features of a threatening character, it is our opinion tin all complicated cases the cough itself had better be ignored athe complication attended to above everything else. This coursewill facilitate the choice of a remedy and will prove advantageouto the patient. The whooping-cough will certainly disappear assoon as the catarrh is removed.Of particular importance and involving a good deal of danger isa combination of whooping-cough with tuberculosis, whether thelatter was caused by the cough or existed previous to its occurrehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 181 of 653Naturally enough the paroxysm of cough irritates the diseasedlungs in a most dangerous manner and invests the cure with immensdfficulties. In such cases lodium and SUicea prove excellent remeThe catarrh remaining after the convulsive stage is not distinguished in anything from an ordinary catarrh, provided it is notcomplicated with emphysema. If this is the case, a cure can be20v Diseases of the Lungs.expected from scarcely anything except the persistent use of vegotable charcoal ; in the case of young people a cure is not only psible, but probable.The sequelae are too numerous to admit of an extensive notice inthis place. If whooping-cough is treated homoeopathically fromthe outset, they will scarcely ever happen, except perhaps tubercwhich, however, are never engendered by whooping-cough, but areat most converted into centres of suppuration. As regards thecharacteristic whooping-cough marasmus, we have never yet comeacross it in our own practice,K the homoeopathic treatment only commences at a later stageof the disease, the prognosis of course diflfers greatly from thenosis under full homoeopathic treatment; for at that stage we oftmeet with structural changes which it may be difficult or even impossible to remove.Another important point is the patient's mode of living. In thisrespect physicians differ in their opinions more perhaps than inother disease. As regards nourishment, it has to be of a naturenot to cause any irritation of the stomach or intestinal canal thmight exert a pernicious influence over the course of the cough.It is likewise an indispensable precaution that children should nbe stuffed with food, lest a paroxysm should so much more readilyoccasion vomiting; it is a good plan to keep the children quiet aeating, in order to keep ofl' an attack until the digestion is copleted. If food is vomited up too easily and too often, a smallquantity of Tokay will prove an excellent means of steadying thestomach. If opinions concerning the food and the beverages ofpatients cannot reasonably differ, they are so much more antagonistic as respects the balance of the management. We have alreadystated that Oppolzer, and with him a number of other physicians,prescribe a uniform temperature for the little patients, and evenkeep them in bed. By this means the catarrh is to be removed inthe shortest possible manner. In one respect the usefulness of thproceeding may not admit of any doubt, but in other respects thegeneral well-being of the patients is injuriously affected by it.the absence of other efficient remedial agents, the usefulness ofcofafinement is undoutedly undeniabla Under homoeopathic treatment, however, it becomes a useless deprivation. Of course thechildren should be kept in their rooms until the fever is passedbut if the. whooping-cough sets in with a simple coryza, the chilmay safely be allowed the use of the open air, of course with proTussis Convuisivia, Pertussis. 209http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 182 of 653precautions. Ab soon as the convulsive stage has set in, we enjoiupon the parents the duty of sending the children every day outof doore for a couple of hours, provided the weather is tolerablyWe have never observed any injurious effects from this proceedingeven in winter; the disease does not, on this account, last longethan five weeks, and the children retain a fresh appearance andpreserve their strength and regular appetite. Moreover anotheradvantage should not be overlooked: the children remain in goodspirits, whereas continued confinement in a room usually begets airritable and headstrong temper which has the effect of promotingthe frequency of the paroxysms. Regarding a change of residence,we have already hinted in a previous paragraph our doubts of thepropriety of such a measure. We have never known the childrenof country-people to be favorably aftected by such a change, onlycity-children gain by it sometimes, and in their case it is not tremoval from the influence of the whooping-cough miasm, but thehealthier mode of living that produces the good results. If citychildren are sent back to the city, no good effects are perceivedIndeed, such aids are not necessary. Many lay-people, even physicians, object to washing the children with cold water, or to allothem their usual bath. This, too, is an useless precaution, and meven become injurious for the reason that the skin is made unnecesarily sensitive and its functional activity is forced into an unmode of action.In conclusion we offer a few words regarding the dose of theappropriate remedy. In this respect the partisans of large and smdoses are diametrically opposed to each other, some regardingwhooping-cough as an acute, othera as a chronic disease. It maybe possible to cure whooping-cough with the thirtieth potency ; whave never attempted such a thing; at all events low potencies arnot necessary to effect a cure, nor is it necessary to resort torepetitions of the dose. Our own experience has led us to preferthe middle potencies, giving a dose morning and evening. A frequent change of remedies should be strictly avoided ; rapid succecan never be achieved by such means.[We would call attention to two remedies which Bcehr has omitted to mention, we mean Coffee and Mephitis putorius. The former,if given in dessertspoonful doses of a strong infusion, sweetened^ith sugar and without milk, will have a tendency to shorten andmoderate the paroxysms; the latter has been frequently uliomtBopathic physicianB with good eftect; Doctor Keidh^rd of14210Diseases of the Lungs._ *http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 183 of 653Philadelphia has reported a number of suecesBful cases treated wiMephitis in our various Journals. H.]6. Bronehitis dironlca.Chronic Bronchitis, Chronic Pulmonary or Bronchial Catarrh.In the majority of cases chronic bronchitis owes its existence toone or more attacks of acute bronchitis out of which it arises bygradual development. Even as thus arising as a secondary disease,the affection is exceedingly frequent, but this frequency is stilincreased by the circumstance that it accompanies most of thematerial changes of structure in the lungs, particularly tuberculbronchiectasia and emphysema, and that it likewise occurs as acomplication of diseases of other organs. The latter occurs moreparticularly in diseases of organs that obstruct the return of thblood from the lungs, such as heart-disease and affections of theliver. As a primary disease, chronic bronchitis is more particulamet with among persons who are upwards of forty-five years old ;every chronic pulmonary catarrh of young people excites a wellfounded suspicion that it emanates from some other pulmonarydisease as its source. Men are much more frequently afflicted witchronic bronchitis than women ; children are seldom attacked. InNorthern districts chronic pulmonary catarrh becomes much morefrequent ; in countries with a damp and cold climate it is almostendemic; it likewise prevails among individuals whose businessconfines them to damp and cool places. Persons who have to inhalea good deal of dust during their work, such as stone-cutters, miland sculptors, are likewise exposed to frequent attacks of chronibronchitis. Smoking is likewise a frequent cause of this disease.This use of tobacco causes chronic catarrh of the bronchial lininmembrane much more frequently than one imagines, without anyacute attack having preceded the chronic form.The symptoms and course of the disease are easily understood ifwe keep the anatomical changes which the bronchial mucous membrane undergoes, steadily in view. For this reason we will descrithese changes before going any further. The bronchial mucousmembrane is hypertrophied over a more or less considerable extentof surface ; it is unequally raised up, is of a deep darktraversed by distinctly engorged vessels. It is covered by a masslayer of gray or even purulent mucus, of various thicknesses, orthe secretion is more scanty, but in that case very tenacious, trparent, ropy. The puffiness and thickening of the mucous memiBronchitis Chronica. 211brane, as well as the infiltration of the submucous and musculartissues diminish the elasticity and occasion a consequent dilatatof the bronchia which is mostly diffuse, but may likewise be partEmphysema may likewise result from these anatomical changes.If a bronchial tube becomes closed anywhere, atelectasia of corresponding parts of the lungs takes place. True pus is seldom formeon the bronchial mucus membrane ; hence ulcers, which occur sohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 184 of 653frequently in chronic catarrh of other mucous membranes, are seldom seen on the mucous lining of the bronchia.Considering our mode of living, and when affecting personsbeyond the age of fifty, the milder cases of chronic bronchialcatarrh do not present any marked symptoms. The patients cougha little, most geuerally in the morning, and after that they expetorate some, but assimilation is not affected by the disease, northe respiratory process interfered with, and the condition sometimes remains unchanged for years. The more violent cases, on thecontrary, cause constant and most commonly increasing trouble.After the termination of an acute bronchial catarrh, — for chronicatarrh seldom sets in gradually without any preliminary acutestage, — cough and expectoration remain and continue with slightvariations until made worse again by another acute attack. Thecough is marked by two essentially distinct features. If the bronchial secretion is scanty, tenacious and firmly adhering, the parysms of cough occur less frequently, but in such a case the coughis mostly severely spasmodic and not unfrequently leads to gagginand vomiting. The paroxysms occur most frequently at night, lesscommonly in the day-time. After violent exertions, some of theabove-described mucus is expelled ; sometimes a little mucus is nhawked up till some time after the cough. If the secretion is morcopious, the cough sets in chiefly in the morning-hours or afteruse of warm food ; it may continue for a long time, but is not spmodic, for after a few energetic spells of cough, the mucus is detached and expectorated.Sooner or later the cough becomes associated with more or lessviolent oppression of breathing, which may even creep along without, being perceived and corresponds with the increasing hypertrophy of the bronchial mucous membrane, a diminution of itselasticity and the copious quantity of the secretion. At first thoppression is only perceived by the patients when making an efforduring a rapid walk, going up hill; soon, however, it is felt eveduring an ordinary walk, even during rest, and causes a great dea212 Diseases of the Lungs.of annoyance. In the higher grades of the disease, the patients athreatened daring the paroxysm of cough with danger of suffocation ; even between the paroxysms the nature of the existing affetion is revealed at first sight by the elevated thorax and the cosequent shortening of the neck. The most intense pain, however,is endured by the patients if an acute aggravation of the diseasetakes place. Under such circumstances they exhibit such a perfectpicture of distress that it seems as though they could not possiblive longer than twenty-four hours. These acute exacerbationsoccur almost certainly once at least every spring and fall, eventhe patients have not knowingly been exposed or have not evenleft their room.The structural changes, superinduced by chronic catarrh, renderthe disease, if it lasts any length of time, almost constantly unbearable. Emphysema which often is produced by, but seldomengenders catarrh, usually accompanies the latter and occasions pmanent dyspnoea corresponding with the extent of the emphysema.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 185 of 653Dyspnoea is likewise occasioned by bronchiectasia and by the anomalous conditions of the heart excited by chronic catarrh. Theworst is that the morbid conditions occasioned by the disease, intheir turn feed and aggravate the exciting cause.In unimportant cases the physical diagnosis does not reveal anyabnormal changes. The percussion remains normal as long as thecatarrh has not given rise to any material changes such as atelectasia, emphysema, etc. In a violent attack, auscultation alwaysyields abnormal results. If the secretion is scanty and auscultatis instituted immediately after, or during a paroxysm of cough, aloud inspiratory murmur is heard over the whole thorax and aprolonged and loud expiration with wheezing ; rSLes are very seldom heard, or, if they are heard, the bullse are fine; between thparoxysms, the respiratory murmur may be normal over the largerportion of the thorax ; crepitation or a fine wheezing is only hein detached spots. If the secretion is copious, coarse as well asrales, with sibilant and buzzing sounds, are heard all the time,most loudly previous to a paroxysm of cough.In the beginning the general organism is not affected by thecomplaint ; even tolerably severe forms of this disease are bornea long time without any perceptible detriment. Very seldom, andonly if the secretion is very profuse, emaciation gradually supervenes> in spite of which the patients may live, however, for manyyears. The greatest danger is occasioned by the influence exertedBronchitis Chronica. 213by the impeded respiration over the circulation. ' The functionsthe heart become abnormal; the deficiency of blood in the lungsand its imperfect aeration either cause passive hj'persemias of tliver and a corresponding chronic intestinal catarrh, or disturbain the functions of the spleen or kidneys, or passive hypersemiathe brain with its inherent dangers, so that it is not without rethat a raised thorax and short neck are designated as an apoplecthabit.If the catarrh has become an inveterate disease, it is apt to lasto the end of life; but that such a noble organ as the lungs shoube capable of bearing for so long a time even a severe degree ofapparently dangerous disease, is indeed remarkable. It is notmarasmus the patient need dread, but the constant succession ofacute attacks which indeed are rarely immediately fatal, but mayeasily superinduce oedema of the luiigs ; most patients die of thdisease amid symptoms of general dropsy. If an acute attack assumes the form of capillary bronchitis or pneumonia, the lives ofsuch patients are indeed in extreme peril.In recent cases the prognosis is not altogether unfavorable so faas a cure is concerned ; life is very seldom endangered by such adisease. The chances of course depend upon what structuralchanges have taken place, and to what extent. The worst omen isheart-disease, which almost always terminates in dropsy in a veryshort time.Treatment. Even under homoeopathic treatment inveteratepulmonary catarrhs are very seldom cured ; nor will this treatmenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 186 of 653ever succeed in efiecting the retrograde metamorphosis of emphysema or bronchiectasia. But even though the homoeopathic Materia Medica has only palliatives to offer against the totality odisease, yet we are possessed of many more excellent means towardthe limitation and complete cure of the exacerbations, and for thstoppage of the further progress of incipient alterations of tissand in this way we are able to aflford a relief that may be calleextraordinary if compared with what is accomplished by othermethods of cure. Hence we earnestly advise every physician whotreats chronic bronchitis, to keep these two last-mentioned pointsteadily in view, and never to lose sight of them in the effort teffect a radical cure.With a view of affording a general view of the treatment, wewill first describe the chief remedies in a few short paragraphs.Tartarus stibiatus has already been mentioned when we treated of214 Diseases of the Lungs.acute affections of the mucous membranes, but is perhaps of greatimportance in chronic bronchial catarrh to which it is so characteristically adapted. In bronchitis with a violent, spasmodic couloud rales in the chest, a copious, white expectoration, dyspnoeaoccasioned by the quantity of the secreted mucus, Tart. stib. issovereign remedy; it speedily diminishes the quantity of mucusand thus affords much relief to the sufferer. Very seldom, however, a favorable effect will be witnessed in cases where emphysehas already set in ; for this reason the remedy is better adaptedchronic catarrhs of recent origin, that had taken the place of thacute disease, than to inveterate cases.Pulsatilla is much more useful in chronic than in acute bronchitiif the following symptoms prevail: Cough, prin'cipally at night,excited by tickling in the trachea, with copious expectoration ofmucus ; the mucus is mostly white, but frequently mingled withyellowish or greenish lumps that impart to it au oily, offensivetaste. There must not be any emphysema, w^hereas the presenceof tubercles as cause of the disease points to Pulsatilla. Pulsatis next to indispensable in the bronchial catarrh of chlorotic pawhich almost always, although not in every case, depends upontuberculosis. If, in the case of children, an acute catarrh graduchanges to the chronic form, Pulsatilla is a remedy of the firstimportance.Sulphur is undoubtedly the most important remedy in this diseasebecause it corresponds to the worst and most inveterate cases. Ifemphysema is present, this remedy may never yield any markedresults ; even its palliative effect is questionable. Brilliant rmay, however, be obtained, in cases of chronic catarrh of long sting, if the mucus is secreted in large quantities, or is very tenand the symptoms point to a decided thickening of the mucousmembrane. An eminent indication for Sulphur is the excessivesensitiveness of the skin, so that every trifling change of temperature causes an exacerbation and that, even if the patient remains in his room, he is still powerfully affected by changes inweather. Only this hypersesthesia must not be caused by pulmonary tuberculosis, the tubercles at least must not be in a stathttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 187 of 653of STippuration. What we have said shows that the symptoms maybe distinguished in two series. The cough is either loose, the mueasily detached, but only at times, so that at night, for instancthere is a good deal of dry cough, whereas in the morning andduring the day the cough is moist, the expectoration is mostlyBronchitis Chronica. 215white, compact, but mixed with a number of yellowish or greenishlumps showing that the mucus had been secreted in the bronchiafor some time before being coughed up ; it has a foul taste and ea bad odor, and the accompanying hoarseness and sensation ofrawness show that the larynx and trachea have become involved inthe pathological process. Or else the cough sets in in more violeparoxysms with considerable dyspnoea, is dry and spasmodic, withwheezing in the chest; it occurs most generally late in the eveniand in the night, and it is only towards morning or after risingthat a tenacious, glassy mucus is brought up after a slight coughspell. The digestive symptoms and the condition of the liver whicgeijerally appears very much enlarged in chronic catarrh, confirmthe selection of Sulphur. It has always seemed to us as if thetriturations of Sulphur did not act as well in this disease as thattenuations prepared from the alcoholic tincture, and that, as arule, the higher potencies act better than the lower. We do notinsist upon this point, for a comparatively small number of observations do not authorize the resort to apodictic assertions. Finawe have to observe that in the case of decrepit, and more especiaold individuals. Sulphur seldom does any good.Nux vomica acts in many respects similarly to Sulphur and, according to our experience is, like Pulsatilla, more efficient inthan in acute bronchitis, if the following symptoms prevail: Thecough sets in with particular violence betw^een midnight and morning, is dry, spasmodic, very persistent and racking, so as to caupains in the bowels ; it is easily excited by a change of temperaand is associated with a continual titillation in the chest andtrachea; only in the morning, mostly after, very seldom beforerising, a loose cough sets in, with easy expectoration of a simplmucus. While coughing a sensation of soreness and roughnci^s issensibly felt down the middle of the chest. The condition of thedigestive organs greatly facilitates the selection ol the right redy. In contradistinction to Sulphur, Nux vomica is much betteradapted to comparatively recent cases without any serious complications and is otherwise more particularly suitable for patientsvigorous and otherwise sound constitutions.Phosphorus, although variously recommended for chronic catarrh,is, in our opinion, only adapted to acute attacks of bronchitissetting in during the course of the malady, and when exceedinglyacute and threatening. Particulars may be found in the chapteron acute pulmonary affections.216 Diseases of the Lungs.Belladonna, though not exactly a remedy for chronic bronchitis,renders excellent service in the continued, distressing titillatihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 188 of 653cough, excited by a tickling in the throat-pit, by cold air and ltalking, without any or a very scanty, tenacious expectoration, agenerally with a marked feeling of dryness in the respiratory orgexacerbating during the last hours before midnight. This form ofchronic bronchitis is not very frequent.Calcarea carbonica is used in this disease much less frequently tit deserves. It competes in some respects with Sulphur, but islikewise fully adapted to emphysematous chronic catarrh, if thecough is dry and tormenting, sets in principally at night with aviolent irritation in the respiratory organs, and if, after coughfor some time, a tenacious and frothy mucus of a saltish or offensively sweetish taste is expectorated. We shall revert to this drwhen speaking of the catarrh of tuberculous individuals. Next toSilicea it is the most important remedy in the so-called stonephthisis.Spongia is one of the principal remedies for chronic croupousbronchitis. The patients feel quite well for days; it is only occsionally that they cough once and then only very little; all at oafter an increasing shortness of breath, and excited by cold, a vlent emotion or some other irritation, and attended with wheezingthroughout the whole chest, a violent fit of spasmodic cough setsin, by which the distinctly-perceived murmurs in the lungs are cotinually increased, accompanied by a high degree of dyspnoEja whilasts for several houre and mostly occurs in the night; the coughquite dry, or else there may be a scanty, frothy expectoration whsometimes has to be vomited up, and not till several hours after,glassy, hard, clear mucus of a globular or vermiform shape is eashawked up in small pieces. Very commonly these symptoms pointto tuberculosis, but not as a rule.Sepia may claim our attention in a similar cough as Spongia, butwe must confess that we have never derived very striking resultsfrom its use. The numerous symptoms in the pathogenesis of Sepiawhich point to bronchial catarrh, give evidence that Sepia must ba remedy for this disease. Only it is difficult, owing to the multude of symptoms, to present a characteristic group. The leadingsymptoms of the group are: Dry, spasmodic cough, or cough witha copious, saltish expectoration, which is apt to set in during tlate morning-hours. Sepia is not adapted to bronchial catarrhsaccompanied with bronchiectasia, emphysema, etc.Bronchitis Chronica; 217lodium is related to Spongia ; perhaps it acts more readily thanthe latter; the paroxysms of chronic catarrh to which Iodine isadapted, occur irregularly during the day; the expectoration isglassy and hard or tenacious, but shapeless ; the paroxysms are aaccompanied by a violent asthma which does not entirely cease during the intervals. lodium is probably never suitable in cases ofpeople.Lycopodium is suitable for old people, if emphysema and markedchanges in the bronchial mucous membrane have taken place ; thereis constant tickling in the throat, loud rfiles with scanty or unquent expectoration of a gray color and saltish taste, nightly exerbations.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 189 of 653Manganum is suited to a spasmodic cough with difficulty of raisinthe phlegm; the cough is only in the day-time; only hard lumpsare brought up after hard coughing, of a yellow or green color.Baryta carbonica has acted very favorably in several cases of catof old people, with excessive secretion of mucus and difficulty oexpectorating it, and with paroxysms of a spasmodic cough duringthe period immediately following midnight. Two days after usingthe drug the mucus generally decreased in quantity and the patienfelt relieved.Silicea, although symptomatically indicated in many forms ofcatarrh, yet has only proved efficient in our hands in a very sevform. We are often called upon to prescribe for the common stonecutter bronchitis which is such a common cause of death amongthis class of workmen. It is characterized by profuse secretion omucus, great shortness of breath without any perceptible emphysema ; this shortness of breath not only sets in after an effort,without any cause. These people generally die of phthisis pituitothat is to say in consequence of an excessive secretion of mucus,associate now and then with distinct signs of bronchial suppuration- We have tried a number of remedies against this dangerousaftection almost without effect, whereas Silicea has always actedwith prompt benefit. We must add that we have never derivedany advantage from alcoholic attenuations, but always from thehigher triturations.Stannum has been tried by us in many apparently suitable cases,without any result ; we cannot recommend it, whatever others maysay to the contrary.Senega is adapted to chronic bronchitis when accompanied bylaryngotracheitis, but likewise to chronic bronchitis without thi218 Diseases of the Lungs.accompaniment ; the cough has no expectoration, or else the abovdescribed tenacious, glassy expectoration, especially troublesomenight, and excited by every exertion of the respiratory organs, oby fresh air.Bryonia alba is preferable in the acute form, and is very seldomadapted to inveterate chronic catarrh. It is particularly indicatby a spasmodic cough with a copious expectoration of yellowishmucus ; the cough distresses the patient all the time and is so vthat it seems as though the thorax would fly to pieces; it is easexcited by smoke and dust. We have never seen Bryonia relievea dry cough, or a cough with tenacious, scanty expectoration.Hyoscyanius, of all the remedies here mentioned has the most precise and most prominent indications, which are indeed not often mwith in chronic catarrh. The Hyoscyamus-cough is a nocturnal,spasmodic cough, excited by a recumbent posture and abating immediately after the vertical posture is resumed. This combinationof symptoms occurs very rarely, but if it does, Ilyoscyamus is thright remedy.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 190 of 653Opium must not be overlooked. It is erroneous to suppose thatthe narcotic effect of Opium suspends the desire to cough only foa short time, for there are many forms of cough where Opium onlyexacerbates, but does not afford any relief, or affords relief onwhen administered in very large doses to be folIo\v;ed afterwardsan increase of the cough. In our opinicm Opium is admirablyhomoeopathic to a spasmodic, dry, paroxysmal, titillating coughwhich is especially tormenting at night, and has but a scanty exptoration. The fact that we have often cured a cough of this kindpermanently by means of a few doses of Opium, entitles us to thebelief that Opium is something better than a mere palliative in taffection. But we warn our readers against giving Opium, if thecough is attended with a profuse expectoration of mucus, since adecrease of the cough must necessarily lead to great dyspnoea.Digitalis purpurea is mentioned here as a remedy for pulmonarytuberculosis to which chapter the reader is referred. A special idication for this remedy are cyanotic symptoms in the face and thsensation of an excessive determination of blood to the lungs, bywhich the breathing is at times oppressed and suspended.Arsenicum album is one of the most important remedies for chronicbronchial catarrh. However, it will rarely be indicated in simpleuncomplicated, chronic, bronchial catarrh, but so much more frequently if emphysema has taken place, and if the symptoms whichBronchitis Chronica. 219we have indicated as peculiar to Digitalis, prevail. The cough isalways attended with more or less considerable asthmatic distresswhich does not entirely cease even during the intervals between tparoxysms ; the cough is excited by a severe tickling in the tracor under the sternum, by cold air and more particularly by changein the atmosphere; it breaks out particularly in the middle of thnight, has a dry and wheezing sound, and it is only with difficulthat a frothy and occasionally a tenacious, white mucus is raisedThe symptoms indicating Arsenicum are only occasionally met withamong young people, and only rarely among old ones. If the remedy acts favorably, it does so speedily ; if Arsenic does not impthe case in the first eight days, no favorable change need be expfrom the further use of this drug. Arsenic acts with particularbenefit, if the catarrh has become associated with heart disease,though, in such a case, a radical cure can no longer be expected.Carbo vegetabilis ranks with Arsenic in curative power. Thesymptoms of both drugs are very much alike. Carbo likewise actsbest in old and neglected cases, with emphysema and hyj)ertrophyof the mucous lining ; the circulation of the lungs and heart aswell OS of the head and abdominal viscera is very much impeded;the patient is very sensitive to cold and to the direct action oftants upon the lungs \ the symptoms exacerbate at night, but theexpectoration differs from that of Arsenic : Carbo affording helponly if the expectoration is profuse, not when scanty. At timesthe expectoration consists of mere lumps of mucus ; at other timeit is purulent, or yellow and green, sometimes having a bad tasteand a pungent odor, suggesting the possibility of an approachingpulmonary phthisis. If the larynx is very much involved, Carbois indicated so much more. The drug must not be expected to acthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 191 of 653immediately, because patients for whom Carbo is suitable, are generally very much reduced and the lungs are so deeply implicatedthat a rapid improvement has become impossible.Beside the remedies we have named, a number of other drugsmay be ranged in this category ; they are only of secondary importance, and we confine ourselves to giving their names: Ipecacuanhaj Antirmnium crudum^ Conium maculatum^ Hepar sulphuris^Natrum muriaticumy Cuprum^ Kali carbomcum^ Ambra^ also Chinasand Ferrum.A bird's-eye view of the therapeutic indications may facilitatethe selection of the particular remedy appropriate in a given casStarting from the mucous secretion which accompanies the220 Diseases of the Lungs*cough, we have two principal kinds, one with copious, and theother with scanty or no expectoration. The remedies for the firstkind, are : Bryonia^ Tartarus stibiatus^ Pulsatilla, Calcarea carLycopodiumy Manganum, SUicea^ Sulphur j Stannum^ Baryta carbon,^Carbo veget.^ DigitcUis^ China^ Ferrum^ Antimonium crudum^ Awbra.For the second kind, the remedies are : Nuz vomica^ Belladonna^Spongia^ lodium^ Senega, Hyoscyamus, Opium, Hepar svlphuris, Arsenicum, and, in so far as this second kind appears in the form oa spasmodic titillating cough: Belladonna, Senega, Hyoscyamus,Opium.For chronic bronchitis of recent origin, when arising from theacute form, the following remedies are particularly appropriate :Bryonia, Tartarus stihiatus, Pulsatilla, Sulphur, Nux vomica, Beldonna, Hepar sulphuris. Ipecacuanha; if remaining after measlecatarrh: Pulsatilla; if after whooping-cough: Cuprum, China,Ferrum, Arsenicum, Hepar.Among old people, chronic bronchitis requires : Tartarus stibiatuLycopodium, Baryta, Carbo vegetabilis. In their case only a pallitive effect can be obtained, that is to say a limitation of the msecretion ; we cannot expect to accomplish more by continuing theexhibition of these remedies.For the so-called stone-cutter phthisis the leading remedy isSilicea, next Calcarea carbonica, Carbo vegetabilis. Tartarus stiwill seldom do much good, although the symptoms may seem toindicate this remedy. It is, however, indispensable that the resptory organs be no longer compelled to inhale the stone or flouror the- dust and delicate fibres of the wool. The best protectionagainst this exposure is a moist sponge tied in front of the moutand nose, or a thick woollen mask around the nose and mouth,which is continually kept moist. By adopting this course we haveoften succeeded in restoring stone-cutters who seemed irretrievablost so as to enable them to resume their work and attend to itpermanently. The difficulty is that such patients dread the derisof their fellow-laborers and that it is next to impossible to ovecome this obstacle.If the catarrh has either originated or is accompanied by organichttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 192 of 653heart-disease, a cure cannot well be thought of. Arsenicum, Carbovegetabilis, Lycopodium^ Tartarus stibiatis may be tried, but theefficacious remedy is undoubtedly Digitalin, about yj^y or ^iiF ograin per day, and administered at intervals. Persons who do notsmoke, will derive much relief for their asthmatic distress fromBronchitis Chronica, 221moderate smoking. Old women know this well ; they are very aptto smoke a pipe for the sake of easing their lungs.For the passive cerebral congestions, with which organic diseasesof the heart are so often associated, and likewise for the oedemathe lungs originating in a similar cause, Digitalin is likewise tbest palliative ; Arstnic or Garbo vegetaJbilis are much less freproductive of any good results. If the disorganizations have progressed too far, it is no longer possible to save the patient, anwe can do is to palliate his sufferings.In the intercurrent acute exacerbations, mostly of a threateningcharacter and which, if the mucous membrane is considerablyhypertrophied, cause extreme anguish and dyspncea, and a blueor livid bloating of the face, the choice is between Bryonia^ MercuriiLSy PhosphoruSj and Arsenicum. These exacerbations are of athreatening import, for the reason that they are most apt to causcedema and paralysis of the lungs. But even in lesser grades ofchronic bronchial catarrh the exacerbations cannot be treated witsufficient care, because they so commonly increase the chronictrouble and originate bronchial changes of structure. Old peopleare more particularly exposed to danger from this source; duringthe transition-periods of the seasons they have to use great cautin exposing themselves to the deleterious influences of atmospherchanges.In obstinate cases of chronic bronchial catarrh, if the patientsare otherwise young and vigorous, we are forced to suspect thepresence of tubercles, which will almost always be discovered onexploring the chest. For the remedies to be employed under thesecircumstances, we refer to the chapter on tuberculosis.The general management of the patients cannot be made to conform to fixed general rules, but has to be adapted to the circumstances of the patient. The uncomplicated chronic bronchialcatarrh of young and vigorous individuals does not require anyparticular caution ; above all, the patients must not use any excsive care lest the acute exacerbations should occur so much moreeasily. "With ordinary caution the patients may safely go out eveif a tolerably high wind should be blowing; they should never beencouraged in the use of an inhaler. An inhaler is only admissiblif every acute bronchial catarrh portends danger, as in tuberculoin which case attention has, of course, to be paid to wind and teperature. A measure of precaution, which is too much neglected,is the use of water-tight, warm shoes or boots; for nothing is mo222 Diseases of the Lungs.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 193 of 653apt to give a cold which reacts upon the respiratory organs, thandamp feet. We do not mean to advocate the use of India-rubbershoes which afford poor protection, for the reason that they prevthe proper action of the skin. On the other hand, double leathersoles with woollen stockings aftbrd the most certain protection,without any incidental disadvantages ; this foot-gear is doubly nessary to those who are troubled with sweaty feet. It is upon sucapparently trivial circumstances that the success of our treatmensometimes depends.In the case of children our measures of precaution have to bemore complete than in the case of adults ; even if a physical exploration does not reveal any abnormal changes, yet, in their casthe conditions which give the first impulse to tubercular diseaseare much more easily developed.For fjersons of an advanced age, it becomes imperatively necessary to guard against exacerbations and to submit to measureswhich would spoil young people and make them morbidly sensitive;we must not forget that the human body, after reaching the ageof sixty, can no longer be prevailed upon to change its habits, dpositions or susceptibilities. Here it becomes necessary to provimuch as possible for an uniform temperature and for a supply ofclothing corresponding with the deficiency of animal heat; byattending to these things, many have succeeded in prolonging theilives for years.These general rules for different ages are not suitable for all idividuals, and we must not insist, from preconceived notions, upoadhering to a regimen that may be prejudicial to the patient.Many young people cannot undergo the process of hardening,many older persons, on the contrary, do not feel well unless theygo out in every kind of weather; one child is kept in the housefor weeks and yet the catarrh of this little patient does not abain the least, whereas it gets well very speedily if the child isallowed to be all day in the open air. These differences have tobe found out while the patient is under our treatment.Pure air which is the normal food of the respiratory organs, isof course an essential requisite for the cure of all pulmonary dieases. This circumstance is very much overlooked in the management of bronchial catarrh, for the reason that the influence of vated air is not so readily perceived and does not cause the patieany immediate discomfort. We know that the continued inhalation of dust will give rise to pulmonary catarrh; Mrill not theBronchitis Chronica. 223same cause operate in feeding the catarrh that already exists?Let the patient, therefore, avoid dust and smoke, and let oldpeople especially have their attention directed to the injuriouseifects of living in a room filled with tobacco-smoke, WoUencarpets in the rooms of such patients are objectionable, becausethe inhalation of the fine dust which detaches itself from thewool, may cause violent paroxysms of cough. Even lighting therooms with gas is prejudicial to many persons, and does everybody some harm. The patients are not always aware of the factthat it is to the gas that they are indebted for some of theirhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 194 of 653worst paroxysms of cough. [We think that these precautions areexaggerated ; carpets, if kept clean and free from dust, have manadvantages over bare floors, and oil or kerosene irritatep the aipassages a great deal more than pure gas. H.]As a rule food has no great influence over the course of thedisease. Knowing, however, that the digestive organs becomeeasily involved in the morbid process, we are bound to protectthem with becoming care. It is only if the disease causes emaciation, that a nourishing diet is indispensable and that the cautious and moderate use of fat is quite proper, whereas farinaceouarticles of diet should be restricted as much as possible. In thecase of children especially the proper diet has to be prescribedwith great definiteness; despite the prejudice that milk overloadthe system with mucus, milk ought to constitute their chief nourishment; for chronic catarrh is really met with only among childrwith diseased constitutions, and it is in their case especially tthe deleterious influence of catarrh upon the constitution is besperceived.In conclusion we will add a few words regarding the use of particular places, the climate of which is supposed to exert a benefinfluence over the health of invalids. "We do not deem it advisabto remove patients from their habitual home and climate so longas they may be able to recover their health at home ; moreover awarm climate is not very favorable to uncomplicated bronchialcatarrh. We may be able to do much better in our immediateneighborhood. The sojourn in mid-mountain woodlands is notonly a palliative, but very often a genuine curative remedy for every serious pulmonary diseases. This statement has been verifiedto us during the last years of our practice by so many irrefutablproofs that we do not intei^d to send away a single patient whohas not first tried the influence of mountain-air in his own neig224 Diseases of the Lungs.borhood. This air stimulates the lungs so powerfully that theresult leads us to infer that even an existing emphysema maydecrease under its agency, at the same time as the whole bodyseems to become invigorated by the change. More recently theresults obtained by a sojourn in artificially compressed air haveclaimed the attention of the profession. Our own investigationsand the results we have been able to achieve in our own practice,have satisfied us that this method of treatment has a distinguishfuture before it; we cannot with sufiicient force urge upon ourprofessional brethren the importance of acquiring a thorough knowedge of these new methods.We cannot undertake to recommend particular spas for thereason that the curative virtues w^hich are claimed for them arenot expressed with a sufficiently definite scientific precision.predilection of lay-people for the spas of Ems and others is undoedly very great, but the benefit derived from them is very questionable and is very frequently owing to the fact that the warmwater which is drank early in the morning, promotes the solutionof the mucus, but probably no more so than plain warm waterwould have done.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 195 of 653[Bflehr has included in the article on chronic bronchial catarrha peculiar form of cough which is often described in pathologicaltreatises as dry bronchial catarrh or Catarrhus bronchialis siccutussis spasmodica or tussis titilans^ spasmodic or titillating coA special chapter has been devoted to this subject in Kafka'sTherapeutics, which we transfer to this work, together with suchremedies as have not been mentioned by Bsehr.We designate, says Kafka, by this appellation a cough that setin in paroxysms during which a titillation or tickling is continufelt in the trachea without any perceptible definite catarrhal aftion of the bronchia. After the paroxysm the respiration, ingenuine cases of such a cough, is again perfectly normal.The appearance of the cough in paroxysms, the absence of adesire to cough and of any perceptible catarrhal process in thebronchia between the paroxysms, stamp this form of cough as aneurosis of the trachea.The primary idiopathic titillating cough is independent of anydisease of tlie mucous membrane of the bronchia ; it is a diseasethe course of which no sort of anatomical changes can be perceivein the mucous membrane of the trachea.In the secondary form of titillating cough we observe an hyperBronchitis Chronica. 225eemia and hypertrophy of the mucous membrane which is readilyseen by inspecting the fauces provided the titillation is locatedthat region. At the same time the mucous membrane is generallydry. The hypertrophy frequently spreads from the pharynx to thelarynx and glottis, in consequence of which dyspnoea and spasm ofthe glottis frequently set in. If the hypertrophy extends to themore delicate bronchial ramifications, their contraction may causasthmatic disturbances in the process of respiration.If the titillation continues for a time, a muco-albuminoid substance, mingled with lumps of gray mucus, the sputum margaritaceum of Laennec^ is secreted and is coughed up without any rhonchus in the bronchia being heard.Utiology. This form of cough is more frequently met withamong children and women than among men. Primarily it ismost commonly occasioned by irritants that affect directly theperipheral nerves of the bronchial mucous membrane. Theinhalation of cold or damp air, an intense cold, a sudden changeof temperature, cold winds, a draught of air, acrid gases or vaposmoke, dust, very cold beverages such as ice- water, too long orloud talking, especially during a walk or run ; crying, screamingsinging, shouting, loud reading, especially if mixed up with a godeal of talking; exertions of the windpipe by the use of windinstruments, whistling, by the blow-pipe, dancing, springing, etccontribute greatly to the development of this form of cough. Itis likewise excited by fits of passion, chagrin, loud quarrellingsudden fright or surprise, etc. Sympathetically, this cough mayattack hypochondriacs, hysteric women, children during the periodof dentition, girls during the menstrual flow.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 196 of 653Secondarily this cough often supervenes during coryza, influenza,measles, acute or chronic bronchial catarrh, emphysema, tuberculosis.Symptoms. The primary titillating cough generally sets insuddenly and without any preliminary symptoms ; it occurs mostfrequently at night after one has laid down or during the first pof the night. The patients may spend the whole day or eveningwithout being seriously troubled by the cough. Suddenly, aftergoing to bed or being on the point of lying down, the patients arattacked by a violent irritation and desire to cough which does nallow them a moment's rest and prevents them from sleeping. Theirritation is either experienced in the fauces, or in the larynx,throat-pit (in the region where the trachea bifurcates), or in th15226 Diseases of the Lungs.middle of the sternum or in the epigastrium ; the irritation seemlike a tickling and usually causes in the fauces a sensation as ilittle worms or insects were crawling about there ; in the larynxand trachea a sensation of roughness is experienced, or as if thethroat were irritated by dust, the vapors of Sulphur or Phosphoruor by feathers or hairs ; the titillatiou is sometimes so violentit causes a spasm of the glottis. If the irritation is seated inmiddle of the sternum, the patients experience a sensation of oppression on the chest and a more or less violent degree of dyspnowhich may even increase to asthma. The irritation in the epigastrium is sometimes very violent, causing considerable contractionof the diaphragm and an upward pressure of the abdominal viscera,which may result in nausea or vomiting. It is on this account thathis form of cough has been dubbed " stomach-cough."The cough is dry, continued, racking, not hoarse ; sometimes ithas a hollow sound ; at times, if the titillation is located in tlarynx, it is a dry cough ; if spasm of the glottis supervenes, tinspirations are labored or accompanied by a peculiar panting souowing to which this cough is sometimes confounded with AsthmaMillari (spasm of the glottis).A titillating cough most generally sets in in single turns, sometimes two or three short paroxysms in succession ; the subsequentinspiration is rendered difficult only if the glottis participatethe attack or if asthmatic symptoms supervene. Lighter grades ofthis cough are soon appeased ; more violent attacks may continuefor several hours or even the whole night. The patients are verymuch excited by the continual irritation and desire to cough ; thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 197 of 653face becomes flushed, the temperature of the body increases, thepulse is accelerated, a warm perspiration breaks out in the faceover the whole body ; sensitive women and delicate girls are soviolently shaken by the cough that the urine spirts out involuntarily during an attack.After the dry cough has lasted for some time, a muco-albuminoidsubstance is usually secreted, mixed with a little saliva and containing here and there detached lumps of a gray, pearly mucus(sputum margaritaceum), which the most careful auscultation isunable to discover by the presence of rhonchi in the bronchia ; tpart of the trachea, where this little lump adheres, is stopped uand the respiratory murmur at this place is entirely absent ; butsoon as the little lump is expelled, the normal respiratory murmais again heard in this place, whereas the obstruction may againBronchitis Chronica. 227occur at some other spot. Percussion, at every point of the thoraelicits a proper resounance. The expulsion of this little lump issometimes a sign that the cough is going to terminate which, whenviolent, sometimes ends in vomiting.After the paroxysm is over, the patients feel very languid, soon,however, fall asleep and wake with little or no cough ; they remaalmost entirely or altogether free from cough during the day, therespiratory mucous membrane likewise remaining unaffected, untilat bed-time or in the first hours of the night they are again attacked by a paroxysm of cough.The secondary form of titillating cough either supervenes duringthe course of acute catarrhal diseases, such as coryza, influenzameasles, acute bronchitis, and, in company with these diseases, ran acute course, or else it accompanies, as a chronic cough, chrobronchial catarrh, emphysema or tuberculosis. Even when associated with these diseases, the titillating cough is recognized aresult of a constant irritation which is felt, for a longer or shtime, at different hours of the day as well as night, or even durthe early morning-hours, and finally ceases and is replaced by acommon catarrhal or tubercular cough which always has a catarrhalexpectoration ; whereas the titillating cough is generally dry, oattended with only a trifling expectoration. The titillation is oexperienced at the places indicated by the patient to whom it issource of real distress.Sometimes this titillating cough sets in with a sort of typicalregularity.Course, TerminaHons and JPrognosta. The primary titillatingcough generally runs an acute course, more especially if iwas caused by a cold, by excessive exertions of the respiratoryorgans or by epidemic influences. The fever which accompanies it,is sometimes so violent that a speedy localization in one or theother part of the respiratory apparatus may be apprehended. Thisis particularly the case with children who are unable to explainthemselves regarding the seat of the trouble. However the subsequent course of the symptoms, particularly the free intervalswhich often last for hours, and the return of the continual titilhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 198 of 653tion after the cessation of these free intervals, soon disclose tnature of the cough. Very frequently it sets in with but slight oeven without any febrile motions, and the attacks continue untilthe causes or their immediate effects are removed. Sometimes onlyone or several attacks occur, sometimes they continue for several228 Diseases of the Lungs.days, even from eight days to a fortnight, and they break out onthe least provocation.Most generally this titillating cough occurs in an uncomplicatedform ; sometimes, however, especially in the fall, winter or spriduring the prevalence of cold winds or in very cold weather, orwhen the weather is cold and damp, wet or foggy, or during theprevalence of an epidemic, the cough combines with one of theabove-mentioned acute catarrhal diseases, and with them assumesan epidemic form and runs a similar course.This disease always terminates in recovery; only when complicated with other diseases, these complications may superinducethreatening symptoms.If the primary titillating cough lasts a long time and is veryintense, emphysema or hernia may set in and may continue to theend of the patient's life.Treatment* In treating this cough we have to aim at appeasing the existing paroxysm and preventing its return.In the treatment we have to be guided by the exciting causes,the seat of the titillation, the phenomena developed by the coughin the general organism and more particularly in the organs ofrespiration, the consensual symptoms of the diaphragm, stomachand the upward action of the abdominal viscera, the circumstancesby which the attacks are either meliorated or aggravated, theperiod when they set in, and the complications.Above all we have to keep an eye on the causes that excite thetitillating cough. To this end cold and damp localities, or localcontaining acrid gases, vapors, dust or smoke, have to be abandoned, and every exertion of the respiratory organs by talking,reading, singing, blowing, etc., has to be avoided. The patientshave to avoid with great care every sudden change of temperature,sudden cooling, draughts of air, cold or damp air, cold drinks, aevery violent mental excitement; nor should they go out in windy,foggy, snowy or rainy weather. The room which the patientsinhabit, must be kept at a uniform and moderate temperature;even in the night the temperature should not fall' below 40^ or 4Fahr. ; according to our experience, a lower degree of temperaturin a room easily excites or exacerbates the'cough.Light cases of titillating cough, even if complicated with fever,do not require any medicinal treatment* A free perspiration bymeans of warm tea, warm lemonade, etc., and confinement in bedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 199 of 653Bronchitis Chronica. 229until the perspiration has ceased, is generally sufficient to resthe normal condition in the shortest possible space of time.If the fever is severe, attended with dryness of the fauces andlarynx and with a continual dry cough provoked by an unceasingtitillation in the fauces or larynx ; if the disease is the resulcold, surprise or an excessive eifort of the respiratory organs;is aggravated by excessive warmth of the room, by talking, drinking cold water ; if the paroxysms set in in the forepart of the nduring the first sleep, and if they are complicated with coryza,influenza, measles, acute bronchial catarrh, we give Aconite 3 insolution, after which the patient transpires profusely in two orhours and all the symptoms improve.Even in cases without fever or complications. Aconite acts withpromptitude and efficacy, if the previously described symptoms arpresent.If a troublesome feeling of dryness is experienced in the mouth,pharynx and trachea, attended with a continual titillation in thefauces and on the posterior wall of the larynx; it' there is a setion in the throat as if dust had been inhaled ; if the cough isviolent that spasm of the glottis or asthmatic symptoms withflushed face, and heat of the head set in ; if the nerves becomeirritable and sensitive to light and noise; if the disease has beoccasioned by exposure to a draught of air, or by sudden fright ocooling off suddenly while the skin was covered with perspirationif the paroxysm breaks out at the time when the patient wants toretire at night, and is made worse by talking, drinking or cryingBelladonna 3 is to be given, whether a fever is present or not, owhether the cough is complicated with coryza, influenza, measles,acute bronchial catarrh, hysteria or hypochondria, or not. Forthese symptoms Belladonna is always preferable to Morphine or thewater of Laurocerasus; but it should be given in the form of tincture, the extract being less reliable.If the titillating cough attacks teething children; if their moutare hot and their gums red and swollen, with much saliva and redness of one cheek; if they start during sleep and are very peeviswhen awake; if the cough continues uninterruptedly after theyhave been put to bed, and if it is dry and short, we give Chainoinilla 3. The same remedy is given if the cough is complicatedwith coryza, bronchial catarrh, when coarse rales and an audiblerattling of mucus are present; or for cough accompanying influenzand acute intestinal catarrh, if the children cry violently previ230 Diseases of the Lungs.to an evacuation, draw their legs up, and the passages look greenor like stirred eggs. This remedy is likewise applicable in the cof sensitive women, if the titillating cough is caused by the inhtion of cold or damp air, by fits of anger, and is attended withhigh degree of nervous erethism, and if the tickling in the trachis associated with a constrictive sensation in the chest ; if theis experienced at bed-time and torments the patient without ceasing. In our hands a single dose of Chamomilla has often sufficedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 200 of 653in a vast number of cases to calm this cough, to quiet this coughduring the night, which often keeps children, girls and womenespecially during the menstrual period, from sleeping.Similar symptoms and complications likewise indicate Mercuriussol. Hahn,^ especially in the case of teething children ; it maywise be used if the cough has a hollow sound, the titillation isperienced under the upper third of the sternum; if the cough hadbeen caused by a cold, breaks out in nocturnal paroxysms, thepatients perspire a great deal without bein^ relieved by it, andafter the attack, there remains an unconquerable disposition tostretch the limbs.Conium 3 is used by us, if the titillation is felt in the middlethe sternum; if the cough is caused by exposure to rough weatherand the paroxysms occur at night; if the cough is dry and so violent that it causes vomiting; if the use of acids and of salt foodrawing a long breath make the cough worse; if during the coughthe chest is spasmodically constricted and if, after the subsidenof the paroxysm, the patient complains of stinging pains in thehead and a painful sensitiveness of the abdominal muscles. Itdeserves particular consideration in influenza, measles, acute brchial catarrh and in the case of hysteric patients.Rhus toxicodendron 3, for tickling and a feeling of dryness in ththroat, down the trachea ; the symptoms abate for a while after aswallow of warm tea or water and sugar, but soon reappear againin the same degree; accompanied by tearing pains in the extremities, especially if they set in at the same time as the cough insequence of the patient being exposed to the influence of a dampand cold air, or getting soaking wet ; the paroxysms occur in thenight, attended with complete sleeplessness; the cough is complicated with coryza and frequent, spasmodic sneezing, or in caseof influenza with typhoid symptoms.If the titillation and cough have set in after a walk in keen andcold air; if the tickling is chiefly felt in the larynx or extendBronchitis Chronica. 281down to the bronchia: if the cough is dry and bo violent that itcauses a spasmodic constriction of the throat and chest, and a moor less violent degree of spasm of the glottis, with an expressioanxiety in the face, cold sweat on the forehead and extremities,the patients have more and more a cyanotic look; if the violenceof the cough causes vomiting, and the paroxysms recur typically,we give Ipecacuanha 3 with decided benefit.If the titillation is felt in the throat or pit of the stomach; icough is caused by rapid walking, running, mortified feelings orsulting treatment ; if it is attended with dyspnoea and vomitingthe ingcsta ; if the attack sets in in the morning-hours and is avated by talking or eating, we give Katrum muriaticum 6, likewiseif coryza is present, with entire loss of smell alid taste, or ifcough is complicated with emphysema and tuberculosis. In the caseof emphysematous women the titillating cough is usually attendedwith sjiirting out of the urine. This remedy is likewise valuableif the titillating cough breaks out typically, or in the case ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 201 of 653chondriacs or hysteric females.We prescribe Ignatia 3 for a dry, constant, titillating cough whisets in more particularly at bed-time; the irritation is seated ithroat-pit, as from the inhalation of fine feather-dust, or the ttion is felt in the larynx or even in the epigastrium; the coughof a preeminently nervous character and is caused by depressingstates of the mind, or by humiliating treatment, grief, care ; thcough is worse in the open air, after eating or drinking coiFoe.disease may be primary and idiopathic, or attended with coryza anbronchial catarrh. Ignatia is particularly to be commeiuled forhysteric w^omen and for children inclined to spasms.Ammonium carbonicum 8 is indicated by titillation in the larynxand a sensation in the trachea as of inhaled feather-dust, attendwith dyspnoea ; the paroxysms occur at night and are followed byhigh degree of exhaustion ; the cough is made worse by talking an0[)en air; complicated with coryza, influenza and acute and chronbronchial catarrh.Acidum benzoicum 8 for a titillating cough caused by a cold,attended with a stinging sensation in the middle of the sternumwhich is worse during a deep inspiration ; the cough is accompaniby asthmatic complaints and rheumatic pains in the joints.Rumex crispus 3 is recommended by Kafka, if the titillation proceeds from the throat-pit or the middle of the sternum, attendedwith a sensation of soreness in the trachea; if the cough sets in232 Diseases of the Lungs.bed-time or after the patient has laid down, and is caused by theaction of dry, cold air, esiDecially in the winter-season; it desespecial attention in bronchial and laryngeal catarrh. Doctor Carroll Dunham of New York has published a long and interestingarticle on the subject of Rumex crispus in the second volume of tAmer. Horn. Review, page 530, to which we refer the reader forfall and correct information concerning the therapeutic uses of tdrug in affections of the larynx, trachea and bronchi.Graphites 6 for titillation in the larynx, with a feeling of soreand burning in the throat; for nocturnal paroxysms of cough, withhard pressure on the chest; it is particularly useful in cough wichronic coryza or in the case of individuals who are at the sametime attacked with a scrofulous eczema, or in the case of womenwhen they have their menses."We prescribe Zincum metallicum 6, if the titillation is locatedthe region of the sternum ; if the cough is dry and exhausting, wstitches in the chest and oppression of breathing; if the respirais labored and talking is quite an exertion, the attack takes plaat night and deprives the patient of sleep; deserves particularattention for the cough of hysteric women and during the menses.Kali carbonicum 6 is indicated by a dry titillating cough, withstinging in the larynx, pains in the chest, choking, violent headexhaustion after the attack which commonly sets in at night ; isuseful for titillating cough during the menses and in a case ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 202 of 653incipient tuberculosis.AVe have seen a very violent, acute titillating cough cured veryspeedily by means of a decoction of Senega; the patient was a ladand had contracted the cough during an ascension of the Rigi.This remedy is appropriate for cough, if the titillation is seatethe larynx, and the cough is attended with roughness in the throaand oppression on the chest ; if the cough is made worse by thebreathing of fresh air, and if the patient has to sneeze frequentand continually until the head feels heavy and giddy, without anycoryza being present. It may be used during an attack of influenzand acute bronchial catarrh.These remedies have enabled us to control every attack of primarytitillating cough, no matter of what kind. (We remind the readerof the propriety of referring to the chapter on chronic bronchialcatarrh for the other remedies not mentioned in this extract fromKafka.)Even in the secondary form of this disease these remedies haveBronchitis Chronica. 233always been found sufficient in our hands. In the titillating couof tuberculous individuals, especially in the last stage of the dthe best tried remedies sometimes remain without effect ; in suchcase we resort to empirical remedies from motives of humanity,such as Cannabis indica 2, Atropin. sulph. 2, or Morphium aixt 1.(The Spirits of Turpentine on sugar and the Balsam of Copaivalikewise on sugar, or the alcoholic solution of the balsam have bfound useful in chronic titillating cough.)The selection of the proper remedy is often a very difficult mattespecially in the case of children who are unable to indicate thelocality of the titillation or to furnish a proper account of thesubjective sensations. The difficulty is likewise great in the caof hysteric females, because the consecutive, consensual and reflphenomena succeed each other with remarkable rapidity, and areexceedingly diversified. In such cases experience has taught us tpay exclusive attention to the objective phenomena which, to thishave to be investigated with great correctness and interpreted wian enlightened knowledge of their character and meaning. Afterwe have obtained an exact objective picture, we shall have nodifficulty in picking out the remedy best suited to the case.Having hit upon the remedy adapted to the present case by anarithmetical process as it were, we may rest assured that everyBubsequent paroxysm will yield to it. We exhibit the remedyduring the paroxysm moat commonly in solution, mixing four, sixor eight drops in half a pint of water and giving one or two dessspoonfuls every quarter or half an hoar, or every hour. Triturations like those of Mercuriu^ sol. or Hepar sulph. are likewise oevery half hour or hour in about grain-doses. After the terminati" of the. paroxysm we continue the same remedy every two or threeAours until the cough has entirely ceased. In order to prevent thJ^turu of the cough, we give two doses of the same drug every day^^ Some time longer. The patient's attention should be directedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 203 of 653*^piie necessity of observing the dietetic and general hygienic r^iclx we have fully explained in previous paragraphs.'^ ^ case of secondary titillating cough, we first stay the parJ'^ixxs and afterwards continue the treatment of the primary affe. ^'» ^lach as coryza, acute or chronic bronchial catarrh, measle^^^^Xza, emphysema, tuberculosis, for which we refer the readerr^^ir respective chapters."tVie titillating cough occurs typically, we give, according toine By|r,ip|;Qij^g^ ArsenicuMy Ipecac.,^ Nux vom.^ Natrum muriat.i234 Diseases of the Lungs.these remedies prove insufficient, we give Chinin. sidph. Ij andobstinate cases Chinin. arsen. 1, of which remedies we prescribedose every two or three hours during the apyrexia.While the titillating cough lasts, the food should be salted orspiced as little as possible; mild nourishment containing a gooddeal of saccharine matter, is best. Even such articles of diet ascontain a good deal of starchy matter, such as potatoes, chestnuts, peas, lentils, etc., should be avoided. Kancid fat, acids,and heating beverages are likewise hurtful.Individuals who are liable to attacks of titillating cough, shoulobserve the same precautions as those who are suffering with acutbronchitis, or are liable to attacks of this disease. H.]7. Bronebiectasla.Dilatation of the Bronchia.We should not have mentioned this affection if it were not ofparticular importance to the correct appreciation of chronic bronchial catarrh.A dilatation of the bronchia is of two kinds, a uniform or diffuse dilatation and a sacculated form. The former is always aconsequence of an inflammatory acute or chronic disease of thebronchial mucous lining in which the elastic and muscular tissueshave become involved, in consequence of which these tissues havelost their elasticity to a greater or less extent. This alteratiothe bronchia is rarely confined to a small portion, but most commonly reaches over a large extent of the bronchial tubes. The sacculated form is caused by the closing of delicate bronchial ramifcations above which it is located ; this closing leads to atrophythe pulmonary parenchyma and thus assists in restoring the spacefor a dilatation of the bronchia ; or the dilatation may be a conquence of the closing of bronchial tubes occasioned by atrophy ofthe corresponding portion of the lungs.Diffuse bronchiectasia, if not too prominently developed, is of nparticular consequence ; if occasioned by an acute attack, it isable ; but if resulting from chronic bronchitis, it may be diffichttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 204 of 653to repair the disorder. It has the same phenomena as chroniccatarrh, or chronic catarrh in conjunction with emphysema whichis scarcely ever absent.Sacculated bronchiectasia is much more important, because iteasily leads to suppuration and gang eue of the mucous membrane,Emphysema Pulmonum. 235and very frequently presents the picture of pulmonary phthisis, agenerally modifies quite extensively the results of percussion anauscultation. Atrophy of the lungs superinduces retractions of thcorresponding intercostal space, which, however, are not oftenobserved at the apex of the lungs; the percussion-sound is dull,auscultation does not reveal any vesicular murmur, but bronchialrespiration or else consonant murmurs, pectoriloquy, wheezing,coarse rales. The diagnosis is somewhat complicated, dependingrather upon the absence of general symptoms of tuberculosis thanupon the presence of any directly observed phenomena. In a caseof severe chronic bronchial catarrh, bronchiectasia may be suspecwith a tolerable degree of certainty if the expectoration has a vfetid odor. Otherwise the symptoms here are likewise the same asin chronic bronchial catarrh, very often associated with the phenomena resulting from the presence of emphysema which is veryapt to supervene on such occasions.Of course the treatment cannot aim at restoring the elasticityand contractility of the bronchia; hence it cannot be directed agthe bronchiectasia, but the physician has to make the cure of theaccompanying catarrh the chief object of his attention. Even adilatation caused by an acute catarrh, if it should have been correctly diagnosed, does not require any special treatment. If weonce have become satisfied of the presence of bronchiectasia, wefeel convinced that the existing bronchial catarrh cannot be enticured, and we refrain from instituting fruitless experiments; atsame time as we may obtain light concerning the proper remediesto be prescribed which, of course, can only aim at a palliation othe symptoms. For all that, though bronchiectasia is an undesirable complication, yet it does not necessarily render the prognosin a case of bronchitis more doubtful. Such patients may live toan old age, even if afl^ected with sacculated bronchiectasia, ifexpectoration is decidedly purulent, and has a foul odor.8. EmpliyBeina Pnlmonum.Emphysema of the Lungs.Two essentially different kinds of emphysema have been described,an interlobular arising from the passage of air into the pulmonarconnective tissue, and a vesicular representing an entirely diffeprocess, namely a dilatation of the air-cells. We have only to dewith the latter form.Emphysema very commonly arises in consequence of processes in236 Diseases of the Lungs.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 205 of 653the lungs by which a portion of this organ is rendered inaccessibto the respiratory process ; it may accompany atrophy or infiltration of portions of the lungs ; it most commonly accompanies chanof structure which at the same time superinduce a diminution ofthe volume of the lungs. This form of emphysema can scarcelybe regarded as anything morbid and will never become an objectof treatment ; it is termed vicarious emphysema. Vesicular emphysema has an entirely different origin and is of much higherimportance; in a practical point it is essential that this originbe known. We do not deem it necessary to recite the differenttheories regarding the origin of emphysema ; we simply give whatwe consider the most correct explanation. Emphysema may becaused by morbid conditions of the air-cells which impair theirelasticity more or less. This defect may arise in cases of violenbronchitis, pneumonia, etc., in which case the air-cells are affesimilarly to the bronchia in diffuse bronchiectasia. This accountfor the frequent occurrence of emphysema in chronic bronchia^catarrh Emphysema may likewise have another and diffcrtmode of origin. In consequence of an excessive but otherwist>entirely normal exercise of the respiratory functions; or in consequence of the respiration being obstructed by organs situated oside of the thorax, the air-cells may become dilated to such anextreme degree that little by little they lose the power of resumtheir former size, precisely in the same manner as an Indiabag that is often and excessively dilated, loses its elasticity.In the former manner emphysema occurs principally in catarrhsof the bronchial mucous membrane, more especially in chroniccatarrh with marked hypertrophy of the mucous membrane, andin an almost normal manner in old age where the walls of the aircells, like most other tissues, lose their elasticity more and moIn the second manner, emphysema is caused by excessive exertions in running, dancing, lifting, playing on wind-instruments,obstructed expiration by affections of the larynx, the closing ofbronchial tubes, paralysis of the diaphragm, owing to which theexpiratory act is performed in an incomplete manner ; by occupations which leave one part of the lungs in a continual state of ition, Very frequently both modes of origin combine, which isreally always the case if chronic catarrh is sustained by lesserdegrees of emphysema ; at the same time chronic catarrh being anobstacle to respiration, and diminishing the elasticity of the aicells, always increases the existing emphysema.Emphysema Pulmonum. 237Hence the more special etiological causes determining the existenof emphysema are: catarrh of the mucous lining, especially chronicatarrh; various other affections of the lungs, whoopingplaying on wind-instruments, excessive bodily exertions, croup,stenosis of the larynx, paralysis of the diaphragm, tumors of theabdominal viscera, heart-disease, etc.Emphysema may take place in every age, but occurs more particularly among persons beyond the age of fifty. Men are moreliable to it than women, probably for no other reason than becausthey are more exposed to the causes producing it. Some individualhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 206 of 653evidently inherit a disposition to the disease. Thin individualscontract the disease more easily thani fleshy and robust persons.The symptoms of pulmonary emphysema very naturally resultfrom the anatomical changes it occasions. Some of the airexcessively distended; hence, owing to their inability to contracsufliciently or at all, they no longer participate in the respiraprocess, and consequently give rise to phenomena of dyspncea.These are increased by the circumstance that the distended cellscompress other neighboring cells and withdraw them from theprocess of respiration. The impeded respiration occasions passivehypersemia of the lungs which again causes chronic catarrh, adeficiency of the heart's action, sanguineous engorgement of theabdominal viscera, the vessels of the head, and finally, in consequence of an abnormal composition of the blood, exudation of serufrom the vessels and consequent dropsy.These changes do not develop themselves all at once, nor do theyall occur in the same sick individual ; hence emphysema presentsvarious groups of symptoms which we deem it unnecessary todelineate in this place. We prefer giving a more detailed description of the more prominent characteristic features of the diseasePulmonary emphysema runs an exceedingly chronic course, andthe changes it occasions occur almost imperceptibly under the guiof a light chronic catarrh, but after some time progress with dourapidity since the existing emphysema necessarily originates additional emphysematous disorganizations. Patients may feel tolerablwell for years, when suddenly the dyspnoea begins to increasesteadily and imprints the true picture of emphysema upon the'patient.A physical exploration does not reveal at all times distinct phenomena. If on percussion, the pulmonary murmurs are heardbeyond the liver and heart, we may safely conclude that emphysema238 Diseases of the Lungs.is present ; tbis circnmstanee, however, occurs only in high gradof the disease. Auscultation usually reveals only the symptoms ofchronic catarrh which is in reality never absent, and moreover avery feeble, scarcely audible vesicular respiration which, owingthe extreme respiratory efforts of the patient, is indeed quite cacteristic. If the emphysema has reached a high degree of development, the thorax assumes the shape of a tub. The ribs owingto the excessive action of the inspiratory muscles, retain the powhich they assume during the act of inspiration, and thus it isthat the upper portion of the thorax is dilated whereas the lowerportion retains its normal width. Owing to the excessive inspiratefforts the cervical muscles become very prominent, and the drawiup of the thorax gives to the patients their characteristic shortnecks. The influence upon the heart results more especially inabnormal changes of the right heart. Owing to the obstruction ofthe circulation in the lungs, the right heart is engorged with bland finally permanently distended. It is only in the higher gradeof emphysema that the heart is pushed out of its place. The effecupon the left heart is not constant. The change in the right hearexplains various other phenomena of the circulation, the throbbinhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 207 of 653in the pit of the stomach, the venous hypersemia of the thoracicviscera, the engorgement of the veins of the neck and head. Fromthe deficiency of respiratory action and of the functional activiof the heart results a change in the composition of the blood whifluid finally assumes an intensely venous character. Usually thepulse is uncommonly small and feeble, frequently irregular or intmittent.What torments the patients most, is the dyspnoea. If the catarrhis moderate, the dyspnoea is bearable, but it increases by everycumstance that interferes with the breathing, even by moderatelyfilling the stomach, flatulence, but most permanently and mostthreateningly by an acute bronchial catarrh. It seems almostimpossible that the patients should be able to bear this torturelonger than a few days, and yet but few die of an attack of thiskind. The most common cause of death is dropsy resulting fromthe above-described anomalies of the circulation. It most generaldevelops itself gradually, very seldom to a high degree, becauseascites and oedema of the extremities are most commonly associatewith oedema of the lungs.The whole duration of the disease may be thirty, forty and moreyears. Emphysematous individuals, if pursuing a regular modeEmphysema Pulmonum. 289of life, may live to a high age in spite of all apparent danger.stantly occurring variations in their state of health are not occby an increase or decrease of the emphysema, but by an increase odecrease of the accompanying chronic catarrh. On this account summer and a dry and cold winter-air are most favorable to the patiewhereas the transition-periods from one season to another cause tfrequently or almost regularly a violent distress ; they commonlyhalf a day in advance every approaching atmospheric change.K we expect to effect a complete restoration of the patient, theprognosis is very bad ; as far as longevity is concerned, it maysaid to be very favorable. If emphysema has developed itself sofar as to enable us to diagnose it, a retrograde metamorphosis cascarcely ever be thought of; all we can expect is to diminish theextent of the disease. The chances of a long life are mostly detemined by the condition of the heart ; as long as the heart preserits normal state, we have nothing to fear. The renal functionslikewise deserve our attention, since their condition generally fenables us to prognosticate the termination in dropsy.If we mean to indicate a treatment of emphysema, we shall firsthave to inquire how far this disease can at all be treated. Theelasticity of the air-cells is gone, they have become distended tsuch an extent that they cannot possibly recover their normal sizin many instances the walls of adjoining cells have disappeared,and cavities have formed in their places. Is it, under such circustances, possible to restore the elasticity of the air-cells ? Frour stand-point this question, which a fanatical homoeopath fromstand-point of his dogmatic faith, not from that of practical obsvation, may rashly answer in the affirmative, has to meet with adecidedly negative answer. Even if we admit that slight degreesof emphysema can be compelled to retrograde, by what method ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 208 of 653investigation, what objective or subjective symptom will we beenabled to diagnose a trifling emphysema, and to demonstrate thefact that the improvement we had aimed at, has been achieved?After an emphysema has become evident to the senses it must haveacquired an extent of development which renders a retrogrademetamorphosis an impossibility. In our opinion a radical cure ofemphysema of the lungs cannot be thought of, nor can any directtreatment be instituted ; in other words, we declare this disorgazation an incurable malady.In saying this, we do not mean to assert that every treatment ofemphjsGD^ '^ futile and useless; on the contrary, a physician can240 Diseases of the Lungs.benefit his patients very essentially in two different directionsthe first place, a certain prophylactic treatment can be institutwhich of course cannot aim at preventing the disease altogether,but staying its further spread. Let every intense chronic bronchicatarrh be treated with the utmost care, especially in the case opeople and individuals disposed to shortness of breath, and let econtrivance or circumstance that might interfere with the respiratory functions, be avoided, more particularly tight clothes, contstooping, violent bodily exertions. At the same time let the patiguard as much as possible against catarrh of the respiratory orgaThat this cannot be accomplished in the most efliicient manner byconfinement in the room, by warm clothing, or in general by excessive care, has been shown by us in a previous paragraph. Suitableclothing does not mean very warm clothing; on the contrary, thisis least appropriate. Strict attention to temperature, wind, raindryness of the atmosphere should be paid by every emphysematousindividual; no one ought to dress more in accordance with changesin the temperature and weather than persons sufltering from emphysema. Wearing flannel next to the skin, is undoubtedly beneficialfor the reason that extreme respiratory efforts easily excite a ptranspiration even during a slight bodily exercise such as walkinWearing flannel is indispensable, if the weather where the patienresides is habitually damp and cold. Much smoking is decidedlyprejudicial, although we do not mean to assert that tobacco causeemphysema. The circumstance that the blood of such patientsdoes not receive a suflicient quantity of oxygen, suggests the prpriety of advising them to avoid localities where the air is vitiby crowds.Secondly we are obligated to try to meet the affections whichinevitably accompany emphysema. At the list of these affectionswe place catarrh of the bronchial mucous membrane. Be it theprimary catarrh as an exciting cause, or only a secondary affectiwe should by all means endeavor to moderate or remove it, usingfor this purpose the remedies that have been recommended for acutand chronic bronchial catarrh. Some among these remedies aremore valuable because the catarrhal symptoms in their pathogenesiwith which emphysematous individuals are most usually afilicted,have been confirmed by abundant practical applications. For thechronic form of catarrh we select: Carbo vegetabUiSy Arsenicum^Tartarus stibiaius^ Baryta carbonica^ SUiceaj Ipecacuanha^ Lycopodium. The three first named again deserve the preference ; any onhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 209 of 653Emphysema Pulmonum, 241\rho uses them in suitahle caecB, must be amazed at the improvemethey a

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 210 of 653the abnormal results, of course, cannot be removed. Digitalis isbest calculated to palliate the distress, whereas Arsenic^ Lycopoand other remedies almost always leave us in the lurch. In onecase Natrum muriat. relieved the truly frightful cardiac distressIn conclusion we will make mention of an agent that exerts adecided influence over emphysema, we mean the pressure of theatmosphere. More recently we have become enabled to increase ordiminish this pressure ad libitum to suit the condition of ourpatients ; both the decrease as well as the increase of this presexert a wonderful effect upon emphysematous individuals. Adiminished pressure of the atmosphere is procured by causing ourpatients to reside on high mountains. By this change the aftectiois improved in an uncommon degree, almost without an exceptionand in a very short time, the catarrh becomes less and the patienvery soon gains in flesh. Any one who has resided on high mountains, must have experienced the great ease with which the act ofrespiration is performed, and what a pleasantly stimulating eftecmountain-forests have upon the organism. Not only must thegreater ease in breathing feel very pleasant to the patient, butquality of the inhaled air must likewise aftbrd a pleasant stimultion to his weary frame. Be this as it may, the best thing emphysematous individuals can do for themselves in the summer, is tolive on high mountains.How it happens that an increase of atmospheric pressure likewiseexerts a beneficent effect upon emphysematous individuals, we areunable to decide, nor do we deem it essential to entangle ourselvin hypothetical speculations on this subject. That this effect isproduced, is not only corroborated by experience, but likewise bythe apparatuses contrived for the inhalation of compressed air.But few of such apparatuses are as yet in use, but we feel confi.dent that in every large city an apparatus of this kind will soonor later be introduced, and we deem it so much more our duty todirect the attention of our Colleagues to artificial contrivancesthis kind, as our Materia Medica is utterly destitute of remedialagents for this disease, and the most we can do is to palliate thpatient's distress. More detailed information concerning this subject may be found in the Essays of Dr. Vivenot, Jr., in Vienna, whas published several of them. The essential effect of inhalingPneumonia. 243compressed air for several hours is a decreased frequency of thenumber of respirations and the pulse. The relief obtained byemphysematous individuals must be owing to the circumstancethat the inspirations become fuller and more oxygen is supplied tthe lungs. We trust that all who have an opportunity of testingthis method, or otherwise observing its effects, will take the trof directing their attention to it. ,9. Pneamonla.Inflammation of the Lungs.By pneumonia we understand the effusion of a fibrinous exudation on the free surface of the pulmonary cells. This form of pnemonia is termed croupous in opposition to the interstitial and cahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 211 of 653rhal form, the first-named of which, however, is the only one thais, strictly speaking, entitled to be classed among inflammationsthe lungs.On account of its frequency and the importance of the affectedorgan, pneumonia is one of the most important diseases. To thehomoeopath it becomes so much more important on account of circumstances which we shall endeavor to explain at the commencement of the paragraphs devoted to the therapeutics of pneumonia,although this proceeding may render us liable to the charge ofinconsistency in not avoiding, according to promise, every specieof polemics. But in the present instance the dispute about the firank must be settled and is, therefore, unavoidable.Ktiology* An affection like pneumonia, which has at all timesand more especially during the last decades, since the introductiof a physical exploration of the chest and the development of patological anatomy, commanded the fullest attention and the mostcareful investigation on the part of all physicians, must necessahave led to the most diversified views concerning its origin. Toavoid prolixity we shall only mention the most important etiological causes. The two principal kinds of pneumonia are -the primarand the secondary form.Primary pneumonia may occur at any age, but attacks moreespecially individuals between the ages of twenty and forty yearsvery rarely children in the first years of infancy. No constitutiis exempt from the liability to an attack ; if a robust and plethconstitution is generally regarded as more susceptible, it is, moprobably, because robust men are more frequently exposed to theexciting causes of pneumonia. This circumstance is most likely th244 , Diseases of the Lungs.reason why men are bo much more frequently attacked than women ;the occupations pursued by men expose them more fully and more,frequently than women to the deleterious influences productive ofpneumonia. Infants at the breast, and children who have not yetpassed through the first period of dentition, are seldom attackedwith croupous pneumonia. The nature of the country does notseem to exert anr palpable influence; for pneumonias occur in alevel country as well as on mountains, in sunny districts as wellin exposed places. The seasons, on the contrary, exert a decidedinfluence. Our statistical tables show to a demonstration that thtransition from cold to warm seasons is the most fruitful sourcepneumonia; the transition from warm to cold seasons is less productive of this disease, winter still less and summer least of anThat there must be other causes at work than the mere temperature, is self-evident. The great changes of temperature in Apriland May being at the same time attended with the most markedchanges in the electric conditions of the atmosphere, it is conclnot without reason that these conclusions are correct, and thatelectricity exerts a powerful influence as one of the exciting caof pneumonia. The influence of electricity likewise accounts in tmost natural manner for the frequent occurrence of epidemic pneumonia which, though not always very extensive, yet is often veryintense, and which, owing to the peculiar course it takes, has ofvery characteristic features. We doubt very much whether a merehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 212 of 653cold is such a frequent cause of pneumonia ; it unfortunately isconvenient to attribute pneumonia to it. In the absence of otherconstitutional predispositions it is only a very violent cold thacapable of causing pneumonia; even in such a case we would notregard the cold as a cause of the disease, unless it had taken plno later than eighteen hours before the commencement of the disease. Mechanical injuries, more especially a violent blow or kickmay likewise give rise to pneumonia ; noxious agents acting direcupon the lungs, such as irritating gases, excessive cold or heat,likewise excite the disease. A real predisposition to pneumoniawill very seldom be met with; but it cannot be denied that thetreatment of pneilmonia with debilitating drugs, more especiallysanguineous depletions, always leaves an increased disposition tosimilar attacks. • In the case of tuberculous patients a dispositcannot well be shown, they are more easily attacked with bronchitis. It likewise seems an established fact that individuals wia preeminently arterial habit are more liable than others, and thPneumonia. 245for instance, emphysematous individuals with venous constitutionsare not often attacked with pneumonia.Secondary pneumonia is frequently an exclusively consecutiveaffection, originating in the spread of inflammatory affections tlungs. It is particularly met with among children, much less frequently among adults, and occurs as a complication of all possiblacute diseases, particularly exanthems. Pyaemia is one of the mosfrequent causes of secondary pneumonia. In chrdnic affections italways a very dubious undertaking to show their connection withintercurrent pneumonia.Pathologico^anatomical Changes* We give a descriptionof these changes, because they facilitate a comprehension of theapparent symptoms.For the sake of facilitating a methodical arrangement of thepathological changes, the pathological process has been divided ithree different stages which, however, are not so rigidly distinguished from each other in reality, and often run a parallel courThe first stage is that of bloody infiltration. On opening thethorax the affected part of the lungs does not collapse ; the plecovering this part is usually opaque, the elasticity ^-t this parmore or less completely lost, and the color is sometimes muchdarker. Otf cutting into the lungs, only a feeble or no crepitatiis heard. The cut surface is of a strikingly dark redness, usuallin sharp contrast with the sound portion ; on pressing upon it adark-red or brownish, viscid, tenacious fluid is squeezed out. Thtissue is dense. The weight of the affected portion is much moreconsiderable than its normal weight, and in water this portionimmediately sinks to the bottom of the vessel.The second stage comprehends the period when the process ofexudation is completed, and is generally designated as the stagered hepatization. The affected portion feels dense and hard ; thepleura over it has almost always lost its lustre and is thinly cowith exudation. It exhibits all the signs of the first stage poinhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 213 of 653to a deficiency of air. The cut surface has the same color as infirst stage, or more usually it has the color of rust. When the limpinges upon it, the cut surface shows distinct granulations whiare still more apparent on the surface adjoining the thorax and acaused by the firm exudation-plugs in the pulmonary cells. In spiof its density, the pulmonary tissue is much more easily torn.The transition into the third stage does not, properly speiaking,constitute part of the normal course, for by the normal course th246 Diseases of the Lungs.resorption and exudation of the infiltration proceeds from thesecond stage. This third stage is designated as the stage of grayhepatization and purulent infiltration. The cut surface now has agray color with a yellowish tinge, mingled with red or brownspots which often impart to it a mottled appearance. The granularappearance has disappeared or still exists very feebly. The tissuis quite friable. On pressure a turbid liquid is discharged fromconsisting in most part of pus corpuscles. Gray hepatization ofcourse arises from the red ; the hsematin is more and more decomposed or reabsorbed, on which account all transitions of color arcommonly noticed, from a dark brown-red to a yellowish, rusty orgray color, and if the purulent transformatic»n is perfect, to acolor.The third stage may still be succeeded by the formation ofabscesses, gangrene of the lungs, thickening of the exudation ; wshall speak of this more fully hereafter, as well as of the lessquently occurring deviations from the general anatomical changes.As regards the extent of the pathological process, in croupouspneumonia a whole lobe or at least a large portion of a lobe is cmonly attacked ; less frequently a lobe is attacked on both sidesstill less frequently all the lobes together. If only one side isit is most commonly the right lungs, less frequently the left. Ifonly isolated, detached lobules are infiltrated in consequence ofpneumonic process, the inflammation is not usually a simple croupous pneumonia, but almost always of a secondary character.Symptoms and Course. As yet we are not acquainted withany disease which, in the absence of any particular complicationsits course in such fixed and stable forms as pneumonia and adhereas fixedly as this disease to definite critical days. In the chapon the therapeutics of pneumonia we shall show how far the formerly customary treatment of this disease has been influenced bythe discovery of a fixed typical course.Pneumonia begins almost without an exception with a chill whichis usually very severe and is in many respects of great importancIt is from this chill that we date the commencement of the diseasand by it we determine the critical days. Moreover this chill whiis sometimes of very long duration and is immediately succeededby, but never alternates with fever, is in no other disease of supeculiar nature, so that it may almost be considered pathognomonimore especially if we consider that as soon as the chill sets in,muscular strength vanishes so that the patient finds it almosthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 214 of 653Pneumonia. 247impossible to stand erect. We will now first describe the courseof pneumonia in the case of a robust and sound individual, andwill append to it the description of various deviations.As soon as the chill which almost always lasts several hours andscarcely ever only a few minutes, is over, a violent, dry feversets in, and the pulse becomes more or less accelerated, fuller amore tense, but very seldom exceeds the number of 100 beats. Thetemperature is always raised a few degrees. The face which duringthe chill has an almost cadaverous appearance, now becomes flushesometimes only on one side ; the cheeks are bright-red, the eyesinjected, and very commonly some headache is felt, and the patiengenerally feels thirsty, but is very seldom disposed to vomit. Thappetite is at once gone, and owing to the intense fever, all thesecretions are suspended. The patient feels more exhausted thanhe really is. This condition which is as yet free from all localsymptoms, may last longer than twenty-four hours, but in such acase the local symptoms appear at an earlier period; in rare casethey precede the chill. The patient complains of unceasing stitching pains which he generally points out with tolerable accuracy aexisting at the affected spot, very seldom far removed from it ;are aggravated by every unusual exertion of the respiratory organespecially by coughing, and they sometimes increase to a highdegree of intensity The pain usually sets in associated with ashort and at first dry cough, the respiratory movements are muchless full and more frequent in number. The breathing is not onlypainful and accelerated on this account, but the violent fever liwise occasions an increased desire for breath which cannot be grafied and causes great restlessness and anxiety and a marked activity of all the other respiratory muscles which are not usually veseriously taxed in performing the respiratory movements. Theseexertions are generally so striking that pneumonia can be recognifrom this very fact, more especially from the flapping of the alnosi during an inspiration. Vocalization is of course altered, feand shorter, and frequently interrupted.Soon after the cough has begun to set in, the patient begins toexpectorate ; this expectoration is important as a diagnostic sigIt is scanty, very tenacious, and usually intimately mixed withblood from the commencement, which imparts to it the color ofrust, or brick-dust ; this color is scarcely ever absent in the cyoung, robust individuals. At this stage the physical symptomshave so far advanced that they render the diagnosis perfectly248 Diseases of the Lungs.certain. During the first daj^s the fever gradually increases, shing but slight morning-remissions. Considering the high degreeof temperature, the pulse is not so very frequent, scarcely everexceeding 120 beats , however, in proportion as the parenchymabecomes more infiltrated, the fulness of the pulse decreases considerably.The end of the inflammatory infiltration generally designateshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 215 of 653the period when a change takes place in the symptoms. The infiltration is seldom completed on the third day, sometimes not tillseventh, even still later. After this, the pains almost always cethe breathing becomes more tranquil, the fever is apparently lessthe pulse remains unchanged, the constitutional symptoms do notmend very perceptibly. The local as well as the general symptomsmay remain unchanged in intensity, until a change takes place inthe disease. Such a change seldom takes place before the fifth daand, according to Traube, sets in on the odd days, which is denieby others This critical change is very often preceded by the breaing out of herpes labialis which almost always authorizes the expectation of a favorable turn. Previous to the critical change, tintensity of the symptoms either rises to a great height by a graincrease, or else it is often the case that after two to four quidays a violent fever again rages for twelve to eighteen hours, afwhich the disease decreases very suddenly. This reappearance ofthe fever is most easily accounted for by the exudation of serumwhich is required for the reabsorption of the exuded fibrin. Inuncomplicated cases the disease decreases with an uncommonsuddenness and rapidity, sometimes in a few hours, and it is diffcult to understand how the dyspnoea can decrease so rapidly sinceas a rule, a copious expectoration does not occur and is sometimeentirely wanting. This shows that the exudation of serum whichis alone capable of removing the exuded fibrin by a process of reabsorption, is chiefly concerned in disembarrassing the respiratofunctions by the removal of this exuded material. In simple pneumonia, without abnormal deviations from a regular course, the socalled sputa cocta are only met with in small quantity and not byany means as a general rule. Convalescence takes place so rdrpidlthat on the fourteenth day every trace of the disease has generaldisappeared. As we shall see presently, the mode of treatmentexerts a great influence in this respect.In order to establish the diagnosis of pneumonia with perfectcertainty in all dubious cases, it is absolutely necessary to resPueumonia. 249a physical exploration of the respiratory organs. We discuss thissubject separately from the other symptoms of the disease, lu ordto aftbrd a clearer and more connected view of the whole.Pneumonia does not alter the shape of the thorax, or so littlethat no stress need be laid upon this symptom ; nor are the intercostal spaces altered any more than the general capacity of thethorax. Very commonly, however, a more distinct vibration of thethoracic wall, corresponding to the diseased portion of the lungsis perceived when the patient is talking. The most important positive signs are yielded by percussion which informs us with toleracertainty whether a larger portion of the lungs is infiltrated orWe speak, of course, of croupous pneumonia, for it is this alonethat causes the infiltration of a considerable portion of the lunmost commonly of a whole lobe. In the incipient stage of pneumonia, the sound either remains unchanged, or is only changedvery slightly ; hence, immediately after the occurrence of the chno ahanges can be discovered. But in proportion as the hyperemiaincreases, the percussion-sound becomes more tympanitic, sometimeto such an extent that one might be led to believe, a piece of inhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 216 of 653tine had been struck. Hence, the tympanitic sound is really charateristic in pneumonia, and is only less marked, if the thoracic wAre very thick, or if the diseased portion of the lungs is separaf^m the thoracic wall by a normal layer of pulmonary parenchyma,-to croupous pneumonia, this is very seldom the case. The more^'Dplete the infiltration, the more completely the air escapes frf^he lungs, and the more empty the sound becomes unless a layer,^ra ^which the air has not yet escaped, lies over the diseased pojort of lungs On the sides of this normal layer, the dulness ofterst olanges to the tympanitic and further on to. the normal sound® "^^rapanitic sound is sometimes heard even in the non-P^*"t:xoii of the lungs, most likely owing to the accompanying hy^^^^•- A change in the infiltration is revealed by percussion if^^*^tion takes place, in which case the tympanitic sound mostjT^^^^only returns for a short time and soon after gives way to t-. ^ound. The results of auscultation are equally valuable as^^ostic signs. At the commencement of pneumonia, the normal. ^■^^^sitory murmur is very often quite feeble, much less freque..^^^6ed. As soon as infiltration begins to set in, and the air i. ^l)le to circulate in the inflamed portion of the lungs, we per^> especially during an expiration, the crepitation that is so^J^ absent that it can almost be regarded as characteristic in250 Diseases of the Lungs.pneumonia. It is- less audible, if a co-existing bronchial catarrhides it by rfiles. With the completion of the exudation, when thpercussion-sound becomes empty, every murmur caused by the circulation of the air in the air-cells, necessarily ceases, and a brespiration takes place, associated in the non-affected portionsthe lungs with a more or less increased vesicular respiration corsponding perhaps with the necessary increase of the respiratoryefforts in these portions. In the same manner as the air in thebronchia, when reaching the ear through the pulmonary parenchyma, sounds more loudly, so does the sound of the voice giverise to intense bronchophony and pectoriloquy, while the voicegreatly increases the vibrations of the thorax. The resolution ofpneumonia is indicated by rfiles. In the cells they are necessarivery fine, and on this account are sometimes described as crepitation, and sometimes are veiled by co-existing coarse rales in thebronchia. They often continue for a long time.This most simple couree of pneumonia is often modified by varioustrifling deviations which are of importance to a homoeopathic physician and the more frequent of which we will now proceed topoint out.In the case of children, the invasion of the disease is often marby convulsions, such as may occur in other acute affections ^ incase of adults, spasmodic symptoms are seldom witnessed. A verysevere intestinal catarrh sometimes constitutes the stage of invaIn such a case the vomiting only lasts until the infiltration ispleted, whereas the diarrhoea often continues throughout the wholcourse of the disease. In the case of children, as well as of oldpeople, very seldom in the case of adults, pneumonia throughout iwhole course is sometimes accompanied by such prominent cerebralsymptoms that a physical exploration alone is capable of establising the diagnosis upon a perfectly reliable basis , for even thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 217 of 653in such cases is often wanting. These cerebral derangements aresaid to accompany the inflammation of an upper lobe much morefrequently than those of a lower lobe. The patients sometimesremain unconscious during the whole course of the disease, whichneed not run a prolonged course on this account. Cerebral derangements of a lighter grade, a light delirium, mostly of a merry natsleeplessness or sopor, are very common occurrences. These happenmost frequently in the case of drunkards. The tongue does not exhibit any regularly-occurring changes , at times it is quite cleasometimes very much coated, at times humid, at other times quitePneumonia, 251dry. The last-mentioned appearance is not very promising, it isespecially ominous if the balance of the symptoms impart to theaftectiou a dubious character. The appearance of a slight icterusafter the completion of the infiltration is very common, nor is iany particular importance; but if icterus sets in together withsymptoms of gastro-intestinal catarrh, it always indicates an unwelcome complication which threatens to delay the course of thedisease. As a rule the skin remains pretty dry during the wholecourse of the disease; profuse or exhausting sweats occur much lefrequently.The symptoms specially appertaining to the lungs, vary considerably. The cough which is usually not very violent and occurs insingle short turns, may assume a spasmodic character when, onaccount of the increase of pain, it becomes a source of great disto the patient. It rarely is entirely wanting, or is quite dry. Iparticularly old people who sometimes do not cough at all. The frquency of the respirations is sometimes but inconsiderably increaand it is the insufficient depth of the inspirations that revealscharacter of the disease. The pain varies more than any othersymptom; in the case of old people it is generally very slight; itheir case the admixture of blood in the sputa is generally missiIn the case of young and vigorous individuals the resolution ofthe infiltration generally takes place very rapidly, sometimes insingle day, but it may likewise be more protracted, without on thaccount a transition into the stage of gray hepatization havingnecessarily taken place. Thus we find that the fever decreases onthe ninth day and that the patient generally feels a little bettebut there is no sudden decrease of all the abnormal phenomena, noimmediate, but a scarcely perceptible, dragging commencement ofconvalescence. We seldom notice this condition of thmgs m thecase of robust men ; it occurs quite easily among weakly personsand after an exhausting method of treatment. Sometimes, afterconvalescence has begun, an exacerbation with progressing infiltrtion sets in, in which case the fever is very apt to assume anasthenic character and the appearance of typhus, yet the courseof the disease need not necessarily be very much protracted orunfavorable. But almost without an exception, important complications exist in such cases; such a form of pneumonia is very seldom the result of epidemic influences, but most generally of anexhausting treatment. Among the complications we notice moreparticularly pleuritis, bronchitis, peri- and endocarditis, all owithout an exception, exert a disturbing influence over pneumoi:'http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 218 of 653252Diseases of the Lungs.Experience has shown that the seat of pneumonia is of greatimportance as regards the probability of a normal termination. Asa rule pneumonia of the right side is much more favorable thanthat of the left, pneumonia of a lower lobe lighter than that ofupper one, which is apt not to terminate in resolution and to assa tubercular form. Inflammations of the left upper lobe are especially obstinate and deviating from the normal course; they occurthe least frequently.The deviations of the infiltration are very essential, since thedeviations in the course of the disease are mostly founded upon tformer. One of the most common deviations is the tardy resolutionof the infiltration. It occurs rarely in uncomplicated forms ofpneumonia, but is a very common event if carditis supervenesduring pneumonia. In such cases the deficient energy of the circulation seems to constitute the sole obstacle, for a purulent metamorphosis is not necessary to lead to such a result. We shall refto this afterwards in treating of chronic pneumonia. No resolution of the infiltration need take place even for years ; in onethat of an apparently healthy man we discovered after a numbciof years over one or two pulmonaiy lobes, especially at their posterior border, marked bronchial respiration and a perfectly emptypercussion-sound. Or else the infiltration may remain in some portions of the lungs, disappearing entirely everywhere else, and thpatient may enjoy perfect health. If the infiltration remains, buchanges to a tubercular deposition, the phenomena of the diseasechange entirely. We not only meet with this change in individualswho had been previously affected with tubercles, but likewise inindividuals of whom we positively know that up to the time whenthey were attacked with pneumonia, they had enjoyed perfecthealth. On the critical days the fever indeed decreases, but someof it remains, and the patients are not able to recover their stror only slowly and imperfectly. There remain a dry and hackingcough and an imperfect fulness of the respiration, and sooner orlater the symptoms of tubercular phthisis supervene, which in suca case usually runs a very rapid course. We should not, however,in every case of tardy reabsorption, infer a tubercular metamorphosis and express a prognosis corresponding with such a change.often takes months before such a metamorphosis can be diagnosedwith perfect certainty.The most important, most frequent and at the same time mostdangerous change of the infiltration is the transition into the sof gray hepatization or purulent metamorphosis. It must aH^^avP4«http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 219 of 653Pneumonia. 253be apprehended if pneumonia eontinuefl beyond the ninth day withconsiderable febrile motions, and, unless we examine the symptomsvery accurately, a progression of the pneumonia alone may deceiveus for a short time. Upon the accession of this purulent metamorphosis the fever always assumes a marked adynamic character, andthe process henceforward bears a striking resemblance to typhus.The fever increases very considerably, the number of pulsationsfrequently exceeds that of 120 beats which is the normal numberfor adults in a case of pneumonia, and at the same time becomessmall and feeble, Not unfrequently the burning heat is mingledwith short chills. The tongue which, even in a violent case ofpneumonia, seldom becomes dry previous to the stage of purulentmetamorphosis, resembles the tongue in typhus, and the supervention of delirium makes the resemblance to typhus still more striking, so that on first seeing the patient an error in diagnosis iseasy, especially if diarrhoea is present. It is only the physicalexploration of the chest, together with the previous history of tdisease that affords certainty in such a case. Percussion does noyield exclusively an empty, but likewise a tympanitic sound. Auscultation reveals beside bronchial respiration, more or less extesive, consonant rales. The air passes through a fluid,but the gencondition of the patient shows that no process of reabsorption isgoing on ; this is likewise evidenced by the expectoration whichis at times pure pus, at other times mixed with blood and has ofta very offensive odor. If the pathological process takes this turlife is always in great danger. Recovery always takes place veryslowly, with frequent variations between worse and better days,and is frequently protracted for months. Death sometimes takesplace already in the second week and at other times at a muchlater period. It sometimes sets in quite suddenly, while oedema othe lungs is supervening, and sometimes slowly in consequence ofgeneral exhaustion associated with the formation of abscess organgrene, neithe: o( which, however, can be diagnosed with reliable certainty during the lifetime of the patient; for foul sputaare no sure indication of gangrene, and an abscess cannot be recognized with positive certainty until it begins to discharge andpatient raises a quantity of purdlent matter.Another, not less important, but much lees frequent form of theexudation-metamorphosis is chronic pneumonia. That a chronic,non-tubercular process of infiltration can take place in the lungcannot well be doubted; but it is a rare occurrence, and a reliab254 Diseases of the Lungs.diagnosis cannot often be established in such cases. Hence, in thplace, we simply speak of chronic pneumonia resulting Ironi auacute attack. It exhibits essentially all the so-called metamorjiof pneumonic infiltration, except in a less acute form, and, on taccount, with less immediate danger to the nrescrvation of theorganism. Either we notice a,, simple infiltration at some particspot, which had remained after an acute attack and which eitherdoes not affect the organism or else keeps it in a long-http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 220 of 653of debility, with disposition to a renewal of an attack of acuteinfiltration. Most likely it is owing to these remnants of nonabsorbed exudation, that individuals who have had one attack ofpneumonia, are so often liable to being attacked a second time. Oelse only part of the infiltration remains consolidated ; in oneseveral portions of the lungs we hear bronchial respiration; at tsame time another portion of the infiltration undergoes the pirocof resolution, and cough with purulent expectoration sets in, inconsequence of which the general organism necessarily 8ufl^*er8.Although fever is not always present, yet it is rarely ever absenin which case it has more or less the character of hectic fever;hence the patient has a sick, yellow-gray appearance, and veryspeedily shows signs of considerable emaciation. If the exudationdissolves, and the pulmonary parenchyma is involved in this proceof disorganization, an abscess forms distinguished from the abovementioned abscess by nothing but the slowness of its course, loryears sometimes pass away before the abscess finds an outlet throthe bronchia. Several abscesses may form, but such a thing is notoften the case. Where several abscesses form, the tendency to gangrene and ichorous dissolution is very commonly present. But theorganism need not necessarily show severe signs of sympatheticsuftering either from the presence of an abscess or that of gangrThe patients look like tuberculous individuals in whose case thepathological process makes slow progress. They are not robust,but without fever, and emaciate very slowly. At various intervalswhich sometimes last for months, some fever generally sets in, thpatients are attacked by great prostration, they have to lie downand after this condition which is most easily brought about by aslight catarrh, has lasted for a short time, they suddenly dischaafter coughing and gagging an enormous quantity of foul, badlycolored pus succeeded for a few days by a moderate expectorationthat has likewise a very foul odor. At the same time the exhaustion continues to increase until the pus has been completely evacPneumonia. V v 255/ '_ated, after which the strength returns very rapidly, hnfi^ot to tsame degree as before the breaking of the abscoS^ A cu're is possible, if the suppurating portion of the lungs is h^to& large* c^the strength is not too much reduced. Death either t^kes'^la(f^i^consequence of hectic fever or of the supervention of s^me '^cut^process. Finally we must mention a termination of pirefljudKiia \which is of rare occurrence and exceedingly troublesome, we meanthe evacuation of the pus through the walls of the thorax, 'tjiishas occurred twice in our practice. The patients were young men,and the right lower lobe was inflamed. Although the profuse suppuration at first occasioned great exhaustion, yet both were completely restored.Having said all we intended concerning croupous pneumonia, wewill now add a few remarks concerning interstitial and catarrhalpneumonia.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 221 of 653Catarrhal pneumonia is scarcely ever a primary disease, butgenerally arises in consequence of the inflammatory process spreaing from the bronchia to the pulmonary cells. It is almost withouaa exception confined to single lobules, and on this account thename of lobular pneumonia has been given to it. There may bemanj' such scattered centres of inflammation, without the percussion-sound being altered in consequence; nor do they occasionbronchial respiration, so that it is scarcely possible to diagnoswith positive certainty. All we know is that capillary bronchitisis very apt to superinduce lobular pneumonia. Like capillarybronchitis, this form of pneumonia is preeminently a disease ofinfancy, and it has to be treated in the same manner as the worstkinds of bronchitis. Interstitial pneumonia is of no particularimportance to us, because it does not require any special treatmeon the other hand it is of importance with respect to prognosis aas regards the diagnosis of other affections to which it resembleIt is always a secondary complication. The process is quite likethe process in cirrhosis of the liver, on which account it has betermed cirrhosis of the lungs. An exudation takes place into theconnective tissue of the lungs; this exudation first changes to cnective tissue and afterwards to cicatrizing, shrivelling firm tiby which the air-cells become compressed, and a condition ariseswhich is designated as induration of the lungs. Since this procesmay likewise set in as a consequence of croupous pneumonia, interstitial pneumonia is likewise a special form of the so-called chrpneumonia. Its most important result is atrophy of the pulmonary256 Diseases of the Lungs.tissue with caving in of the thorax and the development of sacculated bronchiectasia in consequence of which chronic bronchialcatarrh assumes such a peculiar form.Inasmuch as in pneumonia the prognosis depends more evidentlythan in any other disease upon the treatment that happens to bepursued, we have assigned to it a place in the section on the thepeutics of pneumonia.Treatment. We have already stated at the commencement ofthis chapter that the treatment of pneumonia is well calculated tshow the advantages of Homoeopathy over other methods ; henceit behooves us to devote some attention to the modes of treatmentadopted by other Schools.In the first place we have to consider the expectant method whichHomoeopathy has in truth created ; for it is the success of homoepathic treatment which could not well be denied, although homoeopathic doses were supposed to be equivalent to nothing, that emboened the partisans of active treatment to try the treatment of dieases without any violent interference. We confess to our inabilito comprehend a purely expectant treatment of pneumonia, for noconscientious physician will stand by quietly in a case of pneumoand allow the disease to run its course from beginning to end witdoing something for his patient. This may do in cases of simplepneumonia, if the patients are otherwise endowed with soundhealth, and the disease runs a perfectly normal course; but whatto be done in regard to the more or less threatening deviations fhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 222 of 653the normal course? Will the physician remain idle? We do notbelieve it. But if we take the expectant method in a less rigorousense of the term ; if we allow the use of some mild adjuvants, tstatistical tables of this method become at once vitiated. We admhowever, that this method of treatment leads to much more favorable results than tht. usual treatment with sanguineous depletionand a mass of powerful remedial agents.The medicinal treatment of pneumonia is effected by means of alegion of remedies, which every physician admits are not so muchgiven for the pneumonia, but for the inflammatory fever, or forsingle symptoms. The only remedy which years ago was used as aspecific for pneumonia, is Tartar emetic. The use of this remedyas a specific has, however, been abandoned, for the reason that iwas found impossible to determine the kind of pneumonia to whichit was specifically adapted instead of using it indiscriminatelyall kinds. Every homoeopath is able to explain how it happenedPneumonia. 2R7that Tartar emetic tftected a cure in some cases of pneumonia, anproved a specific remedy even in whole e^ idemics, and yet left tphysician in the lurch in so many other cases. The use of thisdrug in large doses has only yielded unfavorable results in respeto the whole duration of the disease. The other medicines in voguare almost exclusively given for single symptoms of the wholegroup. Such medicines are mostly used as are supposed to have adepressing influence over the fever, such as Digitalis, Quinine,trine, etc.. We do not mean to say one word against these remedies, for we are well aware that under certain circumstances eachone of them has its value as a remedy for pneumonia. But we cannot help giving utterance in a few words to our doubts regardingthe propriety of prescribing these remedies for the fever in pneunia. Fever in any disease is the manifestation of a reaction on tpart of the general organism against a disturbance set up in itsinterior. Hence, fever is no disease of itself, although it is asary attribute of many diseases. At all events, pneumonia remainswhat it is, even if no fever should supervene. Hence, even if itwere possible to combat the fever, in combating this fever we wounot combat the disease. We even go so far as to maintain that, ifthe fever could be removed without the disease being acted uponat the same time, the treatment is sometimes without effect, andusually hurtful and never of any use. For after the organic reaction has been depressed or even suspended, the morbid disturbanceis either prolonged or does not disappear at all. In suppressingfever, the natural curative agent would likewise become inoperative. It is different if Digitalis is given in prder to diminishimpulse of the heart and depress the heart's action, and by thismeans to lessen the pressure in the pulmonary vessels. But in suca case Digitalis should only be given at the beginning of pulmonahypenemia, or might at most still be continued at the commencement of hepatization, which, however, is not done. In order toobtain a normal process of reabsorption, an undiminished actionof the heart is indispensable ; its decrease may afford momentaryrelief to the patient, but cannot act favorably. Such an exhibitiof palliatives may not always be hurtful and may not interfere withe course of the disease: it is certain, however, that this kindtreatment cannot be made the foundation for a true system of therhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 223 of 653apeutics in pneumonia.A somewhat complete review of the common treatment of pneumonia would oblige us to exhibit the whole of the so-called anti17258 Diseases of the Lungs.phlogistic apparatus, from Calomel to the xrco&t harmless neutralsalt. Inasmuch as the use of these drugs is based upon the sameidea, they can be dispatched with the same arguments. A generalantiphlogistic treatment is just as absurd as the exhibition of Qnine for the fever in pneumonia; the real disease is not met. Itnot such a difficult thing to depress the organism by the copioususe of cathartics and other remedies until an active reactionbecomes impossible; of course, the theory has been complied with,the inflammatory fever is gone, but an adynamic fever has takenits place ; and even if this is not the case, there is scarcely adoubt that the conquest of the local disease will not take placemore rapidly.At one time Chloroform-inhalations made a great noise, but seemto have been abandoned by modern practitioners. Todd's methodof prescribing spirits, is nearly related to these inhalations. Hhappens it that Englishmen have not long ago stoned this destroyeof all faith in antiphlogistic treatment!A proof how much pneumonia can endure without undergoingany essential modifications in its course, is cold-water treatmenEven Niemeyer is favorable to this method of treatment, but he isutterly unable to give any reasons for it ; his only argument isit helps. FFom a physiological stand-point we should reason in thwise: The wet bandage, frequently repeated, diminishes the amountof blood in the cutaneous vessels, hence superinduces in the inteof the organism a sort of engorgement, and at the same time actsas a stimulant, for it is followed by an increase of reaction; hocan such an agent be said to act as a curative in a case of pneumonia? We consider this mode of reasoning correct.Pneumonia being attended with pain. Opium has been made useof very liberally ; this is all that can be claimed in its favor.In conclusion we have to consider the chief remedy, we meanblood-letting. It constitutes the apple of discord in modern medicine, and because homoeopathic practitioners have discarded it, ein pneumonia, they have been called murderers. How much hasbeen said and printed on the subject of pneumonia, both pro andcon^ more especially after a physician had dared to treat a pneumonic patient without bleeding, in spite of which he obtainedwonderfully favorable results. This change in the treatment ofpneumonia would have caused less astonishment if physicians hadpaid some attention to Homoeopathy during the last fifty years.Formerly pneumonia and blood-letting were as intimately unitedPneumonia. 259http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 224 of 653as the arm and hand. This is very different at the present time,and since we only deal with the present, we shall content ourselvwith considering the modern developments of this question. "Wunderlich and Niemeyer are sufficiently authoritative to permit uspresent their views as the ruling opinions of their Schools.Niemeyer gives three indications for a course of general depletion. First' Appearance of the pneumonia in a vigorous, healthy,young man, the temperature being over 92 ° Fahr., and the pulseover 120 beats. — Second: Collateral hypereemia of the uninflamedportions of the lungs. — ^Third : Symptoms of pressure on the braaccompanying the pneumonia. Wunderlich gives the same indica*tions, except that he adds to number one, that the patient shouldbe bled on the first and second, or on the fourth and fifth day,on the third, rarely afte;* the fifth unless hypersemia should stexist. The effect of bleeding, according to Wunderlich, is as follows, Niemeyer not attributing to bleeding a positive influence opneumonia, but only a general influence or an influence over particular symptoms.In the first place, venesection is said to shorten the course ofdisease and to achieve the termination in recovery more rapidlyand more completely. We ask any physician who has ever watchedthe course of pneumonia treated with blood-letting, whether thistrue. We admit that immediately after the bleeding the feverabates quite considerably; but in twenty-four hours already thefever returns even worse than before. Every homoeopath knowsthat pneumonic patients who are treated with blood-letting, evenin accordance with the above indications, seldom finish their convalescence in a few days, but remain weak for several weeks. Evenif we admit that Wunderlich's favorable prognosis is sometimesrealized, yet, supported by our own experience, we cannot helpaffirming that the favorable change more frequently disappointsthan meets our expectations, and that it is very often illusory.Secondly, venesection affords the patient a sensation of relief.This is not always the case, but it is so commonly ; but we wouldwhether a mere sensation of the patient is more important than thregard for the general course of the- disease, and whether the phsician is not perpetrating a piece of quackery if he resorts to bing as a means to impress the patient with his power, when hemust be well aware that the effect of this remedy passes away infew hours, and the patient feels necessarily more exhausted thanbefore.260 Diseases of the Lungs.Thirdly, the pulse decreases in frequency after bleeding; this cabe accounted for, but it is not true that the former frequency donot return. It does return, but the quality of the pulse is alterthe pulse is feebler than it was.Fourthly, the temperature declines, but the same thing happensas with the pulse. This mania of depressing the chief febrile symtoms, has been commented upon by us in our review of the remedies that are used for such a purpose ; we need not repeat our crcism in this place.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 225 of 653Fifthly, venesection moderates the dyspnoea and thus preventsacute emphysema. That this is not the case, can be affirmed byevery homoeopath ; acute emphysema is a very rare occurrence inpneumonia and, if it does occur, it must have been the result ofimproper treatment.Sixthly, venesection, by moderating the pulse and the temperatureprevents nervous exhaustion and acute consumption. How this isto be brought about, is an enigma which physiology does not solveNor does Wunderlich account any more explicitly for the possibility of such a process.A few other points seem to us too unimportant to be mentionedhere in detail; we shall interpolate them in our subsequent remarks.Against the above-enumerated statements we will add to ourprevious remarks the following counter-propositions.It is rather hazardous to declare an individual to whom we arecalled as a physician, positively robust and healthy up to the tiwhen we are called. Every physician must have been deceived inthis respect, and deceptions of this kind, if occurring in pneumocannot lead to pleasant results. There are individuals who are vethin and pale and yet enjoy the most perfect health ; on the othehand, we see weak persons who apparently look stout and florid.By what exact diagnostic signs are individuals suitable for the findication, characterized ?Again we generally notice that robust men seldom have a pulseof over 120 beats, whereas such a pulse is very commonly met within the case of weak persons. Why should not the latter be equallyfavorably affected by venesection? Have they a relatively lessquantity of blood ? The answer is that they do not bear venesection as well as robust persons who can bear a few venesections inpneumonia without any great disadvantage, whereas weakly persons cannot bear them. Where is the boundary, and how do thosePneumonia. 261fare who occupy the line and in whose case we do not know whetherthey belong to one class or the other ?Blood is only to be taken fFom robust individuals. Since bloodletting is reputed one of the most powerful remedial agents, thisphrase must be intended to mean that the pneumonia of robustmen is much more dangerous than that of weakly persons, or thatrobust individuals find it more difficult to conquer the diseasethe amount of strength on hand. This mode of reasoning is certainly not logical. The reaction of a robust man must naturally bmore energetic and prompt than that of a person weakened by exposure, and that the strength of a vigorous person is capable ofbearing a great deal more than that of a debilitated individual.Why should the more intense fever of vigorous persons entail moredanger? We are at a loss to understand the anxiety caused by thepresence of febrile symptoms ; we admit, however, that the qualitof the pulse is an excellent index of present danger, but not thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 226 of 653number of the beats, or at least only to some extent.Every homoeopath can testify that collateral hypersemia in pneumonia does not very frequently occur in a threatening form. If itexists, its intensity may be diminished by venesection; but thiswould be followed by the bad consequences to inflammation thatwill soon be enumerated. In such a case the question still is, whpathological process is worse, the hyperaemia which is a transitocondition, or the pneumonia which is liable to such unfavorableterminations. If, as is often the case, hyperaemia sets in aftervenesection, it is very questionable whether the venesection is nin a great measure the cause.The phenomena of cerebral hyperemia are, at all events, theworst indication. They may be very marked and persistent, butthey do not imply the presence of danger, and still less frequentof so great a danger that it has to be met by such an energeticremedy as blood-letting.Let no one imagine that our views on blood-letting which are sodirectly antagonistic to those of other physicians, are mere vaguassertions. No true homoeopath will ever bleed either in pneumonior in any other disease ; hence only a homoeopath is able to judgwhat course pneumonia takes with or without bleeding.In the case of vigorous individuals, the course of pneumonia frequently remains unaffected by mild blood-letting, but full convalcence is always retarded by it. To many vigorous individuals, andthe less vigorous the more so, venesection is decidedly injurious262 Diseases of the Lungs.and superinduces one or the other unpleasant consequences thatwill be enumerated by and by. Niemeyer accounts for the rapidsinking of strength by the anaemic condition which is occasionedby a profuse exudation associated with an increase of waste by thfever, and a diminution of the supply ; it is his opinion that mopatients succumb to this acute marasmus. If this be so, nobodycan comprehend how a sanguineous depletion and consequent increase of the loss of animal fluids can act favorably, and everymust see that the necessity of first repairing the waste, delayscomplete restoration of strength.The apparently or momentarily favorable effecta of bloodscarcely ever last longer than twenty-four hours^ and are very frquently succeeded by the transition of the fever to the adynamicform, or by an increase of the symptoms ; the French method ofexcessive venesections has occasioned these results.The exudation is never arrested by venesection, much less cutshort or entirely prevented, but the possibility of oedema of thelungs is considerably aggravated by it. This results from thecircumstance that the inflammatory exudation and the loss of bloodiminish quite considerably the plastic portions of the blood, anthat hence the blood contains much more serum and becomes muchmore disposed to serous exudations.The resolution of the exudation is delayed, or is incomplete, orhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 227 of 653else it takes place by purulent dissolution, or not at all. K Wunderlich lays so much stress upon a diminution of the fever, thatto say of the pulse and temperature, we admit that a decrease ofthe fever on the critical days implies a disappearance of the locprocesses. Nevertheless it is not unfrequently the case that thedation remains in spite of the defervescence ; we have abundantevidence of such a fact. In such a case the re-absorption goes onslowly and uniformly, or else by fits and starts ; but the patienscarcely ever recover their health very rapidly, but they remaina long time feeble, although without fever. This result has onlyoccurred to us after sanguineous depletions or, which deserves p>ticular notice, after complications with inflammatory affectionsthe heart. The same remark applies to cases where remnants ofexudation are left behind, not including the cases of tuberculousindividuals in whom it is difficult to decide whether we have remnants of exudation or tubercles before us. The setting in of grayhepatization, the purulent dissolution of the exudation may sometimes be owing to peculiar constitutional or external atmosphericPneumonia. 263circumstances ; indeed pus may form as the result of any inflammation ; in such eases it is not likely that blood will ever be dexcept perhaps in a case of pneumonia that runs its course underatmospheric influences and when one of the above-mentioned indications may indeed come into play. But if we mean the primary,uncomplicated pneumonias of persons who had hitherto enjoyed avigorous and sound constitution, no pus will ever show itself unda strictly homoeopathic treatment, but not very unfrequently aftea debilitating, more especially after a depleting treatment. In vof the observation that the pneumonic exudation can be rein a few hours under favorable circumstances, and seldom requiresmore than a few days for such a purpose, we must suppose thatevery reduction of the patient's strength, more especially by sanguineous depletions, causes a decrease of the reactive energy, cosequently a diminution of the reactive exudation required for thebusiness of re-absorption, and hence again a misdirection of theorganic activity in the removal of the exuded fibrin. A proof forthe assertions here made is furnished by the pneumonias that areassociated with severe intestinal catarrh, in whose case the resotion takes place more or less abnormally. We account for thisphenomenon simply by the excessive loss of animal fluids, on whicaccount we consider the systematic use of purgatives in pneumoniaas hurtful as bleeding. The tubercular metamorphosis of the exudefibrin, if the patients were otherwise free from tubercles, has tattributed to treatment. It is well known that tubercles andansemia are closely related to each other, hence it is not ditHcusuppose that an artificially excited ansemia may favor the formation of tubercles. All the cases known to us, where the j)neumoniexudation had this termination, had all been treated with bloodletting.These remarks show that chronic pneumonia is very commonlya consequence of debilitating treatment. We again call attentionto the fact that carditis as a complication of pneumonia is apt tocca«ii)n a malignant metamorphosis of the exudation. In sucha case it is not so much the perverse quality of the blood, whoseinfluence we are, however, not disposed to deny, but the diminislhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 228 of 653energy of the circulation that exerts a disturbing effect upon thcourse of pneumonia. This is an additional proof how unphysiological is the theory of depressing the pulse in pneumonia.The observation that individuals who have had one attack ofpneumonia, are easily liable to a renewed attack, will scarcely i264Diseases of the Lungs.be made by a Qomoeopathic physician. If such freqT:^nt recurrences of pneumonia^, are witnessed even under homoeopathic treatnieut, the former attacks had always been treated with depletionswe account forthissusceptibility most naturally by the circumstanthat the exudation had not been completely absorbed.After this excursion into the therapeutic domain of the OldSchool, the length of which we beg the reader to excuse on accounof the importance of the subject, we now enter uf)Ou a consideratof the prognosis of pneumonia. We might on this occasion availourselves of the existing statistics, if they were not calculatedmislead, and, on the side of Homoeopathy, not sufficiently numeroOn this account we confine ourselves to short statements; if anyone should feel disposed to doubt their corre(;tnes8, we advise hbefore pronouncing judgment, to first treat a few dozen cas^^s ofpneumonia homoeopathically. An uncomplicated pneumonia, nomatter whether the patient is robust or weakly, always terminatesin recovery under homoeopathic treatment, at the same time as anabnormal dispersion or alteration of the infiltration occurs veryseldom. We can substantiate the correctness of this statement byupwards of two hundred and fifty cases of pneumonia from ourown practice and that of other physicians. Accordingly pneumoniais one of the least dangerous diseases to a homoeopathic physiciaOn the contrary, Wunderlich calls it one of the most frequent andmost dangerous diseases that can befal man ; in saying this he donot quote figures, but must have been lead by numerous deaths tomake such a statement. Among the complications, carditis,intestinal catarrh, bronchitis and tuberculosis promise the leastchances of a successful treatment. We have shown above why thefirst two complications present such ominous difficulties, althoueven in such cases we have never had to deplore a single loss.Bronchitis is dangerous on account of the dyspnoea being extremelaggravated by this complication; and a co-existing tuberculosisbecomes dangerous on account of the probability of the metamorphosis of the exuded fibrin into tubercles, or of the hastening osuppuration of existing tubercular depositions. Whether the seatof the inflammation exerts a peculiar influence during the presenthese complications, is not quite certain, but we may take it forgranted that an inflammation of the apices, which are the mostcommon locality of tubercular depositions, terminates in suppuratmuch sooner than an inflammation of any of the other lobes. It isfrequently inconceivable why the pneumonic process should leavehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 229 of 653Pneumonia. 265tabercles intact, whereas in other cases it leads directly to phtWe are almost without any data for a correct interpretation of thdifferences, and for this reason alone complicated pneumonias ofnature should be strictly excluded from all statistical tables. "shall have to revert to this subject when speaking of pulmonarytuberculosis. Whenever pneumonia meets with morbid conditionsin the respiratory organs, its course generally deviates from thenormal line, and its process is much more destructive. This remarapplies principally to pulmonary emphysema, to stenosis of thelarynx, to chronic heart-disease, especially of the right heart.more these or any other affections aggravated the breathing beforthe supervention of pneumonia, the more dangerous they becometo life on account of the existing dyspnoea. As regards constitutional conditions not of a morbid kind, old age and pregnancy areof particular significance with regard to the prognosis. Old peopare often troubled with chronic catarrh and emphysema, to thepresence of which the danger in pneumonia is principally to beattributed. For all that, we ought not to despair too soon ; we cpoint to three old men between the years of seventy-eight andeighty-three, all of whom had chronic catarrh, and whom we curedof pneumonia after a somewhat protracted, but otherwise entirelyfavorable treatment. Pregnancy is exceedingly dangerous, themore so#the more advanced it is. Whether the danger is owing tothe obstructions in the respiration occasioned by the distendedabdomen, or likewise to the altered composition of the blood, weare unable to decide. If a miscarriage takes place, which is notunfrequently the case, death is almost unavoidable, on account ofthe excessive exhaustion. Such cases likewise afford a strikingpicture of the effects of venesection, for it is evident what a drious effect the loss of blood exerts upon the parturient woman,whereas parturition ought to diminish the dyspnoea and consequently lessen the danger. In order to meet objections, we willstate that we do not overlook the occurrence of two importantprocesses going on in the organism simultaneously with pneumoniaand that it is to these double functions that we attribute in a gmeasure the fatal termination.Our opinion of the success of homoeopathic treatment in complicated cases of pneumonia is to the effect that it is most commonland preeminently favorable, especially when contrasted with othermethods of treatment. We do not even except tubercular pneumonia. Thus we are able to assert without extravagance that266 Diseases of the Lungs.pneumonia does not appear a very dangerous disease to a homoeopathie physician, and that the disease may be considered comparatively devoid of danger, if we consider what an important organthe lungs are, and how intensely they are affected by an inflammation.We pursue the same course on this occasion that we have pursuedin regard to all other important pathological processes, and prema list of the most important remedies.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 230 of 653Aconitum. All homoeopaths admit the excellence of this remedyin pneumonia; their views only differ as regards the boundaries oits appropriate sphere of action in this disease. 'We cannot examthese views any further, since this would lead us too far. Forparticular information on this subject we refer to Miiller's essapneumonia in the first volume of the Vierteljahrsschrift. According to Miiller's arrangement, the following are the most prominenAconite-symptoms in pneumonia: Intense fever preceded by a chill,with burning heat and dryness of the skin, quick and hard. pulseand a deep, sometimes bluish redness of the face; accelerated,labored, incomplete respiration with restlessness, anxiety and patation of the heart ; stitches in the chest during a deep inspiraand during motion, or dull pressure and weight on the chest, dryand racking cough, with a small quantity of a tenacious, slimy,blood-streaked or rusty expectoration; recumbent postureback; dullness and pain in the head; great thirst; scanty and redurine ; evening exacerbation of the symptoms. The thorax is lessmovable, it is less depressed during an expiration; in otherrespects we have the physical signs that have been indicated forfirst stage. By comparing toxicological post-mortem phenomenawith these symptoms, we shall be able to determine the period upto which Aconite is suitable in pneumonia, with much more precision. Both in Miiller's cases of poisoning by Aconite as well ain the cases, whether acute or chronic, which we ourselves havecollected in the last ten years, the lungs were in every instancefound engorged with blood, but in no case was a trace of croupousexudation to be seen. Although we do not expect that in ourphysiological experiments a drug that is said to be a specific rewill reproduce all the objective signs of the corresponding pathological series, yet the constancy with which a simple engorgementoccurs as a post-mortem symptom of Aconite-poisoning, is remarkable. Experience has moreover satisfied us that this condition isthe true therapeutic sphere of action for this agent. When speakPneumonia. 267ing of pulmonary hypersemia, we stated that in active pnimonaiycongestions Aconite is the leading remedy. In pneumonia the stageof red hepatization implies a most perfect hyperaemia ; hence weconsider Aconite best adapted to this stage where its specific cutive virtues have been exquisitely confirmed by a multitude of thmost favorable practical observations. On this account we do not,however, consider Aconite indicated in every case of pneumoniaunless all the other symptoms correspond. Among these symptomswe distinguish more particularly the following: The disease attacindividuals with an active circulation; it is caused by a cold;according to many, by exposure to a dry, cold wind; it attacksrobust individuals up to the age of sixty to seventy years, lessquently beyond this period where the characteristics of old agebegin to creep along; there are no directly antagonizing complications, among which we number more especially an intense intestinacatarrh. Aconite alone will scarcely ever cure pneumonia, muchless cut it short. On this account its importance in pneumoniashould not be underrated. No one who has watched the strikingefiects of Aconite, will ever doubt its great virtues in this disAconite diminishes the vascular excitement and reduces the pulmonary hypersemia more brilliantly than the most copious bleeding;http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 231 of 653Moreover it diminishes the exi;idation to some extent and promotein a corresponding ratio the favorable course of the disease. Thifavorable change which affords such great relief to the patient,in within twenty-four hours in almost every case. But as soon asthe percussion-sound over the inflamed portion of the lungs becomempty, as soon as the breathing becomes bronchial, Aconite in ouropinion, which is shared by many, ceases to be indicated. Thereare, however, exceptions to this general statement. We stated inprevious paragraph that an excessive, collateral hyperajmia is onof the most common indications for venesection. This indicationis specific for Aconite. If the exudation is completed ; if the dpnoea remains nevertheless considerable and out of proportion tosize of the inflamed portion of the lungs ; if the sputa are thinfrothy and tinged with a bright-red blood. Aconite is decidedlyappropriate and, even if it leaves the infiltration unchanged, rethe extreme distress of breathing speedily and surely. Aconite islikewise indicated, if the pneumonia progresses by fits and startwhich is very seldom the case under homoeopathic treatment.According to our previous remarks. Aconite will very often beindicated in the subsequent course of the disease, if it had been268 Diseases of the Lungs.treated in the first place with the antiphlogistic apparatus of tOld School. In tubercular pneumonia Aconite has an admirableeffect at the commencement of the treatment, the same as in thepneumonia of otherwise perfectly sound individuals.Belladonna is, in our^ opinion, improperly commended in pneumonia. Toxicological appearances only show a more or less considerable engorgement of the lungs with dark blood. The pathogenesis of Belladonna does not point very strikingly to an inflammatory process in the pulmonary parenchyma, and, in a case ofcroupous pneumonia, we should find it very diflicult to select Bedonna in accordance with its physiological symptoms. On the otherhand certain anomalies in the symptomatic appearances of thedisease point so unmistakably to Belladonna that no one who isacquainted with the pathogenesis of this drug, can hesitate toprescribe it. These anomalies refer principally to the manner inwhich other organs have become involved in the pathologicalprocess ; it is more especially the cerebral hy persBmia that poiBelladonna. Inasmuch as Aconite may likewise be required bythe same series of symptoms, we establish the following distinctions in favor of Belladonna: A dark-red, bloated and hot face,with evident turgescence of the veins: stupefying headache; drowsiness with delirium; sopor; convulsions. In such cases Belladonnis prescribed on account of the danger that threatens the brain,the pneumonia being left unnoticed for the time. Another seriesof cases that are frequently adapted to Belladonna, are the pneumonias arising from or accompanying acute bronchitis. In suchcases Bronchitis is generally much more dangerous than pneumonia, and it is of importance that the former should be attendedto with more particular care. Ifot unfrequently whole epidemicsrun a course of this kind, and they generally show typhoid symptoms from the commencement. In the case of very old peopleBelladonna is usually preferable to Aconite at the outset, likewiin the pneumonias of drunkards. In both kinds the symptomshave generally a typhoid character from the beginning. [Duringhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 232 of 653this first stage of hypersemia, both of the lungs and brain, Veratrum viride is given with great success. It has been found sufficient in hundreds of cases to effect a radical cure of the diseBryonia alba is, like Aconite, indispensable in Pneumonia. Thetoxicological appearances described in the Viennese reprovingsshow that Bryonia is capable of occasioning exudations in thelungs. The pathogenetic symptoms do not furnish one constantlyPneumonia. 269recnrring picture of the disease, but can be made available invarious directions. This is evidenced by the diiFerent views entetained concerning Bryonia, all of which, however, are foundedupon physiological provings. These indicate most commonly anacute pulmonary affection, with violent stitching pains, wherepleuritis is manifestly indicated by a variety of secondary symptoms, on which account the remedy is very warmly recommendedfor pleuro-pneumonia. There are, however, numerous other Symptoms which refer to the pleura much less than to the lungs; and iis upon these symptoms together with the general constitutionalphenomena that the employment of Bryonia in pneumonia isfounded. We find it inexj)edient to enumerate the symptomsreferring to the homoeopathicity of Bryonia in this disease; moreover it is indispensable that such an important remedy should beknown and remembered in its integrality. Nor do we deem itnecessary to comment upon trivial differences of views in the useof this agent, since most of them harmonize in all the main pointAccordingly Bryonia is particularly indicated after the fever hasabated and has no longer a decidedly inflammatory character,whereas the local process has reached its completion and appearsto rest. This is the period when red hepatization is fully develoThe patients have passed through the excitement and constant restlessness of the first stage and are lying in a state of exhaustiobut quietude; or they are in a condition when it is not quite cerwhether the fever may not assume the character of adynamia. Theskin now begins to show some moisture, a valuable indication forBryonia. If Bryonia is given at this period, the inflammationgenerally runs a rapid and favorable course, and the remedy neednot be left off until all the morbid symptoms have disappeared.However, if the resolution of the exudation is too tardy, anddelays, may be, beyond the ninth day ; if symptoms of a purulentdissolution make their apj)earance, Bryonia will be of no furtheruse, even if the symptoms should still indicate this drug. In pnemonia running a normal course, such as we have depicted at thecommencement of this chapter, we have never had occasion to useanother remedy after Bryonia. As regards deviations from thenormal course and from the ordinary symptoms, Bryonia is particularly adapted to cases where the tongue is covered with a thickwhite fur, the stomach is completely inactive and the liver isengorged and somewhat painful. But we have never obtainedany good results with this drug when diarrhoea was present, which270 Diseases of the Lungs.we regard as a positive counter-indication. In addition to thesehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 233 of 653statements we have to direct attention to another indication, wemean pneumonia complicated with bronchitis, for which we recommended Belladonna in a previous paragraph. As we said before,pneumonias of this kind are generally epidemic, with the characteof adynamia and typhoid appearances, without, on that account,taking a decidedly unfavorable turn, and are more particularlydistinguished by the presence of a marked gastric catarrh. InHanover we are just now in the midst of such an epidemic, andwe become every day more and more convinced by experience whata splendid remedy Bryonia is, which has proved such an indispensable resource to the homoeopathic physician in so many other epidemic diseases. If, guided by more recent observations, we haveto deny in opposition to Hartmann, that dry and cold weathercauses the kind of pneumonia to which Bryonia corresponds, wefeel on the other hand bound to give prominence to another ofhis indications, namely the rheumatic and bruising pains in themuscles of the chest and back. In conclusion we wish to state, asevidence of the healing powers of this drug, that we scarcely evenotice under its administration a copious secretion of the sosputa cocta, and that the re-absorption of the infiltration takesplace with very little, or perhaps without any expectoration, or,judging from the stand point of pathology , taking place in its mperfect form.Mercurius is one of those remedies that is much more recommended than employed in pneumonia; we opine that this is anoversight. It is true an uncomplicated pneumonia has scarcely eveindications pointing to Mercurius; but they occur so much morefrequently in complicated oases. We will not endeavor to showthat Mercurius causes inflammation of the lungs in the healthy,and what special symptoms point to pneumonia. This can belearned from the Materia Medica. We are acquainted with onemercurial preparation which, in a case of poisoning, caused a fuldeveloped pneumonia, we mean Mercurius corrosivus^ to which wedesire to call attention, thinking that a similar case may occursome time as a natural disease where this agent may prove curative. If, in addition to the existing physiological symptoms, weconsider the whole manner in which Mercury affects the organism,its recommendation as a remedy for pneumonia seems perfectlyjustified. We cannot, however, agree with Muller, if he assignsMercurius to the more chronic forms of pneumonia after the diaPneumonia. 271ease lias run beyond the properly inflammatory stages. The thirdstage is undoubtedly adapted to Mercurius, but it is not the onlyone. Miiller has the following more special indication for the thstage: The hepathization of a portion of lung continues and thecritical sputa are entirely wanting; the cough is dry, not frequeand very rough and fatiguing, with violent irritation and urgingto cough , the dyspnoea remains unaltered, the fever is rather cotinuous and lentpscent, with profuse and exhausting sweats, theurine is scanty and dim, the color of the skin sallow, grayish ;patient is troubled with gastro-intestinal catarrh. Under these ccumstances Mercurius is indicated so much more, if the disease isseated in a scrofulous, or generally dyscrasic organism. Nor canwe agree with Miiller when he asserts, in contrasting Mercurius aSulphur, that the latter is indicated under similar circumstanceshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 234 of 653Mercurius, if the symptoms are more violent and tumultuous. Wewill afterwards account for our dissenting opinion. There are twoforms of pneumonia where we consider Mercurius as a leadingremedy. One is pneumonia complicated with bronchitis. MuUermentions this form ; we have quoted his statements in our chapteron influenza, page 185. This form of pneumonia is almost alwaysan epidemic disease ; having at this very time had frequent opportunities in this district of testing the curative virtues of Mercin an affection of this kind, we cannot deem a short descriptionour epidemic superfluous. Under the modifying action of a widespread influenza, that is to say of catarrh accompanied by a deepirritation of the nervous system, the nose, larynx and tracheabecome affected with a slight catarrh which seems quite triflingfor a few days; suddenly the fever becomes more violent, the catarhal secretion ceases^ dyspnosa sets in, together with a spasmodigenerally nocturnal cough, without any, or with a yellowblood-streaked expectoration; the pulse is upwards of 120; in theease of a lady of upwards of fifty years, the pulse had 150 beatsit is small, has very little resistance, the skin is burningtimes covered with copious perspiration, the tongue is yellow andvery soon becomes dry, the sensorium is blunted, there is violentheadache, the patient lies in a soporous condition, with light deriam ; he has a great desire for cold drinks, after which the coueasily breaks out again. At the same time the patients do notcomplain of pain, and scarcely ever of pain in the affected side,on ^vhich account a careful exploration is very apt to be neglected* Such an exploration shows extensive hepatization, that272 Diseases of the Lungs.is to say, complete dulness of sound with rales, and attended witbronchial respiration. This condition resembles typhus to suchan extent that we do not wonder at hearing many physiciansassert that influenza has changed to typhus. That this affectionis of a serious character, is apparent from the fact that underallopathic treatment numerous deaths have taken place within afew weeks, and that even young and robust individuals havesuccumbed to the epidemic. We three homoeopaths so far havenot lost a single patient and, without having had any previousunderstanding on the subject, we have all of us commenced thetreatment with Mercurius a« the best and principal remedy. Thesefavorable results have been obtained in an affection which, inopposition to MuUer's statements, is attended with an exceedinglysevere fever. The selection of Mercurius in broncho-pneumoniamay be justified by its admirable action in bronchitis; for it canot be denied that the greatest danger proceeds from this quarterand that, after the removal of the bronchial symptoms, the remaining pneumonia is comparatively insignificant. A third form ofpneumonia, which is particularly adapted to Mercurius, is thecatarrhal form or lobular pneumonia which has an entirely different meaning from the former. As soon as we have reason, in acase of bronchitis, whooping-cough, etc., to suspect the formatioof small foci of exudation, Meruurius will first commend itself tour judgement as a remedial agent, and we shall have before oureyes an image of epidemic influenza, such as has been described ipreceding paragraphs. In tubercular pneumonia we have nevernoticed any good effects from Mercurius. "What mercurial preparation deserves a preference, we do not dare to decide. In thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 235 of 653present epidemic we use Mercurius soluhilis; although we do notobject to the Sublimate by way of experiment, yet Hahnemann'spreparation is so excellent in this disease that one hesitates toperiment with any other drug. As regards dose, we have foundthe third and fourth triturations the most useful ; higher attenutions are of no use whatever.Phosphorus. Fleishmann, of Vienna, the passionate advocate ofPhosphorus in pneumonia, went so far as to assert that a pneumonia which cannot be cured with Phosphorus, cannot be curedhomoBopathically. He has been bitterly assailed for making thisstatement; yet we must admit that the period when Phosphorusought to be administered in pneumonia, can easily be inferred frohis arguments. We understand the case as follows. A simplePneumonia. 273croupous pneumonia in very many cases nins to a favorable termination without any medicine, and, even if not indicated. Phosphorus, when given in a veiy small dose, will not interfere withnormal course of the disease; hut if deviations from the normalcourse take place, Phosphorus will most generally prove the correremedy. We cannot, in this place, discuss the various views concerning this important remedy, and, for particulars, we refer thereader to Sorge's treatise on Phosphorus, where a full expose ofthese views may be found. On the other hand, we cannot altogether share the opinions which Sorge has expressed in his brochure. Supported by at least a hundred and fifty eases of pneumonnot one of which terminated fatally in our hands, we are bound toassign to Phosphorus a much larger sphere of action than Sorgeseems willing to allow. Sorge only allows a therapeutic sphere foPhosphorus corresponding to its physiological action upon thelungs as far as this action has been determined by actual experimentation ; we fancy, however, that this sort of exclusiveness wicompel us to treat many cases of disease without Similia, and itour decided opinion that practical trials, based upon suggestionsderived from the Materia Medica, ought to have great and decisiveweight. Among the symptoms of Phosphorus we find but fewprominent kinds of pains, except vaguely localized stitches, a moor less marked embarrassment of the respiration, a bloody, mucosanguinolent, or sanguineo-purulent, badly-colored, difficult exptoration, and a decided exacerbation of the symptoms towardsevening and during the night. Adding to this the post-mortemresults: Severe hypersemia of single lobes, more or less extensivhepatized portions of the lungs, and, according to Bibra, distinctuberculization of the exuded fibrin, we are abundantly authorized to believe in the homoeopathicity of Phosphorus in pneumoniaTo these local symptoms the general symptoms of Phosphorus haveto be added, these two are mostly full of meaning, but we shallhave to leave their more particular examination to the reader's ojudgment. Backed by the pathogenetic effects and by numerouspractical, indisputable observations at the sick-bed, we recommenl^hosphorus in the following more special cases :If pneumonia sets in at the outset with the symptoms of adynamic fever and bears a close resemblance to typhus. Here Aconitewould not even be suitable at the beginning of the treatment,Belladonna would do better, and Jthus toxicodendron still better,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 236 of 653but even in twenty-four hours the symptoms will change so as to18274 Diseases of the Lungs.indicate Phosphorus , but even if the indications for riiosphomsshould not be perfectly precise, let no precious time be lost witother medicines.If pneumonia sets in as a partial manifestation of typhus, or ifit has to be regarded as the exclusive localization of the typhoiprocess in the lungs. Pneumonias of this character leave us indoubt whether they are inflammations modified by the ruling typhoid type, or whether they are genuine typhus. We are disposedto incline to the former opinion as long as no signs of abdominaltyphus are present.If pneumonia does not set in with the characteristics of genuinetyphus, but modified by the ruling epidemic. This condition ismostly met with in pneumonia setting in during epidemic influenzaand in general in all cases of epidemic pneumonia, but we have toobserve at the same time that, according to our most recent observations, Phosphorus is so much less appropriate, the more fully aprominently bronchitis co-exists as a complication of the pneumoninflammation.If, after red hepatization is completed, on the third or fourthday of the disease, the fever increases instead of abating, the ptration becomes very great, the tongue dry, the sensorium bluntedin short, if phenomena set in, which lead us to suspect the supervention of an abnormal course of the disease.If a purulent dissolution of the infiltration is evidently approaing ; in such a case Phosphorus is, in our opinion, indicated onlduring the first twenty -four or forty-»eight hours, and is no loindicated if the suppuration is under full headway. Altogether,under such circumstances. Phosphorus is much less reliable than ithe previously-mentioned conditions; but we have to observe that,whenever Phosphorus is employed in proper season, suppurationwill scarcely ever take place.K pneumonic infiltration supervenes during the presence of bronchitis, assuming the form of lobular pneumonia. In such a case,however. Phosphorus is not the principal remedy, at any rate, itshould not be given at the outset.If pneumonia is accompanied by marked and threatening hypersemia, together with signs of adynamia, or if, after one lobe hasbecome hepatized, the pneumonic process continues to spread fromone portion of the lungs to the next.If pulmonary oedema becomes apparent, as manifested by theabove described symptoms. It is a very dangerous condition ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 237 of 653Pneumonia. 275things and the least significant manifestations of cedema have tocarefully watched. Phosphorus is possessed of extraordinary curative powers against ODdema, and it alone is almost always sufficito subdue this complication.If pneumonia attacks tuberculous individuals, it is, with someexceptions, a distinguished remedy. Tuberculosis must not yet havassumed the form of phthisis, the patients must not manifest anygreat disposition to hemorrhage, and their strength must not yetLave become too much reduced.Among the complications, the presence of intestinal catarrh pointvery forcibly to Phosphorus. We stated above that this complication leads most easily and speedily to collapse, for which alonephorus is such an excellent remedy. On the other hand, it is ouropinion that a prominent gastric catarrh almost counter-Phosphorus. The very common and sometimes threatening complication with hypenemia of the liver and slight icterus is a decindication for Phosphorus.To these indications we have to add a few considerations whichare, in our estimation, additional recommendations for PhosphorusOne of them is the patient's age. Neither very young, nor veryold individuals are best calculated for the favorable action of Pphorus, nor are individuals with exhausted constitutions ; robustmiddle-aged persons are most susceptible to the restorative actioof this agent. We should never employ Phosphorus in pneumoniarunning the above-described normal course ; but the patient shoulbe visited at least twice a day, for the symptoms sometimes undera most remarkable change in twelve hours, and the right periodwhen Phosphorus ought to be given, is easily missed. If pneumonia is complicated with a higher grade of pleuritis (for it is alalways associated with some of the lighter grades of this diseasePhosphorus is, in our opinion, much less appropriate than otherremedies, and we feel unable to accede to the opinion of somehomoeopatic practitioners who regard Phosphorus as peculiarlysuitable to pleuritis. In the third stage. Phosphorus is apparentappropriate, but we deem it proper at this stage to recommendother remedies more urgently. In chronic pneumonia we havenever seen Phosphorus do any good. Regarding the dose, we desireto state that we have never seen an aggravation caused by ten ortweve drops of the third attenuation in two ounces of water, givein dessertspoonful-doses; but that the second attenuation is veryeasily succeeded by the production of primary symptoms, especiall276 Diseases of the Lungs.an increase of hypereemia, even hemorrhage, more particularly mthe case of tuberculous iudividuals. As far as higher attenuationare concerned, we confess that we have never witnessed any effectfrom any above the sixth. [Some years ago we had an opportunityof witnessing a very beautiful and striking effect of Phosphorus.Some time during the summer, late in the evening, we were summoned by a farmer who complained of a severe stitch in the side.The patient was of a consumptive habit of body, forty-five yearsold ; we found him lying on the sofa, with a high fever, short anhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 238 of 653panting breathing and a dry, racking cough with very scanty expectoration. It being very late, we made a rather hurried examination, and being satisfied that we had a case of pleurobefore us, we prescribed Aconite 2, and left him with the promiseof an early morning-visit. Next morning we found our patientworse, if any thing. Fever very high, skin dry, like parchment,complexion very sallow, dull headache, considerable thirst and extreme exhaustion. The cough was no longer dry, but mucoguinolentsputa were raised in some quantity. The patient complained of exquisite soreness at one spot in the left lower lobethe lungs. The balance of the organ seemed to be in a state ofhypereemia; percussion still yielded some resonance, very littleiiess anywhere, except in the left lobe. Prescribed Bryonia. Sawthe patient again in the middle of the day ; he was steadily failSaw him again in the evening and found him in a state ot sopor,grasping at flocks, picking at the bed-clothes, and raising profuquantities of a yellow-green pus having an exceedingly unpleasantodor. The pus was discharged from the first-named sore spot. Thesoreness now had reached a very high degree; the least pressureupon this spot caused the patient to moan ; the cough was veryshort and the patient seemed to dread it ; his tongue looked likeparched leather, his complexion bad a dark-brown icteric hue ; thdelirium was constant, bland; pulse about 140. It was evidentthat we had a large cavernous abscess before us, and that unlesswe succeeded in effecting a favorable change very soon, our patiewould be a dead man in a very short time.We now put him on Phosphorus 8d trituration. Half an hourafter taking the first powder, a favorable change manifested itseThe medicine was continued through the night every hour or whenever the patient should wake. Early in the morning we found himwith a moist skin, pulse down to 85, breathing much improved,symptoms of a general resolution apparent, passed water freely, tPneumonia. 277urine being thickly charged with decayed mucus; no headache,Bputa muco-purulent, without any bad odor; the region of theabscess no longer sensitive, only a little sore but over a smalleface. Continued the Phosphorus every two hours. In a fortnightafter our first visit, the patient was able to resume his labor;forbid symptom having disappeared. H.]Sulphur. The symptoms which this agent causes in the respiratoryOrgans are too numerous and varied to enable us to detach some of%'m from the whole list; the remedy has to be studied in itstotality, more especially with regard to the respiratory organs f^hich it is of such extraordinary importance. If Muller says thatthe writers on sulphur agree in their views concerning the actionof this agent, we cannot altogether agree with him, since the exiing differences in their opinions are somewhat striking and ofessential importance. The importance of this remedy must be ourexcuse, if we examine some of the details with more minuteness.In the first place and very generally Sulphur is recommended forpneumonias in dyscrasic individuals. Some authors mention psoraby name, others undoubtedly had it in their minds. Is the existenof psora founded in reality ? According to our own experience, wecannot admit this, esj>ecially in tubercular pneumonia where sulphttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 239 of 653exerts curative ettects only in very few cases. For this reason wbelieve with Muller that the indications for sulphur are chieflyup a priori, and we cannot forbear taking this opportunity of agacalling attention to the unprofitable part that psora has playedHomoeopathy. Nor can we give our assent to the proposition thatSulphur should be given in the third stage when a purulent dissolution of the infiltration is already far advanced. Practical exprience is against this proposition which is likewise contradictedthe results obtained in inflammations of other organs, where thecompletion of a purulent transformation constitutes a positivecounter-indication to Sulphur. Hartmann likewise talks of a latendyscrasia where the apparently best indicated remedies remainwithout eftect; but we would ask how it happens that there arepneumonias almost all of which sometimes act in this manner in ;the same year among all those that are attacked by this disease ?Of what use is it to at once jump at the doctrine of a latent dyscrasia? The same position is occupied by Watzke when he recommends- Sulphur in pneumonia consequent upon the suppression orretroeeesion of an exanthem. With the access of almost any veryucute inflammation exanthems disappear almost without au excep278 Diseases of the Lungs.tion either for a time or for ever, which is of no more importancthan the cessation of a coryza after the supervention of an inflatory process. The more serious affection does not tolerate thesimultaneous presence of a less serious one. Metastasis under succircumstances cannot be appealed to, nor can a definite influenceover the course of the whole disease be determined beforehand.We transcribe Miiller's chief indications: In the second and thirstages of pneumonia, especially when the inflammation is deepand extensive. Sulphur deserves particular consideration as an inpendent remedy. If after the removal of the first vascular excitement which generally results from the supervention of the exudatian exacerbation of the febrile and other symptoms sets in againafter the lapse of one to three days, as is frequently noticed inwhere no dispersion takes place, and the disease runs its coursethrough the second and third stages. Sulphur is best calculated tmeet this exacerbation, if characterized by vascular excitement,dyspnoea and intensity of the thoracic symptoms, and not by theso-called nervous symptoms, for which PhosphoruSy Belladonna^Bryojiia^ Rhus toxicodendron and other remedies are indicated.Jlence Sulphur must be indicated by extensive hepatization andsuppuration (second and third stage) where not the nervous, butthe synochal symptoms prevail, resembling those that indicateAconite in the first stage of the disease. What we have to objectto Miiller's views is that we do not believe Sulphur ever meetssynochal febrile symptoms. If we advance our own views concerning the indications for Sulphur, it is not so much in the expectaof uttering anything new, but of uniting existing opinions in onegeneral series. In our opinion Sulphur is indicated, if pneumoniapasses through its first two stages without any great deviationsthe normal course, or without any striking changes, and thenremains stationary without the supervention of any typhoid symptoms, such as occur in pneumonias to which Phosphorus is 8jadapted. It is a period of anxious expectation to a physician,because he cannot decide whether re-absorption or a purulent dissolution of the exudation will take place. The patients do nothttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 240 of 653seem extremely ill, the fever may be intense or may have commenceto abate ; in this condition the disease has often continued forThis is most frequently observed in pneumonias treated with venesections. Now is the period for the exhibition of Sulphur, and it18 astonishing with what magical rapidity the organic reaction issometimes kindled by this agent. It makes no ditterence whetherPneumonia. 279the individual is otherwise diseased or not, whether dyscrasias,psora, tubercles are present or not. A deficiency of reaction andsimultaneous absence of such symptoms as point directly to thedestruction of the organic powers, constitute in our opinion theindications for Sulphur. But if suppuration has really set in, wefeel disposed to doubt the curative virtues of Sulphur. The samerelation obtains in chronic pneumonia; if it exists with symptomsof dissolution, Sulphur is most commonly capable of superthe re-absorption of the atonic exudation, whereas in pulmonaryabscess this remedy is altogether ineffectual. It is, however, coceivable that Sulphur may still have a benelicient effect in purudecomposition. Suppuration frequently sets in on a limited scale,gradually invading the infiltrated portion of lung, and it is thuconceivable that Sulphur may occasion the normal re-absorption ofthe remaining firm exudation. From this point of view we agreewith Wurmb when he advises not to delay the employment ofSulphur too long. The fifth or sixth day is generally the best tifor this medication. After what we have said, we do not deem itnecessary to institute special comparisons between Phosphorus,Mercurius and Sulphur. The relative position of these three remedies can be defined in a few words: All three are only suitablea second stage; Sulphur in the absence of all signs of reaction;Mercurius, if there is a good deal of vascular excitement, andPhosphorus, if the reaction is excessive, and is necessarily follby adynamia.Tartarus stibiatus. It is well known what extravagant praise wasbestowed, not very long ago, upon this drug as a remedy for pneumonia, and how soon it has been abandoned. These frequent changesin Old-School Therapeutics can only be accounted for by a homoepath who is acquainted with the fact that there are no general buonly individual specifics, but that these latter, when applied tolarge number of similar cases of disease, are very apt to be regaas general specifics. Tartar emetic is undoubtedly one of the mosimportant remedies in pneumonia, but only when it deviates fromthe normal course. We again forbear quoting symptoms and confine ourselves to the well established indications which the symptoms had first suggested. In uncomplicated pneumonia Tartaremetic is scarcely ever indicated in the first stage, not even atbeginning of the second stage. The sphere of action of this drugcomiraences with the resolution of the exudation. If the resolutitakes place rapidly, and the re-absorption is slow, the dyspnoea280 Diseases of the Lungs.generally becomes quite considerable, because the lungs are unablto remove the copious contents from their cells. If great dyspnoehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 241 of 653is present, and a spasmodic cough with expectoration that affordssome relief; if the infiltrated portion of lung yields a tympanitnot altogether empty sound, and loud and coarse rales over a largsurface, Tartar emetic will have a fine effect. This terminationpneumonia is generally characterized by a sinking of the tempera^ture with an increased frequency of the pulse, great anxiety andrestlessness with copious, cool perspiration, cerebral congestionwith a livid or at least a strikingly pallid complexion. In contrdistinction to Phosphorus, the indications for Tartar emetic pointo a deficient reaction ; hence it is more suitable for old peoplfor vigorous and young persons. We doubt whether this remedywill ever be found appropriate in the stage of purulent dissolutiAmong the complications it is particularly bronchitis that pointsto Tartar emetic. Here we meet most commonly with the abovedescribed condition, an excessive crowding of the bronchia, withinsufficient ability to remove the secretion. It is this speciespneumonia, which is so apt to set in in an epidemic form, that hagiven rise to the commendations with which Tartar emetic hasbeen honored as a remedy for pneumonia with unquestionable propriety ; for in this kind of pneumonia the remedy displays extraordinary curative powers. It deserves particular attention in themore dangerous forms of bronchitis in the case of children, in pnmonia as a complication of whooping-cough, in pneumonia whensupervening during the presence of emphysema. Not only by bronchitis, but likewise by an intense catarrh of the stomach is Tartemetic indicated in pneumonia, and in this respect it may be properly given after Bryonia. We should never lose sight of the factthat when a large quantity of mucus accumulates in the lungs, theexjiectoration is difficult, but that, when it does take place, grelief is afforded. Regarding the dose, physicians agree most remarkably in the case of this remedy ; so far as we know, a highertrituration than the third is not advised by any physician. Thesecond trituration in grain-doses is probably the most appropriatsince it never gives rise to nausea.Hepar sulphuris calcareum. We are amazed that this remedy is solittle or rather not at all mentioned in the therapeutics of pneumonia ; we w^ould urge physicians to try Hepar in this disease. Imaking this request we are supported by several really brilliantcures, one of which we will relate very briefly. A boy of six yeaPneumonia. 281who had enjoyed good health up to that time and was otherwiseof a robust constitution, had been treated for pneumonia by anallopathic physician for upwards of eight weeks, without recovering; he was allowed to languish in a diseased condition until arapidly increasing curvature of the thorax set it. Twenty weeksafter the first commencement of the pneumonia, the parents soughtour advice. The child was exceedingly emaciated, had a slighthectic fever, was constantly troubled by a sometimes spasmodiccough, with a purulent and fetid expectoration, diarrhoea, loss oappetite. The right side of the thorax had caved in quite consideably, the left was abnormally bulging ; on the right side the percussion-sound was perfectly empty, with intense bronchial respiration and slight r&les. We diagnosed pleuro-pneumonia of the rightside, with absorption of the pleuritic exudation, but continued psence of the pneumonic infiltration in a state of purulent dissolhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 242 of 653After various ineffectual remedies, the child was finally put onHepar, 3d trituration, with such excellent success that in eightalready the caving in of the chest was considerably less. In aboufour weeks the right lung had almost been restored to its normalcondition, and the curvature of the thorax had entirely disappear80 that the child now looks perfectly straight and thoroughly souand healthy. A second pneumonia, with which the boy was attackedfour years after the former, was radically cured in seven days.Since then we have often made use of Ilepaj and have arrived atthe following results: Hepar is preferable to other remedies aftethe third stage has set in, provided the general symptoms are comparatively mild, a lentescent fever is present and the suppurativprocess does not extend over a large portion of lung. It will actmuch more powerfully the younger and more vigorous the childrenare. In pneumonia complicated with bronchitis there is scarcely abetter remedy after Mercurius than Hepar. The above describedcase shows that chronic pneumonia is the best sphere for the therpeutic action of Hepar. In a case of pulmonary abscess, Ilepareffected a cure as far as the restoration of this patient was posRhus toxicodendron. Miiller's statements regarding this remedyin his Essay on Pneumonia seem to us so appropriate that we feelcalled upon to transcribe his remarks : " Hahnemann's recomniendatiou of Rhus tox. as a remedy for the typhus that devastated thhospitals during the war of 1813, and the consequent employmentof this remedy in nervous and gastric fevers, and in typhus, seemto have secured for it a predetermined part in the treatment of282 Diseases of the Lungs.pneumonia. It seems certain that nothing in the present pathogenesis of Ehus entitles this agent to a place among the remediesin the ordinary pneumonias of a lighter grade, and that the localchest-symptoms of Rhus have scarcely any relationship to this disease. What stamps it a remedy for pneumonia, are its generaltyphoid symptoms arising from a depression of the cerebral functions. These symptoms are undoubtedly very marked, placing thedrug ahead of Belladonna and Bryonia, assigning it even a placeby the side of Phosphorus and Arsenicum. Since these nervoussymptoms occur in all three stages of pneumonia, Rhus need not berigorously assigned to a definite stage, although the typhoid depsion of the sensorium, as manifested by the symptoms of Rhus, ismore particularly a characteristic of the later stages, and may nso nmch result from an obstructed circulation as from a deterioration of the blood in consequence of the purulent dissolution of texudation and other causes ; on which account Rhus may be moreadapted to this stage, whereas Belladonna and perhaps Bryoniacorrespond rather to the cerebral symptoms occasioned by simplestagnations in the circulation and by cerebral congestions. Amongthe symptoms indicating Rhus, the following would, therefore, bethe most characteristic : Loss of strength, sopor, hardness of heing, subsultus tendinum, unconscious discharge of stool and urinedryness and heat of the skin, dry, hard and sooty tongue. (WhyDr. Wurmb does not expect any marked effects from Rhus or anyother remedy in purulent infiltration of the lungs, is difiicultcomprehend ; at any rate, this condition of the lungs does not leimate doubts any more than any other condition ; he seems toregard this stage as more unfavorable and dangerous than it reallis, nor does he seem to consider that in every case of pneumonia,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 243 of 653which is not cut short in the first stage, a purulent decompositiand resolution is the normal and almost the only favorable couiAmong the local symptoms one at least seems to deserve a moreprominent place, it is a dyspnoea peculiar to Rhus and occasionedby distention of the pit of the stomach ; however, even in thisrespect, it will only compete with other remedies, especially witNux vomica and Phosphorus. Kreussler's recommendation of Rhusin case miliaria break out, attended with a general aggravation othe whole condition of the patient, is in our opinion, founded innothing else than the marked tendency inherent in Rhus to causeexanthems, some of which resemble miliaria ; nor can it be deuiedthat it is in pneumonias complicated with miliaria, that the abovPneumonia* 288described nervoas syinptoms are moet apt to prevail. Hhus mightlikewise be principally recommended for pneumonia occasioned byexposure to wet and cold, provided the power of Rhus to cure suchcatarrhal diseases, and which is now generally believed in, had asure basis ; it is evident, however, that this view has not beengested by physiological experimentation, but rests upon an empirical basis ; moreover, the definition of catarrhal disease is evitoo vague and indefinite to deserve very serious consideration. Imight bo replied that the reputation of Arnica in contusions hasbetter foundation ; but here the case is a very different one. Thvirtue of Arnica in removing the consequences of contusions andblows, is not the result of empiricism, but a knowledge thereof hbeen obtained by physiological provings and could not have beenobtained but for the circumstance that the symptoms occasioned byexternal injuries, are definite and fixed in their characteristicfestations, and that their correspondence with drug-symptoms canvery readily be established. The consequences of a cold, on the ctrary, are not circumscribed within such narrow and precise limitbut are of the most diversified kind and meaning, so that, if weknow a cold to be the cause, the connection between cause andeffect can readily be suspected, but cannot, as in the other caseinferred with perfect certainty from the existing symptoms." Tothis exposd we will add a few remarks. When speaking of Phosphorus, we stated that Rhus might be found indicated above everyother remedy in cases of pneumonia setting in from the commencement with adynamic fever. We repeat this statement in this place.If in the first two days the diagnosis wavers between tyj^hus andpneumonia ; if the local process commences at the outset as if mofied by a general deterioration of the mass of blood, Rhus will bfound indicated, although, we have never seen the disease cut shoby this remedy. In pneumotyphus Rhus ranks next to Phosphorusto which it may even be regarded as superior. Whereas Phosphorusis less adapted to pneumonia complicated with bronchitis, Rhus, othe contrary, is in its place in such circumstances, as we have lterly learned to know from abundant experience. Bronchitis isattended with a scanty secretion of mucus, it precedes pneumoniaa few days ; the pneumonia itself supervenes almost imperceptiblyand is only recognized by the increasing dyspnoea which becomesunbearable by exposure to stove-heat, and is accompanied by acharacteristic dry and tormenting cough, by which sleep is disturbed particularly after midnight. As a rule, attention had betthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 244 of 653284 Diseases of the Lungs.be paid to Khus in epidemic pneumonia where it often renders excellent service.Arnica. The value of this medicine has in some respects beenimpaired for having been so universally accepted as a remedy forthe consequences of contusions and other mechanical injuries. Itsuse has almost been confined to this range, as the use of Aconitehas been limited to inflammatory fever. But if our provings reveasuch a decided, and we might almost say such a specific relationdefinite organs, and more especially to the lungs, we must supposthat Arnica will prove an excellent remedy in pneumonia. In thefirst place, then, in pneumonia this remedy deserves a preferenceover any other in all cases where the disease is occasioned bymechanical injuries. We likewise recommend Arnica in caseswhere the pneumonic infiltration is associated with a marked tendency to hemorrhage. This coincidence generally occurs only inthe case of plethoric individuals with sensitive and irritable nefor which Arnica is said to be preeminently suitable, and in whomthe blood has undergone a peculiar alteration resembling the altetion in typhus, for which Arnica, if the results obtained by ourprovings can be accepted as reliable, is likewise a proper remedylong as the strength of the patient is not in a sinking conditionUnder these circumstances it competes with Belladonna, for Arnicahas likewise symptoms of marked cerebral congestion. For thisreason we commend Arnica in cases of pneumonia complicatedwith symptoms of meningitis. The first stage furnishes the mostcharacteristic indications for Arnica ; the second stage, and stithe third will scarcely ever afford a suitable sphere for a displthe curative virtues of this drug.China will never be found suitable in pneumonia without anydecided deviations ; it may often be indicated for some of thesedeviations, but more on account of its general effect upon theorganism, as on account of its specific action upon the lungs. Itrecommendation for bilious pneumonia is suggested by theoryrather than founded upon practical results; a slight degree oficterus is such an ordinary accompaniment of severe pneumoniasthat it cannot be regarded as an important complication ; and ifthe stagnation in the liver is more considerable when the right lis inflamed, the reason is simply because the circulation in theis obstructed by the impeded circulation in the lungs ; as soon athe pneumonic infiltration is removed, the hepatic circulation wiresume its normal course. To judge from the results obtained byPneumonia. 285means of our physiological provings, China is best suited where tcourse of pneumonia has been interfered with by sanguineous depletion, especially if hectic symptoms have set in with marked prostration of all reaction, or if, during the subsequent course of tdisease, the threatening pulmonary symptoms become associatedwith hypersemia of the liver, icterus, intestinal catarrh, violentress in the stomach. For this reason China may be ranked amongthe principal remedies for chronic pneumonia, but its action is olimited extent, and it is scarcely ever the only remedy sufficienhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 245 of 653effect a cure. Without doubt it often helps to kindle a reactionwhich is a necessary preliminary to the curative action of otherdrugs. Whether intermittent pneumonia can be reached by China,is not yet settled ; this recommendation is very much like the OlSchool recommendation of China for all typical or intermittentparoxysms. In pulmonary abscess it can only be depended uponfor its general, not for its local symptoms.Carbo vegetabilis. Few remedies in our Materia Medica exertsuch a marked and energetic action upon the lungs as Carbo ; andwill still prove efficient even in the most desperate cases. We cnot here transcribe the number of symptoms referring to the respiatory act, but we would urge upon every physician the proprietyof making himself thoroughly acquainted with them in the MateriaMedica. The general tendency of Carbo is to extinguish the reactive energies of the organism and to develop, at the same time, atendency to decomp)Osition and decay. From this stand-point therelation of Carbo to pneumonia can most easily be explained andaccounted for. It is the third or suppurative stage that presentssymptomatic picture for the employment of Charcoal. The patientsseem listless, covered with a profuse and cool perspiration, theis very rapid and small, without resistance ; the tongue is dry,the patients do not seem very thirsty; they pass foul, decayingdiarrhoeic stools ; their breath has a foul odor, decubitus threato break out ; the respiration is superficial, a loud rattling isin the chest, yet, in spite of the distressing cough, the patientnot raise the least particle of any thing. All the symptoms pointincipient paralysis. A bloated countenance, with injection of thefacial veins, is a striking indication for Carbo. Such conditionsapt to set in among older people, to whom Carbo is an importantremedy generally. If pneumonia assumes a chronic form ; if abscesand gangrene set in ; if the sputa become fetid and badly coloredno remedy is likely to afford the least help, if Carbo fails us.286 Diseases of the Lungs.course, an imniediate improvement must not be expected ; the character of the disease renders such a thing impossible. Among thecomplications, Carbo is indicated by every process that interferewith the pulmonary circulation. Hence, we find it such an excellent remedy in the pneumonia of emphysematous individuals, whereit is undoubtedly preferable to Arsenic; likewise in pneumoniacomplicated with defects of the right heart ; and finally in pneumonia where the inflamed lung is suffering from chronic catarrh.In such cases the chances of a favorable termination are sometimeexclusively confined to the employment of Charcoal. It is likewisexcellent in cases of pneumonia complicated with acute bronchitisIn such cases it is principally the dry and spasmodic cough, attewith mucous rales in the chest and occurring chiefly at night, wisoreness and a burning pain, that points to Carbo, and makes it avaluable remedy in the malignant forms of influenza, especially oolder people. The resemblance of Carbo to China is very great,extending even to. the presence of bilious symptoms ; neverthelesin a given case, the selection is not so very difiicult, providedabove-described general range of action is kept in view. FromTartar emetic to which Carbo bears likewise a great deal of resemblance, this drug is best distinguished by the circumstance thatwith Tartar emetic the expectoration is possible and afibrds relihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 246 of 653whereas Carbo has but a very slight expectoration which, moreover, aftbrds no relief.Lycopodium is recommended by Hartmann, if the patient feelsvery nervous, without heat in the head or flushes on the face, wicircumscribed redness of the cheeks, great weakness, perspirationwhich does not relieve, redness and dryness of the tongue, frequent urging to cough with a little grayish expectoration which iraised with difficulty, after which the rfiles in the chest are ndiminished in the least, and the dyspnoea is very striking. Thesesymptoms seem to us very vague, and we doubt whether such agroup has ever been seen in practice. Adding to the above thestatements of other physicians, we assert that Lycopodium is onlysuitable in pneumonia after the acute symptoms have all passedaway, whereas hectic symptoms have taken their place. HenceLycopodium is very closely related to Carbo veget., even the locadrug-symptoms are very much alike. As distinctive signs we pointout under Lycopodium a deficiency of the symptoms denoting ageneral decomposition, the absence of colliquative symptoms inother organs, especially in the intestinal canal, and the absencePneumonia. 287lesser degrees of passive congestion, and finally the copious exptoration which affords no relief. In pulmonary abscess Lycopodiummay be tried, but it is not a leading remedy.Regarding Opium, Miiller, after quoting the scanty, literary material, has the following: "Despite the poverty of the homoeopathliterature, Opium can be assigned a place in pneumonia with tolerable certainty. Excluding all acute inflammatory conditions of thlungs, Opium can be given with great success for paroxysmalobstructions of the respiration and for suffocative paroxysms thaare occasioned by various disturbances of the pulmonary and cardifunctions (hence also in the course of a pneumonia where no resoltion has taken place,) as well as when general cerebro-spinal afftions are complained of. The following symptoms are especiallycharacteristic: These symptoms originate during, or are aggravateby sleep; absence of pain, except a constrictive sensation on thechest ; labored, rattling respiration, or very slow, almost impertible, even* suspended breathing; sudden blueness of the face; sting, immovable, half-closed eyes; somnolence before or after anattack; trembling, twitching and jerking about the whole body, orelse rigidity of the body, general coolness of the skin; irregulaintermittent pulse, constipation. Many give moreover the followinsymptoms as indications for Opium : Bad effects of fright and fealikewise of w^ine-bibbings and ailments incidental to old age; geeral insensibility of the nervous system and deficient reaction acertain medicines." We do not consider these indications sufficieclear and definite to be of much practical use in the treatment opneumonia; for this reason we add a few detached observations,because we regard Opium as a really important remedy in pneumonia. That Opium causes pneumonic infiltration, is evident froma case of poisoning of a child of three months which is reportedBoyd-Mushet in the Med. Times and Gazette, March 20, 1858. Itis remarkable that it is precisely in the case of children that tnot simply narcotic effects of Opium are so prominently developedon which account it is our opinion that it is only in infantile phttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 247 of 653monia that Opium ought to be exhibited, more especially in caseswhere the pulmonary inflammation is absolutely disguised by symptoms of cerebral congestion and oppression. In such cases theBiniilarity between the pathological group of symptoms and thoseof poisoning by Opium is exceedingly great. Particular attention18 due to the cyanotic color of the upper parts of the body withslow, stertorous respiration which must evidently be regarded as288 Diseases of the Lungs.Bign of paralysis proceeding from the brain. In old age a similarpicture of pneumonia is not unfrequently met with. In general weaccount for the well-founded recommendation of Opium in caseswhere all medicines are ineffectual and where considerable cerebrsymptoms are generally present, by the circumstance that the medicine brings the central nervous system back again to its normalactivity and consequently secures a normal reaction. In the pneumonia and in many other diseases of drunkards the excellence ofOpium is accounted for by a similar train of argumentation.It now remains for us to mention a tew remedies that have beenrecommended for pneumonia, but have neither been made use ofvery frequently, nor are they to be regarded as genuine and radiccurative agents in this disease.Nux vomica is not by any means an important remedy for pneumonia. This is our opinion as well as Miiller's. Although we donot expect to see the therapeutic sphere of every remedial agentthat we present as such, specifically marked out by pathologicotomical appearances, yet it must indeed seem strange that Nuxvomica, of which we possess such a vast number of fatal cases ofpoisoning, has never yet occasioned a single decided hyj)er8emia,much less infiltration of the lungs. This one circumstance is apositive argument againt the employment of Nux in pneumonia.We do not even find the remedy indicated in pneumonia complicatedwith bronchitis; for such a bronchitis will greatly differ from twhich comes within the curative range of Nux. In the pneumoniasof drunkards Nux may influence the general disease, but it isexceedingly doubtful whether the local disease will ever be reachby it. For this reason we cannot recommend Nux for practicaltrials either a priori, nor upon the ground of experience.To Pulsatilla the same remarks apply as to Nux. Of late yearsPulsatilla has not been employed in pneumonia, and if the formersuccess of this drug in pneumonia is appealed to, we beg leave tosuggest that in those days the certainty of spontaneous cures ofpneumonia was not nearly as well established as it is now. It ismore especially in the pneumonia of anaemic and chlorotic individuals that Pulsatilla is principally recommendod ; in such cases ievidently the general spasmodic condition of the organism, not thlocal aftection that has been had in view.Cannabis is considered by Hartmann a very valuable remedy inthe subsequent course of the pneumonia, if the disease affects prcipally the lower portion of the thorax, or is localized in the lhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 248 of 653Pneumonia. 289lang; if palpitation of the heart, oppression under the Bternumwith dull shocks in the region of the heart, frequent singultus,coldness rather than warmth of the whole body, with increasingheat of the face, are complained of as accompanying symptoms.It is in asthenic pneumonias that, according to Hartmann, theremedy deserves particular attention. It seems to us that theseindications are not only vague, but useless. The symptoms ofCannabis do not by any means point to an inflammatory process inthe lungs, but seem to result from the powerful action of Cannabiupon the heart. The remedy not having been employed to anyextent in pneumonia, there do not seem to exist sufficient reasonwhy its use in this disease should be recommended.Senega, according to its pathogenesis, is to some extent a remedyfor pneumonia, but its therapeutic value in this respect is verymuch diminished by the accompanying remark that the painfulsensations which Senega occasions in the thorax, are more particularly felt on the outside. In other respects Senega is particulaadapted to diseases of the respiratory mucous membrane, and,for this reason, to pneumonias complicated ' with bronchitis.Striking practical results by means of this drug have not yet beepublished.Hyoscyamus. Toxicological post-mortem appearances determinethe relation of this drug to pneumonia better than all its pathogenetic symptoms. The lungs exhibit marked hypersemia, but theyare filled with a black, fluid blood, and are infiltrated with seIf, in addition to this, we consider that Hyoscyamus has no intenpains and that the cough is more particularly dry and breaks outat night, we have a right to declare that an ordinary pneumoniadoes not come within the curative range of this agent. On theother hand we consider Hyoscyamus, even with reference to itscerebral symptoms, a valuable remedy in hypostatic pneumoniawhen supervening during the course of other chronic aiFections ;in pneumonia complicated with typhus ; in the pneumonia of oldpeople and when acute oedema of the lungs sets in. A violent delirium should always direct our attention to Hyoscyamus. As anintercurrent remedy, Hyoscyamus is often admirably useful in anocturnal, spasmodic, dry cough, such as frequently occurs in pnemonia during the prevalence of influenza.Arsenicum album. Howsoever much we may be disposed to regardArsenicum as one of the most prominent remedies for pu^m:affections, yet it does not appear to us that it occupies a promi19290 Diseases of the Lungs.rank among the remedies for pneumonia. Among the large cumber of toxicological post-mortem appearances, a decided fibrinousinfiltration of the pulmonary parenchyma has never been noticed,but always only a marked hypersemia and oedema. This circumstance could not possibly occur, if Arsenic were possessed of a shttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 249 of 653cific power to excite an inflammatory action in the lungs. In anuncomplicated case of pneumonia we should therefore pever resortto Arsenic. On the other hand, cases occur where the accessorysymptoms indicate Arsenic so thoroughly that they entirely overshadow the fact of pneumonia ; in such a case it is not prescribeas a pneumonic remedy. Wurmb gives the following more specificindications : Rapid and disproportionate prostration ; tendency tcolliquation and dissolution ; marked periodicity of the more proinent symptoms; aggravation during rest and in a recumbentposture, with excessive restlessness and anxiety, and prevalencethe burning pain. It is at all events strange that Arsenicum shoube so seldom mentioned in our literature as a remedy for pneumonia, whence we infer with tolerable certainty that it has only befound useful as an intercurrent remedy and not even then in a verstriking manner. In our own opinion, Arsenic should be resortedto, if gangrene of the lungs develops itself with very marked sigof reaction ; in the pneumonia of emphysematous patients and whencomplicated with cardiac affections ; if oedema of the lungs setsall at once, with passive hypersemia of the lungs as not unfrequeoccasioned by defects of the right heart; and finally in hypostatpneumonia.Sepia and Silicea both by their local as well as general symptomsare important remedies in excessively slow, purulent, as well astrue chronic pneumonia. The large number of important symptomsdoes not permit us to detach the most prominent from the series.These drugs have to be studied throughout. We likewise call attention to Cuprum which certainly deserves more particular attentionin lentescent pneunomic conditions than has hitherto been devotedto it. We have the records of a case of poisoning by Copper wherean abscess in the lungs was found. An observation of this kindshould be treasured up with so much more care as our MateriaMedica oflTers few, if any, similia for such a disorganization.For the sake of cu i nplct c— >y w» wmmimm tk» naaM^cf a fewother remedies which, so far as present experience goes, are of sordinate value: Squilla^ Zincum metallicumy Acidum phosphoricuma^d nitricumj Kali nitricum and Kali carbonicunij Camphora^ lodiuPneumonia. 291Spngiaj Digitalis purpurea^ and others. We have often given it asour opinion that too large a number of medicines for one class ofdiseases produces confusion and complicates the selection of aremedy; we have perhaps given too large a number of remediesin the present instance; our excuse must be that we considerpneumonia more important than any other disease as affording thebest illustration of the efficacy of homoeopathic treatment.A condensed review of these remedies may not be superfluous inorder the better to enable the physician in a given case, to hitthe specifically adapted agent; we shall adhere as closely as possible to the definitions we have presented at the commencement ofthis chapter.In the first stage of pneumonia, Aconite is the chief remedyadapted to a vast majority of all the cases. If severe cerebral cgestions are present. Belladonna is indicated together with Aconihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 250 of 653(also Veratrum viride). If pneumonia is occasioned by mechanicalcauses, Arnica is given, which likewise corresponds to a cocerebral hypcrsemia. If the fever assumes from the outset thecharacter of adynamia, Rhus is preferable, very rarely Phosphorusin the first place. Complications that will be stated by and by,may alter the choice of the remedial agent, so that other remediemay be required at the outset of the disease.In the second stage Bryonia is the most essential remedy as longas the course of the disease remains normal and no exceptionalchanges set in ; it likewise corresponds to the very common butslight co-existing hypersemia of the liver. If, side by side withinfiltration, the congestion continues as collateral hypersemia,nite is in its place ; in such cases the alternate use of these tdrags may seem indispensable. If the reabsorption delays withoutthe general symptoms changing alarmingly for the worse. Sulphurbecomes the most important remedy. If the symptoms assume atyphoid character, Phosphorus should be given at once ; in a fewcases Bhus may be indicated. Tartarus stibiatus requires to be giif the resolution of the infiltration takes place very speedily,the reabsorption is very slow, and hence it becomes necessary topromote expectoration. If we are called upon at this stage to trea pneumonia that had been managed with sanguineous depletions,JPhosphorus^ Sulphur and China may be suitable remedies.In the third stage Phosphorus is commonly useful only at thecommencement, and here competes with Mercurius; Phosphorus,and perhaps also Mercurius, are counter-indicated by excessive292 Diseases of the Lungs.prostration. The last-named drug may come into play, if the disease exists in dyscrasic, especially in scrofulous individuals. Isuppurative process goes on without any marked febrile symptoms,assuming rather the form of a slowly-progressing hectic conditionentirely confined to the lungs, Sulphur is often calculated to brabout a favorable termination ; however we place more confidencein Hepar svlphuris. In such circumstances lodium may likewisebe prescribed with great propriety. If purulent dissolution takesplace, and the whole organism seems to be affected by this changein a threatening manner, China deserves our first consideration,next to which we may compare Lycopodium^ Sepia and Silicea. Pulmonary abscess, whether acute or chronic, requires the aboveremedies ; in a case of chronic abscess, we would likewise dependin some measure upon Carbo vegetabilis and Cuprum. Gangrene ofthe lungs is always a very threatening change, and a cure canscarcely ever be expected. Carbo veg» and Arsenicum^ and perhapsalso LycopodiuMj are probably the only remedies by means of whicha favorable change can be wrought. To what circumstances Terebinthina owes its recommendation for gangrene of the lungs, cannowell be explained from the homoeopathic stand-point, this remedywill most probably exert a more specific curative effect when administered by inhalation than when conveyed to the diseased organby the stomach. On account of their general action more than onaccount of their special relation to the lungs, the mineral acidsmore especially Acidum phosphoricum and nitricum^ deserve particular attention during the whole course of the third stage, but onas intercurrent remedies.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 251 of 653The following constitute particular forms of pneumonia withreference to the circumstances which either occasion or accompanythe attack, although they cannot be considered as complications.Pneumonia of children assumes most commonly the form oflobular pneumonia, the more so the younger the individuals. Insimple croupous pneumonia no other remedies are required than inthe case of adults, although we would call attention to two remedin such cases, namely Mercurius and Opium. The former is rarelysuitable for adults in the second stage, on the contrary, it is oserviceable to children and is usually preferable to Bryonia, Opiis a very excellent remedy for the severe cerebral hypersemia witwhich children are so often attacked. This condition of the brainvery often makes Belladonna superior to Aconite even at the beginning of the pneumonia. Very seldom the symptoms in the case of^LPneumonia, 293children will point to Phosphorus which is aptly replaced by Mercurius or even by Bepar sulphuris. As a general rule, a simpleuncomplicated pneumonia is neither a very important nor a verydangerous disease to the infantile organism; but it can easily bemade so, especially by sanguineous depletions and cathartics. Inthe ease of children the momentary effect of a debilitating treatis greater; in the case of adults it is less instantaneous than psistent.In old age pneumonia is almost always associated with catarrhof the bronchia, and hence much more dangerous. Simple pneumonia not unfrequently sets in with symptoms that call for Belladonna rather than Aconite ; sometimes Bryonia is indicated by thesymptoms from the very beginning. Here too the co-existing cerebral symptoms often call for Opium and Hyosciamus. The reabsorption is usually trifling; a crisis generally takes place bycopious expectoration, and although Sulphur may be perfectlyappropriate for a few days, the copious, but difficult expectoratrequires without any further delay the exhibition of Tartar emetior Carho vegetabilis or Lycopodium^ also Baryta. We would notadvise Phosphorus for the reason that all signs of an excessivereaction are wanting. The greatest danger to old people is theacute cedema and the paralysis of the lungs by which the oedemais often speedily followed. In order to obviate this event, thepatient should be put on a nourishing diet and have a little stimlating wine given him, whatever the antiphlogistic theory may sayagainst it. As far as medicines are concerned, help may be expectfrom Tartar emetic, Arsenicum, Digitalis, perhaps also from Jffyocyaraus and Squills; even Veratrum album may have to be used insome cases. As a measure of precaution, which is of great importance to the patient, he should not be allowed to remain lying onback too long at a time, but should be directed to change his postion quite frequently, and to keep the upper part of his body inmore or less vertical posture, lest hypostasis should set in, whihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 252 of 653might otherwise easily occur.Hypostatic pneumonia cannot, properly speaking, be regarded as ^inflammation; it represents a peculiar hypersemia of the lungsdei.>ending upon a paralytic weakness of the circulatory and respatory organs. It only occurs as a part of other pathologicalconditions, on which account no special treatment can be assignedto it.Iiobular pneumonia is likewise a co-existing and very serious294 Diseases of the Lungs.complication of bronchitis, not an idiopathic affection, and it istill more difficult to point out for it a treatment based upon erience, for the reason that we are not in the possession of any mfor obtaining an exact diagnosis. Knowing, however, that whooping-cough easily leads to lobular pheumonia, and the results of otreatment being uncommonly satisfactory, we may assert with goodreason that we possess real remedies for this dangerous diseasewhich will prove efficient in cases that did not originate in whoing-cough. If lobular pneumonia sets in with a decisive increaseof the fever, or with a more violent fever generally. Belladonnavery often be found suitable, but still more frequently MercuriusIf the signs of cerebral hypcrsemia prevail, we have in Opium aremedy that indeed does not cause the whole process to retrogradebut exerts an exceedingly curative influence by preparing the roafor other more direct remedial agents. Ipecacuanha should be mentioned here side by side with Opium, because it likewise causesmarked hypercemia of the brain, but not sufficiently violent tocause sopor; convulsions, an exceedingly spasmodic cough withsuffocative paroxysms and asthmatic complaints which even remainafter the cough ; loud mucous rfiles in the chest, coldness of thextremities and heat of the head are the chief indications. Stillmore important for this kind of pneumonia is Veratrum albums aremedy which, in the form of an alkaloid Verainney has foundgrace even in the Old School. Its most essential indications aredyspnoea with slight rattling of mucus, dry and spasmodic coughaccompanied by marked cerebral congestions, a hurried and smallpulse, cold skin and cold sweat, together with excessive debilityThis group of symptoms may sometimes require the use of Veratrum album in croupous pneumonia. Moreover Phosphorus^ Tartaremeticy Hyoscyamus and Cuprum deserve to be mentioned in thisplace ; in general, all the medicines that have been named underbronchitis, deserve attention in lobular pneumonia. The consecutidiseases have to be regarded with special care. A rapid terminatiin recovery is comparatively rare in lobular pneumonia ; the patiremain feeble for a long time, hack a good deal or have to passthrough frequent and severe paroxysms of cough ; the assimilatingfunctions are suffering, although diarrhoea need not necessarilypresent; physical exploration reveals more or less distinctly acatarrhal condition of the most delicate bronchial ramifications.In such a case it would be a decided mistake to leave the furthercourse of the disease to Nature, as it is perfectly proper to doPneumonia. 295http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 253 of 653the remains of most other acute affections. In such cases Snl'phvr shows an extraordinary persistence of penetrating action;we advise, however, the use of high attenuations at protractedintervals. This action of Sulphur is most easily accounted for bythe supposition, that the pneumonic exudation which, as was saidabove, takes place progressively from one portion of lung to thenext adjoining, still exists either entirely or in part, keepingpatient's illness, and that it is this exudation which is reabsorby the aid of this drug. Calcarea carbonica likewise has often avery excellent effect in this protracted course of the disease, eif slight febrile motionB or even hectic fever with intestinal casupervene, or if infantile organisms are attacked. As for Heparsulphuris we have not yet had an opportunity of trying this remedin a pathological condition of this kind, but we deem it essentiaadapted to it and worthy of a trial.We shall discuss typhoid pneumonia when we come to treat ofthe typhoid process generally. Typhoid pneumonia is a partialmanifestation of typhus, scarcely ever an idiopathic disease. Theinflammatory processes in the lungs depending upon tuberculosiswill likewise be discussed in the chapter on tuberculosis.The pneumonia of drunkards is almost always characterized bypeculiar phenomena depending upon sympathetic cerebral andcardiac irritation and a deficiency of reactive power. The cerebrsymptoms mostly point to Opium^ much less frequently to Nuzvomica. In the second stage Tarta7'us enieiicus occupies a prominpart. Phosphorus is less frequently useful, although it might seereasoning from analogy in other forms of pneumonia. If Tartaremetic is ineffectual, Carbo vegeU may still be of eminent use. Bladonna and Hyoscyamus are on a par with Opium^ whereas DigUtalis and Rhus deserve our commendation in the second stage.Regarding Ammonium carbonicum we have no experience of our ownto otter, but we consider this medicine worthy of a trial. Sulphuwill be found of little use in this form of pneumonia, whereasArsenicum album may render good service in the same circumstancesthat we have pointed out for Sulphur in simple pneumonia. [Cannabis saliva and the Bromide of Potassium may be important remediin this form of pneumonia. H.]Epidemic pneumonia either presents a characteristic group ofsymptoms, or else it has the peculiarity of not yielding to remedthat are apparently the most suitable, and of seeming disposed torun a perverse course. In naming the different remedies we have296 Diseases of the Lungs.had in many respects regard to these exceptional characteristics.To hit the right remedy for epidemic pneumonia, the most persevering investigations in the domain of Materia Medica will oftenfound indispensable. According to present experience, Bryoma^Hhus^ Belladonna^ Mrcurius^ Hepar sulphuris^ Phosphorus andTartar emetic are the medicines that we shall have first to selecfrom in epidemic pneumonia.It is more particularly the complications of pneumonia thatrender the treatment difficult and the result doubtful. Theyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 254 of 653determine in a great measure the selection of the remedy, and, onthe other hand, present great difficulties in finding the true refor the reason that they often present a very confused group ofsymptoms. The most important complications are the following:Pleuritis of a higher grade of course complicates the course ofpneumonia in an eminent degree, in the first place because of itsit is a severe affection, and in the second place because it intewith the process of reabsorption in the lungs. We shall refer tothis complication when treating of pleuritis.Bronchitis as a complication is jjerhaj^ equally important aspleuritis, and requires a more careful selection of the remedy thpneumonia itself; for a normal coarse of this disease can only beexpected after the bronchitis has been moderated. In selecting aremedy, those have to be considered first that are suitable to boaffections at once, but more particularly to the catarrhal procesFrom the reasons stated, and from our remarks concerning Aconitein the chapter on bronchitis, we shall commonly find that thismedicine, which is such an excellent remedy for pneumonia, isgenerally inefl'ectual in pneumonia complicated with bronchitis.Hence we consider ^he very usual recommendation of Aconite as aremedy against the totality of the febrile motions as unfounded,and, in our opinion, its employment would imply a loss of time,without being of any advantage to the disease. At the commencement of the disease, the best medicine to be prescribed, is Belladonna^ less frequently Mercurius. It is impossible to indicate chteristic distinctions of both remedies, for the reason that bothtoo many points of resemblance. In a given case these distinctioncan be pointed out with more facility. A few valuable symptomsare: violent, remitting fever with sweat, for Belladonna ; remittfever with profuse, strong-smelling perspiration, mingled withcreeping chills, for Mercurius. The latter has a thicklytongue, the former a thickly-coated tongue, with free borders. AlPneumonia. 297curius has intestinal catarrh, Belladonna constipation. Belladonncan only be employed for a few days, especially in the case of adwhereas its use can be continued longer in the case of children.After Belladonna, Bryonia is generally suitable, which, in thiscomplication, is undoubtedly one of the most important remedies.Mercurius sometimes corresponds alone with the course of thispathological process, especially in the case of adults, until notremains to be done but to accelerate the reabsorption of the pneumonic infiltration. For such a purpose, remedies like Sulphur andSepar sulphuris will have to be chosen, one of which, we meanHepar, is eminently serviceable. Rhus toxicodendron is particularuseful, if the catarrh is dry, and malignant fever-symptoms manifest themselves. The indications for Tartar emetic have been giveabove; it is only in rare cases that this remedy will be found incated at an early stage, it is more commonly indicated in the subsequent course of the disease. This is likewise true with regardCarbo veget. Of other remedies that may come into play, we mention Nux vomica^ Hyoscyamus^ and Senega^ perhaps also Pulsatillaand VeratrwTL,Chronic bronchitis and emphysema as complications of pneuhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 255 of 653monia are no less dangerous than acute Bronchitis. Previous tothe acute attack setting in, the respiratory movements had becomevery much embarrassed, and these embarrassments are enhancedby the access of pneumonia, since the habitual expectoration ofmucus is most commonly suspended as soon as the pneumonia commences. At the outset of such inflammations, if the fever is veryacute, -Bryonia and Mercurius are indispensable; Rhus will rarelyever appear suitable. Sometimes the symptoms indicate Tartaremetic from the start, or at any rate in one or two days ; in afftions of this kind, Tartar emetic often renders eminent service,vided the practitioner is not afraid of giving a sufficiently lardose. We have always found the second trituration necessary butsufficient. Verairum album deserves attention in such a case, espcially if marked cerebral symptoms are present, together with arapid sinking of strength and marked febrile motions, the pulsebeing at the same time very changing. Phosphorus^ which oftenseems indicated in such pneumonias, as well as Sulphur^ will scarever be of much use. In the further course of the disease, whetheit shows a very slow and gradually progressing improvement orelse an aggravation of the symptoms, Carbo veget. is a medicine ogreat importance which sometimes affords help even in desperate298 Diseases of the Lungs.cases. But not too mncli must be expected in a short time^becansethe course of the disease is always very much protracted. Lycopodium may come into play, although we cannot recommend itfrom i>ersonal experience. Nor have we derived much benefitfrom the use of Arsenicum which apparently seems indicated insuch cases ; at any rate it is much inferior to Carbo. The tardyabsorption of the infiltration is not specially accelerated by Suprobably because the conditions are wanting which favor the actioof this drug, namely a sufliciency of reactive power and a free aof the remaining respiratory channels ; Silicea^ on the contrary,motes the course of the disease in a striking manner. ' If the sytoms of passive hypenemia of the brain are very marked, the moatprominent remedy is Digitalis which may have to be given at thecommencement as well as at any other period in the course of thedisease ; it either removes or moderates the threatening symptomsof an imperfect return of blood from the brain.If pneumonia supervenes during whooping-cough, it is generallylobular, and as such has to be treated with the same remedies thahave been advised for the more malignant forms of this disease.Among them we mention more particularly Tartarus stibiatusyCuprum^ Mercurius^ Veratrum alburn^ Ipecacuanha. , Owing to theuncertainty of diagnosing this pathological complication, it is vdifficult to hit upon the most available remedy. No less malignanthan lobular pneumonia is croupous pneumonia, if supervening during whooping-cough. In such circumstances the course of the disease will scarcely ever be normal. Nervous phenomena set in at anearly period, the infiltration remains undissolved for a long timand a long illness may be expected without doubt, during whichthe lives of the children are in the greatest danger. In the casea child of eight months, which terminated favorably, Tartar emetihad the best eflTect, and next to it Veratrum and Ipecotmanhaywhereas Hepar sulphuris, Phosphorus, Sulphur, and other medicines apparently had not the least influence over the disease. Ifhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 256 of 653we ever should have another similar case to treat, we should givetwo ren^edies in alternation, one for the whooping-cough, and theother for the pneumonia. It is true, after the inflammation has sin, the paroxysms of cough become leas frequent and less violent,but they cause a horrid distress to the patient and they do notexert a good influence over the disease. It might be well, in succircumstances, to try to subdue the paroxysms by means of Cuprum."We do not mean to be understood as though we regarded these fewPneumonia. 299remedies as the only ones suitable to this complication ; they arthe only remedies that have done us any good in such cases. Besidthese remedies all those that have been recommended in previousparagraphs for whooping-cough complicated with acute bronchitis,may have to be employed, and for the sequelae or secondary diseasanother class of remedies may come into play, which it is impossible to enumerate in this place.Pneumonia complicated with influenza, has to be treated according to the same rules that have been laid down for epidemicpneumonia.Cerebral hypersemia is a serious complication, although more frequently in appearance than in reality. Most commonly it can onlybe regarded as a disturbing symptom. But if, owing to its intensity, it should develop paralytic phenomena, sopor and coma, or ithe patient is far advanced in age, this hypersemia will requireticular attention and treatment. Among children it is of much lesimportance. It has to be treated with Belladonva^ Opium^ HyoscyaviuSy Verairum^ Digitalis^ Tartarus stibiatits. The first threthese remedies are more suitable for children, the last three forpeople. In the case of these cerebral phenomena we have to becareful in determining whether they originate in pure hypersemia,or depend upon the process going on in the lungs, and a consequent alteration of the blood, and, therefore, belong to the cateof typhoid symptoms. In the latter case, quite difterent remedieshave to be used, such as : Phosphorus^ Mercurius^ Rhus tpx.^ andothers. Sometimes a mistake is not easily avoided, especially incases where the disease had a typhoid character from the beginning. The importance of cerebral hypersemia is likewise to bemeasured by the locality of the pneumonic process; it is of muchless consequence if it arises from an inflammation of the upperlobes, for in such a case it can be readily and directly accounteby a disordered circulation, whereas, when the lower lobes are inflamed, the hypersemia appears more in the light of an idiopathicdisease whose connection with the fundamental inflammation is noteasily explained.Attections of the heart, whether they existed as chronic affections previous to the occurrence of pneumonia, or whether theyoccur as acute affections during the course of pneumonia, constitute most threatening complications. If chronic affections of theheart are present, the dyspnoea is extremely aggravated by theirpresence, an active as well as passive hyperemia of the brain sethttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 257 of 653800 Diseases of the Lungs.in much more readily, and the resolution of the exudation is muchretarded and is rendered much more doubtful by such a complication. The selection of a remedy likewise becomes so much moredifficult, since we cannot determine the degree of attention thatheart-symptoms may legitimately claim. Tartarus stibiatus^ J^igitalis J Veratrura alburn^ Cannabis saliva^ Sulphur^ correspond mofully with both orders of symptoms ; Lycopodium^ and Carbo vegetabilis may likewise be included in the list. At all events, suchcomplications render a most thorough investigation of our MateriaMedica indispensable. Acute diseases of the heart, if considerablfar advanced, constitute very dangerous complications, since theyalways interfere with the normal course of pneumonia. Of muchmore importance than that of bronchitis is the treatment of thiscomplication, since the heart-disease has to be removed befdre thcure of pneumonia can be thought of. We therefore refer thereader to the therapeutics of diseases of the heart.Hepatic hypersemia is a very ordinary accompaniment of pneumonia, and is generally the most severe, if the lower portion ofright lung is affected. On account of the presence of icteric symtoms, a form of pneumonia, termed bilious pneumonia, has beenadopted by pathologists ; but it is our opinion that hepatic hypesemia is too natural a consequence of an obstructed pulmonary circulation to deserve a very large share of attention. Quite recentwe attended a man who had all the symptoms of. a violent hepatitis, and yet was in reality attacked with nothing but a pneumonof the right side. This combination is in the first place met byBelladonna^ afterwards Bryonia^ and Mercurius^ and finally Phosphorus and China are the most suitable remedies. The hepaticsymptoms only require special attention, if the flow'of bile is cpletely suspended and the gastro-intestinal catarrh is kept up anaggravated by this stagnation of the biliary current.Gastro-intestinal catarrh in a higher or lower degree is an almosconstant companion of pneumonia. If violent, it contributes greattowards impressing a typhoid character upon this disease. Gastriccatarrh alone is not very important, although the modification ofthe symptoms superinduced by the catarrh, may render the exhibition of Bryonia or Mercurius^ Veratrura or Tartarus emeticus indipensable at the very commencement of the attack.Chronic pneumonia, which we will class in the same category aslentescent pneumonia, has very different symptoms and requiresdifferent remedies. If it consists mainly of the pneumonic infiltPneumonia. ' ^ /> 801tion, without any other marked morhi^ mahjfeslfalions, the consistcut use of Sulphur is alone calculated^to fetjng' a'^put a cuBut if the infiltration is partially firm and p^tially- di^d

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 258 of 653play, especially if the formation of an abscess threatens. Not onof these remedies, however, is a guarantee of success, and we, thfore, again call attention to the use of compressed air. We havewitnessed most strikingly favorable results from the use of compressed air within the space of four weeks, results that wouldastonish any body who witnesses them. A similarly favorable effecis produced in chronic pneumonia by a sojourn on high mountains.In conclusion we have to devote a few words to diet for the purpose of scattering the prejudices which still prevail in referencthis subject both among physicians and laymen, although, not byany means to the same extent as formerly.Pneumonia being very generally regarded as the result of a cold,the fear of increasing this supposed cold is so great that at theoutset of the attack the windows are hermetically closed, and thepatients are not only covered warm, but are kept in an artificialtemperature of 65° to 75° Fahr. This shows to what erroneousmeasures a wrong and arbitrary hypothesis may lead, and howthese measures in their turn afford sustenance to the hypothesis.The absurd method of keeping the skin too warm, makes it sosensitive to the least exposure that every draught of air must neessarily cause aggravations in the patient's condition. "We cannowarn with sufiicient urgency against such management. Let thetemperature of the room be kept at an uniform point of 50° to 55°Fahr., rather less than more, and, if this degree of heat has toreached by keeping a fire in a stove, let a vessel with water bekept on the stove in order that the dryness of the heat may bemodified by the vapors ascending from the water. The patientshould, moreover, be lightly covered with woollen blankets. Thiscoarse will render the burning fever-heat more tolerable ; at anyrate, we enjoy the comforting assurance that the heat has not beeunnecessarily increased. A copious perspiration during the courseof pneumonia is never an agreeable circumstance. No lees censur802 Diseases of the Lungs.able is the dread that some people have of washing the skin for tpurpose of keeping it clean. Any one who, during an attack of fevhas enjoyed the luxury of a rapid cold ablution of the face, neckarms, will not hesitate to vouchsafe this blessing to a distressemonic patient. A main point is the quality of the air in a sick rNo physician, not even a reasonable layman, will want to administer spoiled food to a deranged stomach ; yet people have a dreaof conveying pure and fresh nourishment to the lungs. Opening awindow in the room where the pneumonic patient is confined, isregarded as a crime; yet it is absolutely necessary that fresh aishould be admitted to the sick room, for the air is vitiated notby the respiratory efforts of the patient and his attendants, butlikewise by the cutaneous exhalations and the odor of excrementitious matter. Why should these odors be less pernicious in pneumonia than they are now universally admitted to^ be in typhus ?The patient's own feelings may be taken as an evidence that freshair is indispensable, for a larger number of persons in the roomalways unpleasant to him and augment the difficulty of breathing,which can easily be accounted for upon physiological principles.While the inflammation lasts, the patient will scarcely ever wanthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 259 of 653anything else in the way of nourishment than some beverage; eventhe slightest desire for solid food is an exception to the rule.fresh water is the best drink and should be avoided only in caseswhere it excites the cough. Water sweetened with sugar, is notadvisable; it causes acidity of the stomach, but water mixed witha little currant jelly, may occasionally be allowed. A small quantity of malt-beer, sweetened with a little sugar, and not drank toften, is exceedingly refreshing. The common prejudice againstthis beverage is entirely unfounded. Water-soups and dilute milkwith a little wheaten bread, will be sufficient nourishment. Butsoon as the fever begins to abate and the appetite returns, a morsubstantial animal diet will have to be allowed, for the reason ta considerable waste has to be repaired. A change in the courseof pneumonia may render corresponding changes of this simplediet indispensable. If the patient feels very weak at an early peof the disease, good broth may be given him without fear ; andthe presence of adynamic fever may even require small quantitiesof some gSBHOTM' wine, espedally in the case of old people; an uudue stimulating effect need not be apprehended. In the case ofsmall children it is a very common mistake to quench their thirstwith wine. But if the stomach is again and again called upon toGangrxna Pulmonum. 803recommence the process of digestion, the catarrhal affection of torgan must, of course, be made mach worse than it was in consequence of the pneumonic process ; this conduct is reprehensible ashould by all means be avoided. The avidity with which childrendrink cold water during their fever, is abundant evidence that itin harmony with the wants of the infantile organism. Special cautions in regard to diet are only required by the presence of a coplicating intestinal catarrh.When the patient may again go out in the open air, will dependupon the weather, and likewise upon the fact, which has to be welascertained by a careful exploration of the chest, that the pneumonic infiltration is completely reabsorbed. In this respect thesuperiority of homoeopathic treatment is likewise apparent, for iscarcely ever leaves the lungs so sensitive to open air that fromaction upon this organ any untoward consequences need be apprehended.10. Ckftngrsena PulmonmiuGangrene of the Lungs.(According to Kafka.)[This morbid process is distinguished from other similar processes in the organism by the circumstance that putrefaction associates itself with the death of the mortifying parts.Anatomical Characteristics. Pathologists distinguish twokinds of gangrene of the lungs, circumscribed and diffuse gangrene.Circumscribed gangrene occurs most frequently. Detached portions of pulmonary parenchyma of the size of a hazel or walnut,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 260 of 653are transformed into a tough, brown-green, humid, horriblying scurf which is sharply circumscribed and surrounded by oedematous tissue. The sphacelated portion of lung which is at firsttolerably firm, soon dissolves into an ichorous fluid. It occursfrequently at the periphery of the lungs and in the lower lobes.a bronchial trunk opens into the gangrened portion of lung, theichor often runs into the former, causing an intense bronchitis.Gangreneud scurfs may likewise form on the pleura. After softening, ihe-gmBgreoovLB ichor runs into the pleural cavity, causingsevere pleuritis; if the gangrened portion of lung communicateswith a bronchus, pyopneumo-thorax may result, and, if the vesselsbecome corroded, hemorrhage from the lungs may take place. If804 Diseases of the Lungs.interstitial pneumonia develops itself round the gangrened scurf,the latter is enclosed in a capsule as it were, and a cicatrix isformed ; this termination is exceedingly rare.Diffuse gangrene frequently affects whole lobes of the lungs; theparenchyma forms a decaying, blackish, fetid tissue, which issoaked with a blackish-gray, horridly-smelling ichor. The processis not circumscribed, but extends to the surrounding, cedematoushepatized parenchyma. If the gangrene invades the pleura, thisorgan becomes. involved in the process of destruction. The patiensuccumb to constitutional prostration.Metastatic abscesses and embolia in the different organs are notunfrequently the consequences of gangrene.Etiology. Diffuse pulmonary gangrene sets in, although rarely,at the height of pneumonia, if all renewal of the blood and thenutrient process have entirely ceased in the inflamed lungs; pneumonias arising from the clogging up of the air-tubes in consequenof the intrusion of particles of food, are very apt, owing to theputrefaction of these molecules of animal matter, to terminate ingangrene.Circumscribed gangrene of the lungs may be occasioned by sanguineous clots compressing the bronchial arteries; the putrid contents of bronchiectatic caverns may give rise to putrid decomposition of the pulmonary parenchyma.Diffuse gangrene of the lungs in the case of drunkards or of individuals whose constitutions are broken down by misery and starvation; the occurrence of pneumonia in the case of insane persons,without any foreign bodies having become lodged in the bronchia ;and gangrene of the lungs setting in in the course of severe asthfevers like typhus, measles, smallpox, puerperal fever, etc., areficult to account for.Sf/mptoms. A characteristic symptom of gangrene of thelungs are the cadaverous, blackish-gray, liquid sputa, and thecadaverous odor of the breath which, in some cases, precedes thesputa for a few days. The stench is often so horrid that neitherthe patient nor his attendants can bear it. The sputa, like the fexpectoration from bronchiectatic caverns, separate into threehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 261 of 653layers, namely, a superficial froth, a fluid, middle layer, and athicker sediment at the bottom. The sputa contain elrfstic fibresdark-brown masses resembling tinder, with a blackish tint, andsoft plugs containing fat-aciculre.Diffuse gangrene in consequence of pneumonia manifests itselfGangrsena Pulmonum. 805by sudden collapse, a high degree of debility, a small and irregupulse, and by cerebral symptoms, with wliich phenomena the characteristic sputa and respiration soon become associated. If diffugangrene sets in without pneumonia, we perceive from the startsymptoms of adynamia resembling the phenomena that generallyaccompany septicaemia with chills, stupor, delirium, singultus, eCircumscribed gangrene sometimes cannot be recognized untilthe gangrenous ichor has passed into the bronchia and is expelledby the mouth.Some patients bear this severe disease without much distress;their constitutional condition is not very much disturbed; theyhave no fever, walk about, attend to some light, domestic employment, and the disease often drags along for months.If the gangrened portion of lung does not communicate with abronchus, and has become isolated as within a capsule in consequence of secondary inflammation, the cadaverous odor may bealtogether wanting.To infer the presence of pulmonary gangrene alone from thecadaverous odor, would be an exceedingly superficial mode ofreasoning, since this symptom may likewise occur in bronchiectasiand when tubercular caverns are present.The physical signs during this morbid process are not veryimportant.In diffuse pulmonary gangrene consequent upon pneumonia, percussion at first yields a dull or tympanitic sound; auscultationreveals indistinct respiratory murmurs or rales ; in the subsequecourse of the disease percussion reveals cavities in the lungs, tsame as in the case of tubercular caverns, and auscultation reveabronchial respiration and cavernous sounds.Circumscribed gangrene is very difficult to recognize by physicalexploration.Course, Terminafian, Pi^ognoHts. As haa already beenstated, even when affected with circumscribed gangrene, patientsmay seem apparently well for a long time, even for months, untilhemorrhages set in sooner or later, which exhaust the strength,or else the patients perish in consequence of subsequent astheniahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 262 of 653tabes. However, a radical cure is not impossible ; in such a casethe fetor of the sputa gradually disappears ; they gradually assua yellow color and a purulent consistence, and, as soon as the gagrenous focus has become encysted, it dries up and the sputa ceasentirely. This favorable termination may set in in consequence of20806 Diseases of the Lungs.an acute inflammation, or if the gangrenous process takes place ia bronchieetatic cavity or in some cavern in the pulmonary parenchyma.Pulmonary gangrene arising in consequence of cachectic conditions, by hunger, poverty, misery, long-lasting diseases, etc., imostly difiuse and almost always terminates fatally. Diffuse gangrene arising from any source, is almost always fatal.TreaUnenU K, during the course of pneumonia, the patient'sbreath begins to spread a bad odor, we should at once think of thtermination of pneumonia in gangrenous destruction. If largeportions of the pulmonary tissue are destroyed, the externallyceptible signs of this gangrenous decay become apparent, such as:great debility, collapse, delirium, sopor, decubitus, unquenchablthirst, fetid diarrhoea, etc., and death takes place in consequenutter exhaustion of the vital power.If pulmonary gangrene does not set in with rapidly developingand threatening phenomena ; if the gangrene is limited to a definlocality; if the strength of the patient is sufficient to bear upagainst such a violent attack, and symptoms of adynamic fever setin, we give Arsenicum 6, or China 3 to 6, six, eight or ten dropshalf a goblet of water every two hours.If the course is more protracted. Carlo veget. 6, or Camphor 8 to6, or Kreosoie 8 to 6 may render efficient aid. The last namedremedy is likewise useful as an external application for the purpof neutralizing the fetid odor of the breath and sputa.The horrid odor is likewise said to be neutralized by means ofpulverized charcoal scattered in the spittoon ; the best neutraliis probably the Permanganate of Potash.In obstinate cases Secale comutum 3 to 6 may prove useful, especially if hemorrhage sets in accompanied by collapse, rapid prosttion, coldness of the extremities, exhausting diarrhoea, deliriumvertigo, sopor. If this remedy does not produce an improvement,Ergotin 1 may be tried, which acts with more power and intensity.Skoda recommends inhalations of turpentine, one drachm totwo drachms of hot water, two to four times a day. Niemeyerthinks that these inhalations are only of use if the gangrene setin the neighborhood of bronchieetatic caverns.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 263 of 653Next to the internal remedies we must not forget suitable dietetimeasures. To maintain the general constitution, we have to placethe patient upon an invigorating diet and feed him on generouswines, Hock or Claret, good ale, provide for adequate ventilation(Edema Pulmonum, Hydrops Pulmonum. 807of the Bictroom, frequent fumigations with vinegar, purificationof the air by means of Chloride of lime or Permanganate of Potashand sprinkling the bed-linen, floor, etc., with vinegar or a soluof the Chloride of lime, Kreosote or Permanganate of Potassa. H.]if.

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 264 of 653808 Diseases of the Lungs.left auriculo- ventricular orifice, and hypertrophy of the rightheart; in the course of pulmonary tuberculosis, carcinoma of thelungs, Bright's disease, infiltration of the bronchial glands, etchronic cedema of the lungs is almost always complicated withoedema of the lower extremities, or with hydrothorax, ascites. Insuch cases an apparently trivial cause, such as a cold, a physicaexertion, a sudden outburst of passion, etc., is suflScient to girise suddenly to a very general oedema of the lungs of which deatmay be the speedy result.Acute oedema most frequently sets in during the death-strugglein the most diversified diseases.Symptoms* The first important and striking symptom is thedyspnoea; it may attain a very high degree, is most commonlyassociated with the sensation of an oppressive weight under thesternum which does not abate by any change of position ; at thesame time the expression in the countenance is one of anxiety, anthe 7njobility of the thorax is lesSy in consequence of which theat times sit up erect, at other times rest on their arms and agaistretch their heads forward, in order to facilitate the breathingThe cough is spasmodic, the expectoration is exceedingly profuse,of a frothy-serous consistence, sometimes pale and at other timesdark-red ; moist rfiles are heard in the whole chest ; cyanosis sitself first in the face and afterwards on the extremities.Gradually the sensation of suffocation increases in violence, theexpectoration becomes less, the rattling becomes louder and is beeven at a distance ; little by little, in consequence of the poisof the blood by carbonic acid, the patient becomes soporous, he ino longer able to cough up the sputa, because the muscular apparatus is semi-paralysed; the cough is less frequent, the breathinbecomes more and more superficial and shorter. Finally collapsesets in, the cheeks become livid, a rattling is heard in the tracand the patients die of asphyxia.K the oedema is extensive, and the air has been driven out of alarge portion of the lungs, the percussion-sound is muffled or typanitic ; as long as air remains in the oedematous portion, the pcussion-fiound remains unaltered. The local or circumscribed oedeon percussion frequently yields no alteration of the sound ; if tcells are entirely filled with serum, the percussion-sound may bedull and empty ; if situated at the apex of the lungs, this condiof the cells may be confounded with tuberculous infiltrations. Aucultation generally reveals all sorts of rfiles, except consou: n(Edema Pulmonum, Hydrops Pulmonum. 809The Bymptoms of acute cederaa of the lungs sometimefl set inwith BO much rapidity and violence that one symptom seems tochase the other.If acute oedema sets in in consequence of collateral congestion iportions of lung that had hitherto remained free from the existing pneumonia, pleuritis, etc., new febrile motions generally apphttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 265 of 653accompanied by a more or less high grade of dyspnoea and fine r&Iin the recently-invaded portions of the lungs which, unless speedcounter-acted, are soon succeeded by the above-described signs ofpulmonary oedema.In chronic oedema the above-described symptoms develop themselves much more slowly, and they are variously modified by theprimary disease.Generally the oedema is complicated with oedema of the extremities, sexual organs, serous transsudations into the pleura or pertoneum; percussion yields a dull sound in the lower portions ofthe lungs.Course, Termination, Proffnosis. Acute oedema generallydevelops itself with more or less rapidity, and if the symptoms avery violent, may soon terminate fatally. This is most frequentlythe case, if henomena of collateral congestion set in during thecourse of inflammatory processes in the lungs, pleura, heart, etcThis termination was designated by the ancients as apoplexia pulmonura serosa. In such cases the highest degree of dyspnoea veryspeedily develops itself; amid a constantly-increasing anxiety anrestlessness the patients soon become cyanotic, cough a great deaand expectorate a quantity of frothy serum, more or less tingedwith blood; suddenly they become quiet; sopor and trachealrattling set in, and they die very suddenly of asphyxia consequenupon poisoning of the blood by carbonic acid.Chronic oedema of the lungs generally runs a slow course, andoften has remissions ; sometimes life is suddenly terminated by aacute eftusion. If the constitutional vigor is well preserved, chCBdema can be removed more easily than an acute attack which isgenerally very dangerous ; for this reason the prognosis, as fardanger to life is concerned, is more favorable in a case of chronthan acute oedema.Treatment. In all diseases in the course of which acute pulmonary oedema may set in, the supervention of a sudden dyspnoeawith a characteristic cough and sputa, deserve our most seriousattention. If a more or less violent fever supervenes during the810 Diseases of the Lungs.dyspnoea, we at once give Aconite 3, every quarter of an hour, orevery half hour or hour; the result is generally favorable. At anrate the exhibition of this drug secures us the advantage of moderating the violence of the oedema, and giving the physician timeto arrange a suitable couree of treatment.As soon as fine rales are heard, and the dyspnoea is increasing,even without any sputa, we give at once Phosphorus 8, continuingthis remedy even if a copious frothy serum, tinged with blood, isexpectorated. This remedy sometimes has a brilliant effect; oftenin a few hours the whole trouble is ended.If the cough is strikingly spasmodic, we very soon perceive abluish color of the lips and tongue ; in such a case there is gredanger on account of the capillary engorgement that threatens tohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 266 of 653set in. In such a case we give Ipecac. 8; if no improvement hastaken place in a few hours, we prescribe Arsenicum 8, or LachesisWe have seen very fine effects from these remedies. If coarse ralare heard over the whole chest ; if the characteristic sputa arecopious; if soon after the expulsion of the sputa rales are againheard with equal force and distinctness ; if cyanotic phenomena abecoming manifest, and a high degree of dyspnoea and suffocativeanguish torment the patient, we give Tariarus emeL 8, or Veratrur3 every quarter of an hour. The result of these agents is of courvery doubtful, on account of the air having already been in a gremeasure expelled from the cells owing to the vast extent of theoedema. If the strength begins to fail ; if the cough grows lessthe expectoration is more difficult, we again try Phosphorus whicwe now use as a restorative. Very frequently Phosphorus inducesan increased desire to cough, with more copious expectoration andmomentary relief; soon after all the former symptoms set in withmore threatening intensity, and the patients are in danger of beisuffocated by the mucus. This is the moment when an emetic mayproduce a marvelously favorable effect. Let not the use of anemetic bo delayed until the strength is entirely exhausted and thpatients have sunk into a state of sopor. As long as a certaindegree of reactive power remains, we need not hesitate to giveIpecacuanha at the rate of five grains per dose, or Emetin^ halfgrain per dose, every five minutes, until mucus is vomited up incopious quantities, after which many patients begin to improve.As soon as we notice the first signs of drowsiness, we giveAmmonium carbonicum 1 to 8 ; this remedy may prevent poisoningof the blood by carbonic acid.Asthma. 811A collateral congestion setting in during the course of pneumoniascarlatina, pleuritis, carditis, etc., may become associated, besabove-mentioned febrile and catarrhal pneumonia, with such aviolent determination of blood to the brain, that cerebral apoplemay be apprehended. In such a case we employ Belladonna orGlonoine^ [also Verafrum viride in large doses, no less than fiveof the tincture every half hour, IL], together with applicationsice to the head ; if these remedies have no sort of eftect, we dohesitate, as a last desperate resort, to bleed the patient. [We dnot believe that under the use of Aconite, Belladonna and Veratruviride, in appropriate doses, the necessity for bleeding will eveoccur. H.]If there is insufficiency or stenosis of the mitral valve, we givPulsatilla or Kali carb. If oedema of the extremities, genital oretc., is present, we resort to Arsenicum^ Lucliesis^ IXgitalis. Fserous eifusions in the pleura or peritoneum we give according tothe prevailing symptoms Arsenicum^ HelleboruSy China^ Scilla, Sidphuvy [also Apocynum cannabinum^ H.], but without much hope ofsuccess. H.]19. Asthma.Under this name so many and such diversified pathological conditions have been comprehended from time immemorial that it wouldbe difficult to write a treatise on this disease corresponding wihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 267 of 653the definition of asthma entertained by former pathologists.If we omit the various conditions that develop asthmatic phenomena which have not generally the peculiar characteristics ofnervous paroxysms, the etiology of asthma can be reduced to thefollowing points : in the first place the affection is purely idideveloping neither any special pathological alterations, nor tracto any particular exciting causes. The patients are attacked atindefinite, much less frequently at regular periods. Asthma islikewise met with as a partial manifestation of other neryous afftions, especially of hysteria and hypochondria, in which case itlikewise to be regarded as a primary affection occurring in peculcircumstances. Finally asthma may be caused by topical impressions; we see asthma result with comparative frequency afterexposure to Copper, Arsenic, Iodine, Lead, and to the dust ofIpecacuanha. The most heterogeneous circumstances are assignedas the exciting causes of this disease ; whether rightly or wrongis difficult to decide in view of the utter absence of regularity812 Diseases of the Lungs.the occurrence of the paroxysms. It is certainly a supposable casthat the attacks can be excited by the" direct action of irritantupon the lungs, more especially by vapors and dust ; but it is stthat this irritation does not seem controlled by any law. Intenseemotions are undoubtedly one of the most frequent causes of asthmOf undeniable influence is the condition of the atmosphere in athermometrical as well as barometrical point of view ; the attackare most easily excited during a high state of the thermometer ana low state of the barometer. Electricity likewise plays animportant part in regard to asthma, ior the attacks are very aptbe excited previous to severe thunder-storms. Regarding a predisposition to asthma, it is certain that the male sex is most liablit, and that most cases of asthma occur between the age of pubescence and the age of fifty. Constitutional influences seem almostnull, thin as well as corpulent, feeble as well as robust individbeing attacked. In many cases we have undeniable evidence ofthe hereditary character of the disease.Syjnptotna and Courne* Asthma consists of a series of paroxysms separated from each other by intervals which at first areabsolutely free from all symptoms of the disease. Hence, we haveto consider first the paroxysm itself, and subsequently its efiec• upon the general organism.The attack either sets in with distinct precursory symptoms,among which great exhaustion and an increasing oppression ofbreathing are the most common ; or else, the attack sets in at onwith great violence. It is renoiarkable, although it cannot beaccounted for upon physiological principles, that the attack geneally sets in at night, most frequently in the evening, scarcely ein the day-time. This feature is, however, peculiar to all purelynervous affections, the cause of which may be the circumstancethat the activity of the nervous system is constantly increasingtowards night. Very often the patients are roused trom sleep whenthe attack, sets in like an attack of night-mare. They experiencea constrictive sensation on the chest, with inability to draw a lbreath ; this sensation increases in proportion as the patient mahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 268 of 653an effort to overcome it, and often leads to terrible dyspnoea duwhich he strains every muscle that can aid him in performing theact of respiration. At the commencement of the attack the cervicamuscles are put upon the stretch, whereas the thorax is less callinto requisition. This is owing to the fact that the expirationsless complete than the inspirations, in consequence of which theAsthma. 813lungs gradually become filled with air to such an extent that theedge of the liver is felt considerably below its normal line. Durthe attack percussion yields a normal sound, whereas auscultationreveals before the paroxysm, and always immediately after itsaccess, in the place of the vesicular respiratory murmur, wheezinhissing, and occasionally rattling sounds, that sometimes are louenough to be heard at a distance. That the patients look pale andsometimes have a bluish or livid appearance ; that a cold perspirtion breaks out on them ; that the temperature of the skin is lowthan usual; that the beats of the heart are much feebler andincrease in frequency ; and that the urine is frequently discharginvoluntarily, is easily accounted for by the extreme dyspnoea.After the attack has lasted one to four hours, or even longer, itdecrease manifests itself by a return of the vesicular respiratormurmur, and by a diminution of the wheezing and hissing sounds.The sensation of tightness sometimes disappears quite suddenly anat other times very gradually ; a cough sets in accompanied by thexpectoration of a small quantity of mucus; or violent eructationor vomiting, with emission of flatulence, may take place, afterwhich the patients often feel well again, except a lassitude thatmay continue for days. In other cases the paroxysm does not ceasealtogether, but abates for a longer or shorter period, which remision is again succceeded by a full attack of asthma, until, afterseveral remissions and exacerbations, which may continue forweeks, a complete intermission takes place.The course of such a disease varies according as the paroxysmsset in at longer or shorter periods. In proportion as the diseaselasts longer, the intermissions become shorter, the paroxysmsincrease in intensity, and structural changes in the lungs and hetake place which, in their turn, promote the disease. Emphysema,chronic bronchial catarrh, dilatation of the heart are very commoresults of asthma, which are easily mistaken for causes of the diease. A single paroxysm, no matter how violent, is not of itselfdangerous, provided the paroxysm does not develop preexistingconditions of apoplexy into a full attack. In the long run, however, asthma always becomes dangerous in consequence of the lesions which it occasions, and whiqh are so much more certain, themore violent the single paroxysms are.The termination of this aftection cannot be determined beforeliand. In many cases the paroxysms decrease at a more advancedage and finally disappear altogether; or else, they are replaced814 Diseases of the Lungs.pulmonary emphysema and its consequences. It is difficult to prohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 269 of 653mise an early and complete recovery, for the paroxysms recursometimes after the lapse of years. Death is a very unfrequenttermination of this disease.The prognosis, so far as the preservation of life is concerned, ivery favorable; as far as a cure is concerned, the result of meditreatment must be considered uncertain. In contrast with OldPhysic, which has no remedy for asthma. Homoeopathy can at leastboast of having achieved some brilliant results.The treatment has to aim at controlling the present paroxyaniand at curing the disease.Respecting the possibility of shortening the paroxysm, it kdoubtful whether, in view of the uncertainty how long an attackwill last, any medicine can be relied upon for the accomplishmentof such a result. If the paroxysms only last a few hours, it isimmaterial whether we give any medicine; as regards paroxysmsthat have remissions and exacerbations before a complete intermission takes place, it would, of course, be desirable to relieve thOur own experience compels us, however, to confess that, in thisrespect, we have no very brilliant results to brag of. The sameremedies that seemed to have a good effect in one attack, did nothing at all in the next, although the symptoms seemed preciselythe same. If we are called to a case, we give a little medicine tquiet the relatives, but for a cure we depend solely upon the trement during the intervals. However, in order to avoid the appearance of a purely subjective exclusivism, we will mention some ofthe remedies that are most commonly used at the beginning of theattack, at the same time referring to the remedies that will bementioned by and by, and which may likewise be used for a singleparoxysm.Belladonna, when the attack is accompanied by congestion of thehead and an affection of the larynx, in the case of plethoric indviduals, children and females of an irritable disposition.Aconite, in the case of plethoric, active individuals, with severcerebral hyperaemia, after mental excitement, the face being verymuch flushed.Chamomilla, when the attack is caused by a severe fit of passion,with flatulence, particularly for paroxysms of hysteric asthma, ofor children during the period of dehtition.Nux vomica, for attacks caused by nervous excitement, spirits,much eating, hysteria, hypochondria, inhalations of dust, with coAsthma. 816gestions to the head, distention of the abdomen, especially of thstomach, improvement by a change of position, night-mare; theattack is preceded by signs of congestion of the chest.Pubatilla, for asthma caused by the vapors of Sulphur, by uraemiamenstrual disturbances and hysteria, with copious vomiting ofmucus, which affords relief, vertigo, sudden prostration with paltations of the heart.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 270 of 653IMoschus, for asthma without cough, with a violent feeling ofconstriction in the throat as if the glottis were involved in theattack, in the case of hysterical, hypochondriac, irritable individuals.We might extend this list by adding other remedies ; but sincewe believe that the indications for their use are mostly illusorywill content ourselves with mentioning their bare names. CannabisColchicunij Tartarus siibiatus^ Cocculus^ Staphysagria^ Nuz moschVeratrum^ Opium^ Phosphorus^ Nitri acidum^ etc. Many of theseremedies owe their use to the mistaken notion that a catarrh orany other affection of the respiratory organs with asthmatic symptoms is real asthma. The remedies from which most may be expected during the attack itself, are Bel^donna^ Cannabis^ Moschusand Opium, Opium especially sometimes renders substantial aidwithout it being necessary to employ large doses on this account.Morphia^ 2d trituration, two or three grains at a dose, exerts asufficiently powerful effect, and if this dose is not sufficient,remedy can only do harm. A copious secretion of mucus alwayscounter-indicates Opium. Cannabis likewise only palliates by virtof its narcotic properties, and hence will have to be given in amassive dose ; this remedy is altogether unreliable.As we said before, we have no great confidence in the use of anyremedy during the paroxysm which we compare to an epilepticparoxysm for which very little can be done by treatment. Nevertheless we should not remain idle spectators during an attack, siit is often possible to relieve the patient by all sorts of exterapplications. It is important, for instance, to regulate the patiposture. Some people will not allow him to leave his bed ; yet itof great importance and affords great relief to the patient, if erespiratory movement is brought into play, as much as possible, ba change of position. For this reason the lower extremities shoulnot be kept in a horizontal position, but should be placed verticand pressed against any object in order to facilitate the actionthe dorsal as well as abdominal muscles. All tight clothing shoul818 Diseases of the Lungs,be removed ; if the patient is in his senses, he attends to thisout being told. The temperature of the room must not be kept toolow, for the reason that the paroxysm always excites a profuseperspiration; nor should it be too highland, above every thing elthe air should be kept sufficiently moist. If we are called to atient who has had a number of attacks, we shall find that he keepevery thing on hand which, by it« direct action upon the lungs,may relieve a paroxysm ; nor can it be denied that relief is ofteprocui'ed by such means during one and even several paroxysms.They are generally powerful domestic stimulants, such as thesmelling and inhaling of the spirits of Ammonia; inhalations ofthe spirits of Turpentine or of Camphor evaporated on hot water ;the inhalation of the fumes of burnt nitre-paper, feathers and Suphur. We have tried the last remedy in our own case. That insuch cases it is not the specific action of the inhaled substancethe local stimulation that affords relief, is evident from the cistance that the effect is only palliative and transitory and thatinhalations of Chloroform, which have a direct narcotic effect, ahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 271 of 653scarcely ever borne by asthmatic individuals. Substances that areused for smoking, constitute another series of remedies. In thiscase, however, we deal with thoroughly homoeopathic remedies,such as Tobacco, Iodine, Stramonium, Ilyoscyamus. Tobacco can,of course, be useful only to persons who do not smoke, ladies, foinstance, to whom we recommend for such purposes the smallpaper-cigarettes used by Russian and Spanish ladies. Smokers, onthe contrary, mix the cut leaves of Stramonium or Hyoscyamuswith their tobacco, sometimes with surprising effect ; or they smIodine-cigarettes. The use of these remedies is justifiable, becathey afford relief to the patient, nor should they be discarded uwe have better remedies to recommend in their stead. Very oftenwe accomplish our purpose with the inhalation of simple vapors ofwater. The method of introducing appropriate remedies directlyinto the respiratory organs by means of an inhaler, has not yet bsatisfactorily verified as a superior proceeding.The main-point in the treatment of asthma is to meet the diseasein its totality. As a matter of course, the selection of the remeis not only governed by the symptoms between the paroxysms, butlikewise by the paroxysm itself and by the constitution of thepatient, and it is this indispensable consideration of so many ansuch varied conditions that renders the selection of the properremedy exceedingly difficult. In the subsequent paragraphs weAsthma. 817only furnish short indications for the selection of the most impotant remedies, since it is impossible to present these indicationwith anything like a satisfactory completeness.Araenicum album is undoubtedly the safest remedy for asthma ; itnot only corresponds to the simple spasmodic, uncomplicated asthma, but likewise to the secondary forms of asthma which owe theirexistence to the most diversified aiFections of a more primarycharacter. Arsenic is even used a great deal in domestic practiceand is highly commended by Old School practitioners. This remedylikewise shows very strikingly how the constant physiologicaleffects of a drug can be employed with mathematical certainty asremedial agents when employed according to the law of similarity.In slow arsenical poisonings, asthma always occura without an exception. "We dispense with the enumeration of individual symptoms, since every somewhat violent attack of asthma correspondsto Arsenic. Nor can we particularize the cases where asthmaoccurs as a mere symptom, since in such cases the selection of thremedy is chiefly determined by the character of the primary affetion. "We will state, however, that, in the asthmatic paroxysms otuberculous patients. Arsenic has always left us in the lurch. Itprincipally indicated by the following symptoms: The paroxysmalways sets in towards midnight or shortly after; it seems to begoverned by a tolerably fixed type, although asthmatic paroxysmsoccurring without any typical regularity do not exclude Arsenic;it reaches its acme with unusual rapidity. The more th^ patientsseem on the point of suffocating ; the more painful and distressitheir restlessness ; the more wheezing and louder their respiratithe more Arsenicum will be found appropriate. Accessory circumstances are: sudden access of a high grade of collapse with lividof the countenance, cold perspiration and a very frequent and smahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 272 of 653pulse; palpitation of the heart; distension of the abdomen con.sequent upon the attack; involuntary emission of the urine; unconquerable dread of death ; the paroxysm is excited by changesof temperature, atmospheric influences, talking or laughing, goinup stairs. The consequences of the attack remain for a long time,among which excessive debility and nervousness are most prominent. When given during the paroxysm, Arsenic sometimesexerts a magical effect, so that the patients fancy they have recOpiam; although Arsenic does not by any means help in everycase, yet it had better be tried in every case that we are calledapon to treat. During the apyrexia, the remedy had better be818 Diseases of the Lungs.adminivStered at long intervals and in the higher attenuations,although the success which Old School practitioners have obtainedwith Fowler's solution justifies the conclusion that massive doseare likewise conducive to a cure. The danger is that massive dosemay affect the stomach injuriously. Whether Arsenic possessesspecific antidotal powers against asthma caused by other metalshas not yet been determined.Cuprum is likewise one of the substances which, in cases of slowpoisoning, develops asthmatic symptoms. However, it has notproved of such decisive practical value as Arsenic, for the reasothat it has not the significant indications of this agent. In ouropinion. Cuprum is indicated by the following symptoms: Theremedy is suitable to individuals with nervous, irritable, enfeebconstitutions, who are, moreover, disposed to spasms, whereasArsenic is suitable rather to vigorous and plethoric persons ; oris suitable to children, especially if the paroxysms set in at nior in consequence of exerting the respiratory organs, as for instafter a coughing fit ; the paroxysm very speedily reaches the acmof its intensity; other muscular bundles are involved in the convulsive attack ; the attack is accompanied by a constant hacking,which aggravates the asthma; the attack terminates by vomiting;pallor of the countenance, with cold perspiration. The apj'rexianot perfect, but a slight degree of dyspnoea remains, or violentoxysms of an almost dry cough set in, which likewise end invomiting. The action of Copper in whooping-cough is evidence ofits general adaptation to spasmodic affections of the lungs. Wehave never known Cuprum to be of any use for the paroxysm itself, so that we now limit the use of this drug exclusively to thintervals between the paroxysms.As regards Plumbum, it has not yet been sufficiently tried eitherphysiologically or practically to present clear indications for iin asthma. Nevertheless, the affections of workers in lead showthat thej' are very commonly affected with a violent asthma. Uponthe whole, it bears great similarity to the copper-asthma, fromwhich it is not so much distinguished by its local as by its genesymptoms. We recommend the remedy more especially in thesevere paroxysms of tuberculous individuals, and likewise for theform of asthma, which is accompanied at the outset by a profuseaccumulation of gas in the bowels.lodium is likewise one of those agents which, among its* symptoms of slow poisoning, numbers asthma as one of its constant phehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 273 of 653A.thma. 319nomcna. In our Materia Medica these effects of Iodine are pointedout very imperfectly, and tlie reader is very much disposed tocombine the symptoms pointing to asthma with the symptomsdenoting inflammation. In the "Deutschen EHinik** of 1856, threecases of Iodine-asthma are recorded, which are of considerableinterest: The asthma set in after a protracted use of Iodine,whereas an acute intoxication with Iodine never causes asthma;the paroxysm sets in towards evening or more commonly aboutmidnight and lasts about half an hour ; in one case it commencedwith intense syniptoms of laryngismus stridulus; the paroxysmwas succeeded by excessive lassitude and an irresistible desire tsleep. Nothwithstanding the violent difficulties of breathing, evsign of a material change in the respiratory organs is wanting;there is emaciation ^dthout any increase of the secretions ; greanervousness and restlessness during the intervals. Hence, Iodinecorresponds well with the purely nervous asthma, for which it hasbeen prescribed more recently by several Old School practitionersof course, in enormous doses. Except a few not very striking curehomoeopathic literature does not offer any cases of asthma succesfully treated with Iodine.Stannum may be tried if the attack supervenes during the existence of chronic catarrh, and the decrease of the attack is attendwith a copious secretion of mucus. We do not find any wherereports of striking cures with this agent.Under quite similar circumstances Zincum metallicum will be founda suitable remedy ; an additional indication for this drug is a cous accumulation of gas in the bowels during the paroxysm.Spongia has so far been found useful only in asthma dependingapon tuberculosis, but it has never effected a complete cessationbut only a marked diminution of the frequency and intensity ofthe attacks. The paroxysm is characterized by a marked contraction of the glottis, a wheezing respiration, with complete loss ovoice. In a few hours the patient hacks up a substance resemblingsoaked sago.Aurum certainly deserves more attention than it has yet received.It is particularly indicated in cases where it is not quite certawhether the heart is primarily or secondarily involved in theattack; the attack sets in with violent palpitation of the heart,great anxiety, and marked symptoms of pulmonary hyperaemia.Among the vegetable remedies there are but few that we wouldrecommend for the totality of the disease; most of them are solel820 Diseases of the Lungs.adapted to the complicated forms of asthma. We confine ourselvesto mentioning their names: Ipecacuanha^ Belladonna^ LycopjdiumyBovista^ Lactma virosa^ Bryonia^ Pulsatilla, Lobelia ivflata is madapted to emphysema than to asthma. Opium sometimes affordshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 274 of 653striking benefit in paroxysms that occur during sleep.In a variety of cases we have witnessed remarkably favorableresults from the use of Digitaline. "With this remedy alone we haradically cured frequently-recurring paroxysms of asthma of lessprotracted duration ; in inveterate cases all that we have been ato accomplish with this agent, has been to diminish in some casesalthough to a considerable extent, the intensity and frequency ofthe paroxysms. It is, therefore, with a good conscience that wecan recommend this medicine for further trials in asthma, providethe following circumstances are kept in view: The asthma is altogether a primary affection, it is the purely nervous form, a genuspasm of the bronchia; in such a case Digitaline will have the beeffect as long as no catarrh, emphysema or structural change of theart supervenes. Digitaline is, however, suitable even if thesecomplications exist, to which it is, indeed, preeminently adaptedmore especially to structural alterations of the right ventricle.high degree of sanguineous stasis in the veins of the head, especally a violent throbbing-pressing headache during and after theattack. Palpitations of the heart, especially if the attack is prceded by them. The asthma attacks irritable individuals withweak nerves, more particularly persons who have been guilty ofsexual excesses. We do not simply mean persons who had beenaddicted to self-abuse, for we have known a married man who contracted asthmatic attacks in consequence of excessive sexual intecourse, and who was decidedly benefitted by Digitaline. The influence of Digitaline over the male sexual organs is extraordinarand, in this case, we effected a truly radical cure, as is likewident from what we stated when speaking of the diseases of themale sexual organs. The influence of Digitaline over the femalesexual organs, especially in its bearing upon the nervous system,so difficult to define that we are as yet without any decided datregarding this matter. We always administer this remedy in thesecond or third trituration, giving never more than one grain offormer in the morning before breakfast, never at night, for thereason that sleep is generally disturbed by Digitaline. Nor is itnecessary to give a dose every day ; a dose every two or three dais sufficient. These precautions are important to avoid medicinalAsthma. 821effects and homoeopathic aggravations. UnlesB these precautionarymeasures are adopted, a remedy the great importance of which hasnot yet been sufficiently recognized, might easily fall into discNotwithstanding we believe that we have indicated the mostimportant remedies for asthma, yet if the list of these remedieswere to be exhausted, a great many other drugs might be addedto it. In mentioning the following additional remedies, we recallto the reader's attention the fact that most of the remedies emplfor asthma owe their recommendation to coexisting complications.The following remedies may be compared in particular cases: Sulphur^ Ferrum^ Argentum^ Brornum^ Sepia^ Calcarea carbonica^ Carbovegetabilis^ Causticum^ Lachesis^ Asafoetiduy Tartarus sHbiatus.Beside medicinal agents a few other means to reach the disease,are at our command. These are remedies that invigorate theconstitution generally and strengthen the tone of the nervoushttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 275 of 653system specially, such as cold baths, cold ablutions, the wet sheliving in mountainous regions or generally in the open air, etc.more importance are the means that have more particularly oreven exclusively a local effect. Among these remedial means themovement-cure holds a prominent rank ; it sometimes proves efficient where medicinal influences seemed entirely powerless, moreespecially in the case of women and likewise in the case of menwho had broken down their strength by an effeminate and luxurious mode of living. The movement-cure lias likewise the greatadvantage of acting favorably upon the constitution. The actionof compressed air has likewise a surprising eflTect ; however, ityet impossible to state what particular form of asthma is specialadapted to this curative influence. According to all probabilitythis remedy is particularly adapted to shorten the protracted lenof the paroxysms. Living on high mountain-tops has a favorableefi*ect only in exceptional cases ; the same statement applies toair and surf-bathing.G. DISEASES OF THE DIAPHRAGM.We transcribe this chapter from Kafka. He only treats ofinflammation, spasm and hernia of the diaphragm; atixjphy,paralysis and tonic spasm of the diaphragm being generally partiamanifestations of other pathological processes.21822 Diseases of the Diaphragm.1. Dlapbragmltlis Inflammatian of the Diaphragm*[It consists in an inflammation of the serous covering of thediaphragm, either on its thoracic or abdominal side.This inflammation is never an idiopathic disease, but alwaysoccurs in the course of pleuritis (pleuritis diaphragmatica), orthe course of peritonitis (peritonitis diaphragmatica).According to the statement of older authors the following phenomena are characteristic of diaphragraitis: continued, violent fburning, stinging, tearing and contractive pains all over thediaphragm, the pain encircling the body like a hoop; during aninspiration the pain is felt lower down, during an expiration higup ; it is aggravated by coughing, talking, and by every motion othe patient, rendering a deep inspiration impossible; the breathiis hurried, anxious, superficial ; it is performed with the thorawhile the abdominal muscles remain passive; distressing singultusvomiting of a green substance, great ditiieulty of swallowing, sotimes hydrophobia, delirium, spasmodic laughter, finally collapseFrom the presence of these symptoms in the course of a pleuritisor peritonitis we may conclude that the diaphragm is involved inthe inflammation. Idiopathic diaphragmitis has not yet been methttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 276 of 653with. The intensity of the symptoms is generally extreme; aphysical exploration yields no result.The couree of the disease is generally very acute, the prognosisvery unfavorable.The etiology is the same as that of pleuritis or peritonitis. Thetreatment is likewise the same as that of pleuritis or peritonitiis only if out-of-the-way symptoms exist that they have to be metby special remedies.The most troublesome symptom is the distressing singultus. Forthis symptom we recommend Belladonna 8, especially if complicatedwith difficulty of swallowing, risus sardonieus, delirium and voming. If, in a few hours, this remedy does not afiford the desiredhelp, we give the Sulphate of Atropine 3, or Hyoscyamus 8.Bi7onia 3 is an excellent remedy, if the inflammation proceeds frthe pleura and is attended with considerable dyspnoBa, violent paduring respiration, difficulties of swallowing, cerebral irritatiIf the vomiting is a prominent symptom, as is generally the casewhen peritonitis is present, we resort to Belladonna^ JSux vomicaVeratrum. In obstinate cases we have recourse to Opium.A very disagreeable symptom is the spasmodic laughter, forSingultus, Hiccup. 823which we recommend : Belladonna, Hyoscyamus, Ignatia and Cuprummetallieum 6.2m Siniraltiis, Hleenp.This is owing to a spasmodic contraction of the diaphragm,during which the air is drawn in through the contracted glottiswith a shrill and short sound.The hiccup either originates in the nervous centres, as during ageneral erethism, neuroses, especially in the case of hysteric anhypochondriac patients ; or when accompanying cerebral diseases,such as cerebral ansemia consequent upon long-lasting, exhaustingdiseases or upon considerable losses of blood and other animalfluids, as well as upon violent psychical impressions, such as franger, etcOr else, it is simply a reflex-phenomenon, as during diseases ofthe pleura and pericardium.Consensual singultus may occur during diseases of the stomach,liver, pharynx, intestinal canal, etc.In the case of children it often occurs in consequence of a cold,or acid stomach.Singultus occurring during cerebral ansemia consequent uponchronic diseases, such as carcinoma, Bright's disease, tuberculosetc., or upon exhausting diseases, such as typhus, cholera, or uphttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 277 of 653pleuritis with profuse exudation, likewise upon pericarditis andupon exhausting diarrhoea, is always a very dangerous symptomthat may continue for days and finally increase to convulsions.Treatment. A passing hiccup is scarcely ever noticed ; onlyif it lasts too long and becomes too severe, medical treatment mahave to be resorted to.In cases of simple hiccup it may be arrested by stopping thebreathing for some time, or by drinking a little cold water, byfixing one's attention upon a certain object, such as: holding ain one's hand, by a systematic crossing of the fingers of both haby a sudden surprise, or such domestic remedies as eating a littlsugar, magnesia, ice, etc.Infants who have taken cold, have to be warmed, after whichthey should be put to the breast; if their stomachs are acid, wegive them Calcar. 6 or Nuz vottl 6; if they are aftected withintestinal catarrh, we give them Chamomilla 8, or Rheum 8. Adomestic remedy that is frequently made use of, is calcined Magneas much as will cover the point of a knife morning and evening.S24 Diseases of the Lungs.In one case, where not one of theae renaaiiea would help, a teaspoonful of recently prepared lime-water removed the spasm.If the singultus is intense and lasts a long time, we have to selremedies that correspond to the co-existing pathological conditioor to the exciting cause. For the nervous singultus of hysteric ohypochondriac individuals, we give according to the symptoms:Nvx vomica^ Ignatia^ Belladonna and Hyoscyamus^ Nux moschataand Natrum muriaticum.For singultus consequent upon a fit of chagrin, we give: CJianumUIgnatia^ Pulsatilla.For singultus occasioned by diseases of tne stomach and liver:Bryonia^ Nuz vomica^ Pulsate Natrum muriaticum and Sulphur,For painful singultus caused by inflammation of adjoiningorgans: Belladonna^ Hyoscyamv^^ Atropine.^ Opium 1 or 2.In a case of consensual singultus consequent upon spasm of theoesophagus, accompanied by nausea, Veratrum 8 has rendered usgood service.We are much less successful in the selection and use of remediesfor singultus occasioned by exhaustion of the vital forces andcerebral anaemia. In such cases we have succeeded in relieving thpatient by Ammonium carbon. 3, Phosphorus 8, and in desperatecases by Moschus 1.As elxtemal remedies practitioners recommend: laying gratedhorse-radish upon the epigastrium, dropping ether upon the pit ofthe stomach, painting this region with the oil of chloroform, onedrachm to two drachms of almond-oil, and in desperate cases theinhalation of ether or chloroform.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 278 of 6538. Hernia of the Diapbrafpm.Accidents of this kind originate in rupture of the diaphragmoccasioned by traumatic causes, or in strangulations of thethoracic or abdominal viscera in the natural ojienings of thediaphragm. They occur more frequently on the left than on theright side.The phenomena in the thoracic range are: dyspnoea, cough, painin the chest, singultus, suffocative paroxysms, fainting fits.On the side of the abdominal organs we notice vomiting, colickypains, obstinate constipation, sometimes symptoms of ileus.If the strangulation is partial, the symptoms appear slowly anddisappear equally slowly. If the constriction is very violent andPlcuritis, Pleurisy. 825tfudden, the symptoms set in with equal violence, and life may bein the greatest danger.The worst symptoms are those of ileus, which we meet with Nuxvomica 3 and Opium 1. Tepid baths, and in severe cases frictionsor inhalations of Chloroform are excellent adjuvants. U.]D. DISEASES OF THE PLEURA.1. Plenrltls, Pleurisy.Inflammation of the Pleura.Inflammatory aflfections of the pleura are not by any means rareoccurrences; yea, the frequent adhesions of the lungs to the thorrevealed by post-mortem examinations, show that pleuritic aflfectare not only very frequent, but that they run their course unobserved. The more trifling inflammatory phenomena are withoutany practical value, nor do they ever constitute an object of trement; for this reason we here treat only of the more acute formsof pleurisy with copious exudation.Pleurisies of this character are scarcely ever really primary diseases; in the majority of cases they are of a secondary nature.The etiology of primary pleuritis is somewhat obscure, unless thedisease is caused by some direct and mechanically acting agency.A most frequent cause is said to be a violent cold; but the casehere as in pneumonia, the connection is taken for granted ratherthan proven. The more frequent occurrence of pleuritis duringpeculiar states of the weather justifies' the conclusion that atmpheric conditions exert a decided influence upon the origin of thdisease. To designate such inflammations as rheumatic, is in so fhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 279 of 653justifiable to some extent at least, as acute rheumatisms occurepidemically at the same time. As a rule, primary pleuritis may,like peritonitis, be regarded as a rare disease.On the other hand, pleuritis as a complication or secondary 'aflection, is exceedingly frequent. All inflammatory pulmonaryaflfections, even hypersemia of more than ordinary extent, if occring near the surface of the lungs, develop pleuritis which isgenerally confined to a very limited space, but may likewise be vextensive and violent. Inflammatory aftections of the heart, moreparticularly of the pericardium, may lead to pleuritis. Acute326 Diseases of the Pleura.rheumatism and peritonitis, and likewise acute exanthemata, easilresult in the development of pleuritis. Among chronic affectionsthe following may occasion the disease : Pulmonary tuberculosis,pulmonary abscess, suppuration of the vertebrae and ribs, Bright'disease. The occurrence of pleuritis during the stage of convalescence in severe acute affections, in pyaemia and generally in discharacterized by marked signs of a septic condition of the blood,is a remarkable fact which does not admit of any further explanation. Like peritonitis, so pleuritis is superinduced in its worstand most extensive form by the intrusion of foreign substances inthe pleural cavity, most commonly by the effusion of pus from asuperficial cavern or from a suppurating bone.Symptoms and Course. The peculiarity of certain phenomenain a case of pleurisy can only be understood by an anatomicalanalysis of this process, on which account we premise a concisesketch of the same.By pleuritis we understand the deposition of an exudation uponthe free surface in the cavity of the pleura. As in every otherinflammation so we find here, at the outset, an hyperaemic condition of the cellular tissue situated under the pleura. This hyperaemia occurs most generally in striae or clusters, scarcely evera large extent, and very frequently exhibit-s small ecchymosicspots. It is from these hyperaemic centres that the exudation proceeds over the free surface. According to its constituent principthe exudation is generally distinguished in four different formswhich, however, cannot be rigorously separated from each other,but commingle in various ways. The fii*st form is the soplastic form, where a small quantity of a highly fibrinous exudatis deposited upon the free surface of the pleura as a pseudobrane which, by coalescing with the membrane on the opposite sideof the pleura, causes both sides of the pleural cavity to adherewithout any further complications. This process occurs very commonly in pneumonia, but likewise on other occasions with so fewsymptoms that it is placed beyond the reach of therapeutic definitions. The second form is the sero-plastic form. The exudationconsists of fibrin with which a more considerable quantity of seris commingled. This form has the exuded membranes of the firstform, but they are generally more extensive and thicker, and thepleural cavity contains an exudation of a yellow-green serum whicsometimes weighs several pounds and in which more or less copiousflocks of coagulated fibrin are seen floating. The copiousness ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 280 of 653Pleuritis, Pleurisy. 827the plastic exudation increases the tendency to adhesions whichare sometimes so extensive that they enclose the exuded fluid aswithin a capsule or sometimes as within a net consisting of a number of meshes and cavities. The third form is the purulent exudation, empyema or pyothorax. In this form the eftusion may consistof mere pus, or serum may be mixed up with it in greater or lessquantity. This form either characterizes an uncommonly acutepleuritis, as it is often observed in pysemia, and where pus forma very short time; or else this third form is gradually developedfrom the second form in consequence of the solid constituents ofthis form being converted into pus. The further changes occurringin this form are absorption which is, however, scarcely ever ascomplete as in the other forms and generally leaves callous thickenings behind, or else enclosure of the fluid within a capsule whis a very common event, or finally invasion of the parts surrounding the suppurating process. In consequence of this invasion thepleura is perforated and the pus is discharged through the thoracwalls into the abdominal cavity or even into the bronchia. Recovefrom such an accident is a very rare event. The fourth form, wherscarcely anything but serum is eflused, occurs very rarely, but iimportant for the reason that this serous exudation generallyexceeds all others in quantity, exerts the most violent pressurethe lungs and heart, and that its reabsorption is on this accountexceedingly difficult. The hemorrhagic exudation does not constitute, strictly speaking, a distinct form, because a somewhat considerable eftusion of blood in any of the above-described four fomay determine an hemorrhagic exudation. The ichorous dissolution of the exudation only takes place during the severest prostrtion of the organism as a consequence of general decomposition,less frequently if the pleural cavity comes in contact with atmospheric air.It is absolutely impossible to draw a permanently and universallytrue picture of pleuritis ; the symptoms characterizing an attackpleuritis, vary greatly in intensity as well as extent; many symptoms are sometimes entirely wanting, whereas in other cases theyare most prominently present. However inasmuch as the symptomatic difterences of pleuritis are mostly de|)ending upon thequality of the exudation, we subjoin a superficial sketch of thesdifferences and shall discuss essential details in subsequent pargraphs.The plastic exudation exists seldom as an idiopathic affection :828 Diseases of the Pleura.it generally accompanies other diseases, more particularly pneumonia. Inasmuch, however, as it is scarcely ever, even whenexisting as an idiopathic disease, accompanied by violent fever,may suppose, that even where it exists as a complication, it doesnot contribute much to an increase of the fever. On the otherhand it is precisely this form that causes the most violent painwhich is very much increased by every somewhat more expansivemovement of the thorax and of the body generally, more partichttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 281 of 653ularly by coughing, and which very frequently renders even percussion painful. After the lapse of at most a week the pain disappears again entirely ; but the physical signs, of which we shaltreat by and by, sometimes remain for some time after.It is more especially the sero-plastic exudation that furnishes tpicture of an idiopathic acute pleuritis. Like all other more extsive inflammatory processes, it almost always sets in with a sevechill followed by considerable increase of the pulse and temperatattended with headache, intense thirst, loss of appetite, and almimmediately an intense pain in the inflamed region of the pleura.The pain generally decreases in proportion as the effusion increain quantity. As the exudation increases the breathing of coursebecomes shorter, and a distressing cough sometimes sets in, withthin expectoration which is tinged with blood, but is not to beregarded as a sign that pneumonia or bronchitis has supervened,but most commonly depends upon no other cause than the hypersemia of the non-affected part, which hyperjemia is a necessaryconsequence of the pressure caused by the exudation, and for thisreason does not show itself at the outset of the disease but onlyin its subsequent course. In favorable cases the termination inrecovery may commence with the second week, and may lead to acomplete restoration of health; or else, the process of reabsorpttakes place very slowly, imperfectly, and the patients remain forlong time in a sickly, lentescent condition, where they are threaened with renewed attacks and exacerbations.The third form, empyema, often develops itself, as was statedabove, from the second form. That pus is forming, may be inferredfrom the circumstance that the fever does not abate, on the contrthat in the subsequent course of the disease, and without any incof the exudation, the fever increases in violence, mingled with cor assuming the character of an hectic fever, with a constantlyincreasing prostration of strength. If the purulent exudation isconsequence of pysemia, of a septic state or a general dissolutioPleuritis, Pleurisy. 829of the blood, the exudation may originate and iiin its course witpain; it only aggravates the previously existing morbid phenomenaThe course of the disease depends essentially upon the fact wheththe exudation is re-absorbed or enclosed within a sac, or finallywhether it escapes from the cavity, and in what direction.The fourth form, where the exudation is chiefly serous, usuallyimparts to pleuritis a sub-acute or even chronic character. Thisform is very insidious, because it so often develops itself verygradually and without pain, and even commences without feverwhich does not generally supervene until at a later period. At fithe patients only complain of lassitude, they lose their appetitehave a sickly appearance. Gradually the respiration becomes moreoppressed and labored, but not by any means to a degree that mighlead the patients to suspect the presence of a pulmonary disease.The quantity of the exudation occasions a displacement of thethoracic and abdominal organs. Recovery from such attacks alwaystakes place slowly ; it is only exceptionally that absorption takplace very rapidly amid a profuse diuresis.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 282 of 653Among the symptoms of pleuritis there is not one that could bepointed out as characteristic of the disease. It is true that incases of acute pleuritis we have the peculiar pain, but it variesexceedingly in character and intensity. At times the pain is simpa sensation of tenseness and constriction ; at other times the paa seated, localized, stitching pain ; at other times again the paspread over the whole side of the thorax, and is of a tearing orburning kind. Not unfrequently there is no pain at all ; this hapmore particularly in the most insidious cases. Because there is npain, this is no reason why an exploration of the chest should beomitted. In genuine pleurisy there is very seldom any cough,especially at the commencement of the disease ; if cough sets ina later period, it may be occasioned by simple hypersemia, or bypneumonic infiltration. At all events it causes the patient a goodeal of distress, increases his pain to an extraordinary degree acomplicates the course of the disease, since every additional obsmust necessarily, in view of the existing dyspnoea, imply an additioDal amount of danger. The symptoms presented by other organscanoot be determined beforehand. Most generally it is the actionof the heart, especially that of the right heart, which is altereif any considerable amount of exudation is present, the beats ofheart become irregular, stronger and more rapid, the more so themore the heart is pushed out of its place by the effused fluid. A880 Diseases of the Pleura.displacement of the liver ia attended with pressure in the righthypochondrium, and slight symptoms of jaundice. Neither theintestinal canal nor the kidneys are involved in all cases. The bbecomes slightly engorged, if the effusion is copious and the cirlation is interfered with. The position of the patients deservesparticular notice, more especially as contrasted with their positin pneumonia. Pleuiitic patients almost always lie on the painlesand unaffected side, whereas, if the effusion is not attended witpain, they preier lying on the diseased side. Very seldom thepatient wants to lie on his back; if he does, the trunk has to behttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 283 of 653elevated a good deal.All these objective as well as subjective symptoms, which we havedescribed, are not sufficient to establish a reliable diagnosis.reliable diagnosis is at all possible, it will have to be based uthe results of a physical exploration, which is even more importain this disease than in pneumonia, for the reason that pleurisy oremains such a latent disease that the objective phenomena alonecan shed light upon its existence and true character.In pleurisy with simple fibrinous exudation or moderately extensive empyema percussion reveals nothing abnormal. As soon, however, as the quantity of the effused fluid becomes more considerait compresses the lungs, and a tympanitic sound is heard over thewhole area filled by the fluid. If the whole or only a portion ofthe lungs is completely compressed, the sound is entirely empty,and the boundary of the effusion is indicated by the tympaniticsound. A dull sound is almost without an exception returned bythe lower portion of the thorax, provided the effusion is sufficicopious. A mistake may occur if the effusion is scanty and thelung is infiltrated as in pneumonia, or if the lower portion of tlung firmly adheres to the costal pleura and the lung can neitherbe pushed backwards nor upwards by the effused fluid. In pleuritia change of position occasions very seldom a change in the dulnesof sound. Generally the upper boundary of the exudation isformed by solidified exudation which resists all displacement. Ifa change of position induces a change in the level of the fluid,it is perfectly safe to infer the presence of an excess of serouseffusion.In pleuritis with plastic exudation auscultation reveals nothingabnormal at the commencement of the disease, sometimes not evenduring its whole course. The friction-sounds of the rough surfaceof the pleura, which, owing to the proximity at which these soundPleuritis, Pleurisy. 881are heard, cannot well be confounded with pulmonary murmurs, arenot generally heard until the exudation has existed for some daysbecause the exudation requires this period of time to become suffciently solidified for the production of those sounds. The pleurifriction-sounds are wanting, if the eftusion is very copious, butoften heard towards the termination of the disease, when absorptiof the fluid takes place. If present, they constitute an infallibof pleuritis. Even if the exudation is scanty, the respiratory muis weakened, because the patients are afraid of drawing a full brIf the exudation is copious, the respiratory murmur is often entiabsent at the lower portions of the thorax, whereas higher upbronchial respiration is heard more or less distinctly, and is moespecially marked near the vertebral column. Bronchophony andfiegophony are often heard together. In the free portion of thecompressed lung, and generally likewise in the non-affected portithe respiratory murmur is heard more loudly, and the symptomsof a more or less considerable catarrh are present.Very seldom palpation discovers any peculiar changes during thepresence of plastic effusion. A difference between the sound andthe inflamed side is often noticed as far as the fulness of the rhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 284 of 653atory movements is concerned, but the friction of the rough surfaces of both pleural laminae against each other is perceived lesfrequently even by the touch. If there is a good deal of effusionthe thoracic wall over it does not vibrate from the voice, whereathis vibration is generally stronger at the borders of the exudatA view of the thorax shows very significant changes. Duringthe presence of a plastic effusion, especially while the pains cothe respiratory movements are much less distinct, and the patientmostly bends over to the affected side. If the exudation is copiothe affected half of the thorax enlarges in size; the intercostalspaces expand, and even become entirely eftaced or bulge beyond tribs, and the respiratory movements are either very slight or elsentirely suppressed.In measuring the thorax, the increase in its dimensions enablesus to determine with great correctness the presence of a copiouseffusion.Another important diagnostic sign are the displacements of theheart and liver occasioned by the presence of a large amount ofeffusion ; the return of these organs to their normal localitiesevidence of the fact that the effusion is decreasing.As regards the course of pleuritis, we have already stated in pre882 Diseases of the Pleura,vious paragraphs, all that is needful to observe on this subject.a general rule, this disease comes less than any other within thepossibilities of a reliable prognosis. It may have a scarcely pertible beginning and, in its progress, assume a most malignant foror else, from an exceedingly malignant and acute disease at theoutset, it may run its course rapidly and completely to perfectrecovery. These results cannot be determined beforehand ; on thisaccount, pleuritis has to be treated with great care, and every tcalculated to favor the progress of the disease, or to induce relhas to be carefully avoided.The terminations of this disease are likewise various. The plastiform always leads to adhesions which, however, are seldom veryextensive and do not interfere with the subsequent enjoyment of ^good health. It is usually the case, however, that afterwards thepatients, during unusual bodily exertions, or during every triflicatarrh, complain of pain in the locality where the adhesions exithis pain is, however, without any sort of importance. If the exudation is very copious, it may obstinately resist every effort oforganism to reabsorb the fluid and, by this means, a liability torelapses may be established. Or else pus may form ; even then, acomplete reabsorption may doubtless take place, but the pus likewise readily escapes externally, or into the lungs and abdominalcavity. In the former case, a thoracic fistula most commonly setsin, which generally terminates fatally in consequence of slow consumption, and very seldom heals in a very short time. The escapeof the pus into the lungs and abdominal cavity is likewise dangerous, and holds out little hope of a complete recovery. An excessof serous exudation generally shows very little disposition to bereabsorbed, and very usually terminates fatally after a lingeringhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 285 of 653period of suffering. Death scarcely ever takes place suddenly inconsequence of asphyxia; most commonly it takes place in consequence of one of the above-mentioned changes. As importantconsequences of pleuritis, we have in the first place to keep inthe displacement of important organs which, during a long continuance of the exudation, is very apt to become stationary. A dilocation of the heart may become particularly pregnant with disastrous consequences. Next we have malformations of the thoraxand consequent malformations of the vertebral column. Such malformations result if the lungs, which the effused fluid had compressed, are unable to expand again to their former size. If themalformation had not lasted too long, the prospect of a completePleuritis, Pleurisy* 833cure is not entirely unfavorable. An important consequence is thevery common appearance of tubercles after the reabsorption of thepleuritic effusion.To establish a prognosis in the higher grades of pleuritis isalways a very hazardous thing, since unfavorable complications toreadily annihilate the best founded hopes. As long as no pus hasformed, we need not let our spirits flag; even empyema, if thepatient has kept up a tolerable supply of strength, very often admits of a cure under homoeopathic treatment. All complications,however, which diminish still more the breathing capacity of thelungs, are decidedly unfavorable to a successful treatment of thedisease. In the front rank of such complications, we have pneumonia, whether it sets in simultaneously with pleuritis or supervenes during the course of the latter disease. Here the pleuritisinterferes with the normal course of pneumonia, and the pneumoniaprevents the rapid absorption of the pleuritic effusion. Even anordinary catarrh, acute as well as chronic, is a serious matter,the reason that it very much adds to the possibility of the supervention of acute cedema of the lungs. Inflammatory affections ofthe heart as well as chronic heart-disease constitute dangerous cplications in pleuritis as well as in pneumonia. We need scarcelystate that pleuritis arising from morbid alterations of the bloodfrom pysemia, etc., is exceedingly unpromising.It is sometimes impossible to arrive at a reliable diagnosis ofpleuritis, more e8j)ecially if the effusion only consists of coaglymph. The more the serous exudation, preponderates, the morereliable becomes our diagnosis. What is of particular importanceis to distinguish pleuritis from pneumonia with which, however,only the acute form of pleuritis with sero-plastic exudation, andwhich is of much less frequent occurrence, can be confounded. Pleritis is diagnosed from the absence of the characteristic sputa opneumonia, the different form of respiration, from the absence ofall vocal vibrations which are considerably increased in pneumonifrom the dulness at the lower parts of the thorax with sharply defined boundaries. Bronchial respiration is an unreliable diagnostsign; however it is to be observed that in pleuritis bronchial reration is the weakest in the region where the dulness is the mostmarked and complete, whereas the reverse is the case in pneumoniaThe dislocation of the heart and liver, the projection of the intcoBtal spaces and the expansion of the afiected side taking placeonly after the exudation has become very copious, cannot be rehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 286 of 653S34 Diseases of the Pleura.ferred to at the outset of the attack as distinctive signs of plein coutra-distinction to pneumonia. Nor is pain a safe indicationof pleuritis ; not only is the pain often absent, but a violent lpain may sometimes be characteristic of pneumonia. What is mostdiflS^cult is a correct diagnosis of pleuro-pneumonia, since in taffection it is often very difficult to correctly determine the mof the pleuritic effusion. Cases of this kind have such varied sytomatic manifestations, according as pleuritis is a primary or cosecutive affection or a simple complication, that we do not deemexpedient to dwell upon them any further.To indicate the treatment of pleuritis is not very easy if we meato present it in a complete shape. Pleuritis being very seldom anidiopathic disease, we have to take into account so many accessorcausative and consecutive conditions, and the importance of pleuritis has withal to be placed in the foreground with so much carethat an exhaustive description of the treatment would become avery extensive task. For this reason we confine ourselves to themost important points in the following paragraphs, referring moreparticularly to pleuritis with copious exudation. The following athe leading remedies that may have to be resorted to in the treatment of this disease:Aconitum. Regarding this drug we cannot communicate anything better than Wurmb's statement in the twelfth volume of theHygea, which we transcribe from Riickert's Annals : " If the plaselements prevail in the pleuritic effusion, or if, as the phrasethe disease has a marked inflammatory character ; hence, if, as iusually the case, the disease sets in with violent febrile phenomno remedy deserves to be more frequently used at the outset of thdisease than Aconite. We have never known Aconite to act upon theeftusion itself; however, inasmuch as the curative process only cmences after the fever has ceased, and inasmuch as it is consequently of importance that the fever should be removed as speedilas possible, and Aconite surpasses in this respect all other remeit is quite natural that the treatment should be commencedthis agent. Having observed that Aconite helps speedily, if it dohelp, I do not wait long for the result, and at once resort to anremedy, if I do not soon perceive a favorable change showing adecrease or a cessation of the fever. It is difficult to say howafter giving Aconite, an improvement ought to be waited for ; asrule, however, we need not wait too long, since an improvement isoften perceived already in a few hours; the fever abates, the stiPleuritis, Pleurisy. 885ing pains and the dyspnoea abate or disappear entirely, etc Theexudation still remains the same, but the circumstances of thepatient now are such that ]^ature alone will be sufficient to complete the cure or will only require very little assistance for supurpose. On the other hand, if the fever still continues, althougin a slight degree, nothing further csin be expected from Aconiteand in order to prevent the disease from assuming a chronic form,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 287 of 653other remedies will have to be chosen, especially such as act upothe exudation itself, among which I place Sulphur at the head ofthe list. If the effusion is more of a serous character, or hemorrhagic or purulent, Aconite will not do much for the fever, if anstill remains. If, in a case of pleuritis with plastic effusion,patient's carelessness or indiscretion brings on a relaipse, thefebrile power of Aconite will prove much less efficient than thetime ; and, if repeated attacks take place, Aconite will do lessless for the fever, and finally, will prove entirely powerless."have to^ dissent from the preceding remarks in one particular,namely, regarding the effect of Aconite upon the fever ; it is ouopinion that the remedy exerts its effect by diminishing the hypesemia, by which means the pains are abated and the effusion islimited. Aconite is, moreover, a distinguished remedy at the outset of pleuritis supervening during the presence of tuberculosis,for pleuritis complicated with pneumonia. It is without any efi'eif pleuritis is occasioned by marked decomposition of the blood,by the onward spread of peritoneal inflammation, or by the escapeof pus from the lungs or from carious ribs. Here Aconite cannotbe depended upon even at the outset, if the fever is ever so inteAs regards waiting for a change after the exhibition of Aconite,should never wait longer than twenty-four hours.Bryonia alba is of all remedies more frequently used than anyother in pleuritis and concerning which all physicians entertainequally favorable opinion. Although we cannot help believing thatmany reported cures were due to the spontaneous efforts of Natureand that the removal of a violent pleuritic pain has very often bmistaken for a recovery from a severe attack of pleurisy, whereasthe pain alone is no adequate criterium of the extent and charactof the pathological process. Bryonia could not possibly have beenso often supposed to cure, if real cures had not been effected byagent. Almost all practitioners agree that the period for the exhibition of Bryonia is the time when the fever has abated. In fixing this period, the comparatively rare form of pleuritis is thou836 Diseases of the Pleura.of, that sets in as an acute disease and runs a similar course. HAconite is undoubtedly indicated first, and afterwards Bryonia.In a very large number of cases, however, Bryonia may be exhibited at the outset ; they are the cases where the fever is not vehigh and the pain is severe but not intensely acute. We do notundertake to explain the action of Bryonia in such cases. It iscertain that it has a very beneficial eftect and generally accomplishes a speedy cure. Whether it acts directly upon the exudatioand hastens' its absorption, may be questioned ; it is pretty welestablished, however, that under its influence the exudation scarever progresses, and that the pains rapidly subside. A slight nonfebrile, although very painful pleuritis, is rapidly controlled bBryonia. Bryonia is likewise appropriate in the severer forms ofa purely plastic pleuritis ; in the first stage of the seroit is the main remedy. If the exudation becomes purulent, the useof Bryonia is more questionable. If pleuritis complicates tuberculosis, the symptoms which very seldom point to Acddite, commonly indicate Bryonia. On the contrary we deem Bryonia indicated so much less, the more copious is the exudation ; its spherof action ceases if the inflammatory process is arrested and thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 288 of 653effusion neither increases nor is reabsorbed. In pleuro-Bryonia, after Aconite has been permitted to act for a short periis almost an absolute specific. It is scarcely less specificallycated in cases where bronchitis and pleuritis coexist.Arnica. Hartmann's indications either occur very rarely in pleuritis, or else they are so little characteristic of pleuritis thamay be said to point to any form of this disease. Nevertheless, oMateria Medica Pura contains a sufficient number of symptomaticindications upon which the choice of Arnica can be predicated witgreat precision. Among these indications we range the stitchingpain in the lower part of the chest, which is aggravated by pressure, motion and cough, shortness of breath, a continual day, hacking cough, or else a painful cough with expectoration of a frothyand bloody mucus. This last-mentioned symptom is particularlyvaluable, for it indicates Arnica in cases of pleuritis accompaniby hypersemia of the non-affected side. We do not limit this remedy to the few cases of pleuritis occasioned by mechanical injuriThe excellent effect of Arnica in certain kinds of exudation is lwise verified in pleuritis, if the exudation is rather serous thaplastic, or is copiously mixed with blood. In purulent pleuritisshould scarcely ever think of resorting to Arnica. An existino*Pleuritis, Pleurisy. 887hyperamia of the brain comes within the curative range of thisdrug as much as pneumonia within that of Belladonna. Old exudations are not acted upon by Arnica as positively as exudationsof recent origin.Digitafis purpurea. Wurmb writes concerning this drug: "Thereis a great difference between pleuritis serosa occasioned by anincreased activity of the secretory functions, and hydrothoraxoccasioned by mechanical obstacles. This difference remained unknown to physicians who had been in the habit of confoundingthese two diseases, until more recently pathological anatomydirected our attention to the differences in the pathological appances and a stethoscopic examination corresponding with thesepathological appearances succeeded in clearing up the diagnosis.It is because these two different diseases have been confounded bphysicians, that some of them report such favorable results fromthe use of Digitalis in watery accumulations in the pleural cavitwhereas others, on the contrary, report nothing but utter failureAn enlightened physician will certainly not expect any thing fromDigitalis in hydrothorax occasioned by mechanical obstacles, suchas an insufficiency of the valves of the heart ; nor will he, onaccount, entertain a less favorable opinion of the curative virtuof Digitalis, which renders such excellent service in pleuritis swhere this remedy is really in its place. Dr. Fleischmann has noticed the best effects from Digitalis in pleuritis serosa, and II may very properly recommend this remedy so much more urgently as I attach the highest value to the experience of this ablpractitioner. I prescribe this medicine in the first attenuation;higher attenuations have never shown any curative powers in thisaffection." If Wurmb recommends Digitalis only for chronic pleuritis serosa, we do not think he has done this remedy full justicIts frequent employment by Old School practitioners, of course, ilarge doses, although only intended to depress the fever, is saidhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 289 of 653be crowned with good results in so many cases that it might likewise seem proper for us to experiment in the same direction. Mostphysicians are as yet deterred from pursuing this course by theidea that this remedy is not adapted to acute affections. This opion is certainly erroneous and unfounded. It is particularly inpleuritis, for which we certainly do not possess too many remediethat Digitalis deserves special attention on account of its specirelation to the rheumatic process. If this process spreads to theplenra, or if pleuritis is from the start a rheumatic disease, no338 Diseases of the Pleura.edy 18 next to Bryonia better adapted to this form of pleuritis tDigitalis.Hepar sulphuris calcareum. "No more than we were guided in oarfirst trials with Hepar in pneumonia by the few correspondingsymptoms of this drug, has Wurmb been guided by the symptomsalo^e when he says of Hepar: "To my knowledge, Hepar has neverbeen employed in pleuritis, yet few remedies render such eminentservice in this disease as Hepar. If the effusion is rather of aplastic nature, and if the disease has lasted for some time, or islow, lentescent course is to be apprehended from the commencement of the attack, I know of no better remedy than Hepar.Under its use I have seen copious exudations, which had already eisted for a long time, disappear in a comparatively and incrediblshort period of time, nor have I ever observed a case where, undesuch circumstances, it did not exert some influence upon the exudation. A complication with pericarditis or bronchitis demands itexhibition so much more urgently ; if the effusion is rather moreserous, Hepar is of little use." We share this opinion, adding atthe same time that empyema, provided it is not too old, is aboveall calculated to substantiate the favorable action of this drug,that the evident passage from the sero-plastic to the purulent foof pleuritis points more especially to Hepar.Squilla maritima is much more talked about than actually used inpleuritis. We believe, however, unjustly, for the physiologicaleffects of this drug show that it is in special rapport with thepleura and likewise with the lungs. Squilla is decidedly one ofthe medicines that it is proper to try in the treatment of pleuriIt is more particularly adapted to pleuro-pneumonia, and is moreespecially indicated by a copious exudation of serum and even inserous pleuritis where the curative action of this drug manifestsitself by a profuse diuresis. In former times Squills enjoyed agreat reputation in this disease, and have fallen into disuse inold system of medicine probably for no other reason than becausethe medicine did not help in every case, because its more specialindications were either not sought or physicians did not know hewto seek them.We do not regard Pfiosphorus as a direct remedy for pleuritisalthough, having been mentioned as a remedy for pneumonia, it isvery likely that it may be of some use in peripneumonia, in whichcase, however, the pleuritic exudation will be very scanty. On thother hand we deem it proper, from more general reasons, to direchttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 290 of 653Pleuritis, Pleurisy. 839attention to this drug. in cases of pleuritis caused by or compliwith, pyaemia or septicaemia, and constituting from the start a sof purulent infiltration.Mercurius is recommended by few physicians for pleuritis, andyet it is perhaps more appropriate in this disease than in pneumonia. We know from our Materia Medica Pura that quicksilvercauses a number of symptoms pointing to pleuritis; hence itshomcBopathicity to this disease cannot be gainsayed. Moreoveranalogy justifies the conclusion that Mercurius has just as goodefiTect in pleuritis as in peritonitis, because we know that Mercacts upon definite systems rather than upon single organs. Aspneumonia so in pleuritis, Mercurius is indicated, if the exudatiinclines from the start to change to pus, or if this tendency isimparted to it at a later period without, however, a special tendto decomposition manifesting itself along with it. The followingsymptoms constitute essential indications: violent fever with frequent chills followed by a burning heat and exhausting, foulling perspiration; considerable thirst; marked gastric catarrh wislight icteric symptoms ; intestinal catarrh. In pleurolikewise,if the exudation is somewhat copious, Mercurius is oneof the best remedies. In subacute empyema we do not considerMercurius an appropriate remedy. Several reports in our literaturshow that Mercurius has often rendered distinguished services inepidemic pleurisy, both if the character of the disease was intenrheumatic, or when the disease was complicated with bronchitis.Old School experience, according to which mercurial ointment isemployed in exudative pleuritis with an advantage that cannoteven be denied by the dogmatic adherents of the expectant method,can likewise be appealed to as an additional recommendation forthe use of Mercurius.Hellcborus niger has not as yet been exhaustively proved ; its losymptoms point, however, unmistakably to a pleuritic affecticm.Practical trials have led several physicians to I'ecommeud thisremedy for the serous exudation in pleuritis, to which it is undoubtedly more adapted than to hydrothorax.Arsenicum album is not, in our opinion, a remedy belonging in thecategory of anti-pleuritic medicines. Its exhibition in pleuritiswell as in pneumonia is determined by the general rather than thelocal symptoms. Wurmb expresses himself much more favorablyconcerning this drug in the following words: "In serous eft usionArsenic is probably the most important remedy; my confidence in840 Diseases of the Pleura'.this agent is so great that I doubt the possibility of curing a cwhere Arsenic does not effect the least improvement, as may possibly be the case with hemorrhagic effusions which defy all interference of art. The cases where Arsenic does not afford any relieare not very frequent, whereas this medicine alone effects a numbof cures or changes the form of the disease so that the cure caneasily be completed by other remedies. The beneficent effect ofArsenic generally first shows itself by a change in the distressihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 291 of 653asthmatic symptoms; afterwards dropsical swellings that mayalready have set in, together with the febrile motions, disappearand lastly the absorption of the effusion itself is effected." Wedare not decide whether Wurmb still adheres to these statementsthat were written down a good many years ago.Sulphur holds the same relation to pleuritis as to pneumonia. Itsemployment depends more upon inferences drawn from its generaleffects than upon a rigid application of the law of similarity; iuse is moreover substantiated by a vast number of practical successes. Here, too, we first transcribe Wurmb's views which seemto us strikingly correct in the main points: "In a case of seroplastic eftusion Sulphur is powerless; if a plastic effusion hasexisted for sometime, Sulphur is less eflicacious than Hepar ; onother hand, in pleuritis plastica, after first giving Aconite, orwithout Aconite at the very outset of the attack. Sulphur is a trs'pecific remedy. If the fever is not sufficiently violent to reqthe use of Aconite, I commence the treatment at once with frequently repeated drop-doses of the tincture of Sulphur which isgenerally sufficient to remove the disease in a short time. If thfever runs high, and Aconite which seems indicated, does not verysoon effect an abatement of the febrile symptoms, I at once resorto the administration of Sulphur and so far I have not yet hadthe least cause to regret this course of proceeding. If pleuritiscomplicated with pneumonia, if the disease has already lasted afew days and the stage of hepatization has already set in, Aconite cannot do the least good although the fever may seem toindicate it; everything, on the contrary, may be expected fromSulphur" This very warm recommendation which is indeed substantiated by practical results, seems to be liable to several obtions. In the first place it is evidently too general. Taking thephysiological effects of drugs and their applications in practiceour guide we are indeed authorized to draw conclusions fisir beyothe rigid boundaries of similarity; but Wurmb's mode of reasonPleuritis, Pleurisy. 341ing would lead us to general, not individual specifies, and ourthei-apeutic opponents show us every day where the former wouldlead us. In the next place we are of opinion that all more violenfebrile symptoms preclude the use of Sulphur, no matter whetherthe febrile phenomena arise from reactive endeavors of a moreintense but normal character, or from reactive efforts that are esive and incline to adynamia. Again, the symptoms of an incipientpurulent metamorphosis are decidedly antagonistic to Sulphur.Finally, we think that Sulphur is adapted to every form of pleuriexudation except perhaps an exudation depending upon septicaemia,because this agent is more than any other capable of stimulatingthe absorption of the plastic exudation. We know that in all morecopious, even serous exudations, a thick plastic deposit very oftlines the surface of the pleura, causing almost without an exception adhesions at the boundary-lines of the inflammation and encling the fluid as it were within a capsule. This newly-formed capsule is undoubtedly the cause why the fluid is not reabsorbed.Hence we see an exudation continue for weeks without change,after which it disappears very rapidly for the reason that the pltic fluid has disappeared and the pleuritic effusion is again undgoing a normal process of absorption. In such cases we have ahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 292 of 653right to expect a great deal from Sulphur because it materially/hastens the disappearance of the plastic exudation.lodium deserves to be mentioned, because Old School practitionershave employed it in so many cases externally for the purpose ofbringing about the absorption of the pleuritic eftusion, which haoften been accomplished with undeniable success. From its generaleffect as well as from its influence upon single organs we are jufied in concluding that Todiian can be used for the absorption ofplastic pleuritic exudation, and that, indirectly, it may likewislike Sulphur, aid in the removal of a serous effusion.Beside the remetlies we have named, many more have been recommended for pleuritis. But these reconimendations are eitherbased upon indications that we cannot accept as valid, or uponpractical results where the diagnosis appears more than doubtful,or finally the remedies are recommended upon purely speculativegrounds, and we, therefore, content ourselves with simply mentioning their names; they are: Bkm toxicodendron y Nux vomica^ Tartarus stibvaias^ Carbo vegetabllis^ Sabadilla^ Spigeluj^ Acidum nFor reasons mentioned at the beginning of this article, we do notdeem it expedient to give a cursory view of the various remedies842 Diseases of the Pleura.in apposition with the various forms and stages of pleuritis. Thegeneral management of an acute case of pleuritis is the same as ipneumonia. Here, too, the fear of relapses, the frequency of successive returns of the effusion, and our anxiety for a complete asorption of the exudation, should admonish us that suitable precautionary measures must not be abandoned too soon.The consequences of pleuritis are of importance in two respects.In the first place, remaining adhesions of the two pleuras maycause great anxiety on account of the violent pain which suchadhesions may occasion in subsequent diseases of the respiratoryorgans, and may likewise lead to the use of incorrect remedies.Another consequence emanating from the suppurative process, ismuch more important, and requires the application of direct therapeutic measures. In a case of thoracic fistula, the aboveremedies have to be applied to in the first place; beside these whave moreover Silicea^ Lycopodiam^ Ferrum^ China^ and more particularly Calcarea carbonica and phosphorica. Under the use ofthese drugs, each in accordance with the corresponding pathologic

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 293 of 653special allusion to it desirable.Hydrothorax is either originated by all the various circumstancesthat cause an engorgement of the veins in the lungs, or else it isymptom of general dropsy and depends upon an altered composition of the blood. In no case is hydrothorax a primary affeciion,but is occasioned by heart-disease, defects of the lungs, more paticularly ar high degree of emphysema, in which case the dropsicaeffusion is sometimes an isolated condition without any cooedema in other parts ; or hydrothorax is caused by affections ofthe spleen, kidneys, liver, etc., in which case it most generallystitutes the final development of general dropsy.If hydrothorax arises from a sanguineous stasis m the lungs, itssymptoms, independently of the results of a physical exploration,are scarcely ever of a nature that will enable the phycician to iIPneumothorax, 843the presence of this process with reliable certainty ; for this sguineous stasis is of itself accompanied by great oppression ofbreathing which is only more or less increased by the dropsicaleffusion. In a case of general dropsy, a gradually occurring dyspnoea indeed justifies the conclusion that water has accumulatedthe pleural cavities. The following objective phenomena renderthe diagnosis perfectly certain: Complete dulness of the percussisound, from below upwards, as far as a line which, when the patieis in an erect posture, is exactly horizontal ; when in a recumbeposture, is only felt posteriorly, or much lower down anteriorly;corresponding with this dulness the respiratory murmur is eitherentirely absent or very feeble ; if the lungs are very much compressed, there is bronchial respiration posteriorly ; the vibratifrom the voice are missing ; the thorax is expanded, but the intecostal spaces are not effaced.If hydrothorax is a symptom of general dropsy, the treatment isthe same as that of the latter disease ; if it occurs as a more i«pathic disease, the treatment is chiefly determined by the natureof the existing cause. As a rule, it is beyond our power to effeccure or even an improvement, although we succeed in a few casesto arrest, and even to diminish, the extent of the disorder. We mtry to accomplish this result by means of Arsenicurn^ LycojpodiumAururriy Carbo vegetabilis [also by Digitalis and Apocj/num cannabinum. H.] For a description of the operation of Paracentesis thoacts for the removal of pus or water from the cavity of the pleurthe reader is referred to Surgical Works or to special treatisesdiseases of the Thoracic Organs.3. Pneumothorax.This disorder is likewise in all cases a consequence of otherhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 294 of 653pathological conditions. The entrance of air into the pleural cavis most commonly the result of a perforation of the pulmonarypleura occasioned by ulcerous or other destructive processes in tlungs, or by the escape of pus from the pleural cavity into thelungs ; much less frequently by a separation of the external wallof the pleural cavity. Tuberculosis is the most common cause ofthis accident; the next most common cause is purulent pleuritis,and the least common is gangrene of the pulmonary tissue.Pneumothorax is always a terminal disease which very speedilyends in death unless the opening through which air penetrates intthe thorax, closes in good season. This, however, is very seldom844 Diseases of the Pleura.the case. The excessive apnoea which generally sets in all at oncand is attended with symptoms of the most marked interferenceof the circulation ; the great expansion of the intercostal spacethe aftected side; the very full percussion-sound which changes ilocation with the posture of the patient and is generally associawith the metallic tinkling, without any respiratory murmur beingaudible; the amphoric resonnance and the metallic tinkling duringauscultation render the diagnosis certain beyond all reasonabledoubt.That a cure of this dangerous condition is possible, is undoubtedan established fact ; but such cures are extremely rare. But it ilikewise certain that medicinal treatment is utterly powerless insuch cases. [This statement is too sweeping. It may be necessaryto puncture the chest-walls for the purpose of relieving the patifrom the excessive dyspnoea and the displacement of the viscera.Otherwise palliative treatment by means of stimulants for the purpose of overcoming collapse, diminishing the dyspnoea and relievithe pain, is not only proper, but indispensable. Small doses ofMorphia and alcoholic stimulants, even pure alcohol, may be ofgreat use. If the subsequent reaction is of an inflammatorycharacter, with heat of the skin, a hard and strong pulse, soreneand pain of the aftected side, the same treatment is to be pursuethat has been indicated for pleurisy. H.]/■ 1(p'-)o \ ^http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 295 of 653>(_^NINTH section:Diseases of the Organs of Circulatioiuy ■-'V.A. DISEASES OF THE HEART.The diagnosiB of diseases of the heart as well as an intelligentappreciation of the phenomena characterizing and occasioned bythese diseases, presupposes a correct knowledge of the physicalproperties as well as the physiological functions of the heart. Nbody will expect us to dispatch such a vast subject in a few brieparagraphs ; on the contrary, we shall take it for granted that aphysician is possessed of this knowledge, and confine ourselves,way of introduction, to a few practical statements of particularimportance.Starting exactly from the mesian line of the thorax, the heart issituated about one-third to the right and two-thirds to the leftthis line, behind the sternum and the cartilages of the right andleft ribs, namely between the third and fifth on the right, and tthird and sixth on the left side. The upper border of the heart isituated between the sternal margin of the right and left secondhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 296 of 653intercostal space ; the apex of the heart in the fifth left interspace close to the inner side of the nipple, or behind the cartilof the left sixth rib close below the nipple. The anterior surfacof the heart is mostly covered by the right and left lung, so thapnly a portion of the anterior surface of the right ventricle iscontact with the thoracic wall, within a space which is bounded othe right by a line from the sternal extremity of the sixth rightrib to the sternal extremity of the left fourth rib ; superiorlyon the left by a line curving in an upward direction and drawnfrom the sternal extremity of the left fourth rib to the left nipinferiorly by a line from the nipple to the insertion of the righsixth rib. It is only within this space that percussion retui'nacomplete dullness.(345)846 Diseases of the Heart.The various sections of the heart which it is important to knowwhen exploring this organ, are situated as follows : The right auis situated farthest to the right, almost entirely to the right fthe mesian line, from the sternal margin of the second right intecostal space to the insertion of the fifth right rib. The right vfrom the right auricle towards the left, occupies almost the wholof the anteriorly visible side of the heart. The left auricle isto the left of the mesian line behind the origin of the large vesso that it is almost entirely covered by the latter. The left venis situated posteriorly behind the right ; only a narrow portionits wall, when seen in front, constitutes the left boundary of thspace occupied by the heart.The orifices and valves of the heart are situated as follows: theleft auriculo-ventricular opening with the mitral valve close tosternal margin of the second left intercostal space, and partiallclose above, partially below the cartilage of third left rib. Thearterial orifice with the semilunar valves of the aorta immediatenext to and to the right of the left auriculo-ventricular openingbelow the sternal articulation of the third rib on the left sidethe sternum. The right auriculo-ventricular opening with thetricuspid valve on a line drawn from the sternal margin of thethird intercostal space of the left side to the sternal articulatthe fifth costal cartilage on the right side. The right arterialorifice with the semilunar valves of the pulmonary artery close tthe sternal margin of the second intercostal space on the left siFrom its origin the aorta coui*ses to the right and from beforehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 297 of 653backwards, and the pulmonary artery to the left and from beforebackwards.The impulse of the heart is felt within a space not altogether aninch wide, close below and to the side of the left nipple in theintercostal space.Of particular importance to an exploration of the chest are thefollowing points: Never percuss with the plessimeter, always withthe finger; if exact results are to be obtained, the chest shouldpercussed with firm as well as light taps. Auscultation should beinstituted with the stethoscope for the reason that it can be morexactly applied to a smaller portion of the chest-wall. If the reof two ditt'erent explorations are to be compared, the exploratiohave to be instituted in the same position of the individual. Whepercussing the chest, it should not be struck at one time duringinspiration, and at another time during an expiration, but uniforCarditis, ' 847during one or tlie other. If murmuFs exist in tlie lungs whichmake it difficult or impossible to hear the cardiac murmurs, ormake them appear less distinct, we sometimes succeed in hearingthese murmurs by requesting the patient to stop his breath. Theheart should never be explored immediately after bodily or mentalexertions or excitements, but, if possible, while the patient isquiet a state as possible; it is even well not to examine the patuntil some time after a quiet conversation has been had with himmany become considerably excited by the act of exploration. Regarding the number of heart-beats, it is to be observed that it ismallest while the patient is in a recumbent posture, and highestwhile he is standing up, and that the dift'erence between these tnumbers increases correspondingly with the patient's loss of streA single exploration of the heart is not sufficient to base ourdiagnosis upon. This precaution is too often overlooked in practi1. Carditis.Pericarditis, Endocarditis, Myocarditis.Inflammation of the Hearty Pericardium^ Endocardium^SvJbstance of the HearUWe include the three above-mentioned anatomically-distinctforms of an inflammatory process in the heart in one chapter, because they generally not only occur associated together, but likewise because their treatment is the same in all essential particuInflammations of the heart occur more particularly between theage of pubescence and that of full manhood, or between the agesof fifteen and forty years. Men are more frequently attacked thanwomen. Although it may be sufficient to say that this somewhatunaccountable fact is undeniably substantiated by statistical datyet some light may perhaps be shed upon it by the circumstancethat most cases of this disease originate in acute rheumatic attaand that the peculiar occupations of the male sex expose its members more severely to acute rheumatic diseases. Primary inflammahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 298 of 653tions of the heart constitute some of the least frequent aifectioand where they do occur, their causes are generally wrapt inobscurity. They are said to be occasioned by colds, excessive muscular exertions, abuse of alcoholic stimulants, mechanical injuriof the heart, etc. We likewise know that carditis mav be occasioned by various poisons which will be mentioned hereafter. Generally inflammations of the heart are consecutive or secondary818 Diseases of the Heart.affections arising either by a continuation of the inflammatoryprocess from the lungs and pleura to the heart ; or in consequencof the heart becoming involved in affections of more remote partsespecially of the kidneys, and likewise of the stomach and spleenor else, they may result from the operation of constitutional diseases. Among the latter acute rheumatism occupies the first rank,for there is not a case of intensely-acute articular rheumatism tis not, at the same time, accompanied by an inflammatory aftectioof the heart. We mention, moreover, scarlatina, variola, measles,typhus, and two other affections which are so apt to occasion aninflammation in every serous membrane, we mean pyaemia andpuerperal fever. As regards chronic constitutional affections, itcannot be shown that they act as exciting causes in inflammationsof the heart. Like all other inflammatory aflections, inflanmiartions of the heart sometimes occur in such numbers that we feeldisposed to trace their origin to telluric or atmospheric influenEtiologically the various forms of cardiac inflammation are distinguished so far as this, that myocarditis occurs least frequentas a primary disease, but generally develops itself out of one ofother forms, both of which occupy the same rank in all otherrespects.An exact knowledge of the anatomical changes occasioned bycardiac inflammation is not only essential to an intelligent apprciation of the single symptoms, but likewise to a knowledge of thpossible consequences of such inflammations. We can here onlyindicate the main points.Pericarditis has all the characteristics of an inflammation ofother serous membranes. It is very seldom diffuse and is mostcommonly limited to single spots. The pericardium at first looksinjected, opaque, sometimes spotted in consequence of slight extrvasations, it is loosely-adherent and easily torn ; at a later pethe pericardium appears covered with coagulable lymph, whichmay be disposed as a delicately-organized membrane, or may havethe appearance of granulated fragments of exudation. An effusioninto the cavity of the pericardium is scarcely ever entirely absebut may vary considerably both in quantity and quality. It maybe from a few ounces to several pints. The exudation either consiof plastic lymph, or of plastic lymph and serum, and is not unfrequently mixed with blood, or hemorrhagic ; it very seldom consistof nothing but serum. The exuded fluid may undergo the following essential changes : A complete absorption may take place andCarditis. 849http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 299 of 653the patient may recover entirely. Or else, the fluid portion mayabsorbed, and the plastic portion may be transformed into connective tissue giving rise to a membrane of more or less thickness.else, the eftused fluid may be transformed into pus, which is eitabsorbed or may assume an organized consistence. The more plasticthe exudation, the sooner adhesions of both surfaces of the pericardium take place ; they generally show the most firmness at thebase of the heart, but frequently cdnsist only in threadlike attaments and again cause large portions of the pericardium firmly toadhere to the heart. The exudation is the more copious, the lessfibrin it contains; the hemorrhagic exudation occurs more especially in great abundance.Endocarditis is almost without an exception met with in the leftventricle. It attacks less frequently than pericarditis large porof the endocardium ; most commonly it is limited to single spotsand has its chief locality near the valvular apparatus of the lefheart. The inflamed portions of the endocardium lose their brilliancy, have a dim-white, grayish or reddish-gray appearance ; itpuflfed up and easily torn and detached. This exudation into thetissue of the endocardium may be associated with exudation uponits free surface in the shape of fine fringes upon which fibrinoudeposits are apt to form. Further changes are : Either a completecure by absorption, which is a rare occurrence, or else inconsideable thickening of the exudation not materially interfering withfunctions of the heart. Or else, indurated deposits may occur onthe valves, containing calcareous matter. The most important consequences are those resulting from the breaking down of the exudation. The softened endocardium tears, thus giving rise to laceration of the chordae tendinese or of the valves themselves, and bcoming chiefly instrumental in originating numerous defects of thvalves ; or the tearing of the endocardium on the sides of the vetricle may give rise to acute aneurysm of the heart, in consequenof the muscular substance not being able to resist the constantpressure of the blood. The purulent decomposition on the free surface, during which the broken-down exudation is continually carried along by the current of the circulation, easily results in tplugging up of single arteries or in the formation of metastaticabscesses, especially in the spleen and kidneys. The purulent inftration of the muscular tissue of the heart occasions the samechanges as the next form, myocarditis.Myocarditis generally occurs in conjunction with one of the850 Diseases of the Heart*other two forms. It is never diffuse, but always limited to isolaregions, sometimes in the interior of the muscular tissue, at othtimes more on the internal and external surface of the heart. It■most commonly located in the wall of the left ventricle and in thventricular septum. The inflamed parts first show a dark redness,eyen ecchymoses, afterwards the affected fibres decay, being tranformed into a reddish-gray detritus ; or suppuration sets in leadto the formation of abscesses in the heart. This inflammationhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 300 of 653admits of a perfect cure, which is not very uncommon, if the inflammation is not too extensive. In the other case a partial curemay take place by the insulation and inspissation of the pus, inconsequence of which callous indurations and calcareous concretions may result. If the pus escapes into the cavity of the ventricle, an acute aneurysm of the heart, or, according as the pusescapes in certain localities, valvular defects may arise, or, aspurulent endocarditis, metastatic abscesses and plugging of theblood-vessels may take place. If the abscess is located in the inventricular partition, it may lead to a communication between botventricles. Perforation outwardly results in pericarditis.Symptoms. The fact that inflammations of the heart occuralmost only as complicating and consecutive affections, and thecharacteristic peculiarity of the symptoms occasioned by these inflammations, render it not only difficult but almost impossible tdraw even a moderately-correct and striking picture of the diseasIn the following paragraphs we shall, therefore, confine ourselveto furnishing detached details, first, the symptoms that can be oserved without any physical exploration, and afterwards the physical signs. If, by pursuing this course, we are not afforded anopportunity of furnishing a perfectly coherent description of inflammations of the heart, on the other hand, we avoid the muchmore serious mistake of either describing these pathological condtions incorrectly or delineating fanciful pictures of disease.All these forms of cardiac inflammation not unfrequently runtheir course with such inconsiderable signs of disease, or even sentirely without any symptoms, that the patients either do not cosult a physician at all or that, in case carditis supervenes durithe existence of other affections, the physician does not suspectheart-disease unless he institutes a very rigorous examination. Wought even to take it for granted that many cases of carditis escthe most minute physical exploration, since we so frequently meetCarditis. 851with remains of which not a trace had beon discovered during the(if&-time of the patient.Carditis setting in most commonly during the course of someother disease, its commencement is very seldom marked by a chill,generally it is even impossible to determine from the patient's ostatements where the disease has precisely begun. Only pericarditcommences very commonly with shooting, more or less violent painsin the region of the heart. Most generally the patients complainan intense feeling of illness and great anxiety, which they descras proceeding from the pit of the stomach. If the inflammation hafully set in, the following symptoms are perceived in different cbinations and degrees of intensity: Extreme feeling of illness nocorresponding with the affection that the patient was already suffering with, and not suspending muscular power. Lassitude withconstant restlessness, weariness, yet the patient is unable to slAlteration of the expression of the countenance; this symptom isoften suflicient for the attentive observer to suspect the presenof carditis : the face generally becomes more pallid, seldom turgcent, the features assume an appearance of tension, the eye has ashy, wandering expression, and, what is characteristic of this dihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 301 of 653ease, the lips tremble a little while the patient is talking, atsame time the speech is somewhat hurried and jerked out as itwere, which is not owing to the dyspnoea. The posture of thepatients has no particular significance; they do not by any meanslie steadily on the left side. Headache, which is sometimes of aviolent kind, is a usual companion of carditis, whereas severe cebral symptoms, such as delirium, sopor, coma, are rare occurrenceexcept in very bad cases which bear great resemblance to thetyphoid process. The patients are restless, appear anxious withoubeing conscious of it themselves ; in severe cases the anxiety anrestlessness become extreme, the patients manifesting an extremesensitiveness to all psychical impressions. K fever was present,is very seldom increased by the supervention of carditis, the temperature is less than when most other vital organs are inflamed.Chills occur very frequently, but they do not last long and are nsucceeded by a burning heat. There is very commonly an excessivedisposition to profuse perspiration which has generally a peculianmsty odor. At the beginning of the attack the pulse generallybecomes more rapid, fuller, harder, and has a peculiar tension;afterwards it remains more rapid, but becomes small, feeble, andinclines to be irr^ular. In some cases, on the contrary, the puls852 Diseases of the Heart.IB remarkably slow ; in a case of pneumonia with pericarditis andendocarditis, that came under our observation, the pulse had sunkto forty-two beats in the minute. We likewise notice that in thesame case the pulse is sometimes very rapid and at other timesslow. Upon the whole, the character of the pulse is of no specialvalue as a diagnostic sign. Sometimes the patients complain ofsevere tearing pains in the left shoulder-joint, or in the wholeloft arm ; rheumatic pains may even be experienced in other partsthe body. The digestive organs are not influenced by carditis inanything like a constant manner. The respiration is very usuallydisturbed, dyspnoea of the most varied degrees setting in. At theoutset of the attack the respiration is quick and short, but, wherequested to do so, the patients are able to draw a long breath.Cough is not a usual symptom ; at times it is dry and tearing, atothers attended with expectoration of mucus and blood. The secretion of urine is almost always considerably less, the urine is sarated, depositing urates ; sometimes albuminuria is present. It ifurther to be observed that, if carditis supervenes during a preexisting disease, recovery from the latter is much more tardy.Other characteristic symptoms are : Marked interference with thecirculation; oedema of the face, ankles; cyanotic phenomena in thface; passive hypersemia of the brain. Increased dyspnoea. Accompanying disturbances of the spleen and kidneys. The profuse secretion of mucus is apt to result in the development of miliaria, whhas given rise to the most erroneous views concerning metastases.K miliaria breaks out about the time when cardiac inflammation isabout to terminate fatally, and the miliaria disappears again witthe fatal termination, death has been laid to the retrocession ofexanthem which thus became invested with a peculiar significance.The truth, however, is that what takes place with other exanthemslikewise takes place in the case of miliaria: all these eruptionsappear at death in consequence of the sudden decrease of the vitaturgeseence.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 302 of 653All the above-mentioned phenomena may be present during everyform of cardiac inflammation. We will now proceed to designatethe most common symptoms characterizing each form of the disease.Pericarditis: The disease sots in with a chill ; rapid increase othe frequency of the pulse ; pains in the region of the heart, whmay likewise spread towards the back and shoulder, and are increased by a change of position, a deep inspiration and pressureCarditis. 853the pit of the stomach ; palpitation of the heart which is exceedingly distressing to the patient. Dyspnoea sets in in a few days,after the exudation has become more profuse. Continued singultusis a not unfrequent symptom.The symptoms of endocarditis are much more vague. It alwaysapproaches in an insidious manner, without pain, or only with adisagreeable sensation of pressure and constriction in the regionthe heart. On the contrary the action of the heart is almost alwatumultuous, more rapid and generally irregular, assuming the formof palpitations. The pulse, however, does not diminish in frequency. The respiration is accelerated, but dyspncea is scarcelyever complained of during the first days of the disease. A violenheadache, delirium, typhoid phenomena, swelling of the spleen andnephritic pains only set in in the subsequent course of the diseaMyocarditis is not distinguished by regularly-occurring symptoms. Its supervention during one of the other forms of the disease may be suspected if the pulse becomes suddenly weaker andthe action of the heart generally exhibits signs of excessive weaness. Even rupture of the myocarditic spaces does not furnish aclear picture of the pathological process. There is no pain, butcommonly an intense feeling of anxiety which may be accountedfor by the rapidly diminishing power of the heart to propel theblood.In contrast with these changeable, exceedingly inconstant morbid phenomena, we have the physical signs which are so muchmore important since they are much less apt to deceive and arevery commonly sufiSicient for the establishment of a correct diagnosis.At the commencement of pericarditis, the shock of the heart isstronger and is felt over a somewhat larger surface. Frictionmurs are heard at an early period of the disease, very seldom nottill a few days have passed. They vary a great deal in intensity,they are heard first and loudest at the base, do not follow therhythm of the sounds of the heart, very often differ according toposition of the patient, and are heard more distinctly if the steoscope is pressed against the chest, but not too hard. If the exuation remains scanty and chiefly plastic, the friction-murmur likwise continues to be heard, whereas, with the accumulation oflarger quantities of serum or other fluid, the murmur grows feebland finally, especially at the base, disappears altogether. The dtension of the pericardial sac by the exuded fluid occasions thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 303 of 65323854 Diseases of the Heart.lowing pnenomena : The intercostal spaces on the left side becomeeffaced or even bulge, the shock of the heart cannot be felt, butits stead we sometimes notice an undulating motion. Percussionreturns a larger extent of dulness within a triangular space, witits base downwards. On auscultation, the sounds of the heart ina recumbent posture are only feebly audible, whereas if the patiestoops forvv'ard, they are frequently heard very distinctly, at.rate much more distinctly than in the former position. At thecommencement of the disease, a feeble systolic blowing murmur isoften noticed in the region of the mitral valve, likewise in theregion of the aorta, or a double aortic murmur. Occasional throbbing of the veins of the neck. If the left lung is compressed byprofuse exudation, a tympanitic resonnance or even dulness resultThe first consequence of a decrease of inflammation is that the dness becomes less in extent ; after which the friction-murmurs agbecome audible, and may yet continue for some time. An importaut diagnostic sign of pericarditis is that while the area of cadulness increases in size, the sounds of the heart become less auble, and the impulse of the heart diminishes in force.The physical diagnosis of endocarditis is much more difficultthan that of pericarditis. Since the sounds of the heart constituthe most important criterium by which the presence of endocarditican be determined, it is of the utmost importance that the anatomand functions of the normal heart should be correctly known,otherwise valvular defects that had already been existing for a ltime, might be mistaken for consequences of the recent endocarditOn this account we should guard against a hasty diagnosis, andexplore the chest once a day or at least as often as may be convenient.As long as the valvular apparatus has not been invaded by theendocardiac inflammation, the disease may remain completely obscured. Although a bad case of endocarditis, with formation ofabscess, metastatic phenomena, etc., may exist without any valvular disease, yet a physical exploration does not reveal the exisof such inflammation by any positive sign. At the outset, the irapulse of the heart is generally stronger and felt over a larger eit is likewise more tumultuous, yet the pulse is not unfrequentlystrikingly small. Endocarditis attacking almost exclusively theleft ventricle, the first changes are noticed in the region of thfices, one of the first changes being an increased ringing or tinof the first sound. With the increase of the pathological processCarditis. S55with the softening or partial disorganization of the valves, or iconsequence of their incapacity from any other cause to close theorifices, a murmur is heard, most distinctly at the apex of theheart, side hy side with, or in the place of, the systolic murmurFriedreich calls attention to the fact that the diagnosis can oftbe more securely established by the circumstance that this murmurhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 304 of 653changes its intensity, duration, etc., more or less rapidly or slDiastolic murmurs from disease of the aortic valves, or from excrescences upon the auricular surface of the mitral valve, are, uthe whole, rare occurences. Of essential significance is the incrintensity of the second sound of the pulmonary artery, which isheard soon after the murmurs, and the increased extent of the cardiac dulness which almost sets in simultaneously. It is hardly posible to indicate the variations in the cardiac murmurs with anything like absolute correctness, since they must necessarily diffcorrespondingly with the various changes resulting from the diseaMyocarditis is not recognized by any fixed physical signs; ifsuch are present they belong to the accompanying endocarditis andpericarditis. The participation of the muscular structure of theheart in the inflammation is more particularly inferred from thegreat weakness of the pulse co-existing with a tumultuous actionof the heart. This pathological change can only be tonjectured ;it can never be verified with positive certainty.The course and terminjjJiShs of cardiac inflammations show thegreatest differences in degrees of intensity as well afi in otherrespects. In describing these particulars we -ehall follow a verysummary course, since particular terminations will have to be dweujK)n afterwards. Our object will be best accomplished by consideing the three forms of cardiac inflammation each by itself.Pericarditis of a middle degree, if attacking individuals of anotherwise sound constitution, is not a very dangerous disease, bugenerally terminates in complete or almost complete recovery. Aftexudation is completed, the patients are confined for a few daysweeks without being very sick, unless they are prostrated by somepreviously-existing disease, strength gradually returns to them,friction-murmurs that had disappeared, again become audible, orthe existing murmurs become less distinct. Termination in recovernever takes place rapidly or suddenly, and the frictionsometimesremain distinctly audible for months, during whichperiod the patients continue to retain their suffering and feebleappearance. In acute affections where rapid changes take place, p856 Diseases of the Heart.carditis Bometimes disappears very rapidly. Most commonly, however, we shall find that the supervention of cardiac. inflammatioduring a primary affection imparts a lentescent character to thelatter. If the exudation is very copious, it may only be partiallabsorbed, the patients incline to shortness of breath, palpitatiothe heart, and relapses easily take place, chiefly for the reasonthe patients do not take proper care of themselves. These relapseeither have an acute or chronic character, in which latter case tgive rise to a condition which is described as chronic pericarditIt is very seldom that fibrinous pericarditis suddenly terminatesfatally. On the contrary, if the exudation is purulent or hemorrhagic, a fatal result may take place very suddenly, and is generally determined by paralysis of the cardiac functions which leadsto acute oedema of the lungs. An excess of serous exudation mostgenerally results very speedily in softening of the muscular tissof the heart, consequently in cedema of the lungs and generaldropsy, this end is to be apprehended if the cardiac dullness,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 305 of 653which persistently remains the same, extends over a large area anthe pulse becomes very small and increases in frequency. A copiouemission of urine only seldom occurs as a critical change. Adhesions of the pericardium are of subordinate importance, althoughof frequent occurrence. Very commonly pericarditis results inmore or less considerable hypertrophy of the heart. The qualityof the exudation cannot be determined with certainty from thecourse of the disease, although this very desirable knowledge wouexert a great influence upon the prognosis. As a rule it is safetake it for granted that a purulent or septic exudation only occuas the result of a general dyscrasia or in consequence of pyaemiapuerperal conditions.Endocarditis always runs a tedious, sub-acute and even chroniccourse. Of itself the disease very seldom leads rapidly to a fatatermination, and, if it does, it is always in company with exquisitely typhoid symptoms. The commencement of the disease ismostly uncertain; hence its duration cannot well be determined, smuch less since the affection, in cases where it is diagnosed witpositive certainty, had already developed valvular disease. Acomplete cure is possible, if the valves have not been invaded; bwe likewise deem a cure possible provided the valvular alterationdo not consist of loss of substance or solutions of continuity. Apartial cure is still possible if the valvular changes do not matinterfere with the functions of the heart. The most common terCarditis. 857mination of endocarditis is the development of valvular diseasewhich gives rise to chronic ailments and a slow decay of theorganism. If these valvular defects arise from such lesions ascicatrices in the substance of the valve, they may not manifestthemselves until after the endocarditis has terminated without anapparent anomalies of the valvular apparatus. Purulent endocarditis often results in speedy death in consequence of the disewhich it develops in other organs, more especially by plugging upimportant arteries.Myocarditis generally runs a latent course; but if it is extensivif an abscess forms within the parietes of the heart, it may. resvery speedily in a fatal end ; if it coexists with the other twoforms of cardiac inflammation, the former becomes the chief causeof death.A combination of the three forms of cardiac inflammation impresses a different character upon the course of the disease. Apericardial inflammation alone can be very rapidly reabsorbed,whereas, if it is associated with endocarditis, the course of theformer is always retarded by such a combination and a completecure is rarely ever effected. The hypertrophy which usually resuleven if no complicating disorders are present, is greatly increasby the valvular deficiencies; paralysis of the heart consequent userous infiltration of the muscular tissue of the heart, is likewconsiderably facilitated by a complication of cardiac disorders,especially by valvular disease, and the reabsorption of effused ffrom the pericardial sac must necessarily be interfered with by tdeficient action of the circulatory organs. Less prejudicial, altalways sufficiently ominous, is the influence of pericarditis upohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 306 of 653endocarditis. The more impeded the movements of the heart, andthe greater the effort this organ is called upon to make, the moreasily valvular lesions will occur.What we have said must show that the prognosis of cardiacinflammations must be exceedingly uncertain. In a case of complicating pericarditis, the prognosis is most favorable, if the cing disease is not characterized by septic phenomena. In all othecases and forms the sequelte which are almost sure to occur, forbthe assurance of a favorable prognosis, and although Homoeopathyachieves much more satisfactory results than the Old School, yetcannot boast of infallible success. Cardiac inflammation occurring in connection with chronic dyscrasias, more especially tuberculosis, is almost certain to terminate fatally, yea, may be rega858 Diseases of the Heart.as the terminal and necessarily fatal result of a constitutionaldisease.Treatment* Although we can boldly assert that the homoeopathic treatment of cardiac inflammations has so far resulted mucmore favorably than the treatment of these diseases in accordancewith the principles of the Old School, yet we do not mean to aflithat we possess a large number of reliable indications for the usof our drugs, or even a number of such drugs as we might termcardiac remedies. We ought to accomplish a great deal more thanwe do ; yea, in the treatment of heart-affections we are much lessuccessful than in the treatment of diseases of the respiratory odigestive organs; nevertheless our successes are decidedly greatethan those of the Old School, were it for no other reason thanbecause we have abandoned so many therapeutic follies that eventhe modern physiological School is guilty of. We should be carrietoo far, if we would indulge in special statements bearing^ uponpoint, subsequently we shall find opportunities for offering variremarks on this subject. We must, however, even here, protestmost emphatically against heart-affections being treated by bloodletting either by physicians of the Old or New School. We wouldenter this protest even if we had no other reason than because evbleeding diminishes the functional power of the heart and theregularity of its action.Let us at the outset dwell a little more fully upon the reasonswhy the therapeutic chapter of heart-diseases in the domain ofHomoeopathy is as yet so incomplete and so ill-conditioned. In thnumerous homoeopathic publications bearing upon this subject, thereason is given that jOur provings are deficient in symptoms corrsponding with the signs elicited by a physical exploration of thecondition of the heart. This is undoubtedly a great defect whichcannot be remedied by re-provings were they conducted with everso much energy and devotion. Nobody will probably want topoison himself so thoroughly as to produce distinct cardiac murmurs. The only light we can obtain in this direction is by a carestudy of accidental cases of poisoning and by means of extensiveexperiments on animals. It is strange that in cases of poisoningcareful exploration of the heart before and after death has beenomitted.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 307 of 653If the possession of objective physiological symptoms of heartdisease is still the object of an unfulfilled desire, we must gowork and discover a method of arriving at a knowledge of the trueCarditis. 859remedy without such Bymptoms. It is our opinion that the onlymethod is the practical experiment, by which we mean that ourmedicines ought to be applied in accordance with our existing,vague, unreliable and insuflSlcient indications, and that the resshould afterwards be registered in accordance with the most carefphysical diagnosis. This has not yet been done, and this is thereason why the homoeopathic treatment of cardiac affections isBO much more defective than that of any other class of diseases,A pneumonia and even a pleuritis can be recognized with tolerablecertainty without percussion or auscultation, but the special forof an aftection of the heart, and sometimes the existence itselfan affection of the heart cannot be determined without resortinga physical exploration of the chest. Now we ask, in how manyreports of heart-diseases contained in our literature have the resites of a physical diagnosis been complied with? And how far,in the presence of such glaring defects, do these reports deservebe credited? In passing these remarks we do not mean to cast aslur upon the labors of our homoeopathic veterans who could notpossibly be acquainted with our present means of diagnosis ; wedeem it so much more necessary to point out these defects in ordeto stimulate the efforts of our rising physicians to acquire thisindispensable and highly useful knowledge.It is from these points of view that we request the reader to consider the following statements, and to excuse the defects he maydiscover in them. One or the other remedy may perhaps have beenomitted, but we have stated more than once that we consider anenumeration of too many remedies embarrassing rather than useful to the practitioner. The following are the main remedies incardiac inflammations:Aconitum. We have already shown in several paragraphs of thiswork that great abuse is made of Aconite by being given contraryto the homoeopathic law in inflammations of various organs andother febrile affections. This admirable remedy deserves to bepointed out so much more emphatically in cases where it is trulyhomoeopathic, and where its curative virtues have been so often a80 brilliantly verified. There is no doubt that the lungs and theheart are the main organs upon which Aconite exerts its chiefinfluence ; whatever objections may otherwise be raised againsttheir method of proving, Schroff and Van Praag have earned ourthanks for having shed more light on the relations which AconiteIiolds to both the lungs and the heart. We here only relate the360 Diseases of the Heart.symptoms pointing to cardiac inflammation, as developed by adeeply-penetrating and protracted poisoning. At first the beataof the heart become more rapid and more violent, and this increaslasts so much longer the less excessive the quantity in which thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 308 of 653experimental dose was taken. At the same time the respiration isextremely accelerated, the temperature is increased, a feeling ofsickness is experienced, and all the symptoms of a more or less csiderable cerebral hypcraemia set in. The pulse is hard and stronThe pain in the cardiac region is not a constant symptom, but wasoften felt. In the further course of the proving the beats of theheart become slower, sometimes to a great extent; or else theyremain quick and grow feeble, irregular, they seldom remain vehement. On the contrary, the pulse changes to a feeble and smallpulse, not synchronous with the beats of the heart, intermittingunequal ; the temperature is lower while the number of respiratioincreases rather than decreases. This last circumstance alone woube sufficient to stamp Aconite as a cardiac remedy, for slownessthe pulse and a simultaneous and considerable decrease of the number of respirations are phenomena that only occur in diseases ofheart. As to the symptoms developed in the organism generally,we do not mention them in this place; they embrace all those thatalways accompany cardiac iniiammation. These physiologicalresults have been confirmed by practice in a most striking mannerIn every pericarditis and endocarditis, whether primary or secondAconite is the first and most important remedy whenever the inflammation sets in with febrile phenomena. We consider thisremedy indicated even if the fever is moderate or is altogetherwanting. Aconite is not only indicated at the commencement ofthe disease, but in many cases during its whole course, more especially in rheumatic cardiac inflammations, as long as the organicalterations do not result in paralytic or cyanotic symptoms. Wewould rather treat a case of cardiac inflammation with nothingbut Aconite, than a case of pneumonia. Of course, we must not,as is the custom with homoeopathic routine-practitioners, limit oselves to synochal fever as a paramount indication, but keep thewhole series elicited by a thoroughly-penetrating proving iu viewIt is in this manner only that the full therapeutic range of thisgreat remedy can be determined.Digitalis purpurea has been and still is regarded by many as inappropriate in acute diseases and more especially in acute cardiainflammations. We cannot sufficiently protest against this viewCarditis, 861which has a tendency to restrict the usefulness of a drug that maexert such a beneficent influence over disease. If Digitalis weremore frequently and more rationally used in acute heartweshould be much less frequently called upon to employ it inchronic heart-disease. Since I have devoted, for yeare past, specattention to the use of this drug, I have found it much more frequently applicable in the treatment of disease than in former timand I am now prepared to assert most positively what I was thenonly able to announce in rather dubious language, that Digitalisan excellent remedy in acute affections of the heart, more particlarly in pericarditis. Digitalis is not so much adapted to inflamtions setting in with very violent symptoms, but to inflammationsapproaching in an insidious and scarcely observable manner, moreespecially without any local pain, but with a rapidly increasingembarrassment of the respiration. We should take a very oneview of the action of this drug, if we were to regard the irregularity and slowness of the pulse as the chief criterium for its ahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 309 of 653cation, since a rapid and very weak pulse constitutes an equallyreliable indication. Even a violent excitement of the functionalactivity of the heart, as generally occurs at the commencement ofcardiac inflammation, is in characteristic accord with the flrstsymptoms of poisoning by Digitalis. Among all the various formsof cardiac inflammation, we consider the rheumatic form bestadapted to Digitalis, and likewise if it is associated with a copeff'usion of serum ; less, however, to pericarditis if the frictimurs continue unchanged from the beginning of the disease. Thesooner these murmurs disappear, the better is Digitalis adapted tthe case. In endocarditis it seems almost impossible to indicatespecial heart-symptoms requiring the use of Digitalis ; in such cthe constitutional symptoms will have to determine our choice. Inmyocarditis the doubtful character of the diagnosis will render ian especially difficult task to point out indications for the useDigitalis that have been confirmed by experience; one circumstancspeaks in favor of Digitalis which is, that in myocarditis the acof the heart is most suddenly weakened to an extraordinary degreeAmong the general symptoms the following invite more particularattention to the use of Digitalis: Rapidly-increasing dyspnoea, woccasional symptoms of acute congestion of the chest ; inflammatiof the pleura or lungs; bronchitis; chronic catarrh of the bronchexpectoration mixed, not streaked with blood; spasmodic cough.Livid, turgescent face with blue lips; headache, vertigo, deliriu862 Diseases of the Heart.Bopor. Yomiting at the commencement or during the course of thedisease ; hy persemia of the liver, slight icterus, catarrh of thneys. Excessive feeling of illness, not corresponding with the peceptible symptoms ; great anxiety, but without any continual restlessness. Aggravation by the slightest motion. A drawingpain in the left shoulder.Vepatrum album is one of the choicest cardiac remedies, althoughthis place has not yet been assigned to it by homoeopathic practitioners; the stage of functional excitement of the heart is stillmore apt to rapidly change to a state of paralytic weakness ; thepulse becomes very irregular, generally extremely rapid, small anfeeble ; -this change takes place although the alvine evacuationsmay not be by any means excessive, so that the heart-symptomshave to be regarded as the effect of direct action, not as resultfrom a highly acute anaemia. Veratrum is our first choice in acutcases, if the following general symptoms are present : Violent dypncea; constrictive sensation in the throat; constant short, dry,hacking cough., Bluish complexion, with an expression of deepprostration; sopor, stupefaction, excessive dulness and tightnessof the head. Vomiting and diarrhoea. Considerable diminution ofthe urinary secretion. Convulsive motions, more particularly of aclonic character. Cool, dissolving perspiration, with icy coldnesof the extremities. So far we have no clinical records confirmingthe homoBopathicity of Veratrum to heart-disease.Arsenicum album is frequently mentioned as a chief remedy in cardiac inflammations ; we confess, however, that we have never seenany good effects from it in acute aflections. It is a remarkablethat among the large number of cases of poisoning by Arsenic,post-mortem examinations have never yet revealed a single symphttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 310 of 653tom that might lead us to infer that Arsenic exerts a specific inflammatory action upon the heart. This shows that the heartsymptoms, which Arsenic occasions so constantly and exquisitely,have to be accounted for in a different manner than by means ofan inflammatory process. Clinical experience leads us to trace thsymptoms to dissonances of the cardiac nerves, or else to regardthem as secondary symptoms. Myocarditis presents many pointsof resemblance to the symptoms of Arsenic, and it is more especiain this disease that we should try Arsenic, were it only for thereason that Arsenic exerts an intensely-paralyzing effect upon tlmuscular tissue of the heart. This effect of Arsenic determinesits relation to the other two forms of cardiac inflammation. IleuCarditis. 863we consider Arsenic indicated in the cases where Veratrum seemsindicated, if the pulse very speedily loses its fulness and strenand an excessive state of debility sets in at an early period. Thmost generally the case with cachectic individuals, and Arsenic ione of the most essential remedies in most cachexias. Amongsecondary heart-diseases, chronic pericarditis is the only one whArsenic would be appropriate, if a copious exudation is present.In valvular disease, we have never obtained any decided improvement by Arsenic ; it only acts as an uncertaih palliative.Spigelia is an important remedy in heart-affections, but its provings have to be greatly improved. In accordance with what ispublished of this drug, Hartmann gives the following symptomaticindications: Undulating motion of the heart; indistinct beats ofthe heart running into one another; when laying the hand uponthe heart, tumultuous beating of the heart in a recumbent as wellas in a sitting posture, not synchronous with the radial pulse;spasms of the chest, suffocative complaints ; tremulous sensationthe chest and temples ; increased by motion ; tearing sensation ithe chest, when raising the arms over the head, and when touchingthe pit of the stomach; purring murmur during the beats of theheart; stitches in the region of the heart; pulsations of the carwith a tremulous motion; great dyspnoea at every change of position ; bright redness of the lips and cheeks, changing to palloring every motion ; the impulse of the heart raises the four lastribs, the sternum and xiphoid cartilage, and displaces the dorsalvertebrse; audible beating of the heart, causing a pain that is fthrough to the back; cutting pains from the heart to the shoulderas far as the head and arms ; excessive dyspnoea, with a pressingcutting pain in the abdomen, at the insertion of the ribs; arthripains and stiffness of the joints ; dull stitches where the beatsheart are felt, and recurring with the measured regularity of thepulse; the beats of the heart can be felt through the clothes, wianxious oppression of the chest ; scraping in the throat, affectithe tracheal and bronchial mucous membrane; the beats of theheart are not synchronous with the pulse; purring murmur. Asrespects this enumeration, it is to be observed that these symptofor the most part are not the result of physiological experimentation, but clinical symptoms observed upon the sick, and hence 'arof less value to us. At any rate these symptoms do not contain thsymptoms of sero-plastic, nor of serous pericarditis. On the othehand we distinctly recognize in this complex of symptoms both thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 311 of 653864 Diseases of the Heart.purely plastic pericarditis as well as incipient endocarditis. Buupon what basis are we to prescribe Spigelia in cases where thedisease is painless and has scarcely any symptoms ? This showsthat it is a great mistake to lay too much stress upon sensationspain, which is not by any means a constant companion of cardiacinflammation. "What invites more than all these theoretical statements to the use of Spigelia in heart-affections is the fact thathas been so often and so variously employed in practice with deciadvantage. According to practical experience, Spigelia is particularly adapted to rheumatic pericarditis, likewise to seropericarditis during its whole course, especially if the patient cplains of an intense local pain, and the affection is evidently cacterized by all the signs of cardiac inflammation ; and to rheumendocarditis in its incipient stage, or to endocarditis generallymarked valvular changes have taken place.Nitrum has so far commanded too little the attention of practitioners, nor are we in possession of any decided clinical testimoNevertheless we have every reason to recommend Nitre in cardiacinflammation, more particularly if it sets in in company with actpulmonary congestions, or as a symptom of Bright's disease, orassociated with acute rheumatism. A striking participation of thekidneys in the pathological process going on in the heart, pointsurgently to the employment of Nitre.Phosphorus is not usually numbered among the cardiac remedies,nor can it be denied that its relation to the heart is not by anymeans constant. But if the post-mortem examinations of individuals who had been poisoned by Phosphorus, so often reveallesions about the heart, especially where death did not take placimmediately after the ingestion of the poison, it seems as thoughwe could not deny the fact that Phosphorus exerts a direct actionupon the heart, and that the cardiac phenomena which Phosphorusoccasions, are not merely of a sympathetic or secondary nature.The main post-mortem appearances as far as the heart is concernedare : the muscular tissue is flabby and easily torn ; opaque appeance and interstitial distention of the endocardium; bloody infiltration which in certain circumscribed spots peneti'ates the wholthickness of the muscular tissue. If, in addition to this, we consider the very feeble, small and exceedingly frequent pulse ; thefrequent observation that the sounds of the h(ai*t either frequendisappear or are replaced by murmurs, it seems to us that Phosphorus has more claims to be regarded as a remedy for cardiacCarditis. 865inflammation than most other medicines, more especially in casesof secondary origin. We cannot deny, however, that the indications upon which its homoeopathic application has so far been basappear to us totally erroneous. In our opinion the following arethe true indications suggested by physiological experimentation :Phosphorus is exclusively suitable for inflammation of the endocardium and the muscular tissue, never for pericarditis. The constitutional symptoms would lead us to recommend Phosphorus inhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 312 of 653endocarditis associated witb Pneumonia, where it has rendered usthe most signal service on two occasions, we mean against thecardiac inflammation, not against the pneumonia, for we havealready stated when treating of pneumonia, that, when pneumoniais complicated with cardiac inflammation, the presence of the latconstitutes an absolute obstacle to the absorption of the pneumonexudation. In the next place Phosphorus takes the precedenceover every other medicine in cardiac inflammations when occurringas complications of such processes as lead us to infer a dissolutthe blood, like scurvy, puerperal fever, malignant exanthematouseases, typhus, etc. Finally we possess few remedies that embody ipathogeneses as plain a picture of nephritic and cardiac inflammation, as Phosphorus. And lastly Phosphorus is almost the onlyremedy of which we are sure that it occasions an infiltration ofmuscular tissue, and that on this account it becomes a highly important remedy in myocarditis. We are not in possession of anyclinical material to prove the correctness of these statiBments,with a view of substantiating them more fully, we will call attention to one circumstance. Phosphorus is employed by most homoeopaths in pneumonia as well as in other inflammatory and exanthematic diseases with the best result, whenever the inflammationassumes a nervous or rather a typhoid type. In a vast majority ofsuch cases a strict examination would undoubtedly show the presenof cardiac inflammation, for it is this that most frequently impaall at once a typhoid character to pathological processes that geerally run an ordinary course. It is our belief that Phosphorus hoften cured cardiac inflammations without the physician beingaware of it. Finally we have to point out a symptom which mostdecidedly indicates Phosphorus, we mean the dilatation whichdevelops itself during endocardial inflammation with such surprisrapidity. After all these remarks we do not deem it necessary tocriticise the indications offered by other physicians, for they aalmost all of them vague and indefinite.366 Diseases of the Heart.Colchicum aufumnale seemB to us to be improperly ranked amongcardiac remedies. We are in possession of a large number of bothrapid and slow cases of poisoning, but in no case does a postexamination show more than a quantity of bloody coagula in theright ventricle and the venae cavse; only in one case the endocardium was found ecchymosed, and there was a complete absence ofpericardial fluid. All the heart-symptoms arc of a secondary natuand are founded in the* excessive losses of fluids occasioned bychicum. Although Colchicum is highly praised for rheumatismof the heart ; this may be owing to the general curative powers imanifests in acute rheumatism, though not by any means in a verystriking or constant manner. According to Miiller, Colchicum ismore suitable as a remedy for pericarditis than for endocarditis.Hartmann's indications are utterly meaningless. One importantpoint has to be well kept in view in selecting Colchicum, it is tthat Colchicum causes an extraordinary increase in the secretionuric acid. It is precisely this circumstance which invests this redy with importance in heart-affections during an attack of gout.Bryonia alba is, next to Aconite, regarded by many homoeopathicpractitioners as the main remedy in pericarditis with seroeffusion. In this case the exhibition of the drug is evidently nohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 313 of 653based upon the symptoms in the Materia Medica Pura, for theheart-symptoms in the pathogenesis of Bryonia are mostly unmeaning or at least very vague. The analogy of pleuritis and pericarditis has doubtless led to the use of the drug; nor do we intenddispute the propriety of such a conclusion, since Bryonia has sucan excellent eftect in all inflammatory affections of serous membranes, and is altogether indispensable in acute rheumatism. Welikewise admit that the pathological picture developed by thesupervention of pericarditis during pneumonia or pleuritis, generally corresponds very fully with the pathogenesis of Bryonia. Wewould limit the use of Bryonia to such cases ; for uncomplicatedpericarditis we undoubtedly possess more suitable remedies.Cannabis is undoubtedly one of the remedies that has a directaction upon the heart, but we do not yet know what is the precise nature of this action. More recently a number of investigations have been instituted concerning the nature of Indian hemp(haschisch), from which we have extracted the following group ofcardiac symptoms: Violent palpitations of the heart, sometimeawithout any anguish, and sometimes attended with perfect agonyor the most frightful restlessness ; pulse small and sometimes inCarditis. 867mitting for a minute, from 100 to 120 beats; constriction of thepit of the stomach ; paroxysms of anguish ; the beats of the hearare scarcely perceptible and extremely weak ; fear of death, whicis felt every time the pulse intermits. To judge by these fewsymptoms, which always set in after large doses of Cannabis, thisdrug would seem to be a powerful cardiac remedy ; yet all secondary circumstances being considered, we shall find that this is nothe case. The incipient exaltation of the heart's action coincidewith great exaltation of cerebral action which is attended withphenomena of congestion. The cerebral exaltation very soonchanges to extreme depression, even partial paralysis, (for instaof the nerves of the senses, skin,) and this depression is likewiaccompanied by symptoms of diminished action of the heart, thelatter lasting precisely as long as the cerebral depression. Fromthis connection we can infer almost with certainty that the heartsymptoms do not arise from disease of the heart itself, but fromfunctional change in the brain. Otherwise it would be inconceivabhow such marked alterations of the functions should pass off sospeedily and without leaving a trace behind. Our opinion that Cannabis cannot be relied upon as a remedy in cardiac inflammations,is confirmed by the circumstance that the clinical trials that habeen instituted with this remedy, have not in any respect substantiated the recommendations with which this medicine has beenhonored.Opium might claim the privilege of being considered a cardiacremedy with as much propriety as Cannabis ; but in its case thecardiac symptoms are likewise secondary results of a primary functional change in the brain. If one of these two remedies were tobe employed in heart-affections, it would be in cases of endocardwhere the brain is very much involved ; this scarcely ever happenin pericarditis.Laohesis. It is a remarkable fact that the opinion of practitionehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 314 of 653concerning this agent are diametrically opposed to each other.Many pretend to have effected extraordinary cures with this agentothers have always used it without any benefit. The reason of thiis undoubtecLly that one preparation was reliable and another wasnot ; for that the serpent-poison has a powerful effect, is shownevery fresh bite of the reptile. Every case of poisoning by the bof a serpent shows that this class of poisons exerts a specific aupon the heart. We have an unusual increase of the frequency ofthe pulse which becomes feeble and small, or intermittent ; there868 Diseases of the Heart.pain in the region of the heart, the pain being sometimes intensepalpitations of the heart, fearful anguish, bloody expectorationwith constant hacking cough, marked symptoms of cyanosis, icycoldness of the extremities, with cold perspiration, retention ofurine ; paralytic sensation in the whole left side of the body, oviolent pain in the left shoulder and left arm, etc Postexaminations have always shown the heart more or less affected.The endocardium in the region of the valves is infiltrated and eaily torn ; ecchymoses cover its internal and external surface ; edations in the muscular tissue of the heart. According to thesesymptoms, Lachesis must prove a good remedy in very acute casesof endocarditis, not in j)ericarditis. As a matter of course, ourclinical trials must be instituted with a good preparation, whichought to be readily obtainable, since the poisons of the differenkinds of Viper act equally upon the heart. The fact that the bloois speedily decomposed after the Lachesis trigonocephalus has inflicted its bite, djeserves special consideration. This circumstaindicates Lachesis very pointedly in typhus and acute exanthems.[Bsehr has omitted the mention of Naja tripudians as a remedy forheart-disease. We are indebted to Dr. Russell, of England, for aproving of this snake-poison. Dr. Hughes, in his late Manual ofPharmacQ-dynamics, confirms the therapeutic value of this agentin diseases of the heart. "To quiet," says he, "chronic nervouspalpitation, to aid in the restoration of a heart recently damageby inflammation, and to assuage the sufterings of chronic hypertrophy and valvular disease, it was ranked by Dr. Russell as thechief remedy: and I think I can confirm his estimate." II.]Sulphur is not classed by us among the cardiac remedies, althoughits pathogenesis contains a number of symptoms referring to theheart ; nevertheless, we consider it valuable for reasons that wehave already stated when treating of inflammatory processes informer chapters. No remedy is better able than Sulphur to effectthe reabsorption of an exudation that had already existed for atime, and in our opinion this proposition applies to all inflammatory processes. In a case of pericarditis, where uncommonly loudfriction-murmurs and a rubbing of the pericardial surfaces againseach other, that could even be felt by the hand, had already exisfor upwards of three months, these symptoms disappeared entirelyafter Sulphur had been given for a fortnight. We only recommendSulphur for pericarditis, especially the plastic form of the diseafter the inflammatory stage proper has run its course. In endohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 315 of 653Carditis. 869carditis there is generally no exudation to be removed ; for itsconseqaences are limited to losses of substance which it is diffito replace.lodium likewise deserves attention where all that remains to bedone, is to remove the exudation. Indeed, we cannot aftbrd tooverlook a single remedy of this kind, considering the small number of those that can be of any use in this direction. Besides, hever, the pathogenesis of lodium contains a number of usefulsymptoms referring to cardiac aflfections.If we would here furnish an exhaustive list of our cardiac remedies, we should have to add a considerable number to those alreaddescribed, more particularly if we were to include all the remedireferring to the remote consequences of cardiac inflammation, towhich we have devoted a separate chapter under the heading of"Valvular Diseases." Many remedies among them we do notregard as cardiac remedies and consider their employment governed by peculiar complications. Such remedies are : Belladonna^Pulsatilla^ Tartarus emeticus^ MercuriuSj RhuSj Arnica. Other remedies have not yet been sufficiently investigated in their relatito the heart, such as : Bismuthum^ Laurocerasus^ Acidum oxalicum.The efiects of the last-named remedy upon the heart are certainlyworthy of a careful study.In order to facilitate the study of these drugs we here furnisha synoptical view of each drug, with reference to the special cardiac conditions, with which it is in therapeutic accord.In pericarditis, if setting in as a primary affection, Aconite wialways be the best remedy to commence the treatment with. Howlong this remedy is to be continued, will depend upon the coursethe disease takes, more especially upon the course of the existinexudation. As soon as a copious exudation has set in, both thepains and the fever generally abate, after which some other remedmay be chosen with great propriety. Bryonia^ Spigelia^ Digitalis^and likewise Nitrum may now claim our attention. Bryonia andSpigelia may be given when loud friction-murmurs are heard, andthe patient complains of continual pain, the area of cardiac dulness is somewhat enlarged, and the pulse is accelerated and not-weakened ; Nitriim may be resorted to, if the lungs are intenselcongested, and there is a good deal of cough with bloody expectoration. DigitaliSy if the cardiac dulness is rapidly extending ova larger area^ the friction-murmurs disappear very rapidly and colapse sets in, the pulse being either very quick and feeble, or e24370 Diseases of the Heart.very slow or intermittent. Veratrum album acts similarly to Digitalis. These two remedies, in connection with Arsenicum, are mostgenerally adapted to the violent dyspnoea with cyanotic symptoms.After the true inflammatory stage has run its course, the absorption of the plastic exudation is promoted by Sulphur and perhapsIodine^ and of the serous exudation by Arsenicum^ Digitalis^ andhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 316 of 653perhaps also by Tartarus siibiatus and Colchicum.In the secondary or complicating pericarditis, the followingremedies are of importance : For acute rheumatism, with increaseof fever: Aconite; if rheumatism sets in without any special symptoms: Digitalis; if pains are present: Spigelia^ moreover CclchicTartarus stibiatus^ BhuSj Mercurius, — If complicated with pneumonia: Aconite^ Iodine^ Phosphorus^ Bryonia; — if with pleuritis:Bryonia^ Spigelia, Digitalis^ also Nitrum. In the malignant formsof pericarditis supervening during the presence of pyaemia or othseptic forms of disease, Arsenicum^ and above all. Phosphorus, wiprove the most important remedies. Pericarditis, complicated withacute exanthemata, requires principally: Aconite in the case ofmeasles ; Rhv^ toxicodendron in scarlatina and measles ; Mercuriuand Tartarus stibiatus in small-pox ; AmTnojiium carbonicum in sclatina; it is questionable, however, whether the cardiac inflammation had not rather be treated first without reference to theexanthem.It is only in rare cases that primary endocarditis will be of anature to require Aconite exclusively. The chief-indication herethe quality of the pulse ; as long as the pulse is hard and fall,nite is undoubtedly suitable. We have shown above that Aconitemay be indicated during the whole course of the disease. AfterAconite, Spigelia may be required, Digitalis less frequently; Nitand Veratrum album may likewise have to be given. In very acutecases Lachesis, Veratrum album, or Arsenicum, may often be requirfrom the first. If the brain is greatly disturbed : Veratrum albuCannabis, Opium,In rheumatic endocarditis with complications: Aconitum, Col"chicum, Spigelia, less frequently Digitalis; if co-existing "withpneumonia or pleuritis : Phosphorus, Veratrum album, Nitrum^ alsoBryonia; with typhus: Phosphorus, also Rhus tozicod, and Arsenicum, Opium and Cannabis; with nephritis: Phosphorus, NitrwnyArsenicum, Cdchicum, also Cantharides; when acute exanthemaare present, the same treatment as for pericarditis : •' In myocarditis we would depend upon Phosphorus, ArsenicumCarditis. 871and Digitalis; we likewise call attention to the importance ofPlumbum in this disease.[Of Kalmia latifolia which has likewise been recommended as acardiac remedy, we have no reliable clinical reports worth mentioning.Cactus grandiflor'us is the last important cardiac remedy whichhas been introduced to the profession by Doctor Rubini of Naples,It seems to be particularly adapted to the organic defects consequent upon acute cardiac inflammations, especially rheumaticendocarditis. Hypertrophies and valvular deficiencies seem to commore particularly within its curative range. In the cases where whave tried it, we have seen better effects from it in the tincturin the attenuations. The case of hypertrophy of the right ventricreported in the May number 1866 of the British Homoeopathic Review, presents a very fair illustration of the curative effects ohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 317 of 653tus in heart-disease. It is likewise recommended for chronic nervpalpitation. According to Dr. Hughes, the feeling as if the heartwere grasped and compressed as with an iron hand, is very characteristic of Cactus in these cases of nervous palpitations. If thiBO, it rivals Digitalis which causes this feeling in a most markemanner. See my Materia Medica. H.]If the three forms of cardiac inflammation occur together, ourchief attention should, in our opinion, be first devoted to pericditis, the presence of which always favors the progress of the ottwo forms of inflammation and retards their retrograde metamorphosis.Dietetic and hygienic measures are of the utmost importance incardiac inflammations, especially if the disease runs a rather lacourse, which might throw the patients off their guard and evenmake them believe that a little exercise will hasten their cure.chief attention should be directed to avoid every thing that mighhave a tendency to stimulate the heart's action ; hence mental aswell as bodily exertions are entirely out of place. This point munever be lost sight of, even if all signs of inflammation have dipeared, es{>ecially in a case of endocarditis. The stomach beinggenerally involved in the cardiac disturbance, the patients generreject all kinds of nourishing food ; but even if this should notthe case, the most rigid diet should be advised as a matter ofprecaution, at least at the beginning of the disease. This is allthe more advisable since cardiac inflammations do not of themselves exhaust the system. Coexisting affections, of course, may372 Diseases of the Heart.render dietetic modifications necessary. As soon as the febrilesymptoms have been subdued, a more invigorating diet may beadvised. However, if in the case of other inflammatory aflTectionwe have not hesitated to recommend a glass of wine or beer duringconvalescence, we would with equal emphasis advise against theuse of these stimulants in convalescence from cardiac inflammatioThe smallest quantity of such stimulants has a tendency to excitethe functional activity of the heart. This remark applies even tomalt-beer, which contains a suflftcient amount of carbonic acid gto excite the circulation in many persons. The fact that cardiacinflammation often runs a latent course, is undoubtedly the reasowhy, in such circumstances, stimulants often have an injuriouseffect upon convalescent persons, and so greatly predispose theminds of physicians against their use. The severe diet observedduring the period of convalescence should be pursued some timeafter, for the reason that the inflammation very often leaves remains that escape our observation and entail a tendency to relapsor to organic alterations, such as hypertrophies and valvular diseases, that can only be prevented by the utmost care from increasing to a fatal termination.8. Sypertfroplita Cordis.Hypertrophy of the Heart.By this name we designate a condition of the heart, where itsvolume is considerably enlarged by the increased thickness of itshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 318 of 653muscular tissue, and by a more or less considerable distention ofcavities. The formerly current forms of hypertrophy of the heartare no longer accredited before the tribunal of modern pathology.An increase of the size of the heart by adventitious formationswithin the tissue of the heart, is no longer regarded as a genuinform of hypertrophy.This disease is caused by conditions which sooner or later determine an increased activity of the heart, on which account hypertrophy is generally to be regarded as a secondary or consecutiveaflfection. Since the whole heart does not become hypertrophied aonce, but the hypertrophy generally begins with one particularcavity, we find that hypertrophy arises from the following pathological changes :Hypertrophy of the left ventricle: stenosis and insuflSiciency ofthe aortic orifice, stenosis of the aorta itself, aneurisms of thHypertrophia Cordis. 878atrophy of the renal parenchyma, amputation of the thigh andconsequent ligation of the femoral artery. The same causes mostcommonly lead to hypertrophy of the left auricle and stenosis ofthe mitral orifice. 'Right ventricle: Stenosis and insuflBciency of the orifice of thepulmonary artery ; insufficiency of the mitral valve and stenosisthe left auriculo- ventricular orifice consequent upon the obstrution offered by this insufficiency to the complete emptying of thpulmonary veins ; diseases which restrict the capacity of the lunand considerably diminish the lesser circulation, such as emphyseatelectasia, tuberculosis, pleuritis, caries of the vertebra, curHypertrophy of the right auricle alone scarcely ever takes placeon the other hand this auricle always participates in the hypertrophy of the ventricle.Every attentive observer must have noticed that primary hypertrophy arises in consequence of hereditary disposition without anapparent cause; or it may develop itself in cases where a peculiamode of living stimulates the heart to a constant and severe actias may take place in consequence of severe manual labor, continuerunning, excessive gymnastic exercises, fencing, abuse of strongcoftee, wine, beer, spirits; or finally, hypertrophy may arise ifheart is kept in a constant state of tumultuous action by strongj«ychical impressions, hence in the case of individuals with intesanguine temperaments.Hypertrophy of the heart may occur at any age between theyears of fifteen and forty. Males are decidedly more liable to itthan females, especially to hypertrophy of the left ventricle; thhowever, is probably owing to the circumstance that men are morefrequently exposed to the causes giving rise to such structuralchanges.The anatomical changes consist in a thickening of the walls ofthe heart and of the inter- ventricular partition, in a more or lconsiderable dilatation of the cavities, very commonly in a darkecolor of the muscular tissue, in displacements of the heart andhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 319 of 653changes in its external shape. If the hypertrophy is general, theheart assumes the shape of a triangle with obtuse angles; if theleft ventricle alone is hypertrophied, the heart becomes elongateand somewhat conical, and the apex is turned more towards theleft side ; if the right ventricle is hypertrophied, the shape ofheart becomes more rounded, its diameter in breadth is longer, anthe heart approximates more to the right side. The base of the874 Diseases of the Heart.hypertrophied heart generally reaches a little below the aormalline.Sf/mptoms and Course. Only two forma of cardiac hypertrophycan Re described symptomatically, because they alone occuras primary diseases, we mean hypertrophy of the whole heart andthat of the left ventricle ; whereas hypertrophy of the right ventricle is almost always of a secondary character, and its symptommanifestation is essentially depending upon the nature of theprimary disease. So far as hypertrophy of the right ventricle isconcerned, we shall therefore have to confine ourselves to indicathe general consequences of this disorganization.Whereas primary hypertrophy of a certain grade always represents a really morbid condition of the heart, secondary hypertropcan at the commencement only be regarded as an endeavor of theorganism to restore the disturbed equilibrium. This is the reasonwhy the lesser degrees of this structural change exist without anmorbid symptoms, or are only accompanied by disturbances, suchas are called forth by accidental stimulations of the heart's actThe more frequent and violent such stimulations and the longertheir duration, the more they contribute to increase the existinghypertrophy and to complicate it by the production of valvulardisease and dilatation of the cardiac cavities.In moderate hypertrophy of the left ventricle, without anymarked dilatation, the arterial blood is driven with increased pointo the arteries of the systemic circulation and likewise througan increased frequency of the contractions of the heart. Theimpulse of the heart is stronger and generally visible, and extenover a larger area, so that it can be felt even in the fifth andintercostal spaces, and even beyond the nipple. A larger extent odulness is not always traceable on account of the overlapping portions of lung. While in a state of rest, the patients generally fwell, they complain at most of a slight feeling of pressure in thprecordial region. Every rather violent and continued motion,every mental excitement not only causes a troublesome and evendistressing palpitation of the heart, but along with it an oppresand feeling of anxiety in the chest, a sensation as it the clothewere too tight, dyspnoea. The increased excitement in the arteriacirculation gives rise to congestions of the head, the face looksflushed, the eyes glisten and are injected, the margin of the lidoften looks as if inflamed, there is buzzing in the ears, vertigothe congestion is less frequently met with in the tract of the aoHypertrophia Cordis. 875http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 320 of 653descendens, because the situation of the arteries it supplies renthem more yielding to its impelling power.A high grade of hypertrophy of the left ventricle scarcely everexists without valvular defects, most generally stenosis of the aorifice ; it very soon becomes associated with dilatation of theventricle. As long as the mitral valve remains intact, such ahypertrophy is characterized by the same phenomena as thosedescribed above, only in a more intense degree, and with shorter,or without any intermissions. But if, owing to the excessive dilatation, the mitral valve is no longer sufficient to close the aurventricular orifice, the consequence is that the more forcible exsion of the blood into the aorta becomes associated with a stasisthe lesser circulation and more immediately in the function of thright ventricle, in consequence of which the whole heart becomeshypertrophied in the most dangerous acceptation of this term. Theimpulse of the heart is perceived over a large extent by the eye,ear and touch ; it is even heard without the ear being applied tothe chest; the concussion of the thorax is extreme; the dulnessextends further on to the left, and is returned over a larger arethe heart descends below its normal line, the ribs even bulge. Thsounds of the heart are either mufiled, or else ringing, and, ifvalves are diseased, murmurs are heard. Other symptoms can easilybe inferred by any one who considers that the arteries are extremely engorged, and that the lungs are in a state of hyperoemiaAll these conditions will be dwelt upon more fully when we cometo treat of valvular anomalies.The phenomena emanating from the hypertrophied right ventricle, are very frequently entirely disguised by those of the aftion which had given rise to the hypertrophy. Anxiety, dyspnoea,oppression, palpitation of the heart, may be caused by pulmonaryaffections alone. Simple hypertrophy merely results in a greateraccumulation of blood in the lungs, and a consequent catarrhalaffection of the lungs, with hemorrhage, hypersemia of the lungs.The physical signs are : Increased extent of dulness on the rightside, even beyond the right border of the sternum; pulsation inthe pit of the stomach, perceptible raising of the lower border othe sternum; accentuation of the second sound of the pulmonaryartery.Hypertrophy with dilatation may be very considerable without8ui)erinducing any serious derangements. It implies a sort of uniform compensation of functional power, and the patients only per876 Diseases of the Heart.ceive a dirturbance of equilibrium if they undertake to undergosevere bodily exertions. In hypertrophy with dilatatioil the hearoften thumps very violently, without causing the patient any greatrouble ; the impulse of the heart often raises the head of the acultating physician, and is felt over a much larger extent ; thediac dulness is returned over a longer and wider area ; the soundof the heart are stronger and more sharply accentuated, and havevery often a metallic ring.The courae of hypertrophy is more especially determined by thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 321 of 653consequences resulting from it to the general organism. Underfavorable circumstances such patients may live to an old age provided they live within the bounds of moderation, prudence andfrugality. If other morbid dispositions exist, the cardiac diseasmay give them a fatal start. Cerebral as well as pulmonary apoplexy of young people is preeminently a consequence of cardiachypertrophy. If hypertrophy coexists with, or is depending uponaneurism or an atheromatous condition of the vessels, it acts botas a compensation to the obstructed circulation and as a (^ause othe rupture of the vessels. We should always bear in mind that\ imple hypertrophy is not, of itself, a dangerous condition, butthat it becomes dangerous as soon as valvular defects arise. We,therefore, refer the reader to the chapter on valvular diseases wall these complications will be explained and accounted for.Professor Niemeyer furnishes the following excellent diagnosticdetails : For eccentric hypertrophy of the left ventricle : Visibpulsation of the carotids ; loud systolic murmur in the large artries, full pulse which is visible even m the smaller arteries;increased impulse of the heart, felt much higher up from the apexthe apex of the heart reaches lower down than normally; largerextent of dulness from the apex upwards; increase of the soundsof the heart in the left ventricle and in the aorta, and sometimemetallic ringing. — For the hypertrophy of the right ventricle:Stronger impulse of the heart, extending to the sternum and sometimes even to the left lobe of the liver ; displacement of the apoutwards, scarcely ever at the same time downwards ; greater extent of cardiac dulness in breadth, increase of the sounds of theheart, in the right ventricle and in the pulmonary artery, thesecond sound of which is most important. — For hypertrophy withdilatation : The arteries and the pulse as in hypertrophy of theventricle ; the impulse of the heart is considerably stronger andextending more in length and breadth ; the apex of the heart poinHypertrophia Cordis. 877lower down and outwardly; cardiac dulness is felt over a largerarea in every direction ; all the sounds of the heart are louder.The prognosis becomes in the long run unfavorable, for thereason that the disorder bears within itself the conditions ofgrowth.Treatment* That cardiac hypertrophy is a curable disease aslong as the disorder is not too far developed, is admitted on allsides, although the chances of a cure are not very great. Moatpathologists, however, doubt whether a cure can be effected by thdirect action of medicine. Before indicating the drugs that requito be used in the treatment of this disease, it may be well to ofa few suggestions that may be of importance in conducting thetreatment.If hypertrophy .is a necessary and compensating consequence ofother morbid conditions, it would be wrong, by removing the*hypertrophy, to disturb the equilibrium which the hypertrophyhad restored. Fortunately, this is not well possible ; nevertheleattempts are too readily made to depress the apparently excessiveenergy of the left heart more particularly, and it is this proceehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 322 of 653which we consider injurious. In such circumstances all we can andshould aim at, would be to remove the primary pathological cause,and, if this is not possible, to leave the condition intact and ato treat a few incidental troublesome symptoms. The physicianwill have enough left to do in supervising and regulating thepatient's mode of living, and in controlling intercurrent conditithat might result in an increase of the disorder. If the hypertrois a primary disease, either congenital or imperceptibly acquiredthere is still a prospect of the disease being overcome, providedphysician is made aware of it in time. As long as the body continues to grow, we deem it possible to remove the hypertrophy, or aleast to reduce it to scarcely perceptible dimensions. For this rson, it is of the utmost importance that, if there is the least scion of heart-disease in the case of children or growing people,hearts should be examined with the utmost care. Young peopleaddicted to the practice of onanism, are very apt to be afflictedhypertrophy of the heart ; when excited by such a cause, the disease can undoubtedly be arrested or even completely removed.In our opinion the following points ought to determine the treatment of cardiac hypertrophy.In the first place, if possible, the cause should be acted upon.This will be difficult if the circulation is obstructed by some m878 Diseases of the Heart.rial obstacle, sach as an aneurism, an atrophied kidney, conertrition of the aorta, valvular defects. A possibility of this kind,ever, exists, in the case of young people, if the hypertrophy iscaused by onanism, premature mental exertions with their necessary attendant consequences of nervousness, excitability, chlorosanreraia. The remedies adapted to this purpose are numerous andhave already been mentioned in the chapter where the corresponding pathological diseases were treated of. A second causal indication requiring particular attention is the patient's mode ofliving.The dietetic management has to aim at two objects, in the firstplace the avoidance of every thing in the patient's mode of livinthat might aggravate the disorder ; and secondly, to surround thepatient with influences that will have a direct tendency to amelirate his condition. As regards the first point, spirits, coftee,spices, the excessive use of salt, very substantial and more partularly fat food will have to be avoided. The patient should begoverned by the nature of his business in the quantity of food heconsumes. Overloading the stomach is very hurtful; frequent andsmall meals are preferable. A person afflicted with cardiac diseashould never go to sleep immediately after dinner, or go to bed wa full stomach. Every bodily motion occasioning a sensation ofincreased action of the heart, is too great a tax on this organ ;mental excitement is likewise strictly to be avoided. As regardsthe second point, we would call attention to the fact that we veroften succeed, by changing the patient's mode of living, in avoidor diminisliincr the violent conjjestions of the head. A businessthat compels the patient to lead a sedentary mode of life, or exphim to much ejj^citement, should be abandoned. If icy coldness ofthe lower extremities is accompanied by heat of the head and ahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 323 of 653flushed face, this trouble might perhaps be remedied by rapidwalking which, by exciting the action of the heart, would, on theother hand, prove a source of mischief, whereas gymnastic exerciswith the feet alone might often render the best service, withoutcausing palpitation of the heart. An exhaustive development ofthese rules would occupy too much space in a work of this size.What we have said will suffice to show in how many ways a patientwith heart-disease claims our attention.In the third place, it is a matter of essential importance that amorbid conditions as well as isolated symptoms, which occasion anincreased action of the heart, should be remedied as speedily asHypertrophia Cordis. 879possible by appropriate remedies. Here, too, all we can do is tosimply mention the leading remedies that we may have to resort toin meeting complicating disorders of this kind, the most importanof which we will now proceed to point out.Palpitations of the heart, that is to say : a very violent increaof the action of the heart setting in without any fixed order, wiirregularity of the beats of the heart, and always of short duratare generally met with only in the case of very irritable, nervouindividuals. We have obtained the best success in such cases fromthe use of Digitalis or Digitalin, which we recommend as the bestremedies to begin the treatment with. The paroxysms being short,we cannot expect to do much for a single paroxysm, on whichaccount the remedy has to be continued for a time at rather longintervals. Ferrum may likewise be tried, of course very cautiouslespecially if the affection is complicated with tuberculosis andchlorosis. Pulsatilla and China may be classed in this category,but we cannot speak in their favor from personal experience. Inone case we have seen good effects from Argentum nitricum andPlatina, Sepia may prove useful to women, but will not do muchin the case of men.Palpitation of the heart is one of the most common and mostdistressing complaints in cardiac hypertrophy, but is at the sametime so intimately connected with this disorganization that it isimpossible to apply to it remedies that will have an infallibly cative effect. If the palpitation takes place at altogether irreguintervals, or if it only lasts a short while, or even if it contithe time, we advise the remedies that will be found indicated inthe following chapter, and which may be given with a view oftreating the whole disease, not merely a single symptom. If theparoxysms set in frequently, or at definite periods, or last sometime, we have remedies that have a decidedly soothing effect. Ifthe attack is excited by severe mental labor, by the abuse of cofor spirits, or by some unpleasant emotional excitement, Niix vomimay be resorted to; with this precaution that it as well as theremedies to be named hereafter, must not be given in strong dosesIf the palpitation attacks robust, full-blooded, excitable indiviwith bright complexion, disposition to changes of color in the faglistening eyes, injected conjunctiva, headache, stinging or shoopains in the prrecordial region, Aconitum is the most appropriateremedy. It is likewise suitable for palpitation caused by a suddeor intense emotion, and more especially if the individual is afflhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 324 of 653X880 Diseases of the Heart.■with tuberculosis. Arnica is indicated very nearly by similar conditions. If the palpitation is excited by a fit of anger or vexatin the case of very nervous persons and children, we give Chamomilla. If excited by a violent fright, or if attended with soporrestlessness, the face being livid or pallid, we give Opium in asmall dose. Coffea is indicated by nocturnal palpitation of the hwith great weariness and a constant change of position, with apeculiar anxiousness, after too copious a meal, or after imbibingardent spirits. Chlorotic individuals require Pulsatilla, If thetients do not smoke, or to female patients, smoking often aftbrdsrapid and essential relief, and constitutes one of the best palliLittle paper-cigarettes are best adapted to such palliative purpoIf any one should be disposed to doubt the homoeopathicity of thidrug, let him read one of the many published essays on the etFectof tobacco.Pulmonary hypersemia or rather pulmonary congestion does notoccur very frequently, but is very distressing. If emanating fromthe left heart, Aconitum will most generally relieve it completelJSelladonna has never seemed of much use in this complaint ; Armmand Cannabis may do some good. [Likewise Veratrum viride, H.]If the pulmonary congestion is traceable to the right heart. Digitalis generally proves a sovereign remedy to which BeUadonna^Pulsatilla^ Carbo vegetabilis are essentially inferior.Cerebral congestions which are sometimes excessive, are likewisefrequent accompaniments of cardiac hypertrophy, especially hypertrophy of the left ventricle. Here, too, Aconite is one of the moefficient remedies. We prefer Opium if the head feels excessivelyconstricted, the complexion is dark-red, and the anxiety and restlessness extreme. We should never resort to Belladonna in such acase. If the congestion originates in hypertrophy of the right vetricle, Belladonna is sometimes useful ; Digitalis^ however, affirelief more efficiently and promptly.The characteristic headache accompanying hypertrophy of theheart, and resembling hemicrania, can scarcely ever be relieved.If such a headache is attended with, and perhaps caused by, hypersemia, the remedies which we have indicated previously, will haveto be depended upon. If the headache is unaccompanied by congestive symptoms, we advise Digitalis^ Arsenic or Spigelia,In the fourth place we must try to meet the hypertrophy by allproper remedies. We are aware that to many the abatement andBtill more the cure of an hypertrophy of the heart seems an imDilatatio Cordis. 881http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 325 of 653possibility; indeed we ourselves should not feel anxious to rashland unhesitatingly promise a favorable result from our treatment.Nevertheless we have often found that, after using proper remediethe dangerous phenomena consequent upon hypertrophy of theheart became less, and that in young individuals the hypertrophyyielded so far as to become inaccessible to the usual means of dinosis. Hence we would, by all means, advise to treat such a case,were it only to make the patient believe that he is taking something, and thus to keep him from using strong and generally deleterious drugs, or to continually remind him, by the use of a littharmless medicine, of the necessity of avoiding every kind of excess and even the least violation of the rules laid down for himby his medical adviser. The medicines which we deem the bestadapted to such puri)0ses, are almost all of them metals or inorgsubstances, no vegetable drugs. At any rate, we have never obtained any permanently good results from a vegetable drug. Werecommend Arsenicum^ Aururn^ Argentum^ Cuprum^ Plumbum^ PlaUna and Ferrum. It would be useless to undertake to assign toeach of these remedies definite limits in the treatment of hypertrophy ; we only recommend in general terms Arsenicum^ Plumbumand Ferrum for hypertrophy of the right ventricle, and the otherremedies, including likewise Arsenicum, for hypertrophy of the leventricle. In a given case, the selection of the remedial agent whave to be governed by the nature of the existing general symptoms. Sulphur^ Nairum muriatlcum and Petroleum may be addedto our list of metals. If we desire to obtain good eflfects fromdrugs, we must guard against too strong and too frequently repeated doses, and against changing the remedy too often.Considering the mischief which is so often done by the abuse oflarge doses of Digitalis, we repeat with decided emphasis that theffect of this drug in hypertrophy of the heart is never permanencurative, but only palliative, and that, if it is given for sleepit will act so much more like Opium, the more it is homceopathicaindicated by slowness of the beats of the heart.8. Dilatatio Cordis.DilataHon of the HeartWe mention this condition here so as to avoid incurring thereproach of incompleteness and rendering the pathological statements in other numbers unintelligible. As regards treatment, the382 Diseases of the Heart.treatment of dilatation of the heart coincides with both hypertrophy and fatty degeneration.Dilatation of the heart may arise, if the heart or the respectiveventricle or auricle is exposed during diastole to an increased pof the inflowing blood which overcomes to a certain degree theresisting power of the walls of the heart. Inasmuch, however, asthe blood flowing in during the diastole of the heart is driven ba proportionally feeble vis a tergo^ it is easily understood whythick walls of the left ventricle and auricle are so rarelv dilatand why this dilatation is so much more commonly met with onhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 326 of 653the side of the right ventricle and auricle. Since, in such circustances, the ventricle makes greater eiforts to free itself fromcontents which have become excessive, a dilatation is almost alwasucceeded by hypertrophy, giving rise to eccentric hypertrophy.In another series of cases the cause of dilatation is not an incrpressure of the blood, but a diminished energy of the muscularstructure of the heart, and here we meet with a genuine dilatatiowithout any compensating, consecutive hypertrophy. This diminished energy of the muscular structure o:' the heart eitheroriginates in exceedingly debilitating constitutional diseases, sas typhus and a high degree of ansemia ; in which case dilatationof the heart is merely a symptom of these pathological processeswhose disappearance generally implies a complete disappearance ofthe dilatation ; or else this defect originates in a disease of tmuscular tissue itself, most generally fatty degeneration, less fquently serous infiltration, such as may take place during inflammation of the muscular tissue of the heart, in which case this foof dilatation and fatty degeneration become more or less identicaFrom these reasons we have deemed it unnecessary to devote aspecial chapter to the treatment of dilatation.4. Adipositaa Cordis.Fatiy Defeneration of the Heart.Fatty degeneration either consists in an abnormal increase of thenormal quantity of fat about the heart, or in the adventitious fomation of fat within the muscular tissue of the heart.In the former case, the fatty heart proper, the disease can betraced to all those causes that determine a general increase ot fhence fatty heart is generally met with among persons inclined togrow fat; fatty heart is likewise the result of an excessive useAdipositas Cordis. 388ardent spirits. On the contrary and in defiance of all physiologiexplanations, a fatty heart is sometimes, although rarely, met wiin cachectic individuals or in persons tainted with a constitutiodyscrasia.The sedond kind, fatty degeneration of the muscular tissue, notunfrequently results from the former. Other more or less reliablecauses of this disorganization are : All pathological processes timpair the assimilative power of the muscular structure of theheart, myocarditis, adhesions of the pericardium, largely develophypertrophy of the heart, valvular defects, more particularlyobliteration or degeneration of the coronary arteries. —causes that result in morbid fatty metamorphoses in other organs.J>yscrasia of drunkards.In fatty heart, the normal quantity of fat covering the sulcusand apex of the heart, etc., is sometimes increased to such a degthat the whole heart seems surrounded by a thick cushion of fat.The layer of fat deposited on the right side of the heart, is alwmore considerable and is formed sooner than on the other side.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 327 of 653Not unfrequently the fat dips into the interstices of the musculafibres, impairs their nutrition and either results in atrophy orfatty degeneration of the muscular tissue.In fatty degeneration which affects more particularly the left heas the other form, fatty heart, affects more particularly the righeart, the affected parts of the heart have a pale, yellowish colare flabby and easily torn. Commonly the degeneration is confinedto striated portions of the muscular tissue, is apt to afiect thecolumnse carnece, and, if very extensive, is always accompanied bconsiderable dilatation of the heart. The single muscular fibrilswhen seen under the microscope, are seen filled with fatand have lost their transverae strise.Symptoms and Course. The lesser grades of fatty heart andfatty degeneration of the heart may run their course without anymorbid phenomena; there may even exist a considerable depositionof fat, and yet the general health of the patient may be perfectlsound. Morbid symptoms may not take place until the pressureof the fat causes atrophy or fatty degeneration of the musculartissue. The first symptoms of this disease consist in functionaldeficiency of the heart: peculiar feelings of weakness, dyspnoeafrom the least exertion. In addition to this we have dispositionto vertigo, fainting fits or paroxysms resembling syncope and somtimes even apoplexy. Except a distressing sensation of pressurethe patient does not experience any pain. In the higher grades* "884 Diseases of the Heart.this disease the skin becomes cool, disposed to perspire profuselassumes a pale and sickly appearance, oedema sets in, and theexcessive weakness of the circulation may result in dropsy. Thephysical signs are the following : Increasing weakness of the impof the heart ; feebleness of the sounds ot the heart, especiallythe first ventricular sound; increased extent of cardiac dulness,only in far advanced cases; blowing murmurs in the region of theorifices, owing to the circumstance that the diseased columnsecarneie no longer permit the valves to completely close the orifieasily compressible, soft, unresisting pulse which may show everypossible irregularity and is often extremely slow.This affection only runs an acute course if the fatty degeneratiosets in rapidly and very extensively in consequence of inflammatoprocesses ; otherwise the disease runs a very chronic course andpending upon the following conditions. If the fatty degenerationaffects an hypertrophied heart with valvular disease, dilatationfinally paralysis of the heart result, or else rupture of the heatakes place. This may likewise result from a less extensive fattydegeneration, after partial dilatation has occurred. The diseasevery commonly characterized by marked remissions or even complete intermissions. Death takes place, although not in a majoritof cases, either by general marasmus with dropsy, or by oedema ofthe lungs or paralysis of the brain, or, which is most commonlythe case, very suddenly by acute ansemia of the brain, rupture orparalysis of the heart.In treating this disease, we have to aim in the first place atarresting its progress by the avoidance of every hurtful influenchttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 328 of 653generally and every dietetic indiscretion in particular; next, atstopping the paroxysms of distress as soon as possible ; and finaat effecting a retrograde metamorphosis of the disorganization.In a curative point of view, tlie dietetic treatment is really apcable only to fatty heart, not to fatty degeneration. There is nodoubt that we are sometimes able to remove an excessive tendencyto fatness, and most probably to influence by similar proceedingsthe excessive deposition of fat about the heart. In this respect,extraordinary etiicacy of the Karlsbad springs is so well knownthat we could not help censuring a physician who would refuseto send his patients to Karlsbad from no higher motive than afanatical adherence to a therapeutic system. Unfortunately thefat which had disappeared under the influence of Karlsbad, but tooften and rapidly returns even in an increased quantity after theAdipositas Cordis. 885patient has gone back to his home. This is sometimes and perhapsmost commonly the patient's own fault; but not unfrequently it isthe fault of the improper dietetic instructions emanating from thphysician. We should be led too far, if we were to go into fullparticulars regarding the diet ; all we shall do is to present thlowing general propositions to the reader's attentive regard. Theproduction of fat is owing to an excessive supply of food, the suconsiderably exceeding the waste. The quantity of fat producedwill be so much greater the more the supply consists of substancethat are known to make fat, principally animal and vegetable fatsand starch-containing food. ]ieer generally promotes the formatioof fat either directly or indirectly. Meat, if constituting the carticle of diet, scarcely ever makes fat. These few points sufficgeneral dietetic directions. Let the supply and waste be properlybalanced by bodily and mental occupation, and let whatever excessremains be done away with. The patients should principally uselean meat, not starch-containing vegetables or fruit, and but litbread and wine ; and they should be directed never to overloadtheir stomachs as so many people do from mere habit, not fromnecessity. By pursuing such a system of diet and hygiene, thepatient will be able to do without a resort to Karlsbad. Starvaticures are the more condemnable in the case of such patients, themore the heart has already become diseased. At the same time, itmust be admitted that there are many persons who, most generallyin consequence of abnormal changes in the functions of the liver,deposit such quantities of fat, even under the simplest and mostcautious diet, that it seems, impossible to suggest any furtherchanges in this respect.Fatty degeneration may sometimes, but assuredly only in rareinstances, have its primary origin in a constitutional tendency tfatness ; otherwise we are unacquainted with any other cause ofthis disease that might suggest special dietetic preventive rulesIf the presence of the cardiac disease is substantiated beyond andoubt, the patient's mode of living has to be regulated with a viof preserving his strength as much as possible. Substantial nouriment, so far from being forbidden, should be recommended; themoderate use of wine is generally attended with the happiest resuIn the case of drunkards, spirits should be withdrawn gradually,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 329 of 653not all at once. A sudden and complete abstemiousness might leadto dropsy ; indeed the frequent occurrence of such an event shoulbe a warning to us. The prostration which follows every consider.25886 Diseases of the Heart.able exertion, admonishes the patient never to nse his strength tthe point of exhaustion. This precaution likewise applies to mental efforts. The frequent paroxysms resembling syncope or simulating apoplexy are very apt to lead to the adoption of measureswhich, by depressing the strength, are at the same time calculateto aggravate the patient's condition for the reason that these cebral phenomena do not depend upon ansemia, but hypersemia. Venesection is of course out of the question ; patients with whom wenot yet sufficiently acquainted, should have their attention direto the pernicious consequences of blood-letting, lest they shouldfeel disposed to resort to it without the advice of a physician.Of the intercurrent morbid phenomena these pseudo-apoplecticparoxysms and those resembling angina pectoris deserve most attention and should by all means be met by some appropriate remedy.In the former, Camphora will be found most efficient, more particularly on account of the rapidity with which it acts. Beside Camphora we may try Veratrum album and Pulsatilla. As soon as afainting sensation comes over the patient, he must be laid in ahorizontal position, with the head on a level with the rest of thbody. If the syncope lasts too long and life seems to be endangerby it, Ammonium carbonicum and even Mher may be resorted towithout fear.In paroxysms attended with an increase of the heart's action,Digitalis is the most homoeopathic and therefore the most efficieagent, provided it is given in a small dose. Opium^ Cannabis^ JLacerasus may likewise be administered with some chances of successThe disease in its totality will have to be acted upon both bymeans of medicines that exert an influence over the excessive formation of fat, such as Ferrwriy China^ Calcarea, Arsenicum^ andlikewise by such medicines as are in special rapport with the heaFirst in rank we have undoubtedly Digitalis whose pathogenesispresents the most striking image of excited and yet powerless, extremely irregular action of the heart. Whether it is of much orany use in adiposis, we dare not either affirm or deny; but in fadegeneration its influence is as great as that of any other remedOf course, the dose has to be proportioned to the quantity of reative power with the utmost care. lodium is likewise of considerable importance. It has an extreme tendency to palpitation of theheart during the least motion, improved by a horizontal posture;has the peculiarity inherent in inflammatory exudations to undergan abnormal metamorphosis ; it has a disposition to an abnormalAdipositas Cordis. 887http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 330 of 653deposition of fat. Hence lodium is one of the few remedies thatcorresponds to the morbid process in question in every direction.On a former occasion we have already once denied the power ofArsenic to influence structural changes of the heart; we here repthis statement, although it is undoubtedly true that the pathogenesis of Arsenic has many symptoms which, when detached fromtheir connected series, can be referred to fatty heart. We have tother remedies which we cannot recommend with sufficient emphasis in heart-disease generally and more especially in fatty deeration, we mean Cuprum and Plumbum. Both remedies act similarly, except that the action of Plumbum is more persistent andpenetrating. We would only use either of them in cases of uncomplicated fatty degeneration. Since their provings do not containsingle heart-symptom, we will indicate those that may be found incases of poisoning. Cuprum has : Pulse irregular, small, easilycompressible, intermitting, accompanied by excessive musculardebility; the beats of the heart are scarcely, or not at all perceptible; the sounds of the heart are indistinct; dyspnoea, feeling of anxiety, disposition to faint. Plumbum has : The impulseof the heart is very feeble, or even imperceptible, intermitting;sounds of the heart indistinct ; palpitations attended with excessive dyspnoea; pulse very soft, easily compressible, intermittingirregular, fifty to sixty in the minute, less frequently over a hdred, after which it is scarcely perceptible; heart flabby; suddeparalysis of the heart; fainting fits during every exertion, alsoattended with slight convulsions ; extreme muscular debility andoppression from the least motion; despondency and dread of death;nightmare; oedema of the skin. As for -Sulphur^ we should notexfiect any favorable eftects from it in these disorganizations ;pathogenesis does not indicate it in this disease, nor can it bereferred to it by a process of analogy ; for even if fatty degenetion were to be regarded as the expression of a perverse metamorphosis of some inflammatory exudation, we cannot show fromanalogy in other organs that Sulphur is capable of antagonizing ametamorphosis of this kind. Aurum^ on the contrary, is a remedywell worthy our attention, more particularly if the heartcauses great depression of spirits ; usually the local symptoms ainsufficient to legitimate the choice of this agent; and clinicaltestimony is entirely wanting.888 Diseases of the Heart.9. Anomalies.Abnormal Conditions of the Orifices of the Heart;Valvular Diseases,Although every alteration of the orifices might be designated asan abnormal condition, yet, in pathology, this terra is applied itherapeutical aspect to such alterations only as really interferethe functions of the heart. In view of our powerlessness in thepresence of such disorganizations, nobody will find fault with usfor only mentioning the most essential characteristics of these dorders.The etiology of these abnormal conditions of the orifices is veryobscure, and in very many cases no definite cause can be assignedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 331 of 653to them. All influences that occasion acute endocarditis, maylikewise be considered as causes of valvular diseases ; among thecauses rheumatism occupies the most prominent rank. This appliesparticularly to anomalies aftecting younger persons. Among personof a more advanced age it is the still obscure process of chronicendocarditis, the atheromatous deposition and degeneration whichaftects the valves as well as the arteries. Other causes which, hever, are extremely rare, are: Dilatation of the heart, externalpressure or a severe strain, excessive exertions, ruptures. Sex dnot seem to have any influence in this direction, except thatrepeated observations have shown that women are more frequentlyaffected with anomalies of the venous, and men more frequentlywith anomalies of the arterial orifices. Beyond the age of twentyfive a liability to every, kind of anomaly sets in, which seems tincrease in proportion as persons grow older. Corresponding withthe prevalence of endocarditis, acute as well as chronic, in theheart, it is only exceptionally that orificial anomalies are metin the right side of the heart.The following are the more particular alterations to be met within the different orifices respectively :a. Insufficiency of the Mitral Valve.During the systole the mitral valve closes the ventricle more orless imperfectly against the auricle, either because its lappelsshrunk or torn, or the tendinous chords and the coulmnee carneasare abnormally altered. Hence, during the systole blood regurgitates into the auricle. This causes a gradual dilatation of theAnomalies. . 889auricle* the flow of blood from the pulmonary veins is impeded,the vessels constituting the lesser circulation, become engorgedwith blooa, finally, the right heart is overcrowded with blood, ging rise to eccentric hypertrophy and, as an ultimate result, caua stasis in the peripheral veins. If the insufficiency is but litthe left ventricle remains unchanged ; the higher degrees of insuficiency lead to dilatation and hypertrophy of this ventricle. Phical signs : Greater extent of cardiac dulness in breadth ; impulof the heart stronger and over a larger area ; undulatory movements of the right ventricle. Systolic murmur, most distinct atthe apex, sometimes like a purring murmur ; second sound of thepulmonary artery louder, sometimes so loud that it can be felt;pulse either normal, or, if the insufficiency is considerable, vemuch weaker, sometimes irregular.The consequences of this anomaly to the whole organism are :hypersemia of theiungs; sanguineous clots in the lungs; catarrhof the bronchial mucous lining; hsemoptoe; dyspnoea; emphysema;hypersemia of the brain, liver, spleen, kidneys, stomach, with chgastric catarrh; subsequently cedema and serous efiusions in thediflterent regions attacked by hypersemia.The prognosis of this aflfection, of itself, is not entirely unfaable. Although a cure is scarcely ever possible, yet patients maywith care, live to an advanced age. This depends upon the compensation established by the right ventricle and auricle; as longhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 332 of 653this compensation is sufficient, the patients are not in any verygreat danger. But if an increase of dyspnoea, a stasis in the pereral circulation, or oedema show that the compensation is incomplete, an approaching termination of the patient's suiFerings maybe safely prognosticated. The prognosis is still worse if valvulainsufficiency becomes associated with stenosis of the left auricuventrieular orifice, as is most frequently the case. Before speakof the treatment, let us dwell a little further on the stenosis oleft auriculo-ventricular orifice.b. Stenosis of the Left Auriculo-ventricular Orifice. ,jA constriction of this orifice interferes with the passage of theblood from the auricle into the ventricle, so that a portion of tblood remains behind in the auricle.This result is superinduced by the following anatomical changes:The valves are thickened, especially at their insertion or base,their segments or lappets are more or less completely soldered together or variously distorted in shape, or the chordae tendinese890 Diseases of the Heart.lie contracted, shrunk and deprived of their elasticity, so thatvalves are drawn down into the ventricle, and their segmentsassume a funnel-shaped appearance. In this way, an ostium naturally large may be reduced to the condition of a mere slit or to tdiameter of a goose-quill or pea.The consequences of stenosis are the same as those of insufficiency of the mitral valves : Imperfect emptying of the left auristasis of the blood in the pulmonary vessels, overcrowding of theright ventricle followed by eccentric hypertrophy as a means ofcompensation, which may increase to such an extent that the tricuspid valve becomes insufficient to close the right auriculoular orifice. The left ventricle receives a smaller supply of blohence, the flow of blood through the arteries becomes less activethe pulse grows very small and feeble. In the course of time thecapacity of the ventricle becomes reduced and its walls becomeatrophied. These changes do not 1;p,ke place if the stenosis is aciated with conditions in the aortic system inviting increased extions on the part of the left ventricle. Even in more remote orgathe stenosis results in the same phenomena of stasis as are consequent upon valvular insufficiency, and generally more rapidly andmore extensively.This lesion is characterized by the following physical signs:Cardiac dulness very extensive in breadth, owing to the oftenextraordinary distention of the right ventricle ; the impulse ofheart is heard over a more extensive area both to the left and tothe right, even as far as the right sternal border, and powerfullshakes the thoracic wall ; the prsecordial region is sometimes arthe flapping of the tricuspid valves is sometimes sensible to thehand; diastolic purring is very commonly perceived at the apex ofthe heart. Auscultation returns a diastolic murmur at the apex ofthe heart, and the first sound is considerably feebler; or if thestenosis is associated with valvular insufficiency, a murmur is hinstead of the sound. The aortic sounds are weaker, the sounds ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 333 of 653the pulmonary artery, especially the second sound, are considerabstronger.From what we have said, the subjective symptoms may be readilyinferred. The pat\?nts always suffer more from stenosis than fromvalvular insufficiency; the untoward consequences set in soonerand more intensely, and hemorrhages of the most varied kindaccompany stenosis much more commonly. Accordingly the prognosis is of course much more unfavorable, since in the long run aooTDT^nsatinfi: equilibrium cannot possibly be maintained.Anomalies. (^ .V 891-

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 334 of 653We have symptoms of intestinal and gastric catarrh ; moreover atendency to serous effusion. In short, the whole complex of thepathological phenomena points to Digitalis as our first choice intreatment of these disorganizations. Digitalis is even indicatedJ392 Diseases of the Heart.the peculiar pneumonia which is not unfrequently favored and evenexcited by the stenosis of the left auriculo-ventricular orifice.1^3t the remedy be administered in a small dose ; this is of paraimportance. Even if large doses seem to agree at the beginning,yet in the long run they exert a decidedly pernicious influence.We advise the use of Belladonna in all cases where Aconitumseems indicated by the symptoms. In this kind of disorder Aconitenever exerts a favorable influence. Belladonna is especially indiby the paroxysmally increasing pulmonary hypersemia and theheadache which sometimes reaches a terrible degree of intensity.It is less frequently eificacious in the resulting hepatic derangments.Pulsatilla cannot be numbered among the prominent remedies;we would at most employ it in the higher grades of bronchialcatarrh.Veratrum album competes with Belladonna as far as the affectedorgans are concerned ; yet there are symptomatic difterences. Itsuitable for cerebral and pulmonary congestions setting in withpallor and coldness of the outer skin, or with a decidedly cyanottinge.Opium, in small doses, in the case of drunkards is a main remedyfor celebral hyperoemia, less for the respiratory difficulties. Icases it often acts with wonderful rapidity and completeness,although the effect does not last.Tartarus stibiatus is indicated by bronchial catarrh with profusesecretion of mucus, and by a gastric catarrh the symptoms of whicmay be compared in the Mat. Med. Pura.Arsenicum which seems indicated much more frequently than itreally is, has only shown a decisive eftect in our hands againstsleeplessness which is a not uncommon symptom in these disordersit has never seemed to be of any use in affections of the respiraorgans for which it seems such an excellent remedy if these afiections are not occasioned by valvular defects. Nor does it ordinarseem to have any eftect .in drojmcal difficulties.The remedies we have named so far, are in general adapted onlyto overcoming single ailments either acute or subacute; to this lwe will add the following: Phosphorus^ Squilla^ Secale cornutuitilodium^ Ammonhim carbonictim. Another series of drugs has to beopposed to chronic secondary affections which, although necessaryconsequences of the cardiac disorganizations, very often admit ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 335 of 653diminution, or at least of an arrest of the symptoms.Anomalies. 893China and Ferrum here occupy the first rank; the former moreespecially, if the anfiemic phenomena which are an inevitable consequence of the deficient activity of the left ventricle, are asswith frequent paroxysms of passing congestions of the brain, andif the hepatic functions are greatly interfered with. Ferrum isindicated rather by a tendency to pulmonary congestions and tohemorrhage from the bronchia, by prominent symptoms of gastriccatarrh, and, like China, by enlargements of the spleen. Ferrumis not very suitable to old people; Cldna^ on the contrary, is emnently so.In chronic ailments Arsenicum deserves more attention than inacute complaints. It may be tried in liver-complaint as well as irenal afiections; sometimes it renders good service, but more frequently it leaves us in the lurch.Baryta carbonica has already been mentioned in the bronchialcatarrh of old people ; we likewise recommend it, if the catarrhoccasioned by valvular deficiency.Carbo veget. may still afford help, if every other remedy had lefus in the lurch. This remedy embodies in its pathogenesis all theconsequences of the anomalies here treated of: a disposition to ahemorrhage; the anaemic symptoms in cyanosis; oedematous swellings, pulmonary oedema; passive hyperaemia of the brain, lungs,liver, spleen ;' chronic bronchial catarrh in every stage, pulmonhemorrhage; gastric catarrh. There is scarcely another remedythat represents so clearly a definite morbid condition. Clinicalresults have substantiated the truth of this similarity.Beside these remedies, those that have been named for fattydegeneration may likewise be ranked here, especially PlutnbumjCuprum and Aurum. For single symptoms : Lycopodium and Nortrum muriaticum are particularly efficacious. The last-mentionedremedies likewise embrace within their curative range, if help isat all possible, the last link of this series of consecutive disonamely : local and general dropsy.The mode of living has an influence upon the final result thatmust not be underrated. Bodily motions and exertions are regulated without the least difficulty ; proper dietetic precautionseasily violated. Inasmuch as the whole tendency of the anomalies,of which we have treated, is to change the blood to venous blood,since the interference with the lesser circulation only admits ofimperfect oxygenation of the blood : our whole aim should be tofamish the patient with such nourishment as will not require the894 Diseases of the Heart.assistance of the pulmonary circulation, and likewise in an easilassimilable form on account of the gastro-intestinal canal beinggenerally very much disordered during the presence of these anomhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 336 of 653alies. Hence, fat food and starch-containing substances have to bavoided, whereas good meat and beef broth should be recommendedas chief articles of diet. The use of wine which seems to be counindicated by the tumultuous action of the heart, is not only veryuseful, but even necessary, especially in the case of old people.likewise call attention to the inhalation of compressed air whichdeserves particular recommendation in this disease; a great dealdepends upon rendering the act of respiration easier to the patieby furnishing him a larger supply of oxygen, which is accomplisheby this proceeding.c. Insufficiency of the Aortic Valves.The semilunar valves are no longer sufficient to effect a completclosure of the aorta during the diastole of the heart. This may bowing to a shrinking, laceration, rigidity, adhesions and distortof the valves. Disorganizations of this kind very seldom result fmechanical force or from acute endocarditis, but commonly fromchronic endocarditis and from atheromatous degeneration. On thisaccount aortic insufficiency is generally met with in older persoInsufficiency results in a regurgitation of the bloofl during thediastole of the ventricle from the aorta into the ventricle. In csequence of this overcrowding, the ventricle becomes abnormallydistended ; hence, if the valves are insufficient, the left ventrbecomes more distended in consequence of this anomaly than fromany other. The increase of the ventricular contents invites anincreased contraction of the muscular fibres, thus giving rise toeccentric hypertrophy which becomes the more excessive the greatethe valvular insufficiency. If at the same time the left auriculoventricular orifice is normal, the insufficiency shows no furthersequences in the lungs, nor does it react upon th^ right ventriclOn the other hand, the consequences are visible in the arterial stem; the arteries, being exposed to a considerable increase of prure or a force acting a tergo^ dilate and, in the further coursethe disease, very commonly undergo an atheromatous degeneration.The objectiv.e symptoms of aortic insufficiency are generally verplain as soon as the affection has acquired a certain degr

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 337 of 653nary artery is at most somewhat louder. The changes in thearteries yield the following exceedingly characteristic phenomenaThe pulsation of the arch of the aorta is sometimes felt in thejugular. The carotids pulsate so strongly that their vibrations adistinctly seen and that the whole neck and head are sometimesshaken by the motion. A distinct murmur is likewise easily heardin the carotids in the place of a feeble second sound. The arteriat the periphery are dilated and pulsate visibly. The pulse is lahard, and bounds against the finger in a peculiarly short and rapmanner; sometimes it vibrates, especially under soft pressure.The subjective symptoms differ greatly according as the insufficiency is more or less considerable or the hypertrophic compensatmore or less complete. As long as the hypertrophy equilibrates thinsufficiency, the patients feel quite well and do not even complof palpitation, no matter how much more forcible the impulse ofthe heart may seem. But as soon as the compensating equilibriumis disturbed by an excess of hypertrophy, constitutional derangements begin to become manifest. These consist at first in moreor less violent congestions especially in the brain which, if accpanied by considerable atheromatous degeneration of the arterialwalls, easily result in rupture of the vessels and apoplexy. Attaof vertigo, luminous vibrations before the eyes, highly flushed fwith a violent throbbing sensation, throbbing headache, sleeplessness, etc., if occurring during insufficiency of the aortic valvealways unwelcome phenomena which show that the compensatingequilibrium which Nature had set up, is disturbed. In other organlikewise, -we notice a tendency to bloody extravasations, especia896 Diseases of the Heart.from the genital organs of young women. If the opposite takesplace in the course of the disease ; if the hypertrophied ventricunahle to compensate the valvular insuiSiciency, which is apt tothe case if a process of fatty degeneration is at the same time sup in the muscular tissue of the ventricle, the morbid pictureassumes an entirely difterent aspect. The vessels which had beenvery much dilated previously, now receive too scanty a supply ofblood, and, in consequence of having lost their elasticity, are neven able to completely propel this smaller quantity ; hence, symtoms of cerebral anaemia supervene, and even in the veins the blocourses more slowly. At this stage, the discharge of blood fromthe left auricle is likewise interfered with, and all the consequof stenosis of the mitral orifice develop themselves in this casealthough in a less degree and less rapidly.This shows that the prognosis of aortic insufficiency dependsgreatly upon the equilibrium between the action of the heart andimpediments to the circulation. As soon as this equilibrium isdisturbed the danger increases the more, the more considerable thdisturbance. The older the patient; the greater the probability oan extensive atheromatous degeneration of the arteries, the moreseriously is the patient's life threatened' which generally endsa sudden attack of apoplexy. If symptoms of disturbance in thepulmonary circulation supervene, the final catastrophy is undoubtedlv at hand. If valvular anomalies at other orifices are simultaneously present, our previous remarks will of course undergoconsiderable modifications.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 338 of 653As regards treatment we may refer to our statements whenspeaking of hypertrophy, since it is hypertrophy that invests valvular deficiencies with threatening danger. The general conductof such patients has to be regulated with much more care than insimple hypertrophy, for the reason that every unusual exitementof the action of the heart may result in what is so much to bedreaded, a rupture of the vessels. Every sort of bloodletting isexceedingly pernicious ; even now this is sometimes recommendedby physicians, or resorted to by the patient without the physiciaadvice, for the purpose of preventing or removing intercurrentcongestions.d. Stenosis of the Aortic Orifice*The aortic orifice is constricted and does not admit of a freepassage of the blood. The narrowing is occasioned by a thickeningAnomalies. 897of the semilunar valves consequent upon endocarditis, which incapacitates the valves from adjusting themselves to the walls ofthe aorta. This constitutes an insufficiency the force of which iin inverse ratio to stenosis.The necessary consequence of an impeded emptying of theleft ventricle is an increased activity of its w^alls to propel tblood, hence hypertrophy. It is to be observed that, if stenosisthe only difficulty, the hypertrophy does not become eccentric, oat least only very little so, whereas, if insufficiency is presenthe same time, hypertrophy becomes associated with dilatation.Stenosis does not exert a marked influence over the other parts othe heart until the hypertrophy is no longer sufficient to keep uthe compensating equilibrium. In such circumstances the pulmonary circulation is disturbed, the right ventricle becomes hypertrophied, but never in such a high degree as from stenosis of theleft auriculo-ventricular orifice. The influence of stenosis uponmotion of the blood through the arteries is manifested by the incompleteness and feebleness of the arterial current.The objective symptoms of this disorder are: All the symptomswhich have been previously indicated as characterizing a considerable hypertrophy of the left ventricle. Auscultation over theaortic orifice usually returns a loud systolic murmur which frequently reaches a -good ways laterally and downwards, disguisingthe sounds of the heart more or less, and being most commonlyaudible even in the arteries of the neck. The first sound of theaorta is absent, the second sound is generally feebler, more inditinct, or likewise replaced by a diastolic murmur if the stenosiscomplicated with insufficiency. The sounds of the right side ofthe heart are normal. As long as the stenosis is properly compensated by hypertrophy, the pulse is indeed somewhat small buthard, and only becomes small and even soft after the compensatingequilibrium is disturbed. The pulse generally constitutes an excelent means of obtaining a correct judgment of the condition ofthe heart.In cases where the stenosis is completely equilibrated by venhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 339 of 653tricular hypertrophy, the subjective symptoms are generally of noimportance; the patient may feel quite well, only his countenanceis somewhat pallid. If the compensation becomes insufficient,Bymptoms of a deficient supply of blood to the brain and of realanaemia first become apparent, after which symptoms of stasis inthe lesser circulation and in the veins slowly show themselves.898 Diseases of the Heart.It is impossible to indicate a definite mode of treating thisstenosis, for the simple reason that the character of this anomalvaries too much and that it is always complicated with otherabnormal alterations. As long as the patients feel well, medicineis useless or even hurtful; the stenosis cannot be cured and allthe medicine might possibly accomplish, would be to disturb thefunctional cardiac equilibrium. If the compensation becomes insufficient, we have to resort to the remedies that were recommendfor fatty degeneration: Veratrum^ lodium^ Arsenicum and especiallDigitalis^ and with reference to the deficiency in the process ofsanguification: Ferrum^ Calcarea carbonica and China. If symptoms of venous stasis make their appearance, we have to choosesuch remedies as have been reconmiended for mitral stenosis. Theregimen to be pursued differs of course from that recommendedfor aortic insufficiency, since in view of the deficient supply oarterial blood the process of assimilation is of course rendereddifficult. Hence our chief aim should be to give the body a chancto make good blood, by furnishing it a supply of easily digestedand nourishing food and an abundance of fresh air. Even the useof wine need not be forbidden; on the contrary, it is often to berecommended, both in order to promote the process of digestionand as a direct stimulant for the heart. If the stenosis is at thsame time associated with insufficiency of the semilunar valves,the treatment becomes much more difficult, because it is often dicult to decide, the consequences of which of these two anomaliesought to be met first. Generally one anomaly wnll probably bemore marked than the other, in which case the course to bepursued in the treatment is naturally indicated.The combinations of valvular diseases of the left heart, as theygenerally present themselves, complicate the treatment by presentdifficulties for which it is, however, impossible to arrange defitherapeutic rules and practical applications of drugs. Since condtions of this kind fortunately never require the immediate intervention of remedial agents, there will always be time enough in agiven case to consider what treatment had better be pursued, andwhat remedies are most adapted to the case. Any special presentation of the symptoms characterizing such combinations is notcalled for, since anybody may construct such a series in his ownmind.Palpitatio Cordis 899«• Defects of the Orifices and Valves of the Right Heart.They occur so seldom, especially as isolated affections, that wewill coudense all we may have to say on the subject, in a few brihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 340 of 653remarks.Insufficiency of the tricuspid valve is the most frequently occurring defect on the right side of the heart, and originates in themorbid processes as insufficiencies in the left heart. Its conseqare: eccentric hypertrophy of the right ventricle and stasis of tblood in the veins of the systemic circulation. If the anomaly isconsiderable, it gives rise to venous pulsation. Defects of the mvalve and of the consequent excessive eccentric hypertrophy of thright ventricle may lead to a so-called relative insufficiency oftricuspid valve which is of special importance to a proper diagnoappreciation of the whole condition, for the reason that, on theappearance of this insufficiency, the stasis in the venous systemreaches an extraordinary degree, and dropsy is eminent. Thediagnosis is determined by a systolic murmur which is most distinctly audible in the region of the tricuspid valve. The treatmehas to be conducted in accordance with our remarks on mitralinsufficiency, since the consequences are entirely the same as thof the latter anomaly*The rest of valvular diseases as well as stenoses are exceedinglyrare; no special remarks can be offered regarding their treatmentO. ]f errons Palpitation of tbe Seart*Palpitatio Cordis.Palpitation of the heart, by which we mean a momentary, moreor less continuous increase of the frequency and strength of thebeats of the heart, is not only met with in a large number of morconditions beside the cardiac affections of which we have treatedin the preceding numbers, but likewise in persons of sound healthafter violent mental and bodily exertions. This is not the kind opalpitation that we wish to consider in this article, but thosedetached paroxysms of increased cardiac activity which set inwithout any demonstrable alterations in the substance of the hearand without any definite exciting cause.The etiology of this affection, as far as regards a knowledge ofthe physiological connection between cause and effect, is exceediobscure. All that we know is, that this palpitation frequently, b400 Diseases of the Heart.not by any means constantly, sets in after strong emotions eitherof an exciting or a depressing kind; that it may result from allsuch circumstances as weaken the nervous system and consequentlyrender it more irritable, such as anaemia, chlorosis, onanism, veexcesses, excessive mental exertions; that it may likewise resultfrom certain nervous afiections, such as hypochondria, hysteria,spinal irritation, softening ; that it may likewise result from tcondition which is designated as general plethora ; and that it fmay occur as a reflex etfect of certain morbid conditions, especiof the abdominal cavity, such as helminthiasis, cholelithiasis.The symptoms of this affection vary in the main in two directionsaccording as the increased action of the heart is only felt by thpatient, or is likewise perceptible as an objective phenomenon. Ihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 341 of 653neither case is the paroxysm preceded by distinct symptoms; itarises all at once after a trivial exciting cause, or even withouevident reason. Paroxysms where the patient alone is conscious ofthe palpitation, are by far the worst and attended with the greatdistress. The heart feels as if it were hanging loose, tremblingfalling down, without any external change being observable; thesingle beats even are feebler rather than stronger. At the sametime the patient experiences a fearful anguish and restlessness,with every new paroxysm imagines that his death is at hand. Theface is pallid, covered with a cold perspiration, the eyes stare,extremities are cool, the consciousness sometimes seems to vanishfor a time. The pulse is always small, compressible, sometimesintermitting. Paroxysms of this kind seldom last for a long tiraeperhaps only a few minutes, seldom longer than an hour. Paroxysmsof the second kind are characterized by an externally perceptibleincrease of the cardiac activity, the impulse of the heart is a gdeal stronger, the beats succeed each other more rapidly, the patexperiences a painful throbbing in all the arteries, the pulse isand hard, and even in this case not unfrequently unrhythmical.The face is turgescent, highly flushed, the eyes glistening and sing, the body is at times cool, at other times liot. The patientscomplain of headache, buzzing in the ears, luminous vibrationsbefore their eyes, dyspnoea which interrupts speech and obliges tto sigh frequently, and of vertigo which may even be very violentNothing abnormal is perceived at the heart, only the sounds of thheart are considerably stronger. These paroxysms at. times are onof short duration, at other times they continue for hours.The course of this affection varies; often it is very obstinate,Palpitatio Cordis. 401other times it disappears together with the complaint occasioningit. Very seldom the paroxysms show any regularity. If the affection is incidental to the period of evolution, it generally disapof itself and gradually.The affection is not a very serious one, provided life is notdirectly threatened ; this could only be the case if other complashould assume a dangerous character in consequence of the abnormal increase of the heart's action. The disorder being a source otorment to the patient, the physician must necessarily desire tohim from it completely. We can certainly promise a cure unlessthe palpitation depends upon an otherwise incurable affection.The diagnosis must never be based upon an examination instituted during the paroxysm, but should be derived from the condition of the patient during the free intervals.As regards treatment, it is of importance that the previouslyestablished distinction between subjective and objective palpitatshould not be lost sight of, if possible. Cases do occur where thobjective increase of the heart's action is associated with subjetive palpitation, although not always to the extent that the patient's distress and lamentations might lead us to suppose. For treason the remedies contained in each of the two following seriesrespectively ought not to be considered as belonging to either ofthem exclusively, but we have resorfed to this arrangement simplyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 342 of 653with a view of facilitating the selection of the appropriate remedial agent.Another point deserving special consideration in selecting a remedy, are the influences which excite the attack and the affectionif any, of which the palpitation constitutes a particular or themost distressing symptom. We can neither afford time nor spaceto dwell upon this point more fully, since this would lead to reptions, and the appropriate remedies are, moreover, specially mentioned when the different pathological processes are treated of.treating the palpitation of a chlorotic female, for instance, ourendeavor will certainly be to find a remedy that shall correspondwith the totality of the chlorotic symptoms.We do not wish to incur any censure if we mention the followingremedies very briefly ; it is our opinion that in a difficulty, wis so entirely local, the suitable remedy can be just as easily fin the Materia Medica as if we here compiled a repertory of all tremedies bearing upon such a case. For the sake of completeness26402 Diseases of the Heart.we should likewise have to indicate the various accessory circunistances, which would plunge us into a maze of details.For the objectively perceptible palpitation, which is particularlcharacterized by congestive symptoms, we recommend the followingremedies :Aconitum in the case of robust, plethoric, young individuals, likwise in the case of persons with excitable temperaments and whoare subject to rushes of blood from every trifling emotion; likewin the case of tuberculous individuals, where pulmonary congestions and palpitation of the heart exist together. Aconite is notindicated unless the column of blood is in a general state of excment and increased movement. The action of Aconite is not governed by any particular time of day, but it is particularly suitaif the paroxysms occur more habitually towards evening. Themovements of the heart are stronger, more rapid, but not by anymeans irregular.Spigelia : The action of the heart is increased, but it is irreguboth in rhythm and impulse, which is more like an undulatingmotion ; the paroxysms occur at indefinite periods, but more especially in the morning; the patient's temperature is unequal, theextremities are cold to the touch ; Spigelia is indicated for paltions arising from worms.Arsenicum: The heart beats much more forcibly and rapidly,seldom irregularly or indistinctly ; the paroxysms occur principaat night during sleep, or about midnight, and are attended withexcessive anxiety and restlessness ; the skin does not feel cold,burning hot ; at most the extremities may feel cool. Arsenicum isparticularly suitable if the paroxysms set in with typical regulaor more particularly at the time of the menses ; it is likewise sable for chlorotic and asthmatic individuals, and for drunkards.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 343 of 653Ferrum is adapted to chlorotic and anaemic individuals, if thepalpitation is attended with frequent changes of color in the facand if the face looks flushed at the beginning of the paroxysm ;is likewise adapted to tuberculous individuals, likewise to indivuals with excitable nerves, or with nerves rendered irritable bycessive excitement ; it is adapted to females more particulariy imenses are scanty and the patients are suftering with uterine catNitrum as well as Acidum nitricum are characteristically distinguished by violent, but short-lasting pulmonary congestions without any real pain, they either precede the palpitation, or else ssimultaneously with it.Palpitatio Cordis. 403Nux vomica deserves particular consideration, if the palpitationis occasioned by irregularities in the digestive process, never llong, is attended with cerebral congestions or nausea ; also if tpalpitation is caused by abuse of spirits, in the case of drunkaror if caused by abuse of coffee, or depending upon spinal irritatPlatina, if the palpitation is attended with menstrual irregularities or retention of the menses ; likewise if it is attended witgood deal of sexual excitement.Belladonna is indicated under similar circumstances ; it may likewise prove suitable for palpitation generally.Phosphorus, Veratrum album, Aurum, Argentum likewise belong inthis category.In the second series we class the remedies that have a debilitating influence over the action of the heart, which the patientimagines m oikly excited momentarily or transitorily by thesedrugs.Pulsatilla, if the palpitation is excited by the least irritationattended with great anxiety which seems to be oat of all proportion to the slight objective symptoms ; there is a rapid change ocolor in the face, the patient feels chilly; if the palpitation irelieved by motion, especially by exercise in the open air, or bylittle pleasant social entertainment ; if the palpitation rousesfrom sleep at night. Pulsatilla is excellent in chlorosis if thenervous symptoms prevail, and is likewise suitable for palpitatioduring the menses.China: Palpitation of the heart, with external coldness, soft andsmall pulse; after losses of animal fluids; in the case of indiviwith great nervous prostration, hypochondriacs, persons addictedto self-abuse.Camphora, for irregular palpitation, with unusual oppression ofthe chest evidently not arising from determination of blood, withvery feeble pulse, general coldness of the body.Ignatia, Sepia, Asafoetida, Nux moschata have very similar cardiasymptoms ; they all have a small and weak pulse during the palpihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 344 of 653tation and a variable irregularity of the heart's action. They archiefly adapted to hysteric palpitation of the heart.In hypochondria where the heart's action is as frequently disturbed as in hysteria, the main remedies are: Ifatrurri muriaiicuand Lycopodium^ moreover, CocculuSj Aurum^ and Nux vomica.Cannabis is next to Digitalis the surest remedy for palpitations404 Diseases of the Heart.occasioned by self-abuse and by an erethic weakness of the maleorgans.Cbamomilla and Opium are regarded as specific for palpitationcaused by fright. [Also Aconitum, H.]A third series is composed of drugs that may be classed indiscriminately in one or the other of these two series.Digitalis is here the most important remedy. We have given itscharacteristic symptoms on former occasions, and here again pointout a marked excitement of cardiac action associated with evidentweakness of the muscular tissue, and likewise the irregular movements of the heart. Digitalis is the surest remedy for palpitatiocaused by self-abuse, in general for palpitation arising from somcause in the male sexual sphere.Coflea. The palpitation is at times strong and visible, at othertimes is only felt by the patient ; a characteristic symptom is grestlessness with weariness, yet the patient has no sleep, more pticularly after a copious meal and late in the evening. Every onewho drinks coffee, has experienced the good effects of coffee indirection after a copious meal. For evening-palpitations Coffea gerally affords relief to such only as do not use coffee as an habbeverage. As a rule, the excitement of cardiac action occasionedby coffee is not associated with an increase of temperature orflushed face, even if the patients experience a sensation of incrwarmth.Calcarea oarbonica is an excellent remedy, not for a single paroxysm, but for the affection generally. It is particularly adaptedchlorotic females, without pallor of the face, and with great tenency to rush of blood; it is especially adapted to children andyoung women, whose habitual palpitation it very often cures without the aid of any other drug.Sulphur likewise is eminently useful in obstinate cases, where itoften effects a radical cure. It holds the same relation to malepersons of a somewhat advanced age, that Calcarea does to womenand children.Whether in a given case the treatment ought to be conductedwith reference to the single paroxysm or to the whole disease, issometimes difficult to decide. If the palpitation is excited bydefinite causes every day, or at least very frequently, the bestcourse to be pilrsued is, not to prescribe for the single paroxysbut to continue the suitable remedy at somewhat extended interhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 345 of 653vals and for some time, as we do in other chronic cases. ThisAngina Pectoris. 405course has, of course, to be pursued if the palpitation is causedsome other pre-existing aftection. If the paroxysms occur at indeinite periods and continue for a long time, the patient must havehis medicine always handy, for it is of the utmost importance,with a view to shortening the existing paroxysm, that the remedyshould be taken as soon as possible after the commencement of theattack. Or else a suitable remedy may be prescribed for thespecial paroxysm, and afterwards another medicine for the diseasegenerally.The diet and mode of living that have to be recommended, varyaccording to the origin of the trouble, but can easily be inferrefrom the nature of the case. We should, however, strenuouslyguard against the mistaken notion that invigorating nourishment,vigorous bodily exercise, even gymnastics or the use of wine mustbe avoided by those who are liable to palpitation of the heart.This disorder is but too frequently symptomatic of great weaknesshence requires invigorating nourishment and a strengthening modeof living.If the palpitation arises from sexual disturbances, cold sitzof a moderately low temperature and not persisted in too long attime, will prove excellent auxiliaries. General cold baths very sdom agree with a patient thus afflicted, nor do cold shower7. Angina PectorUi, Stenocardia.This upon the whole very rare affection has not yet been accounted for in such a manner that any explanation that has beengiven of it, might not be objected to for a variety of reasons; ntheless all attending circumstances justify the classing of thisease among the neuroses. Whether the cardiac plexus is the seatof this disease, or not, cannot be determined with any degree ofcertainty.The etiology is obscure and vague; we only know from statisticaldata that males are infinitely more subject to this disease thanfemales, and that fat individuals, or such as incline to make fatare principally attacked. Persons beyond the age of forty aremostly liable to the disease, and they generally belong to the hiclasses. Its frequent combination with cardiac anomalies, especiawith atheroma or ossification of the coronary arteries, does notjustify the opinion that the disease originates in such disorganitions, for it is known to occur without any material alterationsthe heart. All exciting causes are very often entirely absent ; b406 Diseases of the Heart.the attacks are usually provoked by a bodily effort giving rise tan augmentation of cardiac activity.It is only exceptionally that a paroxysm does not set in suddenlyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 346 of 653generally it takes place after very short and altogether vague prliminary symptoms. The patients suddenly experience a peculiarpain in the praecordial region, which is sometimes extremely seveand at other times dull, yet of such a peculiar kind that the sufferer is scarcely ever able to describe it either according to itquality or extent. With the pain a sensation of prostration andfainting sets in ; all patients agree in describing this sensatiodeath were at hand. What is remarkable is that not a sound ofpain escapes the lips of the sufferers, probably however owing totheir dread of increasing the distress by the least exertion. Thecarry this precaution so far as to arrest the breathing which givthem the appearance of great dyspnoea, although they are perfectlable to take a long breath, if they choose. Generally the patientremain immovably erect or in a sitting posture, a recumbent posture suits them Yery seldom. The action of the heart is at timesnormal, at other times slower than usual, and again hurried andirregular, especially if the patient is afflicted with heartVery seldom the pain remains confitied to the prsecordial regionmost commonly the pain radiates to the left shoulder and arm, lesfrequently to the neck and nape of the neck, or to the lower extremities, or even the right side. The pain very seldom increasesgradually; it mostly sets in immediately in its greatest intensitA single paroxysm generally lasts only a minute or two, itscarcely ever exceeds one hour. As the paroxysm generally sets inin all its intensity, so it generally ends all at once. It is onlparoxysms are slight, that the patient's health is at once complerestored or at least very soon after the cessation of the paroxyswhereas in this as in most other paroxysmal nervous affectionsgreat lassitude and sleeplessness remain for some time.The course of this whole disorder varies greatly. Very seldom aparoxysm is succeeded by a complete feeling of health. It morecommonly happens that the paroxysms commence slightly andincrease in intensity with every succeeding attack. Except in casof heart-disease, the intervals are quite free from all morbid sytoms, the patients do not show a single trace of the insidious diease, they often have even a very florid appearance. The singleparoxysms, as well as the whole disease, are of an indeflnite durtion; a paroxysm seldom occurs more than once on the same day;Angina Pectoris. 407ordinarily they are separated by days, months and even years.Many doubt the possibility of curing this disease; we, however,believe in the absolute possibility of the contrary, although a vlent paroxysm may suddenly terminate in death. It is questionablewhether the disease ever changes to some other form of heartdisease, for the reason that the heart-disease most likely was alin existence when the angina first broke out.The prognosis is decidedly bad, if the angina is associated withorganic heart-disease, and likewise in the case of older individuwhereas the purely nervous form in the case of young persons verypossibly admits of a cure. We must always keep in mind that thisinsidious disease sometimes remains quiescent for a long time befit suddenly breaks out again in all its former, or with an increaviolence.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 347 of 653Treatment. A treatment for a single paroxysm cannot wellbe arranged ; we might even inflict injury if we would violentlyinterfere with the position the patient may have selected instinctively for his relief. Even the use of local applications, especisevere cutaneous irritants, to which we might feel tempted, mayprove dangerous ; in no case is the people's rule, not to touch aindividual seized with a nervous spasm, more appropriate than inangina pectoris. Such precepts as may be found in every therapeutic treatise, are unpractical, for the reason that the attacknot last long enough to test their clinical value. This remark liwise applies to the use of remedial agents which we might not evebe afforded sufficient time to procure before the attack is endedIf the attacks ]ast long enough, we may try Arsenicum^ and nextto Arsenic Laurocerasus and perhaps Ignatia.We have a number of remedies that seem homoeopathic to thedisease, but we confess that our clinical records are exceedinglyscanty and unreliable ; in view of the great rarity of this diseathe scantiness of our clinical cases cannot well surprise us.The only case which we have ever been called upon to treat inour own practice, and which had already been going on during anumber of not very violent paroxysms, we have cured with notvery often repeated doses of Digiicdin^ 2d and 3d trituration. Thpatient has now been free from the disease for the last six yearsIt was a purely nervous angina pectoris. It would not be safe torecommend a remedy upon the strength of a single experiment, ifthe symptoms and the whole therapeutic range of the drug did notcorrespond with the disease. Whether Digiialin and the Tincture408 Diseases of the Heart.of Digitalis would have an equally favorable effect in angina pectoris accompanied with heart-disease, we are unable to decide.Hartmann recommends Digitalis and bases his recommendationupon the ground of practical experience in the use of this drug.Next to Digitalin Arsenicum undoubtedly promises the mostsuccessful results in the treatment of this disease. Hartmann hasthe following remarks : " Not only the actual paroxysms, but thedisease generally finds in Arsenicum its appropriate remedy, provided the disease is not complicated with structural changes of theart and the large arteries, or other extensive disorganizationsis indicated if the patient can only breathe very gently with hischest stooping forward, and if the least motion causes a completeloss of breath ; if oppression and stitches in the praecordial reare associated with anxiety and a fainting sort of weakness ; ifbreath gives out even while the patient is getting into bed, andtakes him a long time to recover his breath ; if the paroxysm iscited afresh by a simple change of position in bed. In my opinionand according to the experience I have had, Arsenicum is the chieremedy, more especially if the angina is a pure neurosis ; its cuative power is of course problematical, if the angina is complicawith disorganizations which we can never expect to cure and wherewe can only exert a palliative influence. In this respect no remecan be more certainly relied uj on than Arsenic." We will add afew suggestions bearing upon the dose. There is not the remothttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 348 of 653doubt that in purely nervous affections Arsenic, if given in a lotrituration, either does not show any curative effect at all, orcauses severe aggravations. Our urgent advice therefore is that iangina pectoris only the higher attenuations should be used, bothfor the actual paroxysm as well as during the intervals.Although the frequent occurrence of angina pectoris in conjunction with atheromatous degenerations of the larger vessels and thheart itself, suggest all the different remedies of which mentionhas been made in the paragraph on fatty degeneration, yet we callparticular attention to Plumbum; for particulars we refer to whatwe have stated at the end of the fourth chapter.We have not a word of commendation to offer in favor ofSamhucus^ Augustwa^ Lactu^ca virosa^ Veratrum album, Asafcetidaand Sepia, which are likewise recommended by Hartmann. Ourdissent is of course based upon theoretical reasons, but Hartmannhas no clinical proofs to offer any more than we have. AsorAngina Pectoris. 409f(Biida and Sepia might be tried if the angina seems an hystericaffection.Regarding the dietetic treatment but little can be said. K thecauses which give rise to an attack, are well known, they have tocarefully avoided. That the mode of living exerts otherwise adecided influence, cannot well be maintained. Nor can we expectmuch good from a course tending to a general invigoration of thenervous system, for most patients of this kind are in general menof robust constitutions. All that the patient can do, is to obsera regular, quiet and prudent mode of living and to avoid everything that might excite the heart's action.\TENTH SECTION.Derangements of single Systems.A. DISEASES OF THE BONES, MUSCLES,AND ARTICULATIONS.1. Ostitis, Periostitis, Pott's Disease.Inflammation of the Bones and Periosteum.luflaminations of bones occur in every age, less frequently, however, before the second and after the fiftieth or sixtieth year.most cases they originate in mechanical injuries or mechanicallyacting deleterious influences, they are less frequently owing tohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 349 of 653extension of inflammation from the soft parts. In the greatmajority of cases the mechanical is associated with a constitutiocause, very frequently the latter existing alone. Among theconstitutional diseases it is more particularly scrofulosis, tubeculosis, syphilis and hydrargyrosis that give rise to ostitis. Veoften it is very difficult to trace the cause with anything liketainty, especially so far as an inflammation of the substance ofbones is concerned, because it generally develops itself with scaperceptible symptoms and in a very insidious manner, hence toolong a period of time may have elapsed since the cause first begato act, to permit of the disease being traced to a definite origiBones that are but thinly covered by soft parts, are particularlyexposed to inflammation from mechanical causes; inflammationarising from more dynamic or constitutional causes may attackany bone; nevertheless inflammations of the mastoid process, of tinferior maxilla, of the vertebrse, the bones of the hands and feand of the ribs, occur most frequently and are of particularimportance.Periostitis occurs more particularly on the fingers, on the bonesof the lower extremities and on the skull-bones.The symptoms and course of ostitis diifer very remarkably inextent as well as intensity. It is very often found that at the410Ostitis, Periostitis. 411outset the disease is entirely without any symptoms until thedisease is finally revealed by the process of suppuration. It verseldom runs an acute and rapid course; this is generally the casethe inflammation attacks the outer surface of the bone and theperiosteum. In such a case the intensity of the pain depends uponthe extent of the inflammation; the fever is high, delirium som^times sets in, slight chills are common and the patient very soonbegins to lose his strength. Cases of this kind, which run a rapicourse, always terminate in suppuration, and the artificial removof pus is in most cases a matter of absolute necessity. After thepus is evacuated, a cure does not always take place immediately;the bone divested of its periosteum becomes more or less cariousbefore a cicatrix has time to form.If the periostitis runs a slow and somewhat chronic course, theinflammation of itself is not very painful ; but very violent paican be excited by contact ; here too the exudation may be transformed into pus, but is likewise apt to result in osseous growthsand to form extensive flat or tuberous bony indurations.If the inflammation is located in the interior of the bone, thelatter is generally distended in its whole length, is not very setive to pressure, but the patient is tormented by paroxysms ofpeculiar dull boring pains which, even in the absence of any speccause, are particularly apt to set in, and to become aggravated anight. These pains are usually felt for some time before the bonecommences to swell; they interfere with the mobility of the limbmore or less, generally the less the more remotely they are felthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 350 of 653the articulation.Ostitis of this central character always runs a chronic course.Its terminations are suppuration or ossification of the exudationThe pus is seldom reabsorbed, nor does it often become transformed into a tubercular mass ; most generally it escapes outwardand, unless the disease is cured, caries and necrosis result. Theichorous dissolution of the exudation generally determines a morerapid course of the disease. If one of the large bones is invadedby the suppurative process, death almost always results, althoughin some cases not till the patient has lived through years of sufing. An important diagnostic symptom is the presence of albumenin the urine ; it almost always occurs if the suppuration is exteand afgurs very badly for the final result.The importance of inflammations of bones varies a good deal.Age exerts a characteristic influence ; whereas children and youn412 Diseases of the Bones, Muscles, and Articulations.people generally recover from such inflammations, even if theseshould last a long while, unless they originate in inveterate, cotutional maladies; older persons, especially when on the other siof forty, generally fall victims to such inflammations. Childrenvery often recover when the second period of dentition sets in, owhen they enter upon the period of pubescence. The seat of ostitiis of no small importance; inflammation of the bones in the upperpart of the body is less dangerous than inflammation of the pelvibones, or the bones of the lower extremities. It is likewise impoto determine whether the inflammation is so located that vitalorgans may become involved ; on this account inflammations of theskull-bones and ribs are more threatening on account of the dangeof meningitis or pleuritis resulting from them. What renders theprognosis in every case of non-traumatic inflammation doubtful, ithe uncertainty concerning the transformation and extent of theexudation. Sometimes the inflammatory symptoms disappearentirely for a time, and then suddenly reappear again from somecause or other, or without any cause; or else, in one portion ofbone the inflammation runs a favorable course, and then all at ontakes a new start either continuously in the tissue of the bone oin separate portions. Every inflammation involving more than onebone, renders the prognosis so much more unfavorable.Among the terminations of ostitis we have to mention two ofparticular importance, caries and necrosis.Caries represents a process where the purulent transformation ofthe inflammatory exudation, involves the destruction of the bonysubstance; hence it always implies a loss of substance of boneoccurs more particularly in scrofulous and tuberculous, but maylikewise take place in perfectly healthy individuals. It most commonly involves the spongy portion of the bones.The symptoms of caries vary greatly like those of ostitis. Inrare cases, if the pus has no escape or the carious portion of bois very small, it may remain a latent disorganization. In othercases the pus finds an outlet outwardly, and the rough surface ofthe bone can be felt with the sound ; the detached particles of bhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 351 of 653can even be discovered in the pus between the fingers and certainunder the microscope, liut if the carious process takes place deein the interior of the bone, the pus may gravitate downwards,may form fistulous canals and finally break forth in some^motelocality.The disease always runs a chronic course, sometimes extendingOstitis, Periostitis, 413througli a series of years, unless, owing to the presence of someother disease, a radical transformation into ichor brings about arapid termination.Terminations: Recovery by means of granulations, resulting in afirm, tense, retracted cicatrix, or else death amid symptoms of shectic consumption, or in consequence of the inflammation extending to other vital organs; in less frequent cases bones continuesuppurate for years without the organism being much affected bythe loss. After the bones are healed, the destructive nature ofcaries, in case the loss of substance is great, very often leavesdeformities and other derangements depending upon the nature ofthe bone affected. Among these deformities the most importantare: Cyphosis in caries of the vertebrse, and impaired mobility othe lower extremities from caries of the head of the femur.The prognosis is very doubtful. If the patients are otherwisesound, and the pathological process is limited in extent, a curebe depended upon with tolerable certainty ; otherwise it is, afteall, questionable whether the disease will not sooner or later refatally. If the carious process takes place very near the serouscovering of important viscera, we have at all times to expect anextension of the inflammation to these parts.Necrosis is the gangrenous destruction of a bone or part of abone. It is a frequent consequence of ostitis attended with sclerand a frequent accompaniment of caries. It is a well known factthat Phosphorus may cause necrosis of the inferior maxilla. Amedicinal treatment of necrosis is of course out of the question,except in so far as secondary ostitis may be present; all that cadone, is to remove the necrosed portion of bone.Treatment. The frequent occurrence of ostitis in individualswhose constitutions are tainted with some constitutional dyscrasiinvites a careful inquiry into the presence of such a constitutiotaint, even though not manifested by any outward signs; and, inthe second place, to employ such remedies as not only correspondwith the constitutional affection, but likewise aim at remedyinglocal disease. A mere comparison of symptoms will scarcely everanswer the purpose, for the reason that the localities may differmuch ; it is only for a few definite localizations of ostitis thapossess real similia. In general we advise therefore that the gennot the local symptoms be taken as our guide ; on this account wemention the following remedies with a few short comments.Merourius is a medicine of whose specific and almost constantlyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 352 of 653414 Diseases of the Bones, Muscles, and Articulations.definite relation to the osseous tissue we may always rest satisfIt is indeed suitable in most cases of ostitis and periostitis prthey do not originate in mercurial poisoning. It is particularlyindicated by : Violent bone-pains, distention, swelling, rednessinteguments, and in general by the more acute symptoms of thedisease. However, we do not mean to deny its usefulness in chronicases of ostitis, and even in caries. The infantile organism is mrapidly and certainly afiected by Mercurius. The dose had betterbe as small as possible ; the slow course of the disease would seto point to small doses and given at comparatively long intervalsas preferable to large doses of this agent.Mezereum antidotes Mercurius in the bone-range ; this alone showsthat both remedies must be homoeopathic to ostitii^. Mezereum isparticularly adapted to periostitis, less to ostitis, and is partappropriate at a period of the disease when no complete suppuratihas yet set in. With this remedy we have cured an inflammationof the tibia, where a portion of the bone, several inches in extewas considerably and painfully distended ; the patient was a bey^whom there could not have existed the remotest suspicion of somespecific cause. We cannot point out a special loeaKty for Mezereuaccording to Hartmann, it is particularly the superficially situabones to inflammatory conditions of which Mezereum is bestadapted. [This may have been a case of scrofulous rheumaticinflammation ; in the couree of our practice we have cured quitenumber of such cases by means of Aconite^ Belladonna^ the Iodideof Mercury J likewise Iodine and Iodide of Potassium. H.]Aoidum nitricum is indeed chiefly indicated in mercurial ostitis,[and in ostitis originating in syphilis and abuse of Mercury, H.]yet this recommendation must not be understood too literally; forthis agent may likewise be of use in other forms of ostitis, espeof the lower extremities, and in periostitis generally.Phosphor! aoidum is generally preferred to Acidum nitricum innon-mercurial ostitis; it is indicated in the inflammatory boneaflTections of children, especially in inflammations of the verteif there is an evident disposition to caries and ichorous dissoluIn fully developed caries with symptoms of slow hectic fever,Phosphori acidum is one of the most important remedies.Phosphorus is inferior to Phosphori acidum for the reason thatthe latter acts more specifically and more penetratingly in chronafifections. In other respects the therapeutic sphere of both remOstitis, Periostitis. 415edies is very similar; we would accord the preference to Phosphorif consumption with unceasing colliquative diarrhoea has set in.Staphysagria is indicated, if the ostitis runs its course with sepains, and the bone and its periosteum are aftected at the sametime ; in the case of scrofulous individuals ; if the facial bonethose of the legs and feet are involved.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 353 of 653Manganum is recommended by Hartmann for painful periostitis,and for inflammation of the articular extremities of the bones.Baryta oarbonica is eminently adapted to a slow and almost painless scrofulous inflammation of the bones of the extremities, aftsuppuration has begun to set in*Aurum is, like Nitric acid, an exquisitely anti-mercurial medicinand hence deserves special attention in cases of mercurial ostitiIt has likewise an excellent effect in non-mercurial ostitis withcaries, and violent pains, especially at night. Aurum is a specifremedy for inflammatory ulceration of the nasal bones and facialbones generally. In aflfections of this kind we prefer Aurummuriaticum to the common gold.Silioea is one of the most important remedies in caries from anycause and at any age, as soon as the inflammatory stage has runits course ; it is adapted to every constitution, but may not havvery favorable effect in acute ichorous suppuration. We must notforget that Silicea acts very slowly ; we recommend small doses along intervals.Sulphur, in our hands, has never had a permanent effect in cariesnor have we ever been able to effect with it a return towardsrecovery. It can at most be of use only in the latter stages of tdisease, not at the beginning.Calcarea. This agent is not so much indicated in uncomplicatedostitis, as in ostitis depending upon scrofulosis; in our opiniondoes not act directly as a curative, but by virtue of the favorabchange it effects in the scrofulous disease. On this account itsshould be deferred until the suppurative process is fully establiWe will not decide whether Calcarea carbonica or phosphorica ispreferable; we consider it a wrong theory, however, to employ thePhosphate of lime because it is a constituent of bone. In cariesof the vertebrfls Calcarea is superior to any other drug; often aleast, it arrests the destructive process.For further comparison we recommend: Hepar svlphuris^ lodium^JKali bichromicum, GhraphiteSj also Bhus toxicodendron and Lycopodium. Ehufl is particularly recommended for periostitis. The416 Diseases of the Bones, Muscles and Articulations.use of Aconite, Bryonia and Pulsatilla as recommended by Hartmann, seems to ns to involve a loss of time; we do not considerthese drugs adapted to ostitis. On the other hand, Belladonna isappropriate in the ostitis of scrofulous children with floridcomplexions.S. Rliaclittlft.Bickets.We treat of this affection here, instead of deferring it to thechapter on constitutional anomalies to which it really belongs,because it is exclusively localized in the bones.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 354 of 653The causes of rhachitis are upon the whole involved in obscurity.It is certainly not correct to describe rickets as a consequenceecrofulosis, for not all children who are afflicted with rickets,scrofulous. With respect to rickets the following are. establishefacts: Rhachitis can only be diagnosed with reliable certaintybetween the first and second period of dentition ; it is preeminean affection of the lower classes, and more particularly of childthat were- brought up by hand; sometimes it seems hereditary.The almost constant coincidence with more or less intense digestidisturbances justifies the inference that the main cause of thisdisease is an abnormal condition of the assimilative functions.SymptontM and Course. Manifest symptoms of rickets arewith few exceptions preceded for some time by precursory symptoms. The children are afflicted with diarrhoea which is at firstmore slimy and afterwards watery; they lose their appetite or,which is still more common, they have perverse tastes, cravingblack rye-bread and potatoes; the abdomen is distended, thecomplexion sickly, the desire to move about is less, and yer, intlectually, the children are more matured than their age would seeto indicate. This lack of disposition to move about, which isparticularly prominent in the case of children that had alreadycommenced to walk about, is the first suspicious symptom whichis very soon, and sometimes almost immediately followed by painsin the bones and articulations. That these pains exist is evidentfrom the cries which the children utter, whenever an attempt ismade to have them move about. This circumstance is often interpreted as naughtiness, more especially since the children alreadycommence to cry at the mere approach of their parents whom theysuspect of an intention to make them move about. Soon thecharacteristic changes in the articular extremities of the bonesRhachitis. 417become manifest, more particularly, on account of the tliin muacular covering, at the lower articulations of the radius and ulnaat the lower articulation of the tibia, and at the sternal extremof the ribs. These articular extremities are enlarged, sometimesunequally bunchy, separated from the shaft by a more or less deepfold of integument The disease is almost always accompanied byemaciation, especially of the lower extremities, which causes theswelling of the articular extremities and the distention of theabdomen to become still more prominent. The painfulness of thearticulations is generally very great, scarcely ever hardly percetible; hence not only the pain, but direct weakness seem to be thcause why children absolutely refuse to walk.In the further course of the disease all those changes take placewhich depend upon the softness of the bones. The lower extremitiebend outwardly, if the children attempt to walk, whereas theyremain straight, if children are attacked who are not yet able towalk and have to remain extended in a recumbent posture. Thebone often looks as if bent at an angle. The ribs are pressed inthe sternum protrudes, giving rise to the so-called chickenThe upper extremities are less crooked, but bent a great deal morif the child crawls about on all fours. The vertebral column attimes assumes the form of cyphosis, at times that of scoliosis orlordosis; the form of the pelvis is likewise altered. The closinghttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 355 of 653the fontanelles and sutures delays for several yeara.It is remarkable that the rickety bone does not show any disposition to inflammation with suppuration and caries; nor is such abone as liable to fracture as a bone normally constituted. The cosequences to the general organism which are sometimes inconsiderable even with fully developed rhachitis, consist in impedimentsthe respiration owing to a narrowing of the thorax and deficientmobility of the ribs, with chronic catarrh of the air-passages.Excessive emaciation, with greatly distended abdomen. Delayed,irregular, sometimes perverse dentition. Great tendency to spasm,especially eclampsia, sometiihes setting in in consequence of theleast pressure on the fontanelles.The aftection always runs an exceedingly chronic course, sometimes extending over many months. The disease may heal spontaneously at any stage of its development; we see this in caseswhere no physician had been employed, and where the true characteof the disease can be inferred from the still remaining articularswellings. The first sign towards an improvement is the restorati27418 Diseases of the Bones, Muscles, and Articulations.of a normal digestion. The articular swellings seldom disappearvery rapidly; the curvatures never disappear entirely, but usualldiminish very materially.The common termination is in recovery ; if death resulta, it ismostly in consequence of the supervention of otlier complaints, ais the result of actual marasmus only in cases where the patientutterly neglected.So far as danger to life is concerned, the prognosis is extremelyfavorable, whereas the curvatures may give rise to many secondaryaffections in after-life; a rickety pelvis, for instance, may matinterfere with the process of labor.The treatment of rachitis has to be, above all, strictly prophylactic or hygienic. It is certain that in almost all cases the didepends upon abnormal assimilation, and hence first manifests itsby disturbances in the assimilative sphere. On this account weoften succeed in arresting the development of the disease, if weto it that the children are properly fed, kept clean, their skinwashed and rubbed, and they have an abundance of fresh air. Acompliance with these dietetic rules is a primary duty not only athe commencement, but likewise in the further course of the diseaIt is moreover of great importance that the children should be prvented from moving about, and more particularly from sitting,since they avoid motion anyhow. By pursuing this course, veryconsiderable curvatures are often very much improved, their furthincrease is checked, and the development of new curvatures is prevented. The most appropriate position is a recumbent posture uponan uniformly stuffed, not too hard mattress with a slightly raisepillow, or no pillow at all. Sea-weeds or fine chips, cornexcellent material for the stuffing, likewise on the score of chehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 356 of 653ness, since such patients generally belong to the poorer classes.Concerning the diet, we have already stated our views when treating of the intestinal catarrh of children, and shall refer to thisubject again in the chapter on scrofulosis.The medicines which we require for the cure of rickets, are fewin number, but so much more reliable in their effect. After attening to the main requisite for a cure, namely the regulation of asuitable mode of living, the next business in order is to removeintestinal catarrh as soon as possible, for which purpose the mosrigid diet is often insufficient. All the medicines that have beerecommended for the intestinal catarrh of children, may be calledinto use, but Calcarea carbonica undoubtedly heads the list. It iRhachitis. 419well known that the partisans of the Bational School account forthe use of this agent in rickets upon chemical grounds, namely asa compensation for the excessive loss of the salts of lime in theurine. This excretion of the salts of lime is not the cause, buteffect of the disturbed nutrition of the bones, nor is it borne imind by "rational" physicians that substances like lime, whengiven in their crude shape and in a massive dose, have no effect,even act injuriously. On this account the use of such agents issoon discontinued, again. Nevertheless Calcarea is the surest remfor rhachitis, and we can present it to our opponents as a strikiillustration of the efficacy of small doses. When given in thehigher attenuations, it shows curative effects very promptly, eveif there is no change in the mode of living; we have noticed thison many occasions. We have never witnessed such ,rapid resultsfrom the lower triturations ; hence we advise everybody to firstthe sixth and higher attenuations before resorting to the lowerattenuations and triturations. The diarrhoBa often ceases after tfirst dose, and this change implies a positive victory over the dease. Having almost constantly succeeded with the Carbonate ofLime^ we scarcely ever venture to change to the Phosphate or AcetA copious, watery, sour-smelling diarrhosa is the surest indicatifor Calcarea. .A second remedy which is likewise extremely beneficial in everysuitable case, is Arsenicum. As regards the dose, we apply to itthe same remarks that we have to Calcarea. The Arsenic-diarrhoeais less copious, less watery, of a foul smell as of decomposing mattended with a good deal of flatulence, hectic fever, great restness, sleeplessness, also vomiting, loss of appetite, whereas Calis characterized by a great craving for certain inadmissible kindof food.Sulphur is seldom indicated in rickets. Its chief indication isseldom present, namely a slimy or muco-purulent diarrhoea, withdischarge of pure bile or a copious admixture of bile. It is asseby many that a few doses of Sulphur administered previous toCalcarea, renders the effect of the latter more reliable and promwe have no experience of our own to offer on this point.These three remedies are sufficient to a cure in by far the largenumber of cases. For other remedies we refer the reader to ourchapter on intestinal catarrh. [In this disease the continued usehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 357 of 653of small quantities of Cod-liver oil is decidedly appropriate. H.420 Diseases of the Bones, Muscles, and Articulations,8. Eneliondroiiia.Pcedarthrocace ; Spina ventosa*Enchondroma repreBents a disease of the bones where cartilaginous substance is formed within the bone, in consequence of whicthe substance of the bone is more or less destroyed.The causes of this affection are quite obscure; assigning scrofulosis as the origin of the disease, does not shed much light onsubject. It occurs most commonly among children and duringpubescence.The enchondroma is most commonly located in the metacarpalbones and in the phalangeal bones of the fingers, much less frequently in the bones of the feet, but may likewise occur in otherbones and organs. It either commences without any pain, or elsewith indefinite sensations in the affected bone, very seldom withmarked pains like ostitis. The swelling of the bone is generallythe first symptom. It seldom spreads uniformly over the wholebone, but has mostly a spherical or conical shape. The swelling iof slow growth ; the soft parts by which it is covered, retain folong time their normal appearance, until finally, after the swellhas reached a considerable size, the skin reddens and breaks in oor more places. The sound now penetrates into the opening without any difllculty, and is easily passed around in the swelling wis commonly found to consist of a very soft, spongy mass. Thereis very little discharge from the opening, very seldom any pus, brather a serous liquid resulting in the formation of a crust thatcloses the opening. At this stage pains are generally entirelyabsent.The disorganization runs a very chronic course. If adults areattacked, the general organism is much affected by the disease ;the case of children a cure may be promised with perfect safety.For this disease we do not possess any specific, properly speakinbut have to select our remedies in accordance with the rules ofanalogy. Practically Silicea has so far yielded the best results,to which we rank Graphites. Besides these two, the following remedies are recommended : Calcarea^ Staphysagria^ Mezereum^ Cuprum^Sulphur^ Ledum palustre. There is no clinical experience recordedwith these agents. We should always bear in mind, in treating acase of this kind, that enchondroma can never be cured with external means, and that the knife never need be resorted to.Psoitis. 4214. Psoitis.Inflammation of the Psoas-muscle.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 358 of 653Of inflammationB of muscles this is the only one that is proportionally of frequent occurrence, and is of very great importance.If psoitis sets in as a primary disease, its causes are involvedgreat obscurity ; excessive exertions, a cold, rheumatism, etc.,assigned as probable causes, most likely because no better causesare known. Mechanical injuries seldom result in psoitis. Secondarily psoitis may supervene during inflammation and caries of thelumbar vertebrse.At first, the disease is often quite painless and develops itselfvery slowly ; sometimes, however, it sets in in an acute form. Insuch a case the patient experiences a sudden or rapidly increasinviolent pain in the lumbar region, which he finds it difficult todefine; it often radiates upwards or downwards; as soon as thepain is felt, the motion of the limb is interfered with, especialflexion and rotation inwards. Under such circumstances a violentfever is always present, the pulse being remarkably rapid. Thepatients lie with their thighs semi-flexed and somewhat turnedinwards. Pus forms sometimes rapidly, and at other times slowly,and sometimes in such profuse quantity that its. first appearanceindicated by creeping chills. The fully-formed abscess can be reasorbed, which is, however, seldom the case ; or else, it bursts ilumbar region, the pus escaping inwardly and immediately threatening life ; or the pus burrows downwards following the course ofthe psoas-muscle until it finds an x)utlet, generally on the antesurface of the thigh, rarely posteriorly by the side of the vertecolunm. The pus thus forms a fistulous canal, which is always thecase if the lumbar vertebrae are carious.If suppuration sets in, the couree of the disease is always slow;it is only in rare cases that the inflammation does not terminatesuppuration; the organism may become involved in consequenceof a profuse suppuration gradually consuming the patient'sstrength, or in consequence of the escape of the pus into the *abdominal cavity, or of the inflammation communicating itself tothe vertebrsB. For these reasons the prognosis is always doubtfulThe treatment is not surgical, except in so far as it may benecessary to open the abscess. Homoeopathic physicians have ahigher duty to perform. In the first place we have to try toscatter the inflammation before suppuration sets in ; even if thi422 Diseases of the Bones, Muscles, and Articulations.cannot be accomplished in all cases, it is at all events certainthe spread of the inflammation can be prevented by appropriateinternal treatment. For this purpose we commence the treatmentif a violent and continuous fever is present, with Belladonna^ escially if the fever is accompanied by copious perspiration and evmotion aggravates the pain extremely. Rhus should be given ifthe fever consists of a burning, dry heat, with intense thirst, itrouble seems to have originated in a cold and the pains are worsat night, and when the patient is lying down. If these two remedies do not effect an improvement, and the fever is mingled withchilly creepings, the pulse becomes very much accelerated, and thskin is at times burning-hot and at other times drenched in perspiration, we should at once give MercuriuSy which is the onlyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 359 of 653remedy that can arrest the suppurative process, if such a resultat all be accomplished. If an abscess forms, we give Hepar sulph,in order to promote the suppuration ; for the main point now is tevacuate the pus as rapidly as possible and by this means to healthe sore as soon as the pus is discharged. Hartmann names anumber of drugs, such as Bryonia^ Nux vom.^ Pulsatilla^ CantkarideSj etc., without any practical testimony, and, in our opinion,without practical value. Staphysagria may be tried if the diseaseruns a slow course, without much fever. After the abscess bursts,and the patients are free from caries, we advise the continued usof Hepar sulph. ^ by which means a rapid termination of the formation of pus is most speedily effected. If the opening becomes fisulous, we must be prepared for an exceedingly tardy recovery. Ifthe pus is of good quality and the patient preserves his strengthSilicea^ and next to it " Sulphur ^ are most calculated to promotcure, although we confess that we have never seen any decidedeffect from their employment. If the pus becomes watery, sicklylooking, acrid ; if the strength begins to fail and hectic symptoset in, we still may succeed in arresting the bad turn by PhosphjChina, Ferruw, or by Calcarea carbonica. If the smell and thegeneral quality of the pus show that the continuance of the purulent discharge is due to caries of the vertebrae, we can scarcelyexpect any change from any medicine and the patient must be prepared to die of slow consumption.5. liUinbago.This affection being commonly regarded as rheumatism of thedorsal muscles, it ought to have had its place assigned to it inLumbago. 428chapter on rheuraatism; however, inasmuch as we have severalreasons for questioning the rheumatic nature of this affection, wwill describe its character and point out its treatment in thisplace.The affection is supposed to originate more particularly in a colattended with a severe exertion. That this explanation is improbable, is evident from the circumstance that lumbago is commonlyan isolated affection, not attended with catarrh and extensive rhmatic symptoms ; yet, if a cold were the real cause, this would ba very strange localization, so much more as scarcely a trace offever is present with the attack.The difficulty arises suddenly almost without an exception ; it irarely preceded by vague pains in the lumbar region. The patient,while stooping, or making an attempt to raise anything or torapidly turn about, suddenly experiences a fearful, racking painthe back, which makes it almost impossible for him to raise himself again, and which may even be so intense that he tumbles forward as from a blow. The pain continues, is fearfully increased bevery movement of the trunk and even the extremities, even bycoughing and sneezing ; it is suspended for a short time while thpatient is lying quiet, but then returns again and compels him tomake a painful attempt to change his position. Sometimes walkingis utterly impossible, or else the person has to walk with the trrigidly erect, or stooping forward, with an unsteady gait, becaushttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 360 of 653the least misstep causes a horrid pain. No constitutional disturbances are experienced unless they are occasioned by the excessivepain. If the affection is left to itself, it lasts at least threebut may continue for several weeks, after which the pain leavesgradually, mostly with great tendency to relapses.We do not see upon what ground Hartmann proposes so manyremedies for a strictly local affection. In all cases the symptomare alike and differ only in degrees of intensity. On this accountwo or three remedies have always sufficed in our hands for a curTartar emetic^ second or third trituration, a dose every three orhours, helps more rapidly than any other remedy. In twentyhours the pains generally disappear, except a little stiffness. Bis preferable if the lumbago originates in a sudden cold and thepain, so far from being mitigated by rest, is, on the contrary,aggravated. Arnica is indicated if the attack is caused by a seveexertion. Beside these three remedies we have never been obligedto employ any other; it is only in order to be complete that we a424 Diseases of the Bones, Muscles, and Articulations,the medicines mentioned by Hartmann : Bryonia^ Nux vomica^ Sulphury Ledum^ Pulsatilla^ Rhododendron^ Colchicum^ China.Kneading and pounding the affected locality is of undoubteduse, so is the application of humid warmth* This application ismade by dipping a towel in cold water, wringing it well, foldingfour to six times and then applying it to the painful locality, awhich a dry cloth folded together several times, has to be laid othe wet compress, and a hot flat-iron pressed upon the whole, sothat the heat penetrates through the whole and imparts to the skian intense sensation of warmth. These applications only palliate,but never remove the pain entirely. [We have cured numbers ofcases of lumbago by rubbing a moderately strong liniment of thetincture of Aconite-root upon the back, and at the same time giving the first or second decimal attenuation of Aconite-root internally. H.]O. Progressiye Muscular Paraly«is«The origin of this very peculiar affection is involved in greatobscurity. We are not acquainted with any really constant causeof this disorder, and such causes as have been assigned to it, aexcessive exertions, hereditary descent, are at all events doubtfWhat is certain is, that men are more particularly liable to thisdisease.An essential characteristic of this disease consists in a gradualatrophy of one or more muscles attended with fatty degenerationof the affected part. It first invades the muscles of one hand,especially the right, less frequently those of the arm, shoulderface, and never those of the lower extremities; and even wheninvading the muscles of the hand, it almost always first affectslimited portion of them, after which it gradually spreads furtherGenerally it sets in without pain, seldom with an intensely acutepain, and almost imperceptibly, the affected muscles losing moreand more their functional power and at the same time becomingatrophied. Not till the atrophy is complete, does the palsy reachhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 361 of 653its acme; until then the muscles retain their sensibility, reflexaction continues and the sensitiveness to the electric current ispreserved more or less.The affection may remain confined for years to the startingwithout making headway, but this is a rare circumstance. It morefrequently happens that the muscular affection gradually spreadsProgressive Muscular Paralysis. 425from one muscle to the other, successive portions of the body become involved in the paralysis, and, after having suiiered for yethe patient finally perishes if the muscles of deglutition and reation become paralyzed.This disease can be distinguished from ordinary nervous paralysis by the circumstance that in progressive muscular atrophy thesusceptibility to the electric current remains intact for a longWith scarcely an exception, the prognosis is unfavorable, especiaif the disease rapidly progresses from the start.As for the treatment of this disease, we are as yet unacquaintedwith reliable specific remedies. It is characteristic of this disnever to invade the muscular fibres of the heart, so that fattydegeneration of the heart and muscular atrophy seem to be verydistinct diseases. In the therapeutic range we can only recommendPlumbum and Cuprum^ both of which have paralysis with emaciation ; but it is not certain whether the emaciation is not altogethe consequence of the palsy. At all events Plumbum is moreappropriate than Cuprum. Arsenicum may likewise give rise toexpectations of success. Bepide these three remedies we still recmend Sulphur J Causticum and LacJiesis. Gymnastic exercises, witha careful avoidance, however, of all active exertions and a striclimitation of the exercise to passive motions, and likewise a resto electricity by induction, or faradisation, are said to have ocsionally yielded favorable results, and to have effected an arresthe palsy and even an increase of muscular volume. [This diseaseis also described by English pathologists as wasting palsy. DoctoWilliam Roberts, of Manchester, published the first systematictreatise on this subject, in 1858. In France, the disease has beedescribed by the name of *'*' atrophic musculaire progressive,'^^^paralysie gradudle du rmuvement par atrophic musculaire.'* Therare several other forms of progressive paralysis, one of which isdescribed as progressive locomotor ataxia or the ataxic locomotriprogressive of Duehenne. We transcribe the following descriptionof the disease from Aitken.'s Science and Practice of Medicine:" Pains like rheumatism first attract attention, rather than failpower. Paralysis of the sixth or third pair of nerve^ giving riseto temporary diplopia, with unequal contraction of the pupils, arearly symptoms ; and another distressing harbinger of the diseaseis incontinence of urine, associated with spermatorrhcea during tnight, with a great proclivity to sexual con2;ress, which is no mimpotent desire but results in effective sexual intercourse. In t426 Diseases of the Bones, Muscles, and Articulations.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 362 of 653erect posture, the muscles may sustain a heavy weight ; and generparalysis does not supervene after these extremely anomalous symptoms until a period of months or even years. There is then a gradual and progressive loss of the power of co-ordination in the actof volition. An awkward, unsteady gait is the earliest indicationof such progressive paralysis. '* "At first the feet are moved inslatternly manner, the heels lounging on the ground before thetoes ; and then, as the disease advances, they are thrown involuntarily to the right or left without purpose, and without the poweof restraining their irregular movements The act of turninground is performed with great difficulty. The sensation of the feis apt to become blunted during this period of the disorder, 5o tthe patient feels as if he were always walking on a soft carpet,is therefore so much the more insecure. . . . The bladder and recare also frequently implicated .... but electro-muscular contractility is retained throughout the whole disease (see Meryon, Medico-Chimrgical Transactions, vol. 35*, page 194). The duration ofprogressive ataxia is from six months to ten or even twenty yearsIf the patient is put on his legs with his eyes shut, and his feetogether, it is seen that, although he has the muscular power, hehas not the muscular sensibility to preserve his body from fallinor to guide him in taking even a few steps forward with his eyesclosed. He will reel and tumble about like a drunken man (seeTrousseau, Meryon). It is a disease of middle age and affects malrather than females; and is apt to be hereditary." H.]7. Inflamntatioii of Joints.The articulations composed of a number of essentially differenttissues, are variously exposed, both by their functions and theirsituation, to inflammatory affections which differ greatly in thenatures, for the reason that several of these tissues may be attatogether and in various combinations. Moreover, an articular inflammation, wherever it may be located, is always of special impotance, on account of the organism falling such a ready victim toits consequences. Homoeopathy has given abundant evidence thatit is possessed of means to modify the course of these inflammatiand to impress upon them a favorable change. It has no specificremedies for articular inflammations generally, but for each specform thereof. We call attention to this point, because we cannotdwell upon every special form of articular inflammation and requethe reader to select the proper remedy for himself in a given casInflammation of Joints. 427Among these inflammationB we single out the following as themost important :a. Cozalgiaj Coxarthrocace, Inflammation of the Hip-jointThis inflammation, the chronic form of which is designated asluxatio spontanea or " voluntary limping," cannot be traced to andefinite cause. It affects principally children and young peopleduring the first years of pubescence. Its extremely frequent occurence during the years fourteen to seventeen, and in persons ofrapid growth, leads us to infer that a rapid growth of the boneshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 363 of 653constitutes a disposition to this inflammation, and that an exerta cold or other scarcely apparent circumstances simply act asexciting causes. A connection between this disease and some constitutional affection Cannot be traced with any positive certaintAcute coxarthrocace sets in suddenly even with a violent chill,like all other acute inflammations, with which severe pains areassociated. The patient locates these pains at times in the smallof the back, at other times more in front, very seldom in the hipjoint; they are extremely acute, tearing, burning, stitching, shoing, aggravated by every motion of the lower extremities, notaltogether, and sometimes not at all, relieved by horizontal postAt the same time a high fever accompanies the pains, the pulsebeing not unfrequently upwards of 120; this circumstance distinguishes the disease from lumbago with which it is easily confounded. Amid symptoms of this kind which may becomesufficiently intense to simulate typhus, the following objectivephenomena become manifest in one, two or more weeks: Theaffected hip and the buttock of the same side swell, so that thebetween the nates is much deeper ; the thigh is somewhat rotatedoutwards and slightly drawn up towards the abdomen ; the kneeis half bent; extension and rotation of the thigh are very painfunor can these movements be executed completely. Walking is notentirely impossible, but can only be performed with the greatestpain. It is very seldom that an improvement begins at this point;as a rule an extensive suppuration sets in, amid frequent chillsburning heat of the skin. After this, a short intermission seemsto take place in the further development of the disease, until thabscess reaches the skin and bursts. This may take place posteriolaterally or in front. After the pus is discharsjed, the patientmuch better, and then worse again, provided the suppurationbecomes very profuse and continuous. Upon the whole, the prospect428 Diseases of the Bones, Muscles, and Articulations,of a speedy closure of the cavity is very slim; most generallyfistulous openings result. The articulation itself is variously aaccording as one or the other tissue is most involved. If the infmation was originally located in the bone, this is partially desttogether with the acetabulum, and caries is the result; if the inmation emanates from the fibrous tissues or from the synovialmembrane, the bones may remain intact. Thus the terminationsof the disease are: Very rarely a complete and rapid restoration;long-lasting suppuration with final recovery and a total or partidestruction of the articulation ; long-lasting suppuration with cwhich may end in hectic fever and death. The prognosis is alwaysvery uncertain.Chronic or subacute coxarthrocace presents a very diflferent grouof symptoms. The disease commences with vague symptoms inthe hip-joint resembling rheumatic pains and alternately exacerbaing, remitting, or even intermitting for some time. These painsmay be absent and in their stead the patient mwy only complainof a stiflT joint which is more especially felt during motion. Sepressure on the hip-joint generally causes more or less pain, andthe thigh is usually rotated outwards to some extent as soon as tdisease commences. With such trifling symptoms it may go onfor some time, before more serious changes become manifest. Thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 364 of 653pains increase in intensity and cause the patient to limp, the this slightly flexed and turned inwards, being at the same time, hoever, rotated outwards. Almost without an exception a more orless violent pain is at the same time felt in the knee, very genesurpassing the pain in the hip-joint in intensity. The aftectedlimb becomes elongated, its muscles become relaxed and flabby, thglutei muscles of the aflFected side become depressed, the gluteafold is much deeper, the trochanter is somewhat turned outwards.In the further course of the disease suppuration supervenes, thepus escaping on the outside and destroying life by caries and hecfever. A cure at this stage is a rare occurrence; or else no supption sets in and the head of the femur and the acetabulum adheretog'ether; or finally the head of the femur slips out of theacetabulum, in which case adhesions occur with a greater or lessdegree of immobility of the thigh, or with suppuration outwardly.It may take several years before the disease exhausts the diflferphases of this course. The prognosis is always doubtful, and, sofar as a final cure is concerned, generally very unfavorable. Theyounger the individuals the more hope we may entertain of a finalInflammation of Joints. 429cnre; the older the patient the greater the danger of hectic fevesucceeding the suppuration.Although the number of homcBopathic remedies for coxarthrocaceis but small, yet the success with which they are used in thisdisease, is a source of pride to our practice. In view of the almpositive certainty of a correct diagnosis in most cases of hipdisease, the clinical results that have been obtained in the treament of this disorder, may be regarded as absolutely reliabletestimony. In the following paragraphs we give the treatment ofthe different varieties of coxarthrocace and their stages.At the outset of acute coxitis with violent fever and acceleratedpulse Belladonna or Rhus tox. may be required, but only as long ano pus has yet formed. For the distinctive symptoms of both drugsthe Materia Medica may be consulted. If the symptoms are notvery violent, Bryonia may deserve a preference. If symptoms ofsuppuration have plainly set in, no remedy can compete withMercurius which of itself is capable of moderating and even arresing the suppurative process. Only if the abscess threatens to brewe advise a resort to Hepar sulphuris. After the bursting of theabscess, the selection of a remedial agent will depend upon theconstitutional symptoms. If the patient gains in strength and thesymptoms point to a rapid healing of the sore, Caicareaearb. rendexcellent service in so far as it promotes the nutritive process.Acidum phospK is likewise appropriate under such circumstances.If the suppuration is profuse, and a laudable pus is discharged,continued use of Sulphur will bring about a diminution of thesecretion or, if Sulphur should fail us, Silicea will achieve thiresult. K the pus becomes thin, smells badly and the patient losestrength, we have to select in accordance with the constitutionalsymptoms: Phosphorus^ Acidum phosph. and nitric. ^ Calcarea carboand phosphor.^ Arsen.^ Lycopodium.We have a few remedies which, when given at the outset ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 365 of 653chronic coxitis, have often succeeded in decidedly arresting thefurther progress of the disease. Rhus toz.^ if the pains are chiefelt during rest, affect the whole thigh, and the lameness is vergreat. Belladonna in the case of young, robust, plethoric individuals, if the pains are severe, limited to circumscribed localitieset in more particularly towards evening and after exercise. Arniif the disease is traceable to some mechanical injury, with a burand frequently shifting pain which causes a great deal of restlesness. Colocynthis for very severe and constant pains resembling430 Diseases of the Bones, Muscles, and Articulations.ischias and increasing or decreasing independently of externalcircumstances.Even in the second stage of the disease, Cdocynthis is still indicated, and is very much commended by physicians. If we aresatisfied that suppuration has set in, Mercurius will of course bour choice, more especially in the case of scrofulous individualsCalcarea carbonica and He-par sulphuris are likewise variously remended at this stage.If pus is formed and the abscess has burst, the same treatmenthas to be pursued as in a case of acute coxitis.The following remedies are recommended in isolated cases, andmay be investigated more particularly in the Materia Medica:Coniiim^ Lycopodium^ Pulsatilla^ Petroleum^ Digitalis purpurea^Aurum.The rest of the treatment may be condensed in the followingpoints which it would lead us too far to account for by a specialtrain of reasoning. The patients should not remain in a state ofabsolute rest, on the contrary, they had better move about by meaof crutches. If pus forms, warm poultices may be applied ; theynot only promote the formation of pus, but very often favor itsreabsorption. Only if carious destruction of the joint has takenplace, the patients will have to remain quiet lest spontaneous lution should result; in such circumstances a suitable extensionapparatus may be resorted to, which will have to be applied, however, with a great deal of caution. The diet should be at all timplain and strengthening; the use of fat is to be rigidly prohibitb. Gonarthrocace^ Tumor Alhus Genu^ Gonitis^ Inflammation of theKnee-joint*This is one of the most frequently occurring inflammations ofjoints; owing to the exposed situation of the knees, this mightindeed be expected. Its etiology is no less obscure than that ofinflammation of any other joint; it is certain that a mechanicalinjury is the least frequent cause of this inflammation. Yery oftgonarthrocace seems to be the expression of a constitutional affetion. As regards age, young people are indeed more disposed tothis disease, which is likewise, however, met with after the twenfifth year of age, and occurs, it appears, more frequently amongfemales than males.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 366 of 653A simple inflammation of the knee, to which the name of tumorInflammation of Joints. 431albus should never be applied, and which is generally the resultsome mechanical injury or of excessive use, is an unimportantafiection as long as the inflammation is confined to the integumeIt is scarcely ever attended with fever, is never ushered in by achill, and runs its course within a few weeks. However, inasmuchas we can never be sure whether such an unimportant disease maynot result in the more dangerous tumor albus, it ought to be managed with all due precaution.Tumor albus never runs an acute course, at most subacute andusually very chronic. While using the joint, the patient complainof pain and impaired mobility ; in more rapidly progressing casesthe temperature of the joint is higher than usual. If the inflammation emanates from the soft parts, the pains are generally lessthan when the bones constitute the starting-point. Sometimes theknee swells rapidly, at other times more slowly, and most slowlythe bones receive the first shock of the disease. In the latter cthe knee preserves its form for a long time, whereas in the othercases the swelling soon modifies any former shape of the knee. Asthe swelling increases, which generally has a very white appearanit grows progressively softer, elastic, and finally shows symptomof fluctuation. The cutaneous veins become very much enlarged.The pains generally increase with an increase of the swelling.Sometimes not till after the lapse of years, and, in a few cases,that of weeks, distinct fluctuation is perceived in one or moreplaces ; here the skin reddens, breaks, and a pus which is mostlythin and mixed with flocks, is discharged. In spite of this evacution of pus, the swelling remains almost unchanged.The suppuration in a c^ise of tumor albus is generally very tardyThe openings may close for a short time, after which they generalopen again, so that, in a fortunate case, suppuration may ceaseafter many months, and the swelling may grow smaller, but thejoint remains stiff and thick, and the leg somewhat bent. A cure'of this disease is witnessed only in the case of young people. Ifthe case terminates less favorably, the suppuration gradually supinduces hectic fever, and finally ends in death.The prognosis is always bad, for no one escapes from such anattack without some permanent injury; the difference in favor ofyoung and robust individuals is that death needs not be apprehendin their case, which is generally sure to occur in individuals ofupwards thirty years of age.Xreatment. We cannot boast of possessing many similia for482 Diseases of the Bones, Muscles, and Articulations.gonarthrocace whose clinical value has at the same time been testby an abundance of practical observations. ^Moreover, it is unfortunately a difficult matter to select a remedy for a given case iaccordance with the symptomatic records of the Materia Medica.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 367 of 653The simple, rapidly terminating and benign inflammation of theknee, without any alFection of the bone or any marked tendency tosuppuration, readily yields to Arnica^ if the trouble originatesmechanical injury. If the trouble proceeds rather from internalcauses, Belladonna will generally be found sufficient, if there imuch pain, and Bryonia^ if both pain and swelling are considerable; Conium^ Pulsatilla or liffUS toxicodendron will be requiredfrequently. [We think Pulsatilla is not sufficiently appreciatedby Bsehr; we know of no remedy that has a more specific relationto the synovial lining of the cavity of the knee than Pulsatilla;hence in gonitis, if the inflammatory process is primarily and chlocated in the synovial membrane, Pulsatilla is undoubtedly theleading remedy. In chronic gonitis of this character we shoulddepend chiefly upon Silicea, higher attenuations, with intercurredoses of Pulsatilla. H.]If tumor albus begins as a subacute disease, with severe pains,slight febrile excitement, rapid increase of the swelling, Bryonithe main remedy as long as the inflammation is confined to thesoft parts ; if the trouble is primarily located in the bone, ifpain is excessive, although the swelling is only slight, Mercuriuwill have to be employed. In the case of young and robust individuals Belladonna is preferred by many physicians, even if thebones are affected primarily. If the swelling progresses withoutmuch pain, Conium is indicated. Beside these remedies the following deserve attention at the outset: Ledum for severelynocturnalpains ; Mczereum for nocturnal, tearing pains; Rkus torif the pain is very much increased in a recumbent posture; andLycopodium. We shall seldom be able to arrest the swelling withthese remedies ; as a rule, it will progress to the stage where whave to dread the advent of suppuration. At this stage a favorable change may yet be effected by one of the following remedies:MercuriuSy Iodine^ Hepar sulphuris^ Sulphur. Their special indications cannot well be stated a priori^ because they generally resufrom the constitutional symptoms which the disease happens tohave evolved ; all we can here say is that Mercurius and Sulphurare more adapted to very hard and not very extensive swellings ;Iodine and Hepar suLphuris to large and soft swellings, with sympInflammation of * Joints. 483toms of fluctuation. If pus forms notwithstanding, and the abscesbursts, a remedy has to be selected, with reference to two conditions, namely : whether the suppuration threatens to speedily supinduce consumption, or whether the patient's strength bears wellup under it. In the former case Calcarea carhonica and Phosphoruswill have to be given ; in the latter, Siliceay Graphites and BarArsenicum may likewise be of eminent use in the case of scrofulouindividuals.External applications are not always appropriate in this disease.Poultices are injurious if they increase the pains ; in most casethey not only relieve the pain, but likewise exert a favorableefiect upon the reabsorption of the pus in the diseased joint. Anuninterrupted recumbent posture is to be avoided as long as thepatients remain capable of moving about ; only the diseased limbmust not be used for a walk. A moderate and constant pressurehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 368 of 653by a starched bandage is only borne if the bones are not too muchdiseased ; it has the double advantage of antagonizing the swelliand protecting the limb during motion. It has the best effect, ifthe abscess has already broke, for, in such a case, the bandage mdecidedly promotes the course of the suppurative process. Amputation is only advisable if the joint is utterly disorganized andconstitution begins to show signs of failing under the constantpain and loss of fluids.c. Inflammation of the Tarsus.The inflammation is either seated in the bones or where theyarticulate with those of the metatarsus ; or else in the articulaof the tarsus and tibia, or in both localities at the same time.Here, too, mechanical injuries are rarely the cause of the inflammation. An inflammation of the metatarsus is particularly metwith among children and during the age of pubescence; an inflammation of the tibio-tarsal articulation occurs more frequently amadults.The symptoms are most commonly the following : At first a painis felt in walking, particularly during certain positions of thein a state of rest the pain subsides almost entirely. Gradually tjoint begins to swell, the swelling increasing more and more andgradually extending over the whole foot ; at the same time thepains increase, become continuous, and walking is entirely out ofthe question. At last the pus finds an outlet in one or more placIn &vorable cases the suppuration now decreases, the strength28434 Uiseases of the Boifes, Muscles, and Articulations.keeps up, the fistulous openings close, although sometimes not tiyears have elapsed. Or else, the swelling continues to increase eafter the bursting of the abscess, the foot becomes completely ditorted, and hectic fever is the unavoidable consequence.The course of the disease always exceeds one and even moreyears, until the pus escapes outwardly. At all times life is indanger even in the case of children; adults succumb almost alwayswith scarce an exception.A peculiar form of tarsal inflammation is a flat foot. Sometimesit affects already small children, although it is only slightly doped at that age; it mostly shows itself after pubescence, mostgenerally among males if they suddenly grow up in height. Everytime after the foot is perseveringly used, violent pains are expeenced in the joint, which becomes stiff after walking, with inabito stand upon the affected limb. On the inside a little swellingperceived under the malleolus. Little by little the foot loses ithttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 369 of 653arched shape, the os naviculare is turned downwards, away fromthe heel, and the patients generally walk on the inner edge of thfoot. The malformation of the foot may become very considerable,and may materially interfere with its use. Sometimes the troubledoes not cease spontaneously until after the patient is thirty yeold. This form of inflammation which, under similar circumstances, may likewise occur at the knee, never results in suppuration.The treatment involves difficulties for the reason that we areentrusted with it at too late a period, and likewise because we cnever expect to accomplish a rapid success. At the outset of theinflammation we may still hope to accomplish something by meansof Staphysagria^ Ledurrij Sabina^ jRuta, Mezereum; but it is onlyfew cases that we succeed in preventing suppuration. If the bonesare the starting-point of the inflammation, Belladonna and Mercurius are preferable to the previously-named remedies. Suppuration generally sets in slowly and amid signs of an apparentimprovement which, 'however, should not deceive us. Suitableremedies are : CcUcarea carbonica^ and especially He-par stdphuribesides which we have Graphites j if the metatarsus is likevriseinvolved. If the abscess bursts on the outside, the same remedieshave to be employed that have been recommended for tumor albnsunder similar circumstances, to which Aurum may still be added.Poultices are out of place in an affection of such slow growth. TArteries. 435abscess sTiould never be lanced; a tight bandage scarcely everagrees with the patient's feeling of comfort.For flat foot Staphysagria and Graphites seem to us to be thebest remedies ; their effect is, however, questionable, for the rthat in all the cases that we have had to treat, we have alwaysresorted to a firm bandage, most generally a starched bandage, inorder to afford the joint the necessary support ; indeed we haveoften cured this disorder radically by means of such a bandage*Shoes fi.rmly laced beyond the ankles, and with only moderatelyhigh heels, are indispensable.Articular inflammations of the upper extremities are less important, because they are less dangerous to the organism. Suppuratiois borne for years without any great inroad upon the general healThe remedies to be employed are mostly the same as those mentioned for inflammations of the lower extremities ; other remediecan be found in the Materia Medica, which is so much more practicable as the disease does not require any immediate medicinalinterference.B. DISEASES OF THE ARTERIES, VEINS,LYMPHATICS,LYMPHATIC GLANDS.1. Biseases of the Arteries.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 370 of 653The various diseases of the arteries are, indeed, of a very highpathological value, but of very little importance in a therapeutipoint of view, for the simple reason that they cannot be treatedmedicinally.Arterial inflammation, mostly only a symptom of other diseases,is scarcely recognizable with positive certainty, even in the caslarger arterial trunks. Of course, an inflammation of the largerarteries is highly interesting, because the closure of an arteriatrunk near the heart may give rise to cardiac hypertrophy.486 Diseases of the Arteries, Veins, Lymphatics, etc.Aneurisms are not exactly pathological diseases, but consequences of other influences. We do not see how medicines are toaccomplish anything in such cases, either in the uniformly developed arteriectasia or in the aneurism resulting from partial lacetion of the vessel. It is only the disturbances which such arterilesions cause in the heart, that suggest the propriety of medicininterference, and we regard it as downright absurdity to recommend medicines for the cure of aneurisms, as has indeed been done[There is no reason why Aconite and Digitalis should not be triedfor aneurism. We know of a case of aneurism of the subclavianartery that was to be operated on by a celebrated Professor of onof the Philadelphia Colleges. Previous to the operation the patiewas placed on the alternate use of tolerably large doses of Aconiand Digitalis^ for a week. When the patient presented himself forthe operation, the aneurism had so far disappeared that the Professor was unable to trace it and concluded to wait; what becameof the case afterwards, I am unable to say. H.]8. I>isea8eB of the Teins.a. Phlebitis. Inflammation of Veins.Phlebitis, the correct diagnosis of which is a recent triumph, isso far as its consequences are concerned, one of the most importaof all known morbid processes. The veins of the lower extremitiesand of the cavity of the skull are particularly liable to inflammtion, besides all the veins whose sides do not collapse, such as,all other veins, those of the gravid uterus.The causes of phlebitis are: Direct injuries of the vessel; coaguarising from impediments to the circulation occasioned by dilatation of the vessel ; introduction of foreign substances resultingdecomposition of the blood. This last-named explanation is applicable to phlebitis which sets in in an epidemic form in limited lities ; or else the disease may arise secondarily from inflammatoaffections of neighboring parts, or of remote parts, but lying intract of the vein ; or from puerperal conditions, pyaemia, suppurtions of bones, especially caries of the bones and ossicula of thThe symptoms of phlebitis vary according to its extent and intensity. The most intense forms of phlebitis originate in pysemiato which we therefore refer ; in this category belongs especiallyepidemic phlebitis, where the local process is rapidly extendedthrough the whole organism. The less intense cases very usuallyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 371 of 653Veins. 437set in with a chill recurring either irregularly with more or lesfrequency or otherwise, or else setting in typically, like an intmittent paroxysm. The diseased vein is often indicated hy aseated, circumscribed, burning pain, but is quite often altogethepainless. The chill is succeeded by a feeling of illness, usuallysevere that it is entirely out of all proportion to the objectivetoms. The pulse is accelerated and very much reduced in volume,the digestion is interfered with, a tendency to perspire sets in,tract of the vein becomes cedematous. If the circulation in thevein is restored, all these symptoms may disappear as rapidly asthey came. If pus forms in the vein, the inflammation graduallyascends towards the heart, and the picture of pysemia becomes morand more marked. If the vein remains closed, oedema developsitself beyond the closure and, if a collateral circulation can belished, may last only a short while, or else remain permanent. Insuch a case lassitude, chills at irregular intervals, irregular fof heat sometimes continue for weeks.The terminations of phlebitis depend upon the changes going onin the inflammatory exudation. If no purulent decomposition takesplace, life is not exactly in danger ; if pus forms, it may be caalong with the current of blood, and a most malignant phlebitismay suddenly arise notwithstanding the trifling character of thesymptoms at the outset of the inflammation. It is in this mannerthat lying-in women and persons that had been operated upon,often perish quite suddenly although not a single symptom existedat first that could have given rise to the least apprehensions ofdanger.The prognosis is uncertain. If the chills recur but seldom andwith increasing weakness, the danger is less; whereas frequentchills, prostration and sopor, the supervention of icterus andpetechiffi, are decidly ominous signs.Treatment. Phlebitis is one of those diseases that can scarcelyever be treated in accordance with the rules of a rigorous symptomatic similarity, and where, if we do not mean to commit gravemistakes, we have to keep constantly and clearly in view the wholinternal process not manifested to the senses by a single symptomThus a purely symptomatic similarity can only have a secondaryvalue, and the drugs whose special action upon the veins we havebecome acquainted with from cases of poisoning, necessarily occupthe first rank in the treatment of this disease. Their number isnot great, and a portion of those we shall name, is still very li438 Diseases of the Arteries, Veins, Lymphatics, etc.correctly known, and, what is worse, the clinical applications ofthese drugs are still exceedingly unsatisfactory and insufficientAmong these remedies we distinguish: the ser pent - poisons, thepoison of the honey-bee. Curare^ Secale cornutum, Phosphorus, Mercurius and Arsenicum, Of all these. Phosphorus is undoubtedly themost important remedy, corresponding with the most diversifiedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 372 of 653forms of phlebitis, from the most trifling form to that accompaniby icterus and petechise. Apis is particularly indicated, if theof the cavity of the skull are inflamed; it is less homcBopathicphlebitis of the lower extremities. Ldchesis and Secale, as wellArsenicum^ are particularly indicated by the heart-symptoms, theanxiety, dyspnoea, etc. Mercurius is especially appropriate if thphlebitis remains more localized and is attended with externalinflammation and suppuration. We do not dwell upon these remedies more in detail, because they will have to be referred toagain under pyaemia. In lighter cases the following remedies havebeen found practically useful : Bryonia, Staphysagria, Rhus toxicdendron; Bryonia if the inflammation was not very painful, butattended with marked constitutional disturbances ; Rhv^ toz., forlocal symptoms radiating from the inflammatory centre like erysipelas; Staphysagria, for phlebitis of the lower extremities. [Bdonna and Hamamelis virg. are eminently useful in phlebitis; wehave cured a very severe and threatening case of inflammation ofthe femoral vein, where the inflammation spread rapidly as far asthe hip, by means of tolerably large and frequently repeated doseof Belladonna, without the aid of any other remedy. H.]The subsequently remaining and very prominent oedema of theparts which lose their normal circulation in consequence of theobstruction of the vein, cannot be removed by treatment. It doesnot disappear until the collateral circulation is restored, whichsometimes takes years to accomplish; the uniform pressure of abandage, if it can be applied, may, if it does not effect a cure,at least a good deal of relief.b. Phlebectasia. Varices; Dilatation of Veins.In most cases the causes of these very frequent dilatations canbe determined with perfect certainty ; in other cases, however, tare involved in obscurity. These are the cases where the diseasecannot well be traced to some mechanical obstruction in the circulation of the blood. At all events, these cases are the least fquent. But even in cases where mechanical causes undoubtedlyVeins. 439co-operate, they cannot be regarded as the sole cause of the disesince individuals who are exposed to the sanie^deleterious influeremain free from any such trouble. Hence, the existence of a pecuiar predisposition in the walls of the veins, or else the subsequsupervention of a morbid change in those walls, will have to betaken for granted. The most frequent causes are : Obliteration ofthe vein owing to which the portion beyond the obliterated veindilates in its whole extent; dilatation or contraction of the ventrunk, which has the same eftect as obliterations, only in a lessdegree ; every pathological change that interferes with the flowblood to the heart, such as dilatation of the right ventricle, aftions of the liver, emphysema, tumors compressing the vein, tightclothing. In all such cases, phlebectasia is of a secondary charater ; it may likewise occur as a primary disease in a manner thatwe have not yet been able to account for, in the case of men whohave to be continually in a position that interferes with the refof the blood, persons for instance who have to be continually insitting or standing posture. In a sitting posture, the dilatationhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 373 of 653the vessels can often be accounted for by the pressure exerted upthe abdominal viscera in the stooping posture; in the standingposture, on the contrary, the dilatation is entirely owing to thecircumstance that the vertical position of the body embarrasses tcourse of the blood onwards through the veins. In very many casesanother influence exists of whose mode of action we have no definite idea, namely bad nutrition and living in damp, unwholesomedwellings. That these circumstances are of importance is shownby the frequent occurrence of varices on the lower extremitiesamong the lower strata of the population, more particularly amongweavers and washerwomen.Every vein in the body may become dilated; dilatations occurmost frequently in the veins of the rectum, lower extremities andspermatic cord. We will briefly dwell here upon varices of thelower extremities. They occur more frequently among women inwhom the cause of the dilatation is traceable to the impregnateduterus, whereas primary dilatations are decidedly of more frequenoccurrence among men. What we have said just now concerningthe originating causes of dilatation is particularly applicable tform. At first one of the larger cutaneous veins of the leg is mocommonly affected, whence it does not usually extend to the thighbut involves very regularly the larger as well as the more minuteveins of the foot, especially the veins situated around the ankle440 Diseases of the Arteries, Veins, Lymphatics, etc.where they give rise to a considerable swelling covered with abluish net of both delicate and coarser vessels. In most cases thvaricose veins are painless. In other cases the leg pains tor a stime, after which the pain again disappears. Very often the painis felt while a portion of the skin assumes a bluish redness, sweand becomes quite hard; the pain increases continually, finally tskin suddenly breaks at the place of infiltration, without this lbeing caused by mechanical injury as most of these patients fancyand an ulcer of the size of a pea forms, which is at first roundprovided with thin, somewhat undermined edges. Without propermanagement and hygienic precautions the pains increase all thetime; the ulcer spreads, its edges gradually swell, the surroundiskin becomes hypertrophied, the ulcer secretes a watery and sometimes exceedingly fetid fluid, and its base has a sickly color. Ithe same mode of living is continued, during which walking hurtsonly a little, but standing hurts a great deal, the ulcer may sprover the whole surface of the leg from the ankle to the calf, andmay even penetrate to the periosteum. Ulcers below the ankle andon the anterior portion of the foot are of rare occurrence. Thefetor of the ulcer increases in proportion as the ulcer spreads oa larger surface. In one of our cases, during the summera crowd of worms of half to three quarters of an inch in length,were seen in the ulcer whenever the dressing was removed. Personsgo about with such ulcers for years, and it is inconceivable thatconstant drain of their vital fluids does not result in speedy emciation. If a fever or some other constitutional disease breaks oduring the existence of the ulcer, it seems to heal spontaneouslywhich case the disease is very conmaonly, but improperly, regardeas the consequence of the healing.If the patients are so situated as to be able to remain at once ihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 374 of 653a recumbent posture, the little sores heal very speedily, but breopen again very easily if the person has to stand a great deal, sthat the existence of such ulcers at any previous period leaves aconstant liability to their returning again at a subsequent time.In the higher walks of life, where every measure \a taken fromthe start to prevent the formation of ulcers, a peculiar cutaneouaffection is witnessed in their stead. The skin assumes a very daand bluish color, and scattered and violently itching pustules fovery frequently, or else the skin peels off in scales, leaving thface moist. This form of the varicose affection is by far the mosmalignant and distressing.Veins. 441"With an entire change in the mode of living the varicose ulcersmay heal of themselves, but this is undoubtedly a very rareoccurrence.Treatment. Painless varices, without ulceration, cannot beregarded as an object of treatment, nor do we believe that anybody can imagine the feasibility of removing them by means ofmedicines. If pains are felt, and the subcutaneous cellular tissubecomes infiltrated, it would seem as though medicines might beuseful; at any rate we have seen a rapid improvement take placeafter the use of Staphysagriay Lycopodium and Graphites. Theseare the only remedies which we can recommend as long as j^heulcers are painful. Of other remedies, of which we have had abundant opportunities of trying a large number, such as Sulphur j SepSilicea^ Mercurius, Aurum, Rhus toz., etc., we have never perceivthe least effect. \_Ha7namdis virg. is frequently used by Americaphysicians. H.] If the ulcer has become atonic, even the threefirst-named remedies are no longer of any use, and a mechanicaltreatment is the only treatment that can prove of any use. Thesethree remedies are likewise the only ones that we can recommendfor the peculiar cutaneous affection, but we must confess that thtoo will often leave us in the lurch. Our main resource in treatithese varicose disorders are external or mechanical means. Thedilatation of the veins being chiefly a passively mechanical chanit is evident that moderate compression by means of a good bandage will moderate and finally remove the varicose dilatationaltogether. If individuals with marked varicose dilatationsconstantly wear a bandage, they will never be troubled with ulcernor with any other cutaneous affection. Existing ulcers heal veryrapidly under a carefully-applied bandage, so much more rapidlyif we first cover them with strips of adhesive plaster and a layeof cotton wadding over these, so as to protect them from all contwith atmospheric air. By pursuing this course we have neverknown ulcere of any size or of upwards of twenty years' standingto remain uncured ; but we have never shunned the trouble ofapplying the bandage ourselves. The longest time it has taken usto heal these ulcers, is six months. In this case the ulcer was aa quarter of a square foot in size, the subjacent periosteum wasconsiderably infiltrated, the skin was hypertrophied from the toeto the knee as in a case of exquisite elephantiasis, and had theappearance of an enormous wart. All these deep-seated alterationsvielded to the exclusive use of the bandage. If the excessivehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 375 of 653442 Diseases of the Arteries, Veins, Lymphatics, etc.sensitiveness does not admit of the immediate application of abandage, the patient must be kept for a short time in a recumbentposition with his leg raised ; in such a case warm cataplasms affa good deal of relief.8. Biseases of the rympbatle TesseUi and Glands.a. Lymphangioitis and Lymphadenitis Acuta.Acute inflammations of lymphatic vessels occur so seldom alone;lymphangioitis especially occurs so seldom without inflammationof the lymphatic glands, that we will treat of both these condititogether.These inflammations exist very seldom as primary diseases; evenif they seem to be of this character, yet a careful examinationshows even in such cases that the inflammation is a secondaryoccurrence. Secondarily the afiection most commonly supervenesduring the course of pathological processes that depend u{K>n somspecial infection, such as syphilis and variola, or during the coof diseases depending upon or occasioning septic processes, suchpuerperal fever and typhus. Any, even ever so trifling suppuratioon the skin may inflame the adjoined lymphatic vessel and itsglands ; sometimes this may not take place until the primary suppuration has healed, so that the inflammation in such cases mayseem to have originated as a primary disease. We may finallyobserve that some constitutions show a striking predispositon toinflammations of lymphatic vessels, whereas others are scarcelyever attacked by them.Lymphangioitis, so far as it is an object of observation, if theinflamed vessel is situated near the periphery, sets in suddenly,sometimes after an injury of the primarily inflamed parts, and aplike a fine, sharply circumscribed, rose-colored cord which is vesensitive to contact, and interferes with the free motion of theThis lasts very seldom longer than two days. Sometimes even afew hours after the appearance of the red cord, at times not tillhours have elapsed after its disappearance, one or more of the lyphatic glands in relation with the inflamed vessel begins to swelbecomes painful, and very speedily shows an inflammatory redness.It is more particularly the inguinal, axillary and posterior cervglands that are liable to becoming thus inflamed. Sometimes nokind of pain is felt at the commencement, which may not set inuntil the swelling of the gland has reached a very high degree* aLymphatic Vessels and Glands. 448suppuration has begun to make its appearance^

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 376 of 653balance remain indurated. Most commonly, however^^the^ irfflijnmation terminates in suppuration, the pus escaping outwardly acfileaving the skin round the opening undermined, a closupd of whiGlgenerally takes place very slowly.We have occasionally noticed a very peculiar form of lymphangioitis, more particularly in the case of women, and about the heWith this inflammation a violent fever breaks out very suddenly,accompanied by tearing pains in the scalp and nape of the neck.The abatement of these pains is attended with the simultaneousappearance of several nodes and hard cords about the head, which,however remain seldom longer than forty-eight hours. After ashort interval of ease another attack takes place, and this may bgoing on in this manner for several weeks. We have never beenable to trace such an occurrence to any definite cause.The treatment has to be in conformity with the exciting cause.Of syphilitic inflammations of the lymphatic glands we shall speaiu the further course of this work. If the inflammation is causedby the introduction of poisonous substances into a wound, the besremedies are Ammonium carbonicum^ Acidum nitricum and muriaticuin, and likewise Apis ; the last-mentioned agent more particuin cases running a rapid course. If an important constitutionalderangement supervenes during the local aftection, Arsenicum andRhus toz. are likewise indicated. In such cases remnants of inflamation usually remain, that have to be treated precisely like anyother case of chronic lymphangioitis, of which we shall treathereafter.If the inflammation of the lymphatic vessel is not caused by aspecific virus, the first requisite of the treatment, if suppuratinflammation is still present, is to direct our chief attention tcondition of the gland as the starting point of the whole diseasein order, by this means, to deprive the pathological process in tlymphatic system of its nutriment. If the inflamed vessel and itsgland are very painful, and no suppuration has yet taken place, afew doses of BellaOonna are frequently of much use; this treat444 Diseases of the Arteries, Veins, Lymphatics, etc.ment, especially in the case of children, will sometimes secure tretrogression of the inflammatory process. If the gland is verymuch swollen, Mercurius is the only remedy capable of still preveing suppuration. In many cases, where fluctuation is already distinctly perceptible, and a raised and very red spot shows the poiwhere the pus will escape, Mercurius still eflfects a cure. As awe hold that it is best to give Mercurius at the onset, more partularly in the case of individuals in whom every little wound is dposed to suppurate. If the suppuration progresses unceasingly inspite of all treatment, Hepar svlphuris undoubtedly hastens the spurative process, but is only suitable until the abscess begins tdischarge. Considering the circumstance that Mercurius so veryoften acts favorably even in cases where pus has already begun toform, we may sometimes be disposed to doubt the propriety of giving Hepar. We may be guided by the rule that, if the cellulartissue round the gland is very much inflamed, and suppuration cannot be prevented, Hepar should be given at as early a period aspossible; if the gland alone is inflamed, the use of Hepar shouldhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 377 of 653postponed as late as possible. The subsequent suppuration neednot be assisted by treatment as long as the pus has a healthy appearance and shows a normal consistence. If the pus becomes thin,assuming the consistence of serum. Sulphur at protracted intervalis appropriate to this condition. On the other hand, if the suppuration proceeds sparingly, and the bottom of the ulcer is fillewith whitish flocks of cellular tissue, which, when touched withthe sound, show the consistence of lard, we advise decidedly theemployment of Iodine. As regards the other consequences of suchan inflammation, they coincide entirely with chronic lymphangioitis..In the above-mentioned form of lymphangioitis of the headneither Bryonia^ nor Belladonna^ Bhus tox. or Mercurius has beenof the least use to us ; Apis showed a marked effect, so that nomore paroxysms took place.As regards external applications, we do not deem 'them necessary,although they need not be rejected, for they very often alleviatethe pain and enable the patient to enjoy longer intervals of restBut we only recommend warm poultices which not only favor absorption on the one hand, but promote suppuration on the other.We are not in favor of any premature lancing of the abscess; theabscess should only be lanced, if, owing to the depth at which thgland is situated, the spontaneous escape of the pus meets withLymphatic Vessels and Glands. 445difficulties, or if the pus can be distinctly seen shining througinteguments. *b. Lymphadenitis Chronica^ Chronic Inflammation of LymphaticGlands.This affection either develops itself out of the acute form, orelse it is a primary disease depending upon constitutional peculities, such as cht^acterize scrofulosis ; or else, in infectious dit takes the place of an acute inflammation. Chronic lymphadenitisometimes occurs as a phenomenon of marasmus with typhoidcharacteristics. Childhood and the period immediately after pubescence furnish most cases of this disease.I£ chronic lymphadenitis develops itself out of the acute form,the swollen gland either remains unopened, or else, if the pus hafound an outlet on the surface, the opening closes again at an eaperiod, and the gland which had been reduced in s'ize by an incomplete suppuration, remains as a firm and hard swelling thatgradually becomes quite painless but may continue to grow bysubsequent turns of inflammation and finally suppurate. In caseswhere chronic lymphadenitis sets in as a primary disease, it firsattacks only one gland, but soon invades a number. The swellingis generally without pain and takes place very gradually; mostcommonly such swellings reach a much larger size than in acutelymphadenitis. Tlie swollen gland may remain unchanged foryears, after which it may gradually disappear spontaneously, theswellings that had originated in childhood, commonly disappearingimmediately after pubescence ; or else further degenerations of thttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 378 of 653gland may take place. It is a common occurrence for a torpidglandular swelling that had remained painless for a long time, tosuddenly become painful, and to inflame and break. Such a swellinalways discharges a thin, badly-looking pus, the swelling decreasvery slowly in size, the bottom of the abscess is filled with a wish, elastic, lardaceous substance. Very commonly several openingexist at the same time. The suppurative process is always veryslow, and, if the patient is unfavorably situated in life, may dean hectic state of the system ; or else the sore may heal with abadly-colored, radiating, retracted cicatrix, under which remnantof the indurated gland are very commonly still felt. It oftenhappens that after one gland is healed, another adjoining glandswells and passes through the same process ; this may be the cour446 Diseases of the Arteries, Veins, Lymphatics, etc.of the glands for years. An affection of this kind is at a laterperiod very generally followed hy tuberculosis. ,There is another form of lymphadenitis where the glands arelikewise swollen and where a row of such swellings extends alongthe tract of a lymphatic vessel, but the glands are soft and flucing, generally painful even if not red. There is not always anescape of pus, in consequence of which the swelling rapidly discharges and heals to return again in some other locality ; absorpsometimes takes place in spite of the evideijtly considerableaccumulation of fluid. "We have noticed a phenomenon of thiskind in the case of a child one year old which was affected withan intense ansemia and — we state this incidentally — exhibited tpeculiarity that blowing murmurs were heard over the whole extentof the skull-cap; in this case the whole body was covered withthese swellings ; they fluctuated, became inflamed, disappeared athen showed themselves again in other places. The child died ofhydrocephalus at an age of eighteen months. Another chronicform was observed in the case of a man fifty years old. In thiscase the swellings appeared in company with the symptoms of ageneral marasmus, every swelling broke, but was perfectly painlesand the patient's strength was rapidly consumed by the suppurating process. The most ordinary localities for chronic lymphadenitare the neck and the upper extremities including the axilla, muchless frequently the lower extremities, without mentioning the nonsuppurating glandular swellings in the abdominal cavity.The manner in which the swelling originates, is of considerableimportance in a therapeutic point of view, exclusive even of specglandular swellings to which no reference is made here. If theswelling remains as a rest of acute lymphadenitis, Sulphur is asovereign remedy to disperse the swelling. This agent will seldomleave us in the lurch, and compel us to look for other remedies,such as Aurum^ Iodine^ SUicea, Calcarea carbonica.For a primary glandular, swelling Baryta is one of the mosteflElcient remedies ; in many cases this agent alone has enabledto avoid the suppurative process and to effect a complete absorptespecially of glandular swellings on the neck. Conium has nevershown any marked effect. If suppuration has set in, lodium andCalcarea carboniea render the most reliable aid. Beside these tworemedies we mention Graphites^ Sulphur^ Phosphorus, Silicea, Kalihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 379 of 653bichramicum and likewise Aurum^ not the metallic Gold but theIschias. 447Muriate. We should never lose sight of the fact that a rapid disappearance of the swelling is among the impossibilities.If the swellings constitute the expression of an intense hecticconstitutional aflGection, Ccdcarea deserves a preference amongchildren and Arsenicum among adults. In such cases a cure is athing of very doubtful possibility.In other respects the treatment is very plain. K the patient'smode of living is improper and the constitution is likewise taintthe first thing to be done towards a cure is to regulate the dietand to prescribe an abundance of out-door exercise. This is moreeffectual than medicine. We are acquainted with a family wherethe children, three in number, were all of them suflfering withextensive lymphadenitis in consequence of occupying an unhealthydwelling in town and being restricted to an improper diet. Theyoungest child succumbed .to hectic fever and marasmus, the othertwo children who were sent into the country, have regained theirhealth and have grown stout and fresh, although both, at the timewhen they moved out of town, were afflicted with at least a dozenglandular abscesses.We ought not to omit mention of the Iodine springs of Hallwhich are an admirable remedy for these glandular abscesses.Unfortunately most of our patients are too poor to visit thesesprings, and the bottled water is not by any means what it shouldbe and leaves a good deal to be desired.0. DISEASES OF THE NERVES.The nervous system as immediately connected with the brain andspinal cord, having been considered in a previous chapter where aits general morbid alterations were treated of, it remains for usto devote a few paragraphs to two other abnormal conditions of thnervous system. We did not deem it expedient, from many reasons,to treat of all the difierent neuralgias generally in one chapter1. IscUas.Neuralgia of the ischiadic nerve constitutes one of the most frequent, and at the same time one of the most distressing forms of448 Diseases of the Nerves.neuralgia. Its causes are generally involved in uncertainty; a coexcessive exertions, abdominal afiections, stagnation of habitualhemorrhages, etc., are mentioned as such causes, but it is difficto trace a distinct connection between these two orders of phenomas cause and afiect. It is of course true that ischias attacks heand robust individuals much less frequently than persons of a sichttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 380 of 653frame.At times the aftection commences very suddenly, at other timesthe pain arises gradually from sensations that resemble a slightattack of rheumatism. The pain is generally located between theischium and knee, so that the course of the nerve can be determinvery exactly by the pain. It is very seldom that the pain radiateupwards, more generally downwards below the knee as far as thefoot, on the internal or external surface of the leg. We distingutwo kinds of pain ; either the pain is constant, somewhat remittebut never entirely intermittent, and usually following very exactthe tract of the nerve without the patient being able to define tquality of the pain; or else peculiar tearing-darting pains maysupervene, resembling electric shocks, setting in paroxysmally anbeing excited by motion or by making a wrong step, sneezing orcoughing. At the same time one or more places in the course ofthe nerve are generally sensitive to pressure. Although the paindoes not seem to exacerbate at definite periods, yet all patientscomplain that it is worse in bed, and that this exacerbation issometimes so great that they dare not go to bed. Inasmuch as thepains are very much increased by an extension of the leg, by presure or by the nerve being put on the stretch, the patients generakeep the limb slightly flexed, using it as little as possible durwalk or for the performance of any other motion. This is generallthe cause why the diseased limb, after the ischias has lasted forsome time, grows thin, although the emaciation may likewise becaused by a gradually-developing paralysis. The diagnosis beingsometimes extremely difiicult, it is important to know that ischialways attacks only one limb.In ischias antica the pain follows the tract of the crural nerve;this form of ischiadic neuralgia is very scarce, nor is the painas acute as in ischias postica.This disorder runs a chronic course. The attack is supposed toat first set in with a fever, but these are exceptional cases. Aspontaneous cure only takes place with a gradual abatement of thepains, but not till mouths have elapsed. The general health is veIschias. 449mncli disturbed by the constancy of the severe pains and by thesleeplessness; the appetite becomes inoipaired and the bowels aretorpid.The treatment of this affection constitutes one of the shiningfeatures of Homceopathy, not so much because we cure every caseof this kind as because our opponents admit that they have nomeans of doing anything for this disease and have to let the patisufier for months; whereas we homoeopaths never fail of a cure inthe course of a week or two at latest. Yet even we ought not toboast of being absolutely certain of success, for the reason thatthis aflfection has but few symptoms, and only a few of them areentirely local; hence the selection of a remedy is always investewith difficulties, and a successful result is often defeated on taccount. However, in order not to wrong Homoeopathy, if no cureis effected, or is effected very slowly, we call attention to thethat ischias sometimes depends upon causes that cannot be removedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 381 of 653such as exostoses in the pelvic cavity.The four leading remedies for ischias, the effect of which has beverified in many instances, are: Cdocynthis^ Rhus tox., Arsenicumand Lycopodium. Colocynthis is more particularly adapted torecent cases, the pain sets in suddenly in all its fierceness, itconstant pain, becoming intolerable only in paroxysms excited atonce by cold and motion ; at the same time a feeling of numbnessis experienced in the whole extremity. — Rhus tox> is very seldomadapted to quite recent cases, but comes into play in the furthercourse of the disease, if the following symptoms are present: Stiing or burning-tearing pain, increasing during rest, and alleviatonly for a short time by motion ; heaviness, lameness and evenactual paralysis of the affected limb ; frequent paroxysms of crain the calves. — Lycopodium in more chronic cases, the pain ischiefly a burning or fine stinging pain, with complete intermissiaggravated by rest and somewhat alleviated by motion, with lameness of the extremity, disposition to painful muscular twitchingsespecially if the bowels have become very much constipated inconsequence of the distressing affection. — Arsenicum^ if the paiare marked by complete intermissions, break out with typicalregularity, exacerbate every night even to an unbearable degree ointensity ; they are a burning-tearing distress, seem to be seateclose to the bone, are increased by vigorous, and alleviated by gmovements, excited at once by cold, and momentarily moderated by'vv'armth. At the same time the patient feels sick, the paroxysms29450 Di: eases of the Nerves,are characterized by an extreme restlessness and an inability toremain long in the same position.These four remedies do not, however, constitute the whole of ourcurative means for ischias; they only correspond with the mostfrequently-occurring forms. Other important remedies are: CAaTmmilla in recent cases, for a drawing-tearing pain which becomesintolerable at night and is especially aggravated by the warmth othe bed. Arnica for a burning-tearing, or stinging-tearing pain,with a numb and bruised feeling in the affected limb, with greatsensitiveness to any kind of touch ; for the ischias of lyingfemales. — Pulsatilla for a drawing pain which is worse at night,compels the patient to move the diseased limb continually ; the pis much improved by movement, and is sometimes increased bywarmth, not by cold ; the cause of the attack is menstrual suppression. — Carbo vegetaJbilis in protracted cases; the symptomslike those indicated for Arsenic. — Causticuin for ischias anticafor the paralysis caused by ischias. — Fenrum; the pain is at firincreased by motion, but improved by the continuance of motion,more particularly suitable for worn-out individuals with extremelirritable nervous systems.We might mention a number of other remedies, but those wehave named will suffice. In special cases a suitable repertory mabe consulted.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 382 of 653We do not advise the employment of external applications ; theygenerally weaken the patient still more. . The vaunted applicatioof strips of fly-blister is very seldom of any use; if it is, itprobably because its action is in homoeopathic rapjKjrt with thesymptoms. We may not often be obliged to send a patient afflictedwith this neuralgia to the springs; if this should be necessary,would recommend Teplitz and Sulphur springs.8. IVenralsIa InAercostalUkIntercostal Neuralgia.This species of neuralgia is still more frequent than ischias; itattacks principally females, and occurs very seldom before the agof pubescence, and subsequently to the critical age. The physicalc6nstitution does not seem to influence this affection; nor can itraced to definite causes. This affection succeeds very frequentlan attack of herpes zoster; it much less frequently precedes thisexanthem. The intercostal nerves of the left side, and more parJNeuralgia Intercostalis. 451ticularly the nerves between the sixth and eighth intercostal spaare most frequently attacked.As in ischias, so in intercostal neuralgia, the pain is very seldfelt all at once in all its intensity, but most commonly developsitself progressively ; it is generally located in one intercostalis at times tearing, at other times lancing or jerking, and alwaymingled with a burning sensation ; every more violent movementof the thorax excites or aggravates the pain. A characteristicpeculiarity in this affection is that three spots are uncommonlysensitive to contact; namely one spot close to the vertebral coluin the middle of the intercostal space, one half way between thesternum and vertebral column, and a third spot towards the front,close to the sternum or mesian line of the abdomen. These pointsare very seldom missing; they are well known to the patients, andthe extreme sensitiveness of these points, which is very much increased by the least attempt at percussion, easily suggests thepresence of inflammation. This suspicion is set at rest by thecircumstance that hard pressure is generally borne without troublThe affection is unaccompanied by fever, its course is mostly chrand may last for years. The more gradually the pain arises, themore obstinate it is as a rule. The paroxysms of syncope, palpitation of the heart, dyspnoea and the like, which are often causedby the intensity of the pain, are very apt to mislead one in thediagnosis.In treating this affection we shall find it difficult to hit uponremedy, if we depend upon the symptoms in tbp Materia Medica.In selecting a remedy, we may lay great stress upon the circumstance that the pain is semi-lateral and likewise that the kind opain, the time of its appearance and other features, are characteistic indications. The favorable results which have so far beenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 383 of 653obtained by the use of Ptdsatilla, Rhus toxicodendron^ Arsenicumand Mezereum^ speak very much in favor of these drugs. [Ciynicijuga racemosa is likewise excellent. H.] Mezereum is undoubtedlythe chief remedy, and is especially indicated if the neuralgia sein after zoster. The general indications, as stated above, are eaverified by corresponding symptoms in the Materia Medica. Thefollowing remedies are indicated a priori^ although they have beevery little used in practice: Ranunculus sceleratus^ RhoflodendroLedum and Spigelia, Many circumstances speak in favor of thelatter, more especially the efficacy of Spigelia in neuralgia oftrigeminus. We will here repeat the advice which we have repeat452 Diseases of the Skin.edly given on former occasions, namely not to give too large dosewhich are apt to superinduce homcBopathic aggravations ; nor torepeat the dose too frequently, for the reason that a favorable eis never obtained very suddenly.D. DISEASES OF THE SKIN.Ik treating of diseases of the eyes, we have pointed out severalinconveniences which render even an approxiraatively satisfactoryarrangement of the therapeutics of ophthalmic diseases a very difficult task. In regard to cutaneous affections, it is likewise alimpossible to present them from the stand-point of homoeopathicTherapeutics. In order to render such a presentation profitable,it would have to be very extensive and take in a good deal that ipurely hypothetical. The space that is allotted to us, is too limfor such a purpose. For this reason we have confined ourselves tothe most essential points, and have only stated practically veriffacts. Before, however, passing to the consideration of the specicutaneous affections, we deem it proper to briefly expound thereasons why cutaneous diseases are a sore point in the homoBopathMateria Medica.Cutaneous diseases are not, like the affections of other organs,spread over several parts of the body ; they only offer us a singsymptom, namely the cutaneous efflorescence, as a means of diagnosing the cutaneous disease and selecting the appropriate remedyThis symptom is of course accompanied by a variety of generalsymptoms, but we would go too far if we were to allow these variable companions of the cutaneous affection to decide the selectioof the remedial agent ; at all events these accessory symptoms aronly of secondary importance. Hence we only have one objectivesymptom of disease, but where do we find a corresponding symptomin the Materia Medica ? The leading symptoms of our drugs are,moreover, indicated in such a superficial and vague manner thattheir true meaning can hardly be deciphered from such a text. Inmaking this assertion, we expect to incur the censure of those whdeem it a crime even to think of the possibility of amending theMateria Medica. Well, we will endeavor to pocket the censure,but we desire to be convicted by logical evidence. Until then wehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 384 of 653Erythema. 453shall stick to our text that it is impossible to treat cutaneouseases with certainty if we take the Materia Medica for our guide.We will now consider another expedient which might be resortedto in this case, as it is in other cases, for the purpose of suppor covering up the defects of our Materia Medica, we mean thepractical result, the experience gathered ex usu in morbis. But welse do we meet with in this direction but endless confusion ? Ifour literature exhibited the richest treasure of really useful prtical observations, it would either have to be left untouched, orthe use of it would involve a great deal of trouble or expose usnumerous mistakes. For the last fifty years, cutaneous diseaseshave constituted an arena for those who were anxious to subservethe purposes of Science by manufacturing names or making anostentatious display of their erudition. In this manner we haveobtained a brilliant nomenclature which, however, is unintelligibto those who have not devoted years to its study. This circumstance has reduced the value of clinical cases almost to zero.In the presence of so much uncertainty and want of clearness inour Materia Medica and of confusion in the department of cutaneous diseases in the literature of our School, a therapeutical arangement of cutaneous diseases is certainly a hazardous task.Many preliminary labors are required before. we can think of perfecting a tolerable system of therapeutics of the cutaneous diseaabove all, we recommend uniformity in our nomenclature, coupledwith a rigid precision in diagnosis.The febrile exanthemata which have been excluded from the following list, have been transferred among the constitutional diseafor the reason that their importance is determined by the accompanying derangements of functions rather than by the form of theexanthem. The series in which the special forms are successivelypresented, has been arranged in accordance with the pathologicoanatomical changes ; we have simply avoided the custom of distinguishing special sub-divisions in each form.!• Erythema.Erythema occupies a middle rank between hypersemia andinflammation of the skin ; it is easily confounded with a benignform of erysipelas.It« causes are : Mechanical injuries of the skin ; the influencea high temperature, of various medicinal agents ; continual moist454 Diseases of the Skin.euing of one part of the skin by lirine, liquid stool, perspiratitears and even the constant use of moist compresses ; constant irtation of the skin by rough clothes. In the case of children, erythema seems to be likewise caused by hearty and fat food. Erythemseldom occurs as a wide-spread affection, to which the designatioof "epidemic" might be applied. Chronic erythema breaks outchiefly in the face, and more especially on the nose; its causessometimes seem to be purely local, and at other times constihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 385 of 653tutional.Erythema is characterized by a more or less diffuse redness of thskin, not separated from the normal redness by sharply-drawn outlines, assuming a yellowish, not a white tint under the pressurethe finger, and continuing for some time and, finally, terminatinin desquamation. These characteristics belong to all forms of erythema. Erythema caused by external irritants, most generallybreaks out on the scrotum, at the anus, between the thighs, in thaxillse, face, and in the deep integumentous folds of fleshy persor at the place where the irritating cause exerts its influence.the cause ceases to act, the erythema generally disappears of itsin a few days. If the irritation continues, the epidermis maybecome detached (intertrigo), and ulcers may form, or the skin maeven become gangrenous, as in decubitus. Erythema arising frominternal causes, is almost exclusively located on the dorsal surfof the hands and feet, where it is never absent, even if other paare likewise affected. At first the place exhibits a redness, andin a few days darker-colored papules of various sizes spring up,which remain even for some time after the diffuse redness has disappeared; the affected spot likewise retains a yellowish tint forsome time after. In particular circumstances subsequent crops ofthis eruption break out on its borders, by which means the affection runs a very protracted course. This form of erythema is generally attended with a little fever, and at the diseased spot adarting-burning pain is generally experienced. The former varietyon the contrary, has no fever as long as the erythema is of thesimple kind, whereas the intertrigo of sensitive children may beattended with fever. The second variety, without any subsequentcrops, lasts from one to two weeks.In treating the first variety, all that it may be necessary for uto do, is to remove the exciting cause. In some individuals thedisposition to erythema is so great, and it leads so easily to moserious consequences that we are led to suspect behind the localErysipelas. 455irritation the existence of some constitutional disposition. Thisticularly the case with the intertrigo or soreness of children. Sthis soreness is often caused by improper diet, the first thing tdone is to regulate it with care; if the soreness continues in spof this change, a few doses of Mercurius vivus or sdubilis will cthe trouble very speedily. K this remedy should fail us, Lycopodium will efiect a cure. Among local applications, finely pulveristarch is the best and most harmless ; frictions with grease mustavoided, they are very apt to give rise to the formation of pustuFor erythema from internal causes, Mercurius is likewise aspecific remedy, if the redness is intense, the red spot raised asensitive, and the erythema is accompanied by fever. Hhv^ tox.has always proved ineffectual in such cases. If the erythema isconfined to the leg, Mezereum is the more appropriate, the more taffected spot itches and burns. Ledum likewise deserves our attention; so does Staphysagria; this remedy is especially indicated ithe erythema is seated on the upper extremities. We advise Lycopodium, if the eruption runs a protracted course in consequence osuccessive crops breaking out for a time.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 386 of 653Erysipelas proper is altogether a primary affection the cause ofwhich it is difficult to trace in every case. The disease occursalmost exclusively between the age of pubescence and that of sixtand is of less frequent occurrence among old people than amongchildren. Atmospheric influences are generally regarded as thecause of erysipelas, but this theory is not justified by the evidof fact. All we know positively is that erysipelas often sets ina sporadic disease, and that sometimes it breaks out in the forma limited epidemic which never assumes a very extensive range andhas given rise to the erroneous view that erysipelas is a contagidisease. It is a characteristic feature of this disease that everattack of erysipelas increases the patient's liability to other awhich only becomes extinct at an advanced age. The cause ofsuccessive attacks of erysipelas is very often to be found in vioemotions, gross errors in diet, and in colds, more esjjecially inaction of severe cold upon a heated skin. We have known a ladywho was several times attacked with erysipelas simply because shesuddenly went from the kitchen-stove into the cellar.The origin of wandering erysipelas is involved in complete456 Diseases of the Skin.mystery; it is to be observed that it inclines to set in previousthe age of pubescence.Traumatic erysipelas is regarded by many persons as a' simpleform of dermatitis. It arises in consequence of injuries if suppution ensues, or even at the start, soon after the infliction of tinjury ; or it accompanies suppurating inflammatory processes, suas gum-boils. It may be looked upon as an excess of reactionagainst the inflammation from which it proceeds. Erysipelas neonatorum is altogether a form of traumatic erysipelas. The introduction of septic substances undoubtedly exerts a prominentinfluence over the origin of this disease. This circumstance likewise accounts for those cases of erysipelas that supervenes durintyphus and other constitutional diseases as a malignant complication or as a terminal disease.'8ymptoni8 and Course. True, or the so-called exanthematicerysipelas really only breaks out in the face, whereas erysipelasother parts of the body is, properly speaking, erythema. Theappearance of the exanthcm upon the skin is generally precededfor a few hours or even days by a preliminary stage consisting ofsevere fever with marked gastric symptoms, with which symptomsof cerebral hypersemia, and more especially a violent headache,sometimes become associated at an early period. During a firstattack these precursory symptoms are scarcely ever absent; butthey do not usually occur with a return of the disease. While thefever is on the increase, the face feels hot and tense, and sometrheumatic pains in the nape of the neck are complained of, a viviredness breaks out at a certain circumscribed spot in the face, wspreads rapidly and causes a burning pain. In proportion as theredness becomes more intense, the swelling likewise increases andthe skin assumes a glistening appearance. Erysipelas generallybreaks out on one cheek, whence it spreads to the nose, the eyeliforehead, ears, less frequently to the lips, and scarcely ever tochin. Within two or three days, and sometimes in thirty-http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 387 of 653the erysipelas reaches its acme at the spot where it first appearamid febrile symptoms which are sometimes exceedingly severe,attended with a foul-smelling catarrh of the mouth, vomiting, andmost generally delirium ; these symptoms, however, are not constant, whereas the headache and soporous stupefaction are exceedingly annoying. The face is now very much swollen, the featuresare disfigured to such an extent that they are no longer recognizble, the redness has a bluish and even brown-red tint, and vesiclErysipelas. 457of various sizes sometimes spring up upon the inflamed surface,which always indicate an intense degree of illness. The inflammation decreases very rapidly ; the redness disappears after the exvesicles had dried up previously and had become transformed intothin and flat crusts, and very soon desquamation commences firstin large patches and afterwards in very small scales. But inasmucas the disease never terminates with its first appearance, and usspreads over the whole head, we find erysipelas in full bloom cloto the original spot in process of healing, and find the rednessgradually diffusing itself into this spot, whereas it forms a shacontrast with the surrounding normal parts of the face. In thismanner erysipelas gradually wanders over the whole face, evenbeyond the ears, invading a portion of the nape of the neck, andspreading over the forehead and the hairy scalp. In this latter cthe patients sufter severe local pains, even after the fever abatThe intensity of the fever, as it first breaks out at the commencment of the disease, does not keep pace with its gradual progression. Whereas at one spot the inflammation runs its full course ifive to six days, yet, on account of its progressive appearance idifferent localities, the whole course of the disease lasts fromdays to a fortnight. The process of desquamation may last muchlonger, and the most severely aftected parts often exhibit for atime a yellowish tint with signs of serous infiltration.Deviations from this course are not unfrequent. The whole facemay be covered so rapidly that it would seem as though the exanthem had broke out all over at once. These are cases of intensevirulence, where one ear, however, commonly remains uninvaded.Moreover, the inflammation may communicate itself to the cerebralmeningse; generally, however, this does not take place until thelocal process has reached its height. In such a case the rednesssoon assumes a dingy and livid look; the skin becomes lax andwrinkled, a most violent* delirium sets in, and coma and deathspeedily supervene. This course has been mistaken for a metastasiof erysipelas; whereas in such a case the same changes take placeas in other similar cases, namely that, with the appearance of aviolent disorder, the previously-existing lesser disease abates adisappears. Erysipelas seldom becomes associated with diseases ofother important organs. Attacks of erysipelas succeeding the firsattack are very apt to show deviations from the normal course.These attacks are very seldom preceded^ by precursory symptoms,the less so the more frequently the attacks have occurred. Nor isDiseases of the Skin.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 388 of 653the fever as severe, the swelling is less, and the spread of theease over the face takes place more slowly. It not unfrequentlyhappens that in subsequent attacks the patients are not obliged tlie down and that their appetite remains the same as in their norcondition. Subsequent attacks are more like erythema than erysipelas. The frequency of the attacks ditfers greatly in differenindividuals; sometimes there are several attacks in a few weeksand, after a short time, cease entirely; or months and even yearsintervene between the attacks; in such cases a spontaneous cessation is much less frequent.Among the consequences of true erysipelas the following deserveparticular mention : Swelling of the skin, especially that of thelids, nose and lips; the swelling is mostly oedematous, the epidehaving a pale look and being disposed to the formation of comedones ; if the attacks are very frequent, the swelling may reachconsiderable degree of thickness, and is very obstinate. Loss ofthe hair, which almost always falls out if the scalp had beenintensely affected by the disease; in most cases the hair growsagain, but there are exceptions to this rule. — Subcutaneous abscesses in the lids, lips, ears. — Severe catarrh of the externalwith obstinate hardness of hearing. — Catarrh of the conjunctiva,which is generally very obstinate. — Disposition to neuralgia oftrigeminus.Wandering erysipelas, or erysipelas ambulans or erraticum,attacks the face less frequently than the extremities. On one ofthe extremities an erysipelatous spot appears which heals exactlylike the above-described spots, only there is very little tensionpain, and the general organism is not so much involved. From thisspot the erysipelas spreads towards the trunk; the spot whichis attacked next, being either in close contact with the first,or else all subsequent spots being more or less remote from eachother.Symptomatic erysipelas, as an accompaniment of inflammatoryprocesses, is of no great importance, except when it covers a larextent of surface and depends upon septic causes. Generallyit disappears of itself as soon as the cause that occasions it, iremoved. If it is very intense, it may result in suppuration organgrenous destruction of the skin. If the erysipelas sets in inthe course of serious, constitutional febrile diseases, it is alwbad omen. In such cases the redness is never very vivid, ratherdingy, having a bluish tint; the swelling is not excessive and yeErysipelas* 459the disposition to form blisters is very great; these blisters doalways dry up, but often become transformed into badly-lookingulcers which are apt to become gangrenous. The fever accompanying this form of erysipelas, always increases to a high degrebut speedily assumes the character of an adynamic fever, the pulsbecomes very small and frequent, the temperature increases considerably, the cerebral phenomena become very marked, and soporand coma set in at an early period, and death sometimes takesplace so rapidly that life becomes extinct already on the third dafter the ap^»earance of the inflammation.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 389 of 653Erysipelas neonatorum generally sets in in the first week afterthe birth of the infant, very seldom after the first month. It alalways proceeds from the umbilicus, on which account it has beentraced with great probability to the consequences of an impropermanagement of this organ, more especially to a purulent inflammation of this organ which can easily be accounted for by badmanagement. — As a rule the erysipelas spreads from the umbilicusover the abdomen, the sexual organs, thighs, less frequently overthe thorax and back. The redness is not very vivid, the swelling,on the contrary, is very considerable. The children are exceedingrestless, feverish, and incline greatly to spasmodic aftections asopor. The dermatitis is very apt to become associated with peritonitis. Death is the most common termination.Treatment* In speaking of the efficacy of a medicine forerysipelas, it is in the first place important to inquire whethercouree of the erysipelatous inflammation is shortened by the medicine. It is well known that erysipelas of the face, if the wholeface is covered with it, never disappears, spontaneously under nidays, and that the course is limited to five or six days if onlyside of the face is invaded; this last-mentioned circumstance hasoften led to the supposition that a case had been cured by mediciwhereas the cure was altogether spontaneous. In a first attack ofprimary erysipelas it is very seldom the case for only one side othe face to be aftected. At all events, we should be very guardedin claiming curative virtues for some of our remedies for erysipeand should only believe after repeated and successful trials in ttreatment of analogous cases that they were cured by means ofdrugs.Simple, smooth erysipelas of the face, as long as fever is presenis best combated by Belladonna, and, under this treatment, generally runs its course in six days. Nevertheless, although Belladon460 Disease of the Skin.responds completely to the symptoms of violent cerebral hypersemia, yet it is not suitable for the meningitis which may supervduring the course of erysipelas. Here Rhus tox. is preferable. Thremedy is generally more particularly adapted to the higher gradeof the disease, more especially If copious vesicles spring up upothe inflamed skin, if the fever, although intense, yet assumes anadynamic type, if the tongue becomes dry and the nervous excitement is superseded by a soporous stupefaction. Even the color ofthe aflfected part affords a decisive hint for the selection of othe other drug; Belladonna is indicated by a bright-red, and Bhistox, by a bluish or yellowish-red tint. — If we may credit recentreports concerning Apis mellifieay this remedy is preferable to eBelladonna or Rhus tox. Apis is said to be a specific remedy notonly for smooth, but likewise for vesicular erysipelas, and to besuitable even if the brain is affected. "We have not yet had an.opportunity of verifying the pretended virtues of this drug in ouown practice. A special indication for Apis is an inflammation ofthe mouth and fauces accompanying erysipelas. Although theseremedies are sufficient in all ordinary cases, yet other remediesbe required to meet exceptional deviations from the normal type.For the excessive cerebral phenomena, while the exanthera is stilout and hence no meningitis had yet set in, Arftymnium carbonicumhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 390 of 653and Camphora are important remedies; Opium likewise is often animportant intercurrent remedy, when the patient is lying in a staof sopor. True erysipelas, especially erysipelas of the face, verseldom terminates in gangrenous destruction; if this should be thcase, Arsenicum albums Carbo vegetabilis and Secale cornutum woulhave to be administered. An incipient suppuration cannot be cutshort by Mercurius; it is much better to at once give Hepar sulphuris and thus to promote the suppurative process. For theerysipelas of old people Lachesis is said to be superior to eitheBelladonna or Rhus iox. Here too we would advise to keep an eyeon Amwjonium carbonicum^ [also on Arsenicum. H.]For erysipelatous attacks without fever, we have never foundeither Belladonna or Rhu^ iox. suitable ; they are not homoeopathto this condition. On the other hand we cannot recommend Lycopodium with sufficient emphasis, and if the local process is strimarked, Hepar sulphuris^ were it for no other reason than becauseboth these remedies prevent the frequent return of the disease. Isuch cases Borax may be a reliable remedy which Bcenninghausenrecommends for erysipelas on the left side of the face; for it isErysipelas, 461in this non-febrile form of erysipelas that the inflammation isgenerally confined to one side.The sequelfle generally deserve particular attention, for the reathat they are mostly very obstinate and because it is in them thathe disposition to relapses is generally founded. Some redness ana doughy, not oedematous swelling generally are some of the mostcommon sequcbe of erysipelas ; the swelling is apt to be increaseby extreme cold or heat, in which case a stinging and tensive paiis experienced in it. As long as this swelling lasts, the use ofremedies must not be discontinued. The remedies which will eftectthe removal of this swelling, are Graphites^ Sulphur^ Aurumy andif the swelling is frequently painful, Lycopodiam and Hepar sulphuris. These remedies are the only ones capable of counteractingthe extensive oedema of the face which sometimes baffles all treament for years, or yields only very slowly. — Swellings of lymphaglands do not often remain ; if they do. Baryta is most efficientremoving them. After erysipelas of the hairy scalp, the hair is ato fall out; in the case of older individuals, this kind of baldncan scarcely ever be arrested, much less cured ; in younger persoon the contrary, the hair grows again without anything being donefor it. For chronic conjunctivitis after erysipelas, we advise prcipally Graphites^ and likewise Arsenicum. A subsequent deafnessor hardness of hearing is very difficult to cure, it generally reunchanged. Sulphur and Baryta may be tried for it.If the erysipelas is not seated in the face, some other remediesmay have to be resorted to, more particularly if the erysipelasbreaks out on the lower extremities. Nux vom. is recommended asa specific remedy in such cases ; we prefer, however, Staphysagriand Graphites^ and if there is a great deal of pain, Mercurius. [senicum may likewise be very efficient. H.] If erysipelas developitself as a consequence of debility, or attacks old people, so thgangrenous destruction of the skin has to be apprehended, Secalecomutum lasiy render efficient service.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 391 of 653Symptomatic erysipelas, if caused by external irritants or by asuppurating injury or sore, does not require any special treatmenthe use of such remedies as are recommended for it, is very problematical. If it arises from general causes as a terminal affectiof a most threatening character, we have of course every reason thunt up efficient remedies. Bhus tox. and Apis will be very oftenfound indicated in such cases ; likewise Phosphorus^ Carbo vegetabilis and Arsenicum^ The selection, of course, will be governed b462 Diseases of the Skin.the character of the disease in whose soil the erysipelatous inflmation has taken root.In a practical point of view, it is best to regard erysipelas neonatorum as a form of phlebitis and to treat it with the remediesthat have been recommended for phlebitis. Hence we are in doubtwhether Belladonna will ever be capable, as Hartmann thinks, ofarresting the mischief; in the place of Belladonna we should atonce give Mercurius or Hepar siUphuriSy and, if icterus has supervened. Phosphorus or Bryonia. .Wandering erysipelas is generally a very obstinate disease, forwhich it is very difficult to select remedies from the Materia Medica. Graphites has furnished practical evidence of its curativepowers in this disease, whereas Fulsaiilla^ Lycopodium and Cocculare unreliable.As regards other points in the treatment of erysipelas, we desireto deprecate the common practice of resorting to an excess of warcovering which can at most only increase the intensity of the inflammatory process going on on the skin, as well as the dispositito relapses by superinducing an extreme sensitiveness of the skinThere is neither use nor reason in covering the inflamed skin witcotton wadding, nor is there any reason why the patients shouldnot remain in a uniform temperature, without any extra amountof covering.[It is well known to every physician and nurse that the distressing itching and burning of the inflamed skin is very much relieveby sprinkling a thin layer of fine flour or pulverized starch upoIn erysipelas of the extremities I have likewise resorted to a wewatery solution of the Sulphite of Soda as an external applicatioThe effect has been to blanch the skin, alleviate the itching andburning, and, in conjunction with proper internal treatment, toshorten and moderate the course of the disease.Traumatic erysipelas of the face, in the case of habitual drunkards, is very apt to involve serious consequences, especially undallopathic treatment. If the inflammation invades the meningae,which it is inclined to do, death under this treatment is all butcertain.Some years ago, a case of traumatic erysipelas occurred in ourcity, which speedily terminated fatally under Old School treatmenThe patient, a very stout man, had been on a bender for a day anda night, and was very much under the influence of liquor. A fallhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 392 of 653Erysipelas. 463on his face lacerated the skin near the left temple. Erysipelas sin, and he died in two days. *Inasmach as I may not have another opportunity in the courseof this work, of offering the present remark, I desire to avail mself of the present chance. Delirium tremens is the ultimate resuof alcoholic poisoning. Can such a condition be removed in everycase with such small doses as we are in the habit of using in ourpractice? This is questionable. In my opinion there are caseswhere we cannot do our patient justice without treating him withlarge doses of the proper antidote. We remember a case of deliriutremens where the patient complained of vermin crawling over hisbed and hands. Arsenicum 30 cured him entirely. In other similarcases this treatment utterly failed. A stout young man had drankthirty-nine glasses of whisky on a wager in one night. We foundhim cold and the skin dry and husky like parchment. He feltnumb all over. Pulse scarcely perceptible. He was in great agonyof mind and expected to be utterly paralyzed. He was unable tosustain his own weight. I gave him six globules of Nux vomica 30,in half a cup of water, a dessertspoonful every five minutes. Thepatient sank visibly under this treatment. Being satisfied thatNux was his remedy, I now mixed five drops of the strong tincturein six tablespoonfuls of water, of which mixture I gave him adessertspoonful every five minutes. After the second dose he begato perspire. The perspiration seemed to be pure alcohol ; he wasliterally drenched with alcohol. He had to be changed seven timesduring the night ; next morning he felt quite well, except a littweak. I have treated a number of cases of delirium tremens withvariable doses. Upon the whole, small doses have not provedvery eflectual in my hands. Doctor Reed, Jr., of this city, hastreated a number of cases ; proceeding upon the principle of curing the patient as speedily and effectually as possible, he treathis patients irrespective of dose. A few of his cases will show tdelirium-tremens patients sometimes bear unusually large quantitiof medicines. To illustrate this fact I will take this opportunitrelating a few of the cases which he has related to me from hisnote-book.G. L., forty years of age, a butcher and confirmed drunkard,precipitated an impending attack of delirium by falling and breaking three ribs; he suffered but little from pain or prostration.tremor was severe, but the case was remarkable in the character othe delirium, and as showing the immense quantity of Opiumnecessary to overcome the obstinate wakefulness.464 Diseases of the Skin.For two days the delirium was evidenced by the most delightfulvisions, he saw angels hovering over his bed, and held delightfulinterviews with the saints. Not being properly watched, he atnight escaped from the house, and after the lapse of some hoursreturned to relate how he had been upon another Mount of Beatitude, having held sweet converse upon a neighboring sandhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 393 of 653our Saviour and the Blessed Virgin, returning after the holy inteview much edified, to demand more whiskey. His hallucinationswere all of this religious character, and this before the Opium hbeen given.Within twenty-four hours there was given him in divided dosesat least three ounces of Laudanum, he being carefully watched forthe result, and it was only after the last half-ounce dose of thequantity stated, that he showed any ettect from the drug. Thiseffect, however, was a good and in all respects natural sleep, lathirty-six hours and followed by an entire relief from all the sytoms of his disease.C. C, laboring under his fourth attack of delirium tremens,under the care of a Doctor who had treated him in the oldway, with Opium and Digitalis, had passed seven nights withoutsleep.On visiting the patient on the morning of the eighth day, I foundhim quietly brushing the vermin from his clothing, and occasionalordering the nurses to clear the room from the strange animals whwere in every corner, and under every chair. His pulse was fair,tongue but lightly coated, skin moist and warm, appetite good, fasomewhat flushed. The attack, and all former attacks had commenced with severe vertigo. His eyes were injected, bowels loose,owing to purgatives. I ordered rest from all medicines, strongsoup, and oysters with an abundance of Cayenne pepper throughthe day ; at 8 o'clock at night I administered one drachm of theBromide of Potassium to be followed, if necessary, every hour byone half the quantity. The dose had to be repeated but once, aquiet sleep being obtained for twelve hours.Five months subsequently C. C. again suffered for the fifth time,and for three days I used every endeavor to obtain sleep. TheBromide which had before acted so effectually, failing entirely.the fourth night, however, sleep was obtained after the use of la.doses of Opium and Tartar emetic; recovery followed immediately.An habitual drunkard of great capacity, having already sufferedfrom many attacks of delirium tremens, after, according to hisRoseola, Rubeolx. 465own and his friends* accounts, abstaining from food for some weeksubsisting entirely upon liquors of which he took a great varietyand an incredible quantity, was attacked with a very severe formdelirium tremens. The prostration was extreme, the tremor excessive, but the delirium bland, the chief hallucination being thatceiling was about' to fall and crush him, rendering it necessaryhim to jump from the bed and hop around the room with as greatactivity as his weak condition would allow. His tongue was heavilcoated, pulse small and irregular, skin moist, the forehead beingconstantly bedewed with a cold, clammy sweat. His voice wasfeeble, husky and tremulous, he had had no sleep for three nightsThe treatment was directed principally to sustaining his strengthbut all eftbrts to obtain sleep were for fifty-two hours unavailiAt the end of this time two boluses containing each one scrupleof Cayenne pepper, were given, and within two hours the patienthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 394 of 653was quietly sleeping, the skin, feet and hands for the first timebeing warm. After fourteen hours of quiet sleep, he awoke witha desire for something to eat, and from this mpde a fair recoveryDuring the treatment Digitalis acted very satisfactorily in tendoses of the tincture in strengthening the heart's action.A tailor of intemperate habits, aged about forty, after a protracted debauch became delirious, imagining that he was pursuedby demons. I was first called owing to his having jumped from athird story window. His fall having been broken by a shed, hesustained no severe injuries.He complained of seeing horrible phantasms, struggling with hisattendants that he might escape from them. However, he answeredintelligibly to inquiries, complaining of pain in the head andstomach ; his tongue was heavily coated, face pale, pulse small aquick, skin dry but cool, had eaten nothing for some days, and hahad no sleep for two nights. I prescribed the tincture of Nuxvomica, three drops every half hour. Upon calling within threehours, I found the patient sweating profusely, relieved from painin the head, and from the phantom which had been troubling him.Under the use of supporting measures his recover) v^as rapid anduninterrupted. H.]8. Roseola, Rnbcolse.This exanthem is characterized by spots of the size of lentils anof a bright-red color, more or less scattered and rarely appearin30466 Diseases of the Skin.in groups; they are not attended with fever, or else the fever isslight, and does not result in any perceptible desquamation.Roseola sometimes accompanies severe catarrh, in which case theexanthem lasts at most twenty-four hours ; if it is preceded by aslight catarrhal stage, the exanthem disappears at the latest onthird day. In this last shape roseola sometimes appears epidemically, but not over a large extent of country, in which case theeruption looks very much like a mild form of scarlatina to whichit is related like a sort of transition-link. In the same house whave seen two children laid up with the mildest form of roseola;another child, on the contrary, was attacked so violently that itseemed perfectly justifiable to diagnose scarlatina, so much moredistinct desquamation took place, and a slight degree of oedemawas noticed over the whole body. Roseola never involves anydanger.The disorder may originate in catarrh or in a marked change oftemperature, as a rule it is owing to such atmospheric conditionsas favor epidemic diseases. A species of roseola which is apt tosupervene during the course of dangerous constitutional diseases,more particularly of typhus, does not belong in this categoryOwing to the trifling character of this disease, the employmenthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 395 of 653of medicines is generally unnecessary ; if catarrhal angina is coplained of, a few doses of Belladonna may be administered. Thefever is scarcely ever sufficiently severe or generally of a charto require Aconite, [A few doses of Aconite are very serviceablethis eruption, even if the fever is ever so slight. H.] If thisexanthem is confounded with a mild attack of scarlatina, the poorpatients suffer from such a mistake in consequence of being keptthe room for an unnecessary length of time ; we shall dwell uponsuch a proceeding more fully when treating of scarlatina.4. Vrticaiia*NetUe-rashj Hives.Blotches or wheals may be caused by the direct action of irritantupon the skin, such as extreme heat alternating with cold (ladiesat a ball often expose themselves to such influences), mosquitoflea-bites, bed-bug bites, bee-stings, the stings of gadwith nettles and other plants; or else by the action of irritatinsubstances which, after being introduced into the stomach, reactupon the skin. This, however, is not generally the case, but theUrticaria. 467result of peculiar idiosyncrasies, as from strawberries, raspberrcrabs, oysters, etc. Urticaria proper is for the most part dependdpon individual predispositions which it is impossible to accountfor with any certainty; a very common exciting caase is gastriccatarrh from indigestion, and likewise catarrh of the female sexuorgans, chronic as well as acute. In acute constitutional diseaseblotches sometimes break out, but they are not of any specialsignificance.Urticaria very commonly commences with febrile symptoms sometimes of a considerable degree of intensity, and which may continduring the whole course of the eruption. It is a question, howevewhether the urticaria does not result from the fever instead of tfever from the urticaria. Generally the digestion is very much affected, symptoms of cerebral hypereemia are less commonly presentThe appearance of the exanthem is generally immediately precededby great restlessness and an oppressive anxiety. In other cases teruption comes out suddenly after a short feeling of indispositiowithout any fever. Amid a burning and violent itching of the skina dift'use redness or rather large red spots, without sharp outlimake their appearance, upon which soon after risings or elevationstart up, of a white or red color, but more generally with whitetops. Their size varies from a quarter of an inch to one inch inlength and breadth; most commonly they are isolated, less frequently they appear in clusters on the same spot. The warmth ofthe bed seems to promote their appearance. A single wheal doesnot remain out very long ; it disappears even in a few hours, witout leaving a trace, but other wheals may break out in other placby which means the whole, process may be very much protracted.The localities where the exanthem most commonly breaks out, arethe extremities, and the anterior surface of the trunk, less frequently the face. The urticaria from gastric causes likewise orignates in this manner, except that it scarcely ever lasts longer ttwelve hours; on the other hand, its first appearance is oftenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 396 of 653attended with an intense fever, anxiety and restlessness. Even thurticaria caused by the stings or bites of insects, is often attewith fever.A first attack generally superinduces an increased disposition tothe disease ; this disposition increases in proportion to the freof the attacks, and may continue for years under the designationof chronic nettle-rash. In such circumstances the fever is less wevery new attack, whereas, on the other hand, the most trifling468 Diseases of the Skin.«error in diet, the least cold may excite a new crop of wheals. Inthe case of women the eruption often seems to have some connectiowith the menses. In chronic urticaria the wheals are always scattered, and the surrounding redness is trifling or entirely wantinthe wheals generally look red. This chronic urticaria is'a very onate disorder, but often remains uncured for the reason that theconstitutional anomaly in which it originates, is not regarded.A single attack, if not very violent, does not require any treatment ; medicines may have to be resorted to on account of the constitutional symptoms, not for the exanthem. For decided symptomsof indigestion, Pulsatilla may be given; for a severe gastric catAntimonium crudum. If the fever is intense, Hhus tozicoderuiron ia chief remedy; the severe rheumatic pains, which sometimesaccompany the eruption, require Bryonia^ the acompanying diarrhoea, Dvlcamara. If the aflection becomes obstinate, and newwheals continue to break out, or if a first attack is soon followby a second or third, the speediest possible interference with suable remedial agents is eminently proper. The selection will haveto be chiefly determined by the constitutional symptoms. If nosuch symptoms are present, and if every attack is occasioned bythe most trifling changes of temperature, without fever or anyother derangement, Urtica urens is a very excellent remedy. Thisremedy is likewise appropriate in cases of urticaria complicatedwith renal and urinary difliculties. In the case of children, Calcarbonica is suitable for urticaria without any constitutional sytoms. Of the Balsamum copaivce, which is recommended by manyphysicians, we have no special indications, and should, therefoinot use it until Urtica urens had been tried in vain. If the urticaria breaks out with the menses, Pulsatilla may be given if themenses are scanty, Belladonna if they are profuse. If a chronicuterine catarrh is the cause of the eruption. Apis is an excellenremedy, which may be associated with Lycopodium. It is not necessary to mention more remedies for such a trifling aflection, thdifferent combinations of which it is, after all, inexpedient toout. [We have almost always succeeded in controlling our casesof urticaria with Aconite and Ipecacv/inha. H.]In habitual urticaria the diet plays an important part. In thefirst place, if the skin is excessively irritable, we have to aimhardening it ; this object is more easily reached by vaporby cold bathing and cold ablutions. In the next place the dietitself has to consist of simple articles ; fat, spirits, acrid anulating spices have to be avoided.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 397 of 653Miliaria. 4695. Hlllarla.Has/uMiliaria is mostly a secondary, symptomatic affection; as aprimary and more particularly as an epidemic disease it is a rareoccurrence among us. Symptomatic miliaria may break out duringthe course of all kinds of severe acute diseases.Primary, epidemic miliaria runs its course after the fashion ofall other acute exanthemata. The eruption is preceded for one tothree days by febrile symptoms characterized by the presence ofrheumatoid pains in the limbs, frequently shifting from one localto another; excessive perspiration, great anxiety and oppression,and finally by peculiar prickling, burning pains in the skin. Aftwainis small vesicles break out, first on the neck and subsequenton most other pans of the body ; they are of the size of milletseeds or lentils, are seated upon a red base, and at times are fiwith a clear, at other times with a dim fluid. — Miliaria rubra aalba. — These vesicles generally spread in clusters. — The violensymptoms of constitutional disturbance disappear with the breaking out of the vesicles which separate in bran-shaped scales withfive to seven days. Inasmuch as the same period of time is requirfor every new crop, the duration of the disorder may be protracteto a fortnight and longer. The usual termination is recovery, except in epidemic miliaria where the disease sometimes assumes amalignant type and frequently results fatally.Symptomatic miliaria is regarded by some as a symptom of thehighest import, whereas others view it as resulting from the actiof certain external influences, and not deserving any special atttion. We are decidedly inclined to share this opinion. Symptomatic miliaria generally attacks individuals who perspire a greatfrom excessive covering, as in the case of lying-in women, rheumauatients, likewise in cases of measles and scarlatina if mismanagin the old fashion, and in other febrile or even non-febrile affeExcept in acute rheumatism, we shall always find that miliaria iscaused by excessive external heat. This circumstance will easilyaccount for the symptoms preceding the eruption, such as restlessness, anxiety, dyspnoea, even delirium; the bad management stillrendered worse by the anxiety caused by the appearance of theexanthem, ex[>lains why miliaria may give the disease a bad tarn.That our explanation is founded, is evident from the fact thatmiliaria is scarcely ever seen in hospitals, but is a very commonoccurrence in private practice, and that it never breaks out on470 Diseases of the Skin.patients who are constantly kept in a mean temperature under amoderate amount of covering.In view of the frequently dangerous character of primary miliaria, medical treatment in all such cases is indispensable; the rhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 398 of 653occurrence of the disease has not yet, however, afforded sufficieopportunities of positively determining the remedies that are inspecific curative adaptation to it. The most suitable remedy whiccorresponds with the whole course of this pathological process, iAconitum, more particularly if the eruption is not so much accompanied by anxiety as by great nervous excitement. If there ismuch anxiety and restlessness and a burning feverish heat, Arsenicum is the remedy ; if the patient is lying in a listless conditwith typhoid symptoms, Bryonia is best suitable. Mercurius maylikewise deserve attention in this disease, and if the patient pespires to excess, Sambucus.Regarding the propriety of instituting a treatment for symptomatic miliaria, it is our opinion that it is unnecessary arid thatefforts to prevent the appearance of miliaria by medicinal agentsare of very doubtful utility. Moreover, the selection of a remedyin all acute diseases depends rather upon the more important symptoms of the disease than upon the appearance of the vesicles.Nevertheless, in order not to slight the views of our Colleagues,mention the remedies recommended by Hartmann for this exanthem : Ipecacuanha (for the precursory symptoms in diseases wherethe miliaria may be expected to break out); Bryonia (under similacircumstances) ; Arsenicum (for restlessness and anxiety) ; Aconi(for violent rush of blood); Belladonna (for accompanying congestive symptoms of the brain); Coffea^ Chainomillay Valeriana.Hartmann further remarks: "Chronic miliary eruptions whichpartially disappear in one spot in order to reappear sowewhere eland cause a good deal of itching and burning^, are most safely anreliably removed by such antipsoric remedies as Mezereum^ ClemaUSSarsaparilla^ Staphysagria^ Arsenicum^ Ammonium carb.^ Sulphur ^and Carbo vegetabilis.^^6. Pityriasis.Dandruffs DandriffThis exanthem consists m an exfoliation of the skin either in thiscales, or in larger patches : it may be unaccompanied by any othcutaneous symptoms and the exfoliating skin ma^ to all appearPityriasis, Dandruff, DandriC 471ances be perfectly sound ; or else, the process may be accompanieby trifling local or more extensive symptoms of hypersemia of thecutis. According as the skin is unchanged or looks red under thescales, the attection is designated as pityriasis simplex or rubrThe causes of this affection are very obscure; in some cases thedisease can be traced with some certainty to a derangement of thefunctions of the liver and of the female sexual organs.Pityriasis rubra, when spread over more extensive portions of theskin, not unfrequently sets in with slight febrile motions whichmay break out at every renewed appearance of the exanthem.On portions of the skin, which itch and burn very fiercely, largespots of indefinite and irregular shapes make their appearance.Accompanied by a peculiar feeling of tension, the cuticle on thesspots very soon begins to exfoliate. The eruption first manifestshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 399 of 653itself on the trunk, and only invades the face if exceedingly sevThe almost inevitable itching may cause a moisture to ooze from totherwise dry spots on the skin. This itching which is absolutelyagonizing, very commonly interferes with sleep. The aflection isvery obstinate, but at the same time one of the rarer forms ofcutaneous diseases.Pityriasis, confined to isolated spots, is muqh less frequently othe character rubra than a general pityriasis ; it is most commonmet with on the hairy scalp, in the palms of the hands, on the soof the feet, and in the face. The itching is much less distressinbut is still very violent on the hairy scalp. By scratching the suntil it tears, a moisture is secreted from the irritated spot, ring in the formation of superficial scurfs and crusts and agglutition of the hairs.In treating a case of general pityriasis, we must not forget thatwe are dealing with a very chronic affection which never promisesrapid success, and where it would be consequently improper eitherto make a frequent change of medicines, or to repeat the dose toooften. The most important remedies are Graphites and Arsenicum^with which it is most likely that a cure can be best effected. Thgood eftects of Lycopodium are questionable, and Sulphur^ in spitof its symptomatic similarity, scarcely ever acts with sufficientpersistence.In partial pityriasis we never depend upon Arsenicum, whereasin pityriasis capitis Graphites renders excellent service. Besidetheoe remedies we may compare the following : Sepia^ Thuya^ Catcarea carb.

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 400 of 653the further progress of the exanthem, this ring^opens, losing itsroundness — psoriasis gyrata — and finally disappearing altogetheAll these stages, or most of them, coexist side by side in almostevery case of this disease. Psoriasis is not attended with itchinor at most only at the commencement, ^ut in no case if it hasbecome an inveterate disease. It may remain stationary, thoughbreaking out in new places, or it may intermit in its manifestatifor months and even years.Treatment. In selecting our remedies, we must not overlookthe fact that psoriasis is not an itching eruption. This seems tohave been ignored by many practitioners; Hartmann's delineationof the disease is especially untrue to Nature. The selection ofremedies is rendered particularly difficult by the circumstance tthe patient enjoys perfect health, and that on this account we arwithout any co-determining symptoms. It is wrong and unscientificto try to get symptoms out of a patient by persistent questioningand to hunt them up even among his ancestors in order to realizeour dreams about reliable remedies. For this reason we contentourselves with giving merely the names of the remedies that haveIchthyosis. 473already been employed in this disease with some advantage, or thamay seem $ulapted to further trials. We arrange the series inaccordance with the practical value of each drug : Sulphur^ PhospkoruSj Sejpia^ Petroleum^ Calcarea carbonica^ Acidum nitricum anpkosphoricumy Arsenicum and TellurixinuAmong external remedies the only application which is neverhurtful and usually efficient, is the vapor-bath accompanied by ftions with castile soap, or, if the affection has already existedlong time, with brown soap. Cold bathing is of decided use,although its effect may not be perceived immediately.8. Ichthyosis*Fish-skin^ Porcupine Disease.According to Hebra, ichthyosis is an hereditary or, at any rate,congenital disease, never acquired ; where acquired ichthyosis isspoken of, the eruption has beeji mistaken for psoriasis or someother cutaneous disorder. It occurs most frequently among males,so that even in its hereditary descent the disease is confined tomale branch of the family, leaving the female branch intact.Ichthyosis is characterized by an hypertrophied condition of thepapillee of the skin, with excessive development of the epidermisthe function of the sebaceous follicles seems to be entirely extiThis disease does not show itself plainly until after the first yof infancy unless the children are frequently and carefully washeUntil then the patients only show a remarkably harsh and tough,dry skin which often has a deep-yellowish tinge. The scales neverform in the face, nor on the flexor-surface of the joints or on tscrotum ; they form most copiously on the extensor surface of thearms, thighs and legs, and on the knee. In this affection the skiis not infiltrated ; where the scales are seated, the skin has acolor. In the lesser grades of the disease the scales are thinlyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 401 of 653tered over the skin ; in the higher grades they form a thick, horcovering exhibiting cracks and furrows in all directions and, onaccount of the dirt which adheres to them, having a dingycolor. Scales that fall off, or are picked off with the fingers,constantly replaced by new ones.The disease is considered incurable ; it does not endanger life.Tr^atmentm We are not acquainted with a single case of cureof this disease by means of homoeopathic remedies ; nor have weever had an opportunity, in our own practice, of trying the effec474 Diseases of the Skin.of homcEopathic treatment. In our part of the country the diseaseis of very rare occurrence. If we had a case to treat, we shouldin the first place depend upon Silicec^^ Sulphury Calcarea carbonand Lvcopodiurn ; and in the next place upon Arsenicum^ Aurumand Petroleum. Knowing that cleanliness and attention to the skingenerally can keep the disease at a very low stage of developmentwe urgently recommend the daily use of warm baths and frictionswith castile soap, likewise vapor-baths. K we desire a speedy removal of the scales, we have to rub the affected portions of theskin with oil a few hours before bathing.9. Uehen, StroplmliiB.Tooth-rash.This exaiithem appears in three distinct forms, as strophulus,lichen simplex and agrius.Strophulus is in reality nothing else than lichen simplex in thefirst period of dentition. It is caused by a continued irritationthe skin, or is a consequence of bad nutrition, catarrhal irritatof the intestinal canal, or else it seems to be exclusively occasby the process of dentition. Beside the derangements which suchcauses necessarily occasion, the appearance of this eruption seemvery seldom preceded by fever and restlessness. On one or moreplaces, sometimes only in the face, and at times over the wholebody, scattered papulse or pimples break out which either have areddish or else a natural color like the rest of the skin. If thechildren are sufficiently advanced in age, they show by their manner that the papulse itch, especially in the bed. A single papuleheals in three to four days, but successive crops of papuise areto occur, protracting the whole process for weeks.Lichen simplex arises from similar causes as strophulus ; it maylikewise be occasioned by a high degree of temperature and occursin every age. Its appearance is very seldom preceded by distinctfever. The papulae come out unperceived, mostly in the face, havethe same color as the skin or look a little redder; they generallform clusters and itch pretty severely ; the destruction of theirby scratching gives rise to very small scurfs. Single papulee disappear within ten to twelve days ; this form of lichen may likewibe protracted by successive croi)S for months, so that the originacute disorder may assume a very obstinate, chronic form.Lichen agrius often represents a higher degree of the former, buthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 402 of 653Lichen, Strophulus. 475it may likewise break out as a primary disease. Its appearance isalways preceded by febrile symptoms which sometimes do not entirely and speedily disappear even after the eruption is fairly oThe pimples are surrounded by a red halo and cause a burningpain. The unavoidable scratching not only increases the cutaneoushyperfemia, but likewise changes the eruption to that of eczema.The pimples sometimes, though seldom, scale off already in tendays to a fortnight, and without leaving any alterations. Newcrops of pimples generally break out in rapid succession, in consequence of which the skin becomes infiltrated to such a degreethat even long after the disappearance of the pimples the skinremains hard and callous, and even chappy. Lichen agrius constitutes one of the more obstinate exanthems ; if the whole body iscovered with it, the eruption may even involve danger to life. Insuch a case the patient emaciates very rapidly and a generalcachexia is the consequence.Treatment. Strophulus, if unaccompanied by other derangements, does not require any special treatment; the most that isrequired is that every attention should be paid to cleanliness anto the clothing of the children. If it sets in as a consequence oother morbid conditions, the medicines administered for the lattewill likewise remove the strophulus.Nor is lichen simplex, when it first breaks out, of sufficient cosequence to require medical treatment. If it is spread over a considerable portion of the skin, and the itching is intolerable, Stagria or Mercurius may be given. If it increases to lichen agriusor becomes chronic, the medicines indicated for this form of lichwill have to be used. [Aconite is an admirable remedy to controlthe hypenemia of the skin and to afford material aid in removingthis distressing eruption. H.]In a case of lichen agrius Mercurius is most appropriate to theparoxysms of acute exacerbation [also Aconite^ H.], and next to iRhus tozicod. and Staphysagria. Coccvlus is likewise recommended.To eradicate the disease, other remedies are required, such as :Graphites^ Lycopodium^ Arsenicum^ Sulphur^ also AzYn addum orConium; the selection of a particular drug depends a good dealupon its homoeopathicity to the accompanying constitutional symptoms. External applications, even baths when indulged in toofreely, most generally prove injurious.476 Diseases of the Skin.10. Prarlfco.According to Hebra, genuine prurigo is only met with amongthe lower classes; it never shows itself previous to the secondperiod of dentition, and gradually disappears again after the fifyear. Sex does not exert any modifying influence over the diseaseBad nourishment and want of attention to cleanliness and the condition of the skin generally, are the main causes of the disorderhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 403 of 653The first symptom of prurigo is a violent itching as from thesting of an insect ; at the itching place a small induration is safter perceived, which rapidly rises above the skin in the shapea papula. The color is the same as that of the adjoining cuticle.If pricked, this pimple discharges a small quantity of a clear flNew pimples keep constantly breaking out, whereas the formerones, owing to the scratching, impart a changed appearance to theskin. The top of the pimple or papule being lacerated by thescratching, a small quantity of blood oozes out, which dries up othe pimple and forms a small dark scurf, a number of which maybe seen on the skin of persons afflicted with prurigo. As the dislasts longer, the papulre and crusts increase in size, and not unquently the eftused fluid suppurates, causing pustules which formlarger crusts and, by running into one another, undermine portionof the skin, and give rise to lymphangioitis and swelling of thelymphatic glands. In this manner prurigo assumes an exceedinglyvariegated appearance. If the scurfs and crusts fall off, they lecolored marks which, by their number, impart a spotted appearanceto the skin. At the same time the skin usually becomes hypertrophied, especially in the folds of the larger joints. The lesser gwhich occur among young persons, are generally confined to thelower extremities, and are designated as prurigo mitis; the morefully developed form as prurigo fomiicans. The disease remits inthe summer or fall ; in the winter and spring it generally reacheits acme.The consequences to the general organism are less severe than theconstant and distressing itching, which is worse in bed, would leone to suppose. Nutrition is not perceptibly impaired. On theother hand, it not unfrequently happens that the disease becomesintolerable as to drive persons to suicide. The higher grades ofdisease have a peculiar disposition to rapid eftusions of serum,especially into the pleural cavity and the meningse ; in this waymany patients fall victims to the disease, or become mentally dePrurigo. 477ranged. According to Ilebra, these not unfreqnent terminal aftections of prurigo represent the itch-metastases of the ancients, athere is no denying the fact that this view has great probabilitiin its favor. Patients afflicted with prurigo most commonly die otuberculosis, which might likewise suggest the idea of metastasisinasmuch as with the increase of phthisis the itching disappearscompletely. The disease is never contagious.As regards diagnosis, prurigo is distinguished from scabies, withwhich it is most easily confounded, by the circumstance that inprurigo most of the efflorescences and scratched places are foundlocalities where they are either wanting, or else very sparse inscabies, namely on the extensor surfaces of the extremities, moreparticularly on the leg and back.What is otherwise called prurigo, such as prurigo senilis, prurigpedicularis, etc., has nothing in common with true prurigo excepta very violent itching.In regard to prognosis, Ilebra considers the affection altogetherhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 404 of 653incurable; nevertheless by timely and uninterrupted managementit is possible to maintain the disease in the form of prurigo mitand thus to avert its worst consequences.Treatment. We are not acquainted with a single case ofprurigo that has been cured by homoeopathic treatment; however,we do not mean to assert that such a cure is impossible, or thathas not already been achieved. Ilebra is the first who has givenreliable and accurately defined diagnosis of prurigo. Physicianshaving formerly been entirely unacquainted with the genuinecharacteristics of this disease, it was very easily confounded. wscabies. Owing to the great rarity of the disease, it will be a ltime before we have a comparatively sufficient number of curesrecorded in our published writings. Among the remedies for thisdisease we have to rely solely upon such antipsorics as will meetdyscrasic and exceedingly chronic character of the disease; wename: Sulphur^ Sepia^ Arsenicum^ Calcarea carbonica^ Fluwhum. Afew other remedies may be required for acute exacerbations andcomplications which arise in the course of prurigo more frequentlthan in that of any other exanthem. The vapor-bath and frictionswith brown soap should never be omitted ; by such means the skinis properly cared for, and the relief to the patient is speedy anlasts a pretty long time.In conclusion we request every practitioner who has treatedprurigo with success, to publish his cases, not omitting a specif478 Diseases of the Skin.well as differential diagnosis of each case. We have already showin previous chapters that a careful examination of prurigo is calculated to annihilate the whole theory of psora and the itchtases, and it is time that this stain should be removed from theescutcheon of Homoeopathy.11. Acne.Stone-pock.Acne is situated in the sebaceous follicles of the skin ; it depeupon the quality of the sebaceous secretion, and is not, or at levery seldom, determined by the narrowness or closure of the excretory duct. If the sebum secreted by the follicle is too thick, itnaturally reaches the surface with more difficulty, solidifies nethe external opening, and closes the follicle by means of a plugwhich has generally a black color. These blackish points are callcomedones, or acne punctata. In certain circumstances the diseasemay not progress any further; on some portions of the skin, as foinstance on the nose, this condition becomes habitual. Under othecircumstances that will be stated below, the glands thus closed sa disposition to become inflamed. That this ip not alone owing tothe pressure of the sebum upon the follicular walls, is shown bycircumstance that in persons of a more advanced age the comedonesscarcely ever inflame, or that they enlarge to the size of smallbursse without any symptom of inflammation whatsoever. The inflamed follicle either changes to a small pustule, discharges andsometimes forms small scurfs, or else the inflammation does notterminate in suppuration, the follicle retains for a time the shahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 405 of 653of an indurated, somewhat painful and red papule, and graduallythe exudation is reabsorbed. If the inflammation is severe, if thirritation is increased by the pressure and friction of the cloththe subcutaneous cellular tissue becomes involved, giving rise tofuruncle of a larger or smaller size. These different changes orprocesses come under the designation of acne simplex. This formof acne appears principally in the face and on the neck, on theback, buttocks, thighs, less frequently on the chest, sometimes othe skin of the penis and scrotum. No other consequences areinvolved in this affection, except that the places of the acneremain red for some time. Considering that a number of folliclessometimes become diseased while others are at the same time infull bloom, the face must become considerably disfigured.Acne scarcely ever makes its appearance except between the ageAcne. 479of piibe|pence and tbe twenty-fifth or thirtieth year. After thisperiod, a few single follicles may become inflamed, but not a whonumber together. Males are more subject to acne than females.All the circumstances connected with this eruption show that acnehas its essential origin in the sexual sphere. In corroboration othis statement we will allude to the circumstance that on manyladies a few acne-pustules break out during the menses, and thatalmost every individual who is addicted to onanism, is afflictedan excessive breaking out of acne. We do not mean to say thatacne only breaks out in the faces of onanists. Among the youngpeople of the city acne seems to be general, whereas among countryouths it is comparatively a rare disease. If a predisposition exacne may be developed under the operation of a variety of causes,such as overheating, washing a heated skin with cold water, partaking of boiled and roasted or fried fat, more particularly theof geese ; indigestion, the excessive use of wine or spirits. Amous, for instance, acne prevails in the winter-season, because sopork or gooseflesh is eaten in winter; jews are likewise troubledwith acne, for the reason that they replace the fat of swine bygdose-fat, and for the additional reason that they are generallyof very fat eating.It follows from these remarks that the first thing to be donewhen treating a case of acne is to prescribe a careful and appropriate diet. This task, however, is very difficult of accomplishmfor the reason that acne-patients generally enjoy the sensation operfect health, and that a rigid diet, if only persisted in for atime, effiscts very little improvement in the disease. The next pis to see to a proper management of the skin generally. Cold bathing and washing is of no use ; on the contrary, the trouble seemsto get worse in consequence. For acne on the trunk, frictions witsoap and the use of the flesh-brush in a vapor-bath are the bestremedy; for acne in the face the following proceeding is betterthan all cosmetics : Every morning, or, if the patient has to leahis home early in the morning, then every evening, the face shoulbe gently rubbed for a few minutes with a soft piece of flannelmoistened with warm water and greased over with soap, afterwhich it is washed with warm water, and subsequently again withwater that is almost cold. The best soap for such a purpose is thso-called Venetian soap made of vegetable fats. By means of thesehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 406 of 653washings the disorder is reduced to its minimum proportions. Theformation of pustules is, moreover, best prevented by the comedon480 Diseases of the Skin.being squeezed ont. The nails must not be used for such^n operation, but a small watch-key, the opening of which must neither betoo narrow nor angular, is placed upon the spot so that the blackpoint of the comedo is exactly encompassed by the opening of thekey which is firmly and vertically pressed upon the skin. This habetter be done previous to washing. By resorting to such simpleproceedings, the face can be kept tolerably clean.A treatment of acne with internal remedies is undoubtedly possible, but likewise superfluous in most cases. In very bad caseshave derived very satisfactory results from Arsenic, but a cure hnever been achieved. Hartmann and others likewise recommend :Cantharides^ Sulphury Staphysagria^ Antim. cruduniy Dulcamara^MezereuMy Natrum muriaticum^ Acidum nitricum^ Capsicum^ Sepia^etc. In our opinion, however, internal remedies need not be resorted to as long as a non-medicinal external management willaccomplish all that can be desired.12. Sycosis, Hentaii^ra.Barber^a Itch*Tills is exclusively a disease of the male sex, and occurs aboutthe age of twenty-four or twenty-five years, when the hair of thebeard, grows thick and hard. If persons who do not shave areattacked by it, which is a very rare occurrence, its causes are vobscure. In cases where the beard is shaved, the eruption may becaused by bad or irritating soap or by a dull razor, and, althouggenerally so frightfully obstinate, yet may, under such circumstances, heal spontaneously even without much loss of time ; allthat nead be done is to omit shaving the afiEected parts. Dirt ansnufiT likewise seem to occasion sycosis.The disease generally sets in, like herpes labialis, with a sensaof burning, heat and tension ; most commonly we first notice oathe chin a small cluster of isolated, red tubercles of a pretty lsize, ea^h of which is perforated by a hair. Some of these tubercin a few days change to pustules, break and form dark crusts, witout the infiltration which forms the little tubercle, disappearinthat account. In spite of all care, and generally in consequencecontinued irritation, the number of tubercles increases slowly buuninterruptedly, the former ones growing larger; the skin uponwhich they are seated, becomes more and more infiltrated ; afterbreaking, the pustules change to ulcers ; deep, ulcerated rhagadeand finally bullions infiltrations of a pale-red color are perceiSycosis, Mentagra. 481The patients do not complain of much pain, but their ugly appearance fills them with anxiety. The disease is extremely obstinateand may last for years. It is true that it not unirequently abatehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 407 of 653in severity, and at times even disappears altogether ; but it breout again with renewed fierceness, and in such a case in more thaone spot simultaneously. Its first appearance is almost always onthe chin ; it is here that the disorder exists most commonly in ifiercest intensity, but it likewise invades every other bearded ption of the face, and in severe cases even the eyebrows.Treatment, Although sycosis, when it first breaks out, sometimes heals spontaneously, yet a spontaneous cure, after the disehas existed for some time, is a rare event, and the higher gradesof the disease obstinately resist every attempt to cure it. Howevwe have seen cases where a mentagra of many years' standing per*manently disappeared after an attack of typhus.In treating this affection, success depends upon commencing thetreatment as early as practicable. The first and most importantmeasure is to investigate and remove the cause of the disease. Wewould not advise the use of internal remedies until we are satisfafter having pursued this course for a short time, that it leadsno satisfactory result; otherwise we might easily be deceli?ed regarding the eifect of our remedies. We have cured three cases ofthis disease permanently and radically with Graphites 4th and 6thtrituration ; two of these cases had lasted for several years, antwo of these patients, moreover, never shaved. This statementshows that Graphites deserves our attention in sycosis. Acidumnitrieum is another remedy that is often very useful ; its symptobear the greatest resemblance to this disease. However, we oughtto state that we have never achieved a cure with this remedy alonalthough the cases improved considerably under its influence. Wemake the same remark of Aurum muriaticuyn. Siliceaj Oleander^Carbo animalis^ and a few other remedies, are indicated by thesymptoms, but we have no clinical evidence to adduce in theirfkvor. Hartmann mentions a few other remedies; but it is evident,from a perusal of his description of sycosis, that he classes undthis denomination all sorts of heterogeneous eruptions.We must not omit to mention a few external remedies that maybe of great use. In recent cases of mentagra it is undoubtedly ofuse to pull out the single hairs that perforate the tubercles. Thbeing a painful proceeding, it must be carried out gradually. However, it IB of very little, if any, use if the whole cutis is hyj31482 Diseases of the Skin.trophied and infiltrated. Among the caustics Acidum nitricumoccupies the first rank, probably because it is eminently homoeopathic to the disease. Aurum muriaticum is likewise a good caustiin some cases. Hebra advises to pull out the hairs before cauteriing; this proceeding undoubtedly increases the effectiveness, butlikewise the painfulness of the cauterizing process. Hebra's modeof treating this disease deserves being mentioned so much more ashe professes having cured every case by means of it. First thehairs are pulled out, and afterwards a paste of Sulphur, Glycerinand Alcohol is rubbed upon the diseased skin every morning andevening. A cure is very rapidly effected. Sulphur is the onlymedicinal ingredient in this case. "We shall revert to the externhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 408 of 653application of Sulphur in the next chapter. All other externalapplications of corrosive substances, except Nitric acid^ are uttcondemned by Hebra.18. Aene RoAacea, Gntta Hosaeea.Copper-nosey Bottle-nose.Acne rosacea is an exanthem consisting of tubercles with somedisposition to suppurate, suppurating tubercles; and, moreover, ocontinual venous hyper»mia.It almost always commences at the tip of the nose, whence itspreads over the dorsum of the nose and over both cheeks, finallyover the forehead and the rest of the face. First we notice an erthematous spot of small extent, painless, and distinctly traverseby dilated cutaneous veins. Upon this erythematous base singletubercles start up, which sometimes suppurate at an early period,but likewise spread in size after the pus is discharged. New tubecles keep constantly forming, new erythematous spots keep constantly breaking out, the skin becomes more and more hypertrophiethe veins become more and more varicose, the isolated little blotchange to large tubercles, cracks and deep rhagades, and even ulcmake their appearance, and the face looks very much disfigured inconsequence of this extreme development of the nasal exanthem.At first the affection has remissions, but the dark redness neverdisappears entirely ; at a later period the disorder keeps growinthe time.Abuse of wine and spirits is the cause of the disease in by farthe larger number of cases ; but it likewise breaks out on indiviuals of very moderate habits and where the disease cannot be tracLupus. 488to any apparent cause. Among women the disease is of rare occurrence and most generally associated with menstrual anomalies. Thedisease is not often seen previous to the twenty-fifth year ; itafrequent occurrence is after the fortieth. Overheating the systemand immoderate drinking are very apt to cause a renewed outbreakof the disease. It is exceedingly obstinate and, in its higher gris considered incurable.Hartmann recommends the following remedies for this disease :Carbo animaliSj Kali carbonicum^ Arsenicum^ Veratrum alburn^ Cannabis^ Acidum nitricxvm and phosphoricumj Tlmya^ Phosphorus^ Eurphrasiaj Silicea^ Ledum^ Huta^ Aurum^ Kreosotum^ Sepia^ Petrdeum^Plumbum^ Sulphur^ Acidum sidphuricunij Capsicum^ Clematis^ Psoricum. We cannot be blamed for not attaching any sort of importance to so many remedies for a morbid condition that is socharacteristically marked by definite and unvarying symptoms,and so little involves the general health. Among the abovetioned remedies, Carbo animaliSj Arsenicum^ Acidum niticicumj Aurrumj Sepia and Sulphur are the only ones that promise partialsuccess in the treatment of this disease; Carbo animalis and Arseicum in the case of drunkards, and Sepia in the case of females.The treatment is always protracted and the results uncertain orimperfect, for the redness most generally remains. More recentlyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 409 of 653we have witnessed a marked improvement after the followingtreatment : We mix two drachms of the washed flowers of Sulphurwith two ounces of distilled water, and after vigorously shakingthis mixture, we cause a linen rag to be dipped into it and haveaffected parts of the face moistened with this rag every eveningbefore bed-time, allowing the liquid to dry upon the skin, whichwashed clean again in the morning. By means of this simple proceeding the tubercles are made to disappear in a surprisingly quiperiod of time, and the redness likewise becomes less intense. Thsuccess of this proceeding never fails, and this instance again swhat an excellent effect the external application of a specific redy will sometimes have, whereas the internal use of this samespecific would either have no eflect whatever, or else develop itcurative results in a very tardy manner.Wdf^ Jacob's Ulcer.Lupus is ]>reeminently a disease of the lower classes; it occursmore frequently in some parts of the country than in others, but484 Diseases oi the Skin.attacks individuals indiscriminately any where, without distinctiof sex. Lupus has not yet been known to occur previous to thetenth and after the fortieth year; it is most frequently seen betthe tenth and twentieth years of age. It is said to result fromBcrofulosis and congenital syphilis ; this, however, is problematthe more so since lupus likewise attacks persons of sound healthand vigorous constitutions. It is never infectious.In describing this disease we will distinguish four differentforms, namely : Lupus exedens, hypertrophicus, exfolians and nonexedens.Lupus exedens commences with the formation of a few, rarelyof a number of dark-red or brownish spots, or of dark, smallpapules resembling acne and seated upon a cuticle rendered smoothby infiltration. The spots slowly enlarge in size, the papules neincrease rapidly in number; some even, which are situated in thecentre of the affected spot, disappear, but are immediately replaagain by new ones starting up at the circumference. The epidermison the affected spot continually exfoliates in small scales. Aftethe papules have lasted for an indefinite length of time, and whithe cutaneous hypereamia and infiltration are increasing, the topof the. papules ulcerate and become covered with scurfs which areconstantly growing in size and thickness and hide somewhatfunnel-shaped ulcers that gradually unite in one and destroy theskin over a large extent of surface. The healing of the sore alwacommences in the centre, while the ulcerative process is beingrenewed at the periphery; this constitutes the lupus serpiginosusLupus exedens is chiefly located in the face, but nc^ unfrequentlspreads to the neck and ears^ and may likewise break out on otherparts of the body. If the lupus is situated on the nose, it notxmfrequently happens that the ulceration destroys the integumentscartilages, and even bones. This seems to be a particular form oflupus that sometimes commences on the mucous membrane of thenose. Lupus exedens is the. most frequently occurring form oflupus.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 410 of 653Lupus hypertrophieus .likewise breaks out more especially in theface; the papules increase to the size of large tubercles and thesubcutaneous cellular tissue becomes strikingly hypertrophied, absorbing the tubercles in such a manner as to give rise to a prominent, deep-red elevation of the skin, which is soft to the feel awhos^ periphery new papules keep constantly forming, some ofwliidi Buppurate but never to any^ considerable extenu After aLupus« 485time a retracted cicatrix may be seen, traversing the diseased suface. Gradually the affection may invade the larger portion of thface, the ears, and may even spread below the chin; it is mostcommonly associated with considerable eversion of the lids.Lupus exfolians, which Hebra is unwilling to regard as a formof lupus, begins, like the former species, with a dark-red, superficially infiltrated spot upon which very flat or no papules areseated, and where the epidermis is constantly passing through aprocess of exfoliation. This spot never heals spontaneously, neitdoes it increase in size, the only alteration it exhibits, is a mmarked paleness of the skin. It is more particularly seen amongfemales, is easily confounded with neevus, from which it may bedistinguished by the circumstance that this form of lupus does nobreak out until persons have reached an advanced age, whereasnsevus is a congenital affection.Lupus non exedens commences like lupus exedens, except thatthe papules and tubercles do not ulcerate, but become dissolved aare reabsorbed, leaving a retracted cicatrix with atrophy of theskin at the affected spot, which looks like the scar from a burn.The different forms of lupus are exceedingly chronic; it is a rarevent for lupus exedens to pass through its stage of ulcerationrapidly and as it were subcutaneously. The disease is not painfulnor does it impair the general health ; but it may easily bring oa very severe attack of conjunctivitis and by this means endangerthe visual power.Treatment* In view of the great obstinacy of this affection,the first requisite towards a successful treatment, both on the pof the physician as well as the sick, is a good supply of patiencorder to give the remedies a fair chance to develop and exhausttheir full effect. As far as particular remedies are concerned, ware still without a sufficient number of clinical cases to enableto point to certain remedies as specifically adapted to lupus ; owhich account it is extremely desirable that every case of lupusshould be made public in our Journals. Lycopodium is efficient inlupus exedens, if the disease has not yet existed too long, if thulceration does not penetrate too far into the tissues, and if thorder attacks feeble individuals of a sallow complexion. In lupusexedens as in acne rosacea, both of which conditions have a greatdeal in common. Graphites is one of the most important remedies;Graphites is particularly suitable for nasal lupus with deepulceration. Next to Graphites we recommend Aurumy more partiohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 411 of 653486 Diseases of the Skin.ularly Aurum muriaticum. This remedy has sometimes a sui*prisiDgeflfect; it is indicated if the lupus starts from the Schneideriamembrane, or if it spreads from the skin, gradually invading theSchneiderian membrane, the bones and cartilages. In such casesAcidum nitricum or Sepia are likewise suitable. Calcarea carbonicis adapted to lupus in the case of scrofulous individuals.For lupus hypertrophicus at an advanced stage all remedies proveineffectual. At the commencement of this disorder we may recommend Coniumj Baryta^ Graphites and Sulphur*Lupus exfolians is no less obstinate than the previous variety,and it is very difficult to pick out suitable remedies for this din our Materia Medica. We may try Arsenicum^ next to whichSulphur J Phosphorus^ Kali bichrom.^ and perhaps Thuya.Lupus non-exedens does not require any other remedies thanlupus exedens.Other remedies for lupus are : lodium^ Carbo animalis and vegetabiliSy Silicea^ Alumina.The usefulness of external applications is sometimes evident,but not unfrequently questionable ; cauterization sometimes doesgreat amount of injury. In a case of lupus hypertrophicus, cauterization is especially a proceeding of doubtful propriety; likecarcinoma, it usually grows so much more rapidly afterwards. Ifcauterization is insisted upon, it should be done with the pointeextremity of a stick of the Nitrate of silver ; it is important tremember that only the little tubercles must be cauterized, not twhole of the diseased surface. All liquid caustics irritate the ifiltrated skin still more, and make the disease worse than beforeCod-liver oil in large doses has sometimes an excellent effect ;might perhaps be sufficient to improve the constitution by good asubstantial nourishment ; for cod-liver oil is only useful to patwhose assimilative system has been very much impaired.15. Herpes.Tetter.All forms of herpes are characterized by the formation of littlevesicles, clusters of which are seated upon an inflamed, red epidmis; the vesicles of one cluster breaking out simultaneously andrunning an acute course. In obedience to the habitual nomenclature as well as on account of differences in the treatment, we wiconsider the main forms each by itself.Herpes. .^'', 487a. Herpes Facialis^ Facial ^rpes. "^U,This form of herpes accompanies a large ni^mb^^r of Yebrile andchronic diseases without exerting any specially iaodVying'intluenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 412 of 653over their course; except in pneumonia where tbi§ ^^ ni 9^ herpesis said to constitute a decidedly favorable omen. -4^ atj idirf{)exanthem it seems to manifest itself when indicating the feommtennient of a catarrhal aliection, provided the catarrhsdirritati^ inot very intense. A first appearance predisposes most decidedly trelapses.Herpes facialis (also hydroa febrilis, herpes phlyctsenodes) mostgenerally breaks out on the lips, less frequently on the cheeks,bead, ears, eyelids. A tension, burning, and a marked sensationof swelling are experienced at a certain infiltrated spot, wherevesicles start up amid slight febrile motions and an unusual feelof lassitude. In the face they are always of a tolerably large sibut there are not many of them clustered together, they incline trun into one another; the cuticle of the 8iX)t where they are locdoes not show a "^ry vivid redness; sometimes they are pitted orcleft. They contain a clear liquid which soon becomes dim andchanges to a rather dark scurf that soon falls off, leaving for stime a red, somewhat infiltrated spot ; burning pains likewise refor some time.One attack does not render any treatment necessary, because itdoes not alter the course of the vesicles that are already out. Bif new crops break out in rapid succession, at definite intervalsmay be well to give Hepar sulphuris or Arsenicum in not too frequently rei)eated doses. Bryonia is an excellent remedy if eachsucceeding crop of vesicles is accompanied by fever and great lassitude. If the affection is very obstinate and inveterate. Graphimay be given for it. [^Aconite is better than any other medicine,the eruption is acute, attended with fever; by using Aconite, theinflammation is speedily subdued, and the vesicles dry up, leavinsmall scurfs that fall off in a few days. H.]b. Herpes Preputialis.This is principally located on the prepuce, although it not unfrequeutly appears on the scrotum, penis, and on the female sexualorgans. It bears a very close resemblance to herpes facialis, thesingle clusters are small, the vesicles not very numerous, and pr488 Diseases of the Skin.portionally of some size. It breaks out without any symptoms ofgeneral disturbance; its appearance is accompanied by the burningpeculiar to all forms of herpes. If the vesicles are seated on thouter skin, superficial, bright-yellow scurfs form on the fifth dif seated on the inside of the prepuce, instead of vesicles we mahave superficial ulcers which occasionally become covered with thscurfs. The causes of this afiection are unknown ; what is positively known is that syphilis does not modify the course or charaof this form of herpes ; its frequent association with balanorrhohas led this to be regarded as the cause, whereas the reverse isthat herpes is the cause of a more copious secretion of smegma.Herpes preeputialis acquires its importance from the fact that iteasily mistaken for chancre, especially by lay-persons who had beinfected with chancre previously, and are now living in constantdread of constitutional syphilis. By fixing one's attention to thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 413 of 653following points, the diagnosis becomes quite easy : herpes alwayponsists of several vesicles seated close together upon an infiltbase, in a case of chancre we scarcely ever see the primitive veswhich is moreover completely isolated. If properly guarded, herpevery soon becomes covered with a scurf, the syphilitic ulcer neveThe use of treating herpes prseputialis that is fully out, with aview of shortening its course, is very questionable ; we have thohowever, on some occasions, that this course is abbreviated, if tproper remedy is administered. The main point is to counteractthe tendency to relapses which is just as great in this form of has in that- of herpes facialis. Hepar sulphuris meets both theseindications, provided its use is continued for some time afterthe disappearance of the efflorescence. Hartmann, on the contraryrecommends the red precipitate and nitric acid. Caladium seguinumis likewise indicated, but more in the herpes pudendorum than inthe preputial herpes of males. If balanorrhoea is present, a freqand careful cleansing of the parts is of course indispensable.c. Herpes Zoster j Zona^ Shingles.This form is characterized by the development of clusters ofvesicles, of which there are generally several, along the tract oor more spinal nerves, assuming on the trunk the shape of a zoneor belt, but on the extremities breaking out in a more irregularform.The etiology of this exanthem is involved in obscurity, but everyHerpes. 489physician of extensive practice must have noticed that at certainperiods of the year several cases break out simultaneously or sooone after the other, as though epidemic influences were prevailiuZoster commences almost without exception with rheumaticpains in the parts where it is to break out, and is often attendewith great lassitude and fever. The preliminary pains are notunfrequently like inflammatory pains. At the origin of one or mornerves, in company with a violent and painful burning, an efflorecence breaks out, after which papules arise, next, clusters of vewith tendency to run into one another. These vesicles remain outfor four to six days, after which they change to flat scurfs. Butinasmuch as a new cluster may arise after the first, and these sucessive crops may continue even after the first vesicles are entihealed, the whole process may last even three weeks. It is veryseldom the case that scratching or the friction of the clothes wicause a superficial ulceration. There maybe no pain during thecontinuance of the efflorescences, except the slight burning atteing the successive breaking out of new crops of vesicles ; but thgreatest distress to the patient is the burning itching which iscially severe in bed. After the falling off of the crusts all paigone, or the peculiar itching may perhaps continue for some time,or finally — and this is not by any means a rare occurrencecostal neuralgia of a very obstinate type may set in, apparentlymore readily the less scantily the herpes was out on the skin.Treatment. Although zoster is an entirely typical form ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 414 of 653disease, and we have no certain sign whether our medicines havediminished the number of vesicles, and abbreviated their coarse,yet it is certain that intercostal neuralgia sets in much less frwhen zoster is treated with appropriate remedies, which alone isa sufficient reason why zoster should never be allowed to run itscourse without proper medicinal treatment. The remedies indicatedby Hartmann, namely: Mercurius^ HhuSj Causticum^ Graphites^Sulphur, Arsenicum^ Acidum- nitricum and Euphorbium, with theexception of Bhus and Eaphorbium do not correspond with thegeneral features of the disease. So far as Rhus is concerned, weknow positively that the remedy is usually given without anybenefit, although its symptomatic similarity would seem to recommend it, and as regards Eaphorbium^ we have no clinical evidenceof its curative influence in this disease. Mercurius sometimes seto prevent the breaking out of new clusters of vesicles. Mezereumis a remedy that renders excellent service in some respects and w490 Diseases of the Skin.we cannot recommend with sufficient warmth, since intercostalneuralgia very seldom occurs after its use. "We likewise suggestOleum croionia for experimental trials. The treatment of the subsequent neuralgia has been discussed in a former chapter.d. Herpes Iris and Circinnatus.Both these forms being essentially identical, we describe themtogether.Herpes iris consists of a larger vesicle or bulla which is not unfrequently filled with a blood-tinged liquid, and is surrounded bwreath of smaller vesicles round whose external border another anlarger wreath may form. The course is the same as that of otherherpetic vesicles. The efflorescences first appear on the dorsa othe feet or hands, spreading on the extensor-surfaces from belowupwards, and the new clusters of vesicles appearing either in thesame relative position as the vesicles of herpes generally, or elagain assuming the form of herpes iris. This form of herpes mostfrequently occurs among women and children.Herpes circinnatus which comes out in the same manner as herpesiris, is distinguished from the latter by the circumstance that tcentral bulla is missing, and that only the wreath of vesicles ispresent.Essentially both forms represent a form of herpes zoster on theextremities, so much more as they are sometimes succeeded by apeculiar pain which is not quite as severe as intercostal neuralgThis affection which is altogether of rare occurrence, scarcely erequires any other remedies than those that have been indicated fzoster*40. Eczema.Eczema is one of those exanthems that has given rise to an immense amount of confusion. In the following sketch we reproduceessentially the views and statements of Hebra who enjoys the undisputed merit of having first cleared up this pathological procehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 415 of 653The causes of eczema are either external irritants acting directlupon the skin, or else substances that affect this organ throughgeneral circulation into which they had been absorbed, or finallyconstitutional influences. Heat, for instance, causes the sobaker's itch; and heat, intense cold, salt- baths, mercurial fricCroton-oil, etc., a number of medicinal agents taken internally,food or food giving rise to an unusual deposition of fat, scrofulEczema. 491nffections of the female organs of generation, varices, and in geall kinds of stasis in the venous system, and a number of othersimilar circumstances and influences uniformly occasion eczema.Among the direct cutaneous irritants we distinguish: neglect inattending to the skin, vermin, friction by the clothes, continuedrubbing of a part, for instance between the thighs when riding onhorseback, and by continued walking.The reason why eczema has given rise to so much confusion irf,because its various modes of origination were not properly considered, and an eye was only had to the various modifications whithe appearance of an eczematous part undergoes in consequence ofthe formation of crusts or scurfs, scratching, dirt, hair of thebody, etc. The typical form of eczema is obtained by rubbingCroton-oil upon the skin. Upon a red surface a number of vesiclesor pimples shoot up which, if carefully guarded, heal in a few daleaving the affected portion of the skin injected. If the vesicleare not protected, if they are scratched or rubbed against by theclothes, the vesicles break, and crusts form, beneath which, if tirritation continues, the exudation continues likewise ; or elseexudation may be so copious that no crusts can form, in which casthe affected part always looks red and moist. If the irritation ctinues, the eczema spreads to the adjoining parts ; scratching evcommunicates it to remote parts ; beside the vesicles, pustules flikewise, the so-called eczema impetiginoides, and the original fof the exanthem is totally altered.Three modifications have been distinguished more particularly.First the eczema simplex. Upon the cuticle, having a naturalcolor, small vesicles spring up irregularly, without forming anydefinite clusters ; they gradually grow in size, break, dischargemoisture, heal by desquamation, then reappear again at the sameplace, and, favored by circumstances, pass into the following forEczema rubrum ; upon an injected and infiltrated spot, vesicles osmall pimples spring up whose tops are filled with a watery moistAfter the bursting of the vesicles, desquamation ends the processFinally eczema impetiginoides which is by far the most commonform of eczema, consisting of vesicles and pimples or papulae, soof which change to pustules ending in the formation of crusts ;hence this form is properly speaking a combination of eczema andimpetigo.According to their locality we have several strikingly characterized forms of eczema, among which we distinguish the following:http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 416 of 653492 Diseases of tbe Skin.Eczema of the face (crusta lactea, crusta Berpiginosa, porrigolarvalis, melitagra) is almost always of the impetiginoid form, imay invade the whole face at once, in which case it usually spreato the ears; or else, it may remain confined to single localitiesespecially the cheeks and chin. As a rule, the skin is seldom,and only inconsiderably, infiltrated. This form chiefly attackschildren.Eczema of the hairy scalp is likewise generally of the impetiginoid form ; it makes the hair look and feel like felt, is veryto spread a foul odor and to give rise to the formation of verminand is strikingly disposed to migrate beyond the hair, especiallythe nape of the neck. This form of eczema is more particularlymet with among adults.Eczema of the male organs breaks out on the penis in an acuteform as eczema simplex; on the scrotum, on the contrary j itdevelops itself in a very chronic form as eczema rubrum. Thelast-mentioned form causes a horrid itching, and is generally maitained by a dilatation of the cutaneous veins on the scrotum. Itis almost always confined to the scrotum, and is one of the mostobstinate cutaneous affections. It is very seldom attended with tformation of pustules, but is very apt to lead to hypertrophy ofscrotal integuments.Eczema of the legs (salt-rheum) really depends almost exclusivelyupon varicose veins, more especially upon dilatation of the smallcutaneous veins, whereas the larger vessels may continue in a perfectly normal condition. This eczema is extremely obstinate, itchmost horridly, generally exacerbates in the spring and fall and ispecies of eczema rubrum with occasional formation of pustulesand an infiltration of the skin that makes it almost look likeelephantiasis.Eczema has a peculiar tendency to attack correspondinglysituated portions of the skin, even though the morbific irritatiooriginally only acted upon one side of the body.Eczema seldom runs an acute course ; the extremely acute fonnof "eczema universale" is very rare; on the other hand, it notunfrequently commences as an acute exanthem, with slight fever,but very soon assumes a chronic character. All the difterent formof eczema itch more or less ; scratching, which it is impossibleavoid, is a main cause of the onward spread and the protractedcourse of the disease. Every kind of eczema may heal and doesheal spontaneously, provided the chief requisite towards a cure,Eczema. 498namely rest in a horizontal posture, is attended to. Eczema of thleg and scrotum is the least promising of any.Treatmentm There is no cutaneous aflTection the cause of whichis more easily discovered than that of eczema ; nor is there anycutaneous affection where the removal of the cause is more essentto the success of our treatment. How the causal indication can behttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 417 of 653satisfied in every case, is difficult to determine owing to the dsity and number of the noxious influences giving rise to the eruption. Above all, local irritants giving rise to eczema, must beremoved. In most cases eczema gets well of itself after the causeis removed; however, this is not always the case. Not unfrequently, after the exanthem has lasted for some time, the cutaneous disease acquires such a power of independent existence thata germ of inherent development has become ingrafted upon it.Eczema arising from constitutional causes, is of less frequent ocrence than any other.In the next place we have to aim at removing the cause, whichis the chief promoter of the spread of eczema, namely scratching.In some cases it is impossible to prevent scratching, not only incase of children, but likewise in that of adults; the itching isintense and the scratching may be indulged in by the patient whilhe is sleeping, when the scratching cannot always be prevented inthe long run. Under such circumstances it is a good plan to protethe hands by means of gloves or linen-bags and to remove the possibility of the nails being used; for there is no doubt that thelaceration of the exanthem with the nails may transfer the eczemato other parts of the body by a regular process of grafting. Inother cases scratching may be prevented by appropriately coveringthe eczematous part; on the leg, for instance, by applying suitabbandages, and in the case of children by covering the head with acalf s-bladder from which the mucous lining has been removed, andbeneath which the exanthem sometimes heals with wonderfulrapidity. Finally, we will name a few external applications, aftethe use of which the itching abates with more or less certainty.We ought to state that the greatest amount of irritation, whichsuperinduces the itching, proceeds from the fully-developed crustwhereas a moist eczema itches much less. Hence, the great objectis to limit the formation of crusts as much as possible, or to prtheir excessive adhesion and desiccation. This object is reachedfrequent ablutions with cold or tepid water. We are aware thatthese are dreaded by many physicians and lay people, but without494 Diseases of the Skin.any adequate cause if proper care is used. A shower-bath is stillpreferable to washing ; but the water must not have a fall of morthan two feet, nor should the temperature be below fifty to sixtydegrees. For eczema of the body tepid baths with frictions withsoap are eminently to be commended. Liquid fats are excellentmeans of softening the crusts. By moistening them with almondoil, they break up into little fragments and can be removed moreeasily. Glycerine renders the same service. We must be careful,however, not to apply the oil too often, nor too much of it, othewise it might result in the formation of pustules. Twelve to sixthours after the application of the oil the parts ought to be washwith soap. If very thick crusts are to be speedily removed, thesurest means is the use of warm cataplasms which, however, mustnot be applied too long at a time, for the reason that cataplasmsare likewise apt to lead to the development of pustules. Ointmentno matter what they are made of, can never be of any use, but aregenerally hurtful.Regarding the medicinal treatment of eczema, we find a largehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 418 of 653number of medicines indicated in the books, most of them accompanied by all sorts of the most subtle and refined indications, ware not only of no practical use, but are not even substantiatedthe symptomatic record of our Materia Medica. This subjectaftbrds us another opportunity of satisfying ourselves of the injresulting from an inappropriate and vacillating nomenclaturew^hich positively defeats all the good that could be done by theaccumulated records of clinical experience. Moreover, it is impossible to furnish reliable indications for every drug; the causatiwell as the accompanying secondary phenomena are too varied andyet claim our chief attention, for the reason that the selectionremedy that meets the cause of the eruption, is often exclusivelydetermined by an investigation and knowledge of these phenomena.Tor this reason we have confined ourselves to merely naming themedicines, accompanying some of them by practical hints, andreferring to the Materia Medica for special information, to obtaiwhich the chronic nature of the exanthem affords abundant time.In order to facilitate the search of proper remedies we have associated them with the chief forms of eczema, each according to itslocality.Eczema in the face, which chiefly attacks children, is often madeto dry up in a few days by means of Oleum crotonis^ third trituration. This remedy shows its curative action so much more cerEczema. 495tainly, the more recent the cutaneous affection; moreover, it ismost appropriate in eczema rubrum, and is so much less adaptedto the case, the more nearly the eczema assumes an impetiginoidform. If the disorder is of long standing, and hence more inveterate and more extensive, Lycopodium often acts with surprisingbenefit. Next to this remedy comes Sulphur. For crusta lacteaproper Borax is recommended; Mercurius and Lycopodium^ andlikewise Bepar sulphuris are more reliable. [I have cured the moshorrid cases of crusta lactea with Aconite and Belladonna. H.]From Vida tricolor we have never obtained the least sign of acurative effect. For eczema impetiginoides the remedies we havejust named, are likewise useful, but we have a much better selection among the following : Mercurius^ Hepar sulphuris^ Antimoniumcrudurrij Cicuta virosa^ Baryta. The last-named remedy has a specific action in cases where the eczema is accompanied by swellingof the lymphatic glands, and generally in the case of impoverishescrofulous individuals.[We once cured a baby that had been vaccinated with impurevaccine, of a horrid attack of Crusta serpiginosa^ by means of asingle pellet of Arsenicum 200. On the third day after vaccinatioa black pustule broke out on the arm, which grew very rapidly tothe size of a big potato and was filled with a foul-smelling corrichor. An ugly-looking sore formed wherever the ichor touchedthe skin. In the course of twenty-four hours the face, neck andupper arms looked like one mass of bla9ki8h, dark-brown ulcerartion. This disorganizing process spread almost visibly. The eyescould no longer be seen. The sides of the face and neck, ears andpart of the scalp were covered with this horrid crust. The motherlikewise had become infected. One pellet of Arsenicum 200 wasplaced upon the child's tongue at night. Next morning the soreshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 419 of 653had not spread any further, and those that existed were perfectlydry ; they fell off in two days, and in a week after even the traof the ulcers could no longer be seen. H.]If eczema is exclusively seated on and behind the ears, it is verobstinate; hence, the remedies must not be changed too often. Thebest remedies are: Mercurius^ lodium^ Kali bichromicum^ Baryta^Sulphur.Eczema of the hairy scalp, both when confined to the scalp andwhen the face is invaded by the exanthem, either runs its courserapidly, more especially in the ease of children, and generally ithe form of eczema impetiginoides; or else it assumes the form of496 Diseases of the Skin.eczema rubrnm, mo8t commonly in the case of adults, its course insuch a case being very chronic. For the former acute form the besremedies are: Heparsulph.^ Oleander^ Lycopodium^ Sulphur^ Staphysagria^ Mercurius (when a tendency to acute lymphadenitis prevailBaryta carbonica (when attended with a painless or, at any rate,acute inflammatory swelling of the lymphatic glands), JSorox, Clematis^ and, according to Hartmann's urgent recommendation: Dulcormara. For the obstinate eczema of adults we cannot recommend withsufficient emphasis Arsenicum and Graphites. With Arsenicum alonewe have several times removed an exceedingly humid and horridlyitching eczema in the space of six to eight weeks. Quite recentlywe have cured eczema of seventeen years' standing with Graphites^the patient being otherwise in a state of perfect health. She hadcontinue the remedy for over six months in the fourth to the sixttrituration, but even the excessively hypertrophied ears finallyresumed their normal shape. We do not mean to deny the possibleadaptation of Sulphur^ Lycopodium^ or even Pfiosphorus^ to thisdisease, but we are obliged to confess that we have never derivedthe least curative effect from either of these remedies.Children passing through the second period of dentition are oftenattacked with an eczema that is confined to the lower border of thairy scalp on the occiput, between both ears, and which, after bonce cured, is apt to break out again, and is always accompaniedby glandular swellings of considerable size. Hartmann recommendsDulcamara for this eruption ; we have used for it with perfect sucess : Hhus toxicod.j Calcarea carbonica j Oleum crotonis.Eczema on the scrotum occurs in very few cases as an acute impctiginoid eczema ; for such cases no medicine surpasses Croton ain efficacy, beside which we call attention to Caladium seguinum^Rhus toxicod, and Hepar sulphuris. In cases of chronic eczemagreat patience is required not only on the part of the physician,likewise on that of the patient; it is an exceedingly obstinate ation. The remedies to be employed in such cases are: Sulphur^ Arsenicum^ Lycopodium^ Nitri acidum^ also Graphites^ Petroleum^ Thuand AnihrakokalL A fact deserving special consideration is the vecommon co-existence of profuse hemorrhoids with this eruption;the scrotal integuments are likewise traveled by a number ofvaricose veins.Eczema between the thighs is generally cured by means of Jferhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 420 of 653curius or Lycopodium ; of course the cause has to be strictly avoDaily ablutions of the part with good soap are indispensable.Impetigo. 497Eczema on the leg is likewise very obstinate, no less so thaneczema on the scrotum ; in order to cure this disease, we have toneutralize the eff'ect of the varices by a carefully applied rollbandage. If th© eczema has the impetiginoid form, it is advisableto place the patients for a short time in a horizontal posture, aorder flax-seed poultices to the part ; at the same time Shus ioxor Carbo vegetaUlis may be given internally, and, if erysipelatouredness sets in: Mercurius. — Afterwards the chief remedy is Siaphysagria which is often sufficient to eradicate the disease; welikewise call attention to Graphites^ Sulphury Lycopodium,Beside the above-mentioned remedies the following are likewisemore or less homoeopathic to eczema : Kreasoturriy Aurum muriaticJSarsaparillaj Sepia^ Siliceay Alumina^ ConiumjRanunculucsocleratalso Tartarus stibiatus.17. Impetigo.By this term we designate the breaking out of small pustules onthe skin, either scattered or in clusters.This afiection is traceable to the same causes that have beenpointed out as causes of eczema ; indeed, both these exanthemsgenerally appear associated. Besides this, however, impetigo isgenerally the expression of a constitutional affection, more partlarly of scrofulosis, the first symptom of which is not unfrequenthe formation of pustules. Among adults the disease may becaused by an excessive supply as well as by an extreme deprivatioof good and nourishing food. Owing to peculiar causes, a subacuteimpetigo may break out after vaccination over the whole body.The appearance of the pustules is sometimes accompanied bysymptoms of an inconsiderable febrile irritation, generally, howewithout the general organism being involved. At a certain spoton the cuticle, seldom at several spots at once, an efflorescenceits appearance, attended with itching and burning which, however,never equals in intensity the itching 'and burning of herpes oreczema; very soon the efflorescent cuticle appears covered withsmall vesicles of the size of lentils or peas, containing an opaqliquid ; after having been out a few days, the vesicles break, antheir contents change to yellowish, greenish and brownish crusts,which adhere with a tolerable degree of tenacity and, on fallinghttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 421 of 653oft", leave for some time red and flat cicatrices. In the case ofsingle pustule this course is terminated in ten days to a fortnigBut new pustules keep forming ever and anon, adjoining the first32498 Diseases of the Skin.pustule; they cover a large portion of the skin, and in this mannthe whole process assumes a chronic form. While the new cropsof pustules are developing, the exudative process generally contiat the previously-affected places, by which means the originallyvery thick scurfs are changed to crusts of considerable thicknessneath which a superficial ulcerative process may still be going opetigo rodens). With impetigo the lymphatic glands involved in thexanthem, almost always swell and become inflamed. In pursuingthis course the exanthem may continue on for years, whereas, atother times, the whole course of the eruption may be ended in afew weeks. Scratching and the consequent grafting with the nailscontribute a great deal to the spread of the pustules ; by thismeans the eruption may easily be transferred to other individualsas often happens in the case of children's nurses.Impetigo-pustules, if not excited by local irritants, such as plaor moist poultices, break out chiefly in the face (crusta lactea,melitagra, porrigo larvalis), upon the hairy scalp (porrigo, tinethe nape of the neck and on the lower extremities. The pustulesat times appear isolated (impetigo sparsa), at times in large groor clusters (impetigo figurata), and at other times upon a brightinflamed base (impetigo erysipelatodes). The pustules generallyinvolving a hair-follicle, the hair, in impetigo of the hairy scanot only glued together in clustera, but is likewise dry and brita good portion of it falls out, giving rise to bald spota of moreless size. Otherwise the constitutional condition of the patientnot impaired by this affection.In treating a case of impetigo, the causal indication is just asimportant as in a case of eczema, especially if we deal with littchildren, and a suspicion is consequently excited in our minds, othe disorder being occasioned by a scrofulous taint. In their casit is necessary to attend closely to their diet, cleanliness, etcvery common cause is not, as is often supposed, too fat milk, butthe excessive and too frequent use of milk. We likewise not unirequently see children attacked with impetigo whom their mothersespecially in the country, nurse until the little ones are two oryears old. Many occupations carried on in a high temperature, arelikewise apt to induce impetigo, and all our efforts to cure theease would be fruitless, if this circumstance were lost sight of.Local treatment has to be conducted in accordance with the ruleslaid down for eczema ; above all, the crusts have to be carefullyremoved and their return prevented ; the further spread of theEcthyma, Rupia. 499http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 422 of 653exanthera by scratching has to be limited as inuch as possible byappropriate barriers. In resorting to external applications, we mnot overlook the fact that the skin of many individuals is exceedingly vulnerable, and that the application of oil or of waterpresses, etc., to such a skin may very speedily excite impetigo,increase it where it already exists.Medicines employed for this affection may deceive ns regardingtheir curative powers, for the reason that such an exanthem oftenheals spontaneously within a few weeks. A spontaneous cure ofthis kind can never be determined beforehand, for it but too oftehappens that an apparently acute or subacute course is changed toa very chronic one, or that the disorder is continually oscillatihetween remissions and exacerbations. On this account it is propethat suitable medicines should be given at once at the commencement. In the case of children, and when the face or the hairyscalp is invaded, Mercurius renders the best service as long as tefflorescence of the cuticle continues. Hepar sulph. calc. sometiarrests the disorder at the onset. If the affection has assumed achronic character, Antimonium crudum^ Lycopodium^ Arsenicum^Calcarea carbonica^ Acidum nitricum or Clematis have to be resortto. Lycopodium and Staphysagria are particularly adapted toimpetigo of the legs. According to our experience. Sulphur isutterly ineffectual in this affection; Hartmann, on the contrary,writes of this and other remedies as follows: "In impetigo /S'li/is undoubtedly one of the most distinguished remedies, provided iis not given in too scanty a dose ; even a bright efflorescence obase does not counter-indicate it. Among chronic cutanious affections Graphites seems to be characteristically adapted to impetigAcidum muriaticum is useful for impetigo on the legs in the caseof old people, with burning pain." He likewise mentions Conium^Oarbo vegetabiliSy Sepia^ and a number of other remedies that arescarcely ever in homoeopathic relation with the case. For impetigrodens Hartmann recommends Staphysagria^ Kali hydriodicum ;however, his delineation of impetigo does not seem to us to reprean exact image of the disease.18. Ecthyma, Rupia.Both ecthyma and rupia (or rhypia), according to their generalcharacteristic properties, are nothing else than forms of impetigthat is : pustules upon the skin, differing only in size.Both may have the same etiology as impetigo, and may likewisebreak out on individuals of apparently sound health ; in most cas600 Diseases of the Skin.however, both exanthema are signs of constitutional disease, andare more particularly met with among the poorer classes inhabitindamp and unwholesome dwellings, and not having a sufficient supplof nourishment. The ecthyma-pustule is very often a symptom ofneglected itch, rhypia a symptom of constitutional syphilis.The ecthyma-pustules are seated upon an injected and infiltratedbase which is at times of a bright, and at other times of a dingyredness, the latter, if some constitutional cachexia prevails. Thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 423 of 653are always distinct, very seldom close together ; they are of thesize of a large pea, semi-globular, and at the onset filled withyellowish-turbid, or sanguineously-opaque fluid. Only a few pustubreak out at once, generally only one at first, the other pustulefollowing in successive crops. The eruption is sometimes precededby pains in the joints and febrile symptoms. The halo of the pustule fades away with the desiccation of the vesicle, and a firmlyadhering incrustation forms, not very thick, but which may increain thickness very considerably, if the suppurative process continunderneath it ; this change usually, however, takes place only incase of cachectic ecthyma. In consequence of a succession of cropthis pathological process may become protracted for weeks and evemonths. The pustules are most commonly seated on the legs, muchless frequently on the thighs and the rest of the body, scarcelyin the face.Rupia-pustules are large bullsB sometimes of the size of a modernpenny ; yet they ought to be ranged among the pustules for thereason that their contents though serous at first, yet soon changto a puriform liquid, and are very generally mixed with blood.They are seated upon a dingy-red base, are never very muchelevated above the skin, but are loose blebs which, in a few dayschange to brown incrustations raised in the middle, and sometimesseparating very rapidly, leaving an ulcerated excoriation (rhypiasimplex), or beneath which the suppurative process continues andcauses the incrustations to grow to considerable thickness (rhypiprominens). If the incrustation is removed, a deep, sicklyulcer is revealed underneath which obstinately defies every attemto heal it, but upon which new crusts are disposed to form.Rupia, too, is most generally seated on the leg, never in the facvery seldom on the rest of the body. It ia an exanthem of a badcharacter, but is generally curable; it is only when the ulcerbecomes ichorous (rhypia gangrsenosa) that it may lea/1 to hecticfever and result in death.Pemphygus. 501Treatment. Ecthyma associated with scahies and the syphiliticrnpia will he treated of when we come to speak of the itch andsyphilis. If not accompanied hy malignant symptoms, ecthymahardly requires any medical treatment. Otherwise our best remedyis Antim. tartar.^ which is suitable as long as the cutaneous dishas not assumed a chronic character. Mercuriusis decidedly inferito Tartar Emetic. Arsenicum^ Staphysagria and perhaps Lt/cO"podium may be tried to keep off the new crops of blebs. As longas rupia does not assume a gangrenous character, Shus tozicod.yAcidum nitricum^ muriaticum or phosphoricum are sufficient to curit; but if the affected parts are invaded by malignant ulcerationwe meet this change with excellent effect by means of Arsenicumand Secede comutum^ to which Carbo vcgetabilis and Staphysagriaare decidedly inferior although they may at times be useful. Themain object is to treat the general condition ; both exanthems widisappear so much sooner and will be so much less disposed to breout again, the more carefully the skin is attended to, together wthe internal treatment.19. Pemphyi^fl.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 424 of 653This affection which is likewise described under the name ofpompholix, is characterized by the formation of large blisters. Iorigin, especially that of the acute form, is involved in obscuriwhereas the chronic form is evidently traceable to a constitutiontaint, which is so much more probable as the chronic form of thisexanthem is so apt to terminate fatally.Pemphygus may represent an acute affection, but, as such, is ofvery rare occurrence; we do not consider it necessary to devote amore space to it.Chronic pemphygus most generally commences without fever;nevertheless in cases where the disease consists of several succecrops of blisters, with intermediate free intervals, it often hapthat each special eruption sets in with some fever and pains in tlimbs. The disease commences with the breaking out of lentilsized red spots, attended with itching and burning; soon a whiteappearance is perceived in the middle of the spot, which increaserapidly in size, and forms the blister; this sometimes remains qusmall, and at other times grows to one inch and a half in diameteThe blisters are filled with a clear fluid, very tense, break vereasily, after which no incrustation forms, but the detachM and drepidermis separates, leaving for some time a moist excoriation, s502 Diseases of the Skin.that a blister runs its whole course in about a fortnight. Inasmuas the blisters seldom cease to form after their first, appearancthe contrary new blisters form almost every day, the disease maybecome very much protracted and all the stages of the pemphygusdisease may be seen and observed on the same patient. Pemphygusis most frequently seated on the leg, blisters may, however, breaout over the whole body. The course of the eruption varies greatlEither the blisters come out in crops separated by intervals ofweeks or even months; — this is a comparatively favorable sign;or else the aftection commences with a few'or with only one blistnew blisters continuing to form, which involves a loss of serousplasma that may, after a lapse of time, lead to gradual emaciatiohectic fever and death. At all events pemphygus is one of themost obstinate and at the same time one of the most dangerouscutaneous affections. This statement, however, only applies to thabove-described form, not to the pemphygus which, like theecthyma-pustule, sometimes breaks out as a secondary symptom ofother cutaneous affections and a variety of other acute diseases,and which has no particular significance.TrecUment. Considering the importance of this exanthem, weare not particularly blessed with reliable remedies for it. We macompare : CantharideSj Causticum^ Kreosotum^ LachesiSy ThdcaiyiarJRhus toxicodendroriy Banuncvlus bidbosus and sceleratus^ Secalenutum. These remedies are theoretically indicated by our provingsbut, so far as we know, not one of them has yet cured a single caof this disease. We doubt very much whether Dulcamara iscapable of doing any thing for such a deep-seated constitutionaldisorder. Lachesis of all other remedies has the best and mostmarked symptoms. Mercwias seems to be in curative rapport withpemphygus. Some years ago we saw in Vienna a woman who forseveral years had been a nurse in one of the sections for syphilihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 425 of 653patients, and who had rubbed up a good deal of quicksilver withher bare hand. Since then she was attacked with pemphygus, butwhether her handling of Mercury was the cause, is of courseproblematical. In the subsequent course of the disease other remedies have to be employed for the general consequences of theexanthem rather than for the exanthem itself. Arsenicum^ China^Sulphury Ferrum may possibly keep off the threatening decline, buthey are not homceopathieally related to pemphygus.Furunculus and Carbunculus. 503SO. Farmiealus aad Carbunculus.Anthrax.Although both furnncle and carbuncle are generally regarded assurgical diseases, yet we are perfectly satisfied that either ofpathological processes can be managed by internal treatment insuch a manner as to make all surgical interference unnecessary.A furuncle generally proceeds from a single cutaneous gland, orelse from several in close proximity to one another, and the firsdeposition of the exudation takes place into the glandular follicThe inflammation, however, is not limited to the gland, but spreato the surrounding cellular tissue, enveloping the follicle in aexudation-plug. Amid severe pains, and sometimes in companywith intense fever, pus forms in the space of three to ten and modays, and breaks through the skin. Usually the exudationcore cannot be removed until some time after the opening hasexisted. Furuncles of some size generally break out singly, especially on the buttocks, but it very commonly happens for onefuruncle to be followed by another; lay-people consider it anestablished fact that seven boils must break out one after the otwhich shows how seldom a boil is without successors. The causeof boils is very often a local irritation; but there are real furepidemics which have to be accounted for by atmospheric influenceBoils very often occur during convalescence from severe acutediseases and after the excessive use of fat as an article of dietCarbuncle or anthrax is regarded by many as a combination *ofseveral furuncles ; but in our opinion this theory is erroneous.boil is never attended with gangrenous destruction; with a carbuncle this is the rule. Carbuncle, moreover, has its favorite loities, namely the integuments along the dorsal spine, especiallythe nape of the neck ; less frequently the sternum or the inguinaregion. . Carbuncle, moreover, is chiefly met with among olderpersons ; boils, on the contrary, may occur at any age, especiallamong young people. Otherwise it is diflicult to decide what arethe causes of carbuncle, for it occurs among individuals withcachectic and deteriorated constitutions as well as among perfecthealthy and robust persons. Carbuncle begins and runs its coursewith great pain. At the painful spot a mere change is scarcelyperceived at first ; soon, however, it acquires a bluish and sicklook, but without any perceptible swelling. The pus seldom escapebefore the sixth day, generally in several places at once, whichhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 426 of 653504 Diseases of the Skin.afterwards unite and from which a thick, easily decomposed pus isdischarged, mixed with a quantity of shreds of detached cellulartissue. This whole process is attended with fever which is apt toassume an adynamic type and, after the sudden supervention ofcerebral symptoms, may terminate fatally. In a favorable case thecure takes place very slowly, because the loss of substance may bmany square inches in extent. Further details about the course ofthe disease will be given in the next paragraph.OOreatment. Boils require very seldom any medicinal treatment; warm poultices bring the boil to a head in a few days. Ifthe boil is very large, attended with considerable inflammation othe cellular tissue, and a good deal of fever, and if it breaks vtardily, a few doses of Mercurius vivus^ to be followed by a fewdoses of Hepar sulpL cole, hasten the course. We do not adviselancing, because the pains and the suppuration generally last muclonger in such a case, whereas, if the boil breaks spontaneously,generally heals in a few days; however, we should see to theremoval of the core at as early a period as possible, for the preof the core keeps up the suppuration. To eradicate a tendency toa constant return of new boils Acidum phosphoricum- or nitricumand still more Arsenicum have seemed to us useful remedies. As amatter of course it is very difficult to decide this point.If we desire carbuncle to run a benign course, we have to treatit with medicines from the commencement. Acidum nitricumjSilicea^ Carbo vegelabilis^ Secale comutum are recommended for cabuncle, but it is difficult to determine special indications forof these remedies ; nor are we acquainted with definite and permanent results in any case. Arsenicum^ given at the onset, rendersexcellent service, and contributes greatly towards securing a favable result. Secede comutum^ which is too little thought of in sucases, may be given if cerebral phenomena set in at an early periof the disease ; Phosphorus may likewise be indicated und?er suchcircumstances. Silicea is suitable if the suppuration has fully sin. Here, too, as in the case of boils, we urgently advise againsthe artificial opening of the carbuncle, more especially if it ismature. An early access of atmospheric air favors the developmentof gangrene, pus is but too readily taken up by the cut vessels,the inflammation is enabled to spread. We are fully aware thatsurgeons are of a decidedly contrary opinion; but we can only askthem whether they have ever attempted the cure of a carbunclewithout a crucial incision. No opponent of our view will be ableSeborrhoea. 505to answer this question affirmatively. After the carbuncle is brothe shreds of cellular tissue have to be removed as soon and ascompletely as possible ; the sore should likewise be cleansed verfrequently. Warm poultices ought to be applied from the start.l(l« Seborrlicea.An excessive secretion of sebum on the hairy scalp is a regularoccurrence during the first year of infancy. It may likewise takeplace among perfectly healthy and robust men up to the age ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 427 of 653thirty ; women afflicted with uterine diseases, and likewise pregwomen, often suffer from it.Seborrhoea chiefly takes place on the hairy scalp, more frequentlon the sinciput than on the forehead, nose and on the sides of thorgan. On the hairy scalp the secreted sebum forms fine yellowishwhite scales or, as in the case of children, incrustations whichtimes acquire considerable thickness. In the face the sebum eitheremains liquid, in which case the affected part looks somewhatinjected and has a shining, greasy appearance, and the grease canbe removed by means of blotting paper; or else the sebum coagulates very rapidly, forming a yellowish, scurfy, soft lining, benwhich the skin has a natural appearance, except a little redder tusual; numerous excretory ducts of the follicular glands are likewise seen.This disorder, oscillating between more or less, always runs avery chronic course. It is of no great importance, for the generahealth is not affected by it, except that the patients experiencethe affected part a disagreeable tension and prickling, or a violitching on the hairy scalp. The seborrhoea of pregnant femalesalmost always ceases after confinement. Seborrhoea is importantin so far as it is easily confounded with pityriasis and eczema,mistake that is apt to lead to erroneous and even injurious managment. The diagnosis is secured by the circumstance that in seborrhoea the epidermis remains intact.X^eatmenU Internal treatment is only necessary in caseswhere the affection is of a primary origin, or depends upon uteridisorders. In the last-mentioned case our chief and, indeed, soleobject should be to remove the cause, for the cure of the uteri nderangements involves the disappearance of the cutaneous affectioAs a primary affection the disease is very obstinate ; quite recein the case of a robust young farmer, we have employed in vain506 Diseases of the Skin.every iraaginable remedy, more particularly Aurum, Graphites^Lycopodiuniy Acidum nitricum, Calcarea carbonica. The only remedythat improved the case, was Arsenicum. Tried remedies for thisdisease are as yet very scarce. [We have cured a case of seborrhcwhere the patient, a young woman, looked as if she were envelopedin a coat of liquid and shining grease, with nothing but Aconiteand Samhucus; the treatment lasted about two weeks. H.] Toomuch washing, either with cold or warm water, is hurtful. If soapis used, it must be very mild, lest it should prove disagreeable.Washing with spirits is sometimes usefuL Fat food must bestrictlj^' avoided.tit. FaTiuuHoney-ccnnb Tetter^ Scald-head.This cutaneous affection, which is likewise described under thenames of porrigo decalvans or tinea favosa, is characterized by taccumulation of multitudes of fungi around the roots of the hairshence their exclusive appearance on the hairy portions of the skihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 428 of 653Favus is a disease of the lower classes. It only attacks individuals who pay no sort of attention to cleanliness. In other respecsuch individuals may either enjoy the most perfect health, or elsbe of sickly and cachectic constitutions ; favus may attack eitheclass. This exanthem can be transferred to other persons by hats,caps and other head-gear, likewise by sleeping in the same bed ;has likewise been transmitted purposely from one individual to another.A single favus-efflorescence has its origin in the orifice of a sceous follicle in the form of a small, imbedded, not painful papuwhich is perforated by the hair and keeps constantly increasing ibreadth and height, until the characteristic crust finally arisesit. This crust has the shape of a dish, with a rounded centraldepression and round elevated borders ; it has a yellowish or gratint, without any exudation underneath, and has a peculiar odor.If, as usually happens in old cases, the efflorescences are closegether, they unite to an uneven incrustation, at whose borders thdistinct crusts are never missing, so that the diagnosis is quiteeasy. The consequences of favus are : Partial atrophy of the skinin consequence of the crusts being imbedded in it ; eczema occasioned by the scratching ; destruction of the hair on the affecteparts; on the other hand, this disorder has no infiuence upon theScabies, Itch. 507general state of the constitution. The disease runs a very cTironcourse, yet spontaneous cures occur, although very tardily and nowithout corresponding modifications in the hygienic circumstancesof the patients.According to what we have stated concerning the etiology of thedisease, we deem an internal treatment of it useless and ineffectHartmann's remarks in this respect have no reference to true favuIf constitutional disorders are present simultaneously with favusthey have, of course, to be treated with appropriate remedies ; athe same time they must not be regarded as the originating causeof favus. This can only be cured by removing the crusts in whichthe fungi are imbedded, and by preventing their return. The suresmeans of accomplishing this result, is care and cleanliness. Theremoval of the crusts is secured by softening them with oil, andafterwards removing them together with the perforating hair. Thisis a very tedious, but sure undertaking. Every sickly-looking haihas to be pulled out singly, for the reason that the disease hasalready invaded the soil in which it grows.[This eruption is treated with success in some cases by means ofIris versicolor; a cerate is applied to the scalp, and a few dropthe tincture, even as many as twenty, in half a tumblerful of watgiven internally, in teaspoonful doses, three or four times a daySee Hale's JSfew Remedies. H.]tt« Seables, Itch.It is with a certain reluctance that we enter upon a discussion othis aii'ection, since we are satisfied that our views concerningditter from those of most of our Colleagues. We will, therefore,anticipate all objections by stating that the opinions which we phttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 429 of 653mulgate in this chapter, are simply our own, not those entertaineby a majority of our Colleagues, whose opinions we have not evensufficient space to refute.The itch is caused by a parasite, the acarus scabiei or sarcopteshominis. Any one who wishes to become specially acquainted withthe natural history of this animalcule, is referred to an articleGudden, in Vierordt's Archiv, 1856 ; series XIV, No. 1, from whicwe transfer the following leading points.The female full-grown acarus is from i to J of a line broad, having an ovoid shape, with wavy lines; it is provided with eightlimbs and a number of long hairs. To the bare eye it looks like a508 Diseases of the Skin.faintish-white or yellowish corpuscle. Each acams contains frcmi40 to 60 eggs which are laid seriatim and from which the youngacarus originates in about eight days. The male acarus is muchsmaller than the female, and is said to die soon after sexual converse. In the cold the acarus remains quiet, but in the warmth itmovements become very lively ; the young acarus especially showsa disposition to wander.If an acarus is placed upon the skin, it very soon commences toburrow by placing itself in a vertical position, supporting itselthe bristles projecting from the posterior part of its body. Haviperforated the hard layer of the epidermis, it lowers the posteripart of its body continuing to burrow horizontally and very soonbeginning to lay eggs. At intervals it makes an opening in thecanal towards the outside, probably to afford the young a passageto crawl out. The cuniculi of the male acarus are short, those ofthe female often one inch in length, generally with irregular curbut the young acari soon again leave the spot where they hadburied themselves, hence do not form cuniculi, but papules andvesicles. From ten days to a fortnight elapse between the timewhen the acarus first begins to burrow and when the characteristiitching is first perceived.The places preferred by the acarus, are the hands, between thefingers and on the sides, the surface of the wrists, the inner siof the extremities, the entrance to the axillae, the abdomen, theinter-gluteal space, the region around the nipples, especially thof the mammae, the penis and scrotum, and the feet around thetarsus. The acarus, however, may locate itself anywhere on thetrunk, but is never met with in the face.The cuniculi the presence of which is indispensable to establisha correct diagnosis, are most easily found on the hand, at the plindicated; they appear like fine, irregularly dotted dark streaksowing to dirt having adhered to the orifices of the cuniculi; wheas on the trunk the cuniculi have a whitish appearance. The commencement of the cuniculus is marked by single scales of theepidermis which, being detached, afford an •pening to the cuniculwhich remains uninterrupted in its further course. The end of thecuniculus is recognized by a whitish-yellow, somewhat elevatedpoint which hides the acarus. If the epidermis is carefully removat this spot by means of a needle and the needle is firmly pressehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 430 of 653against, and moved over the cuniculus, the acarus will readilyadhere to the needle and can easily be recognized by means of aScabies, Itch. 609glass. With a little practice it will be found quite easy to catcacarus. In the efflorescences occasioned by the young acari, oneof them is seldom found for the reason that they wander aboutfrom place to place very rapidly. On individuals who do not washthemselves with care, a cuniculus is most easily discovered by lipassing a finger moistened with saliva over it several times, insequences of which the dirt penetrates between and adheres to thescales of the epidermis. In persons with callous hands the acarushas to be sought at the wrist.A transmission of the acarus is most easily effected when it hasthe greatest desire to wander, hence in a warm bed ; it takes plamuch less frequently by touching objects that had been handledby persons affected with the itch; but it is easily accomplishedthrough wearing apparel.The phenomena caused by the acarus upon the skin, proceed fromit either directly or indirectly. The presence of the acarus uponthe skin remains without symptoms except a slight itching whichis not always present, and does not always become very troublesome even when, as is often the case, especially on the penis, thcuniculus is closed by a little exudation deposited below it andits side. But immediately after leaving the canal, the young acaragain bury themselves in its proximity, and small papules toppedwith fine vesicles break out close to the primary canal, itchingviolently, and being either speedily lacerated by scratching or,in the case of children, changing to pustules and forming scabs acrusts of various sizes. The indirect phenomena, according toHebra, owe their origin entirely to the scratching caused by theitching ; as an evidence of this fact he refers to the circumstanthat children and paralytic persons who do not scratch, remain frfrom these symptoms, and that in healthy persons they are onlymet with in localities that can be scratched. First papulee, eachperforated by a little hair, break out, less frequently vesiclespustules. These papules are scratched, after which their tips become covered with fine, dark-looking scabs. After the cutaneousirritation has lasted for some time, pustules arise from the papuOn parts of the body that are exposed to constant pressure, or toconstant pressure with friction, the skin soon appears infiltrateand is thickly covered with the above-mentioned efflorescences, afor instance round the waist in the case of females on account ofthe clothes being fastened around too tightly, or in the case of510 Diseases of the Skin.Bhoemakers on the nates. In these instances, as in any other persistent cutaneous irritation, eczema may break out.After this explanation it behooves us to examine the questionwhether, in a case of what is called the itch, and where the abovdescribed process takes place in its totality, the mechanical irrhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 431 of 653tion of the acarus or some other coexisting agent is the cause ofthe disorder. The doctrine has been started that acari, like Cantharides, contain some corrosive poison which is communicated tothe skin and becomes the origin of a chronic itch-dyscrasia. Butmany other irritations of the skin produce the same symptoms asthe itch, without a virus having been their cause ; we notice, moover, that the itch is always confined to the localities occupiedthe acari; that it spreads in proportion as the acari increase innumber, and that it ceases to spread as soon as the acari are destroyed. In such a case the consecutive cutaneous phenomena mayremain for some time, but the same thing takes place in the caseof eczematous eruptions occasioned by other cutaneous irritants,and which, in the long run, had assumed the character of independent diseases. There is not a single symptom connected with thewhole course of the itch, that might lead us to think that the cosecutive phenomena in the case of the itch differ from those manifested by other kinds of vermin, such as lice or fleas. If we areasked whether all the old doctrines about the terrible consequencof the itch are false, we answer that we partially admit and partially reject them. They are unfounded in so far as they originatin the hypothesis of a specific itch-virus ; on the other hand, tare founded in so far as the itch, especially if the disease remafor a long time uncured, and more particularly as it used to bemanaged in former times, may superinduce consecutive diseases.If the body is rubbed for a long time with ointments containingnoxious substances, the organism undoubtedly suffers in consequenof such a proceeding, and no homoeopalh would want to deny this.The absurd bathing for hours, sweating for days in overheatedrooms, and other similar measures, may make the healthiest personsick, and develop germs of sickness in an apparently healthy individual. Even the continued disturbance of the cutaneous functionsby the itch may cause sickness, the more so, the more coexistingconstitutional disturbances affect the exanthem unfavorably andvice versa.The best proof that the itch is not a constitutional disease, iaafforded by the circumstance that, if the destruction of the acamScabies, Itch. 511is effected with all due caution, the equilibrium of the organismnever disturbed by such a proceeding. This view does not upsetthe formerly entertained doctrines of secondary diseases resultinfrom the suppression of the itch. Only if such secondary affectioresulted, it was not the itch but prurigo. Those who had no knowledge of the acarus, must necessarily have mistaken prurigo for thitch, and it is the suppression of prurigo that leads to the mostdangerous constitutional diseases and more particularly to tuberculosis.After these remarks we need not say what we think of Hahnemann's theory of psora and of Psoricum as a medicinal agent.Psoricum might have had something in its favor, if it had beenprepared from the acari themselves.Treatment, Although we have tried in the course of thiswork, to be in accord with our homoeopathic Colleagues in mostthings, yet in the matter of scabies we have to differ with manyhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 432 of 653of them. We hold that all treatment of the itch, as long as theacarus is not extirpated, is downright absurdityi It is our opinithat the cures of the itch which are reported as having been effeby the exclusive use of internal remedies, are not compatible witcorrectly scientific observation.The destruction of the acari is the causal indication which notonly can, but has to be satisfied. The most simple, never hurtfulproceeding and which never fails, if carefully carried out, is thfollowing: First the patient is placed in a water-bath of about92P F., in which he remains for half an hour. At the end of this• • • ■period of time he rubs himself well with brown soap, more particularly at the places where the acarus is principally located. Bythis means the cuniculi are almost completely opened. After thebath the patient is thoroughly dried and enveloped in a woollenblanket for a quarter or half an hour, for the purpose of removinevery particle of moisture from the skin and at the same timeenabling the ointment to thoroughly penetrate the cuniculi. Wenow resort to frictions with the following ointment: Two ouncesof lard, two drachms of the washed flowers of Sulphur, and halfa drachm of the Sulphuret of Lime. These proportions areabundantly sufficient for every adult. The whole body, except thehead and neck, has to be rubbed very carefully, especially the plthat constitute the favorite haunts of the acarus. The rubbing isbest done by two persons at once, one on each side. After therubbing, the patient is again enveloped in the woollen blankets,which he remains for an hour and a half. At the end of this perio512 Diseases of the Skin.he is placed in a warm bath of a temperature of 92P F. and, whilein the bath, thoroughly rubbed with brown soap. After the baththe patient may take ,a shower-bath, and be kept in the room forsome time longer in order to guard against taking cold. Aft^rsuch a proceeding which we have employed in a number of cases,we have never seen a relapse. The best method of cleansing theclothes as well as the bed-linen is to boil them at a temperature200° F.Under certain circumstances the proceeding here recommendedmay have to be somewhat modified. In a case of pustulous scabieswhich is so often met with among children, the pustules have toheal first, otherwise the soap would irritate the skin too much.According to their ages, children only require one-third, oneor one-half of the quantity of ointment, and, on account of theirskin being so much more tender, need not be kept in the baths, noremain in the blankets as long as adults. If several members of afamily are infected at the same time, they have to undergo thetreatment simultaneously. Frictions with brown soap alone arehardly suflScient to kill the acari; still they may be resorted ttwice a week in order to make doubly sure of the result.After the cure which does not cause any marked irritation ofthe skin, this organ is allowed about a fortnight for its restorahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 433 of 653to a normal condition. If, after this, any efflorescences remain,they are treated according to the principles laid down above. Inmost cases the daily use of a tepid or shower-bath is sufficientcomplete the whole cure. ,We have never known this treatment which can be easily pursuedin a private family, to be followed by any of the terrible consecdiseases described in the books.Lest we should be accused of condemning what we know nothingabout, we will here state that we have tried every remedy recommended for the itch by homoeopathic practitioners, in the form oftriturations, tinctures, attenuations, high and low potencies witthe least benefit. The acari would not die and the pustules keptinci easing in number. In one case, that of a child of six monthswe fancied that SiUphur 6 did arrest very speedily the dispositioto the formation of pustules."Wo are satisfied that in making the preceding statements, weshall give offence to many homoeopathic physicians, but we shallhappy to hear all condemnations and objections, and shall deem ita pleasure and a duty to answer them.ELEVENTH SECTION.Constitutional Diseases.A. ACUTE AND CHRONIC CONTAGIOUSDISEASES.fl. Horbllll.Meades.Measles are not only a contagious, but a more or less universallyepidemic form of disease. In most cases they arise by a transferof the contagium. This is contained in the catarrhal secretions,and is transmitted by contact, and still more frequently by the aIt is not very susceptible of being indirectly transmitted by theclothing ; this theory is probably adhered to with so much zeal fno other reason than because the doctrine that measles are contagious, is to be maintained at all hazards. The incubationof the transmitted contagium is eleven to twelve days, as anybodycan easily determine for himself in any outbreak of epidemicmeasles. The contagium is most active shortly before the appearanof the exanthem upon the skin. We have observed this to be therule in the epidemic that has now been raging among us for upwardof a year. An apparently mild catarrh is taken no notice of, thechild is sent to school in spite of it, and next day the little ohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 434 of 653down with the measles. Exactly on the twelfth day after, thenearest neighbors of the sick children are attacked. In this wayschools become the true nurseries of the exanthem, whence it aftewards spreads to families. After the exanthem is once out, itsinfectious nature is decidedly less, and becomes entirely extinctsoon as desquamation sets in. Personally we hold that epidemicmeasles can spread without contagion, although this is not oftencase. We likewise believe in this possibility in the case of scar33 513514 Acute and Chronic Contagious Diseases.latina and small-pox. It would lead us too far, if we would corroborate this assertion by the evidence of facts ; we be8i>eak somuch more urgently tbe attention of our Colleagues to this fact iexisting epidemics.Measles attack individuals of every age and sex, but least frequently very old people and infants. Inasmuch as almost everybodyhas an attack of measles in his early youth, they are on this accseldom met with among old people. One attack of measles generally protects persons against a second one ; exceptions, howeveare not very rare, although it behooves us to guard against mistaing roseola for measles. [In the late war measles raged with greafierceness in many of our regiments^ and, under allqpopathic treament, destroyed a number of lives. H.] No later than two weeksago we treated two little girls in the same family who were downwith the measles, one severely, the younger without any markedconstitutional symptoms, but with the eruption in full bloom.Three weeks after desquamation had taken place, the younger childwas again attacked with all the preliminary symptoms of measles;indeed, they again broke out with much intensity, attended withsevere constitutional symptoms, but in other respects running thecourse regularly.The ordinary season for measles are the months when catarrhsare common, from October till April ; nevertheless measles ragedhere very extensively last summer, which, it is true, so far as ttemperature was concerned, was more like winter. This circumstance alone ought to sufBce to show that the measles are notexclusively propagated by a contagium.Symptmns and Course. We have already stated that theincubation-period of the measle-contagium, until the efflorescencbreak out upon the skin, is eleven or at most twelve days. Wheretthe general health does not seem in the least disturbed in the fieight to nine days of this period, definite preliminary symptomsshow themselves in the last two or three days. These preliminarysigns are falsely said to have been noticed at an earlier periodinasmuch as catarrhal affections are very prevalent during epidemmeasles, it is very likely that purely catarrhal symptoms have bemistaken fortheprodromiof measles. The prodromi proper beginwith a slight catarrh of the nose, lassitude and some fever. Thisfever increases considerably on the second day, frontal headachesupervenes, the eyes look red, are sensitive to the light, but thconjiinctiva is seldom puffed up. On the third day there is anothhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 435 of 653MorbilU. 515increase of fever, the patients feel unable to sit np, the tonguethickly coated, the appetite gone, and in the night from the thirto the fourth day, immediately previous to the appearance of theexanthem, a hoarse, barking cough sets in resembling croup, whichhowever, is scarcely ever attended with the danger that generallycharacterizes croup, and never changes to true croup. These symptoms may increase to a considerable degree of intensity, may beassociated with vomiting, delirium, sopor ; at times, however, thare entirely wanting or so slight' that it is not deemed necessarconfine children to the room. This is the reason why the measlesspread so rapidly through the schools, for it is precisely on theprevious to the breaking out of the measles that the infectiousprinciple is most active, and that hence the measles are most eascommunicated. We account for this circumstance by the fact thatin the last twenty-four to twelve hours previous to the appearancof the exanthem upon the skin, distinct, lentil-sized measleare perceived in almost every case on the palate and on the sidesof the fauces. We have noticed them in all our cases of the preseas well as of last-year's epidemic. Without doubt, it is the extesion of these spots to the larynx and trachea that causes the peccroupy cough, and we have always considered it an excellent diagnostic sign to find this cough associated with red spots on thepalate, in which case we were able to positively predict the appeance of the eruption within twenty-four hours. In other respectsthe prodromi have no distinctive peculiarity from which the character of the exanthem might be inferred; it can at most only besuspected after several cases had already occurred in the place,in its immediate vicinity. As a rule, adults suflfer much less frprodromi than children, nor has, in the case of adults, the coughvery often the croupy sound.The measle-exanthem breaks out gradually, in one case morerapidly than in another. The first spots always show themselvesin the face, most commonly on the cheeks and temples. They areof the size of lentils, of a bright redness and with rather sharpoutlines ; after being out for a short time, they become somewhatraised above the skin and harder to the feel than this organ. Witmore or less speed, generally within twenty-four to thirtythe exanthem comes out over the whole body from above downwards, and is fully out in forty-eight to sixty hours, so that nospots appear, whereas, up to that time, new spots had continued tbreak 6ut in addition to the first spots that were more or less516 Acute and Chronic Contagious Diseases.scattered and isolated. The spots keep growing in size to such anextent that some of them run together, and the normal skin, inthe place of spots, exhibits here and there irregular red patchesIn proportion as the exanthem comes out more profusely, its colorgenerally grows darker, sometimes with a bluish tint. With thefuller development of the eruption the constitutional symptomsmost commonly increase in intensity. The catarrh of the conjunctiva and the cough especially grow much worse. The pulse somehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 436 of 653times increases to one hundred rfnd forty beats. Sometimes theskin is dry, but at other times covered with perspiration. In verrare cases the constitutional equilibrium remains undisturbed eveduring the eruptive stage ; however, in every considerable epidema child with measles is occasionally seen running about the streeIf the exanthem runs a benign course, its decrease commencesat the end of the third day, seldom before tHis time, and continuwith great rapidity until the eruption has entirely disappeared.The spots grow smaller, assume a distinctly yellowish tint whichis especially marked on pressure with the finger, and within tweltwenty-four hours the spots have completed their disappearance wiout leaving a vestige of their existence. Very frequently, howevethe yellowish tint remains for several days. The fever declines vspeedily, the catarrh of the conjunctiva likewise abates, whereasthe bronchial catarrh most generally continues for a few dayslonger, and resolution sometimes does not take place until a considerable quantity of mucus has formed. Not unfrequently thepatient is at this period attacked with diarrhoea for one or twoProfuse perspiration is not the rule, but is not by any means ananomalous occurrence.Desquamation commonly commences on the seventh day, butmay delay until the fourteenth. The epidermis comes off in branshaped scales, very seldom in larger patches ; in the face and onextremities the desquamation is most distinct. Duripg this periodthe general health is generally good ; except that the bronchialcatarrh and still less frequently the diarrhoea may continue to sextent. In very few case^ the irritation of the conjunctiva likewise continues some time longer.According to the nature of the epidemic or other superveningdisturbances this normal course of the measles undergoes variousmodifications which we now proceed to point out, classifying themas benign, that is such as do not complicate the prognosis, and amalignant. We ought to observe, however, that under certainMorbilli, 617circumstances every anomaly in the course of the measles maybecome a bad omen, and that we have to watch every case wheredeviations from the normal course occur, with redoubled attentionAmong the anomalies of a benign character we class the followingThe eruption does not break out in the face first, or comes outsparsely on the rest of the body.The single spots are topped with little tubercles or vesicles.The exanthem comes out more slowly than usual, and the spotsremain much longer, sometimes beyond a week.In the case of little children the appearance of the exanthem isattended with symptoms of severe cerebral hypersemia or even convulsions.The cough retains its croupy sound beyond the first day or evenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 437 of 653during the whole course of the exanthem.Among the malignant deviations we number the following:The spots, when first coming out, are of a pale-red color whichdoes not increase in intensity, nor does it acquire the yellowishtint. Within the spots hsemorrhagic appearances are manifested,and between the spots ecchymoses are noticed. The spots fade awaysoon after their appearance, or else they fade very suddenly at tregular period or before.In the case of children the pulse exceeds 140 beats, and in thecase of adults 120 beats; moreover it is a small pulse. The tonguis dry. Angina tonsillaris. Diphtheritic membranes form in thebuccal cavity. The respiration becomes hurried and superficial.Sopor and delirium after the second day of the eruption.Of great importance are certain complications of measles, thatare very apt to occur and which were formerly regarded as metastases, because the exanthem disappears with the appearance of thecomplications. Laryngitis with crou{)Ous exudation is of rareoccurrence while the exanthem is still out ; it is more commonlymet with after the exanthem has left the skin. A slight bronchitiis an accompaniment of every case of measles ; it only assumes adangerous character if it continues beyond the stage of decline,reappears again during the stage of desquamation, or otherwise ^assumes a very acute form. It is very apt to run into an exceedingly obstinate chronic catarrh. Pneumonia is not unfrequent ; itis mostly lobular, much less frequently lobar, and may break outevery stage of the disease. It is most threatening, if setting inafter the eruption has run its course. It does not usually terminin complete resorption and, on this account, is very apt to lay t518 Acute and Chronic Contagious Diseases.foundation for subsequent pulmonary phthisis. Pleuritis is a rarecomplication, so is pericarditis. Enteritis is a rather frequentcomplication in some epidemics ; it excites legitimate apprehensifor the reason that other consecutive diseases, more particularlyscrofulosis, are apt to follow in its train. Affections of the brare rare; their intensity is rarely such as to excite apprehensiothe supervention of sopor is a bad sign, because it may usher infatal general paralysis.Of the highest importance are likewise the numerous and alwaysobstinate sequelae of the measles, which make this exanthem oneof the most malignant, whereas its ordinary normal course andcharacter entitle it to be regarded as one of the most harmless.Among these sequelee we distinguish :Cutaneous affections, especially impetigo and eczema, more orless extensive, but always very obstinate.Chronic conjunctivitis, with impaired vision; chronic otitis, witdeafness; chronic ozaena; chronic inflammation of the lymphaticglands, mostly without suppuration; chronic inflammation of theparotid and submaxillary glands.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 438 of 653Chronic bronfehial catarrh, with which bronchiectasia easilybecomes associated and which gives rise to a peculiar spasmodiccough ; or real whooping-cough which is much more severe as asequela of measles than when setting in at other periods, and whivery often develops a most dangerous lobular pneumonia.Anasarca with affection of the kidneys is a very rare sequela ofmeasles; it is not exactly an occurrence of a threatening charactNoma is likewise a sequela of rare occurrence; it is not withoutimportance.After the measles, children are very frequently attacked withscrofulous symptoms. It is very likely that, in the case of littlchildren, the measles simply act as an exciting cause of scrof ulbut it is likewise among larger children that, after an attack ofmeasles, all sorts of phenomena make their appearance, 'which weare in the habit of designating as scrofulous and which go to shothat a morbid change has been impressed upon the whole activityof the organism.Tuberculosis likewise frequently breaks out after measles. Webelieve with Niemeyer that pulmonary phthisis after measles ismost commonly a chronic lobular pneumonia, having nothing incommon with tubercles, or else, a lobular pneumonia with suppuration. That tubercles not unfrequeutly do occur after measles, isMorbilli. 619shown to us by the circumstance that we have recently lost threechildren with acute hydrocephalus, in the neighborhood of Hannover, where the measles prevailed much more fiercely than in thecity. In every one of these three children the symptoms of acutehydrocephalus set in soon after the measles.Treatment* Measles are universally regarded as a typical disease, on which account the so-called rational physicians considerevery interference with medicines in a case of measles running thnormal course, as useless. From the stand-point of Homoeopathythis negative treatment on the part of our opponents, is liable tseveral important objections. In the first place the measles do nconstitute a fixed typical exanthem, for, as regards time, they vgreatly both with respect to the time it takes the eruption to coout, and to the duration of the stage of efflorescence. It is conceivable that this irregularity in the course of the exanthem maybe modified by medicines, and every homoeopathic physician willagree with us in the statement that, under homoeopathic treatmentthe measles very seldom run an irregular course. A second proposition the correctness of which has been demonstrated by an abundance of clinical experience, is that under homoeopathic treatmencomplications are rare occurrences and that sequelae are seen stiless frequently. All our most excellent observers, of whom wenumber a great many, agree with us in this statement. It is,therefore, our advice to treat every case of measles, even themildest, with a little medicine, although the action of the medicmay not always be distinctly perceived.The preliminary stage of measles, if there is otherwise nothingabnormal in the existing symptoms, requires either Aconite or Belhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 439 of 653donna. We prefer the latter if the fever is purely catarrhal, theskin is hot but moist, the tongue thickly coated, the pulse hurribut neither hard nor full. These symptoms were uniformly presentin the preliminary stage of our last epidemic. We prefer Aconiteif the skin is hot and dry, the catarrhal secretion scanty, the tis red and the pulse full and hard. We have never seen the muchvaunted Pulsatilla do the least good at this stage of the diseaseand we are at a loss to perceive upon what grounds the exhibitionof this drug could be justified. The croupy cough is a good indication for Belladonna; at any rate, we have never seen it last lothan twenty-four hours after this remedy had been given. Othersrecommend Spongia or Hepar sulphuris calc,^ either of which maybe a suitable remedy according to circumstances. Aconite renders520 Acute and Chronic Contagious Diseases.excellent service for this croupy, catarrhal cough. If the exanthhad begun to come out, the best course then is to continue the reedy that had been given last, for beside the spots no other symptoms - generally make their appearance: the increased, but shortlasting intensity of the existing symptoms does not justify a chaof remedies, for the reason that such an increase of the symptomsinheres in the normal course of the disease. As soon as the eruption begins to pale oif, we advise the discontinuance of all medicine. If the spots have entirely disappeared, yet the cough continues, the treatment will have to be resumed; if the cough isattended with rattling and wheezing, and the expectoration is notvery difficult, He-par sulphuris calc. is to be given ; if the coparticularly troublesome at night, and is otherwise loose, not vehard, Pulsatilla may be required; for a dry, nocturnal, titillaticough we give Hyoscyamus^ and if the cough torments the patientthe whole day: Nux vomica. The general management of thepatient is of great importance, for it is a certain fact that anular course of the eruption is sometimes attributable to hygienicneglect or to the enforcement of improper rules and measures. Weforbear showing in this place how the poor measle-patients wereformerly abused, and still are very frequently abused by insanenurses and practitioners. We pursue the following course fromwhich we have never seen any bad consequences result. If themeasles prevail, we have the children who complain of a febrilecatarrh, kept at home, but do not confine them to their beds unlethey themselves insist upon it. A measle-patient should never becovered too warmly, nor should he ever remain in a temperatureabove 50° Fahr. The room should be carefully and cautiously ventilated ; pure air is of immense benefit to the patient. The roomshould never be obscured more than is desired by the patientsthemselves. The best beverage is fresh water in small quantities;if this should increase the cough, the water may be drank with thchill taken oft*, sweetened with a little white sugar. There is ndanger involved in daily ablutions of the patient's face and handwith tepid water. Owing to the impaired appetite there is dangerof the patients being treated to improper food. We never refusestewed fruit ; and we allow meat and broth if the patient cravesAfter the spots have disappeared and the cough has ceased, ornearly so, we have the patient transferred every morning from thebed into a lukewarm bath, where he is thoroughly washed withsoap and afterwards well rubbed dry in a woollen blanket. Nexthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 440 of 653Morbilli. 521morning he is rapidly washed with cold water and again rubbedoff in a woollen blanket. We now regard him as fully recoveredand, if the weather permits, send him out into the open air, ofcourse, with all suitable guarantees against taking cold. We havenever yet seen any bad consequences result from this treatment.We will now mention the treatment that ought to be pursuedfor some of the deviations from the normal course, and likewise f4the complications and sequelae, for it is these abnormal conditiothat require a most thorough knowledge of the appropriateremedies.If the eruption is unusually pale, we have to suspect the presencof complications, and if they cannot be traged, we give Veratrumalbum or Ipecacuanha ; if the exanthem disappears all at once, wiout any apparent complication, Arsenicum^ Opium or Digitalis willhave to be given according to circumstances. If the meaaleare hemorrhagic, Phosphorus and Arsenicum are suitable, sometimesalso Mercurius. Angina, which is a rare occurrence in this diseasrequires Belladonna^ Mercurius^ or Apis, Delirium and sopor afterthe exanthem is out, may require Shus toxicodendron^ Zincum^ orOpium; Ipecacuanha may likewise have to be used. This lastnamed remedy likewise arrests the vomiting which sometimes precedes the appearance of the exanthem. A moderate diarrhoea docsnot require any treatment; if it becomes too copious and painful,Mercurius^ or Veratrum album^ or Phosphorus and Ipecacuanha mayhave to be given. Adults retain for som'e time a thicklytongue, and an impaired appetite, for which symptoms Antimoniumcrudum is an excellent remedy, and, if the tongue is clean, Ipecauanha. These remedies should be given at once if the appetitedoes not return immediately after the spots have begun to pale ofComplications require the same treatment that is pursued if theyoccur without measles, hence, we refer the reader to the chapterson pneumonia, bronchitis, pleuritis, etc. But we must not forgetthat these complications are very dangerous and may easily adoptan abnormal course; pneumonia, for instance, may assume a chronicform, pleuritis may be transformed into pleuritis serosa.Like the complications, so the sequelae do not require any speciatreatment on account of the measles ; for special conditions, however, certain remedies have become exceedingly valuable. A chronibronchial catarrh is one of the most common sequelae, and is generally very obstinate ; not to mention other remedies that are spcially indicated by particular symptoms, Sulphur is the regular522 Acute and Chron'c Contagious Diseases.curative remedy in such a case, which we deem, however, equalledby Causticum. If the cough is accompanied with hoarseness, Carbcvegetabilis as well as Tartarus stibiatus will meet the case, ifhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 441 of 653dance of mucus is secreted. If the cough changes more and moroto a croupy cough. Cuprum has to be given the sooner the better.The subsequent hoarseness or even aphonia constitute great impediments to a cure. With the exception of Carbo vegetabilis^ Iodinethe only remedy that has shown any curative results in our handsfor this affection ; all other remedies have proved fruitless, anhas only been in the course of time that the natural voice returnPhthisis after measles can only be regarded as tubercular, if noof pneumonia had been noticed either during the acute stage of thexanthem, or during the period of convalescence; if symptoms ofpneumonia had existed, we may take it for granted that the existing phthisis is the result of chronic pneumonia. This point isimportant on account of the remedies that have to be used ; for ithe last-mentioned case Sulphur, Hepar sulphuris, and Iodine arethe chief remedies, whereas in tubercular phthisis these remediesare of no higher importance than others. Chronic diarrhoea is likwise completely cured by means of Sulphur, likewise by means ofPhosphori acidum. Catarrhal conjunctivitis, if setting in in thestage of desquamation, is exceedingly obstinate. The conjunctivai^not very much thickened, but very red and unusually sensitiveto a glaring light as well as to intensely cold air. For this troArsenicum does more than any other remedy ; only it must not bediscontinued too soon, because the result generally develops itsevery tardily.8« Scarlatina.Scarlet-fever.Scarlatina is unquestionably a contagious disease; at times itoccurs in a sporadic, but more frequently in an epidemic form.What is the nature of this contagium, and what contains it, cannot be determined, but many circumstances argue in favor of thedoctrine that it is transmitted through the air. It is often indiputable and certainly more probable than in the case of measles,that scarlatina sometimes breaks out spontaneously and sporadically without any infectious contagium, and likewise epidemically,in which category belong the cases where scarlatina is said to habeen transmitted indirectly through the agency of non-affectedindividuals. It is difficult to determine the duration of the perScarlatina. 523of incubation ; it is generally supposed to last eight days. Thecontagium is most fiercely active soon after the appearance of thexanthem, during the period of desquamation the contagious natureof scarlatina has most probably become extinct. The susceptibilitto the influence of the scarlatina-contagium is much less generalthan that to the measle contagium; many persons escape scarlatinaaltogether. The largest number and the most malignant cases occurbetween the second and seventh year, a much smaller numberbetween the eight and twenty-fifth year. At a later period, as weas during infancy, scarlatina occurs very seldom. One attack of .scarlatina acts almost as an absolutely certain preventive againsan\^ subsequent attacks. Epidemic scarlatina most commonly prevails during the transition-seasons, less frequently m the summerand least frequently in winter. Although certain atmospheric conhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 442 of 653ditions may be supposed to exist during the prevalence of scarlatina, yet they are unknown to us ; nor are we able to explain whacircumstances render one epidemic so dangerous and leave anothercomparatively mild. Epidemic scarlatina very often occurs simultaneously with, or subsequently to epidemic measles; it likewisenot unfrequently occurs together with small-pox; its relation towhooping-cough is less definite.SymptoniH and Courne. No acute exanthem is so variablein its course as scarlatina, although certain fixed types are alwrecognizable. The various epidemics differ very particularly fromeach other. We have not space to consider all these particular diferences and shall therefore content ourselves with describing thnormal couree of ordinary benign scarlatina, and shall afterwardsmention the deviations from this course, as we have done whentreating of measles.The disease is undoubtedly ushered in by a precursory stage whichhas no characteristic symptoms any more than the prodromic stageof measles. The patients exhibit the symptoms of a severe catarrhfever which, in contra-distinction to measles, is not attended wian irritation of the respiratory tract, but with inflammation offauces and catarrh of the stomacb. This stage differs in no respefrom a catarrhal angina, not even by the pulse which, in an affection of this kind, is generally very rapid. Only the skin of thepatient is much less frequently moist.After the prodromi have lasted for two days, the exanthemmakes its appearance, generally with a marked increase of the fevand the other preliminary symptoms ; children are attacked with524 Acute and Chronic Contagious Diseases.convulsions. The exanthem always first breaks out on the neck,whence it spreads downwards over the rest of the body. First wenotice closely-crowded red stigmata, generally of a much darkercolor than the measle-spots ; these stigmata very speedily run inone another, causing an homogeneoud, faintly dotted redness (scarlatina IsBvigata), or else they grow in size and, running togetheform single spots of a darker color, seated upon a more faintlycuticle (scarlatina variegata), or, finally, small vesicles sprinupon the red surface, most generally in consequence of the intenscharacter of the cutaneous affection, some of which are closelycrowded together, others are more scattered (scarlatina miliaris)The exanthem is generally fully out in twenty-four hours, whenthe stage of efflorescence commences. The redness is most intenseon the neck and on the extensor-surface of the extremities, likewon the hands. Throughout this stage the constitutional symptomspreserve their intensity, but the fever begins to abate in the latwo days ; it does not pass away suddenly, as in the case of measThe angina is very intense, the fauces are dark-red ; the tongue,having got rid of its original coating, looks very dark, with proinent papillsB, imparting to it a strawberry appearance. The urinary secretion is much less. Sometimes a little bronchial catarrhmakes its appearance at this time, but it scarcely ever assumes aviolent form.On the fifth or sixth day after the appearance of the exanhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 443 of 653them, it commences to pale off, with considerable abatement of thfever and more particularly of the angina. Soon after," the proceof desquamation begins. It always commences on the neck in smallscales, whereas on the body, and more particularly on the hands,the epidermis most generally peels off in large patches. The appetite now speedily returns and the patients feel quite well. In afortnight at the latest the desquamation is completed.We will now consider the most important anomalies in the courseof the disease, corresponding with the order in which the differestages succeed each other.The preliminary stage may be so slight that it may seem asthough no such stage had existed. This, however, does not justifythe expectation that the disease will run a mild course. On thecontrary, if the preliminary stage is considerably longer than usif an excessive lassitude is a marked symptom of this stage, wemay almost expect with certainty that the disease will assume acomparatively malignant character. Occasionally the fever reachesScarlatina. 625even at this stage a height that gives to it the appearance of anintense typhus, so that the patients soon fall victims to its furthis stage the angina is never so violent as to cause any anxietyThe convulsions occurring at the breaking out of the exanthem areseldom of any particular significance, for an affection of the brexcept in so far as the excessive fever may cause an irritation othis organ, is a rare occurrence.It is during the eruptive stage and the stage of efflorescence ththe course of the exanthem can be watched and learnt. It variesin color, is at times bright-red, at other times of a violetout these distinctions justifying any particular inferences beingdrawn from them. An extremely bright color is an inauspiciousprognos tic only if the fever has at the same time a marked adynamic type. A union of the smaller spots to larger patches of redness is of no great importance. The formation of petechise andlarger hemorrhagic effusions on the skin always points to a severtype of fever. In some epidemics the exanthem remains quite rudimentary, the redness is very slight, is confined to small spots obright rose-color, remains only a few days upon the skin and is nattended with any marked constitutional symptoms. Such caseshave been designated as roseola or rubeola, and an attempt has bemade to view this exanthem as a special form of disease. The factthat roseola occurs in every mild scarlatina-epidemic, shows thatis nothing else than a very slightly developed case of scarlatinaTlie angina is likewise liable to important deviations. It is generally of an erythematous character, but not unfrequently involvethe parenchyma and shows an extraordinary tendency to invadethe glands and cellular tissue of the throat and neck. Since thischange does not occur until the exanthem has run its course, it hbeen supposed that it is the result of a metastasis, which is notcase. Whereas a parenchymatous angina seldom terminates insuppuration, an inflammation of the cervical cellular tissue, oncontrary, has this termination so much more readily ; it is thiscumstance which constitutes one of the most malignant sequelee ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 444 of 653the disease. What is still more dangerous is the supervention ofdiphtheritic ulcers during the inflammation. Although the diphtheritic ulceration very seldom spreads* to the larynx, it communcates itself so much more frequently to the nose, the Eustachiantube and the inner ear, to the cervical cellular tissue and glandif it does not destroy life by its direct action, the patients suslowly to the suppurative process, or are attacked with an incura526 Acute and Chronic Contagious Diseases.deafness. Not too much attention can be paid to this malignantangina, especially in the case of children, an examination of whothroats we are very apt to neglect in consequence of the difficulattending such an operation. A discharge from the nose which isat first thin and has no smell, is almost always a sure sign thatdiphtheritis has set in ; it should never be regarded as a favorasymptom, for the reason that a simple nasal catarrh never occursin scarlatina.Inflammations of the joints, pleura, pericardium most commonlyonly occur in cases of great intensity, and do not present any paticular features, although they render the prognosis much moredubious and complicated.Nephritis occurring at this stage, is never very acute, and is somuch inferior to the other morbid phenomena that it is allowed topass unperceived.The most obstinate and most dangerous anomalies occur in thestage of desquamation. They do not always date from this period,but are most generally developments of former disturbances thathad remained unnoticed during the violence of the fever. Thisapplies to inflammations of the joints, pleura, pericardium, inneear. Enteritis occurs very rarely ; on the other hand, diarrhoeamay set in, which, within certain limits, is not a dangerous occurence. The worst symptoms are the suppurating inflammations ofthe cervical cellular tissue and lymphatic glands, to which alluswas made previously, and inflammation of the kidneys. Duringthe process of desquamation nephritis becomes a more prominentcomplication, probably because a suspension of the cutaneous functions, as in extensive burns for example, excites the action of tkidneys in an extraordinary degree, in consequence of which a slirenal catarrh, during the stage of efflorescence, changes to a gecroupous inflammation during the stage of desquamation. Thevarious reasons which have been adduced to account for the supervening nephritis, do not stand the test of a rigorous examinationin some epidemics there is no nephritis at all, in other epidemicoccurs in every case, no matter how the patients were managed inhygienic and dietetic respects. "What is certain is, that nephritis more easily excited by excessive warmth, especially by too mucclothing, which precludes the access of air, than by the patientbeing kept in a cool room and accessible to the influence ofpure air. The renal affection sets in almost imperceptibly ; thepatients have felt quite well for several days ; but, without shoScarlatina* 527http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 445 of 653any symptoms of fever, they do not seem properly to recuperate.The appetite does not return as it should ; the discharged urinedark, and the quantity is scanty ; suddenly it shows a still darksometimes hlack or biackish-gray color, and contains a quantity oalbumen, blood-disks, fibrinous cylindrical casts. The apj)etitegone, the skin becomes cedematous first in the face, and afterwarover the whole body, and to a very high degree. If we do notsucceed in controlling the renal affection, the patients die in tmore weeks of

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 446 of 653his " Treasure of Medicine." This is evidently the result of erroviews concerning the sequelae. Since they apparently originate inthe desquamative period, it was supposed that the sequelse had tobe traced to a disturbance of the process of desquamation. Themost common disturbance was supposed to be a cold. We haveendeavored to show that the commencement of all post-scarlatinaldiseases is traceable to the stage of efflorescence, hence that tare continuations of previous beginnings, not new diseases ; andwe here add that the obstinacy of many a consecutive disorder isowing to wrong management during the disease itself and immediately after. From abundant personal experience we recommendthe following rules. The patients should be kept from the commencement of the disease in an ilniform temperature of from fortyto fifty degrees F., and should only be covered with a linen sheeand blankets. If possible, the sick-chamber should be ventilatedseveral times a day, of course with all proper precautions. Thepatient may be allowed to drink pretty large quantities of freshwater, because the fever deprives the body of a large quantity ofmoisture. The juice of fruit is a refreshing beverage, and may beallowed in moderation ; if used too freely, it is apt to cause naand a bad taste in the mouth. Pure malt-beer we have never knownto do any harm. The patients not desiring any food, gruels, milk,and wheaten bread or bread made of unbolted flour, are sufficientnourishment. As soon as the pulse has become normal, the rednesshas disappeared, and the desquamation is fully established, thepatients may be allowed to rise, but the temperature of the roommust be a little higher than while they were confined to their beA fortnight after the disease first broke out, a general ablutionhas been recommended for measles, may take place, and, if theweather permits, the patient may be sent out of the house, of couwith all suitable precautions. No reason can be imagined whysuch a treatment should be injurious.Scarlatina. 629We will now devote some space to the treatment of the anomaliesthat may turn up during the course of the disease, but we shallnot go into details concerning particular indications, for the rethat every epidemic has, after all, to be combated with specificaappropriate medicines whose symptomatic correspondence will haveto be studied out in the Materia Medica.The excessive fever in the preliminary stage, which is often of athreatening character, has to be met by JRhus toxicod. or Arsenicas long as the brain remains free; but if delirium, sopor, etc.,in, Phosphorus or Opium may be tried ; we would likewise recommend Digitalis. — If convulsions set in previous to the appearancof the exan them, .Bfi/^arfonwa is entirely sufficient. If the fein with an adynamic type, and the exanthem delays its appearance,Bryonia alba will meet this condition.We do not dwell upon supposed distinctions between smoothscarlatina and purple-rash, because we believe them to be unfound"We admit that in cases where the angina is very slight or entirewanting. Aconite is better adapted to purple-rash than BelladonnaIf the efflorescent surface is studded with miliaria, Rhus toxicomore appropriate than Belladonna. If petechiee and ecchymosesbreak out, the fever generally has an adynamic character; Phoshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 447 of 653phorus^ Arsenicum and Kreosotum are the remedies adapted to thischange.If the fever has an adynamic type daring the stage of efflorescence, great danger is impending. Bryonia may be sufficient in thlower grades of this fever, but the higher grades require: Rhustoxicod. y Phosphorus, Digitalis, Veratrum album.; the two lastremedies correspond more particularly to the frequent and smallpulse with cerebral symptoms resembling typhus. Ammoniumcarbon, may deserve a preference, if the pulse accompanying thecerebral symptoms is not excessively rapid. Zincum is likewiserecommended in such cases. If a sudden disappearance of the redness is attended with ominous symptoms; if a general paralysisthreatens, Camphora should be resorted to. The special symptomatic indications of these various remedies can be learnt fromthe Materia Medica Pura.The angina, even if only of an erythematous character, is sometimes intense, and Belladonna does not seem to have the least effupon it. In such a case Apis not uufrequently mitigates the severpain. If we may judge by the provings, this agent must be animportant remedy in scarlet-fever ; the clinical record of this d34^'/r ,/'.' ^530 Acute and Chronic Contagious Diseases.is still very scanty. Whether Apis will prevent the inflammationfrom penetrating to the deeper tissues, has not yet been decided.If the angina is accompanied by swelling of the tonsils, Mercuriishould be given ; this remedy often arrests all further progressthis feature of the disease. If the angina is confined to the tonit will seldom be found necessary to give Hepar^iov the reason thno suppuration generally sets in. If suppuration takes place, Hepsvlphuris cede, should be resorted to without delay. If the inflamation invades the cervical cellular tissue and the cervical glanwhich it may do while Mercurius is being exhibited, in which casethis remedy is no longer indicated, Bryonia may be given. We donot advise a premature lancing of the abscess, because such aproceeding would undoubtedly favor an ichorous decomposition.For chronic suppuration we recommend Silicea^ior subsequent indurations Baryta and Sulphur*A malignant form of angina requires the same treatment asdiphtheritis. Iodine has frequently rendered excellent service inthis aflfection ; Acidum muriaticum is likewise commended ; but,we said before, such recommendations are not always to be dependeupon in all cases, for the reason that one remedy will do betterone epidemic, and the very next epidemic may require a differenttreatment. A scarlatina-coryza sometimes requires a peculiar treament; it often remains even after the diphtheritic angina is cureAurum muriaticum is the most reliable remedy for it; Sepia orCalcarea carbon, is less so.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 448 of 653Parotitis is very seldom an isolated affection in scarlatina; itgenerally accompanied by a malignant or parenchymatous anginaand requires to be treated with the same remedies that have beenrecommended for this disorder. K existing alone, we treat it withthe remedies that have been recommended for it elsewhere.Pleuritis and pericarditis as complications of scarlatina have nopeculiar features requiring any special treatment; they are treatas idiopathically-existing, independent diseases; however, we maystate that Tartarus stibiaiua has been variously recommended inpericarditis, and Mercurius and Rhus toxicod. in pleuritis.Articular inflammations in scarlatina have the peculiar featureof rarely terminating in suppuration and resembling almostentirely articular rheumatism. Amicaj Phosphorus and Rhustoxicod. deserve special attention in these affections.Cerebral affections occur very rarely in scarlatina; isolatedcerebral symptoms, although sometimes very marked, must not beiScarlatina. 531all at once taken for inflammatory symptoms. If the symptomsdenote congestion, with nervous excitement and restlessness, Arrtor Ammonium carbon, may be resorted to ; if they occur accompanieby a cold perspiration and coolness of the trunk, Ipecac.^ CamphoVeratrum album may, be tried; marked sopor indicates Opium^convulsions point to Zincum. — We should always endeavor to determine whether the cerebral symptoms are not altogether superinduced by the intense fever and whether our remedies ought not tobe primarily directed against it.For nephritis and dropsy Helleboms has acquired a well-earnedreputation; it sometimes relieves these aflfections very speedilyHowever, it is not suflicient in every case. If the urine containgood deal of blood, Cantharides and Terebinthina may have to begiven ; Arnica and Nitrum likewise deserve our regard in this dirtion. If threatening heart-symptoms supervene, Arsenicum shouldat once be resorted to, and if the renal inflammation has alreadyrun its course, Digitalis or Lycopodium, •Finally we wish to make mention of cold water in connectionwith scarlatina. The not unfavorable results of cold-water treatment while the exanthem is out on the skin, may serve to quietanxious physicians regarding the danger which they imagine theirpatients would incur if they were not kept very warm or were notforbidden the luxury of a refreshing, although ever so carefullyducted ablution. We would not resort to the cold pack during theefflorescent stage, for we have remedies that surpass the coldtreatment in efficacy. Whether cold water will still prove usefulthe exanthem recedes from the skin, is not certain; it can only bresorted to as a last resort in such a contingency. During the peof desquamation cold-water treatment is decidedly in its place. Ihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 449 of 653there is nothing abnormal in the course of the disease, the bathsablutions which we have- recommended for measles, are sufficient;but if oedema has set in, these means are not sufficient, for thehas to be kept very active. In the case of little children .who oto being packed, we sometimes accomplish our purpose by placingthem every day in a warm bath of at least 92° F., leaving them ineach bath for 15 or 20 minutes, after which we have the littlepatients carefully dried and wrapt in a woollen blanket for halfhour. Most generally, however, the wet pack is indispensable ; ofcourse it ought not to be used to excess and after each pack thepatient ought to be rubbed down very thoroughly. In a few daysalready* perspiration begins to set in, when the patient may be582 Acute and Chronic Contagious Diseases.considered safe. Under this management we bave not yet had todeplore a single loss from post-scarlatinal dropsy.8. Tariola.SmcUl-Poz.It is with a certain timidity that we enter upon a discussion ofthis subject, because we are aware that our views in this respectdiiFer greatly from the views ordinarily entertained by physiciannevertheless space is wanting to enable us to substantiate our viby corresponding arguments. We shall have this privilege in duetime, in a more appropriate place.Small-pox is chiefly the result of infection. The contagium undoubtedly resides in the contents of the variolar-pustules, probaalso in the exhalations and in the secretions of the mucous membrane. Although it has been proven beyond a doubt that thecontents of the pustules retain their infectious principle for atime, provided it is kept from great heat and is not exposed to taction of atmospheric air, yet we cannot subscribe to the doctrinthat the exhalations adhering to the patient's clothing retain folong time the power of transmitting the disease ; hence we believin a spontaneous origin of variola as well as of scarlatina. Thecircumstance that small-pox at times only appears sporadically,and at other times breaks out epidemically, likewise speaks in faof our views. The contagium is not very volatile. It is simple inits nature, that is to say, the same in each of the three speciesthe small-pox disease, so that varicella may cause variola in oneand varioloid in another. Hence these distinctions do not resultfrom so many distinct contagia, but from the different susceptibiities of the infected individuals, as is likewise the case with mand scarlatina. For similar reasons we do not attribute the malignant character of one small-pox epidemic and the mild type ofanother to differences in the nature of the contagium, but to different degrees of susceptibility in the individuals, a«other circumstances of a general or local character, upon which tmalignant nature of the epidemic depends ; precisely aa we knowsimilar results to take place during epidemic scarlatina. There inot an individual living of whom we can positively assert that beis inaccessible to the small-pox contagium; it is true, however,at times the susceptibility seems to be considerably greater, andthat it is unquestionably most intense in childhood and up to thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 450 of 653age of forty-five years, beyond which it begins to decline. The sVariola. 533proportion obtains in all epidemic, and likewise in all nondiseases. One attack of small-pox is a tolerablj^ sure, but not aabsolutely certain protection against another attack. This accounfor the apparent immunity of numbers of people; while young,they had an attack of varicella without the fact being noticed, aon this account enjoy a protection against small-pox, which is improperly attributed to vaccination, concerning which we shall givfurther details when speaking of the treatment. Epidemic smallpox breaks out most commonly in mid-summer, very seldom in winter; it is most generally accompanied by epidemic measles andwhooping-cough; yet a connection or logical succession betweenthese epidemics cannot be traced.Symptoms and Course. For the sake of convenience andin obedience to custom, we adopt the division of the variolous diease in varicella, varioloid and variola, although these three fogenerally exist in the most varied transitions to each other, sothat, in a case of varicella, single pustules assume the form ofioloid-pustules and in cases of varioloid, some pustules adopt thform of variola-pustules, or that the whole exanthem runs a mediucourse between two of these forms.Varicella or chicken-pox constitutes the mildest form underwhich the variola-disease with contagious pustules develops itselChicken-pox is infectious and may give rise to either of the othetwo forms. It infects more particularly children, although notexclusively. Quite recently we treated a case where a young manof eighteen years, who had varioloid, infected his sister, a chilsix months, with variola, and his mother with a very mild form ofvaricella.This eruption generally sets in without any precursory symptoms,perhaps with slight symptoms of gastric catarrh, but otherwise veseldom with precursory symptoms resembling those of varioloid.A few red stigmata break out in the face which grow rapidly andspread irregularly over the whole body; the largest number areseen on the chest and back. Each of these red stigmata changes ina few hours to an elevated vesicle, the contents of which grow diin thirty-six to forty hours, and afterwards form thin scabs thatfall off already on the seventh day. The vesicles sometimes breaking out in successive crops, the whole exanthem may require a fornight to complete its course. Very commonly some of the vesiclesgrow to larger pustules, like variola-pustules, and leaving scarsbehind. At the same time the general health is often so little iu534 Acute and Chronic Contagious Diseases.paired, especially if the vesicles are not numerous, that the famhave not the remotest suspicion of the child being sick. Fever,however, is very commonly present on the first days, even a milddelirium not unfrequently occurs, the appetite is gone, the patiefeel languid, complain of headache and difficulty of swallowinghttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 451 of 653caused by the vesicles having broken out in the throat and on thepalate. The constitutional symptoms are never very important.The exhalations from such patients have the same odor as those ofvarioloid patients.Varioloid, or modified variola, always commences with a distinct,but not characteristic precursory stage. The patients experienceviolent chill, or most frequently chilly creepings which are at osucceeded by a violent febrile heat with increased temperature ana rapid pulse, and with such an intense feeling of illness, thatapproach of a severe disease is unmistakable. With the gastricsymptoms, a violent headache and even active delirium becomeassociated, and likewise a somewhat pathognomonic, severe pain inthe back and small of the back. As a rule, the fever remits in thmorning and exacerbates in the evening, increasing every day inintensity until it reaches its acme on the third evening, when theruptive stage commences. Shortly previous to the appearance ofthe exanthem, an hypersemia, consisting of large spots, is sometiperceived on various portions of the skin.The exanthem in most cases first breaks out in the face, whenceit spreads with tolerable regularity over the whole body, fromabove downwards. Red, scattered, lentil-sized spots break outEach single spot passes through the following course of development. In ten to twelve hours it changes to a papula, which, in thnext twenty-four hours, becomes transformed into a vesicle, thecentre of which is perforated by a hair and correspondingly depressed. In the next twenty-four to forty-eight hours the contentof the vesicle grow dim, and a pustule forms surrounded by anarrow halo. About the sixth day after the breaking out of theexanthem, the contents dry up, giving rise to a brown scab whichfalls off in three to. four days, leaving the spot somewhat injecThis course of development of one pock is not pursued by all theother pocks simultaneously, but occurs in the order in which theexanthem broke out, so that the whole process requires about elevdays or a fortnight until the scabs have completely formed. Thegeneral health shows the following changes while these phenomenaare taking place upon the skin. During the eruption the feverVariola, 585abates soraewliat, upon the whole the patient feela a little bettbut is tormented by the breaking out of pustules upon the mucouslining, which cause difficulties of deglutition, photophobia, crocough, urinary troubles. After the eruption is fully out, the patfeels almost well, and only complains of the distress caused by tjected and tense skin. The suppurative process is generally attenwith a mild fever which disappears entirely as soon as the pocksbegin to form, and which gives place to a feeling of health. Wewill mention a few deviations from this course when we come totreat of true small-pox. The remaining red spots seldom disappearentirely under a month. Scars remain after varioloid, the same asafter variola, only not in such large numbers, nor so deep ; in vloid the disorganizing process takes place most generally upon thexternal surface of the cutis, but does not penetrate beneath it.True variola begins with the same precursory symptoms as theprevious species ; according to Hebra, the precursory stage of vahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 452 of 653is often even less severe than that of varioloid. It lasts threeWithout an exception, the exanthem first breaks out in the fape,thence spreading over the whole body, from above downwards,within two, at most three days. The face always shows the largestnumber of efflorescences. Inasmuch as variola penetrates the cutaneous tissue more deeply, the course of each single varioladiffers somewhat from that pursued by a varioloid pustule. Withintwenty-four hours the stigma changes to a papule, and in anothertwenty-four hoars the papule to a vesicle, the contents of whichassume a puriform consistence until the sixth day after the appeaance of the stigma. The pustule thus formed is surrounded by abroad halo. Hence in variola the eruptive stage and the stage ofefflorescence last at most ten, but never less than nine days.The general health in these two stages is about the same asduring a similar period in varioloid. The fever abates to a certadegree ; the affection of the mucous lining is generally a littleintense.On the ninth or tenth day commences the suppurative stage socharacteristic of variola. The fever, which had almost entirelv dappeared, breaks out again with frequent chills and an intense heHebra accounts for this fever by the circumstance that pus hasbeen absorbed, not by the intensity of the cutaneous affection, fit is not unfrequently absent, even during a most violent attackvariola and never sets in until the pustules had become filled fosome time, but, on the other hand, is always present if ulceratio536 Acute and Chronic Contagious Diseases.takes place. The j-yjemic nature of this fever accounts most easifor the dangerous character of this stage upon which we shall dwemore fully by and by when we come to treat of the complications.While the fever is gradually abating, the suppurative stage continues until the fourteenth day, when the desiccation and the scabing process commence in the same order as the eruption had developed itself. The patients, during this time, are without fever, afeel quite well. The scabs very seldom separate before the seventsometimes not till the fourteenth day, leaving reddish-brown, pigmentous spots and scars which disappear very slowly.It now remains for us to indicate several important anomalies inthe course of the disease. In doing this, we shall confine ourselto variola, varioloid having the same modifications except in alesser degree.In the first place the pustules, instead of remaining isolated, mrun together (confluent small-pox). This confluence of the pocksmay take place to some extent in every severe case of smallbut if it is extensive, the disease becomes much fiercer, the fevabates very little during the stage of efflorescence, th^ suppurafever is very intense, because confluent pustules cause deeplytrating ulcerations. As a rule, this' process only takes place inface. In the suppurative stage the pustules not unfrequently become mixed with blood, giving rise to the so-called black pockwhich always constitutes the most dangerous form of the disease,because it sets in w^ith an exquisitely adynamic fever attended whttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 453 of 653profuse nose-bleed, hrematemesis, hsemaptoe. The filling of thepocks with an ichorous pus is a very rare occurence. The size ofthe pustules varies considerably in the same individual. Some onlattain the size of a lentil and dry up very speedily; others resethe bullae of pemphigus, and some again do not even leave theirpapular form. A few single variola-pustules are met with in everycase of varioloid ; it is the universality of the suppurative proand the longer duration of the disease that determine the characteristic nature of small-pox.With regard to the whole course of the disease we distinguishsmall-pox where the fever preserves an adynamic type during thewhole course of the disease, and small-pox with septic tendenciesthroughout its course. It not unfrequently happens that, after thdisease bar. passed its first stage, the fever suddenly assumes aadynamic type. In adynamic small-pox the pustules may not reachtheir fuU development ; in septic small-pox they are apt to becomVariola. 587hemorrhagic and gangrenous. The phenomena accompanying achange of this kind, resemble altogether those of an intense typhVariola without an eruption is a speculative theory rather than apractically verified fact-Complications and sequelae occur much less frequently aftersmall-pox than after measles and scarlatina, but are no less dangous, for the reason that they have their origin in the suppurativprocess; hence, they occur almost exclusively during and after thcourse of variola, and very seldom after or during an attack ofvarioloid. As direct consequences of the variola-pustules we mention : diphtheritis, croup and oedema glottidis. The lastprocess likewise occurs as a complication of varioloid. The coursthese complications and sequel» does not essentially vary from thof other analogous diseases. The croupy sound is often heard alreduring the efflorescent stage of small-pox, but at this period itno dangerous significance ; it only becomes threatening during thstage of suppuration. Violent inflammations especially of the sermembranes, meningitis, pericarditis, pleuritis, inflammations oflarge joints, deep-seated abscesses only occur after the suppuratfever has set in. They certainly do not arise from the intensitythe inflammatory process upon the skin, but from the absorptionof pus. The eyes in consequence of an inflammatory process goingon in their interior, are not unfrequently threatened with hypopywhereas it is immaterial in a case of varioloid whether a numberof pustules have become seated close to the eye or on the conjunctiva. The danger is altogether determined by the supervention ofthe suppurative process.In both variola and varioloid the prognosis is very uncertain ;the most favorable appearances at the beginning sometimes giveway very suddenly to the most dangerous symptoms, and vice versa,cases that set in with symptoms of great severity, turn out verymild at the end. Age is of great consequence in this disease ; olpeople have to suffer a great deal more than young persons, evidently owing to the greater rigidity of the skin. As a matter ofcourse, a vitiated constitution and unfavorable social circumstanabove all, pregnancy and confinement invest small-pox with a character of most threatening gravity.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 454 of 653Treatment, Before speaking of the remedial agents that mayhave to be used for small-pox, we will express our views concernithe great preventive of small-pox, vaccination. "Without questioning the right of the State to require the individual citizen to m688 Acute and Chronic Contagious Diseases.himself or his children sick ; without meaning to inquire whethermorbid matter can be transmitted by vaccination, for this mightbe avoided with due caution ; simply looking at the fact whethervaccination is really useful or not, we feel bound, from this sinpoint of view, to declare our opposition to tliis proceeding, forreason that we do not believe the vaccine-virus possessed of theleast prophylactic virtue against variola, by which we mean againthe transformation of the pock into a suppurating pustule. Ifepidemic small-pox is so much less dangerous and extensive at thepresent time than it was a hundred years ago, this can be just aswell accounted for by the undeniable fact that epidemics graduallincrease and decrease in intensity, as by the universally practisprocess of vaccination. If persons who are not vaccinated, die atthe present time more frequently of variola than those who are, tcause may be that only those remain unvaccinated at the presenttime, who, living in the worst conditions of society, are more apto fall victims to epidemic diseases. The last epidemic among ushas shown very satisfactorily that the danger of small-pox isderived from accompanying local circumstances, not so much fromthe fact that vaccination had been neglected. In the city of Hanover, where we have not had any malignant epidemics since theyear 1846, we have had numerous small-pox cases for the least yeawith only few deaths, whereas more northward, in our marshydistricts, where severe epidemics have prevailed during the lastyears, small-pox has likewise claimed a larger number of victimsspite of vaccination. We, therefore, have no hesitation in admitting that we belong to the number of those who repudiate vaccination, and we favor the more and more rapidly spreading movementthat has been initiated against this measure. It may be difficultentirely do away with this peculiar institution ; but what can beaccomplished is, that, if people insist upon being vaccinated, thoperation should be performed under appropriate circumstances.We deem the following points essential to such a purpose: Frequenrenewal of the lymph by cowpock- virus ; — extreme precaution inselecting the children from whom the vaccine is taken ;of the statute which makes it obligatory upon parents to have thechildren vaccinated in the first year of infancy ; — ^insertion ovaccine in only a few places with a view of diminishing as much apossible all unfavorable consequences to the organism. In thisrespect we maintain that, if vaccination has at all any protectinvirtue, one pustule ought to protect as much as a dozen. SpeakingVariola. ^.^ 589: )http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 455 of 653/ »of vacciuation we cannot help raising the questioi^pvhether thediminished mortality in small-pox epidemics may not^te ovin^toa more enlightened management of the disease. ^^ \ •The preliminary stage which is not always recognizabie^ as ^uch*at the beginning of the attack, will always invite the em^ynijpn^of remedial agents, although the usefulness or efficacy of ^ch\aproceeding is extremely questionable. Aconite is more tha'^^n^.other medicine recommended at this stage, but we do not altogofhjagree with our Colleagues in the propriety of this course of me^cation. Aconite is indicated in all inflammatory fevers, but notfebrile conditions that evidently owe their origin to toxicationthe blood. For this reason we do not advise Aconite either inmeasles, scarlatina or typhus, still much less in smalldonnawill be found preferable, even after a most careful compariof the symptoms, and ought to be continued until the eruption isfully out. Bryonia will be found much less frequently suitable atthis stage of small-pox. Upon the whole we opine that any medicine is useless either totally or nearly so, for the reason thatfirst stages of small-pox are without any malignant symptoms, eveif delirium should set in. As soon as the exanthem is out, thepatient feels tolerably well; but now is the time to administer sable remedies for the purpose of preventing the purulent metamorphosis which must now be expected, and of which we can neverpositively know how it will result ; and, in general, for the purof maintaining the course of the disease within normal bounds.We have but one remedy that answers this purpose; this remedyis Mercurius. In any circumstances we would advise our Colleaguesnever to repeat the dose too often in this disease. It might be adifficult task to show its usefulness as long as we have not a nuber of comparative observations at our command. If medicine isto be given, it is certain that Mercurius is the most appropriateJust as well as Mercurius will prevent suppuration in cases ofabscesses and small boils, — and we know from abundant experiencethat it will do this, — we may likewise expect a favorable eftectit upon the suppurative process in small-pox, so much more as thesymptomatic similarity between the pathogenesis of Mercury andsmall-pox in this special point extends to the minutest particulaIf suppuration does really set in, we may try Hepar sulphuris forthe purpose of preventing the excessive development of this proceAs long as no anomalies occur, these three remedies will be foundsufficient in every case of small-pox or varioloid, if either theJ540 Acute and Chronic Contagious Diseases.quently severe coujunctivitis, nor the difficulty of swallowing,finally the croupy cough demand any other remedies than the threeabove named ; for these phenomena are simply occasioned by thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 456 of 653exanthem running its course upon the mucous lining, and are,therefore, without any special significance. Upon what grounds anumber of other remedies are recommended for small-pox, we areunable to conceive, and we, therefore, do not mention them lesttheir multitude should cause confusion in the reader's mind. Antimonium crudum and tartaricum have made more noise than anyother remedy, nor can it be denied that the principle of similariis in thett favor; so far, however, it has not been shown that thremedies exert either a modifying or abbreviating influence overthe disease, or that the suppurative stage is prevented by them.Among the anomalies and complications we only mention a few,since it is impossible to furnish a complete list of such occurreVariola with an adynamic type of fever is always very threateningand is characterized by an extraordinary tendency to decompositioand to an approach to typhus. At the commencement Bryonia willvery generally be indicated, on the other hand, we think that itunder these circumstances that Tartar oneiic is in its place, morespecially if the brain is involved. After the pustules are formeArsenicum is most likely the most appropriate remedy, not only onaccount of the constitutional symptoms, as on account of the putrdecomposition which is so apt to set in at this period, attendedhemorrhagic eff^usions into the pustules and ichorous dissolutionWe likewise call attention, at this stage, to Secale cornutum^ anthe mineral acids, especially Acidum muriaL This last-mentionedremedy is particularly appropriate if the pustules become associawith symptoms of diphtheritis in the mouth and fauces, and thelife of the patient is in the greatest jeopardy. Croup which setsduring the suppurative stage, is not controlled by the medicinesusually recommended for croup; it is not the ordinary croup, butsymptom of diphtheritis. We would recommend Hepar sulphurisfirst, and afterwards Phosphorus. (Edema glottidis during smallpox requires the same remedies that have been suggested for thisdisease in a former chapter.[I once saved a boy's life with Arsenicum. The child had neverbeen vaccinated, or rather eight difl:erent attempts had been madto vaccinate him, but every attempt had proved futile. The boywas attacked with confluent small-pox. The disease was runningas favorable a course as could be expected, when I was sent for oVariola. 541night in a great hurry because the disease had taken a bad turn.I found the boy in an undescribable state of apathy and lethargy.The pustules had suddenly receded and those that were still outupon the skin, looked black. Involuntary diarrhcEic evacuationstook place every fifteen minutes spreading a most horrid stenchthrough the room. The skin was cold and clammy, the pulse filiform and could no longer be counted. I gave him Arsenicum secondcentesimal trituration, one half of a grain at a dose, repeatingdose every fifteen minutes. After the third dose the diarrhoeastopped entirely, the skin warmed up, the pulse returned, theremaining pustules resumed a normal appearance, and the diseasewent on its course very favorably. After the boy had been sicktwelve days, and seemed all but well ; after the fever had entiredisappeared, and the child expected to be dressed and play aboutthe room, he was all at once taken with a severe angina, the fevehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 457 of 653returned with a severe chill, he was seized with partial convulsiand next day was covered with scarlet-rash. He had caught thescarlatina at school, but the variola kept it under until theseverer disease had run its course. The boy made a fine recovery,and only showed one or two scarcely perceptible pits on thiechin. H.]Secondary inflammations, when occasioned by the absorption ofpus, are generally very severe and obstinate ; they require diffetreatment from what similar inflammations require when setting inas primary diseases. Bryonia^ and above all MercuriuSy PhosphorusSepar sulphuris and Arseiiicum are most generally the most appropriate remedies. Among these five remedies to which we can addSulphury the proper remedy for a given case will undoubtedly befound. [Tartar emetic may likewise be added ; a case of pneumoniasupervening in the course of scrofulous periostitis, and which coonly be accounted for agreeably to Virchow's theory of pushaving been deposited in the lungs by the current of the blood,yield^ promptly and radically in our hands to the exclusive useof Tartar emetic, third centesimal trituration. H.]As soon as the formation of the scabs is completed, all danger isover. Only in very exceptional cases deep-seated abscesses form,but in such a latent manner that they are only discovered after tdesiccation is terminated. Hence the patient may be safely regardas cured.In view of the measures which it is common to enforce even atthifl time in the management of small-pox, a few rules for the ex542 Acute and Chronic Contagious Diseases.ternal treatment of such patients seem to us of some importance.Experience has abundantly shown that the spread of smallcannot be prevented by even the strictest and most careful quarantine ; hence it is useless to exile such patients from all humanalthough it is undoubtedly proper that all unnecessary intrusionsshould be avoided. Above all, let the patient enjoy an abundanceof pure air ; the access of fresh air not only aftbrds the surestguarantee of a successful result, but is likewise the most effectmeans of preventing the further spread of the disease. It is entiuseless to cover the patients burning up with fever, more than thwish to be. Cautious ablutions never hurt, and are always refreshing. As soon as the patient is free from fever, and desires to lehis bed, let him be permitted to do so. The scabs are most speediremoved by softening them with almond-oil, and by frequentlywashing and bathing the patient as soon as possible. Ablutionsand baths have the additional advantage of helping to restore thenormal action of the skin. As regards diet, the patient's ownwishes may be consulted as far as possible ; as long as the feverlasts, he will not want anything, but the lightest feverother kind of food causes nausea and indisposition. As soon asthe fever has disappeared, a more substantial diet may be allowedAs soon as the scabs have come off, the patient may be permittedto go out. Nothing can be more unreasonable than to keep himconfined in a room even after the exanthem has run its full coursan extreme irritability to catarrhal affections are the frequentsequences of such an unnecessary confinement.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 458 of 6534. Syphilis.Venereal Disease.Syphilis is a disease concerning which it is very difficult to macomprehensive and satisfactory statements in a few paragraphs.The disease is too varied, and undergoes too many modifications bconstitutional influences ; moreover the best mode of treating itnot yet positively settled. We request the reader to receive oursubsequent remarks with a good deal of forbearance ; let it be unstood above all things that we do not intend to present a monograph on the subject of syphilis.JStiology. Syphilis is either communicated by a contagium, orelse it is inherited ; this last statement, however, only appliesfew forms; whether syphilis can break out spontaneously, is verySyphilis. 543uncertain, althongh there is no valid reason to deny it The fixednature of the contagium cannot be denied ; it is most certainlycontained in the primary ulcer, whereas its presence in secondaryaffections as well as in the blood is maintained by some, and denby others. The adoption of a different contagium for simple andfor indurated chancre depends upon observations, the correctnessof which cannot be positively impeached. In the vast majority ofcases the chancre-virus is communicated by sexual intercourse ;in a few cases only the virus is communicated by a different chanIt is not absolutely necessary that the chancrous matter should binserted at a spot where the epidermis is injured ; inoculation ctake place, even if the epidermis is intact ; for this purpose itto be very delicate, as the epidermis of the sexual organs generais. Syphilis can be inherited from the father as well as from themother ; it would even seem as though it were more easily inheritfrom the former. Most observations show that constitutionalsyphilis is a protection against a second infection by the virusindurated chancre, as much as a first attack of variola is a prottion against a second attack of this disease, llie incubationis short and does not last beyond the second week, whereas secondaffections incubate for at least five weeks. A disposition to conthis disease, inheres in every individual ; however, its ordinarymode of origination accounts for the circumstance thp,t male adulare more generally affected with it. Some persons seem to possessa natural immunity from constitutional syphilis, whereas othersmanifest a peculiar susceptibility to this disease ; this susceptseems founded in the so-called lymphatic constitution.A description of the separate forms under which syphilis generally manifests itself, cannot well be given in one connected paragraph; we therefore prefer describing the various phases of thedisease, each by itself, in the order in which they generally suceach other.a. Primary Chancre,Syphilis always commences with the primary syphilitic ulcer.Except when the disease is hereditary, we have no evidence thathttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 459 of 653syphilis can have any other l>eginning.The soft, simple chancre is chiefly seated on the inside of theprepuce, on the glans, and in the transition-fold from the prepucto the glans, more particularly on the frenulum ; among women itIB chiefly seated at the posterior commissure, at the entrance of544 Acute and Chronic Contagious Diseases.vagina, and on the lesser labia. But inasmuch as other parts otthe body may either accidentally or designedly come in contact withe chancre-virus, a chancre may likewise break out on the integuments of the penis, on the scrotum, at the anus, on the lips, mamand in the posterior parts of the vagina. Its course is generallyfollows : at the place of inoculation a small vesicle starts up,rounded by a red halo ; or, if the virus was inserted in an openwound on the skin, an ulcer may form immediately which, whenarising from the vesicle, develops in a very short time, so thatvesicle is very seldom seen. The ulcer is generally round, less fquently oval, never sharply angular, of the size of a lentil or pit has sharp, shaggy, not prominent borders and a lardaceous baseIt gradually spreads, but never grows to a large size ; it sometiacquires a fungoid growth from its base, without, however, becoming indurated on that account. At first only one ulcer of thischaracter generally breaks out, very seldom three, but in the couof the disease new ulcers break out in the immediate neighborhoodof the former, so that the glans is surrounded by them as by awreath ; they may likewise become confluent. It is a noticeablefact that the more recent ulcers generally heal faster, very seldmore tardily than the primary sore. These ulcers heal betweenthree and eight weeks. The healing process is manifested by thefact that the bottom of the ulcer loses its dirty color, becomesered with usually readily-bleeding granulations, and that the edglose their shaggy appearance. The cicatrix is generally radiate.If the soft chancre is seated in the urethra, it generally occupithe locality immediately behind the orifice, where it can be seenIf it is seated farther on in the urethra, its presence may be infrom a seated pain when the part is touched, and which is likewisexperienced during urination ; and also from a scanty discharge opus, whereas, if the chancre is complicated with gonorrhoea, thediagnosis is very generally impossible. The cure of this urethralchancre takes place in the same manner as that of a chancre seatein some external locality.The indurated, so-called Ilunterian chancre is chiefly located inthe transition-region from the prepuce to the glans, and on thefrenulum, but it may likewise break out on any other place, thesame as soft chancre. Many look upon the virus of the Hunterianchancre as different from that of the soft chancre. This questionnot, by any means, decided. This chancre often arises not from avesicle, but from an induration in consequence of the dissolutionSyphilis. 645of the inflammatory exudation. According to some, this is its onlmode of origination. It has chiefly a rounded form ; its appearanhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 460 of 653scarcely varies from that of the simple chancre ; its base, howevhas a less lardaeeous and dirty look. If the induration occupiesbottom of the ulcer, the latter is raised, forming the elevated uif the borders are chiefly indurated, they form a wall round thefunnel-shaped ulcer. The induration sometimes spreads to somedistance round the ulcer, and is generally of a cartilaginous consistence. If the indurated chancre develops itself out of a simplchancre, which is very seldom the case during the first appearancof the latter, and generally not till after the latter has existesome time, the appearance of the ulcer often changes very suddenlThe indurated chancre does not niultiply on the surrounding partshence we seldom see more than one or at most two induratedulcers. It heals much more slowly than simple chancre, and isalmost surely followed by secondary phenomena if a slowly disappearing induration remains after the healing of the ulcer. Thedelicate scar of the indurated chancre is easily torn by frictionwhen a chancrous ulcer readily forms again immediately.Phagedsenic chancre is a chancre modified by the constitution ofthe patient. It only breaks out on cachectic individuals, arisingmore generally from the simple than from the indurated ulcer. Ifsuch an ulcer becomes phagedsenic, it assumes an irregular form,with indentations; it shows a dirty-gray or greenish base, linedwith diphtheritic exudations, is surrounded by a sicklylividareola, and secretes a quantity of thin, sickly and very fematter. The ulcer inclines to spread rapidly and to destroy theorganic tissues, in consequence of which it may involve a consideable loss of substance and even result fatally in a short time. Aphagedsenic chancre most commonly arises in cases where Mercuryhad been very much abused ; it is not diflicult to understand thatne abuse of Mercury should aggravate a phagedsenic chancre verymaterially. A cure takes place by a separation of the infiltratedparts in the same manner as takes place in a case of simple chancA gangrenous chancre may arise both from the simple and inaurated chancre in consequence of the parts round the ulcer becoming^ considerably infiltrated ; the ulcer acquires a sickly colortogether with its surroundings, changes to a scurf which is encom])as8ed by a considerable serous infiltration. A cure takes placeiMcans of the scurf becoming separated ; or, in the opposite casetiie disorganizing process spreads, but scarcely ever as far as i35546 Acute and Chronic Contagious Diseases.case of phagedfienic chancre. Death may very readily ensue. It isnot always possible to trace the gangrenous change to its true caEither directly caused by the primary ulcer, or in company withit, without any definite connection being perceivable, and sometimes outlasting the ulcer, we have :The syphilitic bubo, that is, lymphadenitis occasioned by thesyphilitic affection. The bubo is seated on the side nearest to tplace where the infection was first communicated, more especiallyin the groin below Poupart's ligament. We distinguish acute andhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 461 of 653chronic buboes.The acute bubo seldom develops itself in the second to the sixthweek after the appearance of the primary ulcer, seldom at an earlperiod, and likewise seldom after the cicatrization of the ulcer.generally breaks out after simple chancre, and is most likely tomake its appearance if the chancre is located close to the frenulIrritating the ulcer, most likely favors the development of a bubAt a spot in the bend of the groin, the patient, especially wheamoving the part briskly, experiences a pain which is very muchaggravated during contact, although the inflamed gland can scarceyet be felt. It generally grows rapidly in size, is very painfulmay reach the size of a goose-egg. It adheres to the integuments,hence is not moveable, and the integuments soon show a red color.Suppuration does not take place very rapidly ; fluctuation is nevperceived over a large surface, because resolution only takes plafragmentarily. The spontaneous breaking of the abscess takesplace with much dilEculty ; after its discharge the truly virulenbubo forms an ulcer with all the characteristics of chancre, thesecretion from which is infectious. A bubo very seldom arises froa simple sympathetic irritation of the lymphatic gland. In thelatter case, a cure mostly takes place very speedily, whereas informer case the healing process is very tardy, and the swelling mremain even a long time after the wound is closed. An extensionof the inflammatory process to the surrounding cellular tissue, eCO the peritonaeum ; the formation of fistulous canals and a descsion of the pus are not unfrequent occurrences. These bad resultsgenerally occur if the bubo is lanced prematurely. We shall reverto this subject when we come to speak of the treatment of syphiliThere is no difllculty in diagnosing the true nature of a bubo, ecept after the chancre is healed without leaving a scar, or if thbubo develops itself without any previous chancre. A characteristcircumstance in the history of a syphilitic bubo is, that it almoalways breaks out below Poupart's ligament.Syphilis. 647The chronic, indolent bubo runs a slow course ; it comes on without pain and is very obstinate ; it is distinguished from an acutbubo by the circumstance that it only occurs in connection with aindurated chancre, and is not, like an acute bubo, confined mostlto one gland, but involves a number of them. The swelling progresses very slowly ; a single gland does not attain any considersize, but from several glands swelling close together, a large, hbunchy tumor is formed. Single glands very seldom terminate insuppuration ; if this happens, pus forms very slowly, the sides othe abscess are very slack, and a whole gland is transformed intopurulent matter. Very seldom the inflammation attacks the surrounding parts. Whereas an acute bubo does not justify theconclusion that secondary phenomena will certainly make theirappearance, an indolent bubo is almost invariably succeeded bythem. ^A catarrh of the mucous lining of the urethra or vagina does notvery frequently accompany the primary ulcer. Chancres in theurethra may run their course without a sign of gonorrhoea, or elsthe gonorrhoea may be very violent and painful. To account forthe latter case, the doctrine has been started that there is a dohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 462 of 653infection with the chancre as well as the gonorrhoeal virus. Thisis not necessary to account for the gonorrhoea, for a chancre inurethra may very readily give rise to extensive urethritis; if itdoes not, the cause must be the different degrees of irritabilitythe mucous lining of different individuals. The secretion of a chcrous gonorrhoea is characterized by a strong, very offensive smeCondylomata are vegetations of the skin belonging to primaryas well as to secondary syphilis, but they may likewise occur incombination with gonorrhoea without chancre. We will devote afew general remarks to them in this place.There are two pretty essentially distinct species of condylomata,the soft, humid condyloma with a broad base, and the acuminatedcondyloma.Soft condylomata very frequently accompany primary syphilis ;secondary syphilis is almost always accompanied by them. Theyare seated on the integuments of the sexual organs, on the glans,thighs, scrotum, in the intergluteal fold, on the external pudendand in the vagina, in general in localities where two folds of inument s^e exposed to frequent frictions against each other. Theyare flat risings, very little or not at all injected, covered bythin epidermis, very soft to the feel, and moistened with a scant648 Acute and Chronic Contagious Diseases.muco-purulent, and most generally disagreeably smelling secretionBy growing the isolated condylomata may unite and rise to a considerable height. The exulcerations and the deep rhagades on theisurface impart to the skin that covers them a peculiar ulceratedand split appearance, which is most strikingly noticed at the anuThe period when these vegetations break out, differs a good dealthey come most speedily with an indurated chancre, more particularly, if the primary ulcer is accompanied by profuse blennorrhcea.Acuminated condylomata occur less frequently as accompanimentsof chancre, more commonly as accompaniments of gonorrhcBa ; theygrow more especially on places that are continually bathed by thepoisonous secretion, hence in the same localities where the softdylomata are chiefly seated, principally on the glans and prepucein the female urethra, and at the entrance of the vagina. Theirpresence does not always imply the existence of a general infectiAs a rule, they have a cauliflower-shaped appearance, are coveredwith a hard epidermis, are seated on a narrow base, are sometimespedunculate or, in consequence of being flattened by a pressure oboth sides, have a cock's-comb shaped appearance. They often showa great tendency to grow like fungi, in which case they exhibitconsiderable vascularity ; they may reach the size of a man's hanIf they are seated between the glans and prepuce, and of sufficiesize, they may cause a great deal of suffering in consequence ofbeing pressed upon and pulled at. They never suppurate, nor arethey ever fissured, except by the action of direct force. "Whenhealing, they sometimes disappear quite suddenly, sometimesdecline gradually.b. Secondary Syphilis,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 463 of 653The phenomena of secondary or constitutional syphilis are allconfined to the external skin, the mucous membrane and the higherorgans of sense. They succeed the primary ulcer at differentperiods, very seldom, however, before the sixth week and after thsixth month. They are generally preceded by a period of rest orlatent condition, but it likewise not unfrequently happens thatsecondary syphilis breaks out while the primary phenomena arestill running their course. The mercurial treatment of primarysyphilis is said to exert a moditying influence over secondary phnomena ; whether for the patient's weal or woe, is a question thawill be more fully examined by and by. Secondary syphilitic affeoSyphilis. 549tions do not yield infectious matter. It almost always happens than indurated chancre superinduces secondary phenomena, whereasa simj)le, soft chancre may run its course without any such resulMost observers maintain that secondary syphilis never gets wellentirely, but that, on the other hand, it is a protection againststitutional symptoms. It is conceivable that these two conditionsmay coexist, but not one alone without the other. We have seensecondary phenomena break out more than once on the same personafter repeated infectious intercourse ; the phenomena following tlast infection were undoubtedly milder, and lasted less long thanthe phenomena- succeeding the first attack.Constitutional syphilis is not unfrequently ushered in by vagueconstitutional symptoms which sometimes exist during the wholeperiod that the disease exists in a latent state. These symptomsare : lassitude, ill-humor, vague rheumatoid pains, backache, paiin the throat, slight transitory febrile motions. Such symptomsare generally so vague and trivial that the patient does not consit worth his while to complain of them.Cutaneous affections occur in all the different forms that characterize such diseases ; they are distinguished by one reliable dnostic, namely the peculiar copper-color of the hypersemia by whithey are accompanied. The form of the exanthemata is a lessreliable indication of their syphilitic origin. They generally resent circular or curvilenear figures always of the same style, escially the squamous exanthemata. Finally secondary exanthemsreveal a tolerably constant predilection for certain localities osurface of the body, more particularly for the hairy scalp, thefrontal and nasal regions, the nape of the neck, the volar surfacof the hand, the region around the sexual parts, the lower extremities and the soles of the feet. The most frequent exanthems areSyjphilitic roseola^ generally constituting the first stage of cotutional syphilis. It consists of small, rounded, brightwhich rarely run together, and are scattered about irregularly;they are immediately preceded by the above-mentioned symptomsof constitutional malaise. After the spots have been out a good ^while, they assume a yellowish, and soon after a coppertingewhich does not yield under the pressure of the finger. Thespots break out in different crops, hence are present in variousstages of development, which is an important diagnostic Theynever itch.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 464 of 653In syphilitic psoriasis the scales form upon a very dark base ; t550 Acute and Chronic Contagious Diseases.are thin, nor are they massed on top of each other in thick layerdifferent from non-syphilitic psoriasis, it spares the elbows andknees, and is most fully developed in the palms of the hands, andon the soles of the feet. Under the scales the skin is considerabinfiltrated, hard and callous, and superficially fissured.The other forms, lichen^ impetigo^ acncj ecthyma^ rupia^ pemphiguhave no peculiar features except the copper-redness. Hzanthemalictubercles constitute one of the more frequent and, at all events,malignant cutaneous affections, since they evince a marked dispostion to purulent dissolution, and to ulceration. They always exhian intensely red color, and break out chiefly on the forehead asCorona veneris. They give rise to the syphilitic lupus. Theyusually form definite, most commonly circular clusters ; the ulcearising from them retain the same arrangement. However, theyhave a very different significance from real lupus, and very seldinvolve any considerable loss of substance. Their place is reallyamong the tertiary phenomena ; they have been mentioned heresimply for the sake of brevity.The syphilitic exanthemata in one form or another generallyexist throughout the whole course of secondary or tertiary syphilvery often constituting the only symptom of the continued presencof the disease. This applies more particularly to acne syphiliticand to the impetigo of the lower extremities, also to the psoriasin the palms of the hands ; the two last-named exanthems are veryfrequently associated with considerable callosities in the skin.The hair very frequently becomes diseased, but not as a rule. Itis certainly a mistake to suppose that the baldness of syphiliticindividuals is always a consequence of mercurial abuse; we haveseen this baldness occur in two cases where no Mercury had beentaken. What is certain, however, is that after mercurial abuse thhair either does not at all grow again, or only very imperfectly.What causes the falling out of the hair, cannot well be explainedsince the scalp not unfrequently has a perfectly normal appearancThe affections of the mucous membranes are mostly seated in thelining membrane of the mouth and nose, less frequently of thelarynx, and still less frequently of the rectum. In the mouth thefavorite locality are the tonsils and the velum palati, and the rimmediately back of the last molar tooth. Here a deep-coloredhypersemia is generally noticed simultaneously with the appearancof the roseola, attended with stinging pain and a difliculty of slowing as after a cold, which, be it remarked incidentally, freSyphilis. 551quently excites the hypenemia. This hypenemia either remains,or else, it disappears for a short period to return again so muchmore intensely, until finally ulcers break out, having all the aphttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 465 of 653ance of primary chancres. These ulcers may remain unchanged fora long time; sometimes they are very flat, causing very littletrouble. In other cases they show a great tendency to spread tothe nose and to the posterior wall of the pharynx and larynx. Insuch a case they may remain superficial, or else, penetrate eventhe cartilages and bones. From the losses of substance thus occasioned, and likewise from the contracting cicatrices caused by thhealing of the ulcers, great inconveniences may arise. The ulcersof the Schneiderian membrane are most commonly revealed by afetid, puriform, sanguinolent discharge.Syphilitic iritis is a phenomenon that cannot be accounted for.It occurs very frequently, and sometimes runs such a mild course,that it is entirely overlooked and is only recognized by its consquences. It only sets in after the appearance of the exanthems,never at the commencement of the secondary phenomena, and thereis an evident connection between the iritis and the cutaneous afitions; the more intense and extensive these affections, the morecertainly we may expect the supervention of iritis. It most generally affects only one eye, very seldom both eyes together, sometione after the other. The iritis sets in with violent pains in theglobe of the eye; these are scarcely ever absent and exacerbate anight, attended with more or less disturbance of the visual functions and severe illusions of light. The color of the iris seemschanged, the organ looks specked, the pupil is all but immovable,angular or ovoid, the anterior chamber looks dim as if filled witpus, sometimes slightly and at other times more strikingly. Occasionally small excrescences are noticed at the border, or dark poon the surface of the pupils. This affection generally runs a chrcourse, and is less painful in such a case; if the affection is vacute, it is attended with frightful pains, in which case the eyeapt to be destroyed. A complete cure without any disturbing remnants of disease, can scarcely ever be expected.c. Tertiary Syphilis.Under this collective appellation various alterations are comprehended involving a number of organs and being principally locatedin the osseous system. Sometimes they set in very soon after the552 Acute and Chronic Contagious Diseases.appearance of the secondary symptoms, ordinarily, however, afterthe lapse of years. During the development of these tertiary symptoms the secondary phenomena do not disappear, but generallyaccompany the former in a greater or less degree of intensity. Wecannot here undertake to examine the question whether tertiarysyphilis is caused by a gradual spread of the infection, or whethit is indebted for its existence exclusively to the use of MercurThis question it is certainly very difficult to decide in last reWe are most assuredly of the opinion that tertiary symptoms onlyset in in consequence of the improper use of Mercury ; our reasonis that we are not acquainted with a single case of syphilis whertertiary symptoms showed themselves under homoeopathic management. If, in reply to this statement, the objection should be raithat under homoeopathic treatment syphilis is cured more rapidly,we are perfectly willing to throw in tertiary syphilis, for the srior value of our treatment would not be invalidated by such anhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 466 of 653admission. The various affections that will be enumerated in thefollowing paragraphs, have the peculiar characteristic of eithertending to the purulent metamorphosis and consequent destructionof the aflfected parts, or causing atrophy of the attected organsthe formation of adventitious areolar tissue.Diseases of the bones and periosteum most commonly involve theskull, and facial bones, the bones of the lower extremities, andparticularly such bones as are not provided with a thick muscularcovering, such as the sternum, ribs, etc. The disease sets in withorrid pains which have the peculiarity of exacerbating at nightwith terrible fierceness (dolores osteocopi). The pains sometimesprecede the objective symptoms for some time. At the painful spottumors are seen, which seem to be super-imposed on the bone andare of two kinds. Some constitute elastic-doughy, soft, flat swelings, called gummata; they contain a tenacious fluid, and eitherdisappear again gradually, or else, become transformed into abscesses. The other class, called tophi, are infiltrations beneathperiosteum, having all the hardness of exostoses. If these tumorsdo not slowly disappear, they may become real exostoses; theysuppurate only in a few cases. The substance of the bones itselfmuch less frequently the primary seat of inflammation, but is verapt to be invaded by secondary inflammation occasioned by thesuppuration of the above-described swellings. It is more particularly in the bones of the nose and face that the disease developmalignant consequences. These bones are destroyed to a greater orSyphilis. 553less extent, in consequence of which the face becomes horridly difigared. If the aftection is located on the inner surface of theskull, the brain is exposed to great danger, partly in consequencof the pressure exerted upon the brain, and partly in consequenceof the probable or at least possible extension of the disease tomeningeal membranes.Gummata are not exclusively seated on the bones, but likewiseoccur in the interstitial areolar tissue of muscles ; various pectertiary affections of special organs seem likewise to be traceabthe existence of gummata.Syphilitic sarcocele occurs pretty frequently ; it generally attaonly one testicle, very rarely both at the same time, sometimes oafter the other. It is seated in the substance of the testicle itwithout, attacking the epidydimis. Its development takes placeslowly and without pain ; the testicle may gradually enlarge to tsize of a goose-egg, becomes indurated and unequal on its surfaceThe termination in suppuration is a rare occurrence, and mostprobably owing to bad management. A retrograde metamorphosistakes place very slowly, and in a majority of the cases the interstitial infiltration leads to subsequent and sometimes extensiveatrophy of the substance of the testicle. Among the viscera ofthe trunk the liver is first attacked by an inflammatory processthat is exceedingly chronic and sometimes remains latent ; as intesticle so in the liver, this process may result in a contractintrix, and consequent atrophy and callous degeneration of the substance of the liver. For the spleen, heart, lungs and kidneys wehave no forms of disease to which a syphilitic origin might behttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 467 of 653attributed with positive certainty.The contraction of the biceps muscle without paralysis, or withdiminution but not entire suspension of its functions, is almostalways a symptom of tertiary syphilis, whereas, if other musclesare similarly affected, a syphilitic origin is more questionable.Upon the general organism tertiary syphilis exerts without exception a most deleterious effect, either in consequence of the dturbances resulting from the above-mentioned processes, or in amore direct manner. A very common consequence is a deep melancholy and hypochondria occasioned by depressing reflections concerning the obstinacy of the disease, and afterwards leading to tmost inteilse derangements of the digestive functions. This resulis most apt to take place in the course of sarcocele. Finally allthese various complications and disturbances may lead to complete554 Acute and Chronic Contagious Diseases.cachexia which, however, is not distinguished by any particularfeatures.In reviewing the pathological process of syphilis in its totalitywe have to ofler a few suggestions that are not unessential in atherapeutic point of view ; we shall avoid, however, all hypothetical propositions, so much more as a good many points in syphilisstill require further examination. In our previous statements wehave chiefly adhered to the views of Old School practitioners, wia view of presenting an uniform picture of the disease. Inasmuch,however, as the treatment of syphilis must necessarily exert agreatly modifying influence over the form of its manifestations,behooves us now to review the changes taking place under homoeopathic management.The total course of syphilis is the more rapid, the more vigorousand healthy the aflfected individual otherwise is; its course ismore tardy, or inclines to chronic and dangerous developments themore, the more debilitated the constitution of the diseased persoIn view of this general proposition it is undeniable that under ttreatment with large doses of Mercury, the course of syphilis isnot only much retarded, but is likewise more easliy forced intoabnormal deviations.The treatment of syphilis with large doses of Mercury keeps thesyphilis latent for a longer period, and by this means prolongs icourse. A complete cure takes place so much more speedily, themore speedily the secondary symptoms manifest themselves, forthey have to be regarded as curative efforts of the organism. Thegreater the number of single chancres that break out on an individual, the more intense the cutaneous exanthems, the more speedily will a complete cure be effected.Whether there is a secondary sj'^philis, is a fact susceptible ofdemonstration ; but it is not so easy to decide what symptoms ormodifications of secondary syphilis have to be charged to the actof Mercury. In this respect the judgment of Homoeopathy is morereliable than that of any other method of treatment. From thestand-point of Homoeopathy we assert that the spots and papulae,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 468 of 653the intense hypersemia of the mucous lining of the fauces, thesuperficial ulcers of the fauces, and the condylomata are purelysyphilitic ; that, on the contrary, the impetigo, the scaly and mparticularly the tubercular exanthems, the ulcerations of the fauand nose, and likewisd those of the larynx, are unquestionably duto the treatment. Iritis is likewise a syphilitic phenomenon. TheSyphilis. 555whole aeries of phenomena that are designated as tertiary, is undoubtedly the result of Mercury, not syphilis.If syphilis is treated homoeopathically from the commencement,and every objective symptom has disappeared under this treatment?it is safe to assume that the disease is completely cured, providno new symptom breaks out in the space of five or six months.Under the old-fashioned mercurial treatment new symptoms maybreak out even after the lapse of years. It is not fair to inferthese mercurial symptoms are purely and simply the result of mercurial poisoning, for Mercury does not produce such effects whenemployed in other diseases ; the truth seems to be that it is frothe union of mercurial and syphilitic action that these phenomenaresult. The ease is precisely similar to that of intermittent fevcured with massive doses of Quinine; the cure is simply apparentand altogether temporary.Hence the total course of syphilis under homoeopathic treatmentis altogether different from what it is, when the treatment is coducted ih accordance with the principles of the Old School. If wehave availed ourselves of the course of syphilis under Old schooltreatment for the purpose of presenting a full picture of the disit is because homoeopaths are but too often applied to for treatmby syphilitic persons who had been poisoned ^yith Mercury. Underhomoeopathic treatment the course of syphilis is about as followsThe soft chancre heals between six or ten weeks, most generally bmultiplying considerably ; it is scarcely ever followed by secondphenomena. The indurated chancre heals between nine to fifteenweeks, during which period the infiltration disappears ; it is geerally succeeded by secondary symptoms, but they break out whilethe chancre is still existing, and heal completely between two tofour months. An acute bubo breaks only exceptionally, generallyit retrogrades without any subsequent secondary symptoms, and isfinally completely reabsorbed without leaving any particular infitration. We have observed this course in the case of buboes thathad already reached the size of a hen's egg, with intense rednessthe integuments and distinctly-perceptible fluctuation. So far wehave never treated a case of syphilis where, after a complete disappearance of all the symptoms, syphilitic phenomena again showedthemselves at a subsequent period.In conclusion we must not omit to state that in Schneider'streatise, entitled : "Syphilis and the methods of curing it," Lei1861, we possess a valuable work, where the pathological as well656 Acute and Chronic Contagious Diseases.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 469 of 653therapeutical views concerning syphilis, are subjected to a lucidexhaustive criticism. We here call attention to this work for thebenefit of those who desire to become acquainted with the differemethods of treating syphilis, and which we have not space to dweluj)on more fully.Treatment. The only remedy for all the uncomplicated formsof syphilis is Mercury. Every homoeopath accepts this propositionthe practical value of which has been verified in a large numberof cases, as correct. Simple syphilis whose course we have indicaabove, requires for its complete cure nothing but Mercury ; butsyphilis as manifested in the various forms, a description of whihas been given in previous paragraphs, requires for its cure a nuber of other remedies in almost every case. With a view of simplifying the presentation of our subject, we will describe the trment of the above-mentioned single forms in successive order.The simple soft chancre heals in the time indicated, seldomwithin three weeks, under the exclusive use of Mercurius solubiliIf practitioners entertain different views concerning the dose, iprobably because no adequate allowance has been made for thecourse which syphilis takes ; moreover, there is no doubt that onindividual requires a larger, and another a smaller dose. In ourpractice we are in the habit of employing triturations, althoughmany physicians profess to have effected cures with the sixth andeven higher attenuations ; we never give more than one dose aday, of one grain each, second or third trituration. Under thistreatment the chancre never shows an immediate tendency to heal,but it increases in size, three, four or even eight new chancresout, all of which heal within ten weeks at the latest, leaving ascarcely perceptible cicatrix. Hence the appearance of new chancres should never deceive us ; on the contrary, it is a favorablesince secondary phenomena scarcely ever break out in such a case.For the last three years we have likewise applied the second tritration of Mercurius solubilis externally, dusting the ulcer withevery day by means of a little camel's-hair pencil. This proceediseems to hasten the cure; the ulcer becomes a little raised, aftewhich the cleansing takes place very rapidly. As soon as thischange is beginning to set in, we discontinue the local applicatiand now give a higher attenuation less frequently, continuing itfor two or three weeks after the cicatrization of the chancre. Thinflammation of the prepuce is less important than it might seeman operation need only to be resorted to, if the glans is too mucSyphilis, 557constricted by an existing paraphimosis. However, since the circumstance that the cut surfaces are apt to become chancrous, doesnot involve any danger, and phimosis may cause a good deal ofdistress, our advice is to slit the prepuce whenever it becomes iflamed and swollen. In order to protect the chancre from all unnecessary friction, and at the same time prevent an adhesion betwthe prepuce and glans — an event of very rare occurrencecover the chancre with a thin layer of lint.The indurated chancre likewise requires Mercurius sdubilis ; thispreparation is, however, insulEcient in very many cases ; under iuse the disease runs too protracted a course. However, inasmuchhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 470 of 653as we cannot fix a normal period for the curative action of Mercuwe should not lose our patience too readily. It is unnecessary togive larger doses than \n a case of simple chancre ; a dose needbe given more frequently than every other day. In these cases thelocal application of the remedy has seemed to us of decided benefWhether some other mercurial preparation is indicated, had betterbe determined by the nature of the consecutive phenomena. If anindolent bubo forms, we advise the use of the red Precipitate. Fosoft, flat condylomata we prefer Corrosive SMimate^ a weak solutiot* which we likewise apply externally. We have never yet foundit necessary to give stronger doses of either of these two remedithan one grain of the second trituration a day, nor have we everhad to deplore the supervention of medicinal symptoms after eithemedicine. [We once prescribed half grain doses of the red precipitate, first decimal trituration for several Hunterian chancres onlabia majora ; the disease was speedily cured, but a horrid salivbroke out, which it took a week to subdue. H,] Condylomatamost generally last longer than chancre, but very seldom longerthan the induration. Indolent buboes always disappear very slowlyIn order not to be led by our impatience to the commission of mistakes, we should always remember that a rapid cure is only preferable to a tardy one, if it is at the same time safe ; but that inopposite case the latter is decidedly preferable. Syphilis can nebe cured rapidly. If we are called upon to treat an induratedchancre after it had already been for a long time treated with ladoses of Mercury, it is decidedly proper not to give any more Mercury even for three weeks, and to substitute Nitric acid instead.By pursuing this course we obtain so much more certainly an uncontaminated picture of the syphilitic disease, nor need we dreadits progress near as much as the insidious development of a syphi558 Acute and Chronic Contagious Diseases.litico-mercurial monster. Several physicians recommend for indurated chancre the Iodide of Mercury^ and likewise Cinnabaris. It ivery likely that these two remedies act well in this form of chanwe have never yet employed them for the reason that we havealways got along with the remedies above mentioned.As we have stated previously, phagedsenic chancre is determinedby peculiar constitutional tendencies. It does not bear large dosof Mercury ; if this is to be used, it has to be employed with grcaution. The best mercurial preparations for this chancre areCorrosive SvUiiruite and the red Precipitate. Upon the whole, however, Acidum nitricum or muriaticum had better be substituted forMercury until the ulcer spreads no longer, and the bottom of theulcer becomes cleansed. In very bad cases Arsenicum is said tohave had a good effect.A gangrenous chancre should never be treated with Mercuryuntil the gangrened parts have sloughed off and provided the remaining ulcer still shows the characteristic properties of chancrwhich is not usually the case. Arsenicum is the only remedy capable of arresting the gangrenous destruction. It is a well knownfact that this form of chancre is scarcely ever followed by seconary syphilis ; hence the apprehension of secondary symptoms neednever suggest a resort to Mercury.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 471 of 653An acute bubo does not require any other treatment than thatof the simple chancre from which it had proceeded. Under the useof Mercury it generally runs its course without suppuration, andeven, if pus has already been deposited, it is very often reabsorAcidum nitricum^ He par sulphuris calc,^ the red Precipitate andanimalis have likewise been recommended for buboes. ExceptHepary we cannot recommend a single one of these remedies assuperior to Mercurius sd.; Hepar can only prove useful after thesuppurative process has become fully established. Hepar is likewise indicated if, after the evacuation of the pus, or after a paretrograde metamorphosis, the gland still remains for some timehard and swollen. Sulphur may likewise have to be employed insuch circumstances, provided of course that no secondary phenom:ena have broken out.An indolent bubo which is almost always a sure sign of soconstitutional syphilis, never disappears rapidly; hence remediesought not to be changed too rapidly. In such a case the Iodide ofMermry is decidedly appropriate and sufficienti unless the affooSyphilis. 559tions of the skin and mucous membrane which may be beginningto make their appearance, should require another remedy.Gonorrhoea occasioned by chancre in the urethra, does not requireany special remedies; Merc. sdvMlis cures the gonorrhoea at thesame time as it heals the chancre.For condylomata, Thuya is not a sovereign remedy ; this fact isnow established beyond a doubt by abundant experience. It is anexcellent remedy for the acuminated, dry condylomata, but seemsto have very little, if any, eftect upon the soft condylomata, eiwhen used internally or externally. In our opinion, these soft codylomata do not always require any particular medication. If theybreak out. in company with a simple chancre, thoy generally disappear soon after the chanere is healed, and it is good policy, along as the condylomata last, to continue the Mercury in smallerand less frequent doses. If they accompany an indurated chancre,they remain for a long time even after the latter is cured, for treason that they constitute a sign of the more intense and moreuniversal infection. But even in such a case we do not advise anyspecial treatment on their account, because the other constitutiosymptoms are much more important. What is certain, however, isthat as long as condylomata are present that had come out aftera chancre, the syphilitic disease is not cured. If they constitutonly manifestation of the disease, we advise both the internal anexternal use of Corrosive Sublimate. "We have no personal experieto ofter concerning Nitri acid,y Cinnabaris^ iSoMna^ Staphysagria[Tartar emetic^ internally as well as externally, is an admirableremedy for soft or mucous tubercles. IL]Among the secondary symptoms we first notice the exanthems.They are best managed with the more intensely acting mercurialpreparations, Corrosive Sublimate^ red and white Precipitate, andaccording to our own very satisfactory experience, with our Mer*curius vivus which, it seems to us, is not sufficiently appreciatThe violent action of the Napolitan ointment shows that quicksilvhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 472 of 653acts more rapidly, and even energetically, than most other mercurpreparations; we have found this statement corroborated in a number of cases. Of course not the first, but the third triturationto be used. It is, moreover, certain that Mercurius vivus causesexanthematic phenomena more certainly and specifically than anyother mercurial preparation. For this reason we cannot recommendMercurius vivus with sufficient emphasis for experimental trials,BO much more since it likewise corresponds so perfectly with the660 Acute and Chronic Contagious Diseases.hypersen ia and ulceration of the mucous lining of the fauces. Fothe above-described uncomplicated affections of the skin and mucolining, the remedies which we have pointed out will be found sufficient ; however, a marked increase of the cutaneous eflSorescenmust not be regarded as a bad sign, for the more rapidly andnumerously they break out, the more speedily and thoroughly theywill be cured. The falling off of the hair is very often remediedHepar.Iritis cannot well be treated without Mercury; but it has to beused cautiously ; Corrosive SiMimate is the best mercurial prepartion for this disease and the most efficient remedy to avert allmediate danger. After the Sublimate, the remaining symptoms aremost effectually controlled by means of Clematis ; we have curedtwo cases of iritis with this drug alone, although the pupil wasalready considerably distorted.The next syphilitic forms which we shall describe, are a mixtureof syphilis and mercurial poisoning, or, which is likewise possibof syphilis and constitutional anomalies. The treatment of theseforms is therefore very different, sometimes exceedingly difficuland always very tedious. It is of great importance that, even inregard to the forms that we have just described, we should knowhow much Mercury had been used in treating them ; this knowledge is indispensable if we are called upon to treat mercuriolitic combinations. "We ascain call to mind a chief rule which isapplicable to all these cases, namely r that a curative result munot be expected too impatiently, and that we had better commencethe treatment with some indifferent substance, which will affordus time to decide upon the course of treatment that ought to bepursued. We would tender this advice to all those who fancy thata syphilitic patient cannot pass a day without suffering for thewant of medicine. Drenching the patient with quantities of medicine is sufficiently destructive in the hands of Old School practtioners, it is likewise hurtful in homoeopathic hands, ivere it obecause such a treatment obscures the curative results obtainedwith our remedies. And we again suggest with all proper emphasisthat the cutaneous efflorescences and most other syphilitic phenomena are curative endeavors that ought to be sustained ratherthan prematurely suppressed.The remedies which homoeopaths employ to combat the mixedforms of syphilis and m'^rcurial poisoning, and whose value has bascertained by clinical experience, are: Mercurius bijodcUus^ Kalhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 473 of 653Syphilis. 661hf/driodicum^Bepar svlphuris calc.^ Sulphur^ Aurum muriaticum andmetaUicum^ Kali bichromicum^ Acidum nitricum^ Sarsaparilla^ Lycopodium. To undertake to give special indications for every singleremedy would be a vain endeavor. In reality we have to be guidedby clinical experience, without being able to act in full accordthe law of similarity. We shall rarely be able to effect a curewith any single one of these remedies; most commonly frequentchanges will be found indispensable. For this reason we confine ourselves to giving the most necessary rules in the subjoineparagraphs.Syphilitic exanthems, with the exception of roseola, scarcely everequire any Mercury ; it is only if the improvement is tardy, ordoes not seem disposed to set in, and if we are certain that thepatient had not yet been poisoned with this drug, that a few doseof Mercury can sometimes be given while the treatment is mainlyconducted with some other leading remedy. Psoriasis yields mostpromptly to Svlphur^ Nitri acidum^ and, according to some, to Sarsaparilla and Lycopodium. The pustulous forms require the Iodideof Mercury^ Nitric acid^ the Hydriodate and Bichromate of Potash,Syphilitic pemphigus requires: Hepar sulphuris calc.^ Sxdphur^likewise Graphites. Tuberculous exanthems: Aurum Wjetallicum^Acidum nitricum^ and likewise Graphites ; Lycopodium may likewisebe appropiate.The ulcers on the mucous lining are of a mercurial character, ifthey are deeply-penetrating and affect the bones ; we have to avoMercury in treating them, and only resort to it, if we are satistthat no improvement can be achieved by any other means. In suchcases the red and white Precipitates are preferable to all othercurial preparations. For ulcers in the mouth Kali hydriod. may begiven alternately with Kali Uchrormicum ; for ozeena, if the boneare yet intact, Kali hydriod. may be prescribed, and if the bonesinvaded, Aurum muriaticum^ If the patient had previously takena good deal of Mercury, Addum nitricum may be given every nowand then for a few days at a time. Laryngitis requires above anyother remedy Hepar sulphuris^ moreover Iodine and the Bichromateoj Potash^ and according to Hartmann, Lycopodium.The tertiary phenomena require throughout a cautious, but continued use of the Iodide of Potassium. It is only for single formthat other remedies are required, Aurum^ for instance, for syphillupus, for caries of the facial bones, the suppurating tophi, and36562 Acute and Chronic Contagious Diseases.finally for sarcocele. Sulphur scarcely ever produces marked resuin tertiary syphilis, nor does Hepar sulphuris. On the other handthe Iodine-springs of Hall deserve high praise; the water fromthese springs is the mildest and at the same time most penetratinform in which Iodine can be administered.It remains for us now to make a few remarks concerning the dietof syphilitic patients. In this respect opinions differ even amonhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 474 of 653homoeopathic physicians to such an extent that they sometimes arein direct antagonism to each other. We have found the followingrules uniformly substantiated by our own experience. Syphiliticpatients should never be deprived of a sufficient supply of simpland nourishing food ; they should not be allowed to eat to excessnor should they indulge in fat and spiced articles of diet, spiriheavy beer ; light wines do not hurt ; a beverage composed of winand water may safely be permitted. The patient should be allowedto enjoy fresh air, but should avoid violent exertions, long walkdancing, etc., until the chancre is healed. These rules are basedupon the observation that, if the bodily strength is well preservthe syphilitic disease runs through its difierent phases more rapit is moreover a general principle in therapeutic science that threactive energy of the organism should never be voluntarilydepressed in any disease. Mercurial poisoning does not require adeviation from this principle, for it is in debilitated individuaMercury causes the most terrible devastation. Of great importancein protracted cases of syphilis is careful attention to the skinis undoubtedly the most important organ for all critical endeavorof the organism. This is the reason why inveterate secondary andtertiary syphilis improves so rapidly under a rationally and methically conducted cold-water treatment which should always beresorted to in such cases. Sulphur-baths are much less efiectualthey may afford relief, if the patient is attacked with severe rhmatic pains ; otherwise they have no other effect than to increasthe sensitiveness of the skin to atmospheric influences.B. EPIDEMIC AND ENDEMIC INFECTIOUSDISEASES.i. Intermittent Fever, Fever and Ague.Intermittent fever is now almost universally traced to the influence of malaria ; any other origin of this fever is denied. Whatmalaria is, and whence it arises, is either entirely unknown, orour knowledge of malaria is very uncertain. Where a quantity ofvegetable matter is exposed to rapid decay, intermittent fevers aa very common occurrence, and they are the more intense the morerapidly the process of putrefaction takes place, consequently theintensity is greatest in very hot weather. We should be led toofar, if we were to dwell more particularly upon the nature ofmalaria, and we omit this so much more readily as no advantageaccrues to the treatment from such speculations. It is well, however, that our attention should be kept fixed on one point, namelthe decaying vegetation ; for this will remind us of the prophylameasures that it may be necessary to take. Where malaria prevailsintermittent fever is endemic. But this fever likewise breaks outin a more or less epidemic form, when it invades malarious distriwith great violence, or when it visits regions that are generallyfrom intermittent fever, in a mild form, and does not spread overlarge extent of country. Whether epidemics of this kind likewiseowe their origin to malarious miasms that had been wafted overfrom their original locality, is questionable, for, after all, itcult to understand why in one year the infectious matter should bcarried ufion the wings of the wind, and not in another year. Norare such epidemics confined to certain atmospheric relations. Whais remarkable is that such fever-and-ague epidemics are very apthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 475 of 653precede epidemic cholera. Where intermittent fever is an entirelysporadic disease, its origin is still more obscure, as is the casus, for instance, in the city of Hanover.A special disposition to the disease is determined by age only in60 far that middle-aged, robust individuals are more exposed to texciting causes of the fever. In infancy intermittent fever is acomparatively rare disease. Tuberculosis is an almost certainguarantee against intermittent fever.663564 Epidemic and Endemic Infectious Diseases.As regards the seasons, the disease occurs most frequently whenthe decay of vegetable matter is going on most extensively, namelin the months of April, May and June, in hot summers with copiousshowers of rain, likewise in very warm fall-months. Fever andague is least prevalent during the winter-months, in very coldweather and likewise in very warm, dry weather.Predisposing causes of fever and. ague are : errors in diet, cataof the digestive tract, colds, working all the time in wet placesThis last-mentioned circumstance is the reason why brickmakersare so readily attacked with fever and ague, even if the localitywhere they work is situated on high ground.One attack of fever and ague undoubtedly increases the disposition to have a second one; persons who move from perfectly healthinto malarious districts are likewise attacked much more readily,whereas a protracted sojourn in a malarious district diminishes tsusceptibility to the malarious miasm.To picture intermittent fever as it really exists, is a difficultundertaking ; in the first place, the disease of itself varies grin its manifestations; and in the next place the fever is greatlymodified by the employment of remedial agents. Inasmuch as thesedeviations from the normal form will have to be mentioned moreparticularly when we come to speak of the remedies for this feverwe here confine ourselves to a short description of the most essetial modifications.Uncomplicated, genuine intermittent fever is characterized byparoxysms of chill, heat and sweat, returning at regular intervaland separated from each other by a more or less complete apyrexiaThe first paroxysm is very generally preceded by a more or lessdistinct preliminary stage lasting at times a day, at other timesweek and even longer, and not presenting any phenomena thatdefinitely point to intermittent fever. In sporadic cases especiaa gastro-intestinal catarrh with slight remittent fever is very ato run into fever and ague.The paroxysm is very frequently ushered in with a feeling ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 476 of 653malaise, stretching and yawning, drawing pains in the extremitiesthese symptoms are soon succeeded by chills down the spine, and ba feeling of coldness in the extremities and whole body, attendedwith shaking of the body and chattering of the teeth. On the partof the body most remote from the heart, the skin generally losesturgescence, its temperature falls quite considerably, its colorbluish and as if dead. On the other hand, the temperature in theIntermittent Fever. 665axilte as well as in the mouth is considerably higher. The chillvery generally accompanied by violent headache and a distressingthirst, and, if any food had been introduced into the stomachshortly before the paroxysm, it is ejected when the chill sets inThe chill seldom lasts less than half an hour, nor more than threhours. The pulse is small and contracted, the urine has not muchcolor, the spleen is somewhat enlarged.The second or hot stage never sets in all at once ; the chill abagradually and is interrupted by local flashes of heat, until thefinally becomes permanent and general. With the heat, the turgescence of the skin likewise returns, the temperature graduallyincreases to a considerable height, sometimes over 100° F., and tpulse becomes full and bounding. The headache, restlessness andthirst increase considerably, delirium is not unfrequent, the colof the face changes to a bright-red. The enlargement of the spleecontinues during this stage which seldom lasts less than two tothree, but frequently upwards of six or eight hours.The sweaty stage likewise sets in gradually; perspiration firstbresiks out on some parts and gradually covere the whole body. Atthe same time the temperature sinks rapidly, according to Wunderlich, in regular stages, and a feeling of comfort is soon restorethe patient. As a rule, the urine at this stage is strongly saturwith urates. The sweat lasts from one to six and even ten hours ;the apyrexia commences as soon as the sweat ceases. This periodwhich is of the utmost importance to a homoeopathic practitioner,always shows some, although sometimes very trifling morbid symptoms which differ in diiFerent individuals.Fever-and-agne, in its uncomplicated form, generally follows thetertian type ; in other words, forty-eight hours elapse between tsuccessive paroxysms. If the intensity of the fever remains thesame, the paroxysms generally return at the same period. In proportion as the disease decreases in intensity, the next paroxysmalways sets in at a somewhat earlier period, and in a less degreeintensity ; it is much less frequently the case for the paroxysmset in with less force and at a later period. If the paroxysm setin sooner and with more violence, a transformation of the tertianinto the quotidian type may be expected ; a change of this kindalmost always takes place, if the fever lasts a good while. At thsame time the affection shows a higher degree of intensity andobstinacy. The quartan type, that is, the return of the paroxysmsat intervals of seventy-two hours, only sets in after the disease566 Epidemic and Endemic Infectious Diseases.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 477 of 653lasted for a long time, at times developing itself directly fromtertian type, while the paroxysms postpone, and at other timesfrom the quotidian fever. This quartan type implies the highestdegree of tenacity in the disease.The other types, double-tertian, sub-tertian, and whatever theirnames may be, occur too seldom to deserve special mention.It is difficult to say what constitutes the normal course of intemittent fever, for the reason that it is always modified by treatment. The following may be regarded as tolerably fixed: In afavorable case the paroxj^sms scarcely ever cease suddenly; theydecrease gradually both in intensity and duration, and are apt todiscontinue entirely at the end of seven days, the apyrexia beingmore and more prolonged and gradually becoming permanent. Inunfavorable cases, either under the influence of improper management or under the continued action of the malarial poison, butnever, or at least very seldom, under homoeopathic treatment, wehave a gradual development of the so-called malarial cachexiawhich we shall dwell upon more fully after having previouslydescribed a few deviations from the normal type.Upon the whole, these anomalies occur very seldom at the commencement of the malarious infection, but they become the morefrequent, the more the disease approximates to a malarial cachexiOne of the three stages may be entirely wanting, or, if it existsmay be scarcely perceptible. It is generally the chill and sweatystage that remain suppressed, the hot stage is almost always presSome of the stages, more particularly the heat and the sweaty stamay be separated by an apparent apyrexia of a few hours' duration. Among children, convulsions are not unusual in the first twstages, but they are not of a dangerous import, except when violeand long-lasting. An intermittent fever of long duration and undethe continued action of malaria, changes to the remittent type;this circumstance, however, points without an exception to malarial cachexia. In simple intermittent fever, the spleen never enlarges to any very great extent.One of the characteristic eiFects of malaria is intermittent neurgia ; the paroxysms set in with all the typical regularity of fevand-ague paroxysms, but without any marked febrile symptoms.During these attacks, the temperature of the body is generallyconsiderably higher than usual. [There are other intermittentparoxysms which take the place of fever and ague and may beregarded as masked forms of the intermittent disease. Some of theIntermittent Fever. 667more common forms of masked fever and agiie are : Intermittentneuralgia, dysentery, pneumonia, articular rheumatism. AVe havenever been able to get along in the treatment of these maskedforms of fever and ague without Quinine; it is not necessary togive large doses, but Quinine is indispensable. H.]The most important anomaly is the intermittens pemiciosa orcomitata. Most commonly intermittent fever adopts this form inthe subsequent course of the disease, very seldom at the beginninhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 478 of 653Intermittens perniciosa is a form of fever where a simple increasof the ordinary symptoms becomes dangerous to life. This malignant increase often takes place in the first stage, more particulin the case of children, but more commonly during the hot stage;the danger arises either from the brain being paralyzed, or elseparalysis of the heart in consequence of the excessive vascular ecitement. If the brain is threatened with paralysis, the attack icharacterized by delirium, sopor, coma, likewise by paroxysms ofexcessive maniacal exaltation ; if paralysis of the heart threatethe cjiill increases to icy-coldness, like the coldness in cholerMany a case of fever and ague assumes the pernicious type simplybecause the paroxysms are of an extraordinary duration. [Thisform of intermittent fever is designated in our country as "Congestive chills;** it acts precisely as Hufeland's febris apoplectpernicios^. We have seen a great deal of it. During the chill weAconite or Gelsemimim^ as the case may be, and we sometimes resorto the spirits of Camphor to hasten reaction ; during the hot stawe continue the Aconite, or substitute Belladonna; and when thesweaty stage has fairly set in, we give Quinine in sufficient quaeither to keep off the next attack, or at least to secure a modiftion of the paroxysm. We do not believe that congestive chills,such as we see them in our malarious countries, can be arrestedwithout Quinine ; we believe that Quinine is the specific remedythis form of chills, although other remedies may likewise berequired. When the late Dr. Channing was still practising in thecity of New York, he had a case of congestive chills to treat, fowhich he gave the patient, a Western gentleman, a dose of tolerably highly-potentized Nuz vomica, A second chill, of course, tooplace much more violent than the first. The Doctor, with his largbrain crammed brimful with the doctrine of homoeopathic aggravations, being perfectly satisfied that the Nux had aggravated thsymptoms, gave him a drop of Alcohol to counteract the terriblemischief the harmless little globule of Nux had done; a third568 Epidemic and Endemic Infectious Diseases*paroxysm occurred, which destroyed the patient. II.] The febrescomitatae are characterized by the supervention of other threatening symptoms during the paroxysm, more particularly a severeattack of intestinal catarrh like cholera, rupture of the spleen,cessive hypersemia of the brain, inflammatory affections of vitalorgans, hemorrhages, apoplexy.Malarial cachexia in its severest form is most usually met with,if a quantity of Quinine is administered to the patient while hecontinues to be exposed to the action of the malarious miasm. Thiaction alone, without Quinine, never produces a malarial cachexiaof the same degree of intensity. Individuals who had taken agreat deal of Quinine, after moving out of the infectious districare very apt to be attacked with malarial cachexia. According tothe observations that have been made by a number of practitionersthe close connection between malarial cachexia and Quinine cannotbe denied. We will now proceed to describe the course which feverand ague takes when mismanaged by Quinine.With large doses of Quinine we generally succeed in effecting asudden cessation of the paroxysms; but the period following sucha suppression is not free from morbid symptoms; the patients comhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 479 of 653plain more or less. A fortnight, or more commonly three weeks, lefrequently four weeks after the suppression, another paroxysm breout very suddenly. This paroxysm likewise yields to Quinine, butafter this second suppression the patient generally complains morthan after the first; for a third paroxysm, which generally breakout after a short apyrexia. Quinine now proves ineffectual. The poxysms either assume the quartan type, or else they break out witgreat irregularity, and combine with constitutional symptoms thatgradually increase in intensity. The spleen is sometimes so largeit fills one-half of the abdominal cavity ; the liver becomes enland after a while shows symptoms of fatty degeneration; the digestion is entirely deranged, the appetite is gone, the bowels are esively constipated, or else, the patient is troubled with a diarras in hectic fever. The patients seem to be attacked with a deepseated anjemia and have a strikingly sallow complexion. Thechanges in the abdominal viscera may sooner or later lead to asciIf, as we have often noticed, a catarrhal affection of the lungsin, we obtain a complete picture of florid phthisis. The emaciatiof the patients soon reaches a high degree, and, under impro|)ertreatment, death now is an almost inevitable result.The prognosis in intermittent fever revolves around the followingIntermittent Fever. 569points: If the attack is recent, the prognosis is quite favorablelonger the disease had lasted ; the more irregular the paroxysmshad become ; the more strikingly the blood had become altered, thmore protracted will be the recovery of the patient. Sporadic casin a healthy district are of very little importance. Diseases breing out while the patient continues to be exposed to the influencof malaria, get well very slowly ; but even if the patient is remfrom the further action of the miasm, the cure takes place veryslowly. An advanced as well as a very young age ; a dilapitatedorganism, and more particularly alcoholism, render the prognosisvery uncertain.To treat fever and ague according to the homoeopathic law is atask which is undoubtedly invested with great diflSculties even fthe most experienced practitioner. The homceopathic treatmentof fever and ague has undoubtedly led to many errors, for thereason that spontaneous cures were too often overlooked and appropriated as the results of the medicine that had been administeredfor the fever. In consequence of this, the number of our remediesfor fever and ague has been very much increased, to the great incvenience of the physician who is in need of a remedy for a particular case. For this reason we furnish in the subsequent paragrapha limited number of remedies with definite indications; of themore unreliable medicines we shall only give the names.In treating a case of fever and ague a few points should never belost sight of, since attention to these points will save the practioner from many mistakes.In the first place, it is an important point in the treatment offever and ague that the totality of the symptoms should never belost sight of; in other words, not only the symptoms characterizithe paroxysm, but likewise those that are perceived during thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 480 of 653apyrexia, or new symptoms, should be carefully noted. A remedyshould never be chosen exclusively according to the symptoms ofthe paroxysm or the apyrexia. It is evident, however, in view ofthe great similarity of the paroxysms, that the appropriate remedwill more . especially be determined by the symptoms during theapyrexia.lligher potencies are undoubtedly sufficient to effect a cure,although a preference is generally accorded to the lower. If aremedy that is evidently homoeopathic to the case, does not cureit is perfectly proper to try a lower atteimation before partingthis drug.570 Epidemic and Endemic Infectious Diseases.If possible the remedy should never be given during the paroxysm, but as soon as possible after the paroxysm is terminated.If, under the operation of a medicine, the paroxysms decrease induration and intensity, it should be continued as long as the gooeffects of this medicine last ; by pursuing this course we obtainmost reliable information concerning the use of special remediesfever and ague.If an epidemic breaks out in a non-malarious district, it will befound that one or two remedies are generally sufELcient to cureevery case.The following are the most efficient remedies for simple feverand ague:China or Quinine is undoubtedly the most important remedy forfever and ague, but its value is very much impaired by the factthat it is employed as a sovereign remedy not only for fever andague itself, but likewise for all intermittent diseases. We needdwell any further upon the manner in which this remedy is abused;this fact is too well known to the Profession. All we can say isthat China is the most effectual and reliable of all antiicines, but that it only helps when it is homoeopathic to the casChina is suitable in a majority of all cases of endemic and epidefever and ague, even during the whole course of the disease, wherin sporadic cases it is generally of very little use. China is paularly indicated by the following symptoms : Precursory symptomsconsisting in nervous excitement, anxiousness, headache, nausea,general irritability ; the chill is of short duration, very soonwith heat, without thirst which is only experienced at the commencement of the hot stage, and is never very intense. Sensitiveness and excessive irritability especially during the chill ; thestage lasts a long while and the perspiration is exceedingly profDuring the apyrexia we have: great debility with restlessness, loof appetite with canine hunger, bitter taste and thicklytongue. We do not attach an extreme importance to these indications, for they are often deceptive. As a rule, it is true that Ccures every case of fever and ague originating in malaria ; the cmust be of recent origin and attended with nervous irritability agastric-bilious symptoms. In inveterate cases, with marked hypertrophy of the spleen and liver, anaemia, dropsy, China will seldobe of much use; such patients have always been dosed with thishttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 481 of 653medicine to excess. If they have not, China is indicated by: anaemia, a yellowish-gray complexion; occasional attacks of diarrhoeaIntermittent Fever. 671palpitation of the heart, congestions of the head, backirregularityof the paroxysms, the single stages not succeeding eother immediately, and not being completely developed. [We havefrequently met v\rith such symptoms under the symptom-treatmentof high potentialists, where a few small doses of Quinine wouldwipe out the whole disease, after the patient had been kept sicksicker for weeks. H.] Upon the whole, a tertian type is mostadapted to the curative range of China, the quartan-type much lesfrequently. As regards dose we advise the use of the lower preparations in all recent cases, but it will scarcely ever be necesto go below the second trituration of Quinine or the first attenution of the tincture of Cinchona. Fevers that do not yield to sucdoses, are not amenable to the curative action of Quinine, and caonly be suppressed, but not cured, by more massive doses of thisdrug. In the genuine malarial cachexia, China will very seldomrender much service.Ipecacuanha is decidedly adapted to epidemic fever and ague; ifit cures one case, it will undoubtedly cure most of the other casThis circumstance at one time procured for it the inordinate praiof the Old School ; afterwards it fell into disrepute, because itnot found adapted to all epidemics, its opponents not being awarethat fever and ague epidemics differ amongst each other in character. Ipecac, is only suitable in the milder forms of intermittefever, scarcely in any other than the tertian type; the differentstages run their course without much intensity and the chill ismost marked ; it is particularly indicated, if the fever is accompanied by gastric symptoms, such as loss of appetite, loathing offood, nausea, vomiting, diarrhoea with very little bile in theevacuations, or if the paroxysm is caused by dietetic transgressiIntermittent fevers of this character are generally epidemic in nmalarious districts.According to Hartmann Nux vomica is indicated by the followingsymptoms : Fever, with constipation, gastric-b'ilious symptoms ;breaks out after gross violations of diet, and is chamctcrized bynervous symptoms proceeding from the spinal cord. [We oncecured a case of fever and ague of nine months' standing with afew doses of Kux. The patient had been in one of the Ifashvillehospitals for nine months, and had taken Quinine by the ounce.He was very fond of liquor and a paroxysm broke out after everydebauch. Nux cured him so perfectly that the paroxysms did noteven return after he had been drinking. II.] Quotidian and tertia572 Epidemic and Endemic Infectious Diseases.fevers, setting in in the afternoon, evening or night, with altertion of heat and chills, enormous craving for beer, frontal headache, vertigo, nausea, bitter taste and eructations, cardialgia,weakness. — In congestive chills Nuz is likewise indicated by thefollowing symptoms: Paralysis of the extremities at the onset,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 482 of 653prostration, weariness, trembling, fainting, vertigo, dyspnoea, ppitation of the heart, heat of the head with coldness of the bodydelirium. Nuz is undoubtedly one of our more important feverremedies; it will not be difficult to determine its homoeopathieiin given cases. In inveterate cases Nuz would not often be ourchoice. It is likewise an important remedy if the fever is complicated with bronchitis.Veratrum album is likewise one of our most important fever andague remedies; marked chill which is slowly followed by heat, witconvulsive symptoms and great thirst, vomiting or retching, quickfeeble and small pulse ; stupor during the hot stage, with blanddelirium; the third stage is not strikingly marked. In febriacomitata Veratrum album is an important remedy if the cerebralsymptoms, the pulmonary hypersemia and the profuse intestinalcatarrh are prominently developed.Arsenicum, in our estimation is still more important than China;its range of action is still more extensive. In recent cases it iindicated by the following symptoms: Intensity and long durationof the paroxysms, especially burning heat; unquenchable thirstduring the whole attack, and extreme anxiety and restlessnessexcept during the sweaty stage, attended with palpitation of theheart, and a subdued, accelerated pulse; moreover functionalderangements of single organs. Arsen, is indicated the more specifically the cleaner the tongue remains in extremely violent paroxysms, the more rapidly the strength is exhausted by the singleparoxysm and the sooner the characteristic sallow pallor makes itappearance. For this reason Arsen. is an important remedy inendemic fever and ague. In congestive chills the imminentparalysis of the heart points to Arsenicum beside Verat. alb. ; A18 likewise indicated if the fever is complicated with severe choIn fever and ague cachexia Arsen. is a sovereign remedy. Its effeis truly marvellous. With a single dose of Arsenicum 30 we havecured a cachexia of thirteen weeks' standing. The patient, a veryrobust man, presented the picture of a complete phthisis florida;he was cured even without leaving his home situated in a trulymalarious region of country. Another case of nine montlia' stand*Intermittent Fever. 673ing was cured by means of a few doses of Arsen, 30, so completelythat even the hypertrophied spleen was reduced back again to itsnatural size. The patient was a Hollander who brought the diseasewith him; after residing in our very healthy city for four monthsand swallowing large quantities of Quinine^ all the symptoms ofphthisis florida had developed themselves. — Arsen. is not only atever-remedy, but likewise an antidote to Quinine. "We need notpoint out special symptoms, for cachexia is amenable to Arsenicumin all its manifestations, which, it is true, generally resembleother very closely ; it is least reliable when the anaemia is extand the reactive powers of the organism are very much depressed.In the above-mentioned cases we have stated the dose, because weare satisfied that in cachexia small doses exert the most curativinfluence ; on the other hand we are equally satisfied that in morecent cases triturations up to the sixth are most suitable.Natrum muriaticum is very seldom indicated in recent, but so muchhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 483 of 653more so in inveterate cases. The stages are very unequal, the chicontinuous, the heat moderate, but accompanied by all sorts ofaccessory symptoms, among which headache occupies the mostprominent rank ; the perspiration is either wanting, or else it iexcessive and debilitating. At the same time the patient is troubwith chronic catarrh of the mouth and stomach, constant constipation, renal catarrh, palpitations of the heart. The patient has agrayish-yellow look; the spleen and liver are very much enlarged.Arnica is adapted to recent as well as inveterate cases if the chis preceded by violent thirst which abates almost entirely afterheat breaks out ; if during the hot stage every little current ofcauses the patient to feel chilly, and if, during this stage he sto be listless but at the same time very restless.To these remedies we add a few from Hartmann, concerningwhich we do not possess any personal experience.Belladonna in quotidian fever, with horrid headache, vertigo,hallucinations, injected eyes, nausea, vomiting, constant constiption ; or in fevers where each paroxysm is associated with a seveneuralgic attack.Cina, if the fever commences with vomiting of food followed bycanine hunger; the attacks come on every day.Pulsatilla ; vomiting of mucus at the commencement of the chill,heat and sweat without thirst; mucous diarrhoea during theapyrexia, with loathing of food and nausea.574 Epidemic aiid Endemic Infectious Diseases.Antimonium crudum ; heat and sweat break out at the same time,the sweat being only transitory; loss of appetite, eructations,nausea, vomiting, thickly-coated tongue, bitter taste, tension anpressure at the stomach, pain in the chest.Bryonia; the fever sets in early in the morning; the attack isushered in with vertigo, pressure and a gnawing sensation in thesinciput ; at the same time a dry cough with stinging pains in thchest, dyspnoea, vomiturition.Sabadilla ; the attacks set in with great regularity, neither pospone nor anticipate; short chill, followed by thirst and lastly hor only chill without heat or sweat ; apyrexia with frequent chilcreeping, pressure and distention at the stomach, with loss of aptite, nocturnal, dry cough, pain in the chest, dyspnoea.Ignatia ; the chill is removed by external covering ; some partscold, others hot ; heat only on the outside, without thirst ; dulof the head during the hot stage, bruising pain in the occiput, rside, pressure at the pit of the stomach, great lassitude, palenethe face, etc. Thirst only after the paroxysm.Carbo vegetabilis ; the attack is preceded by a beating in the teples, tearing in the teeth and extremities, stretching, cold feetThirst and great lassitude during the chill. During the hot stagewithout thirst : headache, vertigo, flushed face, obscuration ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 484 of 653nausea, pain in the stomach, abdomen, chest, dyspnoea ; the feversucceeded by severe headache.Capsicum ; the chill prevails, attended with intense thirst whichwanting or only very moderate during the hot stage ; sweat duringthe heat. During the chill : anxiety, restlessness, inability toone's-self, sensitiveness to noise ; headache, ptyalism, vomitingmucus, splenetalg' a, backache, tearing and contracting sensationthe extremities. During the heat : stinging in the head, fetor frthe mouth, colic with ineffectual urging to stool, pain in the chand back, tearing in the lower limbs.Tartarus emeticus; drowsiness during the attack; Opium is to begiven if real sopor is present.We niight increase this list, if we would name all the differentremedies that might possibly be indicated. But we do not evenregard most of the above-mentioned remedies as real fever andague remedies ; their choice depends upon the nature of the accompanying symptoms which, if a cure takes place, would have provedto be the cause, not the consequence of the fever. If we wish tobe certain of selecting the right remedy, we have to inquire withIntermittent Fever. 575great care whether the intermittent character of the attack onlyconstitutes an accidental, although very prominent symptom, orwhether the other symptoms emanate from the intermittent paroxysm as their fountain-head. In the latter case the remedies thahave been named first, deserve a preference over any other ; in tformer case the symptoms which are most prominent during theapyrexia, decide a choice of the remedy.In congestive chills as well as in the tebres comitatse the threaening accessory symptoms are the main indications. The mostsuitable remedies cannot be indicated a priori.A fever and ague cachexia is always such a complicated affection,that it is impossible to indicate therapeutic rules for its managapplicable to every case. The whole organism is involved, at timethe spleen being more severely affected, at other times the liverthe stomach and intestines, then again the lungs : sometimes thegreatest danger emanates from the ansemic condition of the patienso that it is often very difficult to hit uj)on the right remedy.China had not been abused, it will meet most of the symptoms,and will prove the best remedy in the case. If Quinine had beentaken to excess, Arsen. will help in the large majority of casesremedy should not be given up all at once, if the improvement isnot very speedy ; in such a case it is much better to change thedose than the remedy. Ferrum is adapted to all cases where theansemia and debility are highly developed, but no oedema has yetset in ; the patients complain somewhat of congestion of the chesand heart, nor is the stomach disposed to retain any nourishment.Natrum muriaticum and Lycopodium are indicated if the digestiveorgans are chiefly affected, and the derangement is characterizedsymptoms peculiar to these two drugs. Other remedies may berequired for extraordinary symptoms. We doubt, however, whetherBelladonna and Staphysagria^ recommended by Hartmann, are everhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 485 of 653of any use in this cachexia.,There is no special diet that can be recommended for fever andague. It depends in every case upon the state of the digestiveorgans and the necessity of guarding the stomach against everypernicious influence, for it is upon the normal functions of thestomach that depends the possibility of the patient's sinking strbeing restored to its natural tone. If possible, the patient hadbetter leave the malarious district, and remove to the mountainswhere recovery takes place most rapidly.676 Epidemic and Endemic Infectious Diseases.Typhus occurs in two forms that do not differ much from eachother, namely: typhus abdominalis and typhus exanthematicus.More recently this last-named form has become much less frequentthan the former. In spite of these differences the etiology of boforms is pretty much the same ; up to this period we have not succeeded in discovering tlie reasons for the appearance of either othe other form.Typhus originates in some infectious agent ; all that is knownof this agent is that it is caused by the decomposition of animalsubstances. Hence typhus occurs most frequently where the decomposition of animal matter is most favored by circumstances, namelin large cities and hospitals ; likewise in localities which arefavorably situated for carrying away the products of decompositiosuch as cities built in a flat country and with imperfect drainagThe infectious principle at times seems to act with great intensiat other times very mildly, so that typhus in crowded localitiessometimes breaks out with an extraordinary virulence, and at othetimes with comparative mildness. According to all probability, agraduated difference of this kind is chiefly owing to the quantitof the infectious agent that acts upon the organism, not to itsquality. The contagium is reproduced by the patient. We cannotshare the views which prevail concerning the formation of a contagium. We do not consider any form of typhus contagious. Anapparently contagious transmission of typhus only takes placeamong those who have been for some time exposed to the emanations from the infected individual, not among those who have onlybeen in contact with the patient for a short period of time. Thesremarks likewise apply to exanthematic typhus which is consideredas decidedly contagious, but which only appears so for the reasonthat it produces a larger quantity and a more infectious qualitycontagious matter. Physicians in private practice are seldom attacked, notwithstanding they are brought in closest contact withthe patients when exploring their chests ; hospital-physicians annurses, on the contrary, are taken down very often. More recentlythe level of the surface-water has been more particularly examinewith reference to typhus and cholera ; a high lev^ is supposed tofavor the breaking out of these plagues. We are still without anyreliable data in this respect. In large cities the construction owells and water-closets deserves great attention ; where both areTyphus. 677http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 486 of 653close together that the well-water can be contaminated by the contents of the closets, typhus is very likely to occur. This subjecwithout doubt worthy the most serious attention of the Board ofHealth, for typhus is not only one of the most dangerous, but likwise one of the most frequent diseases.A few points can easily be inferred from what we have said, suchas: epidemic and endemic, slightly endemic and sporadic type oftyphus; breaking out of typhus in very damp and hot years, during the hot months of the summer and in the fall ; likewise incrowded hospitals, more particularly if they are full of woundedsoldiers; or in densely populated streets, tenement-houses, on shboard, etc. Typhus occasioned by an insufficient supply of food,or by unwholesome and deteriorated food, is less easily accountedOne attack of typhus does not always, but very generally, protect against a second attack. There are certain other circumstances that almost positively preclude the possibility of typhusespecially abdominal typhus; these are: Intermittent fever, tuberculosis, carcinoma, heart-disease of the higher grade. Age does nestablish any positive lines of demarcation ; except infants, perof any age may be attacked, but more particularly young peopleand individuals up to the age of fifty. Vigorous constitutions armore easily attacked and likewise more severely.Exciting causes are: Fear and anxiety; a sudden change of diet,when persons settle in a locality where typhus is endemic; catarrof the intestines ; mental depression, both by excessive mental las well as by care and grief.Sympfoms and Course. "We deem it unnecessary to analyzethe pathological anatomy of typhus, for the reason that the prominent post-mortem phenomena scarcely ever correspond with definitegroups of symptoms in the phenomenal totality of the disease.Hence, we confine ourselves to a few more important data. Inabdominal typhus the ulcers in the intestines act the most important part ; they have even given rise to the name of this form ofthe disease. However, it behooves us to premise the statement thain their various phases these ulcers do not correspond with definphases in the total course of the disease. The ulcers form as follows: At first the mucous lining of the ileum is strikingly hyperfemic, more particularly in its lower half; gradually this venoushyperemia becomes centered in Peyer's and Brunner*s glands,which swell up considerably together with the mesenteric glands.In the former the inflammatory infiltration may be reabsorbed, or37678 Epidemic and Endemic Infectious Diseases.else, which happens much more frequently, the infiltration iadecomposed, destroying the super-incumbent mucous lining, an4giving rise to an ulcer, the enteric or typhous ulcer. This ulcermost commonly located in the inferior extremity of the ileum and,according as it arises from a solitary or a conglomerate gland, mbe round and small, or enlarge to the size of half a dollar, withirregular, undermined borders. The healing takes place veryhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 487 of 653slowly ; the destructive process may likewise penetrate to the detissues, perforating the intestine. The subsequent cicatrix nevercauses stricture of the intestine. The intestinal ulceration veryseldom assumes a (^hronic form, resulting in a slow, hectic feverBeside the intestinal ulcers, the spleen shows tolerably constantalterations; in the first weeks it enlarges even to six times itsnormal size, the capsule is very tense, the substance of the spleexceedingly vascular and crumbling, its color is very dark; afterwards the swelling goes down again almost to the natural proportions of the organ, the capsule is relaxed, the parenchyma pale aanaemic. Except these two almost constant phenomena, typhus doesnot offer any permanent, certainly no characteristic signs. Thebrain, especially, remains unaltered; the lungs, on the contrary,show at first symptoms of pulmonary irritation ; afterwards hypostatic, less frequently lobular or lobar pneumonia. During the fiweeks of the disease the muscles have a somewhat characteristically dark color, and the internal surface of the arteries has lika dark-red appearance. In exan thematic typhus the intestinalulceration does not exist, whereas in this form likewise the spleis considerably hypertrophied and softened, and the vessels alsohave a bright appearance as if injected. Other constantly presentanatomical alterations are not perceived.Abdominal typhus very rarely breaks out suddenly ; it is generally preceded for a few days or even a week by indefinite symptoms, such as lassitude, indisposition to worky loss of spirits,impaired appetite, very seldom hunger almost bordering upon avoracious desire for food; wandering rheumatoid pains in thelimbs, especially in the back, headache of an indeterminate type,sleep full of dreams.The disease is generally ushered in by a chill of moderate violence, or by a marked fainting sensation which is soon followed bthe characteristic feeling of illness, namely: an inability to sterect or move about, and a desire to lie down. Very seldom oaeof these conditions is entirely wanting, so that it is difficultTyphus. 579out the real beginning of the disease; instead of one severe chil.we often meet with a succession of very feeble chills. The diseanow develops itself in the following manner: The patients feelweak, have neither the strength nor the desire to rise from theirbeds; headache, at times more frontal, and at other "times, in thmore violent cases, in the occiput, throbbing and very distressincomplete loss of appetite; altered, generally pasty taste; vomitinot very frequent; bowels quite torpid in the first week; restlessleep; when waking early in the morning, the patients commencevery soon to complain of phantasms which they cannot avoid; yetthey talk very rationally and are perfectly conscious of seeingphantasms. The pulse is generally full, very seldom exceeding onehundred beats, very often dicrotic; the temperature is high, theskin feels burning-hot. The breathing is almost constantly hurrieanxious, the patient talks hurriedly, yet, if desired, he is abletake a long breath. The spleen is generally swollen, the swellingincreasing rapidly in size, and is not unfrequently painful. Theabdomen does not show any constant alterations, but when the iliocoecal region is pressed upon, the patients complain of pain in thttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 488 of 653region, and a gurgling sensation is communicated to the finger,with which the pressure is made. The tongue is at times coatedvery thickly, at other times it only has a whitish coating, and ait looks quite clean, but the coating changes as the disease progresses. Sometimes the patients complain of a little hackingcough, and exhibit symptoms of a slight bronchial catarrh. Theurine is less in quantity, saturated, notwithstanding that thepatients often experience a very violent thirst. All these symptoremain in force only in very violent cases; most generally a sensible remission of these symptoms takes place towards the end ofthe first week.In the second week the symptoms of the disease undergo amarked change, unless the morbid process takes a turn towardsrecovery, which is very seldom the case. For the present we onlyspeak of typhus of a moderately severe type. In this stage thepatients lose their consciousness more and more; they are eitherlying in a state of lethargic apathy, or else, it is only with grdifliculty that they are able to reply to questions or to give utance to their own ideas. In the evening and during the night thissoporous prostration is generally interrupted by a state of nervoexaltation, during which the patients manifest their internal nerousness by animated talking or by a constant endeavor to escape680 Epidemic and Endemic Infectious Diseases.from their beds. Sensations of pain now cease entirely; whenasked how they feel, they answer : " Quite well ; " they expressdesire for drink, but they swallow the offered beverage hurriedlyand greedily ; when repeatedly asked to do so, they put out theirtongues slowly and tremulously, and forget to draw them in again.Another evidence that the influence of the brain is almost entiresuspended is, that the patients persevere for a long time in an ucomfortable position, and that they allow the urine and feeees toescape into their beds. At the beginning of the second, and veryfrequently already at the end of the first week, the patients complain of a violent buzzing in the ears, afterwards they are evidehard of hearing. Corresponding with these changes the countenances of the patients become altered. Although the complexionseems to shine, yet it has a livid hue; the eyes stare, or they ha vague and unsteady expression ; when raised in their beds, thepatients at once turn pale and look as if they would faint. Thevarious functions show the following deviations from their normalcondition : The fever is intense, the temperature rises in the eving to 100° or 102° Fahr., with slight morning-remissions; thepulse is seldom below 100, nor is it often $tbove 120, it is weakthan usual and sometimes dicrotic. The tongue, which alreadyshowed a good deal of dryness in the first week, now is constantldry; the streaked coating, which had marked it hitherto, nowvanishes ; it shows a peculiarly red color, and the papillae seemhave become effaced ; towards the end of the second week thetongue appears covered with a brownish incrustation. The appetite is entirely wanting, yet the patients will taste of what theoffered to eat. They do not seem thirsty, yet they drink greedilythe proffered beverage. At this stage the abdomen begins to bloatquite considerably ; when the ilio-coecal region is pressed uponhard, the patients distort the corners of their mouths. Diarrhoeanow usually sets in, from four to eight passages taking place invhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 489 of 653untarily every day. They have a yellowish color, deposit a sediment of thick consistence over which floats a watery, opalescentsubstance. The urine is secreted in smaller quantities, it is darand is frequently voided involuntarily; sottietimes it is retainealtogether, so that the bladder becomes very much distended. Therespiration is still accelerated, yet the peculiar hurried breaththe first week is scarcely yet perceived ; posteriorly the lungserally return hypostatic dulness; catarrhal symptoms are likewisediscovered, although the patients scarcely ever cough and onlyTyphus. 581rarely bring up a tenacious, yellowish mucus. The spleen continueto enlarge, although, owing to the distention of the bowels and tconsequent displacement of the spleen upwards, the enlargementcannot well be discovered by a physical exploration. Upon theabdomen, thorax and back roseola-spots break out in greater or lenumber, some of which are usually present already at the end ofthe first week.About the middle of the second week all these symptoms generally show an increase, less frequently a remission ; both the incand the remission are, however, of short duration.In the third week, especially at the commencement, the symptoms continue to increase in intensity. The patients are now lyinin a state of complete apathy ; in the day-time they are only slidelirious, but during the night the nervous exaltation is muchworse, attended with subsultus tendinum and grasping at flocks.The prostration is so great that the patients are no longer ablesit erect; they are constantly lying on their backs, and the bodyyielding to the law of gravitation, settles from the pillow downwards towards the middle of the bed. The tongue is only slowlyprotruded after loud and repeated requests; it is quite dry, withfuliginous coating which is likewise exhibited on the teeth and athe nostrils. Deglutition is very difiicult, and it is only witheitbrt that the patient is able to swallow very small quantitiesliquid at one time. The diarrhoea continues, but the passages aregenerally less copious, and not unfrequently tinged with blood. Turinary secretions continue to decrease and paralysis of the bladis not an unfrequcnt occurrence. The abdomen is greatly distendedand is no longer sensitive to pressure. The other symptoms continue unchanged, except that the roseola-spots pale off and becomcomplicated with miliaria and sometimes with ecchymoses. Bedsores are now very apt to torment the patient. Emaciation proceeds very rapidly and his whole appearance is that of a generalcollapse. Up to the middle of the third week, the fever maintainsits intensity. In cases where the disease continues during the foweek, no remission of the fever is perceptible. In most cases, hoever, the seventeenth day is characterized by a sudden abatementof the fever and of most of the other derangements of the functioThis improvement at times is only apparent, inasmuch as in a fewhours already the symptoms again exacerbate ; but at other timesit is a real improvement marking the beginning of recovery. Ifthe patients die, it is most generally at this period ; the remishttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 490 of 653582 Epidemic and Endemic Infectious Diseases.just alluded to, when followed by an exacerbation of the symptomsis generally looked upon as a fatal change. Death takes place witsymptoms of paralysis of the heart and lungs. In favorable casesthe fever remits every morning on the last days of the third weekwhereas the evening-exacerbations decrease in violence, the consciousness returns gradually and with it a desire for food and drAt this stage the fever scarcely ever shows a sudden and considerable decrease, with a correspondingly sudden beginning of convalescence.With the third week typhus of a medium grade has reached itsintensity in so far as signs of convalescence now begin to showthemselves, although very slowly. Every case of typhus outing the third week, may be safely regarded as very severe. Exceptcomplications take place, no new symptoms develop themselvesduring the fourth and fifth weeks. The remissions of the feverare very distinct and grow more decided in character; the pulse,on the contrary, increases in weakness and frequency. The patientlooks as if he were in a state of terrible collapse; occasionallythreatening paroxysms of collapse really take place, more particularly in the night ; in the later course of the disease, such paysms are, however, not as dangerous as they seem. In the case ofadults the consciousness usually returns towards the end of thefourth week; but, if the fever continues, delirium is still veryfrequent towards evening. The diarrhoea is at times less than itwas, and at other times more profuse ; in some cases it now ceasealtogether. The skin looks clean, with the exception of miliariahere and there. The bed-sores which are never wanting duringsuch a protracted course of the disease, grow rapidly in extent amalignancy.If the fever runs a course of four weeks, recovery takes placevery slowly. In very fortunate cases recovery goes on uninterruptedly, but most frequently its course is disturbed by all sortaccidental inconveniences, such as vomiting after certain kinds ofood, or even after any kind ; sudden disappearance of the appetithat had just begun to return; return or protracted continuanceof the diarrhoea; exacerbations of the fever. The decubitus, thenature and conduct of which aftbrd an excellent criterium by whicthe amount of progress in the recovery of the patient can bemeasured, sometimes causes a great deal of serious trouble, provithe final cure of the fever is very much delayed. Death eithertakes place in consequence of the utter prostration of the patiejTyphus. 583^r else is caused by the complications and sequelse that will bementioned hereafter. Before, however, dwelling upon them, wehave to mention various frequently occurring deviations from thegeneral course of the disease. It ought to be observed, however,that typhus varies in its manifestations more than any other disease, sometimes to such an extent that it is only with great diffculty that the attack can be diagnosed as typhus.Abortive typhus may terminate in convalescence in the first orsecond week. In both cases the phenomena of typhus may presenthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 491 of 653a character of great gravity, and may cease quite suddenly; it evgenerally happens that in typhus running a very short course, theoutbreak of the disease is characterized by very violent symptomsThe complete cessation of the pathological process at the end ofthe first week, including a sudden decrease of the temperature, ia very rare event. It has been doubted whether such cases oughtto be regarded as typhus^ but these dou?)ts are unfounded. Thattyphus can abort, is most indubitably witnessed in families wherethis process of abortion takes place side by side with the mostintense forms of the disease. More commonly the fever aborts inthe second week. In such cases all the symptoms still continue toincrease at the commencement of the second week, even to a veryhigh degree: the somnolence, however, is not very marked; in itsstead we notice more frequently great nervous exaltation; thediarrhoea is never very profuse. On the eleventh day the feverdistinctly remits, the remission being sometimes preceded by asevere exacerbation. Every day the remission becomes more distincand more considerable; the appetite returns at the same time andthe tongue loses its dryness. The diarrhoea generally ceases as sas the fever begins to abate. If no striking disturbance takesplace, the patient enters on the twenty-first day upon his full arapidly-progressing convalescence. But if the patient is exposedto severe emotional excitements, or commits serious dietetic trangressions by over-eating and the like, a relapse may readily takeplace in precisely such cases, and the patient may expose himselfto great danger.A precipitated course of typhus is not a very frequent occurrenceThe disease which, at the onset, broke out in its fiercest intensincreases within the first week or even within the first three dato such a degree that life becomes extinct even without the supervention of any special complications; it seems as though theorganism sank exhausted and paralyzed under its excessive efforts584 Epidemic and Endemic Infectious Diseases.to react. This course is only met with among individuals withexceedingly robust and plethoric constitutions.A protracted course of typhus, or the so-called febris nervosalenta, is likewise only rarely met with in comparison with otherforms of this disease. It occurs more particularly among feeble,nervous individuals, hence more especially among females. Thereare two modifications of this disease. In the first place the dismay creep along imperceptibly, without a chill or any evident sigof serious illness. The patients lose their strength more and mortheir appetite leaves them all at once, they are not tormented bythirst. There is no great rise of temperature, the skin feels everemarkably cool; the pulse is at times very quick and small,upwards of one hundred and twenty, at other times strikingly slowDiarrhoea may be entirely absent, or is very inconsiderable. Thepatients look pallid, or else their cheeks show a hectic, circumseasily changing redness. The tongue is seldom coated, never fuliginous, generally of a bright-red color, smooth as a mirror, angreatly disposed to become dry. The spleen is evidently enlarged.In this way the patients may remain six, eight or more weekswithout the least change in the symptoms taking place. Recoveryalmost always takes place imperceptibly. Death either takes placehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 492 of 653in consequence of slow and intense exhaustion or else by the supevention of acute complications. In the other case the disease setin like typhus of a middle grade, continues this course during thfirst three weeks, but in the fourth week it assumes the lentescetype with the previously-described symptoms of the first variety,except that the prostration is still greater and the diarrhoea ismore common. This form is most easily succeeded by sequelaeTyphus of a more intense type runs a very characteristic courseamong children during the first period of dentition. The diseasebegins with the symptoms of a severe catarrhal fever, with intensheat, passing sweats, occasional vomiting, constipation ; the pulinstead of exceeding one hundred and twenty beats which it frequently does in catarrhal fever, usually ranges from one hundredto one hundred and twenty. Towards the end of the first weekthe somnolence changes to sopor, and in the second week to a deepcoma; diarrhoea sets in, the passages as well as the urinary secrtions taking jjlace involuntarily ; the face assumes an apjiearanof collapse at an early period, the pupils are almost always considerably dilated; deglutition is difficult, only small quantitiebe swallowed at a time. The little patients most commonly signifyTyphus. 585tlie presence of a severe headache by moving a hand or a forearmover their foreheads at short intervals, and uttering every now athen the characteristic "m enciphaliqiie,^^ One side of the bodygenerally completely paralyzed. The patients remain in this condition which looks very much like meningitis, for weeks withoutshowing the least sign of a change. To judge from the four casesthat we have met with in the last two years, it seems to us asthough the end of the sixth week were the decisive term of thisfever; for on the first day of the seventh week these four childrwere again restored to consciousness. In such cases the diagnosishas to depend entirely upon the pulse which, in contra-distinctioto an inflammatory cerebral affection, especially to acute hydrocephalus, constantly remains at one hundred and twenty; likewiseupon the presence of diarrhoea, upon the hypertrophy of the spleewhich is seldom very considerable; and finally upon the fetid odowith which the sick-chamber is filled and which strikes one invarably on entering the room from the open air, even if the apartmenis ventilated with ever so much care. Sequel© are not very common in such cases; nor is, in spite of the worst apparent signs,prognosis so very bad, provided the eighteenth day is safely passIn conclusion we have to make mention of pneumo-tj^phus, amodification which occurs very frequently at times, whereas it isnot met with at all in other epidemics. The supposition that insuch a case the typhoid process runs its course upon the pulmonarinstead of upon the intestinal lining membrane, is not correct ;the aflection of the intestinal lining membrane is not entirely wing, although it may be inconsiderable. In pneumo-typhus theinflammatory irritation of the bronchia which we meet with inevery case of typhus, increases to a more marked degree of intensreal pneumonia supervenes, and the ailditional advent of hypostasoccasions a very threatening combination utterly overshadowingthe abdominal phenomena. Pneumo-typhus may exist from thebeginning of the disease, or it may break out in the course of thfirst, second, and even third week, most generally in a very insimanner. Beside the physical signs, pneumo-typhus is not revealedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 493 of 653by any other reliable sign, although the presence of a very hurrisuperficial respiration, a frequent and painful cough, fanof the alae nasi during respiration, circumscribed redness of oneboth cheeks ought to excite suspicion, and awaken our attention tthe disease. The course of the disease is not retarded by this foof typhus, but the critical days are very commonly missed. The586 Epidemic and Endemic Infectious Diseases.danger is very great. Very often pneumo-typhus is followed by thedevelopment of florid phthisis, probably owing to the circumstancthat the typhoid process in the lungs causes existing tubercles tsuppurate.The number of complications that may break out during thecourse of typhus is very great ; for this reason we only mentionfollowing which are most common and most important: Hemorrhages from the bowels and nose ; the latter occur more frequentlat the beginning than during the subsequent course of the diseasethey are of very little importance, provided the loss of blood isexcessive; as a rule, the patients feel relieved after the bleediIntestinal hemorrhage, on the contrary, occurs during the laterperiod of the disease, and becomes very dangerous either on accouof its copiousness, or on account of its exceedingly debilitatinginfluence. If the blood is not discharged from the anus, the hemorhage may superinduce a sudden and complete collapse. Petechiseand extensive ecchymoses are ominous symptoms which indicate abad composition of the blood. The frequently-occurring and excessive cerebral exaltation is of importance in so far as it inducesnecessity of constantly watching the patient ; it manifests itselmore frequently in the first and second week than in the subsequecourse of the disease, and, since it may break out at any time,typhus-patients should never be left alone for one instant. A sudcollapse, with paralysis of the heart, is not generally met withafter the second week, very often while the fever seems to pursuean apparently mild course; one attack of this kind seldom terminates fatally ; but a repetition of the attack, which generally tplace in the evening or during the night, is very apt to end in dParotitis has already been spoken of before ; it is neither a goonor an absolutely bad symptom. Ulcers in the larynx may lead toulceration of the cartilages, and by this means endanger life ; iinconsiderable, they may likewise endanger life by superinducingcedema glottidis. The worst changes are those occasioned by ulcerin the intestines, namely consecutive peritonitis, and perforatiothe intestines with peritoneal inflammation. Both these changesare exceedingly dangerous to life ; peritonitis is more apt to seprevious to the intestinal ulceration, the latter may take placeany time alter the second week, even after convalescence is alreavery far advanced. If no adhesion had previously taken placebetween the intestines and the peritoneum, the inflammation of thmembrane soon becomes diftuse and ends fatally in a few hoars.Typhus, 687Meteorism is a common symptom in typhus ; when excessive, andwhen it threatens paralysis, the meteorism becomes a very dangerohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 494 of 653condition.Among the numerous sequelas of typhus we distinguish intestinalphthisis, occasioned by the number, and continued ulceration of tinfiltrated glands of Peyer, and the solitary glands of Brunner;this ulceration is a very common cause of a protracted convalescence, and may finally terminate in fatal ascites. It is a curablcondition. Inflammations of serous membranes are not unfrequent,but they do not, properly speaking, belong to the sequelse. Ulcerof the larynx may lead to stenosis and to obstinate, generallyincurable hoarseness. Paralysis of the extremities, especially thlower, and paralysis of single organs of sense, are often met witbut as a rule, they gradually disappear again without any treatment. It is only in rare cases that the mind remains impaired forlife. Decubitus may even penetrate to the bones, and may causedeath long after the typhus had ceased. Although typhus scarcelyever attacks individuals with decided, especially florid tuberculwe often see patients who had been convalescent for weeks, suddenly relapse into a fever, and, in a very short period of time,by tubercular phthisis. Whether typhus causes the slumberinggerm to grow, or, by its own inherent agency, implants the tubercular disease, has to remain an open question for the present. Thformer is the more probable of the two,Exanthematic typhus runs a much more decidedly typical coursethan typhus abdominalis ; in this respect it bears the greatestresemblance to acute exanthems.It sets in with very uncharacteristic precursory symptoms, lassitude, want of spirits, a feeling of illness, slight catarrhal symheadache, anxious dreams disturbing his sleep, etc. These symptoms precede the real outbreak by two to seven days.The invasion of the disease is generally marked by a violent chilless frequently by alternate chilliness and heat. The chill is alimmediately succeeded by intense heat, at the same time as thepatients are unable to keep themselves erect. Amid the symptomsthat have been described as pathognomonic of abdominal typhus,and which are generally much more intense when occurring asphenomenal manifestations of exanthematic typhus, more particularly the dulriess and cloudiness of the sensorium, the roseolaspots make their appearance between the fifth and sev^enth day,first in small numbers on the trunk, but rapidly multiplying and688 Epidemic and Endemic Infectious Diseases.covering the whole body except the face. In size, shape and colorthese spots resemble measles, except that they are never strikingraised above the skin. The enlargement of the spleen and thecontinued violent fever enable us to distinguish this exanthem frmeasles ; it remits about the seventh day, but breaks out bo muchworse again afterwards.In the second week, all the symptoms reach their highest degreeof intensity, and may continue unchanged during the whole of thefollowing week ; the cerebral symptoms and the excessive prostration are particularly prominent. The abdomen retains its normalshape; no meteorism takes place as in abdominal typhus, nor is thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 495 of 653diarrhoea which is very often wanting, of the same character as tdiarrhoea of typhus abdominalis. In cases of a moderate degree ofintensity, the fever commonly abates in the second half of thesecond, less frequently at the commencement of the third week ;such an abatement is immediately preceded by an exacerbation.The temperature falls considerably in a very short period of timethe pulse likewise falls to ninety, to hundred, and even a smallenumber of beats. At the same time, a considerable change takesplace in the whole condition of the patient. The sensorium is sticlouded, but he commences to enjoy a quiet sleep, he is more quiein his waking condition : a desire for food is felt, and in a fewconvalescence is under full headway, so that at the beginning ofthe fourth week the patient is able to leave his bed, although hestill feels weak for a long time. Up to the middle of the secondweek, the exanthem continues to increase, the spots assume adarker color ; but as soon as the fever abates, the spots show atint, and pale oft' rapidly without even leaving a vestige of theexistence. Not unfrequently the spots, some of them at least, chato real petechise; altogether this form of typhus is distinguisheby a tendency to hemorrhagic effusions, and to hemorrhages fromevery possible organ. Among the complications, inflammatory affections of the respiratory organs are the most striking; in generalsevere bronchial catarrh is very apt to be present at the first obreak of the disease. A fatal termination most commonly takesplace towards the end of the second week, amid the same symptomsas those that characterize a fatal termination of abdominal typhuIf the disease lasts beyond this period, it is generally owing tocomplications ; but such a more protracted course is a rare occurrence. "With the exception of a long continuance of the cei*ebralfunctions, no other sequelae are apt to occur.Typhus. ' y'' 589The prognosis of abdominal typhus is Vetv uticeptain ; a tumultuous outbreak of the disease does not jusufy the ccJnijlusion thathe course of the disease will be one of greats danger, ^pr doesmild beginning prognosticate an equally mild epdii^. ^"J^^fe maybecome suddenly endangered at any period of the disease; /J^ccording to Wunderlich, those cases are the most seriou^^yhere tl^^^evdoes not distinctly remit at the end of the first week.

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 496 of 653Treatment. Among all possible diseases there is no diseaseof which it is so difiicult to decide whether the treatment thatbeen pursued hitherto has been of any, or of how much use. Ouropponents cannot be blamed for doubting our successes; the expectant method often furnishes equally favorable results; at noperiod during the course of typhus can a positive prognosis be seup, and the diagnosis is likewise exposed to a good many uncertainties. After all, the superiority of the two methods of treatityphus can only be decided by comparing the number of deaths inthe same epidemic, and in a number of epidemics. In this respect,Homoeopathy has a decided advantage, for the number of deathstinder homoeopathic treatment never exceeds seven to eight per cewhereas under other methods of treatment this number amountsto twenty and more per cent. These figures cannot be impeachedby accusing us of errors in diagnosis, which our opponents are juas capable of committing as we are.590 Epidemic aiid Endemic Infectious Diseases*We omit casting an inquiring glance at the manner in whichtyphus is treated by the Old School, and by the adherents of theNew and Newest School of Homoeopathy ; an inquiry of this kindwould not be very profitable ; we cannot help wondering, however,that the rational physicians who consider typhus inaccessible toremedial agents, should combat it with such a mass of heterogeneomedicines. However, we must dwell upon two points that are ofimportance to us homoeopathic physicians who are so often calledupon for aid in the later stages of typhus. In the first place wewish to point out the consequences of a revulsive or derivativetreatment. Sanguineous depletions which are so often resorted toeven now, have a bad eflfect, not only immediately but likewise aa later period ; the patients lapse more speedily into sopor, theprostration becomes more excessive, they perish in larger numbersor, if convalescence sets in, it takes place more slowly and incopletely. Cathartics have likewise a permanently bad effect, and wfeel prompted to regard venesection and the use of purgatives intyphus as acts of wickedness. In the second place, we generallynotice that patients who have been fed on large doses of Chlorateor Quinine, have the functional power of their stomachs impairedfor weeks, and that the integrity of their cerebral functions isrestored very slowly.Regarding the homoeopathic treatment of typhus, we do notshare the views of all our Colleagues in this respect. They quotelarge number of remedies for typhus with the most minute anddelicate indications, whereas it is our belief that we as yet posonly a small number of real remedies for typhus, by which wemean remedies that have it in their power to modify the course ofth^ disease, and that most of the other remedies that have beenrev*.ommended for this disease, only correspond with a few prominent symptoms. Our opinion is based upon the proposition thattyphus owes its existence to some definite toxical agent that penetrates the organism from without, as is the case with acute exanthems. It is for this reason that in no epidemic disease the curavirtue of one or more remedies as genuine epidemic-remedies, hasbeen so thoroughly tested as in typhus; and in our opinion themost important task which a physician has to fulfil in every epihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 497 of 653demic is, to find out the general remedies adapted to each. Asecond, still more important circumstance resulting from this previous opinion is, that the remedy should never be changed unlessdistinctly new, unexpected morbid phenomena manifest themselvesTyphus. 691that are not in harmony with the normal course of the disease. Ifthis course of treatment had been pursued before, and if the natucourse of typhus had been watched and regarded with more care,our knowledge of treating typhus would most likely be muchfurther advanced than it really is. How much, for instance, canbe claimed for the efficacy of a remedy that was administered onthe fifteenth or sixteenth day of the disease, if the fever suddemoderates on the seventeenth ?We wish to call attention to another mistake that very muchimpairs the physician's professional usefulness. In treating typhor other typical diseases, we are very apt to proceed as we do intreating other diseases ; we forget the typical character. "We wato break the fever at any price, and the rage of bringing this abinduces us to administer a new remedy every day. But typhuscannot be cut short, except within the above-stated, definite boudaries ; typhus never disappears before the seventh day ; no typhterminates critically on the eighth, ninth, fifteenth or sixteentday, any more than a measle or scarlatina-eruption can be alteredby medicines.The real typhus-remedies corresponding with the whole courseof this disease, are : Bryonia alba^ Rhus toxicodendron^ ArsenicuPhosphorus^ Acidum phosphoricum and muriaticum.Bryonia alba corresponds to those forms of typhus that run a mildor moderately-intense course. The initial symptoms are sometimesso indefinite that both the selection of a remedy and the diagnosare uncertain, and our choice would properly not fall upon BryoniBut as soon as the typhoid character of the disease has becomefully established, Bryonia is indicated by the following symptomsViolent, pressive headache, buzzing in the ears, dulness of the ssorium, yet the patient does not yet lose his consciousness ; yeland thick^ white coating on the tongue whose edges are brightwithout great tendency to dryness ; acute pains in the ileoand splenetic regions ; nausea or even vomiting after every mealconstipation ; torpor of the bowels or occasional diarrhoea ; pulfull and not very rapid. Bryonia corresponds fully with theseinitial symptoms, and generally with the whole course of the disease which seldom outlasts the seventeenth day. We have oftenseen typhus cut short at the end of the second week by simply confining the treatment to the use of Bryonia. In febris nervosa lenBryonia is likewise one of our best remedies ; its use in this diIB of course more restricted, owing to the variable nature of the592 Epidemic and Endemic Infectious Diseases.symptoms. In exanthematic typhus Bryonia is a distinguishedremedy as long as the brain is not altogether deprived of its funhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 498 of 653tional power. We do not point out single groups of symptoms forthe reason that the symptoms of the disease as well as those of tremedy are too manifold.Rhus toxicodendron differs in its indications so essentially fromthose of Bryonia that it is scarcely possible to confound the tworemedies with each other. Bhus tox. corresponds to typhus of veryintense character ; it begins with a chill, followed immediatelyby burning heat and, even on the first few days, by all the symptoms that render the diagnosis certain. We may lay it down as arule that Jihus is indicated the more specifically the more speedtrue character of typhus can be diagnosed. Bhus is especially indcated by active delirium and great prostration, a dark and lividredness of the cheeks, injected eyes, early dryness and redness othe tongue, and a copious diarrhcea which sets in soon after thefever has fairly shown its true character. Cases adapted to Bhus^never run a speedy course, nor will the crisis have to be expecteprevious to the seventeenth day ; until then the medicine may becontinued w^ithout fear unless some other medicine should be indicated by particular symptoms ; the symptoms of Bhus correspondto all the stages of a most intense typhus, even to the third weeAn alleviating epistaxis, stools tinged with blood, a severe bronaffection with a dirty-looking, sanguinolent expectoration are spindications for Bhus^ which may likewise prove efficacious in pnetyphus. In exanthematic typhus Bhus generally has the advantageover Bryonia not only on account of the greater intensity of thefever, but of the whole course of the disease. Rhus is generallyindicated by excessive reactive endeavors with insufficiency ofreactive power, and an excessive irritability of the nervous systThere is scarcely another remedy that has shown its good effects80 many cases, although we must never expect to cut the fever showith this remedy.Arsenicum album is the most prominent remedy in typhus; it willeven cure cases that seemed utterly hopeless. The cases adapted tArsen. resemble those indicating Rhus, at least in the beginning.The fever is intense, the patients are very restless and show bybehavior that they are in great distress ; the least pressure onccecal region and the region of the spleen causes pain. Symptomsof decomposition of the blood set in at an early period, such asnose-bleed, bloody diarrhcEa, badly-colored, bloody sputa, petech^ Typhus, 593on the skin ; the stools have a foul odor, the exhalations emanatfrom the patient generally, are very fetid. Instead of perfect sowe have a change between great nervous excitement and completeprostration. Bedsores break out at an early period of the diseaseforming gangrenous scurfs with dark-red borders. The pulse isvery frequent, hard and tense. The patients are tormented by anunquenchable thirst. Generally Arsenicum is recommended for thesecond half of the second, and for the third week ; but we doubtwhether this is practically correct ; in our opinion we should acplish a great deal more by means of Arsenicum, if the remedy weremore frequently administered from the commencement or at leastin the iirst week of the disease, for in such a case it, might shits eftect upon the whole course of typhus. Since Arsenicum ismore than any other medicine adapted to the worst forms of allhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 499 of 653infectious diseases, it seems wrong to delay its administration uthe symptoms indicating Arsenicum, are developed in their mostmalignant intensity. Years ago Fleischmann showed that typhusgenerally runs a favorable course under the influence of Arsenicuand we should think that several hundred cures ought to be something in its favor. Fleischmann, however, generalizes too muchwhereas Wurmb, on the other hand, errs in individualizingbeyond necessity. After all, the balance inclines in Fleischmann'favor, for Arsen. produces the symptoms of lentescent as well asinflammatory and putrid typhus. Our advice therefore is that Arseshould be given more frequently than has been customary, fromthe very beginning of the attack, and that we should not waituntil the disease has fully developed its pernicious character. Afew special indications for Arsen. are the following : Striking atypical remission of the fever, having the appearance of an actuaintermission. Marked meteorism of the bowels, with gurgling in thbowels, but no diarrhcea. Extensive hypostasis of the lungs, withbronchitis and considerable hoarseness. Irregular action of theheart, absence of the second sound of the heart. Paroxysms ofsudden collapse towards midnight. Fetid breath. Frequent retching and even vomiting, immediately after drinking, in the secondand the subsequent weeks or during convalescence. Considerableenlargement of the spleen. In exan thematic typhus Arsen. is indicated much less frequently, and is chiefly adapted only to the puform, the so-called putrid typhus. In lentescent typhus Arsen. isan excellent remedy, if the symptoms exacerbate every other day;11" the patients are tormented by anxiety ; if every little meal38594 Epidemic and Endemic Infectious Diseases.retching and vomiting, although the tongue is clean. Arsen. is somuch more extensively applicable the more typhus assumes theepidemic form ; likewise in endemic typhus. Most observers advocate repeated doses of the second to the fourth trituration. [Weremember a case of exanthematic typhus where the putrid stagehad fuUy set in ; the patient was emaciated and extremely prostrated ; the teeth looked black ; the tongue was swollen, blackisand bleeding ; blood oozed from the gums ; the skin was coveredwith petechise, from many of which a black, foul, decomposed bloowas constantly oozing ; involuntary, bloody, horridly-smelling stA few globules of Arsen. 18th excited a reaction which ended inperfect recovery in one week. H.]Phosphorus is one of the most important remedies in typhus ; itscurative action is, however, limited to certain sharply defined cit cannot be regarded as a general remedy for typhus, in the samesense as Arsen. or Bryon. — Above all, Pkosphoms is indicated inpneumo-typhus with violent bronchitis, hepatization, together withypostasis and laryngitis. It is a sovereign remedy for this condtion, unsurpassed by any other medicine. It is indicated by thefollowing abdominal symptoms: Frequent diarrhoeic stools at anearly period of the disease, coming on after every meal, of a dardingy, blackish-gray color, or mixed with decomposed blood andcontaining shreds of intestinal mucous lining. Extreme prostratioafter every discharge. Numerous roseola-spots, with ecchymosesand sudamina. Burning heat of the trunk, with cold sweat abouthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 500 of 653the head and on the extremities. Pulse frequent, small and feebleSensitiveness of the region of the liver and stomach ; considerabmeteorism. A characteristic indication for Phosphortis is vomitinin the first, and at the commencement of the second week; thevomiting contains watery-bilious and slimy masses which arebrought up with great distress. In exanthematic typhus, Phosphorus is one of the first remedies, for the reason that the pulmnary symptoms are generally very prominent and involve the mostdanger. — Among the sequelae. Phosphorus is indicated by diarrhoewhen it acts like colliquative diarrhoea. Hartmann points to sexuexcitement as a not unfrequent indication for Phosphorus,Acidum phosphoricum renders eminent service in typhus ; even theRational School acknowledges its power in this disease without,of course, mentioning the source where this knowledge was obtained. Phosphoric acid is a truly specific remedy in lentescenttyphus, and is never indicated, if the fever is high and the nervTyphus. 595greatly excited. The patients are lying in a state of excessiveprostration and apathy, without being exactly in a state of soporthe face is rather pallid, not turgescent, the pulse very frequenfeeble and small; the tongue is not very dry; it is smooth as amirror, red. The thirst is inconsiderable ; diarrhoea moderate, tdischarges occurring only now and then; the meteorism is notvery marked. The disease does not show any tendency to a speedychange; perceptible remissions do not take place. The whole process has the appearance of a gradual extinction of the vital powewithout any decided reactive efforts being perceptible on the parof the organism. Beside the cases where Acidum phosphor, is indicated from the beginning, sometimes after Bryonia, but never,properly speaking, after Rhus or Arsenicum, Phosphori acidum canlikewise come into play, if, at the end of the fourth week, convacence seems to remain stationary, more particularly if a moderatediarrhoea is frequent.Of the other mineral acids, Acidum muriatlcum is sometimes used ;the forms of typhus requiring this acid are, upon the whole, veryrare. Muriatic acid is more particularly adapted to lentesceutputrid typhus where the decomposition of the fluids is slow andextensive, but does not set in suddenly. The general symptomsresemble those of Phosphoric acid, only the fever is more severe,the restlessness is more marked and the following local symptomsare present : Frequent diarrhoeic stools, but scanty ; the characistic fflecal discharges are mingled with shreds of intestinal mulining and with lumps of whitish mucus. The discharges are mostcommonly involuntary ; the meteorism is very great. The mucouslining of the mouth is ulcerated here and there, the ulcerationsbeing covered with a dirty- white coating. The bedsores have anindolent, pale look ; they are painless and extend very rapidly.patients' breath is very offensive; they have an aversion to anykind of food, but they crave fresh cold water. [Settling down inthe bed, is characteristic of this acid. H.]So far as our present experience goes, these remedies concludethe number of our typhus-remedies ; it remains for us now to indicate a number of other remedies that are more or less useful fohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 501 of 653various phenomena, but do not correspond with the whole character and course of the disease. "We will mention them as briefly apossible.If Aconitum is prescribed for the violent fever at the beginningof typhus, it is probably for no other reason than because the di596 Epidemic and Endemic Infectious Diseases.nosis 18 not yet satisfactorily cleared up ; we do not believe tlAconitum is capable of either exerting a curative or palliativeeffect in typhus.Belladonna, which undoubtedly seems to be indicated in the firstweek of the^ fever, may sometimes moderate its violence at thatperiod, especially the excessive cerebral hyperaemia, but it willscarcely ever produce a striking and incontrovertible effect. Itrenders most efficient aid against the severe bronchitis of the fweek. In the later course of the disease, it is scarcely ever indcated. [We think Bsehr underrates the great virtues oi Belladonnaas a specific remedy for typhus. We have cured many cases oftyphus where no other remedy was used except Belladonna. Wewill mention a few of them.A girl of thirteen years, of a healthy constitution and very mildtemperament, was attacked with a severe angina fancium. Nextday she was slightly delirious, complained of seeing people in throom, strange-looking faces, dogs, etc. Pulse about one hundred aten ; cheeks scarlet-red, eyes sparkling, tongue dry, like soleskin dry and hot, urine red, without any sediment ; bowels constipated ; great prostration and rapid emaciation. I gave her Belladonna 1st attenuation. On the seventh day she left her bed fullrecovered.A lady of about forty years was attacked with pleuro-pneumonia;on the third day of the disease, the symptoms of typhus were fulldeveloped. Severe headache ; eyes sparkling ; cheeks pale, withoccasional deep flushes ; tongue parched, and of a deeplikesole-leather ; skin dry and hot ; pulse about one hundred antwenty; bowels constipated, urine of a deep-yellow color with areddish tint ; grasping at flocks, picking at the bedclothes ; fudelirium ; intense thirst, but the least attempt to swallow a droof liquid caused the patient to utter a piercing cry and threw heinto violent spasms, with foam at the mouth. The patient tooknothing but Belladonna. She improved very gradually every week;sometimes no improvement became perceptible under a fortnightThe whole course of the disease extended during a period of threemonths, I mean from the first outbreak of the fever to the daywhen the patient took her first ride out in a carriageA young lady of twenty-three years was attacked with lentescenttyphus; the leading symptoms were: headache, somnolence, dryand hot skin, pulse one hundred and twenty ; tongue of a dee[>brown color, very dry but smooth as a mirror; urine of a deepTyphus, 597http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 502 of 653yellow color; prostration, utter loss of appetite, emaciation; brchial irritation. The disease ran a course of twenty-one days. Thpatient took nothing but Belladonna, middle and lower poteucies.Arnica in its whole pathogenesis shows so much resemblance totyphus that it must astonish everybody that this remedy shouldnot have been employed in this disease more frequently than it haThe characteristic indications result from a merely superficial vof the symptoms. The disease is more like an inflammatory fever,the cheeks are pale, with flushes of redness, the pulse is not vemuch accelerated, the heat is unequally distributed. The patientsshow an extraordinary sensitiveness of the organs of sense, togetwith a distressing headache ; nose-bleed, bloody expectoration ;delirium without great bodily restlessness. It is questionable whArnica can do anything for bedsores. As regards. the kind andintensity of the cases to which Arnica is homoeopathic, this medicine occupies a middle rank beween Rhus and Bryonia.Carbo vegetabilis is regarded by many as an exquisite remedy fortyphus. We do not share this opinion, and simply believe Carboadapted to certain anomalous manifestations in the course of thedisease. Carbo may be exhibited if the patients are sunk in a staof apathy without any marked symptoms of reaction; if the bodyis burning-hot and the extremities are icy-cold; if the functionapower of the heart fails very speedily ; if petechise break out ilarge numbers, with extensive hypostasis of the lungs, foul anddecomposed diarrhoeic stools, frequent attacks of an ominous collapse, wide-spread decubitus, with burning pain of the sores. Caris rather suitable in cases that seem to be adapted to Bryonia orAcidum Tphospfioricum, In the subsequent course of the disease,Carbo is more particularly indicated by the bronchial catarrh, ifthere is a good deal of tenacious mucus that can only be expectorated with a great deal of diflSculty ; during the convalescencthis remedy may sometimes be required by the characteristicdiarrhoesC.Digitalis can only be exhibited in lentcscent typhus, if constipation is associated with great irritability of the stomach and paifulness of the region of the liver; the pulse is at times rapid,other times slow and feeble, and is very much accelerated by evermotion, especially by rising from a recumbent position; thesensorium is clouded but consciousness is never entirely lost, analthough there is no diarrhoea, yet the strength and the flesh waaway very rapidly. Digitalis is undoubtedly deserving of great598 Epidemic and Endemic Infectious Diseases. •consideration in typhus, were it only for the reason that its sphof action is limited and distinctly circumscribed.Closely related to the former remedy is Cuprum, concerning whosefaculty of producing a connected series of typhoid symptomsFrerichs' observation in Mengershausen (see Frank's Archiv.vol. IV.) furnishes the most conclusive testimony. Without reproducing the facts related in that publication, we recommend themto the careful study of all homoeopathic practitioners. The coppetyphus sets in and runs its course without any violent fever, buthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 503 of 653extraordinary prostration at once makes its appearance, whichincreases so rapidly amid symptoms of sanguineous decomposition(nose-bleed, petechise) that in a short time death takes place wiall the symptoms of general paralysis.Secale cornutum is indicated if the attack sets in with convulsioparalysis of the extremities, gangrenous ulcers especially on theextremities, extensive ecchymoses on the skin.Kreosotum corresponds to putrid typhus if copious atonic hemorrhages exist.Stramonium, Hyoscyamus, Helleborus are only suitable for corresponding cerebral symptoms. In our opinion they will seldomaccomplish any real good, nor will they be required for the reasothat a delirium of the most varied forms does not constitute anyessential deviation from the normal course of typhus. [We do notagree with Beehr so far as Hyoscyamm is concerned. We knowfrom experience that an acute outbreak of typhus may yield toHyoscyamus. A robust merchant of about forty years came homewith a terrible headache. He had had a heavy chill in his counting-room which was very soon followed by fever. The cephalicdistress was principally located in one side of the head. Bryoniawas given. Next day delirium set in, with picking at the bedclothes; the patient was constantly talking about his business, awanted to leave his bed ; the prostration was very great, and helost flesh visibly ; the bowels were loose, the discharges Kavingoffensive smell. The patient was constantly troubled with thepaintings on the wall falling to one side. A drop of the tinctureof Hyoscyamus was mixed in half a tumbler of water, of which mixture a dessertspoonful was given him every two hours. After thesecond dose he dropped to sleep, and woke after a refreshing sleein full tide of recovery. H.]The same remarks apply to Opium ; this remedy is said to frequently have removed the deep sopor of typhus-patients; we haveTyphus. 699never been able to accomplish such a result by means of Opium.[A man had an attack of exan thematic typhus ; the fever had runsix weeks, and the patient seemed irretrievably lost. Towards theend of the sixth week the following symptoms had developed themselves: The patient was constantly settling down in his bed; theeyes were half closed, with the eye-balls turned upwards in theirsockets; depression of the lower jaw; strings of a ropy saliva wehanging out at the corners of the mouth; tongue thick and tremulous; involuntary stools; miliaria; excessive emaciation, complelethargy. A few drops of Muriatic Acid in half a tumbler ofwater re-awakened the sinking reaction. The paralytic symptomswere followed by a deep sopor. This was on the evening of theforty-first day. A drop of Opium was mixed in half a tumbler ofwater, of which mixture the patient took a dessertspoonful everytwo hours. Next morning, instead of the usual exacerbation asound sleep set in, which lasted with short interruptions, for awhole week. No further medicine was given. The patient droveout in a fortnight, perfectly well. In my opinion the Opium hada curative effect in this case. H.]http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 504 of 653Camphora acts well for a short time when given as an intermediateremedy for sudden paroxysms of severe collapse coming on the heelof great exaltation of the cerebral functions.A few other, most nnimportant remedies will be found indicatednnder catarrh of the stomach which very often bears a deceptivesimilarity to the lighter grades of typhus.The general management and the diet to be observed in typhusare of more importance than in any other disease. It is unfortnnately true that in this respect physicians are often guilty of tmost unpardonable delinquencies. In managing typhus-patients weobserve the following rules, the usefulness of which has been abudantly established, and which we have never known to result in anmischief to the patient. The patients should lie on a mattress,never on feather-beds which promote the development of bedsores.A woollen blanket with a linen sheet is sufficient covering. Thedows in the sick-room should never be shut entirely, no matter inseason of tVie year ; if possible, the room should always be keptproperly ventilated by securing a current of air along the ceilinIf possible, the patients should often be changed to another bed,and even to another room. Once every day, and, if the disease hasreached its height, several times a day, the patient should be wawith cold water over the largest part of his body ; an ablution othis kind affords an immense amount of comf^-t to +1^'^ patient600 Epidemic and Endemic Infectious Diseases.The passages from the bowels and bladder have to be removed assoon as possible. If possible, the same person should never be iaconstant attendance on the patient, lest he should become too mucimpregnated with the typhus-contagium. Only the most indispensable conversation should be held with the patient, and allmental excitement should be strictly avoided. As long as the violence of the fever continues, no great supply of nourishment isrequired ; the patient does not desire anything, nor should he bepersuaded to partake of anything substantial. Liquid nourishmentis best adapted to his condition. If the patient desires, he mayhave : beef-tea, broth (no veal-broth), chicken-broth, milk dilutwith one-third water, malt-beer cooked with sago or gruel, whichshould be allowed to cool before it is used ; mucilaginous soups,not exclusively. The best beverage is fresh water ; this should bgiven the patient quite often, even if he does not call for it, fis the best means of repairing the waste of moisture caused by thfever. Sugar-water is hurtful ; water with the juice of fruit dissolved in it, may be partaken of in very moderate quantities. Sodwater very soon becomes offensive to the patient. Water with alittle wine is perfectly appropriate in the later course of the dMalt-beer with a little sugar is perfectly admissible ; it impartthan any other beverage the sensation that the thirst is quenchedand the patients crave it even when they are lying in a state ofsopor. We have never seen it do any harm. Many patients manifest a strong desire ibr fruit which they may partake of stewed,moderately, not too often ; stewed prunes without the skin are thbest kind.The diet during the period of convalescence is very difficult tohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 505 of 653manage properly. Either a real canine hunger is experienced bythe patients, or else the stomach craves food without being abledigest it. The former is the more common result under homoeopathic treatment, the latter is often the result of the abuse ofIn the former case the patient's craving for food may be gratifieevery two hours, but the quantity ought to be small each time,and the food ought moreover to be substantial. Beef, chickens,venison, but very little farinaceous food which, by the depositioquantities of tseeal matter, might irritate ulcers in the intestithat are not entirely healed. Good vegetables are decidedly beneficial. Individuals recovering from typhus have to be treated likpersons that were near starving to death. If the stomach is weak,the food has to be selected with so much more care, nor should thpatient be too often persuaded to eat. Good wine after a mealTyphus, 601sometimes has a marvelously good effect, whereas, if the patienttormented by canine hunger, it is rather hurtful than beneiicial.resumption of our habitual stimulants, such as cofiee, tea, tobacshould be postponed as long as possible. The patients may beallowed the use of fresh air as soon as expedient ; no apprehensineed be entertained of their taking cold.[Among the recent additions to our Materia Medica, Baptisiatinctoria or the wild Indigo is recommended for typhoid fever. Thdrug was first brought to the notice of the homoeopathic professiby Dr. Hoyt in the sixth volume of the North- American Journal.The following interesting cases were published by him :Mrs. C. was taken with typhus-fever and treated allopathically.She became so reduced that her life was despaired of. After thecontinuation of the fever for thirty-one days, as q. last resort,C. prepared a decoction of the Baptisia ; taking a piece of the rabout three inches long and three-eighths of an inch thick, steepit in half a pint of water. He conmienced by giving her five orsix drops of the decoction once in fifteen minutes, increasing tigave nearly a teaspoonful at a dose. In about one hour and a halfthe surface of the patient presented an appearance as though shehad been literally scalded, so red was the skin, accompanied withmost intense superficial heat ; at the same time noticing large dof sweat standing on her forehead, the medicine was discontinued.In a few minutes a profuse perspiration appeared all over her bodwhich continued for nearly twelve hour-s, or till she was bathedfreely with brandy and water. From this time she began to improveand with the occasional administration of a drop or two of theremedy, got well, without any febrile symptoms. It is worthy ofremark that immediately upon the administration of the remedyshe became quiet and fell asleep ; she had been restless and delifor three weeks previous.Mr. and Mrs. S. being very unwell, I was called and found themsuffering with continued fever. After prescribing Aconite, Rhus,etc., without much effect, and my patients growing rapidly worse,was induced to use the Baptisia in decoction as in the former casI remained to watch the operation of the remedy. To my greatpurprise, in about an hour the perspiration appeared upon the forheads of my patients, and it gradually covered the entire surfacehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 506 of 653In about six hours they were thoroughly bathed with tepid water ;the next morning scarce a vestige of the fever remained, and arapid recovery followed.602 Epidemic and Endem'c Infectious Diseases.Mr. R. was taken with typhus fever, and had the usual horaoeopathic remedies for several days. An unfavorable prognosis wasgiven and the Baptisia decided upon. It was administered and itseffects watched. In this case drop-doses of an alcoholic tincturewere used. The fever was reduced more than one half in a fewhours, and by a continuation of the remedy he was saved. A fiercedelirium was present in this case, but it rapidly gave way underthe action of the medicine.English practitioners, Drs. Hughes, Kidd, and others, speak ofthis medicine very favorably in the incipient stages of typhus, amore particularly when gastric fevers show a tendency to lapse inthe typhoid type. According to Dr. Edwin M. Hale, the followingare the characteristic indications for its use: Chilliness all daat night; chilliness with soreness of the whole body; heavy, dullbruised sensation in the head, stupefying headache, confusion ofideas, delirium at night, heavy sleep with frightful dreams, dryred tongue, or brown coated tongue, sticky mouth, fetid breath,fetid sweat, and great fetor of the discharges (urine and stool),great debility and nervous prostration, with erethism; ulcerationof a bad character, etc.According to my own expenence, Baptisia is not so much indicated in fully developed typhus as in intermediate forms of gastrintestinal fever and abdominal typhus. My experience in the useof this drug is limited, but I doubt whether any good can be expected from it after the ulcerative process in abdominal typhus hfully set in. In the first stages of exanthematic typhus, when noother medicines are indicated by characteristic symptoms, Baptisimay have a good effect in kindling a decided reaction. H.]8. FebriB Icterodes.Yellow Fever.This is an epidemic fever of a specific nature and a continuoustype, so called because the skin and conjunctiva look yellow,although cases have been known to occur where this yellowness isalmost entirely absent. Such patients complain of severe supraorbital headache, and soon become delirious. In the subsequentcourse of the disease the urinary secretions become suspended, institial hemorrhages take place, the patient passes black stools avomits a black substance ; this is the stage of black vomit, whicgenerally terminates fatally.This fever is endemic in low districts on the sea-coast, more parFebris Icterodes. 603ticularly on some of the West India Islands^ Cuba, and in some ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 507 of 653our Southern cities, New Orleans, Mobile, Savannah, Charleston, aeven higher North, Wilmington, Norfolk, Baltimore, and occasionally is brought even to Philadelphia and New York. It has likewise been im]..orted into European ports, Lisbon, Southampton, anSt. Nazaire, in the Department of the Lower Loire, in France; butthe fever has never been known to propagate beyond the 48° Northlatitude, nor without a temperature of 72° Fahr. It has a periodof incubation of from three to eight, ten and even more days.It is generally supposed that yellow fever attacks a person onlyonce during his lifetime, but I have known individuals in NewOrleans who had two, and one person who had three attacks of thefever during different epidemics. That this fever is a specific fowing its existence to some specific contagium by which it is propagated, and which may adhere to such fomites as woollens, feathers, cotton, letters, etc., is not only no longer doubted, butfact established beyond the shadow of a doubt by the Lisbon epidemic of 1857, and by the importation of the disease from Uavanainto the port of St. Nazaire by the "Anne Marie," in 1861, and bythe Royal mail-steamer "La Plata" into the port of Southampton,in the month of November, 1852.That yellow fever is a contagious disease, is likewise shown byDr. Holcombe's interesting report of the yellow fever epidemic,which visited Natchez and the surrounding neighborhood in 1853."The firet oases of the fever," writes the Doctor in the twelfthnumber of the North American Journal of Homoeopathy, "appeared in families some members of which had come from NewOrleans within a few weeks. The houses were pleasantly situatedin the central part of the city, and the tenants all in comfortabcircumstances. There were four distinct centres of emanationwhence the disease spread in every direction, not reaching thesuburbs until after several weeks. Many of the inhabitants whofled into the country, carried the disease with them. One gentleman sickened on the road, and stopped at the house of a friend,twelve miles from town, where he died of yellow fever. One of thefamily speedily exhibited the same disease and died. Another fledinto an adjoining county, where he also sickened and communicatedthe disease to those around him."In this manner neighborhoods were scourged by yellow feverwhere the disease was utterly unknown."In several cases which came under my observation, the families604 Epidemic and Endemic Infectious Diseases.were carefully isolated, with the exception of one messenger, whowas permitted to visit the town on necessary business, and uniformly that messenger was the first attacked. This epidemic wasundoubtedly contagious."The yellow fever epidemic which visited Lisbon in 1857, wascarefully investigated by Dr. Lyons, of Dublin, who describes fivdistinct forms of the disease: 1st, the algid form; 2d, the sthenform ; 3d, the hemorrhagic form; 4th, the purpuric form; and 5th,the typhous form.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 508 of 653The algid type is the most suddenly fatal form of the disease." The patient, while in the enjoyment of his usual health, and inthe midst of his usual occupation, feels suddenly the effects, aswere, of a sudden blow from a heavy bar on the back, falls downwhile walking or standing, and dies within a few hours in profouncollapse, and after exhibiting more or less of the other symptomsof this fever." The countenance became sunken, the eyes lookeddull and filmy, the face and trunk presented a dirty livid hue, athe surface was dotted with points of venous congestion,and hemorrhagic spots or patches like purpura broke out here and there. Insevere cases the tongue and breath were cold.In the sthenic form the symptoms of an inflammatory condition of the system, severe headache, a high, full and hard pulse,flushed face and throbbing in the temples, were present.The hemorrhagic type was characterized by eftusions of bloodfrom various organs and tissues, "the hemorrhage never beingsingle, nor from any one source or organ only."In the purpuric form the distinctive signs are purpuric patchesof various tints and colora, caused by subcutaneous efiusions ofcoloring matter of the blood.The typhous form is most generally a sequela of the other types;in some cases the disease presents the character of typhus, withstupor, nervous prostration and other typhoid symptoms, from theoutset of the attack.In reference to the course and characteristics of yellow fever,Dr. Holcombe imparts the following interesting information in hi*interesting paper :"Yellow fever, like scarlatina, presents a wide range of manifestation, from an ephemeral mildness to the most malignantseverity. The impending attack is sometimes foreshadowedfor a few hours by languor, restlessness, and malaise, most commonly a chill comes on, without premonition. Sometimes heat,Febris Icterodes. 606shiveriiigs, headache and nausea, are all confusedly mingled in tonset. When the febrile reaction is complete, the pain in the heaback and limbs is sometimes exceedingly severe ; the skin is hotand dry; the pulse full and hard, from 100 to 130; urine scantyand high colored ; eyes injected, watery, brilliant ; tongue covewith a pasty, white coat, with red edges and ap>ex ; there is somtimes a good deal of mucous and bilious vomiting." This paroxysm,scarcely distinguishable from the incipient stage of bilious remitent, lasts from twelve tb .thirty-six hours, terminating in a geor partial perspiration with great diminution, but seldom with thdisappearance of the symptoms. This remission is the rule, but thexceptions are numerous, and I have repeatedly seen the fever continue uninterruptedly four or five days. In a few hours the patiedeclares himself worse, and another train of symptoms arises. Thepain in the head, back and limbs is not so poignant, frequently ientirely absent. The pulse, tongue and skin may remain natural,whilst in fact the patient is verging into a most critical state.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 509 of 653The febrile irritation is rather of the typhoid than of the sthentype, the pulse being soft, rapid and sometimes irregular. Painmore frequently exists in the epigastric, occasionally in the umbical or hypochondriac regions. It is sometimes intolerable, whilein cases of imminent danger the symptom may be entirely wanting.Diarrhoea, or dysentery, may accompany this stage, but constipatiis more common. Burning in the pit of the stomach, acid and acrideructations^ flatulence, thirst, nausea, all combine to produce aremarkable sense of prostration, and a great degree of tossing ansleeplessness. The skin and conjunctiva assume a light lemonwhich deepens into a deep orange or gamboge color, although thissymptom ifi( by no means universal. The urine is of a sulphur orfron yellow, and stains linen. Sometimes there is slight strangurand in bad cases the secretion of urine is totally suppressed. Herhage from the gums and fauces or other mucous membranes isnow common. Vomiting becomes a distressing and an alarmingsymptom. The matters ejected pass from a greenish-yellow intoa brownish or claret-colored hue ; sometimes blood, red, dark, orbrown, is thrown up. The appearance of coftee-ground vomitleaves but a ray of hope. Still the patient may recover througha tardy convalescence, very liable to relapse. If the disease benot arrested, the temperature of the skin falls, the hemorrhagebecomes more profuse or ominous, the circulation fails, extremejactitation comes on, delirium or coma supervenes, and dissola606 Epidemic and Endemic Infectious Diseases.tion is occasionally preceded by general convulsions. The pat) mtseemed generally to be worst on the first, third, and fifth ("aysDeath appeared to be more common on the sixth, but some fewdied as early as the third day, and many lingered beyond a i#eek.Several cases terminated in dysentery and a good number in common intermittent fever."The above sketch is purely typical, the symptoms of «rhichwould not be presented by any one single case." I will now mention some local featur^ of importance whichhave come under my own observation.^^ Head. The headache was severe during the first pai )xyflra,but abated during the remission, seldom to return and L/>ver toresume its prior intensity. It was throbbing, boring, witl a senstion of undulation in the cranium. There was commonlj sorenessof the eye-balls in motion, sometimes photophobia, and iL one casviolent earache. There was sometimes a sensation as if the headwas very much enlarged. In a few cases the headache wj»8 general,but was mostly referred to the supra-orbital region. I believe itwill usually be found that, when the organic function* bear thebrunt of the disease, the headache will be referred t«»rior part of the cranium, while the derangements of animal lifeare rather displayed by vertical and occipital headache." Eyes. The redness, brilliancy, and watery suiFusion of the eyeis more marked in the first stage of yellow fever than in any ofallied diseases. «" Mouth. Spontaneous ptyalism sometimes occurred, one or twohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 510 of 653cases of which were ascribed by the unscrupulous malice of ouropponents to the secret use of Calomel." Stomach. Positive pain in the epigastrium sometimes occurred,but there was more frequently only soreness, and sense of weaknesand oppression. Thirst, burning in the pit of the stomach, and anindescribable, empty, gnawing, sinking feeling, preceded and accopanied the nausea and vomiting, which were the most troublesomeand distressing of the yellow fever symptoms. An insensibility toexternal pressure stood occasionally in strange discordance withthe gastric irritability, and other symptoms of gastro-enteritis.Acid and acrid eructations were very common. Every thing, evencold water, was said by the patient to 'turn sour on the stomach.Conjoined with these symptoms, there was sometimes a morbid,canine hunger which made the patient forget every thing else andthink that, could he only eat something, he would feel perfectlyFebris Icterodes. 607well. The nausea was provoked by eating, by motion, and, in somecases, by lying on the left side. Hiccough, which Dr. Stokes considers a strong sign of inflammation about the cardiac orifice ofstomach, occurred in some bad cases. The matters ejected variedin their nature. Black vomit likewise occurred, sometimes in greaquantities, and when the patient was much prostrated, the fluidwas merely gulped up, running out at the corners of the mouth.It is said to be distinctly acid, reddening litmus paper, and effvescing with carbonates. It is not always a fatal symptom.** GenitO'Urinary Apparatus. The uterus and vagina were by nomeans exempted from the hemorrhagic tendencies of the othermucous membranes. In a few cases the urine was at first limpid,then yellow, and, occasionally, turbid and brownish like porter.This last was sometimes largely excreted, without proving criticaSuppression of urine is perha^is more frequent in this disease thin any other, excepting Asiatic cholera. It was always a symptomof formidable character, and, when conjoined with black vomit anddelirium, presaged too certainly the approach of death." ChesL The thoracic organs were not principally deranged. Asoft, full, compressible pulse, averaging hundred, was very commothroughout the disease, whether mild or severe. In one case thewrist was pulseless for some hours, as iu Asiatic cholera, the pution returning during a partial, but transitory reaction." Nervous Si/stem. In all points of view, as the medium of themind and of the senses, as an excito-motory apparatus, both voluntary axid involuntary, the nervous system was both primarily andsecondarily implicated. The subjective phenomena were numerousand distressing: pains, nausea, vertigo, numbness, bad taste, thihunger, coldness, burning heat, frightful dreams, etc. The abdominal pains of the second stage, and even the thirst, heartburn,naupea, etc., were sometimes distinctly, but irregularly intermitlike the pains of colic, which is explained by the fact that allfunctions of the ganglionic .plexus are rhythmical in their charaAccording to Volkniann, even a current of electricity is not tranmitted continuously through them, but is broken up into a numberof successive shocks. Delirium occurring in the first stage, washttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 511 of 653of little importance. Later in the disease, it was in some casesfurious, the patient struggling desperately to get out of bed, bugenerally it was of the mild, incoherent typhoid type. In an olddrunkard it was precisely the delirium of mania a potu. Stupor,even to profound coma, often marked the last stages.608 Epidemic and Endemic Infectious Diseases.^^Skin. The temperature of the skin after the febrile paroxysmwas commonly natural. In a few cases there was the calor mordaxof typhus,"The perspirations were very irregular, often partial, sometimesoffensive, and never, that I could discern, of the least prognt)8value. The yellowness came on generally by the third or fourthday, seldom earlier, sometimes not until convalescence was established. Petechifie were sometimes observed in protracted cases.The eruption was sometimes vesicular, sometimes like what is knowas prickly heat, sometimes like nettle-rash, and again the skinpresented the lobster-like redness of scarlatina."I^roynoHis. Aitken arranges the data to judge from, intosymptoms which are favorable, and those which are not so. Favorable symptoms: "A slow pulse and moderate temperature of thebody, and quiet stomach. Streaks of blood during the stage ofblack vomit, or after acid elimination has set in, are favorable,the corpuscles are found entire. If the urinary secretion continuand the black vomit be scanty from the first, or is afterwards supressed, the patient may yet survive. Urine simply albuminous isa less serious sign than when it also contains tube-casts. Free,copious urine, no matter how dark or bilious, is the most favorabof any sign. Prognostics may be derived from the effects of treatment." Under homoeopathic treatment the prognosis is infinitelymore favorable than under the Old School treatment with theirmurderous doses of Calomel and Quinine.Dr. Holcombe treated one hundred and forty cases of yellow feverbetween the 13th of August and the 15th of December, 1858. Noneof them were cases of ephemeral sickness, nothing but unequivocalstrongly marked yellow fever was admitted into the list. Of thisnumber seventy-one were white, and sixty-nine colored ; of thecolored thirty-nine were blacks, and thirty mulattoes. The adultswere ninety-three ; children forty-seven ; cases in town one hundand eleven ; cases in the country twenty^-nine. Males sixty, femaeighty. At least one-half of the cases were very severe, the patibeing for several days in a critical and dangerous situation. Ofone hundred and forty cases, nine died. Of these six were treatedhomoeopathically from the beginning, one case was complicated witabortion and profuse hemorrhage ; another, a cachectic negro, diesix weeks alter the day of attack in a typhoid condition, the seqof the fever. Three came into the doctor's hands on the fourth anfifth day of the fever, two of them having employed allopathicmeasures.Febris Icterodes. 609http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 512 of 653Doctor DaviB, the pioneer of Homoeopathy in that region, treatedfour hundred and fifteen cases, with twenty-four deaths.unfavorable signs are : The more fiery crimson the tip and edge othe tongue, the more irritable the stomach, the severer the headache, the worse the prognosis of the first stage, and vice versaa streak of blood in the early vomit indicates much danger fromthe attack. In the second stage the earlier or more complete thesuppression of urine, and the more copious the ejection of blackvomit, the more imminent the danger. If the urine be scanty, andloaded with tube-casts, entangled in epithelial and coagulable mater, a light buff-colored curdy sediment indicates a complex lesiof the secreting structure of the kidneys. It is the urine symptoin its maximum of severity, and is as fatal as if the suppressionhad already occurred, A faltering of the articulation is a badprognostic, and a difliculty of protruding the tongue, enhances iThe danger of the case is enhanced by inflammatory complications,and by hypertrophy of the heart. A recent residence in a temperatclimate ; the race or complexion of the individual ; the fact ofpreviously having suftered from an attack, will enter into anestimate of his chances of recovery."Treatment. Doctor Holcombe reports: "If the chill was violent, or persisted long, I ordered the tincture of Camphor in drodoses every ten minutes, a procedure eminently successful in Asiacholera, and in the cold stage of malignant intermittents. I met,not long since, in Cullen's Materia Medica, some interesting factproof of the last substantiated view, namely, that its primary efis a great reduction of animal temperature. The operation ofCamphor is so evanescent, that it in no wise interferes with theeflicacy of subsequent remedies. Aconite and Belladonna were usedin alternation in the first stage. To run a parallel between thesymptoms of yellow fever and these drugs, would be to abstractwhole pages from the Materia Medica. I need not speculate on thepathology of Aconite and Belladonna poisonings. They evidentlyshow that profound lesion of innervation, subsequent nervous andvascular erethism, and local determination to the cutaneous andnervous membranes so strongly characteristic of the yellowpoisoning. They are complements of each other in making out thewhole morbid picture, and were therefore used in alternation, evehalf hour at first, the interval being afterwards lengthened to oand in mild cases, to two hours. In a few cases I used a drop ofpure tincture in half a tumbler of water ; but I generally conten39610 Epidemic and Endemic Infectious Diseases.myself with five or six drops of the first centesimal dilution prin the same manner, of which one teaspoonful was given at a time.A similar preparation of Ipecacuanha was commonly left, to beadministered after each act of vomiting. In very mild cases theseremedies alone sufficed." When the second stage came on, the cerebro-spinal symptomsdisappearing, or being much ameliorated, while the patient complained of nausea, prostration, acid or burning sensations, painthe abdomen, thirst, restlessness, etc., a change of remedies washttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 513 of 653demanded." On studying the symptoms of this stage, ninety-nine homoeopaths out of a hundred would suggest Arsenicum as one of the mainremedies. But lest my allopathic reader should distrust Hahnemann's Materia Medica, or Jahr's Manual, I will collate from thenearest allopathic authority, which happens to be Taylor on Poisosome of the prominent symptoms of the Arsenical pathogenesis." Faintness, depression, nausea, with intense burning in the regiof the stomach, increased by pressure. Violent vomiting of a browturbid matter, mixed with mucus, and sometimes stained withblood. Sense of constriction, with a feeling of burning in the thoften accompanied by intense thirst. Pulse small, frequent andirregular. Skin cold and clammy in the stage of collapse, at othetimes it is very hot. Respiration feeble, and accompanied withsighing. Inflammation of the conjunctiva with suffusion of theeyes, and intolerance of light. Irritation of the skin, accompaniby an eruption. Exfoliation of the cuticle. Great nervous irritability. Intolerablepaininthebowels, with bloody stools. Great emaciation, want of sleep, urine scanty, high-colored, and passed wian effort. Suppression of urine. Strangury and jaundice have beenalso noticed among the secondary symptoms. Delirium, jactitation,conia, convulsions." Finally the anatomical lesions of Arsenic are also remarkablysimilar to those of yellow fever. They are the pure dynamic effecof the drug acting through the nervous system ; for it is well knthat its specific effects on the stomach will be produced by injethe veins or inserting it into a wound. Mr. Taylor says: "Arsenicis not an irritant poison ; it does not seem to possess any corroproperties, that is, it has no chemical action on the animal tissand the changes met with in the alimentary canal of a personpoisoned by it, are referrible to the effects of the inflammationexcited by the poison, and not to any chemical action.*'Febris Icterodes. 611"Tn looking for a complemental medicine to alternate withArsenic, in order to fill up the morbid picture, we keep in viewit must be capable, chemically or otherwise, of deteriorating anddevitalizing the blood, so as to give rise to hemorrhage and extrvasation, and render it unfit for the nutritive demands of thenervous system. No poisons, animal, vegetable or mineral, do thismore uniformly and effectually than the virus of serpents. Crotaland Lachesis are remarkably similar in their action, like the isomorphous substances in Dr. Blake's interesting experiments. Wechose Lachesis in the fifth dilution, alternating it with the foutrituration of Arsenicum^ at intervals of an hour. When Belladonnand Arsenicum produced no amelioration, a change to Arsen. andLachesis brought about the desired amendment." These remedies were sufficient for very many severe cases ofyellow fever, but occasional symptoms arose from the idiosyncrasyof the individual, or the peculiarity of the case, which called fother remedies. Veratrum was very useful in allaying the vomitingand abdominal pains. Tartar emetic succeeded promptly in somecases of prolonged and distressing naasea. Chamomilla did morehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 514 of 653for this gastric irritability than its rather mild pathogenesis wlead us to expect, particularly in the cases of women and childreMustard plasters to the epigastrium, and cold enemata were alsoased as palliatives for the nausea and vomiting. Very hot fomentations frequently diminished the excruciating pains in the bowelWhen diarrhoea or dysenteric symptoms supervened, MercuriuSyPhosphorus or Colocynth relieved them readily. Cantharides scarceever failed to remove strangury, and restore the venal secretionsconjunction with Arsenic. Nuz vomica was frequently employed asan adjuvant in persons much addicted to alcoholic liquors. Chamomilla, Sabina or Secale generally caused the symptoms of threatenabortion to disappear. When the strong characteristics of yellowfever gradually subsided, leaving the system prostrated and torpiHhus and Bryonia were used with good effect. Belladonna^ Cojfeaand Hyoscyamus were sometimes indicated at night for nervoussleeplessness. Millefolium was used in one case of abundant hemorrhage from the mouth, and whether it was a coincidence or a cure,it was almost immediately checked. Some of our ultra-IIahnemannian brethren may find fault with us for using such low dilutions, repeating them so frequently, and sometimes employing threremedies in quick succession. But the malignity and rapidity ofthe disease, the diversity and frequent incongruity of the sympto612 Epidemic and Endemic Infectious Diseases.their Protean forms and treacherous character, warranted ns inactive and decisive measures. Homoeopathic aggravation, undersuch circumstances, is very little to he apprehended, foreshadowias it does a curative result. A resort to the higher dilutions, 612th or 80th after the lower had failed, was attended, in somecases, with the happiest effect."If the above remedies proved inefficacious, if the patient sank,if the vomiting became worse, with brownish stains in the matterejected, or any of those various hues which indicated hemorrhagefrom the gastric mucous membrane, Nitrate of Silver was the remedconjoined with Arsenicum and Lachesis. We made a first and secondcentesimal trituration, and as the latter did just as well as themer, perhaps better, I infer that the action, like that of Arseniwas not topically stimulant, but dynamic Indeed, what stimulus,in the allopathic sense of the word, can the one ten-thousandth oa grain of Nitrate of Silver^ dissolved in half a tumbler of wateadministered in teaspoonful doses, give to the whole gastric mucomembrane ? A much more curative one, I venture to say, than thesame remedy would have made in larger doses. As it was, themedicine frequently aggravated ; and one patient complained bitterly of the nausea it produced. In this case, all the dangeroussymptoms were arrested by Lachesis. One negro woman lived aweek after black vomit had set in, apparently, but not permanentlrallied by Nitrate of Silvery Carbo vegetabUis and Hydrocyanic ac" Strict attention was paid to diet ; a point of vast importancein managing the diseases of the blood-making apparatus. Arrowroot, rice-water and black tea with a little sugar and milk in itwere the standard articles for the first stage. During the secondstage, the canine hunger was sometimes distressing; but besidesthe above nutriment, we seldom permitted anything but a teaspoonful of pure cream at regular intervals. Ice was allowed, inhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 515 of 653moderate quantities, for the thirst. During convalescence, theslightest imprudence in eating was apt to induce relapse. I haveseen toasted bread, chicken broth, soft boiled eggs, etc., decideinjurious. When the patient is able to pass from the farinaceousarticles to something more nutritive, he may be permitted at onceto chew pieces of good beef-steak. This is much better than beeftea, because the act of mastication extracts the saliva, and incoporates it with the animal juice, thereby facilitating its digestAlcoholic stimulants were seldom given during the disease, or recommended to promote recovery. Confirmed topers, however, wereCholera Asiatica. 618permitted to use small quantities of their favorite beverages durthe latter stages of the disease." H.]4« Cholera Asiatica.Asiatic ChdercuAsiatic cholera is an intensely epidemic disease ; sporadic caseseven if they bear the greatest resemblance to cholera, cannot beregarded as such, but must be set down as very violent cases ofcholerine. We will not inquire where and how cholera first originnated. The important point ^nth us is to be acquainted with themanner in which this epidemic spreads. Cholera is caused by aspecial contagium which is multiplied by the disease and is contained in the excrements ; its presence anywhere else is very douful. Hence the infection is principally spread by contact with thexcrementitious matter of cholera-patients. This proposition whicwas first started by Pettenkofer is the only one among the multitude of hypotheses bearing on this point, by which the variousbizarre modifications in the spread of the epidemic can be accounfor in a natural manner. This involves a second point, namely :that the development of the contagium does not take place withinthe body of the patient, but in the excrements after their removaout of the body, and that this development takes place so muchmore rapidly and intensely the more the conditions for a rapiddecomposition of the excrements are accumulated. The infection ispromoted by all kinds of aft'ections affiliated to cholera, henceby gastro-intestinal catarrh, by circumstances exerting a depressettect upon the mind, by a cold, by dietetic transgressions. Neitage nor sex shows either a greater or a less susceptibility to thdisease. The epidemic now raging in Egypt furnishes a strikingexample of the origin and spread of cholera. Hence cholera is notcontagious properly speaking.Symptoms and Course. It cannot be stated with perfectcertainty how soon, after the infection has taken place, the firssymptoms of the disease show themselves, but all circumstancestend to show that the period of incubation only lasts three days.It has no characteristic symptoms ; the alterations caused by thedread of the fearful malady must not be mistaken for manifestations of the disease itself.A preliminary stage in reality does not exist. The first signthat infection has taken place, is a painless diarrhoea which ishttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 516 of 653614 Epidemic and Endemic Infectious Diseases.thin, bat is still somewhat tinged with bile ; the patient has frthree to six discharges every day. On a careful examination, anumber of shreds of epithelium are discovered in the excrements.The diarrhoea is not always Associated with a marked feeling ofmalaise ; sometimes the only symptoms present are a disproportionate feeling of lassitude, an increase of thirst and an impaired atite. That this premonitory diarrhoea is real cholera, is shown bthe circumstance that it is capable of spreading the infection. Aany rate, every diarrhoea which sets in at the time of epidemiccholera ought to be regarded as a premonitory symptom of the disease. At times the diarrhoea only lasts a few hours, at other tima few days, scarcely ever beyond a week. It may terminate theattack, or else the disease may pass into the more malignant andmore characteristic forms of the epidemic.This passage to the more malignant type generally takes placequite suddenly. A copious evacuation takes place resembling ricewater, simultaneously with which the debility increases very rapidly. These evacuations succeed each other with more or lessrapidity, an agonizing thirst supervenes, and very soon the patieis attacked with vomiting of substances resembling the alvineevacuations, but having a little more color. At the same time thepatients are no longer able to preserve the erect posture; they atormented by a peculiar anguish which they point out as beinglocated in the prsecordia; the urinary secretions are scanty orentirely suppressed, the patients have a cadaverous appearance, teyes are sunken, surrounded by dark margins, the skin is cool, thhead is bathed in a cool perspiration; the pulse is small; at thistage cramps of the glutei muscles and of other muscular bundlesmake their appearance. The affection may persist for some timeat this height, very seldom longer than twelve hours, after whichrecovery takes place, the passages gradually resuming a bilioustinge, becoming less copious and less frequent, and the skin warming up again. Convalescence from this milder form of the diseasealways proceeds rapidly, without being disturbed by consecutivediseases. Usually, however, this mild form sooner or later passesinto the most violent form of the disease.This type of cholera, designated as cholera asphyctica or algida,very seldom breaks out all at once at the outset, but very oftenceeds the premonitory diarrhoea with the suddenness of a flash oflightness. The quantity of matter evacuated by the anus andmouth, is enormous; it is colorless and inodorous, contains shredCholera Asiatica. 615of epithelium and a few flocks of mucus. These evacuations oftensucceed each other without the least intermission. The thirst nowbecomes agonizing; the vomiting is excited every time after thepatient swallows a drink of water. His anxiety is excessive ; attimes he complains of violent pains in the pit of the stomach, anhe is likewise tormented by severe cramps in the calves. The urinary secretion is entirely suppressed. The consequences of the immense losses of fluids show themselves very speedily. The skinhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 517 of 653becomes cold, very soon it assumes a cyanotic color, loses its elticity to such a degree that a fold of integument on the hands, ipinched up, remains in this condition for a long time ; the facea cadaverous appearance, the eyes are deeply sunken in their sockthe nose is pointed, the lips blue. The temperature is like thatice. The radial pulse can no longer be felt, not even that of thelarger arteries ; the sounds of the heart are very feeble, the sesound is often wanting ; respiration is labored, the breath is cothe voice is extinct. After this condition has lasted for twelveat most, death takes place, previous to which the evacuations upwards and downwards generally cease and the extreme prostrationchanges to a complete stupor, without any real death-struggle, anwithout the rslle which usually precedes death. The disease maychange for the better even after it has reached the acme of thestage of asphyxia, although recovery from this stage is an eventrare occurrence.The stage of reaction shows the most remarkable differences.The disease may uniformly but slowly progress towards convalescence. This change as well as the beginning of reaction generallyis indicated by the circumstance that the patients are able to reliquids on their stomachs, and that the radial pulse returns. Graually the temperature of the skin is restored, the alvine dischardiminish in number and are more and more colored ; at first theyare generally mixed with shreds of intestinal mucous membrane,and have a foul smell. The prostration continues for a few days,the urine is at first turbid and shows traces of an inflammatoryprocess going on in the kidneys. Such a simple convalescence fromcholera algida is always an exception, not the rule. In other casthe icy coldness is suddenly succeeded by a febrile excitement, arapid and full pulse, cerebral hyperaemia; this change is eitherspeedily followed by convalescence, or else, typhoid phenomenamake their appearance. The more malignant forms of cholera arevery generally followed by typhoid symptoms. After the cessation616 Epidemic and Endemic Infectious Diseases.of the vomiting and a return of the pulse, the pulse becomes hardfull and frequent ; the turgescence of the skin is very marked. Tbrain seems blunted, the patients are lying in a state of sopor adelirium, very much prostrated; the temperature rises considerably; the thirst continues and the patient has even occasionalattacks of vomiting, the diarrhoeic stools are decomposed and hava foul smell ; the tongue is dry and has a fuliginous coating. Evsymptom points to the supervention of an intense typhus, withwhich the symptoms of an intense nephritis are generally associated. The transition from this typhoid condition to health alwatakes place very slowly, although more rapidly than in cases of ttyphus. A favorable turn generally takes place already in the second week. Death is a very common termination of this condition.Cholera has no positive sequelse, although the most diversifiedderangements remain after an attack of cholera, which generallyresult from the circumstance that the circulation in the variousorgans had almost been arrested during the frigid stage to the poof inflammatory infiltration. We do not give a detailed statementof the anatomical changes in cholera, because they are almost generally without any characteristic significance. Beside the excessbut perfectly explicable dryness of the tissues, we constantly mehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 518 of 653with an extensive destruction of the epithelium of the mucousmembrane of the ileum ; the gall-bladder is found distended withbile. At all events, the anatomical lesions are not sufficient toaccount for the frightful rapidity of the development of cholerathe lesions of the intestinal epithelium certainly cannot be thecause of the profuse watery evacuations.Treatment. We will in the first place call attention in a fewremarks to the prophylactic treatment which can be arranged incholera more easily than in any other epidemic. We know that theexcrements of the patients are by far the most active vehicles ofthe contagium. Hence, it behooves us either to destroy this contagium in the excrements, or else, to remove it. For this reasonthe discharges should at once be mixed with Sulphate of Iron, andshould not be thrown into water-closets, but into deep ditches refrom inhabited dwellings. The soiled bed-linen is best cleansed bboiling it. In order to protect uninfected persons, they must beforbidden to visit the houses of the sick, and above all, the usethe water-closets must be absolutely prohibited. Nurses shouldnever remain with the patient too long at a time. The enactmentof further measures is the business of the health-authorities; alCholera Asiatica. 617sanitary measures must aim at this one object, to keep the excrements of cholera-patients remote from all contact with healthypersons. On the other hand, it is unnecessary and useless to tryprevent the spread of cholera by placing all cholera-patients inquarantine. If cholera were contagious, every physician wouldhave an attack of it. Among the precautionary measures whichit behooves each individual to observe, the following are the mosimportant : AlS much as possible a regular mode of living ; the uof simple and substantial nourishment ; the slightest possible deation from one's regular mode of living ; avoidance of all debilitating influences, such as excessive mental exertions, depressingemotions, etc., more particularly avoidance of the excessive usespirits. Whatever tends to excite diarrhoea, must be discarded.Persons must take care not to get chilled or overheated. Everydiarrhoea with which a person may be attacked, or with which hemay already be affected during an epidemic, should be carefullyattended to. The observance of these preventive rules is at allevents a much more efficient prophylactic than all the othervaunted preservatives which are almost always made up ofspirits. Good claret is the only kind of wine that can be safelyallowed as unhurtful. No reasonable person will deny the usefulness of suitable prophylactic means which everybody should employ in his own, and likewise advise in other families under thedirection of an enliglitened physician.The medicines which a good deal of clinical experience haspointed out as our best remedies for cholera, are not numerous ;view of the great uniformity which the leading symptoms presentin all epidemics, no great variety of remedial agents can be expected; from the practical stand-point, this must be looked upona great boon to the physician. Our remedies the eflicacy of whichhas been corroborated by trials, are : Ipecacuanha^ Camphora^ Vertrum alburrty Cupnim, and Arsenicum; this list does not include tremedies for the typhoid condition remaining after cholera.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 519 of 653Ipecacuanha is less indicated for real cholera than for tlie premtory diarrhoea ; its efficacy in this diarrhoea is certainly greaan attenuated tincture of Ipecacuanha can be safely recommendedas the best domestic remedy during epidemic cholera. Real cholerarequires Ipecacuanha^ if the vomiting is much worse than the diarrhoea. Ipecacuanha is, moreover, an important remedy in the cholera of little children.Camphora is recommended by Hahnemann himself for an incip618 Epidemic and Endemic Infectious Diseases.lent attack. This recommendation has not been very extensivelyverified by experience ; nevertheless, if the attack is not too vlent, the tincture of Camphor had better be tried ; likewise, ifattack is preceded by unequivocal, premonitory symptoms, in theso-called cholera sicca. Hahnemann announces the following symptoms for which Camphor has been used in many cases with greatsuccess : Sudden and. rapid failing of strength, so that the persattacked cannot stand on his les^ ; alteration of the features,sunken eyes, bluish and icy-cold face, coolness of the rest of thbody ; hopeless despondency and anxiety as if he would be asphyxiated ; stupefaction, insensibility ; constant and unintelligibleing; burning in the stomach and fauces; crampy pains in thecalves ; painfulness of the pit of the stomach to contact ; thirsnausea, vomiting and diarrhoea have not yet set in. After takingCamphor, sweat soon breaks out as a sure sign that an improvement has commenced. As soon as this takes place, the remedymust be given less frequently and in smaller quantities, otherwisit might give rise to a troublesome cerebral hypersemia. For thetyphoid symptoms remaining after cholera, Camphop has likewisebeen given ; the exhibition of Camphor in this condition is, indejustified by the similarity of its pathogenesis to the symptomscharacterizing ursemia. The results, however, are not as yet verynumerous.Veratrum album is, without doubt, our most important remedy forcholera. If we wish to derive good effects from its use, we havebegin its administration in good season, and give it at once forpremonitory diarrhoea, especially if it is colorless. Veratrum isindicated still more, if the attack commences with vomiting anddiarrhoea ; this remedy often stays the further progress of the dease. Veratrum is less reliable if the symptoms of cholera are fudeveloped, although even then it surpasses all other remedies inefiiicacy. Of course, no remedy acts as favorably after the disease has made considerable headway; it is for this reason thatVeratrum should be given at as early a period as possible. If therestlessness of the patient has given way to a dull apathy andinsensibility ; if the skin is cold as marble and the pulse has bperfectly extinct, Veratrum is no longer indicated. In general, iproper to say that Veratrum album ceases to exert a favorable effafter the symptoms of reaction have become extinct.Cuprum is highly commended by some, and entirely rejected byother physicians. An investigation will show that the latter clashttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 520 of 653Cholera Asiatica. 619reject Cuprum because they have not given the proper dose ; Cvrprum 80 cannot be expected to have any effect in such a very acutdisease. Cuprum is not only indicated when the evacuations areBtill unrthecked, but likewise in the stage of asphyxia. This medcine is not endowed with much power to check the diarrhoea, butit is a valuable remedy in preventing the general paralysis of thorganism. For this reason, as long as vomiting and diarrhoea areBtill present, Cuprum had better be given in alternation withVeratrumy more particularly if the spasms are very general andrather of the clonic form. In the frigid stage Cuprum alone isindicated, if the following symptoms are present: Loss of consciousness ; spasmodic twitching of the fingers and toes ; trismuaudible gurgling of the beverage down the oesophagus ; no vomiting, in its place distressing, ineffectual efibrts to vomit ; therhoea has ceased, but on pressing on the bowels a loud gurglingis heard, giving rise to the suspicion that the stools are not expelled, because paralysis of the intestines has set in. Cuprum islikewise indicated if the pulse not only becomes feeble, but intemittent at an early period of the disease. It is of great importance what preparation is used. We doubt whether metallic Copper can ever act with great promptness; we prefer the Acetateand Sulphate of Copper.Arsenicum album displays its curative action in those terriblyrapid cases where cholera algida at once sets in without any premonitory symptoms. The most essential indications for Arsenicum are : Sudden and complete exhaustion, vanishing of the pulsetogether with violent palpitations of the heart, great dyspnoea,inexpressible anguish, constant tossing about, horrid thirst, yetthe least quantity of liquid is vomited up again immediately;burning distress in the region of the stomach and upper portionof the bowels ; complete suppression of urine. In such casessenicum should be given at once, without any other medicinebeing resorted to in the first place. After the exhibition of Arsenic the urine is often secreted in large quantity, a very favorable change.Beside these most important remedies we mention the following, accompanying some of them with brief indications or givingonly their names. It is not an easy thing to introduce new cholerremedies to the favorable notice of the Profession, for the reasothat the above-named remedies have proven themselves reliable inthis fearful epidemic to such a degree that they must necessarily620 Epidemic and Endemic Infectious Diseases.cast all other medicines that are recommended for cholera, into tshade. Who would want to experiment with untried remedies insuch a rapidly and terribly fatal plague ?Carbo vegetabilis has not unfrequently been found useful at aperiod in the course of the disease when no special medicine isdecidedly indicated. Carbo may be administered in the asphycticstage, if the diarrhoea and vomiting have ceased, if every spasmodic movement has disappeared, and the patient lies as if dead.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 521 of 653Carbo is frequently indicated after Arsenicum^ and is particularlits place in cases where every sign of reaction had seemed extincfrom the beginning.Acidum hydrocyanum has similar indications as Carbo, but differsfrom this medicine in the succession of its symptoms. It is indicated if the attack at once assumes the highest degree of intensiso that but a few hours intervene between the commencement ofthe attack and the moment when death seems to be lurking onthe threshold ; Carbo may be sufficient if the failing of the stris less rapid.Opium deserves attention in the cholera of little children ; it iseldom suitable for adults,Colchicum cannot be regarded as a remedy for cholera, for thereason that it has not the colorless stools.We name moreover : Jatropha cureas, Iris versicolor , Cicuta viroConium, Secale cornutum; these remedies, however, are eitherunreliable as similia, or because they have not been sufficientlyproved.As regards dose, almost all observers agree in recommendingthe lower preparations, even the strong tinctures, frequentlyrepeated.We have to devote a few lines to the management and diet ofcholerarpatients. Warm external applications are generally of verlittle use ; they are apt to increase the patients' restlessness,have to be resorted to very guardedly. Continued but gentle frictions with cold wet clothes are much more beneficial. At theonset of the attack, food is utterly out of the question. The besbeverage is fresh well-water; this will moderate the thirst for amoment at any rate. Small lumps of ice in the mouth likewiserefresh the patient a good deal. If Champagne can be had, it maybe administered in tablespoonful doses with great advantage.The typhoid symptoms after cholera are so changeable that it isnext to impossible to recommend a positive course of treatment fooCholera Asiatica. '^^ 621them. The most important remedies are: B^flfdort

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 522 of 653rated tinq^ure of Aconite-root as a specific for cholera. This remendation was laughed at by some, and very coolly received byothers. In the May number of the North American Journal ofHomoeopathy, 1867, we find an article by Doctor Cramoity, translated from the Bulletin de la Soci^td Mddicale homoeopathique deFrance, by Doctor John Da vies of Chicago. In this article DoctorCramoity claims for the tincture of Aconite the rank of a Choleraspecific. He claims that from a therapeutic point of view thecharacteristic feature in cholera is the acceleration or the augmtation of the pulsations. "This," says the Doctor, "is not ahypothesis; for we can well remember in the cholera-cases weexamined when under our supervisiso in the Charity-hospital, in1854, and in our private Clinic in 1865, that the increase of thepulse more or less coincided with the degree of the disease, andwith the anguish or sufiering ; because the pulse frequently disapeared at this moment."At the commencement of the epidemic of 1865 we did not appreciate these symptoms, and had the misfortune to lose four casetwo women and two children ; to these we had given the remediesprescribed in the books for similar cases, which remedies were sato be the most efiicacious in such circumstances." This is therefore the reason for our presenting this theory oftreatment of cholera : our experience and observation establish tfact that the tincture of Aconite is the grand curative agent offlammatory diseases, and the regulator of the circulation." We have prescribed from fifteen to twenty drops of the tinctureof Aconite in six to eight ounces of distilled water, a teaspoonfthe same to be taken every ten, twenty or thirty minutes, accordito the intensity of the symptoms. Under its influence, the patienbegins to revive, the circulation of the blood returns to its norcondition ; the pulse rises, the internal heat ceases ; the thirsallayed, and the vomiting and diarrhoea arrested. At the same622 Epidemic and Endemic Infectious Diseases*time the bluish cast of countenance disappears, the cadaverousexpression changes to a natural one, the agitation of mind and bois replaced by a tranquil condition ; the dread of death is transformed to joy and hope, and the patient recovers in three to fourhours/*i?everal cases are mentioned where the patients, after having beefruitlessly treated with the usual cholera-remedies, such as : Caphor j Veratrurriy Arsenicum^ Cuprum^ and sinking very fast intolast stage of collapse, were* speedily and completely cured withdoses of the concentrated tincture of Aconite.Indeed, why should Aconite be overlooked as a great and specificremedy for cholera ? If there is any truth in the homoeopathiclaw, the effects of Aconite upon the normal human organism pointto it as a remedy for cholera. "We do not think that it supersedethe use of other valuable specifics for this terrible epidemic, nthey, on the other hand, supersede the use of Aconite. A few caseof poisoning will conclusively demonstrate the homoeopathicity ofAconite to Asiatic cholera. With high potencies we must, ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 523 of 653course, not expect to accomplish anything ; large doses of the cocentrated tincture are required to produce a curative effect.The following case of poisoning is reported by Doctor JacobReed, Jr., of this place: A man, forty-five years of age, undertreatment of rheumatism, swallowed a teaspoonful of liniment composed of equal parts of the tincture of Aconite-root and water.This was followed by pain in the epigastrium, numbness of thehands and feet, and a sense of formication over the whole body.One hour after, the dose was repeated. At the time of my visit,an hour and a half after the first dose, the man had swallowed ova drachm of the strongest tincture of the root. I found him in acomplete state of collapse ; after the second dose he had vomitedrepeatedly, first bilious matter changing into copious watery discharges ; he had also had several very large rice-water dischargefrom the bowels ; he complained of terrible pain and anxiety abouthe heart, was pulseless, skin cold and clammy, face indicative ogreat suffering and fear, breath cold to the hand ; occasional paoxysms of general opisthotonic spasms would leave him in a prostrated condition in which it would seem that bis constantly exprefear that he should die, was about to be realized.Before I questioned the family, from my first examination of thecase, I judged it to be cholera ; indeed, if there had been casescholera in town, I would have thought it unnecessary to investigaCholera Asiatica. 623the case further. I discovered the mistake that had been made,and under the free use of stimulants, Coffee and Opium, he recovered, but not until after three or four hours continuance of theabove severe symptoms."The following case of poisoning from the tincture of Aconiteis reported in the October number, 1868, of the Medical and Surgical Reporter, published in Philadelphia. By mistake a child wasgiven a teaspoouful of the strong tincture of Aconite-root. Thepatient was a boy, six years of age. Doctor Hays of Covington,Ky., where the poisoning occurred, reports as follows : I found tpatient so much prostrated that, had there been an epidemic ofcholera, and had I no examination to aid me, or any previous history, but had to depend upon the appearance of the patient, Iwould undoubtedly have pronounced it a collapsed state of choleraThe skin was cold, clammy and livid, with a profuse perspiration,there was no pulse to be felt at the wrist, the action of the heawas quite feeble and irregular, the capillaries were scarcely ablbe refilled when their contents were poured out. The head wascold, the eyes were natural in appearance,- except the dilatationthe pupils which was extreme and not at all sensitive to the effeof light. The facial expression was haggard, the nose pinched, thbreathing extremely labored, the lungs were filled with mucus, thrattle of which could be distinctly heard in any part of the roomThe patient's bowels moved several times involuntarily. Underproper treatment the boy recovered."The eleventh case of poisoning by Aconite in my Materia MedicawaB regarded by Dr. Pereyra of Bordeaux as such an exact representation of the symptoms of cholera that the doctor concluded to anhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 524 of 653dote the symptoms with Guaco which he had found efllcacious durinthe paralytic stage of cholera. The poisoning was caused by a lardose of Aconite taken by a rheumatic patient in the hospital ofBordeaux, France. All the pathognomic cholera-symptoms werereproduced in this case.Doctor Richard Hughes, in his Manual of Pharmaco-dynamicsurges the claims of Aconite as a remedy for Asiatic cholera. Page88, Vol. L he writes : " Some very striking phenomena are observein the sphere of the circulation. In acute poisoning the dilatedpupils, the pale face, the quick and contracted pulse, and the gecoldness within and without speak of an excitation of the vasomotor nerves throughout the body, analogous to that of the musculo-motor centres which results in tetanus. In other words, we624 Constitutional Diseases without Definite Infection.have a condition answering to the chill of fever, the cold stageagne^ the collapse of cholera.^' Page 44 he writes: "Lastly in thcollapse of Asiatic cholera, where the chill is so deadly that, wit not for the * consecutive fever,' its true nature would he harrecognizable, Aconite will still assert its power. I venture to pdict that it will some day be recognized as superior even to Arsein those terrible cases where vomiting and purging are well nighabsent, and death seems eminent from the arrest of the circulatioIf the Doctor will turn to the pages of the British Journal sometwenty years back, he will find that I made the same prediction athat time, and was laughed at for my pains. H.]C. CONSTITUTIONAL DISEASES WITHOUTDEFINITE INFECTION.i« Chlorosis.Green-sickness.Chlorosis as an idiopathic disease occurs exclusively amongfemales, and is connected with the sexual functions in a mannerthat we are as yet unable to account for by a precise and logicalprocess of reasoning. Chlorosis occurs chiefly between the ages othirteen and twenty-four years, seldom at a later period ; if itit can be traced to secondary disturbances, such as : confinementof young women coming rapidly one after another, more especiallyif the women nurse their own children. Hence the real cause ofchlorosis has to be traced to the sexual sphere ; but it is easilceived that unconquerable obstacles stand in the way of a thorouginvestigation. The disease sometimes breaks out previous to thefirst appearance of the menses, more frequently after several menstrual periods ; as an entirely primary disease it only breaks ouamong unmarried women. It appears to be hereditary ; females ofa pale complexion are more liable to be attacked with it ; no constitution is exempt from the disease, although delicate individuawith irritable nerves are more susceptible to it. Among othercauses we may mention: Insuflicient exercise, mental exertionswithout corresponding muscular activity; excitement of thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 525 of 653fancy, especially when caused by novel-reading; excitement ofChlorosis. 625the sexual instinct by onanism, improper converse with the othersex ; deprivation of open air, and interference with the free expsion of the chest by tight dresses. In a given case it is extremedifficult to find out the proper cause ; for this reason, close ain watching the symptoms is indisj)ensable, as for instance in thcase of robust young country-girls. Chlorosis is very commonlymet with among the daughters of a tuberculous mother.SymptamH and Course. A number of observations haveestablished the fact that the number of blood-corpuscles is verymuch less in the blood of chlorotic patients ; in very deepcases this number is diminished by four-fifths of the normal quanWe do not know what the cause of this deficiency is, but thisdeficiency accounts for most of the symptoms of the disease. Itgenerally commences very slowly. The patients become more irritable, they are apt to get tired after every little eiFort ; theyliable to changes of color ; the skin soon loses its bright lustrthe patients complain of feeling chilly at an early period of thedisease. Inasmuch as the pathological picture which now developsitself, may be characterized by a variety of symptoms, we preferdescribing the derangements as they appear in each special organand system.The skin at times has the color of wax; at other times it is rathyellowish or of a dingy-white, the veins being either not at allbut indistinctly perceptible. The color of the cheeks may changequite often within a very brief period of time. The visible mucoumembranes are more or less without color. (Edematous symptomsonly occur in the highest grades of the disease, and excite a suscion that some other disease is at the bottom of these symptoms.The following symptoms occur in the digestive range : Impairedappetite, aversion to meat, longing for strange articles of diet,as vinegar, chalk, coiFee-beans ; bloating of the stomach after emeal, acidity of the stomach, generally the bowels are very torpiIn the nervous system we discover excessive irritability, neuralghysteric symptoms, fitful mood. — The breathing is accelerated;the least physical eftbrt causes an attack of dyspnoea, sometimesa very high degree. The circulation is accelerated, very seldomretarded ; disposition to transitory palpitations of the heart whare easily excited by a physical eftbrt; anjeraic murmur in the lveins of the neck. The menses are irregular, sometimes entirelysuppressed or very tardy, sometimes more profuse than usual, butalways of a lighter color or even quite colorless. Accompanying40626 Constitutional Diseases without Definite Infection.these symptoms are pains of the most diversified kind, very generally uterine catarrh. The urine has a strikingly pale color. Thepatients generally sleep very soundly and have to sleep a long tihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 526 of 653sleep never refreshes them.One or the other of these derangements is generally wanting ; atother times one of them is very prominent, whereas another is inconsiderable ; thus it happens that the most varied groups of symtoms often develop themselves which, however, have essentially thsame meaning. The one characteristic symptom is never absent :dyspnoea and palpitation of the heart from the least unusual effoespecially after going up stairs.The course of chlorosis is always more or less protracted, sometimes very chronic. This, however, must be expected, since thedisorder is depending upon anomalies of nutrition that come (mvery gradually and which can, no more than their consequences,be extirpated very suddenly. If no particular disturbances takeplace, the affection can sometimes be cured in a few weeks, whereif the usual mode of living which had acted as the exciting causeis persevered in, the trouble may continue for years. In such casthe disease has remissions and exacerbations, and is most commonlmore violent in the summer than in the winter-season. Uncomplicated chlorosis always terminates in recovery ; it is only whecircumstances favor the disease that disturbances of the nervoussystem and the sexual sphere, but less frequently of the heart,remain. Among the complications, the simultaneous presence oftuberculosis and scrofulosis is most threatening. We generally fithat scrofulous girls who are attacked with chlorosis, recover thhealth to some extent for a year or two, after which they die ofconsumption, or phthisis may set in as a direct development of aprotracted chlorosis.Treatment. This nas to be directed with a view of meetingthe cause as well as the symptoms of the case. To meet the symptoms, medicines have to be used ; but before prescribing our remewe ought to find out what the remedy is given for, what we intendto accomplish with it, and what we can legitimally expect from itoperation. Most generally, physicians aim at bringing back themenses ; if this is accomplished, they fancy that they have gainethe battle. This view, however, is not only totally erroneous, bumay result in a good deal of mischief. The menses are neither thecause of chlorosis nor do they indicate the grade of its importanThey are often absent, or, if present, they are generally irr^ulaChlorosis. 627pale, watery, but may likewise be profuse and occur too frequentlThis shows that they have no characteristic significance in thisease. Tliis is so true that after the menses cease, the cure of tdisease sometimes commences, as we see in the case of young girlswho are sent from the city into the country where they gain everyday in health and strength without seeing any catamenial dischargfor months. Of course, chlorosis cannot be said to be entirely cuunless menstruation has resumed its regular course, the more sothe older the patients are.The true remedies for chlorosis are : Ferrum^ Arsenicum^ Calcareacarbonica^ Fluwbum^ Sepia^ Pulsatilla; many other remedies may berequired for intermediate conditions.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 527 of 653Feppum. This medicine is a real specific for simple, uncomplicatechlorosis ; every simple case of this disease yields to the curataction of Iron, If physicians complain of the inefficiency of thimedicine, it is most probably their own fault ; for, if given atproper time and in the right quantity. Iron always acts beneficennor need any evil eflfects be apprehended from this agent if thestomach is weak and irritable. It is for such gastric symptomsthat Iron is more particularly suitable. The sooner the remedy isadministered the more speedily it will act ; the longer its exhibis delayed, the less reliable it becomes. It is impossible to detmine the proper dose a priori ; all we can say is that beyond thethird trituration the medicine has no eflfect and that it is veryoften necessary to resort to the crude substance. This has to befound out by careful trials. Of the numerous ferrugineous preparations one praises one, and another another preparation ; each maybe useful, because each may eflfect a cure. We are still withoutany criterium by which the usefulness of any particular preparaticould be determined; we prefer that which is least liable to chanAmong these preparations the simple Ferrum redactum of the Pharmacopoea is undoubtedly the most appropriate. It may be usedwith excellent success in the first or second trituration and isevents preferable to iron-filings. Among the salts of Iron we generally prefer the Acetate on account of its ready solubility ; onthe salt has to be frequently prepared fresh, because it is easildecomposed. The Sulphate and Muriate may be used, but they haveno special advantages. Chalybeate waters do not enjoy any specialsuperiority ; their administration requires some caution and careIn inveterate cases of a high degree of intensity, they are undouedly preferable ; their use renders it absolutely necessary that628 Constitutional Diseases without Definite Infection.patient should change her mode of living, which she might otherwise be indisposed to do. The use of Ferrum is contra-indicated bthe following symptoms: Previous employment of the drug inenormous doses ; even small doses cause a marked hypersemia aboutthe heart and lungs. The last-mentioned effect is apt to occur whtubercles are present in the lungs.Arsenicum is less frequently indicated, but, when indicated, it han eminently curative effect. It is suitable in all cases of chlothat have been mismanaged with Ferrum and which are generallycharacterized by a high degree of debility, with excessive irritaity, oedematous paleness, cardiac phenomena even during rest, andcomplete gastro-ataxia. Arsenicum is likewise important, if thepreviously mentioned symptoms are associated with a dispositionto adiposis, paroxysms of dyspnoea or else continued shortness ofbreath, profuse menstruation, liver-complaint, violent cardialgiasleeplessness at night, drowsiness in the day-time. It is remarkahow soon after the administration of Arsenicum the normal appetite returns and the sickly complexion is replaced by a brighterCaloarea carbonica, unaided by other remedies, scarcely ever effea cure of chlorosis ; generally Ferrum has to be given afterwardsIt is indicated by a disposition to congestions of the head andchest ; constant and abrupt changes of color ; a lively and irrittemperament; the menses are too profuse and premature; acidityof the stomach with complete loathing of animal diet, craving forhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 528 of 653farinaceous and indigestible food. In such cases Ferrum oftenagrees best after Calcarea. As a general rule this remedy is onlysuitable to chlorotic persons during the period of pubescence.Plumbum aceticum is recommended by Winter in accordance withsound reasoning; we have no personal experience with this drug.It is indicated by the following circumstances and symptoms.Severe orthopnoea and dyspnoea, inconquerable constipation, extremuscular debility, oedema of the feet. If, in addition to thesesymptoms, we take the numerous cardiac phenomena, the gastricdifficulties and the cough, we obtain a striking picture of anintense, inveterate chlorosis. Beside "Winter's, we are not acquawith any trials that other physicians have made with Lead.Sepia may be regarded as an excellent remedy for the paroxysmsof hemicrania which constitute a source of distress to chloroticfemales with brown hair and lively temperaments. Sepia is likewise adapted to chlorosis emanating from the sexual organs assecondary afi*ections.Chlorosis. 629Pulsatilla has been long regarded as a remedy for chlorosis ; however, we are of opinion that most of the cures of chlorosis thatattributed to the exclusive use of Pulsatilla^ are questionable.satilla is no remedy for primary chlorosis, although we cheerfulladmit that, like Sepia, it is a very excellent remedy in secondarchlorosis. Pulsatilla is likewise excellent for special symptoms,such as: pain in the stomach, headache, toothache; but chlorosisis scarcely ever acted upon by this medicine.The removal of the cause, including a certain preventive treatment up to a certain degree, is scarcely ever heeded with sufficiattention. We are not able to determine all the special causes ofchlorosis, but the general causes can be clearly made out, and this sufficient both to guard against the disease and to promote thcure. Let our young ladies be properly educated, and let allpremature excitement of the fancy be carefully avoided; let allfashions interfering with the respiration and the digestion be dicarded ; let our girls have an abundance of very active exercisethe open air; let the mothers' gotten tion be directed to the delpractice of onanism and to all premature sexual excitement ; andabove all, let all novel-reading be strictly prohibited. If the dhas once broken out, a radical change in the mode of living iseminently advisable; city-girls ought to be sent into the countryand country-girls to town. A change of this kind alone is oftensufficient to effect a cure. Of course, the deleterious influencewhich we have alluded, have to be strictly avoided. The patientshad better confine themselves to the use of milk, leaving oft* botea and coffee. A moderate amount of bodily exercise is necessarycontinued and fatiguing exercise is hurtful. Cheerful companypromotes the cure very much. Sleep should not be limited to afixed number of hours ; on the other hand, constant somnolenceshould not be yielded to.[Bsehr has left out three remedies that may render efficient service in the treatment of chlorosis; they are: Aconite^ if chlorosis complicated with tuberculosis ; such patients are apt to havehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 529 of 653dark sallow complexion sometimes with a greenish tint and deepflushes on the cheeks ; they are troubled with palpitations, dyspstitching pains in the chest. — Digitalis; in some chlorotic patithe pulse is irregular and intermittent and the heart's action ischaracterized by similar changes ; such symptoms indicate DigitalBelladonna is indicated by frequent paroxysms of headache in theforepart of the head ; the headache is accompanied by bright flus630 Constitutional Diseases without Definite Infection.on the cheeks, deep sparkling looks, heat in the head ; such patiare apt to be of a lymphatic disposition and passive turn ofmind, H.]2. Rhennia.BheurifKUisra.Under this heading we comprehend a group of morbid conditionsconcerning whose essence our knowledge is very defective ; all thhave in common is, that they are localized in the fibrous tissuesthe muscles, tendons, joints, aponeuroses, etc. We may add thatall rheumatic affections are very much aggravated by the influencof cold.Their etiology is no less uncertain and vague than their nomenclature. "Whereas the acute forms occur chiefly between the yearsof fourteen and thirty-five, the chronic forms are principally mewith after the fortieth year of age. The former are principallyoccasioned by exposure to colds and wet, the latter more particularly by damp and cold dwellings, and by continued exposure towet weather and permanently dwelling in wet localities. Thereare atmospheric conditions which frequently cause epidemic rheumatism, generally in company with extensive catarrhal diseases.One attack of rheumatism begets a tendency to new attacks. Inthe case of females, chronic rheumatism is decidedly favored bythe influences of the critical age.The rheumatic process shows itself in four distinct forms whichwe shall describe separately, although their treatment will be codensed in one, in order to avoid unnecessary repetitions.a. Acute Articular Hheumatism.This form of rheumatism often arises from a cold and from exposure to atmospheric influences ; it not unfrequently assumes anepidemic type and, in such a case, breaks out most commonly inthe fall and winter.The disease commences very gradually with a vague feeling ofmalaise, accompanied with slight catarrhal symptoms; it maybreak out after severe attacks of angina, very seldom suddenly, ascarcely ever with a chill, but with alternate chills and heat. Sneously with the fever, very seldom after, and still less seldomone or more joints become painful ; the pain rapidly increases, athe joint swells, sometimes with, and at other times without redhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 530 of 653Rheuma. 681ness ; at thie period the least motion and the least pressure caupain, 80 that the patients remain perfectly quiet for fear of hurthemselves. Generally several joints are attacked at once, veryseldom only one at a time, never all the joints at once from theThe disease progresses in a very characteristic manner. While thejoint that was first attacked, is getting better in three to fivesometimes with a complete cessation of the pain as well as theswelling, other joints are attacked in the same manner ; in thismanner most of the other joints are invaded, after which therheumatism frequently breaks out again in the joint whence it hadoriginally proceeded. At times the swelling is quite considerableat other times scarcely perceptible ; sometimes it is confined tojoint alone, at other times the surrounding parts are very extensinvolved ; not unfrequently the articular extremities feel enlargThe constitutional symptoms are at times very violent, at othertimes very slight ; this depends a good deal upon the number ofjoints involved. The fever runs pretty high, remitting very irregularly ; the temperature is not much raised above the normallevel; pulse about hundred, in very acute cases increasing veryseldom to one hundred and twenty and upwards, small and changeable ; a copious perspiration, having a musty-sour smell, continuduring the whole course of the disease, corresponding with whichthe patients are tormented by a distressing thirst. The urine isscanty, saturated, and, on cooling, deposits a copious sediment.digestion is slow, the appetite impaired, but very seldom entirelsuspended.The course of uncomplicated rheumatism is never very rapid, generally more or less wavering ; recovery takes place gradually ; sjoints may remain painful and swollen for a long time, the pulseremains obstinately accelerated, the perspiration continues, theweakness abates very slowly. A favorable change takes place veryseldom after the first week, a little more frequently after the sbut most commonly only after the third and fourth week. Veryoften we have noticed that, before the disease terminates, everyis attacked twice, and that the second attack only lasts half asas the first. In violent cases all the joints are aftected togeththe termination of the attack, some, however, are more acutelyinflamed than others.Complications generally occasion a more protracted course of thedisease, and determine the amount of danger involved in the attacAmong these complications we seldom meet with pneumonia, pleu632 Constitutional Diseases without Definite Infection.ritis, peritonitis ; endo- and pericarditis, on the contrary, arecommon occurrences. Such complications must be expected somuch more certainly the larger the number of joints that aresimultaneously involved, and the more fiercely they are at;tackedIn a majority of cases the cardiac inflammation develops itself simperceptibly that it is scarcely betrayed by a single symptom ;very seldom sets in with a chill or with acute pain. A symptomthat ought always to excite our suspicion, is the hurried breathiand the abrupt talking of the patient. If this symptom becomeshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 531 of 653manifest, the heart must be explored forthwith. This, however,should be done every day during an attack of acute rheumatism.The disease generally terminates in recovery, although veryslowly, and leaving various inconveniences and discomforts, moreparticularly a peculiar laming weakness. Death is a very raretermination, except when such complications supervene as generallterminate fatally. Very seldom the rheumatic inflammation increases to such an extent that suppuration takes place ; if thispens, the suppurative process always involves a good deal of dangAmong the consecutive diseases, structural alterations of the heawith their distressing consequences, occur most frequently ; paralytic conditions are less frequent, and, moreover, disappear agaivery speedily. Almost all patients retain a great tendency torelapses.b. Acute Muscular Rheumatism.This rheumatism owes its existence almost exclusively to a heavycold ; such muscles are most easily attacked as were engaged inactive work when the exposure took place.This form of rheumatism is one of the milder sort. In rarecases only, it sets in with an acute fever and a continual perspition, the same as acute articular rheumatism; however, it is ofshorter duration and much less dangerous, leaving of course amarked disposition to chronic muscular rheumatism. Most generally muscular rheumatism develops itself very rapidly, even suddenly, in company with more or less severe catarrhal complaints.In the invaded muscles, the number of which is seldom very great,and which are almost always in close relationship with each otherviolent, drawing-tearing pains are experienced during every motiothese pains are likewise felt, if the muscles remain for a long tin the same position, as at night, in bed ; the pains are increascold, and likewise by humid warmth ; dry warmth relieves them.Rheuma. 633The character of the pathological group depends of course uponthe muscular bundles that are invaded, and the violent pain sometimes suggests the thought that internal organs are inflamed. Thiidea may be suggested by rheumatism of the thoracic and intercostal muscles, where the respiration, cough, sneezing, turningabout, cause an intense pain ; likewise by rheumatism of the abdominal muscle T where peritonitis is so easily suspected. Withproper management and. care this form of rheumatism ends in recovery in one week at latest. However, by neglecting to guardagainst relapses, an acute attack may very easily terminate in achronic form, and contractions and paralytic conditions may arisewhich can only be removed with great difliculty.c. Chronic Articular Rheumatism.It most frequently develops itself out of the acute form of whichit constitutes a rest as it were ; it likewise arises from the coaction of damp and cold places.Chronic rheumatism is less frequently located in the externalhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 532 of 653integuments of the joints where acute articular rheumatism is generally seated, than in the synovial lining, the ligaments and artcartilages. Little by little these grow thicker and rough, whichthe reason that, after a time, crepitation is heard in the articuThe disease seldom involves a number of joints ; generally it islimited to one or a few only. Neither the swelling nor the pain ivery considerable ; to some extent the power of motion remains,yet the patients may be entirely deprived of the use of the affeclimb, whereas the rest of the body is perfectly sound. The rheumatism has remissions followed by exacerbations each of which leavethe condition of the joints somewhat worse, and may even lead toanchylosis. These exacerbations often look like an attack of acutrheumatism with fever and slight inflammation of the affectedpart ; sometimes, however, they are without fever, and distinguisonly by pain and loss of mobility. Chronic rheumatism sometimesremains after repeated attacks of acute rheumatism of which itseems to constitute an ultimate stage. The joint is not greatlydistorted by the disease. A complete cure is very much impededby the extreme obstinacy of the trouble, and likewise by the imposibility of preventing the joint from being acted upon by influenthat never cease, by their presence, to perpetuate the disease.634 Constitutional Diseases without Definite Infection.d. Arthritis Deformans, Arthritic Rheumatism.This form of articular rheumatism always runs an exceedinglychronic course ; it does not develop itself out of the acute formoccurs very rarely previous to the thirty-fifth year of age, andmost frequent after the fortieth year. It breaks out among allclasses, especially, however, the lower ; on this account it is vdifficult to determine the degree of influence exerted by bad fooor damp dwellings over this disease. Arthritic rheumatism afiectsmore particularly the female sex ; the critical age undoubtedly fan outbreak of this disease, for we meet with it most frequentlyabout this time.The disease may attack any joint in the body, but it is mostlylimited to the joints of the hands and feet, affecting both sidesthe body at the same time. It generally commences in the hand,whose joints become more or less painful, especially when they armoved or pressed upon laterally. Sometimes the pain is principallfelt in bed ; crepitation is very soon heard in the joint. The joswells very slowly ; at times long intervals occur in the furthercontinuance of the swelling, after which the arthritic processresumes its course amid renewed paroxysms of pain. Towards theend the shape of the joints is very much altered, especially theof the phalangeal articulations. The articular extremities lookbulbous, they are especially enlarged in breadth ; they feel hardtheir integumentous covering has a natural color; the articularsurfaces are no longer in complete coaptation, giving the oppositbones the appearance of being dislocated, and imparting to thehands and feet a deformed shape. The power of motion is notentirely suspended, but motion is very painful ; in the very highgrades of the disease the joints are entirely immovable. Life isnot endangered by this condition, but its curability is very doubThe swelling never disappears entirely ; all that can be properlyaimed at by treatment, is to arrest the further progress of thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 533 of 653disease.Treatment* Owing to the peculiar vagueness and indefiniteness of the single forms of rheumatism, whether acute or chronic,we find it difficult to decide whether and what medicines haveexerted a curative effect upon the disease. The consequence is than unreasonably large number of medicines have been employed forthis disease, all with more or less pretended effect, yet in simicases the same remedy does not always produce the same curativeRheuma. 635result. The natural course of the disease is not taken into accouand a spontaneous cure is mistaken for the work of art.Another reason why our remedies for rheumatism are not perfectly reliable, is the vagueness attaching to a definition of thterm. Here we have a striking demonstration of the fact that it iinjurious to treat diseases in accordance with pathological namesand that there is, on the other hand, great advantage in individuizing cases according to the rules of Homceopathy , without troubourselves whether the morbid condition is called rheumatism orsomething else, provided the abnormal process ceases. No diseaseembarrasses the Rational School more than rheumatism whichmakes a laughing-stock of all hypothetical speculations.Although we have no very exalted opinion of the power of homoBopathic medicines over rheumatism, yet we assert without hesitatithat the homoeopathic treatment of rheumatism is more ettectualthan any other ; at the same time we admit that it is desirable twe should be able to accomplish a great deal more. In our opinionone of the principal reasons why we so often fail in curing rheumtism is the dread homoeopathic physicians seem to entertain, inadministering large doses, which rheumatism often requires, as isevidenced in the case of Sulphur.In the following paragraphs we only mention the leading remedies more fully ; of the other less important remedies we only gthe names, for we believe that too large a number of drugs is prejudicial.Aconitum is the main remedy in acute articular rheumatism if thepulse is not only frequent but likewise full and hard, the temperture is considerably higher, the joint is red and exceedingly sensitive to contact; it is suitable for nervous, irritable, plethorindividuals ; or when pericarditis or endocarditis has supervenedFurther indications may be gathered from the Materia MedicaPura. Aconite has been less frequently used in chronic cases wherit sometimes acts with great efficacy. Aconite is less adapted tochronic articular than to muscular rheumatism, especially whenthe disease is located in the upper extremities. [Aconite is a spremedy for rheumatism of the deltoid muscle. H.]Bryonia alba is a leading remedy for acute and chronic rheumatism, except the arthritic form. The symptoms of this medicine arso numerous that we have to content ourselves with furnishing afew general indications, Bryonia is most suitable for rheumatismhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 534 of 653636 Constitutional Diseases without Definite Infection.caused by exposure to cold and dampness after a severe musculareffort ; the violent fever soon adopts an adynamic form ; the artular swelling is dark-red and exceedingly painful ; the respiratoorgans show symptoms of inflammation; the perspiration has asour smell. In muscular rheumatism, Bryonia is indicated by thefollowing symptoms : The muscles of the trunk are the seat of thedisease, especially the thoracic muscles ; the patient feels muchter during rest ; the pains are severe tearing pains, and inclineshift from one place to another.Mercurius. That Mercury possesses a remarkable power to causea variety of rheumatic pains, is shown by syphilitic patients whocases are mismanaged by large doses of Mercury. Mercurius is notso much adapted to chronic as to most forms of acute and subacute rheumatism, with the following general indications: Thefever runs high ; the pulse is remarkably quick and hard, the perspiration very copious and having a musty smell, the thirst is exceedingly tormenting. The local swelling is not very great, butpainful, intensely red, giving rise to the apprehension of pus foing in the joint ; it is not apt to shift about ; even if other jare affected, yet the original joint remains swollen and painful;breath is foul, the tongue has a thick, yellow coating, the appetis gone, every kind of food causes nausea. The skin is covered wicopious sudamina. The pains are worse every night, towardsmidnight, aggravated by severe cold and ameliorated by externalwarmth. The more frequently relapses set in, the more specially iMercurius indicated. In muscular rheumatism, Mercurius is indicated by the following circumstances: the pains exacerbate atnight, they are deep-seated as if the periosteum were attacked, wgreat sensitiveness to gentle as well as firm pressure. In compliing inflammations of vital organs, Mercurius deserves a leadingposition, in cardiac inflammation as well as in pneumonia and pleitis, likewise in meningitis.Rhus toxicodendron is adapted to every form of rheumatism, except arthritic. In acute articular rheumatism, it is indicated byfollowing symptoms: Violent fever, with tendency to the adynamictype, delirium and excessive restlessness; the swelling is inconsable, admits of some motion, is intensely red and somewhat sensitive to contact. The perspiration is not considerable. The patienare constantly changing their position, for even after lying forshort time in the same position, the pains are very much increaseFeather beds are intolerable, so is external artificial warmth. FRheuma. 637muscular rheumatism, Rhus tox. is the best remedy, if the attackcaused by exposure to wet; if the above-mentioned circumstanceseither improve or aggravate the symptoms ; if the pains at oncebecome associated with paralysis and contraction ; if the musclesof the lower extremities are the seat of the disease. Rheumaticparalysis particularly points to Hhus. In chronic articular rheumtism, Ehus is of little, if any use. [Rhus is generally recommendfor rheumatism, if the patient contracted the disease in consequehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 535 of 653of getting soaking wet. This indication is unreliable. Some timeago I was called to see a Catholic priest who, while visiting a min the country, was overtaken by a thunder-storm and was drenchedto the skin. In this condition he had to travel eight miles on hoback. Ifext day he was attacked with neuralgic rheumatism inthe upper third of the left upper arm. The pain was as if the bonand marrow were being ground into a thousand fragments. Afterhaving been treated allopathically for a whole week, with largedoses of Morphia, Quinine, etc., the patient was reduced to a shaby the pain, deprivation of sleep, etc. Being sent for, I found tarm apparently natural, but the sensitiveness so great that the lattempt to touch the affected limb, caused the patient to exclaimand shudder. The pain extorted agonizing cries. I made up mymind that Mercury was his remedy, of which he took the first centesimal trituration, a powder every hour. Already after the firstpowder the pain began to abate, and next morning he was completely relieved and went out again, two days after my firstvisit. H.]Puteatilia, according to Hartmann and others, is indicated in milsubacute rheumatism of the joints and muscles ; the affection shiabout frequently and speedily ; the pains exacerbate in the eveniand at night ; they are violent tearing, drawing and jerking painincreased by warmth, improved by cold, at least for a short time.Pulsatilla is seldom appropriate in chronic rheumatism, more so ithe rheumatism of muscles and of the joints. It is neither a reliremedy, nor one that can be often used for the reason that therheumatism to which Pulsatilla corresponds, is not of frequentoccurrence. [For rheumatism of the dorsum of the foot, Pulsatillais an excellent specific. A lady, seventy years of age, of a yieland rather phlegmatic temperament, had an attack of acute rheumatism of the dorsum of the right foot. It was very much swollen,red, excessively painful, and very sensitive to contact. The swelhad a shining appearance. The pain was much worse at night, and638 Constitutional Diseases without Definite Infection.deprived her of sleep ; the fever ran high. She had been sufferinin this way for three nights. I gave her six globules of Pulsatil18, dissolved in half a tumbler of water, to be taken in dessertspoonful doses every two houra. After the first dose already thepain moderated, she very soon fell asleep, perspired a little darthe night, and next morning was entirely free from pain, fever answelling. H.]Colchicum is not exactly a remedy for acnte rheumatism, but isexcellent in subacute affections of the joints and muscles, the enal parts of the former being chiefly affected. The fever is notviolent, mingled with constant chills, either without or with verlittle perspiration, the urine is saturated and deposits a copiousediment. The painful joints are neither red nor swollen; the paiincrease considerably at night or by motion and contact. The attacomes on in damp and cold weather.Tartarus emeticus deserves to be used more than it so far hasbeen ; it is one of those remedies that have a good effect in excingly painful local muscular rheumatism, for instance, rheumatismof the dorsal muscles contracted after a cold during the performhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 536 of 653ance of a fatiguing muscular effort. In such a case, Tartar emetivery soon brings relief. In acute articular rheumatism Tartaremetic is indicated by the following symptoms : Marked swellingof a number of joints, the pains are not very^great during rest,this rest is frequently interrupted by spontaneous, spasmodic, vepainful contractions of single bundles of muscles. There is notmuch fever ; the symptoms of digestive derangement, on the contrary, are very prominent. A condition marked by such symptoms,sometimes occurs during the subsequent course of articular rheumatism, scarcely ever at the commencement.Digitalis purpurea is, in our opinion, a most important remedy inacute articular rheumatism ; in the last few years we have oftenseen this remedy produce a striking effect and shorten the courseof the disease. We do not deem it necessary to demonstrate thesimilarity of Digitalis to rheumatism ; the physiological actionthis drug as recorded in the Materia Medica, explains this similaity beyond the possibility of cavil. We do not, however, feel ablto give the special indications of Digitalis in every particularfor the simple reason that we have not had sufficient opportunitito test it in practice. So far we have been guided in the exhibitof Digitalis by the following points : Hurried, small pulse easilaffected by motion ; increased strength of the beating of the heaRheuma. 639but the sounds are muffled and indistinct, mingled with arterialmurmurs ; hurried respiration, with ability to draw a long breathhurried, abrupt speech ; almost complete suspension of the urinarsecretion ; shining-white swelling of the joints, not very sensitto pressure; a number of joints are attacked at once; the wholebody is very pale. During the whole course of the disease we havegiven this medicine without any other drug, and in spite of theviolence of the symptoms, we have never been able to discover anysymptoms of cardiac inflammation, for which Digitalis might, however, likewise be indicated. In conclusion we desire to state thaDigitalis holds a high rank as a remedy for rheumatism among theRational physicians; there is undoubtedly a reason for this.Sulphur bears almost the same specific relation to the rheumaticprocess that Mercury does to syphilis. In an acute attack we woulnot think of giving Sulphur; on the other hand. Sulphur is indispensable to remove the remaining traces of acute rheumatism, uponwhich the extraordinary disposition to relapses generally dependsWhat this remedy ia capable of accomplishing in chronic rheumatism, is shown by the numerous cures which are every year wroughtby the use of Sulphur-springs, and which it is impossible to doubWe doubt, however, whether similar results can be obtained by giving Sulphur internally in small doses ; at any rate, we have nevebeen able to accomplish such a task. All we have been able to dohas been to improve the case, but we have never yet achieved aperfect cure with these small doses. This shows that there mustbe a something, a higher curative power in Sulphur-springs, whichsmall doses of Sulphur do not possess. Sulphur exerts a curativepower over arthritic rheumatism ; it arrests the progress of theease, and materially reduces the swelling of the joints.Ferram is applicable in primary chronic rheumatism as well ashttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 537 of 653after an acute attack, if the patient has been very much reducedflesh. It never shows its favorable effects all at once; on thisthe remedy must not be discontinued too soon.[Cauiophyilum thalictroides, the blue cohosh, is highly recommendfor rheumatism of the smaller joints. Dr. R. Ludlam, of Chicago,prescribed it for a case of inveterate rheumatism of the metacarpjoints of the left hand, in doses of two grains of the second dectrituration every two hours, until relief was obtained. The patiewas a servant-girl ; she had not slept for two or more nights. Afthe second dose she fell asleep, and her pain vanished from thattime forward. There was no metastasis of the complaint, and in640 Constitutional Diseases without Definite Infection.two days she was down stairs at work. While she remained in thefamily, two years, she had no return of the disease. The Doctorwrites : " Since the above result was obtained, I have frequentlyprescribed the Cavlophyllin for articular rheumatism affecting thsmaller joints, and several times with a signal success. It has,ever, ap[>eared more effectual in case of females than of males,were ill with this painful disease." H.]Beside these remedies the following deserve being mentioned.In acute cases : Arnica^ Belladonna^ Nitrum^ Spigelia ; in suband more chronic affections : Ledum^ Sabina^ CocculuSy Mezereum^Clematis^ Rhododendron^ Ruia^ Oleander (especially in cases of rhmatic paralysis); finally, in inveterate cases: lodium, CausticumCalcarea carbonica, Silicea, [In arthritic rheumatism, grafted upa scrofulous basis. Aconite and Iodine are indispensable. H.]Although Sulphur-springs are the most effectual remedy foi* constitutional rheumatism, yet there are other means calculated eithto heal or prevent new attacks; some of these means are oftensufficient to perform a cure. In this class we rank the coldtreatment, sea-bathing, the Turkish and Russian baths. The twolast-mentioned have to be employed witt great care ; if they helpat all, the favorable effect is seen already after a few baths.It is a matter of course that the cause should be removed aamuch as may be.The diet in acute rheumatism is easily managed ; the patientseither do not crave any nourishment, or their appetite is very muimpaired. Fat and greasy articles of diet are decidedly injuriousacid substances, especially stewed fruit, have a very good effectraw fruit may be partaken of, but moderately.S. Arthritis.Gout.The cause of gout is involved in a great deal of obscurity ; speculations on this subject have led to the most one-sided hypotheseAll that we know ix)sitively is, that gout is not only an hereditbut in the majority of the cases that come under our notice, an iherited disease ; however, it may likewise originate as a primarymalady.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 538 of 653We likewise know positively that, if the body receives a largersupply of animal food than can be assimilated either by bodily ormental labor, or that, if quantities of heavy or sour wines or heArthritis. 641beer are drank, the outbreak of the disease is very much facilitabut whether such causes can occasion the disease primarily, is vequestionable. A large majority of cases occur among the male sexthe disease breaks out between the ages of thirty-five and seventyears; if it attacks persons before this time, the disease is inhIn accordance with these statements we find that gout chieflyattacks the higher strata of society.Symptoms and Course. Gout is a decidedly chronic diseasethe course of which is interrupted by acute attacks. It originatevery gradually, with a train of symptoms that do not enable us todraw reliable conclusions regarding the nature of the disease.Shortly after a period, during which a good many dietetic transgressions had been committed, the patients feel out of sorts, irrtable, ill-humored, they complain of pain in the stomach, heartbuvomiting of a sour liquid, pressure and repletion in the abdomen,hemori holds, gastric headache, and the urine is saturated. Afterthese preliminary symptoms have lasted for a longer or shorterperiod, the firstParoxysm of Gout sets in, in the vast majority of cases duringsleep, at night. The patient is roused from sleep by a violent,boring-burning pain, with a sensation as if the part were in a viat the first attack this pain is almost without an exception seatin the first articulation of the big toe of one or the other footincreasing very rapidly to such a degree of intensity, that thepatients are almost beside themselves. Very soon the painful spotshows a vivid redness and is more or less swollen ; but neither rness nor swelling ever spreads over the adjoining parts. Motion iimpossible, and external pressure causes such an intense pain thathe patients cannot even bear the least touch of the blanket. Thipain is often accompanied by a high fever which sometimes remitsBO fully on the following morning, amid a profuse perspiration, tthe day is spent with scarcely any pain. The next night, however,the pain returns, showing that the disease is still there. This cgoes on between one and two weeks, until the painfulness and redness, and soon after the swelling, disappear pretty suddenly, andpatients feel well again, even better than before the attack. Theonly striking change after the attack is the great quantity of urwhich never fail to be deposited in the urine.This first attack may terndnate the whole disease, especially ifpatient changes his present mode of living with determined firmness and consistency. If this is not done, a new attack takes pla41Ihttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 539 of 653I642 Constitutional Diseases without Definite Infection.after a certain lapse of time ; this second attack chiefly breaksduring the period from February to April. This circumstance isin some respects accounted for by the patient's more luxurious moof living during the winter-season, when he takes at the same timless active exercise than usual. The interval is entirely free frailments until shortly previous to the new attack, when the formepremonitory symptoms again make their appearance.With every new attack the free intervals are more and moreobscured and shortened, the local disorder leaves calculous deposon the diseased joint, with more or less permanent pains and a hior less degree of immobility. The paroxysms are less acute, butinstead of at most two, they last eight or twelve weeks; otherjoints, especially those of the feet, knees, hands and shoulders,wise become involved. The so-called chronic or atonic gout now isan established infirmity. The more numerous the changes thatremain after the attack, the more joints are affected, the longerattack lasts, the more prominently the chronic affection shows itcharacteristic features during the interval. The digestion is permanently deranged, the patients complain of pains in the stomach,which sometimes increase to severe paroxysms of cardialgia ; theycomplain, moreover, of acidity of the stomach, pressure, fulnessand flatulence after every meal, torpor of the bowels and hemorrhoidal distress ; they are very irritable and out of humor. Nutrtion is more and more impaired, the complexion assumes a yellowgrayish appearance. The circulation is disturbed in various ways.Such disturbances are very significant in so far as they generallpoint to a degeneration of the valves and arteries ; they commencwith frequent, but short-lasting congestions, palpitations, attacof angina pectoris, asthmatic complaints. The affected joints become more and more deformed and anchylosed.At a more advanced age and by observing a strict diet, thischronic gout may terminate in recovery; of course, the concretionin the joints remain. This form of gout may likewise assume thecharacter of the so-called anomalous gouty which sometimes ushersin the whole disease ; in such a case it becomes exceedingly diflto establish a reliable diagnosis. Anomalous gout may likewisesucceed the first attack of gout in the place of chronic gout. Thpatients suffer with the complaints of chronic gout ; above all,urine looks very cloudy depositing large quantities of urates ; bin the place of acute pains in the joints, we have shortshifting about from place to place frequently and speedily, withoArthritis. 643swelling or redness, "but very frequently with gradual impairmentof the mobility of the joints. Of particular importance are theintermediate affections of internal organs that have been designaas retrograde or metastatic gout. Sometimes they, indeed, dependhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 540 of 653upon material changes, products of a permanently establishedarthritic process ; sometimes, however, the organs are attacked ia manner corresponding perfectly with the invasion of the tarsalarticulation. The internal organs that are principally attacked,the heart and stomach, less frequently the brain ; the attack consists in a sudden violent inflammation with horrid pains, and, asas the brain is concerned, with considerable danger, for the attamay terminate fatally in a few days.Arthritis scarcely ever terminates directly fatally; it is stillfrequently succeeded by perfect recovery. Death results mostlyfrom alterations in the organs of the circulation, very seldom fra gradual prostration of strength. Recovery being generally imperfect, the prognosis is only conditionally favorable.Treatments It has to be directed against the single paroxysm,in which case it is necessarily symptomatic ; and likewise againsthe chronic disease, in which case it aims at removing the cause.The treatment of the single paroxysm leads us to the remediesthat have been indicated for rheumatism ; this is a necessary consequence of the pathological vagueness of both affections and ofinsufficiency of our physiological provings. Many remedies arerecommended for gout, the value of which is very questionable; inrecommending them, their authors probably overlooked the factthat an attack of gout sometimes terminates spontaneously in oneweek. At the same time we are bound to admit that we are notacquainted with any complete cures of gout under homoeopathictreatment. In selecting a remedy, a characteristic phenomenon ofthe gout, namely the deposition of urates in the urine, must notlost sight of. Unfortunately the sediments in the urine have notbeen tested chemically by our provers.For the single paroxysm which is accompanied by violent fever.Aconite renders the most eminent service, but it has to be givenlarge and frequently repeated doses. Arnica has often done goodservice, if the attack had been caused by mechanical injuries, orit sets in after great physical exertions ; if the inflamed jointintensely red, and the patients were very restless in spite of thpains. Arnica is likewise excellent in cases of metastasis to thebrain. According to Hartmann, Pulsatilla is indicated by the fol644 Constitutional Diseases without Definite Infection.lowing symptoms : The pains abate in cool air ; the local affectishifts its locality very rapidly ; the affection of the knee is cterized by shooting, drawing-stitching pains. Such symptoms mayscarcely ever occur in reality, SaJbina is, like Pulsatilla, indiif the affection inclines to rapidly change its locality, but morticularly if the change takes place from the big toe-joint to theand vice versa ; the pains are alleviated in the cool air, and thpatient is constantly obliged to change the position of the affecpart. We have observed all these symptoms in the case of a girlwho had swallowed a quantity of Sabina for the purpose of producing a miscarriage ; these symptoms convey an exact image ofan attack of gout. Staphysagria^ if the paroxysms of gout of thetarsal joint gradually assume the form of anomalous gout. Nuzvomica is evidently recommended on account of the exciting causehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 541 of 653its pathogenesis does not show any homoeopathicity to gout. Digitalis is eminently useful if the attacks are gradually changing icharacter, and have lasted a good while; in such transitions tochronic gout Digitalis is scarcely ever surpassed by any other reedy ; but it must not be given in too small a dose. The first favable change effected by Digitalis is the supervention of a shortsleep. Ledum responds to the imperfect, long-lasting paroxysmsinvolving the carpal and shoulder-joints. Baryta is adapted toaffections of the knee.The treatment of the whole disease is more important than thatof a single attack, which is always somewhat precarious. Theformer treatment must be limited in its main features, especiallythe beginning of the disease when the intervals are still uncloudto the enforcement of an appropriate mode of living. What sortof regimen arthritic patients should follow, is evident from whatwe have said when speaking of the etiology of the disease. In thesubsequent course of the disease when the derangements have already become* more permanent, it may be difficult to get alongwithout medicines, but they cannot be indicated a priori for thereason that the symptoms are too diversified. The following remedies are very often suitable: Nux vomica^ Lycopodiuin, Ferrum,Arsenicum,^ Sulphur^ Addum svlphuricxcm^ [also Acidum benzoicurruH,] In the case of persons of a more advanced age, they mustnot be altogether deprived of their usual supply of substantialnourishment ; nor should the use of wine be entirely prohibited.Sometimes a great deal of good is accomplished, if we substituteweak grog in the placeHydropsia. 645light claret is the least injurious to such patients. Arthritic pbeing so readily disposed to forget the strict rules laid down fothem by their physicians, it is necessary that these rules shouldrepeatedly impressed upon their memory.Among the mineral springs, the use of which is sometimes unavoidable in such cases, Carlsbad-springs occupy the first rank,provided the constitution has not yet suffered too much ; next toCarlsbad, we recommend Vichy, if the patients have already aleaden complexion, the cautious use of Pyrmont-water does everything that can be expected, to raise the sinking power of theorganism, whereas feeble chalybeate springs have no perceptibleeffect. Many other mineral waters are recommended, and thepatients improve by the use of all of them, but no more, generallspeaking, than they would have done without drinking the water,provided they had strictly adhered to the severe regimen enforcedat the springs.4. Hydropsia.Dropsy."We have avssigned this place to this class of diseases because ttreatment of dropsy is so uniformly the same that a separate description of the disease as developed in special organs or systemwould have led to many useless repetitions.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 542 of 653Dropsy is never an idiopathic disease, but always secondary,although it sometimes appears to be of a primary character. In geeral, all conditions which, in the long run, interfere with the clation, or retain the water in the blood, lead to dropsy ; likewiany other conditions that result in the production of a high gradof hypersemia or ansemia. In most cases, however, something elsehas to become associated with these conditions, otherwise it woulbe difficult to comprehend why many anomalies should be able tocontinue so long before resulting in the development of dropsy. Ware unacquainted with the nature of this something ; whether it ia relaxation of the coata of the vessels, or a more copious supplof water in the blood, or whatever else, we have not yet been ablto find out. Most likely it is from this unknown cause that dropsconsequent upon a general marasmus, without any special, mechanical cause results. In accordance with the above-mentioned threecategories, dropsy sets in, if the flow of the venous blood intoright heart is interfered with ; if the circulation is obstructed646 Constitutional Diseases without Definite Infection.thrombi in the larger venous trunks (as for instance in consequenof phlebitis in the lower extremity, in the case of lyingascites arising from inflammation of the vena portarnm); in thecase of pulmonary affections impeding the reflux of the blood, suas emphysema, hydro-thorax, pneumo-thorax ; in consequence ofaffections of the liver resulting from obstructions of the portalculation. — In the case of renal affections, if the function of tkidneys is very much interfered with ; in chlorosis, affections ospleen with hydremia, after copious losses of blood, or after sevdebilitating diseases, in general in conditions of debility of aorder.Symptoms. At the onset dropsy is more or less local ; as arule, it commences with a swelling round the ankles, less frequenin the face ; ascites takes place only when the liver is diseasedthis case it may remain localized as ascites ; in the former casegradually spreads throughout the whole of the subcutaneous cellultissue, unites with ascites, and finally with cedema of the lungsbrain, in which case death soon results.Dropsical effusions are generally accompanied and sometimespreceded by prostration, and by decrease of the urinary secretionThe urine is dark, saturated, becoming cloudy in a short time; thquantity is sometimes very scanty. All the other watery secretionare likewise less, or they are entirely suspended ; the stools ardry, the skin is dry and cracks easily, incapable of perspirationmucous membranes are likewise dry, on which account the patientis often tormented by a distressing thirst.Dropsy at times develops itself very speedily and universally,sometimes slowly and progressing very gradually. It is esj>eciallafter nephritis that water accumulates very rapidly ; it collectsslowly in company with affections of the lungs. It is unnecessaryfor us to describe the special forms of dropsy ; these forms andconstitutional symptoms accompanying them, can easily be determined without any further description.The Course of the disease is at times uninterrupted, leadinghttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 543 of 653speedily to death, or else it makes pauses, a portion of the seruthat had been poured out into the cellular tissue or the cavitiesbeing reabsorbed. This may result from a transitory cessation ordiminution of the obstruction in the circulation, or from copiousexcretions of urine, watery discharges from the bowels, oozingthrough cracks in the skin, or from a general invigoration of thewhole organism. Death generally takes place by cedema of theHydropsia. 647lungs or brain. Recovery is attended with copious discharges ofurine, very rarely with diarrhoea alone.The Prognosis depends upon the chances of removing or neutralizing the primary obstruction or derangement.The treatment has to be chiefly directed against removing thecause ; if this is not possible, it has to be almost purely symptor palliative. The causal indication is met by the remedies thathave been indicated when the affections of the various organs wertreated of; we need not repeat them in this place. Symptomatica!we shall have to select remedies capable of stimulating the diminished action of the kidneys, or of the circulatory organs, and, bthis means, of promoting indirectly the absorption of the fluid.We possess a tolerable number of such remedies which sometimeshelp to diminish dropsy depending upon some incurable disease,and by which means Homceopathy enjoys a striking advantage overany other method of treatment. In mentioning these remedies, wewill accompany them with short statements, for there are so manypossible groups of symptoms, that it is impossible to furnish speindications upon an extensive scale. Moreover, the chronic natureof the disease enables us to compare the remedies in our MateriaMedica with all proper attention.Arsenicum album is our most important diuretic. It is suitablein all forms of dropsy, more particularly in dropsy def)ending upheart-disease, and oedema of the lungs. After giving Arsenicum^ acopious diuresis will sometimes set in with astonishing rapidity,after which the dropsical swelling speedily disappears. The resulis most doubtful, if we have only ascites to contend against. Inasmuch as the medicine shows its good effect in a few days alreadafter a few doses had been taken, it is useless to continue it folonger period, in the vain hope of eliciting good effects from itpersisting in its use.Digitalis purpurea is much less reliable than Arsenicum, althoughit is much easier to determine the indications for its use. It isparticularly useful in dropsy depending upon, or accompanied by ahigh degree of general debility ; the dropsy is caused by pulmonaor cardiac disease. Digitalis is never indicated for ascites alonbut so much more specifically for oedema of the lungs. The natureof the exciting causes is such that Digitalis can only act as a ptive ; if small doses remain ineffectual, larger doses should besorted to before the medicine is discontinued.China is particularly useful in dropsy setting in after debilitathttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 544 of 653648 Constitutional Diseases without Definite Infectiou.diseases, great losses of blood, and when the liver is affected.the whole, however, we have to place China among the less reliablmedicines.Helleborus niger is not adapted to slow^ly developing cases of drbut it is an excellent remedy in acute dropsy, probably because tform of the disease generally arises from an affection of the kidwhich comes within the curative range of this drug.Apis at one time was greatly extolled as a remedy for dropsy, butpractical trials have disappointed us ; we have never been able tobtain any decided results by means of Apis. It is recommendedfor every form of dropsy.Acidum fluoricum has been used by Haubold with success for theanasarca of a drunkard. We are not aware that this medicine hasbeen often used, but we urgently recommend it for trial.Prunus spinosa is so urgently recommended for general dropsy thatit is undoubtedly advisable to try it. Hartmann has seen goodeffects from this medicine in dropsy depending upon heartAurum muriaticum is recommended for general dropsy as well asfor dropsy depending upon derangement of the liver, or for ascitealone, especially in the case of cachectic individuals.[Apocynum cannabinum in various doses, but principally in largerquantities, has frequently cured dropsy, general dropsy as well ahydrothorax.Helonin is recommended for dropsy arising from renal difficultiessuch as albuminuria, Bright's disease, etc.Cochineal is useful in dropsy from the same cause. H.]The following remedies are indicated by the nature of the exciting cause rather than by the presence of the serous effusion : Catharis^ Terebinthina (for renal affections); Tart stib.j Carbo veSquilla^ Sulphur (for pulmonary affections) ; Ferrum^ Kali carboncum^ Phosphorus^ lodium^ Mercurius (for affections of the liver);Lycopodium^ Sulphur (for chronic catarrh of the bladder).In no disease it is more difficult to select a suitable remedy thin dropsy ; nor are we in any disease more frequently disappointeby the medicine employed, very often on account of some causehidden from observation. These disappointments are very oftenowing to the circumstance that we do not give a sufficiently largdose; it is well known, however, that dropsy requires to be treatwith larger doses than almost any other disease, although theremay be exceptions to this rule.Paracentesis is only to be resorted to as a last resort ; it scarScorbutus. 649http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 545 of 653ever heightens the susceptibility to medicinal action, and very gerally leads 80 much more speedily to a fatal termination, for threason that the water accumulates again so much more rapidly.On this account the operation had better be deferred as long aspc^sible.[5. Scorbatns.Scurvy.Aitken defines scurvy as follows : " A morbid state ushered inby debility, lassitude, lowness of spirits, attended by fetor ofbreath, sponginess of the gums, which swell by irritation, till toverhang the teeth in palmated excrescences. Livid, subcutaneouspatches and spots appear upon the skin, especially on the lowerextremities among the roots of the hair. Spontaneous hemorrhagesmay take place from the mucous canals ; contractions of the muscles and tendons of the limbs occur, with pains, and sometimessuperficial ulcerations. An altered state of the albumen of theblood is associated with this condition, and the phenomena arebrought about by a deficient supply of the organic vegetable acidor of the salts of fresh vegetables."Scurvy has been the scourge of armies and navies from the earliest periods of human history. The Roman army under Germanicus was decimated by it after a long encampment in Germanybeyond the Rhine. The French army under Louis IX. in Palestinewas almost wholly destroyed by this plague. Thousands of sailorsand soldiers became its victims until Cook finallj'' succeeded inquering it ; on his return home in 1775, after a three years' cruhe brought back a crew of one hundred and twelve men in a soundcondition, having only lost one man by disease.l^ost'inortein Aiypearances. Poupart and Lind inform usthat the " principal effects of the disease were oL3erved in allin the cellular tissue of the extremities." Lind says that " effublood often lay in large concrete masses on the periosteum, whilethe bellies of the muscles of the legs and thighs seemed quite stwith it, often an inch in thickness." Water and blood were oftenfound efflised into the cavities of the chest and abdomen. Pouparfound that " on examining the joints, the epiphyses had entirelyseparated from the bones ; and in other cases that the cartilagesthe sternum had separated from their bones ; and bones that hadunited after being broken, very often separated again at the sitefracture." The spleen was found very much enlarged, soft andengorged with coagulated blood.650 Constitutional Diseases without Definite Infection.The phenomena of scurvy point to the blood as the seat of someessential alterations in this disease. All the leading eonstitnenof the blood seem to be present, but their normal proportion is dturbed and one or the other essential ingredient is found alteredin quantity and quality. Various opinions have been advanced byChristison, Garrod, and others, regarding the causes of scurvy ;it is sufficient briefly to state, that "one of the most evidentfrom the healthy condition is seated in the blood, which is alterhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 546 of 653in composition either by the addition to it of some ingredient oringredients, or by the absence of such, which ought to exist in iand the deficient ingredient may be one of the ordinary constitueof the blood, or it may be some principle or element entering int.their composition. This deficiency is due to the absence of certarticles of diet ; and the disease is known by experience to be aonce cured by supplying those articles." (Aitken.)Symptoms. The first manifestation of the disease is a changeof color in the face. The countenance looks bloated, and has alivid, jaundiced hue. A bad symptom is when the disease sets inwith a puffiness of the skin around the orbits ; the sclerotic cojunctiva is tumid and gives the cornea an appearance as if seen athe bottom of a well. Wandering, rheumatoid pains in the limbsare complained of; the patients feel weary, yet the pulse remainssoft ; there is no fever, on the contrary, the animal temperatureseems depressed. A very high grade of stomatitis develops itself.The gums look spongy and hang over the teeth in flesh-like, palmated excrescences; they bleed readily; in bad cases the inside othe cheeks sloughs gS in shreds, the tongue looks broad, flabby aindented ; the odor from the mouth is very fetid. At the sametime an eruption like flea-bites breaks out on the lower extremitit has a purple-hue and may ulcerate if the disease becomes verysevere. The muscles of the legs become indurated and painful, andthe skin is discolored in large patches and sometimes over the lapart of the leg. In the higher grades of scurvy, these patches mabreak out in ulcerations which are generally located on the calveof the legs, buttocks, hams, shoulders and arms. The skin is exceedingly irritable, the merest rub causing an hemorrhagic effusiunder the skin. Deprivation of sleep constitutes one of the keenesuiFerings of scorbutic patients. Their strength may be so completely exhausted that death may result from the most triflingbodily effort. Scurvy at the present time is a very rare disease,and with our present means of treatment and our perfect knowlScorbutus. 651iedge of the nature of the dieease, it scarcely ever runs to a fatermination.Mtiology and Treatment, At one time, the excessive orexclusive use of salt-provisions was supposed to be the cause of«curvj, but we know now that scurvy may likewise result fromthe exclusive use of fresh as well as salt meat. The real causeof scurvy is a deprivation of fre^ vegetables. By supplying thiswant, the disease is readily and effectually cured. " The diseasewrites Dr. Parkes, " so fatal when left to itself, is cured withgreatest facility. Symptoms, apparently the most grave and seriouvanish as if by magic, and without leaving behind them any veryserious injury to the constitution. The sanious discharge fromscorbutic sores has been known to change color and to becomehealthy in a few hours after the commencement of treatment. Inpure cases of scurvy, the blood, and the blood only, is at fault."Lemon-juice," writes Dr. Watson, "is really a specific againstscurvy, whether it be employed as a preventive or as a remedy. Itsupplies something to the blood which is essential to its healthyproperties." Ac

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 547 of 653lemon-juice seems to be more effectual than pure citric acid." Thabsence of fresh vegetables deprives the system of the acids whicare necessary to the nutrition of the organism; these are citric,tartaric, acetic, lactic and malic acids which form carbonates insystem by entering into combination with alkalies. " When weinquire," says Dr. Parkes, " whether there is any proof of the deciency of these particular acids and salts from the diets which cscurvy, we find the strongest evidence not only that this is thecase, but that their addition to the diet cures scurvy with greatcertainty. Tartaric, and especially citric acid, when combined wialkalies, have always been considered the anti-scorbutic remediespar excellence^ and the evidence on this point seems very complet"Of the vegetable anti-scorbutics," writes Clymer in his Americanedition of Aitken, "the potato enjoys, and probably deservedly, thighest reputation; sailors cut it in slices, which they pack inmolasses ; next to it are onions, sliced and eaten raw ; which argreedily devoured by scurvy-patients. Cabbage in the form of sourkrout, sorrel, the wild artichoke, the maguey or American aloe, tprickly pear, the dandelion, lamb's-quarter, green corn, the yam,apples, have all been found excellent anti-scorbutics. Uncookedfruits and vegetables are more efficient than cooked in the prevetion and cure of scurvy."652 Constitutional Diseases without Definite Infection.Dr. Parkes recommends Citrates, Tartrates, Lactates, and Malatosof Potash, as drinks, or as additions to the food.Most of the above statements have been taken from Aitken,Watson, and from Parkes' work on the pathology and treatmentof scurvy, to which we therefore refer for more extensive information. H.]6. ScroftilfMis.This is a constitutional anomaly which it is as difficult to defias rheumatism, perhaps more so. At any rate we do not desire topresent an imperfect definition of the disease, and we thereforetent ourselves with stating that scrofulosis is a disease of theperiod of development, the presence of which is manifested by morbid conditions of a peculiar character, more particularly in theglands, skin and bones.Scrofulosis may be inherited from scrofulous parents, whose disease is not necessarily, but in a majority of cases, reproduced ithe children. It may likewise be regarded as an inherited diseaseif the parents were affected with some chronic disorder (more espcially the mother during pregnancy), such as tuberculosis, constitional syphilis, malarial cachexia, mercurialism. Finally there ievery reason why scrofulosis should be regarded as inherited, whethe disease breaks out among the offspring of marriages betweennear relatives, and after such marriages had been continued forseveral generations.Scrofulosis may likewise be acquired by exposure to influencesthat continually impair the process of nutrition. Above all, it ideficient supply of food, or improper food generally, that develoscrofulosis in children the more certainly the sooner the child whttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 548 of 653exposed to such an infiuence. This is the reason why children thaare chiefly fed on farinaceous soups, bread, potatoes, easily becscrofulous, the more certainly the smaller the quantity of milk twere allowed at the same time. Potatoes, and next to them farinaceous food, are the articles of diet to which scrofulosis is chieattributed. Children who are nursed by healthy mothers, can likewise become scrofulous if they are fed too often, or if they aretoo long at the breast, which is so often done in the country bywomen who are anxious to prevent another conception. Moreover,scrofulosis is not perhaps directly caused, but decidedly promotenot only by improper food, but likewise by an insuflicient supplyof fresh air, want of exercise, living in damp dwellings, inattento the skin.Scrofulosis. 633If hereditary Bcrofulosis and the last-mentioned circumstancesmeet, scrofulosis reaches the acme of its development. In ouropinion, improper nutrition is a much more frequent cause of scroulosis than hereditary descent. Parents generally bring up theirchildren as they had been brought up themselves ; the absurditiesof their own parents have become engrafted upon them with themother's milk, and the grandmother generally stands by the cradleas a faithful watch-dog to prevent the old routine from being departed from in the least particular. In this point of view it isoften proper to say, not that scrofulosis has been inherited, butabsurd views concerning the bringing up of children have beentransmitted from one generation to another. As an evidence of thetruth of this statement, we mention the circumstance that the firborn in a family is apt to have a feeble and sickly constitution,whereas children born at a subsequent period, are healthy ; or thsome children who were brought up on improper food, becomescrofulous, whereas no sign of scrofula is manifested in childrenwith whom more rational maxims are pursued.Scrofulosis always breaks out in childhood. It seldom manifestsitself before the second year. Children that are very large andbloated in the first two years, almost always become scrofulous aa later period ; children with firm muscles and slender forms arescarcely ever attacked with the disease. Scrofulosis scarcely evebreaks out after the second dentition, still less frequently afteage of pubescence.SytnptoinH and Course. It is very difllcult to furnish a complete picture of the scrofulous disease, for the reason that it mtiBSts itself in so many diilerent localities and diveraitied forhence a few general statements will have to sufiice. Scrofula chilocalizes itself in theLymphatic Glandular System. Either we find a more or lessextensive hypertrophied degeneration, or else an exudation tendinto suppuration, the surrounding cellular tissue being more or lesinvolved in this process. In the former case the swollen glandsmay remain unchanged for many years until they gradually disappear, most commonly at the age of pubescence, leaving only a fewtrifling remnants of diseased structure. The inflammatory exudation is seldom deposited in an acute form ; generally the glandsswell slowly and without pain, the swelling sometimes even remainhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 549 of 653stationary, or else retrogrades, until gradually one portion of tgland becomes injected, fluctuates and breaks. The suppuration654 Constitutional Diseases without Definite Infection.generally takes place very slowly, because the decomposition of tpus goes forward step by step. In other cases, especially in individuals with sickly constitutions, a complete decomposition of thexudation takes place before the swelling discharges ; in such athe discharge indeed takes place very rapidly, but other glands aattacked so much more speedily one after the other, and the patiestrength is undermined by hectic fever. The cervical and posteriocervical glands are generally attacked first and most extensivelybut the morbid process may likewise be transmitted to every otherpart of the body. It becomes most threatening, if the mesentericbronchial glands are invaded ; in such a case obstinate and severcatarrhal irritations may set in, which are often enough followedby hectic fever and death. If scrofulosis can be suspected, everychronic intestinal catarrh, every chronic bronchitis, must necessbe traceable to a scrofulous origin.The skin is very often the first organ that shows symptoms ofthe scrofulous taint. It is but too often the case that childrenup to the time when they were weaned, looked fleshy and solid,after they are weaned, are attacked by cutaneous eruptions thatalmost always look like eczema and impetigo, less frequently likeecthyma or pemphigus ; the incrustations are generally accompanieby obstinate ulcers which constitute characteristic symptoms ofscrofula. While the exanthem, which is most commonly confinedto the head, is still out, or soon after its disappearance, the gbecome affected.The localization in the bones and joints is one of the most dangerous signs of scrofulosis. We refer to what we have said concerning the bones and articulations in a former chapter ; we wishto^observe, moreover, that the inflammatory forms run a very protracted course, and that it is only when the patient's constitutiis in a very bad state, that those forms terminate in hectic feveand death, but, on the other hand, leave the aftected joints withimpaired mobility, anchylosed and deformed. Scrofulous inflammation of the vertebrae is the most threatening, for it either leadcurvature of the spine or develops hectic fever by the originatioof congestive abscesses.Another symptom of scrofula is the ophthalmia which we havealready described in a previous chapter. It is either confined tothe margins of the lids, or involves the whole conjunctiva. Theears of scrofulous children have a peculiar inclination to dischawith eczema breaking out at the same time round the ears ; veryScrofulosis. 655seldom only, and then only if the affection is very deepinflammatory process communicates itself to the ossicula and themastoid bone.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 550 of 653The mucous membranes do not show any particular morbid symptoms, but an extraordinary susceptibility to catarrhs, especiallynasal and buccal mucous membrane. In the nose the copious secretion is associated with soreness and ulceration, and a swelling othe whole nose, in which the upper lip generally participates inmanner thgt is exclusively peculiar to scrofulosis. In the mouthwe notice frequent attacks of angina, with disposition to hypertrophy of the tonsils.It is only the highest grades of scrofulosis that are accompaniedby peculiar affections of internal organs, such as fatty liver, ahydrocephalus, etc.These various localizations manifest themselves in the most diversified combinations and successions, sometimes one at a time, andat other times all together. Their course is always slow and dragging, subject to many oscillations between remissions and exacerbations, but generally terminates in recovery, as long as the vitorgans remain unaffected by the disease, always, however, leavingsome remnants of the disease behind. Even suppuration of thevertebrae sometimes terminates in recovery with surprising rapidiThe general state of the organism is of importance both to thecourse of the disease as well as to the treatment. Pathologists hadopted two kinds of scrofulous constitution, the erethic and torthey are indeed sharply separated from each other in practice. Therethic scrofulous constitution is distinguished by a lively cirction and a marked tendency to febrile affections. Such childrenhave a fine, transparent skin, flushed cheeks with great tendencyto sudden changes of color in the face, an extreme nervous irritability, increased mental activity, melting, languishing eyes, dcate bones, and slightly-developed muscles. The torpid scrofulousconstitution, on the contrary, Is characterized by a diminishedactivity of the circulation and reproduction, and great tendencyadiposis. The whole body of such a person looks bloated, especialthe face, the features are coarse, the nose and upper lip are swothe bones, especially the skull, are large, and the limbs coarselshaped; other characteristics are: a distended abdomen, flabbymuscles, mental and bodily indolence, a dingy-looking, yellowishgray skin, disposition to caniue voracity. From such generalsymptoms the speedy outbreak of local scrofulous affections can b656 Constitutional Diseases without Definite Infection.predicted with tolerable certainty ; frequently, however, especiaif a proper mode of living is pursued from an early period, thescrofulous habit disappears entirely, sometimes at the age of sevyears, without having occasioned any local diseases.Treatment The treatment of the various local scrofulous diseases has already been discussed in former chapters, and all thatremains for us to do here, is to consider the disease in its totaAccording to what we have said when treating of the etiology ofthe disease, it is evident that the causal indication iqgscrofulooccupies the first rank. Before any medical treatment can bethought of, the nK)de of living has to be thoroughly changed. Thichange refers mostly to diet, habitation, exercise in the open aiattention to the skin, etc. ; in cases of erethic scrofulosis ithttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 551 of 653wise to take into special account the mental development of thepatient, which should never be forced, and premature, and shouldalways go hand in hand with an abundance of bodily exercise. Inthis respect it is difficult to lay down specific rules which migadapted to one child, and decidedly contrary to the constitutionanother. The physician should carefully investigate, and afterwarremedy the defects of education, but definite laws cannot be laiddown to reach such a result. The causal indication likewise includes measures having reference to a true and useful prophylactitreatment ; hence, a physician should make it his duty to watchover the education of the children confided to his care, in everypossible direction and aspect of the case. How much trouble willa physician save himself by such a course, and how much care andanxiety to others !Except in local affections, the medicine that may be regarded asthe chief remedy for scrofulosis, is Calcarea carbonica. It nevercorresponds with a torpid, but so much more decidedly with anerethic habit. This remedy is not sufficient to alter the habit,correct mode of living is indispensable to accomplish this purposbut Calcarea is a most important adjuvans in the treatment. Inasmuch as the effect of this or any of the following remedies is alslow and never very striking, the medicines prescribed for scrofuwill have to be given at long intervals. Side by side with thisremedy, and equally efficacious for the scrofula of torpid constitions, we mention Arsenicum which we recommend upon our ownresponsibility rather than the recommendations of other physiciansince very little is said about this medicine in homoeopathic litas a remedy for scrofula. We have to observe, however, that ArsenScrofulosis. 657IB only indicated by the general symptoms, and only by a few, indeed very few local lesions. Ferrum holds the mean between thesetwo remedies ; it is adapted to the erethic as well as the torpidconstitution, provided the process of sanguification is decidedlydeficient or imperfect, as may be seen from a disposition to congtions, hemorrhages, palpitation of the heart, ataxia of the stomaand a deficient secretion of bile. Ferrum is chiefly suitable, ifscrofula is most strikingly developed during the age of pubescencit is much less adapted to the scrofula of childhood. Sulphur musnot be forgotten in this place ; it is, however, better adapted tlocalized forms of the disease than to its general and vaguely expressed symptoms. Sulphur is a distinguished remedy, if the digestion is very irregular ; if a disposition to constipation is veryif the abdomen is very much distended, the mesenteric glands canbe distinctly felt, the cervical and posterior cervical glands arswollen, but painless, the nose and upper lip are swollen, but noinflamed. Sulphur is likewise indicated in chronic bronchialcatarrh depending upon infiltration of the bronchial glands.These four remedies are the only ones that we can designate asgenerally anti-scrofulous. Other remedies require special indications. We will mention the leading remedies of this class, referrfor particulars to our former chapters on conjunctivitis, lymphadnitis, ostitis, chronic intestinal catarrh, etc.; they are: Chinalodiurrij Silicea^ Aurum rmiriaticum^ Baryta carbonica^ Hepar sutphuriSy Magnesia carbon. y Conium maculatum^ Mercurius^ Graphiteshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 552 of 653Spongia.We cannot help mentioning two preparations that are used agreat deal by lay-persons, even without a physician's order. OneOleum jecoris aselli^ cod-liver oil. We shall revert to this medithe next chapter; a few words on the subject will suffice in thisCod-liver oil is decidedly useful if the digestion is impaired, istomach seems disinclined to retain food, and if frequent diarrhodischarges set in ; if, moreover, nutrition is impaired, the bodyemaciated and destitute of animal juices. *If the appetite is goothe digestion regular, and there is a marked disposition to adipocod-liver oil is decidedly hurtful ; in such a case it is apt todigestion and impair the appetite. However, in view of the highreputation which cod-liver oil enjoys, neither physician nor paticares about the harm it may possibly do, imagining as they do thagood results must be got out of the oil by sheer force. A proceeding of this kind is, of course, prejudicial. The second remedy ar42658 Constitutional Diseases without Definite Infectiou.Bait water-baths, with or without an addition of malt. That theyhave a good eftect, is evidenced by the numerous baths prepared othe mgther-lye of salt-works. When used at home the favorableeffect of the baths may be charged to the benefit which the skinderives from the operation. In the case of children attention toskin is too often and disgracefully neglected.I. Tubercnloeto.Tuberculosis is not only the most frequent of all constitutionaldiseases, but likewise the most common of all diseases. Accordingto Wunderlich it is characterized by deposits into all sorts of tsues and organs, of a pale, yellowish or gray color, of a soft chand sometimes a harder or softer consistence, of the size of smaGgranulations to the size of larger bodies, in which the organic ements (molecular granules and a few imperfect nucleated bodies)persevere in a low state, without any organic connection with eacother or with the adjoining tissue; do not show themselves capablof any further development, and either dry up, or else, becomedecomposed and melt.The formation of these deposits or tubercles depends in mostcases upon peculiar conditions of the organism with which we arealmost unacquainted ; it is very questionable whether tubercles cever be formed without some constitutional anomaly, hence, whethethey constitute a purely local affection from which the constitational disease emanates at a later period. This seems to ob justas improbable as the formation of carcinoma without a previousconstitutional anomaly. We will designate the radical disease intuberculosis as the tubercular diathesis. In almost every case tuculosis can be demonstrated as developing itself under the followcircumstances : It may result from a deficient supply or the badquality of the food in the same manner as has been indicated forscrofulosis ; in this manner tuberculosis often succeeds the lattthat when, at the age of pubescence, scrofulosis disp^ppears, tubcles take the place of the former. It may likewise be occasionedhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 553 of 653a deficient activity of the respiratory organs, as may occnr duricertain trades, which will be named by and by, or as may resultfrom tight dressing, or from a sedentary mode of life. Whether apre-existing germ is excited or created by such causes, is uncertthe former, however, seems to us more probable. It may likewisebe inherited like scrofula.Tuberculosis. 659The tubercular diathesis does not manifest itself by any positivesymptoms, and the so-called tubercular habit consists of nothingelse than the symptoms of general debility and imperfect assimilation. There die as many men without as with this habit. The onlypoint that enables us to be tolerably sure of the existence of acular diathesis, is the fact that the person was affected with scula when young.Tuberculosis is found equally distributed in both sexes, perhapsa little more among women. It breaks out chiefly between the agesof eighteen and thirty years.The deposition of tubercles, and hence the tubercular diseasegenerally; perhaps likewise, in many cases, the origin of thepeculiar tubercular diathesis, are founded in the following circumstances.A scanty supply and a bad quality of food, damp dwellings, deficient exercise in the open air. On this account the disease is chmet with in the lower walks of life, and likewise occurs more frequently in cities than in the country; among individuals whosebusiness confines them to a room ; among prisoners.Too rapid growth, more particularly if the growing persons arefed on improper nourishment, for this will occasion a condition ogreat debility.Continued depressing emotions, especially sorrow and grief, homesickness. The connection of cause and efiect between these influences and the disease is not clearly made out; but that thisconnection exists, can be shown by a number of cases ; tuberclesare often very properly designated as tears shed inwardly.Circumstances incident to pregnancy, confinement, lactation, themore certainly, the more rapidly one confinement follows another,and the longer the infant is nursed at the breast. Women withtuberculous dispositions generally pass very well through their fconfinement; they keep up the nursing business for a year, withoulosing much strength, but after that, they complain of feeling exhausted. During the next pregnancy they apparently feel better inevery respect, but immediately after confinement the symptoms ofan approaching tuberculosis multiply; while nursing her child, thmother experiences all sorts of inconveniences; the next pregnancagain brings an improvement, until phthisis suddenly breaks outin all its might, usually during the first weeks after a new confment, and very often runs a very rapid course to a fatal termination.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 554 of 653660 Constitutional Diseases without Definite Infection.A sudden change in the mode of living; if an occupation requiring constant exercise in the open air, is exchanged for a sedentabusiness; a luxurious mode of living is suddenly replaced by a moof living full of privations ; if the climate is suddenly changedif persoris move all at once from a warm into a cold climate.Circumstances and conditions that permanently interfere withthe breathing; tight dresses preventing a free expansion of thechest ; occupations that render constant stooping necessary, as ithe carpenters' and tailors' trade, etc.; or trades in consequencwhich the lungs become filled with fine dust.Diseases of the respiratory organs. Frequent attacks of acutebronchial catarrh, pneumonia, pleuritis ; above all, measles, whoing-cough and influenza are very common exciting causes of tubercular deposits.Most diseases that cause a rapid decline in the assimilative functions, such as: Typhus, dysentery, cholera, chlorosis, diabetes,inveterate syphilis, chronic exanthems, especially prurigo.Influences which greatly debilitate the nervous system, such aslong continued mental labor, venereal excess, self-abuse.What causes are chiefly instrumental in exciting the first outbreak of the disease, is hard to decide. If the germ is present,most trivial event may kindle the spark into a flame.Certain conditions of system afford a certain immunity fromtuberculosis ; among these conditions we distinguish : an extensipulmonary emphysema, malformation of the thorax, considerablecardiac defects, carcinoma. It is likewise certain that midtain air diminishes the chances of tuberculosis becoming a fullydeveloped disease. In the following pages we shall only give adescription of pulmonary tuberculosis, furnishing now and then ahint concerning the tuberculosis of other organs.In order to understand the meaning of the perceptible symptomsof the disease, a knowledge of the pathologico-anatomical changesis more indispensable than in most other diseases. We meet withthree essentially distinct forms of tuberculosis, namely: chronicmiliary tuberculosis, infiltrated tuberculosis, and acute miliarytuberculosis.In chronic miliary tuberculosis, the single tubercular granulesare found irregularly scattered in the lungs, sometimes singly, aat other times in large clusters, always chiefiy occupying the apof the lungs, and very often limited to the upper lobes. The singgranulation is at first of a grayish color, tolerably firm, afterTuberculosis. 661it assumes a yellowish tint and acquires a cheesy consistence, anat this point, may dry up to a calcareous little body which is lirough little stone to the feel ; or else, it may soften and be trhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 555 of 653formed into pus. These suppurating granulations may give rise inthe lungs to vomicae or cavities filled with pus, and of a greateless size in proportion as the number of granulations is greatersmaller. The vomicae may be present in large numbers ; they mayeither remain isolated, or else unite, forming caverns of the siza goose-egg. The vomica enlarges either by the dissolution of thetubercles that are still embedded in its walls, or else, the depoof tubercles in the walls of the vomica goes forward uninterruptedly, the latter process being the one that is most common. Thewalls of the vomica are excavated, permeated by obliterated vesseand bronchia, or, if the bronchia are destroyed, their irregularlcorroded orifices open into the cavity. The blood-vessels resistthe destructive process longer than the bronchia, and most commonly shrivel up ; but if they are destroyed while blood is stillcirculating through them, they may give rise to extensive hemorrhages. The vomica may be entirely isolated, or else, it may be icommunication with one or more bronchial ramifications. In itsgrowth it may penetrate the pleura and even the chest-wall. Theparts surrounding the vomica show bronchial catarrh, interstitialpneumonia in some localities, with subsequent atrophy, bronchiectasia, emphysema. The vomica may empty itself and cicatrize, orelse, it may become closed and, without being entirely empty, itscontents may become transformed into calcareous matter. Thepleura, even if not touched by the tuberculous process, is generathickened and the two pleuras adhere. Inasnmch as in miliarytuberculosis the deposition of tubercles takes place in successivgroups or clusters, tubercles are not generally found uniformlyaltered, but are met with in all the stages of their course.Infiltrated tuberculosis is distinguished from the former class bthe circumstance that a pneumonic exudation is transformed intotubercular matter, while the organism had either been in a stateapparently sound health, or during the presence of tubercles in oparts. The infiltrated substance passes through the same changesthat have been described above, but it usually dissolves much morrapidly, causes much more radical destructions and its transformation into calcareous matter takes place more tardily.In acute miliary tuberculosis we meet with an extensive deposition of granulations not merely in the whole pulmonary paren662 Constitutional Diseases without Definite Infection.chyma, but likewise in the pleura, the pia mater, thie peritoneumaud the abdominal viscera. The homogeneous uniformity of thegranulations shows their simultaneous origin ; in the chronic forthis does not occur very extensively.Tuberculosis of the intestines, which is scarcely ever absent during the course of pulmonary tuberculosis, reveals at the commencement of the disease granulations in Peyer's and Brunner's glands.These tubercles change to separate round ulcers which unite aathey increase in size, and spread in the ileum in a circular formThe most common alterations co-existing with pulmonary tuberculosis, are : Tubercular ulcers in the larynx, resembling thosethe intestines; fatty degeneration of the liver, dilatation of thheart, or atrophy of the heart, slight degree of Bright's diseasehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 556 of 653the kidneys.Symptoins and Course. In describing this disease we shalladhere to the most common form, namely: chronic miliary tuberculosis.It is very difficult to say, with any thing like certainty, whenthe disease really commences. The deposition of the first tuberclespecially if not very numerous, is accompanied by symptoms thatseem too insignificant to a patient to complain of to a physicianWhen a physician is consulted, the disease is already suflicientladvanced to be discoverable by the usual means of exploration ; aits first beginning no such result can be obtained. That the diseis beginning to set in, can almost positively be inferred if indiuals who were afflicted with scrofula when young, or persons witha tubercular habit, show the following symptoms : Disposition topulmonary hyperseraia, with palpitation of the heart ; dispositioto bronchial, tracheal and laryngeal catarrh, the attacks being vobstinate, with bloody sputa, long-lasting hoarseness ; general nvous irritability, irritability and increased frequency of the puRepeated attacks of catarrh ought especially to excite suspicion,for they evidently indicate the period when the first tubercles adeposited. Very often, however, the deposition may be going onfor a long time without any apparent symptoms, in which case thesupervention of a severe bronchial catarrh which gets worse all ttime, shows the sudden outbreak of phthisis or, in other words, othe purulent dissolution of the tubercles. In young women the disease not unfrequently sets in with all the symptoms of chlorosis,which may lead to very injurious mistakes. The older the patientsthe less distinctly is the beginning of the disease recognizable.Tuberculosis. -0^ 663< J \seldom, however, the disease breaks out suddenly m^'such a mannerthat an apparent fulness of health is sad(4Wy follol!^j^d by a stof illness with all the characteristics of tube^ilosis ; a ijioresickly condition almost always precedes the outbreak. I^.would beof great importance if the first deposition of'^beiicler'pould beclearly made out by a physical exploration of the^^ng^. .S9^g onlknow of two tolerably reliable indications, early att^tim^ t6^, wmay be of the most decided importance to the treatment. Onp^ isa prolonged, although not very much louder expirat^jjy murn*te,which is particularly important if it is heard during U slow expiration with closed mouth. The second is the so-called " respiratisaccadie^'' jerking, wavy, cogged-wheeled respiration, which is mdistinctly perceived during an inspiration. In the place of an unform blowing murmur we hear an inspiratory murmur at intervals,but not otherwise altered in any respect. Another reliable sign iif, during a slight catarrhal attack, the apices of the lungs exhsymptoms of catarrhal irritation. Another sign is, when the expectoration looks like soaked sago, or is transparent, having theshape of fine, firm threads ; this is a symptom of chronic catarrof the finest bronchial ramifications.The existence of a tolerably severe, protracted, acute bronchialcatarrh, or a more or less violent hsemoptysis generally, is an ehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 557 of 653dent and very seldom doubtful sign that the phthisis has set in.At the same time the patients complain of unusual debility,stitches, or a peculiar drawing pain in the upper lobes of the lupeculiar rheumatoid pains in the arm of the affected side; therespiration is accelerated, the pulse very frequent ; this acceleis very much increased by the least motion ; .the existing feversoon shows typical exacerbations setting in in the morning betweenine and eleven, or in the evening between five and seven o'clockor at both these periods, and sometimes attended with such complete remissions that the fever has very much the appearance of aintermittent disease.From this beginning, the symptoms can easily be observed furtherin their character of phenomena of tubercular phthisis, with varimodifications during their course to which we will first call atttion before describing the various local symptoms.The course of the disease, especially among individuals of a moreadvanced age, is marked by stages. After the first evidently tubecular catarrh has slowly disappeared, a feeling of almost perfecthealth is again enjoyed by the patient, who is at most reminded o664 Constitutional Diseases without Definite Infection.the slumbering danger by a dry cough or a disposition to shortnesof breath after an unusual bodily exertion or after talking. In tcourse of months, and sometimes not till years have elapsed, another catarrh breaks out which likewise ends without any untowardsymptoms, and these changes continue until finally an acute attacof marked intensity terminates in fully developed phthisis. At thsame time, nutrition may remain perfect for years, the patient maretain his flesh and healthy complexion, or else -he may lose hisflesh gradually, and acquire a more or less anaemic appearance.A chronic, uniform course of phthisis occurs much less frequentlyafter an acute catarrh. On the contrary it sets in with very trifsymptoms, a slight, hacking cough, loss of fleah, palpitation ofheart, shortness of breath, etc., and the patient already presentcomplete picture of phthisis when all at once an acute catarrh sein which is suddenly transformed into the actual disease. Or elseno acute catarrh ever takes place, the patients continue to failalmost imperceptibly, hectic fever supervenes, a tuberculous diarrhoea and oedema make their appearance, and death takes placeamid symptoms of complete exhaustion.A subacute course of the disease, phthisis florida, succeeds theinitial catarrh sometimes immediately, especially in the case ofyoung individuals and after confinement, likewise after severe acdiseases ; very frequently it forms the conclusion of the more chforms of phthisis. This subacute course is particularly distinguiby intense hectic fever, tuberculous diarrhoea, disposition to punary hemorrhage. The most vigorous patients fail within eight orten weeks, nor is it at all possible to arrest the course of thein the least degree.In reviewing the most important local alterations caused bytubercular phthisis, we have in the first place to attend to thephysical symptoms.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 558 of 653Except perhaps in very acute cases, the form of the thorax isplainly and characteristically altered. The thorax is flattened,pressed in and descends lower down, so that the shoulders form avery obtuse angle with the longitudinal axis of the thorax, and tneck appears to be elongated. The intercostal spaces are sunken,more particularly the jugular fossa, the clavicles are very prominent ; the sternum is much depressed, its upper portion often stout, so as to form an angle with the rest; the shoulderoutvery prominently. These changes are most striking, if theyonly exist in one side of the thorax ; it is true that in such aTuberculos's. 665not all these changes are so decidedly marked, but they are morestriking to the eye. The movements of the thorax are very muchchanged ; respiration is carried on with the lower portion of thethorax, and still more with the diaphragm and the abdomen,whereas the upper ribs are scarcely moved. On palpation, increased vibrations are often perceived from the voice in the uppeportion of the lungs.In the beginning of chronic miliary tuberculosis, percussion sometimes does not reveal the least change ; as the depositions increthe sound becomes less full, tympanitic, and finally completelyempty. Percussion only yields truly valuable results at the apiceof the lungs and in the infraclavicular region; if dulness is plareturned in these parts, an empty sound in other portions of thelungs authorizes the conclusion that tubercles are deposited. Kcaverns have formed close to the thoracic wall, percussion sometimes returns a metallic ring or the sound of a cracked pot.Auscultation returns the most reliable results, because they aremost commonly present. In a previous paragraph we have shownthe value of the prolonged expiratory murmur and of the ^^respiration saccadee" in the apices of the lungs. If these symptoms becoassociated with sub-crepitant rales, the diagnosis becomes so mucmore certain. In proportion as the infiltration increases, the reatory murmur becomes more and more bronchial, and remains so,even if caverns form, or else amphoric sounds and the metallic risupervene during the rale. It is often of importance to auscultatduring a paroxysm of cough, because at such a time certain soundsespecially the rale, are heard more distinctly. If the tuberculardeposits are very extensive, pectoriloquy has often a very high pThe cough of tuberculous persons varies exceedingl3\ At thebeginning a constant short and hacking cough is very usually present, sometimes interrupted by severe paroxysms, resulting in theexpectoration of a light-colored, scanty mucus ; or else, the cousets in in irregular paroxysms which are generally excited bymarked changes in the temperature and by pulmonary eftbrts;these paroxysms often last for several hours, and end with retching ; the sago-like expectoration follows in a few hours. A coughthat at once sets in, with a copious expectoration, is a rare occrence. After suppuration has taken place, the cough becomes nmchless wearing and spasmodic; the coughing fit readily results incopious expectoration. Between the more violent paroxysms, a constant hacking takes place, during which the mucous rdle is dishttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 559 of 653666 Constitutional Diseases without Definite Infection.tinctly heard. In very rare cases there is no cough during thewhole coarse of the disease, although the infiltration may be extsive and numerous caverns may exist.Previous to the deposition of numerous tubercles and their purulent dissolution, the expectoration is without^ any characteristifeatures. K'evertheless a continual expectoration of clear mucusalways a suspicious symptom ; but such an expectoration acquiressignificance when it is traversed by fine streaks of a yellowishand when, moreover, it frequently appears streaked with blood.Still more characteristic is the presence of sago-like firm littland fibres. Much less frequently hard, yellow or greenish, cheesylittle lumps are coughed up at an early period; they generally tavery badly, and frequently have an offensive odor. Sometimes theexpectoration contains small lumps of calcareous matter, chalktubercles, seldom, however, previous to suppuration having fullyset in ; usually after caverns have formed. The cavernous expectoration has a yellow-gray color, less frequently a greenish color,firmly coherent; in the water it forms irregular, shaggy ballswhich slowly sink to #he bottom ; it is surrounded by a quantityof clear bronchial mucus with which, however, it does not mix.The microscope discovers elastic fibres in this expectoration, asign of existing phthisis.The larynx and trachea seldom remain intact during the wholecourse of the disease ; they show more or less marked symptomsof catarrhal irritation. At an early period of the disease, the vbecomes husky or loses its resonnance and firmness of tone; at alater period, these organs become painful, according as the abovedescribed ulcers are located, and not unfrequently complete aphonsets in.The phenomena of the circulatory organs are not by any meansconstant, but at the beginning of tuberculosis we generally finddilatation of the right heart, disposition to a tumultuous actionthe heart, blowing murmurs under the clavicle, anaamic mummrsin the jugulars, continuation of the sounds of the heart as far aboth apices of the lungs. Afterwards the heart becomes more andmore atrophied. The tendency to sudden changes of color is astriking phenomenon only at the commencement of the disease.Very soon the pulse becomes frequent and feebler than usual, it iaccelerated by every movement. In the stage of phthisis it almostalways exceeds 100, sometimes rising to 140. It is only exceptionally that the pulse of phthisicky patients is retarded, and thenTuberculosis* 667occasionally and alternating with a frequent pulse. As a rule, thpulse affords the best means of judging how far the patient's strhas already been consumed by the disease.The digestive functions are generally very much impaired.Usually at an early period of the disease the appetite grows poorhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 560 of 653or cardialgic pains are experienced after eating, which are notunfrequently followed by distressing vomiting. The appetite seldom remains natural ; sometimes, generally shortly previous to thpatient's death, he experiences a morbidly increased hunger. Excein phthisis florida, the stools generally remain natural for a lotime ; diarrhcBa only sets in after the symptoms of extensive suppuration of intestinal tubercles have become manifest. These diarrhoeic stools are peculiar, partly papescent and partly watery,resembling mustard in color and appearance ; most commonly thepassages are accompanied by a quantity of gas, they frequentlycontain blood and pus, and are seldom colorless. They are not frequent, from three to six a day, generally two in the morning inquick succession, in the day-time they occur after the patient hapartaken of nourishment. Sometimes they are preceded by slightcolicky pains, at other times they are quite painless. They arealways a bad symptom, for the longer the diarrhoea postpones, thelonger is the patient's strength preserved. In the first period odisease, the patient is sometimes troubled with diarrhoeic stoolsbut they generally abate in proportion as the pulmonary symptomsdecrease in intensity ; if the tendency to diarrhoea has once becestablished, the course of the disease is generally very rapid. Tliver sometimes becomes very troublesome to phthisicky patientsin consequence of frequent paroxysms of hyperaemia.The skin does not show any special symptoms ; it is pale andsometimes exhibits a yellowish tint. The fatal termination is somtimes preceded by a painful decubitus. At an early period of thedisease the muscles begin to show symptoms of atrophy. A characteristic sign of phthisis is the bulbous thickening of the firsphalanges ; most likely this change takes place because the endsthe fingers do not participate in the general emaciation.What is peculiar is, that in most consumptives the sexual passionis very much excited, especially in the case of men, and that thevirile power continues so long unimpaired in spite of the generalemaciation. The menses remain natural for a long time ; if theycease, death may positively be expected within a few months. Theurinary secretions do not undergo any abnormal changes ; if colliquative sweats break out, the urine is of course diminished.668 Constitutional Diseases without Definite Infection.Infiltrated tubercles are seldom met with, except in the lungs.This form of tuberculosis develops itself from pneumonia, seldomfrom pleuritis with firm exudation. The inflammatory exudationis not reabsorbed, but transformed into tubercular matter whichshows an extraordinary tendency to suppurate; the course of thedisease is very seldom protracted. The transformation into tubercular matter generally takes place while tubercular deposits alreexist ; but it may likewise take place in ,the case of individualwho had never shown any signs of constitutional tuberculosis.A pneumonia setting in with S4ich peculiar symptoms, may runa perfectly normal course at first; or else, symptoms of adynamiamay show themselves at the outset, more particularly a very rapidpulse which does not show any change on the critical days, and anexceedingly exhausting diarrhoea. Not unfrequently the infiltratiis observed to take place at intervals. Most usually tubercularhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 561 of 653pneumonia is met with in the upper lobes of the lungs. It tendsto rapid destruction of the parenchyma, to pneumothorax, and tofistulous openings through the chest-walls. In other respects itdevelops the same phenomena as chronic miliary tuberculosis whilerapidly running its course.Acute miliary tuberculosis attacks simultaneously every nobleorgan in the body. It rarely ever breaks out in individuals who sfar had enjoyed a seemingly perfect health, more commonly afteracute, debilitating diseases, but most generally it sets in as anation of chronic miliary tuberculosis.The symptoms of this form are entirely like those of a violentattack of typhus, with which the disease might be confounded somuch more easily as it likewise runs its course by stages of sevedays. It generally sets in with violent vomiting ; after the cessof the vomiting there is loss of consciousness, and the other symtoms characterizing hydrocephalus to which we therefore refer.Treatment and ProffnoHs* Although the prognosis intubercular diseases is absolutely unfavorable ; although the prosof a tubercular disease that had been diagnosed with positive certainty, is very slim, yet the labor of ia, physician in this direis not without reward, since it may be in his power to postpone tfatal termination. Professional aid becomes still more important,if it is tendered at a period when the tubercular disease was stihidden, or had emerged into light with sufficient distinctness torecognized in its true character with a tolerably reliable degreecertainty. Although success cannot be positively promised at thisTuberculosis. 669period, yet it is our opinion that the formation of tubercles caneither be prevented, or that their further development can be staAfter all, the case may perhaps be the same as that of other acutor chronic diseases which only become incurable after they are tofar advanced. Unfortunately the aid of the physician is not soughuntil the suppurative process has already set in, in other words,the stage of phthisis, when help is exceedingly doubtful.It cannot be denied that tuberculosis is curable at any periodduring its course, although such a result happens very seldom afthectic fever has set in, and more particularly after the tuberculprocess has invaded the intestines and the larynx. For this reasono case shonld at once be abandoned as beyond the reach of successful treatment. A complete cure, that is, a complete reabsorption of the tubercular deposits, indeed cannot be expected ; remnants of the disease will remain, and a new outbreak may takeplace at any time.What we have said shows that the treatment must aim at threeobjects: preventive treatment, the treatment of tuberculosis as aconstitutional disease, and the treatment of the acute intercurreexacerbations and their most prominent symptoms.The preventive treatment has to embrace a vast range, if it is tobe of any use. Inasmuch as mistakes in the first education and caof children may promote, if not originate, scrofulosis, and inasmhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 562 of 653as scrofulosis may easily terminate in tuberculosis, the means ofprevention must necessarily go back to the first years of childhoA correct mode of living from the earliest infancy is an excellenpreventive against the dreaded disease; every physician should seto it that physical laws are properly obeyed in the rearing of chdren, for this will at the same time prevent a legion of other diA physician's duties in this respect are so much more sacred as smany false customs and wrong maxims have been grafted upon theeducation of the young by the present age. Unfortunately it cannot be denied that physicians pay too little attention to the firdevelopment of childhood, and that they confine their solicitudemuch more to the treatment of existing diseases than to theirvention. Of course, preventing diseases does not pay. We havenot space to exhaust the whole subject of prevention ; hence wehave to limit ourselves to a statement of the most essential poinThe diet should be regulated in accordance with the principleswhich are more and more universally recognized as correct. Aboveall, during the first two years the nourishment should principall670 Constitutional Diseases without Definite Infection.be milk ; afterwards other easily digested articles of diet may badded in suitable quantity and order. Potatoes should not by anymeans constitute the chief nourishment of children, nor should thbe fed, as has been the custom, with milk and farinaceous preparations. But not only the quality, also the quantity of the food,which should moreover be supplied at regular intervals, should haour careful attention. It may seem a small matter for a physicianto bother about such trifles, when the children are robust andhealthy, but it is not a small matter ; on the contrary, it is aof great importance. Beside proper diet, a salubrious home, freshair, exercise and cleanliness must likewise be provided for the lones. The mental culture is likewise of the utmost importance.Daily experience shows that precocious development and continuedmental exertions render children irritable, make them look pale,deprive them of their appetite, and predispose them for all sortsbodily sufferings. These symptoms show themselves, already inthe seventh year, but still more at the age of pubescence, particularly among females. How many individuals fall victims at aaearly age to an unreasonable and precocious mania for acquiringknowledge ! The only means of counteracting the absurd claimsof our schools is gymnastics in all its forms, especially if it lparticular stress upon the cultivation of the respiratory musclesbut not by imitating the modern plan of practising necktours-de-force,and straining the muscles to the outermost limitsproper system of hardening children should likewise be pursuedwith a view of rendering them capable at an early period of beariabrupt changes of temperature without being made sick by theexposure.If it is proper that all these rules should be enforced in the edcation of every child, it is still more important that they shoulstrictly carried out in the case of scrofulous children or childrborn of tuberculous parents.At the age of pubescence all the signs denoting the accession oftuberculosis, become more apparent, and the tuberculous habit frequently shows its peculiar characteristics at an early age. To thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 563 of 653above-stated rules a few other important rules may be added. Inthe first place the young people must be taught to breathe propernot merely with one portion of the respiratory muscles. Kothingis more conducive to this end than early singing lessons taking cto pay particular attention to a correct practice of the middle nIt is less important that young people should be invited to perfoTuberculosis. 671frequent and deep inspirations, and slow expirations ; Buch instrtione are too easily forgotten. It is during this period of develment that gymnastics perform real miracles ; chamber-gymnasticsin particular becomes an invaluable aid in the harmonious development of the muscles. However, in practising with the arms, heavy^^eighta must not be used. The dress, likewise, deserves our attetion ; it should be of such a style as not to interfere with thedom of respiration. If a catarrh occurs, it must not be neglectedchlorosis should likewise be carefully attended to. In selectingtrade or a profession, male individuals should avoid such as areknown to favor the development of tuberculosis. Women shouldbe cautioned against reckless dancing and the continued applicatito work that requires constant sitting.A rigid prophylactic treatment is likewise necessary if symptomsof tubercles have broken out, and if the tendency to catarrh hasthe same time become very prominent. Whatever involves an increased activity on the part of the lungs, such as running, dancicontinued talking in large crowds, hurried going upstairs or asceing an eminence, should be strictly avoided at this stage; so shoanything that interferes with the action of the lungs, such as cotinued stooping in a sitting posture, tight clothing, etc. The panow ought to practice deep inspirations ; a substantial, but simpdiet, without any artificial stimulants, is Ukewise indispensablebeing of essential importance that the patient should avoid allopportunities of being attacked with acute catarrh, he will haveavoid keen and cold winds, and provide himself with a respirator,the usefulness of which has not yet been sufficiently recognized.The damper the atmosphere of the place where the patient resides,the more important it is that he should wear flannel undershirtsthis rule applies more particularly to the female sex. A sojourncrowded rooms that are lighted with gas, and in damp and mustychurches is exceedingly prejudicial. Proper ventilation and a moderate heating of the rooms should not escape our attention. At thperiod the food should be more simple and of a more digestiblequality than ever; animal food deserves a decided preference. Milnow commends itself as an excellent nourishment, provided thepatients are able to bear it, which is unfortunately not always tcase. We should be led too far if we would enumerate all the particulars concerning diet and hygiene ; indeed, strict rules cannoalways be enforced, the physician has to accommodate himself tothe circumstances of the patient, and has to blink at a good many672 Constitutional Diseases without Definite Infection.omissions. We must insist, however, that a woman suspected oftuberculosis, should never nurse her children at the breast. It bhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 564 of 653hooves us likewise to direct attention to the circumstance that tmental labor and the mood and disposition of the patient are of tutmost importance to the course of the disease. We doubt whethergrief and care can cause tubercles, but what is absolutely certaithat depression of spirits, sorrow and care, and continued chagriaccelerate the course of tuberculosis, and that a good deal of metal excitement likewise exerts a pernicious influence. Even a chafor a few weeks only from their usual surroundings to a quiet andpleasant retreat, aflects the patients beneficiently.What we have said shows how much importance we attach to acorrectly-understood preventive treatment. Various medicines arelikewise of importance during the course of occult tuberculosis;however, they need not be mentioned in this place, since the indications correspond to the most ordinary precursors of tuberculosinamely chlorosis and scrofulosis, under which respective heads thmedicines and their special indications will be found named.We have now reached the treatment of the fully developed tubercular disease. This treatment, of course, has to be chiefly medicnal, although the above stated dietetic rules should be continuedin all their force. It is diflBicult to furnish full and precisetion in this direction ; in the first place the groups of symptomare too manifold, and in the second place it is next to impossibldraw positive conclusions from clinical cases, for the reason thathe same remedy which helped in one case and eftected a brilliantcure, showed itself perfectly ineffectual in another, apparentlyilar case. We do not intend to supersede the Materia Medica byfurnishing symptomatic groups, and therefore prefer giving merenames, referring to the Materia Medica for the symptomatic detailBronchial catarrhs that break out as an acute disease, and afterwards assume a chronic form, first claim our attention. Their rapcure is of immense importance to the course of the whole disease.As soon as we have ascertained tliat a person attacked with catarhas tubercles, we must in the first place insist upon the patientremaining confined to his room, the temperature of which shouldbe uniformly kept at about 60° F. On the other hand, such patientshould not be all at once confined to their beds. Aconitum whichsuitable in catarrh generally, is still more adapted to tuberculabronchial catarrh commencing with a violent fever which is characterized by great heat without much perspiration. Upon the whole,Tuberculosis. 673however, we prefer BeUoffonna in this form of broncliial catarrhwell as in simple bronchitis; for particular indications we referour remarks in the chapter on acute bronchitis. Belladonna is notonly adapted to cases with high fever, but likewise to cases withmuch fever; no remedy is as effectual in moderating the constantltormenting cough as Belladonna. Bryonia is an excellent remedy,if the patient complains of much lassitude without a great deal ohigh fever; the drawing-stitching pains in one apex of the lungsand the pains in the arm corresponding with this part of the lungor tearing through all the limbs, are likewise complained of; Bryonia is seldom of any use in the subsequent course of the catarrhDigitalis has rendered us excellent service for some years past isimilar cases as those for which Bryonia is indicated ; only if Dhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 565 of 653talis is to help, the cough must not be dry. It has seemed to usthat this remedy arrests, or else reduces the cough very greatlymore speedily than any other remedy. Spongia is an excellentremedy if the catarrh commences with obstinate hoarseness, thecough remains for a long time dry and barking, spasmodic, attendewith congestive sensations in the chest and asthmatic complaints.Bromine is symptomatically very similar to tubercular catarrh ;however, the clinical results that have so far been obtained withBromine, are not yet very numerous. Pulsatilla is indicated ifnothing remains of the catarrh but a racking cough vnih scantyexpectoration of mucus. For other remedies we refer to diseasesof the lungs.If, instead of breaking out with acute catarrh, tuberculosis breaout with bloody cough, we have to depend particularly upon threeremedies, namely Aconite^ Arnica and Digitalis^ the symptomaticindications of which can easily be studied in the Materia Medica.If the treatment of these initial affections has left no doubt inour minds that we have to deal with tuberculosis, it then behooveUS to treat the disease as a whole, without, however, neglectingsymptomatic appearances. It would be a great mistake, however,if after the catarrh is fortunately subdued, we were now to pursuan exclusively symptomatic treatment.The patient may seem ever so well, yet he must still be treatedas if he were sick. His whole mode of living must be strictly conformable to the rules which we have laid down ; a consistent andpersevering enforcement of these rules is the snrest guarantee fothe prevention of new and the calcification of existing tuberculadeposits. The only medicines that can now come to the support43674 Constitutional Diseases without Definite Infection.of the hygienic means, are Ferrum and Calcarea carbonica. Femim,whether it is used as a medicinal preparation or as mineral waterhas to be administered with a good deal of caution. If the patienshow an extreme disposition to pulmonary hypergemia, they arevery sensitive to the action of Iron ; any dose of unusual size etheir circulation and makes them cough up blood. Since this resulis principally owing to the dose, we have a ready explanation whythe Old School has been so averse to prescribing Iron in tuberculIf it is given in small doses, not below the second trituration,shall very speedily notice good eflfects from the drug, if it isistered for the following symptoms and conditions : Pale complexiwith disposition to a change of color, or with a yellowish tint ;deficient appetite, or perverse cravings, with disposition to paithe stomach, and constipation ; frequent palpitations of the hearand transitory congestions of the lungs ; disproportionate musculdebility; lassitude from the least unusual motion; irritability otemper excited by the least unpleasant impressions. The indicatiofor Calcarea do not differ much from those of Iron. The patientshave a florid appearance, their cheeks are very much flushed, theskin being at the same time very delicate ; they are apt to complof congestive headache; they have an excitable disposition andhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 566 of 653sanguine temperament ; at times they digest their food very regularly, at other times they are troubled with diarrhoea ; unless tare under some special excitement, the patients complain of weakness, although, when in pleasant company, no sign of weakness isperceptible ; the sexual system is very active, the menses are prfuse and set in prematurely and with acute pains.Under the operation of these two drugs, the use of which oughtto be discontinued sometimes for a week at a time, we sometimessee the whole disease arrested or even retrograde ; of course, thpatients have to be very particular in observing the strictest diWe need not suppose that these two remedies produce their favorable effect simply by promoting the general nutrition, since theyoften effect a favorable change even at a later stage of the diseChina and Arsenicum are two remedies that can likewise be usedat the beginning of the tuberculous process, although they are lereliable than the former. China is indicated if the pulmonary afftion seems to constitute the whole diflSiculty, but still more, icommences with the symptoms of a severe hyperemia of the liver,and if the patients very soon show a cachectic appearance. It iswell known how often pains in the liver constitute symptoms ofTuberculosis. 675tuberculosis, and how often such patients were formerly sent toCarlsbad to return home again in a dying condition. Arsenicumalbum has only been employed by us for tuberculosis in the last fyears; the cases where Arsenicum is indicated, are too few to enaus to express a positive opinion on its therapeutic value at thistime. So far we have found the remedy of use in cases of tuberculosis with almost typical, long-lasting paroxysms of coughattended with retching, and vomiting of small quantities of tenacious mucus, succeeded in a few days by an easy expectoration ofthe above-mentioned sago-like little lumps. The paroxysms ofcough are ushered in with a sensation like violent asthma and areaccompanied by severe dyspnoea. The general health is not asmuch impaired as the violent cough might lead one to expect.This so-called first stage of tuberculosis, that is, the period wthe tubercular deposits have n6t yet commenced to suppurate, isthe time when a cure of the disease can be hoped for with somecertainty. Unfortunately this stage is too often overlooked by thpatient as well as by the physician. To the above-mentioned remdies which have to be exhibited for months, a number of otherremedies have to be added that we require to use for the removalof all the trifling inconveniences inherent in the disease. Thisof the highest importance lest the nutrition of the organism shoube impaired beyond what it necessarily will be by the tubercularprocess. We cannot go into details in this particular. Codoil, a change of climate, and other methods of cure will be treatof by and by.After the supervention of the suppurative stage, the medicinaltreatment has to be considerably modified. We now have to meettwo indications, the necessity of preventing the further depositiof tubercular matter, and, secondly, of circumscribing its puruledissolution. We need hardly state that the prognosis now is muchhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 567 of 653more unfavorable than previously. To the remedies that have justbeen named, we now have to add a number of others actingdirectly upon the local process. The use of Ferrum, at this stagerequires still more caution than before. Other remedies are:lodium^ Phosphorus^ Kali carbon.^ Hepar sulphuris calc.^ Silicea^Digitalis^ Plumbum^ Cuprum and Natrum muriaticum. All theseremedies seem to have a marvelous effect in some cases, whereas iapparently similar cases they leave us in the lurch, so that it iceedingly difficult to establish positive indications from clinicresults. We omit them so much more readily as the slow course of676 Constitutional Diseases without Definite Infection.the disease afFords plenty of time to consult the Materia Medicafor special symptoms. A few hints will, therefore, prove sufficient.lodium is undoubtedly one of our most important remedies inconfirmed phthisis ; it only suits, however, after the expectorathas become purulent. This remedy effects, more frequently thanany other, curative results, provided we do not obstinately insisupon giving only small doses. Iodine 6 sometimes has a good effecbut Iodine 1 is often indispensable, nor need any unpleasant effebe apprehended from the use of such large doses. lodium is moreparticularly indicated if tuberculosis is the result of scrofulosthe case of young and robust individuals ; if diarrhoea is presenIodine does not act favorably as a rule.Kali carbonicum has, beside the general symptoms of phthisis, acharacteristically persistent, sharp-s'titching pain at a circumsspot in the chest. Unfortunately this remedy often disappointsour expectations.Hepar sulphuris oalc. is particularly suitable if the disease thrto run rapidly to a fatal termination ; a severe fever sets in atonset, the cough is rather dry, although the patients themselveshear a rattling and wheezing in the lungs; scrofulosis had precedthe tuberculosis. Violent diarrhoea contra-indicates Hepar.SHicea is only suitable for the slow phthisis of old people ; itseffect is questionable.Phosphorus, according to our own experience, is less adapted tophthisis as a whole than to single symptoms. It has to be usedwith caution, for no other medicine causes hsemoptoe as easily asPhosphorus ; no other medicine disagrees so completely in the lonrun. The chief indications for Phosphorus are : Continued hoarseness, with a distressing, dry cough, sore feeling in the larynx atrachea ; pain in the stomach after every meal, also retching andvomiting of mucus ; continual diarrhoea, which is excited by eating, after every meal ; excessive excitement of the sexual passioPlumbum ought to be used more frequently than has yet been thecase; the dose must neither be too weak, nor too strong. It sometimes has a good effect after every other remedy has disappointedus, more particularly if there are considerable vomicse, and thepatient is tormented by copious, watery diarrhoeic stools accompanied by severe pain.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 568 of 653Cuprum deserves our commendation in florid or galloping phthisisTuberculosis. 677its symptomB are bo Btriking that we limit ourselves to referringthe reader to the Materia Medica.Digitalis purpurea is, like Cuprum, particularly adapted to galloing phthisis with intense hectic fever from the commencement ; thpatient complains of palpitation of the heart, coughs up blood frquently, has no appetite ; the bowels are constipated and the pulis exceedingly quick. Digitalis is the most reliable remedy tomoderate the hectic fever, but the dose must not be too small. Noshould the dose be excessively large, because large doses are aptexcite the patient.Natrum muriatlcum is only useful in chronic cases, attended withsevere disturbances of the cardiac functions.IMillefolium is an important domestic remedy for tuberculosis.Our provings point to it as such, but clinical results are stillwanting.Sulphur, which is too often mentioned as a remedy for phthisis, inot, in our opinion, adapted to a single case of this disease ; whave used it frequently, but have never seen it do any good ; wheit is said to have produced a good effect, chronic pneumonia hasprobably been confounded with tuberculosis.Concerning the best method of applying all these drugs in practice, views differ considerably. The more striking these differenare, the more earnestly we recommend the golden mean not only inrespect to^the size, but likewise in respect to the repetition ofdose. The attenuations from the third to the sixth are generallysufficient; lower attenuations are scarcely ever necessary, higheones are unreliable. We do not like to give more than one dose aday of the appropriate remedy, sometimes only one dose every twoor three days. If a remedy has once been selected, it should notgiven up too soon ; if the improvement under it seems to stand sta lower attenuation had better be used before the medicine isentirely abandoned. If this should have been found necessary, andthe remedy that is chosen after the former, likewise proves ineffectual, it may be well to return once more to the last remedy thseemed to improve the case. A change of this kind sometimes hasa very good effect. We would likewise warn against a medicinebeing given for every little symptom and a strictly symptomatictreatment being indulged in. This is decidedly injurious and maydefeat all chances of a successful termination.This now leads us to mention a few remedies that are not contained in our Materia Medica Pura. As regards Cod-liver oil, even678 Constitutional Diseases without Definite Infection.the PhyBiological School admits that it acts well in phthisis. Thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 569 of 653Iodine it contains being present only in a very small quantity, tboldest conclusions were resorted to for the purpose of substantiing the theory that the oil alone is the curative agent. That thitheory is erroneous, can easily be shown by some other oil beingsubstituted for cod-liver oil ; the same effect will not be obtaiThe small quantity of Iodine is suflScient for the homceopath toaccount for the action of the oiL That it should be used withcaution, has already been stated at the conclusiJh of our chapteron scrofulosis ; the same maxims that were laid down on that occasion, are likewise applicable to phthisis, so much more as it isdecidedly injurious to phthisicky patients to have their appetitedisturbed and their normal digestion interfered with. The doseshould likewise be carefully measured; a tablespoonful in themorning is sufficient, two spoonfuls at a time are a very big dosIt is decidedly improper to prescribe a spoonful morning and evening. A morning-dose is sufficient ; in the evening the oil disagrwith most persons. No other medicine should be given with codliver oil.Whey-cures which have found great favor with many, have agreat deal against them in cases of perfectly develoi)ed phthisisthey render the stomach very sensitive. For our own part, weprefer the therapeutic use of milk, provided the same rigid dietpursued in connection with a milk-cure that is indispensable whena whey-cure is pursued. Milk does not agree, if the patients induat the same time in a luxurious mode of living, and a highlyseasoned diet. Nor should it be overlooked that milk is a verysubstantial kind of nourishment, and that hence it should not beused as a mere beverage, but should be taken in the place of othefood, as a regular meal.Mineral-waters are highly recommended for tuberculosis, but wemust confess that we are not acquainted with a single kind thateffects only a tolerably favorable change. The weak chalybeatesprings sometimes render good service in the same manner as medicinal preparations of Iron ; only they have to be used with greatcaution. In other respects spas are not more beneficial than asojourn in a beautiful country, accompanied by a suitable mode ofliving generally.A prolonged stay in an elevated region of country has undoubtedly a directly healing influence over phthisis, although the curseldom complete. We believe that living in a mid-mountain atmosTuberculosis, 679phere is better than all climatic cure-places; it facilitates resincreases the capacity of the lungs, and hardens the organism generally. The unusual results obtained by Dr. Brehmer in Gorbersdorf abundantly testify to the excellence of his curative methodwhich is entirely based upon the action of attenuated atmosphericair. No physician should leave these results unnoticed, since itbe possible to send the patient into a high region of country witout changing the climate to which he is habituated.We do not think much of systematic cure-places, such as Cairo,Madeira, Algiers, Pisa, Venice, Nice, Meran, etc. ; they never exa directly curative influence, but are only useful by preventinghttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 570 of 653frequent return of acute catarrhs. Madeira, on account of the seaair, and Meran, on account of its high situation, deserve mostcommendation. As a rule, climatic cure-places act the less favorably the more their climate difters from that to which the patienhas been accustomed. After his return home, he is so much moresusceptible to colds ; a Southern climate could only be preferredprovided the patient intends to make it his permanent residence.Unfortunately this is impossible for a large majority of tuberculpatients. Above all, patients already far gone in consumption,should not be sent away far from home.The remedies and general measures which we have proposed fora direct cure of tuberculosis and phthisis, even though it is soimpossible to employ them, or though they can only be employedon a limited scale, should never be omitted even in apparently holess cases. We can point to three patients who seemed to be onthe point of death, and who suddenly improved and lived for anumber of years in tolerable health.It remains for us to devote a few words to the symptomatictreatment of a few straggling symptoms. Leaving a direct cureout of the question, it is so much more important to speedily remsingle disturbances the less they are connected with the usual coof tuberculosis ; moreover, the duty of rendering the patient's efrom life as easy as possible, imposes upon us the other duty ofsometimes resorting to a purely symptomatic treatment. In thefollowing paragraphs we will give a few hints with reference tothis subject.The cough generally causes the greatest distress to the patients,leaving them no rest. At the beginning of phthisis, when thepatient is constantly teased with a dry cough and dyspnoea, Belladonna usually has a very excellent effect. In the later course of680 Constitutional Diseases without Definite Infection.the disease, after suppuration had really set in, we have obtainespeedy and real relief by means of small doses of Morphine, onetwentieth or one-fiftieth of a grain at a dose, nor have we everhesitated to avail ourselves of the narcotic proj)ertie8 of thisCannabis is exceedingly unreliable. For a cough with a copious,fetid expectoration, Carbo vegeL often proves a most excellentremedy.Hectic fever never requires special remedies; it is a necessaryattribute of florid phthisis.Haemoptysis has to be stopped as soon as possible, not only onaccount of the anxiety of the patient, but of the loss of blood.Aconitum, Arnica^ Digitalis, Ipecacuanha, Belladonna sometimesarrest it very speedily ; if they do not, and the loss of blood igreat and threatening, a small teaspoonful of table-salt may beadministered ; this will sometimes efiect an immediate stoppage othe hemorrhage.The laryngeal diflSculties are purely symptomatic ; they do notyield to any medicine.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 571 of 653For violent headache which deprives the patient of sleep, DigUtalis and Arsenicum are excellent remedies.The gastric derangements are manifold ; they are most distressingif every time the patient partakes of a little nourishment, he exriences pain in the stomach, nausea, retching, vomiting. For suchsymptoms Ferrum generally acts as a specific remedy. Arsenicum^Iodine, Kreosotum likewise deserve our attention.Diarrhaea, when not occasioned by intestinal tubercles, is treateaccording to the usual rules. If it assumes a tuberculous charactPhosphorus and Phosphori acidum. Ipecac., Calcarea acetica and phphorica are the proper remedies.Pulmonary hyperaemia generally yields to Aconite; Belladonnaand Kali nitricum, likewise Arnica may prove useful for such acondition.Infiltrated tuberculosis is treated according to the same principas miliary tuberculosis ; lodium is a very important remedy in thdisease, likewise Lycopodium and Sulphur, together with PAo*phorus.Acute miliary tuberculosis generally defies every attempt to cureit, so much more as it is generally very diflicult to diagnose itcertainty. Verat, alb.. Digitalis, Cuprum, Tartarus stibiatus. Phphorus may be tried, but the experiment will generally provefruitless.Constitutional Plethora. 681In conclusion we will mention a few remedies that are variouslyrecommended for tuberculosis ; at times for the disease in its toand sometimes for single symptoms; these remedies are : KreosotunKali hydriodicum^ Stannum^ Ledum^ Manganum^ Baryta^ Alumina^Causiicum. This number might still be increased, if we couldimagine every possible change in advance, and every occurrencethat might complicate or interrupt the course of tuberculosis. Inview of so many changeable and diversified groups of symptoms,all that we could well be expected to do was, to explain* the genprinciples upon which the treatment of the disease should beconducted.As regards diet, we need not dwell upon it any further ; it resulfrom what we have said when speaking of the prophylactic treatment and the etiological causes of the disease.The following chapters, referring more particularly to the bloodand the sphere of nutrition, are taken from the last number ofKafka's second volume.9« Constltatlonal Plethora, Polycemla, Hjrperceinia.[The volume of blood is increased; this increase of the volumeof the blood involves a proportionate increase of the number ofblood-corpuscles and of the albumen. It is true that many modemhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 572 of 653pathologists deny the existence of plethora ; they maintain thatnobody has too much blood and that plethora most commonlydepends upon an augmentation of the red corpuscles or upon anincreased quantity of the fibrin in the blood. But daily experienteaches us that a constitutional hypersemia does occur, althoughnot very frequently, and that it represents a derangement whichoccasions morbid symptoms.A constitutional plethora most frequently occurs in the case ofyoung people who, having a good and active digestion, consume aquantity of meat and other protein material, without taking muchexercise. It is likewise observed in the case of older persons whwhile appropriating a large supply of food, lead a sedentary orindolent mode of life. It is not unfrequently the consequence ofsuppressed flow of blood, such as Ihe menstrual or hemorrhoidalflow, etc., and is frequently coincident with a peculiar plethoriconstitution, the influence of climate or the seasons.672 Constitutional Diseases without Definite Infection.omissions. We must insist, however, that a woman suspected oftuberculosis, should never nurse her children at the breast. It bhooves us likewise to direct attention to the circumstance that tmental labor and the mood and disposition of the patient are of tutmost importance to the course of the disease. We doubt whethergrief and care can cause tubercles, but what is absolutely certaithat depression of spirits, sorrow and care, and continued chagriaccelerate the course of tuberculosis, and that a good deal of metal excitement likewise exerts a pernicious influence. Even a chafor a few weeks only from their usual surroundings to a quiet andpleasant retreat, aftects the patients beneficiently.What we have said shows how much importance we attach to acorrectly-understood preventive treatment. Various medicines arelikewise of importance during the course of occult tuberculosis;however, they need not be mentioned in this place, since the indications correspond to the most ordinary precursors of tuberculosinamely chlorosis and scrofulosis, under which respective heads thmedicines and their special indications will be found named.We have now reached the treatment of the fully developed tubercular disease. This treatment, of course, has to be chiefly medicnal, although the above stated dietetic rules should be continuedin all their force. It is difficult to furnish full and precise ition in this direction ; in the first place the groups of symptomare too manifold, and in the second place it is next to impossibldraw positive conclusions from clinical cases, for the reason thathe same remedy which helped in one case and eftected a brilliantcure, showed itself perfectly ineffectual in another, apparentlyilar case. We do not intend to supersede the Materia Medica byfurnishing symptomatic groups, and therefore prefer giving merenames, referring to the Materia Medica for the symptomatic detailBronchial catarrhs that break out as an acute disease, and afterwards assume a chronic form, first claim our attention. Their rapcure is of immense importance to the course of the whole disease.As soon as we have ascertained tliat a person attacked with catarhas tubercles, we must in the first place insist upon the patienthttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 573 of 653remaining confined to his room, the temperature of which shouldbe uniformly kept at about 60° F. On the other hand, such patientshould not be all at once confined to their beds. Aconitum whichsuitable in catarrh generally, is still more adapted to tuberculabronchial catarrh commencing with a violent fever which is characterized by great heat without much perspiration. Upon the whole,Tuberculosis, 678however, we prefer Belladonna in this form of bronchial catarrh awell as in simple bronchitis ; for particular indications we refeour remarks in the chapter on acute bronchitis. Belladonna is notonly adapted to cases with high fever, but likewise to cases withmuch fever ; no remedy is as effectual in moderating the constanttormenting cough as Belladonna. Bryonia is an excellent remedy,if the patient complains of much lassitude without a great deal ohigh fever ; the drawing-stitching pains in one apex of the lungsand the pains in the arm corresponding with this part of the lungor tearing through all the limbs, are likewise complained of; Bryonia is seldom of any use in the subsequent course of the catarrhJDigitalis has rendered us excellent service for some years pastsimilar cases as those for which Bryonia is indicated ; only if Dtalis is to help, the cough must not be dry. It has seemed to usthat this remedy arrests, or else reduces the cough very greatlymore speedily than any other remedy. Spongia is an excellentremedy if the catarrh commences with obstinate hoarseness, thecough remains for a long time dry and barking, spasmodic, attendewith congestive sensations in the chest and asthmatic complaints.Bromine is symptomatically very similar to tubercular catarrh ;however, the clinical results that have so far been obtained withBromine, are not yet very numerous. Pulsatilla is indicated ifnothing remains of the catarrh but a racking cough wnth scantyexpectoration of mucus. For other remedies we refer to diseasesof the lungs.If, instead of breaking out with acute catarrh, tuberculosis breaout with bloody cough, we have to depend particularly upon threeremedies, namely Aconite^ Arnica and Digitalis^ the symptomaticindications of which can easily be studied in the Materia Medica.If the treatment of these initial affections has left no doubt inour minds that we have to deal with tuberculosis, it then behoovens to treat the disease as a whole, without, however, neglectingsymptomatic appearances. It would be a great mistake, however,if after the catarrh is fortunately subdued, we were now to pursuan exclusively symptomatic treatment.The patient may seem ever so well, yet he must still be treatedas if he were sick. His whole mode of living must be strictly conformable to the rules which we have laid down ; a consistent andpersevering enforcement of these rules is the surest guarantee fothe prevention of new and the calcification of existing tuberculadeposits. The only medicines that can now come to the support43http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 574 of 653674 Constitutional Diseases without Definite Infection.of the hygienic means, are Ferrum and Calcarea carbonica. Femim,whether it is used as a medicinal preparation or as mineral waterhas to be administered with a good deal of caution. If the patienshow an extreme disposition to pulmonary hypersemia, they arevery sensitive to the action of Iron ; any dose of unusual size etheir circulation and makes them cough up blood. Since this resulis principally owing to the dose, we have a ready explanation whythe Old School has been so averse to prescribing Iron in tuberculIf it is given in small doses, not below the second trituration,shall very speedily notice good effects from the drug, if it is aistered for the following symptoms and conditions : Pale complexiwith disposition to a change of color, or with a yellowish tint ;deficient appetite, or perverse cravings, with disposition to paithe stomach, and constipation ; frequent palpitations of the hearand transitory congestions of the lungs ; disproportionate musculdebility; lassitude from the least unusual motion; irritability otemper excited by the least unpleasant impressions. The indicatiofor Calcarea do not differ much from those of Iron. The patientshave a florid appearance, their cheeks are very much flushed, theskin being at the same time very delicate; they are apt to complaof congestive headache; they have an excitable disposition andsanguine temperament ; at times they digest their food very regularly, at other times they are troubled with diarrhoea ; unless tare under some special excitement, the patients complain of weakness, although, when in pleasant company, no sign of weakness isperceptible ; the sexual system is very active, the menses are prfuse and set in prematurely and with acute pains.Under the operation of these two drugs, the use of which oughtto be discontinued sometimes for a week at a time, we sometimessee the whole disease arrested or even retrograde ; of course, thpatients have to be very particular in observing the strictest diWe need not suppose that these two remedies produce their favorable effect simply by promoting the general nutrition, since theyoften effect a favorable change even at a later stage of the diseChina and Arsenicum are two remedies that can likewise be usedat the beginning of the tuberculous process, although they are lereliable than the former. China is indicated if the pulmonary afftion seems to constitute the whole difficulty, but still more, ifcommences with the symptoms of a severe hypersemia of the liver,and if the patients very soon show a cachectic appearance. It iawell known how often pains in the liver constitute symptoms ofTuberculosis. 675tuberculosis, and liow often such patients were formerly sent toCarlsbad to return home again in a dying condition. Arsenicumalbum has only been employed by us for tuberculosis in the last fyears; the cases where Arsenicum is indicated, are too few to enans to express a positive opinion on its therapeutic value at thistime. So far we have found the remedy of use in cases of tuberculosis with almost typical, long-lasting paroxysms of coughattended with retching, and vomiting of small quantities of tenacious mucus, succeeded in a few days by an easy expectoration ofhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 575 of 653the above-mentioned sago-like little lumps. The paroxysms ofcough are ushered in with a sensation like violent asthma and areaccompanied by severe dyspnoea. The general health is not asmuch impaired as the violent cough might lead one to expect.This so-called first stage of tuberculosis, that is, the period wthe tubercular deposits have not yet commenced to suppurate, isthe time when a cure of the disease can be hoped for with somecertainty. Unfortunately this stage is too often overlooked by thpatient as well as by the physician. To the above-mentioned remdies which have to be exhibited for months, a number of otherremedies have to be added that we require to use for the removalof all the trifling inconveniences inherent in the disease. Thisof the highest importance lest the nutrition of the organism shoube impaired beyond what it necessarily will be by the tubercularprocess. We cannot go into details in this particular. Codoil, a change of climate, and other methods of cure will be treatof by and by.After the supervention of the suppurative stage, the medicinaltreatment has to be considerably modified. We now have to meettwo indications, the necessity of preventing the further depositiof tubercular matter, and, secondly, of circumscribing its puruledissolution. We need hardly state that the prognosis now is muchmore unfavorable than previously. To the remedies that have justbeen named, we now have to add a number of others actingdirectly upon the local process. The use of Ferrum^ at this stagerequires still more caution than before. Other remedies are:lodium^ Phosphorus^ Kali carbon,^ Hepar sulphuris ccUc.^ Silicea^Digitalis^ Plumbum^ Cuprum and Natrum muriaticum. All theseremedies seem to have a marvelous effect in some cases, whereas iapparently similar cases they leave us in the lurch, so that it iceedingly diflicult to establish positive indications from clinicresults. We omit them so much more readily as the slow course of686 • Polyaemia, Hyperaemia.pnoea, oppression of the chest, a dry and tight cough, and dangerof pneumonia or hsemoptoe are present.If the patients have become very much excited by mental labor,committing to memory, by anger or vexation, abuse of spirits, orhave indulged in over-eating or luxurious living; if they complaiof pressure in the frontal region, with nausea or actual saburralvomiting ; if the tongue has a yellowish coating, the taste is soor pasty; if the patients are troubled with frequent eructationsdistention of the abdomen ; if they are irritable, irascible, andbowels are torpid, Nux vottl 8 in solution, every hour, will notremove the hyperaemia but likewise the gastric disturbance.Under similar circumstances and for similar symptoms, Carboveg. 6 or Calc. carb. 6 may likewise prove useful.The last-named remedies, to which we add Sulphur 6, rendergood service for general plethora superinduced by the suppressionof habitual hemorrhoids; if arising from menstrual suppression,we resort to Gonium^ Digitalis or Crocus 8.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 576 of 653These statements, which are suggested by daily practice, aresimply intended to show the manner in which we avail ourselves ofthe results of our physiological provings. These statements do noby any means present an exhaustive discussion of the subject, anddo not obviate the necessity, in extraordinary cases, of studyingthe Materia Medica with special reference to a given case, sincewe have many other remedies, such as Mercur.^ Hepar sidph.y Rhu^tox.^ Lycop.y Sepia^ Tart, emet.y Ibdium^ etc., which are capableremoving a general plethora.Regarding the diet, we recommend to plethoric individuals theuse of vegetables, abstinence from spirits and heating beverages,daily exercise in the open air for a couple of hours, avoidance oexciting or depressing emotions, of sedentary habits and protractsleeping.A spurious sort of plethora accompanying emphysema of thelungs, hypertrophy of the left ventricle, insufficiency or stenosthe bicuspid valve, goitre, stenosis of the larynx, has been fulldescribed in the chapters where these diseases are treated of.Kafka relates the case of a lady, seventy years old, with a largeand indurated goitre, in consequence of which she became cyanoticshort-breathed, dyspeptic, very feeble and somnolent. Iodine proving ineffectual for these symptoms, Arsen. 3, three doses a day,was resorted to. In a few days already a decided improvementset in. fi.]Deficiency or rather Paleness of the Blood. 6879. Anieinia, Ollgieinla.Deficiency or rather Paleness of the Mood.[It 18 only true atifiemia, or deficiency of blood consequent upoexcessive losses of this fluid, that consists in a diminution ofquantity of the blood without any simultaneous alteration in thenormal composition of this fluid. Spurious ansemia with which weshall principally deal in this chapter, constitutes a disease ofblood where the number of the red corpuscles is more or lessdiminished, in consequence of which the blood becomes paler andappears variously altered both quantitatively and qualitatively.Hence it is with a qualitative rather than with a quantitativedisease of the blood that we have to deal with, where the deficieof red blood-disks constitutes a characteristic phenomenon, on whaccount it would be more appropriate, according to Vogel, to denominate the disease digocj/thcemia.In a normal condition of the organism, the reproduction of redcorpuscles equilibrates their decay, so that, within certain limithe percentage amount of blood-disks in the blood, and their totaquantity remains unchanged.In diseases, however, this relative proportion is disturbed, so tmore blood-disks decay than are reproduced; hence arises the condition which Vogel denominates oUgocythcemia.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 577 of 653The results of our pathological and anatomical investigationsshow that the blood of ansemic individuals is deficient in red copuscles ; it contains less hsematin and fibrin, but on the otheran excess of serum.The ansemic blood is fluid, pale, the clot is small, soft, floatsa quantity of serum, its specific gravity is diminished ; the cramentum which is sometimes entirely wanting, is less dense andeasily disintegrated.Anaemia is either a primary or secondary morbid process.A constitutional anaemia depends upon certain ante-natal influences or conditions of development; its causes are either unknor not satisfactorily accounted for.It is either congenital, or inherent in the process of developmenor in the period of involution.Congenital anaemia occurs among children of sickly, debilitatedparents or of parents afflicted with anaemia, tuberculosis, consttional syphilis, carcinoma or other exhausting diseases; it occur688 Anaemia, Oligaemia.among children born before their full term, among children bomfeeble, or whose mothers were suffering with uterine diseases orhemorrhages.Ansemia inherent in the period of development either occursduring the first, less frequently during the secdhd dentition, orthe children are weaned, or in consequence of a too rapid growthor at the period of pubescence, more particularly if this periodor is unduly protracted, or if the sexual instinct is awakened prmaturely and is attended with frequent excitement of the fancyand the sexual organs (chlorosis).The ansemia of involution most commonly occurs during thecritical period of females, or during old age, or if marasmus setprematurely.Consecutive anaemia sets in simultaneously with, or in consequence of derangements the causes of which are generally knownand directly diminish the quantity and deteriorate the quality ofthe blood.The quantity of the blood is diminished by acute losses of thisfluid, such as bloodletting, hemorrhages, operations, wounds, andlikewise by frequent attacks of chronic hemorrhage.The quantity and quality of the blood are impaired by losses offluids, as in consequence of catharsis and diarrhoea, continued ofrequent vomiting, profuse suppuration, excessive or too long continued nursing, profuse blennorrhoea and perspiration, ptyalism,copious nocturnal emissions, onanism and other sexual excesses.A loss of strength, such as may arise' Irom excessive muscularexertions, long marches, running, etc., or from hard work, afterhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 578 of 653severe febrile or inflammatory diseases, especially when attendedwith copious serous, plastic, purulent or hemorrhagic exudations;after various acute exanthems, such as measles, scarlatina, varioetc.; after frequent pregnancies occurring at short intervals, anafter frequent miscarriages, etc., may likewise induce a greaterconsumption of red corpuscles than the organism is capable ofreproducing, and may consequently bring about a condition ofansemia.Consecutive anaemia may likewise occur in consequence of aninsufficient production of blood-disks and hseraatin owing to adeficient supply of food or a total deprivation of nourishment byfasting, starvation-cures, or a scanty supply of, or vitiated foobad or stagnant water, unfavorable climatic or atmospheric influences, excessive cold or heat, damp or vitiated air without aN.Deficiency or rather Paleness of the Blood. 689sufficient supply of oxygen, in damp valleys or malarious districon the borders of large rivers where frequent inundations occur ;or in consequence of the inhalation, in mines, of air impregnatedwith carbo-hydrogen or carbonic acid ; or likewise in consequenceof a deficient supply of light in damp cellars serving as humanhabitations, or in consequence of deprivation of sleep, long watcing, continued and long-lasting pains and spasms, depressing emotions, such as gr;ef, care, sorrow, mortification, homeappointedlove, etc. ; or in consequence of the working of suchpassions, as envy, pride, ambition, etc.; likewise from excessivemental exertions, abuse of the sexual organs, etc.; or in consequof diseases of such organs as are physiologically important to thproduction and propulsion of the blood, such as : diseases of thelungs, heart, arteries, veins, lymphatic glands, liver, spleen, kneys, uterus, intestinal canal, etc. ; it may likewise result froinhalation of dust or metallic vapors of chemical substances exering a hurtful influence upon the formation of the sanguineous flusuch as : Arsen., lead, copper, phosphorus, mercury, silex, zinc,The abuse of Opium, Belladonna, tobacco, alcohol, etc., and theabuse of certain kinds *of nutrient substances, such as: potatoestea, etc., may likewise lead to anaemia.Secondary ansemia only occurs as an accompaniment of othermorbid processes, upon which it depends. It occurs in the courseof tuberculosis, constitutional syphilis, carcinoma, scurvy, scrolosis, rhachitis, diabetes, puerperal fever, etc., likewise in thof chronic articular rheumatism, helminthiasis, diseases of the band spinal marrow, in the course of chronic exudations, such as :hydrothorax, hydropericardia, ascites, anasarca, ovarian dropsy,Having dwelt with sufficient detail upon the general and etiological part of anaemia, we now give a description of its symptomatic, manifestations.The skin is pallid in various degrees, sometimes yellowish or ofa grayish white, at other times livid ; the paleness of the lips,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 579 of 653palpebral conjunctiva and ears is particularly striking. The cutaneous veins appear delicate, bluish, thin and empty. The sclerotimost commonly exhibits a bluish-gray appearance. The temperature of the skin, especially that of the extremities, is in mostdiminished ; even the temperature of the axillae not unfrequentlyfalls below the normal standard. Anaemic persons exhibit a characteristic sensitiveness to cold, a fondness for warmth, and frequeshiverings increasing even to violent shaking chills. The muscles44690 Anaemia, Oligxmia,of aneemic persons are very often soft and flabby ; in many casesthe bodily weight becomes less, more particularly in anaemia of ahigher grade, which is frequently combined with atrophy, subcutaneous cedema or hydrcemia. The muscular strength is always less;after the least bodily exertion, the patients experience great latude in the extremities. When ascending an eminence, goingupstairs, dancing, or making the least attempt to run, anaemicindividuals turn remarkably pale, become short-breathed, the hearpalpitates, and, if the anaemia is of a high grade, syncope may sin. The pulse is mostly small, feeble, short and accelerated. Theincrease of the frequency of the pulse from slight exertions, walabout, and even from sitting up in bed, is a characteristic symptom. If we are in doubt concerning the degree of anaemia, we maydirect the patient to walk about; if the pulse increases in frequency after such a trifling effort, we may rest assured that theanaemia has reached a high degree.The palpitations of the heart, with which such patients are frequently troubled, are often attended with systolic blowing murmurs in the region of the heart and in the larger vessels. The mofully developed the anaemia, the feebler the impulse of the heartthat in the highest grades of the disease, as in cholera, the secsound of the heart and that of the arteries disappears entirely.The cerebral functions are generally depressed ; anaemic individuals are sad, low-spirited, monosyllabic, melancholy; they sleepa good deal, are sleepy even in the day-time, whereas at night thsometimes lie awake for hours.On making a slight bodily eftbrt, their sight becomes obscured,they are attacked with buzzing in the ears and vertigo, phenomenawhich, in high grades of anaemia, may even increase unto syncope.Such patients are frequently attacked by periodical paroxysms ofheadache, prosopalgia, cardialgia, coxalgia, sometimes by toothac(neuralgia of anaemic persons).The spinal nerves likewise become frequently involved in theanaemic condition, so that either disturbances of the sentient sytake place in the shape of frequent attacks of pain, or of the mosystem in the shape of spasms.Respiration only becomes impeded after excessive bodily exertions ; owing to the deficient oxydation of the blood, the patienhas to yawn or sigh quite frequently.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 580 of 653The appetite is frequently impaired, or the patient experiences adesire for unconmion things, such as charcoal, chalk, lime, roastDeficiency or rather Paleness of the Blood. 691coffee, acids, bitter substances, etc. ; the digestion is weak, tappetite is speedily satisfied, and, after eating, such patientsfrequently attacked with oppression of the stomach or flatulence.The thirst is often very much increased, sometimes quite normal,the bowels are generally torpid, the urine is pale, watery, generquite copious and has an alkaline reaction. In the case of malepatients, the sexual functions remain unaffected; in the case ofwomen, however, the menses often become irregular, or very scantyor they are entirely suspended. Profuse menses are of much lessfrequent occurrence ; they exert a very prejudicial influence upothe general organism. Ansemic women are very frequently attackedwith leucorrhoea and sterility. The secretion of milk is impairedthe milk is watery, thin, not nourishing, hence anaemic women areunfit for the business of nursing and the children who are fed onsuch milk, generally become ansemic.Most ansemic persons feel better in a state of rest and in a horizontal posture, whereas they soon feel tired when standing, walking, or when performing bodily labor. Hence they generally feellazy, are not disposed to work, and soon have to desist from theilabor. We are acquainted with patients who become exhaustedeven after doing the lightest kind of work, such as knitting,crocheting, embroidering, etc., and even become shortbreathed,experience an oppression on the chest, palpitation of the heart,sometimes even pains in the muscles of the arms, chest and back,or after standing or walking for some time, pains in the musclesof the calves or thighs.As a general rule, anaemic persons feel most uncomfortable in themorning-hours ; their sleep is not refreshing or strengthening ;feeling of lassitude does not leave them, on which account theyremain sad and depressed in spirits until, in the course of the dthey become artificially stimulated by the use of coffee, tea, wibeer, broth, etc. This circumstance is very important in a diagnostic point of view ; whereas anaemic persons look pale and feellanguid while their stomachs are empty, and at such times eitheryawn or complain of headache and are generally morose: theycommonly feel much bettor after using the above-mentioned stimulants or immediately after eating, their complexion looks muchbetter, tbey are more active and cheerful. Very seldom anaemicindividuals experience an oppression at the stomach, cardialgia orush of blood to the head after eating or drinking, or feel otheruncomfortable and languid.692 Anaemia, Oligaemia.Diarrhoea, hemorrhages of every kind, even if very slight, nocturnal emissions, sexaal intercourse and nursing aggravate thesymptoms of aneemia. Depressing emotions and mental exertionslikewise cause aggravations, whereas moderate hodily and mentalhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 581 of 653exercise, cheerful company and surroundings affect ansemic personvery favorably.An anaemic condition is most strikingly increased by the supervention of some acute disease. An occurrence of this kind is aptto bring on an adynamic condition, prostration and sopor ; such aacute attack is often attended with fibrinous or serous exudationdrags along very slowly, and convalescence is in most cases veryprotracted.All the above-mentioned circumstances are of great importanceto the homoeopathic physician, on which account we have dweltupon them very minutely.It is only anaemic conditions consequent upon acute losses of bloand other animal fluids that run an acute course ; other forms ofanaemia run a chronic course and, while the exciting cause continues, may last weeks, months and even years.The more speedily anaemia develops itself, the more rapidly thephenomena characteristic of anaemia set in.If anaemia runs a protracted course, the greatest attention isoften required on the part of the physician in order to accuratelobserve the pathognomonic symptoms of anaemia. A deficiency ofthe colored corpuscles causes a more or less vitiated nutrition,gradual vanishing of the fat and of the vital turgor, a decreasethe natural temperature and of the muscular strength, a highdegree of lassitude, indolence and ill- humor, increased beatingthe heart after slight bodily exertions, disorders of the nervoussystem resulting in attacks of pain or spasm of the most diversifkind.The termination in recovery frequently occurs spontaneously, ifthe exciting causes cease of themselves, as is often the case institutional or consecutive anaemia. Very frequently a complete cuis effected by artificial means.After acute losses of blood or other fluids, the water and saltsthe blood are often speedily restored, without the reproduction othe red corpuscles taking place with equal rapidity. In consequenof this, a hyperaemic condition is apt to set in, which is descriunder the name of serous plethora and is often accompanied withcongestions of the head, febrile irritation, violent palpitationsthe heart, sleeplessness, etc.Deficiency or rather Paleness of the Blood. 698The more complete the ansemia, tlie more the fat and muscularstrength disappear, the viscera and tissues likewise become impoverished ; the watery constituents of the blood increase more amore, and the red corpuscles decrease in proportion ; this is thereason why certain parts of the body gradually become oedematousand why serous transudations into the difterent cavities of thebody occur at a later period. This hydrsemic condition is mostcommonly observed after copious losses of blood and other animalfluids, after continued derangements of the digestive system, inconsequence of cardiac and valvular anomalies, of Bright's diseashttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 582 of 653after severe acute diseases and exanthems, during long-continuedattacks of fever and ague, chlorosis, during a highly developedtuberculosis, carcinoma, caries and other wasting diseases.If an improvement or cure cannot be obtained, marasmus andexhaustion set in.It may likewise happen that the blood is deficient in red corpuscles and so much richer in colorless blood-globules. A conditiof this kind is generally connected with diseases of the lymphatiglands, the liver, spleen or uterus, and is designated by the namof leuecemia.If the blood is deficient in red blood-disks, but has an excess opigment which is likewise deposited in the tissues, a condition othis kind is denominated melaruemia; it occurs most frequentlyafter old and violent intermittent fevers.After rapid alvine evacuations, as in cholera, the highest gradeof anaemia is complicated with inspissation of the blood which ischaracterized by the highest degree of debility and coldness of textremities and attended with fainting-like paroxysms and absenceof the second cardiac and arterial sound. If this condition cannobe removed, it leads to paralysis of the heart.In treating anaemia, the prognosis depends, above all, upon thevarious forms and degrees of the disease. The better the excitingcauses are known and the more easily they can be removed ; themore easily and certainly the loss of the red corpuscles can berepaired and the harmony between their consumption and regeneration can be eflected, the more favorable is the prognosis.Among the forms of constitutional ansemia, those inherent in theperiod of evolution admit of a favorable prognosis; in congenitalanaemia, and in the anaemia of the critical age, the prognosis isfavorable ; it is least favorable in the anaemia of old people.In consecutive anaemia, that which is consequent on loss of blood694 Anaemia, Oligsmia.animal fluids generanj and of strength, admits of a more favorablprognosis than anaemia depending upon climate, atmosphere, localcircumstances, or the nature of one's business. Anaemia arisingfrom scanty or unwholesome nourishment, vitiated air, unhealthyhabitations, bad water, abuse of spirits or certain kinds of druglikewise admits of a more favorable prognosis than anaemia arisinfrom the effects of passions whose impressions are lasting and canot be effaced.The prognosis is most unfavorable in consecutive anaemia wherethe consumption and reproduction of the red corpuscles are simultaneously invaded by disease, as iB the case in diarrhcea or hemorhages with simultaneous catarrh of the stomach, or when duringextreme bodily exertions, the supply of food is deficient ; or whthe process of nursing is disordered by grief; or when frequentnocturnal emissions are accompanied with disappointment in love.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 583 of 653Secondary anaemia can only be cured in case the primary diseasecan be removed.Age has no decided influence upon the prognosis ; old people mayrecover very speedily after severe diseases, hemorrhages, diarrhoetc., whereas children and robust adults often require a long timfor their restoration. This depends chiefly upon the consumptionof the blood ; in youth and robust manhood this consumption goeson very rapidly and often outweighs the process of restoration,whereas in old age much less blood is consumed, the regenerativeprocess being carried on at an equal ratio.Intercurrent diseases of any kind during the course of anaemiarender the prognosis more uncertain, since the number of blooddisks which is anyhow scanty, decreases with more or less rapidity, more particularly in acute febrile and inflammatory diseasesand most seriously during typhus and intermittent fevers. Theprognosis is doubtful for the additional reason that a rapid desttion of the red blood-disks is attended with a rapid sinking of tvital energy, and a high grade of adynamia, or destructive suppurations or gangrenous disorganizations may be the consequence.Treatment. In our opinion anaemia is a most important pathological condition developed in the depths of the various morbidprocesses ; it frequently becomes an object of observation and heclaims our most serious attention.The homoeopathic treatment of anaemia comprehends three divisions of equal importance : the removal of the causes, diet, anduse of remedial agents.Deficiency or rather Paleness of the Blood. 695If the causes are known and can be removed, the first steptowards a cure is frequently made. Hence all losses of blood andother fluids, the waste of strength, have to be arrested as speedas possible; anomalies depending upon birth, constitution, age, sdevelopment, etc., have to be regulated ; excessive bodily or menexertions, depressing eniotions, sexual excesses have to be rigidavoided; the unfavorable influences of climate and atmosphere havto give way to more favorable surroundings ; the supply has to beof the right quality and quantity ; errors of nutrition and assimtion have to be corrected; the circumstances of education, mode oliving, occupation, habit, etc., have to be considered ; diseasessingle organs and systems, and constitutional anomalies by whichansemic conditions are so often engendered, have to be carefullyobserved, aud the bad eflects of sudden changes of temperature,weather, a sudden rise or fall of the barometer or thermometer, ounfavorable influences of the season, have to be counteracted byappropriate measures.In cases where the causes of aneemia are unknown, where theyare not sufficiently accounted for and cannot be investigated, asmost commonly the case in regard to the various forms of constitutional anaemia, we adhere to our previous statement that the diminution of the red corpuscles, and the consequent aneemia, is eithoccasioned by a too rapid consumption, or by a deficient reproduction of these bodies, or by both these causes at once. If one orhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 584 of 653other of these causes prevails, the homoeopathic treatment is reglated accordingly, and the true nature of ansemia is reached andmodified by these means.The dietetic treatment of anaemia has for its object to so regulathe circumstances of the patient as to secure the normal restoratof the blood. The diet is so important that our opponents attributo it exclusively the good eflects of our treatment. Although wedo not deny that many forms of anaemia, especially of the consecutive kind, are cured by a suitable diet after the removal of thecauses, there are many other forms of anaemia, especially constittional and secondary, where the best dietetic measures are insufficient, and where the interference of art is indispensable to aGeneral dietetic rules adapted to all forms of anaemia cannot beestablished for the reason that every special case requires a diemanagement of its own. For the present we content ourselveswith mentioning the general dietetic arrangements that deserveattention in most cases. Special dietetic rules will be indicatedwhen treating of the special forms of anaemib.696 Anaemia, Oligemia.If the process of sanguification and nutrition is to be improved,the condition of the digestive organs has to be carefully attendeto above everything else.If anaemic individuals digest very rapidly; if, soon after a copimeal, they again feel hungry ; if they do not experience any trouafter eating; if they feel comfortable after a meal and have nofever, the most nourishing diet may be indulged in by such patienThey may use strong soups with the concentrated extract of beef,roast-beef, steak, i-la-mode beef, various kinds of roast withoutmuch fat, venison, eggs, farinaceous food, light vegetables whichare not of the flatulent kind, cake prepared with sugar, but notand without yeast ; fish which is not too fat, is likewise allowasuch as trout, salmon, cod, pike, pickerel, etc.Fat food, salad seasoned with sharp vinegar, husks, fresh bread,etc., should be rigidly avoided.Stewed fruit is generally more easily digested than raw fruit.Eggs, almonds, cottage-cheese may be partaken of in moderatequantities.A well fermented beer is the best beverage for anaemic persons;during a meal light wines may be indulged in. A little Champaigne may be used with the dessert.If there is a good deal of vascular excitement, disposition toheadache and congestions, with sleeplessness, affections of the hor lungs, hemorrhage, etc., the use of wine has to be strictlyavoided ; beer, if partaken of discretly or diluted with water answeetened with sugar, generally agrees with most patients.Ansemic p"fersons had better eat frequently, every few hours, thatoo much at once. If a sensation of hunger, or of a so-calledhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 585 of 653"empty stomach" is hurtful, and may give rise to frequent yawning, cardialgia, headache, a disagreeable and audible rumbling inthe bowels, weakness of the extremities and even attacks resemblisyncope ; on the other hand, overloading the stomach is frequentlattended with oppression of this organ, flatulence, nausea or evevomiting and diarrhoea, by which conditions the patients areweakened and the anpemia is made worse.If the digestion is prostrated, our main object must be to restorthis important function as speedily as possible to its normal stafor without it no restoration of tissue, and hence no amelioratiothe blood can be thought of. The management of the digestiveapparatus will be indicated when we give the medicinal treatment.For the present, it may suffice to state that the sick stomach muDeficiency or rather Paleness of the Blood. 697not be loaded with heavy nourishment ; the least excess causes thpatient serious distress and increases the gastric disorder.As long as the appetite is wanting, the patient had better eatnothing but weak soups ; under certain circumstances he may beallowed a dish of milk, or some farinaceous preparation or stewedfruit. Beer or wine, whether pure or diluted, can only be allowedif not counter-indicated by any of the above-mentioned circumstances. !K the appetite improves, more nourishing soups, light whitemeat, soft-boiled eggs and a light farinaceous diet may be alloweas the digestion continues to improve, beef, venison and a strengening diet may be resorted to.Cooling things, such as: ice, lemonade, orangeade, raspberryjuice, soda-w&ter with wine or syrups, are only permitted by us,if the patients do not cough, are not troubled with diarrhoea orcardialgia, and are not inclined to abdominal pains.We give these dietetic rules in detail for the reason that we havoften seen practitioners urge upon ansemic patients the most substantial diet without regard to their digestive capacities. Beingunable, for want of appetite, to comply with the demands of theirphysicians, the poor patients, instead of gaining in health andstrength, continued to fail and were finally obliged to seek helpelsewhere.Exercise and rest are of great importance to the process of sanguification. It is just as important to regulate the amount of excise with reference to the existing amount of bodily strength, asis important to measure the amount of supply proportionally tothe strength of the digestive powers.As a rule, aneemic patients have pale and flabby muscles deprivedof their normal energy, elasticity and powers of perseverence. Altheir muscles and muscular bodies exhibit a certain degree of funtional debility ; the muscles of the trunk and extremities betraythis weakness by a feeling of languor and lassitude ; those of ththorax by shortness of breath, those of the heart by an acceleratbeating of this organ, those of the stomach by weakness of digeshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 586 of 653tion, those of the intestinal canal by indolence of the secretionby flatulence, those of the uterus by dysmenorrhoea or sterility,This is the reason why anseraic individuals, when exercising toorapidly or too much, are apt to be attacked with dyspnoea, palpittion of the heart, ah increase of temperature, in consequence ofwhich abnormal cerebral irritations in the shape of hemicrania ori_698 Anaemia, Oligaemiaheadache occur. An increased frequency of the pulse is not unfrequently accompanied hy such a high degree of weariness that, unlethe patients rest, syncope may take place. The after-effects of ecessive muscular exertions consist in a high degree of wearinessand weakness, in muscular pains, spasms and cramps, especially inthe chest and calves, in loss of appetite and sleep.On the contrary, muscular movements adapted to the patient'sstrength, and followed by timely rest, produce a gradual invigoration of the muscular fibre, a more active circulation, a proportiwaste and supply, an improvement in all the functions, and a highactivity in the process of nutrition.It is an etablishcd fact that a great deal of strength is lost byexcess of active exercise, and that it is restored again by subserest; exercise is to rest as consumption to restoration, waste tosupply. This shows the importance of subjecting the conduct ofansemic persons in regard to these two factors to a more particulexamination.Anaemic persons should not take any long walks ; as soon as theyfeel exhausted, experience dyspnoea or palpitation of the heart,commence to perspire, they ought to rest and not resume their waluntil they feel able and disposed to do so. Their muscular strengis best ascertained by the condition of the pulse during a walk.the pulse becomes hurried during such exercise, it is a sure signthat their strength is not very g.eat and that much exercise ishurtful to them.Walking rapidly and up hill, in a damp and cold air, or againstcurrents of air, on damp soil, have to be carefully avoided, lestdiseases should set in in consequence of such exposure.Short rides in the country, or excursions on the water, are themost appropriate exercise ; these may be followed by short walkson a level, in a shady alley, garden, forest, or meadow, to be folowed by adequate rest.Running, jumping, climbing, ascending a hill, journeys on foot,heavy work, wrestling, fencing, etc., should be rigorously avoideby anaemic persons.Dancing is an entertainment which, in pleasant company, contributes a good deal to cheering up the spirits ; on this accountdo not prohibit it entirely, except, however, waltzing which wehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 587 of 653positively interdict. In cases of pulmonary, cardiac and cerebraldiseases, dancing is prejudicial under all circumstances."We permit riding on horseback if the patients feel strong enoughDeficiency or rather Paleness of the Blood. 699for this kind of exercise and, while riding, do not experience anpalpitation of the heart or dyspncea. Long rides, galloping, andsharp trot^ do not agree as a rule.The well known indolence of ansemic persons, their dispositionto sit or lie down, should not be encouraged by their physician ;protracted rest or a total deprivation of exercise diminishes thefunctional energy of the muscles and may even result in theiratrophy and paralysis.Sleep and waking likewise exert a powerful influence upon thelife of the blood.Anaemic pei-sons who sleep too much, generally become indolent,peevish, complain of dulness of the head, inability to think ; thyawn, look bloated, the blood becomes paler, the muscular fibremore relaxed, and the formation of fat and the serosity of the blbecome very marked.The want of regular sleep as well as complete sleeplessness makethe anesmia worse, and frequently result in nervous erethism, hypsesthesia, debility, digestive derangements, and emaciation.A natural sleep of six, seven or eight hours is refreshing, strenening, promotes the restoration of the muscular fibre, improves tprocess of sanguification, and invigorates the cerebral functionsVoluntary watching when the hours which should be devotedto sleep, are spent in a state of intentional wakefulness, is verjudicial to anaemic individuals. The will acting in opposition tothe natural want, an efibrt takes place both of a physical andpsychical nature and equal to the sleeplessness added to an excesof bodily and mental exertion, in consequence of which the anaemibecomes more deep-seated.On this account, anaemic persons should neither watch with thesick, nor for purposes of manual or other work; they should notread, study or travel at night. Even social entertainments shouldnot be indulged in after midnight, so that the remainder of thenight can be devoted to rest.Depressing emotions, such as grief, sorrow, mortified feelings,fear, homesickness, disappointed love, etc., and excessive passiosuch as envy, hatred, jealousy, ambition, wounded pride, etc., afanaemic patients equally badly as sleeplessness. Hence it is necesary in the case of anaemic persons that this morbid direction ofthoughts and feelings should be moderated or entirely subdued byan appeal to their reason as well as by the personal influence ofphysician.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 588 of 653700 Anaemia, OHgsmia.The atmospheric air is likewise of great importance as a meansof improving the quality of the blood ; the purity of the air andthe quantity of oxygen it contains contribute greatly to the incrof the red corpuscles. If the digestion is at the same time activand a sufficient supply of proper nourishment is introduced intothe organism, bad cases of ansemia are sometimes cured by thesesimple means without medicine. It is more particularly the anaemiof convalescent patients that can be removed in this manner.Anaemic persons residing in crowded cities or in damp and closedistricts where the air is rendered impure by frequent inundationcoal-vapors, decaying vegetable matter, etc., should, if their cicumstances permit, be sent during the warm season into regions ofcountry where the air is pure and rich in oxygen.The dwellings of ansemic persons must be dry, spacious, withfacilities for being easily heated, accessible to sunlight. We knfrom experience that damp and chilly dwellings give rise to avariety of diseases.The clothing of anaemic individuals has to be adapted to theseason and the weather ; the want of animal heat and an extremesensitiveness to changes of temperature make it desirable thatanaemic persons should be warmly clad or, at any rate, that theyshould at all times and places be provided with a supply of thickclothing, so as to be protected against the bad effects of suddenchanges of temperature or of a sudden access of bad weather. Theymust be cautioned against leaving off their winter-clothing toosoon, or against throwing off their cloaks, coats or shawls in coplaces or while covered with perspiration.Anaemic persons who are disposed to sadness and to keep awayfrom company, must be cheered up by pleasant surroundings, quietgames, entertaining books, theatrical representations, frequent bnot too long walks or rides, short journeys, etc.Baths are only useful to anaemic persons if their temperature ispleasant to them. Experience has shown that baths with a temperature of over 88° F. cause a loss of muscular power and bodilyweight in the case of anaemic patients, whereas baths below 60° Fcause chilliness, a loss of animal heat, followed by an excess oftion. For this reason the best plan to be adopted for such patienis to give them tepid baths between 65 and 85° F. only two or thrtimes a week, and only fifteen to twenty minutes to each bath.Swimming may be allowed, provided the patients are sufficientlystrong, and neither are troubled with cough, nor dyspnoea, norCongenital Anaemia. 701diarrhcBa ; the temperature of the river or sea- water must at lebe 57 to 60° F., that of the air at least 64 ; there must be no cor keen wind, nor must the air be damp or chilly. Hydrsemicpatients should not bathe under any circumstances.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 589 of 653In high grades of anaemia sexual intercourse is hurtful to personof either sex ; however, if they improve in looks, if they feel mvigorous and frequently experience sexual desires or nocturnalemissions, moderate sexual intercourse is admissible.The medicinal treatment of ansemia requires a good deal of discretion and judgment on the part of the physician. In selecting aremedy, it is not only of importance that the exciting causes shobe carefully investigated, but that the physician should understawhether the ansemia he is called up)on to treat, is of a primarysecondary character. A primary ansemia generally admits of adirect treatment and is curable, whereas a secondary ansemia alwarequires a careful consideration of the primary pathological procand can only be reached indirectly by homoeopathic remedial agentand not unfrequently resists the most rational and judicious treament.A direct anti-anseraic treatment requires, beside the removal ofthe cause and a suitable diet, the use of such remedies as have iin their power to correct the process of sanguification by theirdirect influence. We have no universal specific for ansemia. Afteinvestigating the various forms of anaemia, their causes and themorbid processes upon which they depend, we are able to availourselves of a considerable number of remedies whose effects uponthe human organism have been carefully studied, and by theirmeans to obtain favorable results with surprising rapidity even isevere cases where medicinal aid seemed all but useless.Since the selection of homceopathic remedies for ansemia is principally determined by the nature of the exciting causes and by thresemblance between the remedies and the disease, we have deemedit proper to present the various forms of ansemia and to indicatethe special treatment of each of them. By this means we obtain aclearer perception of the various morbid processes, and greaterfacilities in surveying the list of specially adapted remedial ag10. Congenital Anieniia.Owing to liemorrhages of the mother during pregnancy or duringthe act of parturition, children are often born ansemic. If theyarrive at full term, they generally look fleshy, but in the place702 Congenital Anaemia.the natural bright flesh-color, the skin has a pale-yellow appearthe nails and lips likewise look pale, and the sclerotica has a bcolor. Their movements are not very vigorous, their voice is feebthey do not sleep much, moan a good deal, and nurse very feebly.Such infants very soon pick up strength at the breast of a healthwet-nurse whose milk, rendered more nourishing by a good meatdiet and the use of beer, easily and speedily accomplishes therestoration of the red blood-disks.If ansemic children are at the same time bom feeble, they aregenerally emaciated, look old, wrinkled; they are sometimes sofeeble that their moans can scarcely be heard ; their weakness isgreat that they find it very difficult to take the breast, and sohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 590 of 653times decline doing so.Such children have to be fed on the nurse's milk by means of alittle spoon ; otherwise, being too feeble to draw the milk frombreast, they would soon perish of exhaustion ; in order to supporthe deficient nutrition, it is likewise proper to bathe the littlonce a day in tepid cowVmilk. As soon as they have become somewhat more lively and vigorous, we introduce every day the little.finger into their mouths for the purpose of ascertaining whetherthey are able to nurse. If they are strong enough to draw the milthey may then be put to the breast ; by pursuing this course, thegenerally gain very rapidly.If anaemic children are born before their full term, they generalsleep a great deal, have a wrinkled skin which is covered with afine downy hair ; they look old, their little nails are soft, theon their heads is short, their heads are disproportionately largetheir fontanels are far apart, etc.Such children have to be roused from their sleep quite often, inorder to feed them a little nurse's milk by means of a spoon ; thshould be done at least once every two or three hours, if their venergy is to be preserved and sufficiently strengthened. The nutrtion is likewise sustained by tepid milk-baths and injections ofmilk or soup; the injections should only be given in small quantities, about half an ounce, in order to secure their retention inintestinal canal and subsequent absorption.For purposes of nutrition, the milk of healthy and robust nursesis much better than that of mothers whose milk has become wateryin consequence of copious hemorrhages or exhausting diseases, orwhich has become greatly deprived of its protein constituents.Congenital ansemia occasioned by diseases of the parents or ofCongenital Anaemia. 703the mother alone, is generally very obstinate, frequently continuduring the whole period of dentition and even beyond the periodof pubescence. Such children generally cut their teeth at a lateperiod and with difficulty, are frequently attacked with derangements of the digestive functions and of the nervous system, amongthe nervous disorders are subject to frequent attacks of eclampsithey begin to run about, and they acquire the use of speech at alate period, generally have a pale and bloated appearance, haveweak and thin extremities, a bloated belly; enlargements of thespleen, liver and mesenteric glands are frequent occurrences whicare moreover often accompanied by leucaemia; they show greatliability to softening of the bones and to scrofulosis, to nasal,chial and intestinal catarrhs, to croupous processes and basilarmeningitis. The most common results of congenital and protractedanaemia are tuberculosis, scrofulosis, rhachitis and atrophy.Children afflicted with congenital anaemia should have healthywet-nurses during the first months, they should be taken out intothe open air as often as the weather permits, the use of sugarshould be strictly prohibited, nor should they be fed on thick gror pap, lest the digestive functions should become disordered; thhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 591 of 653should never be fed to excess, they should be kept clean and frequently bathed in tepid water. Acute or chronic gastric, intestinor bronchial catarrhs have to be treated in the manner indicatedin their respective chapters ; they favor more than anything elsethe diminution of the red corpuscles.Sleep is likewise a function of great importance to such childrenIf they will not sleep at all, or can only be got to sleep with gdifficulty, we administer Calc. 6, or Nux vom. 8, or Puis. 3, orsol, 3, a dose every two or three hours.If the children become exceedingly restless, so that they will noremain in their beds and have to be carried about all the time, tmost approved remedies for such a trouble are Arsen. 3, Bellad. 3JffnaL 3, Nux vom. 3, or Calc. 6, or Svlph. 6.If, especially during the period of dentition, they frequently stfrom their sleep and afterwards remain wakeful, we resort toChamom. 3, Cqfea 3, Nvx vom. 8, or Nairum mur. 6, or Silic. 6.The slow dentition of such children is attended with great delayin the process of ossification ; the fontanels remain open for atime, the skull-bones are thin and fragile, the articular cartilagrow thick and rickety ; the vertebral column and the long bonesare liable to become curved.704 Congenital Anaemia.In such cases Cede* 6 to 80, two doses a day, is a splendid remedwhich speedily regulates the digestive and assimilative functionsthus improving the quality of the blood and visibly promoting theprocess of ossification. What Iron is to chlorosis, Arsen. to hydmia, that hime is to delaying ossification. This remedy is likewiof great value where the skin is bloated, the abdomen meteoristically distended, the extremities are thin, the mesenteric glandswollen and where the patients are at the same time suflfering wigastnc, nasal or intestinal catarrhs. The continued use of thisremedy for several weeks, in increasingly large doses, accompanieby a proper dietetic management, may lead to favorable resultseven in cases where an hereditary disposition to tuberculosis ispresent.^If the delay in the process of ossification has already resultedactual curvatures; if single bones have become hypertrophied, ifangular edges of the long bones have become rounded off like cyliders, if the articular extremities become disproportionately largand the broad bones thick, we may be sure that osteomalacia hasset in. In such cases a gelatinous substance is found exuded intothe cells of the friable and interstitially distended osseous tisconsequence of which the bones not only become distorted, butosteoporosis takes place, or a dilatation of the medullary canalsand cells.Such phenomena find a sovereign remedy in Silicea 6 to 30, twodoses a day. What Lime is to a delaying ossification, that Siliceis to osteomalacia. Silicea, by first regulating the digestive anassimilative functions, corrects the composition of the blood andnot only secures a reabsorption of the gelatinous mass, but evenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 592 of 653perfect ossification.This remedy likewise renders efllcient service in cases of hereditary disposition and, like Calcarea^ is often administered withvantage in alternation with Sulphur 6 to 80.If Silicea is not suflicient, we resort to Phosphorus 8 to 6, witwhich we have obtained the most satisfactory results in the caseof feeble and exhausted children who did not acquire the use oftheir legs until very late. (See the article "Menin^tis Spinalis,Spondylitis.")Children who learn to walk with diflSculty or at a late period,must not be made to stand upon their feet ; every attempt at making them walk, is an injury to them. It is better for them to liedown as much as possible. Carrying them in a sitting posture orCongenital Anaemia. * 705without changing from one arm to another, frequently gives riseto spinal curvatures. To afford them the enjoyment of fresh air,they have to be dragged about lying on their backs in a little cariage.In all cases of congenital ansemia, country-air and a meat dietare very beneficial.We have already cautioned parents against overfeeding. In orderto keep the children quiet, some parents and nurses are in the haof keeping them at the breast the whole night. As soon as thechildren cry a little, they are put to the breast, or tits are putheir mouths, or they are stuffed with farinaceous paps or thickgruels. Even after weaning them, this system of overfeeding iscontinued ; children are constantly eating bread, pieces of boilepotato, cake, etc. These vicious habits are the beginning of impefect chylification. The habit of keeping the digestive organs constantly employed, leads afterwards to an insatiable voracity. Thedigestive organs, being constantly excited to an uninterruptedactivity, become weak; the children have to vomit frequently, theare suffering from acidity of the stomach, accumulations of phleggastric disorders, painful diarrhcea or flatulent colic, bloatedweakness and thinness of the extremities and other disorders resuing in the final development of scrofulosis, rickets and preparinthe road for the invasion of tuberculosis.Nurselings may be put to the breast every two or three hours ;and after they are weaned, children should have their meals atregular periods ; between meals they may be allowed to run outand play in the open air. Atmospheric oxygen is as necessary toan improvement of the quality of the blood as adequate nourishment is to sound nutrition. Digestion, says Moleschott, transformthe food into constituents of the blood, atmospheric oxygen transforms the bl6od-disks into tissue-making substances.Good food and an abundant supply of pure air are often sufficientto impart to feeble and rickety children an appearance of healthand strength.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 593 of 653Exercise in the open air, and more particularly the various juvenile games, throwing the ball, trundling the hoop, jumping therope, etc., are very much to be commended. Of course, childrenmust be warned against getting heated, or cooling themselves bythrowing off some of their clothing, or drinking cold water whileheated.Under similar precautions fishing, hunting, berrying, etc., may45706 Congenital Anaemia.likewise be permitted, because a moderate exercise of this kindpromotes the metamorphosis of the tissues.Children born of tuberculous parents, or bom feeble and sickly,should not be sent to school before they are seven years old ; geerally such children have bright intellects, but their minds shounot be developed at the expense of their bodily health. They hadbetter be taught only a few hours a day ; the rest of the day maybe devoted to invigorating their constitutions.As has been said before, congenital ansemia very frequentlydepends upon some hereditary disposition which, owing to sometuberculous, syphilitic, carcinomatous or other exhausting diseasof the parents, or to some chronic uterine disease of the mother,continues far beyond the period of dentition and growth, and, incases of the sudden invasion of some acute disease, plays an important part. In such cases a single acute local aftection frequeconstitutes the beginning of a series of changes in adjoining oraffiliated organs or systems. A simple nasal catarrh, for instancmay be seen followed by palpebral blennorrhoea, or an inflammatioof the conjunctiva of the bulbus may be seen accompanied by themost violent photophobia and by ulcers of the cornea, sometimesby otorrhoea and bronchial catarrh, or diarrhcea, etc. j in shortwhole series of disorders of the mucous lining may break oat.In another case a simple tonsillitis is succeeded by hypertrophyof the tonsils ; at the same time the submaxillary, cervical, posterior cervical, axillary and even parotid glands may be seen inftrated and even erysipelatous, presenting a series of glandulardiseases.A simple pleuritis, pneumonia or bronchitis is ofben the beginning of a deposition of tubercles in the pleura or lungs; a simplintestinal catarrh is not unfrequently the beginning of subsequentuberculosis of the intestines and mesenteric glands ; a sunoften occasions the outbreak of basilar meningitis.A simple cold, or excessive fatigue may give rise to spontaneouslimping, a fall on the knee to white swelling, a fall or blow ontibia to periostitis or exostosis, an injury of the nose to ozsenFor this reason it is of the utmost importance that a physicianshould observe and appreciate such hereditary dispositions with athe attention they are entitled to. Unfortunately it is often thecase that anaemic or feeble children are neglected by their parenhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 594 of 653their sickly condition is attributed to dentition, the fact of grdevelopment, and a physician is only applied to after an acute diCongenital AnaemisuP "„/ 707'P \ease has actually broken out. In sncli a case'^e a^ctua}.^^^^^^^to be treated with great discretion, nor oughi the ^hereditary diposition to be left unconsidered. If it should appear\to f)?b phycian that an acute disease is struggling but impet^ctly into^ fulmanifestation, that the disease threatens to assume'^hi^QniOjtljror to pass through a series of other pathological form^Jhe will %to investigate at once the anamnestic circumstances of .ibhe pareand will have to employ such remedies as will weaken or counteract this tendency. Thus the judicious and methodical use of theIodide of Potassium or of the Muriate of Gold will correct the syitic tendency, that of Ca/e., Iodine^ Sulphur or Cod-liver oil thtuberculous tendency, that of Conium or Aurum mur. natr. the tendency to carcinoma. Ars. or SUic. will remove or correct the sickdisposition of children consequent upon chronic suppurations, blenorrhoeas or colliquations of the parents, and will prevent thedevelopment of chronic diseases which it may be either difficultimpossible to cure.It sometimes happens that children who look healthy and plumpat birth, in a few days already look pallid and flabby, they crymoan a good deal, do not sleep well, the lips lose their vermiliohue, the sclerotica assumes a bluish appearance, the features aresharply delineated, the palpebral conjunctiva and the ears look pand the muscles lose their tone. In a more advanced stage of thisform of ansemia the children look like old people, the muscles grperceptibly thinner, and on the neck and extremities visible signof atrophy make their appearance.An anaemic condition of this kind is most frequently caused byan insufficient supply of milk on the part of the mother or nurseIf the children pass little urine and not as often as they oughtif they do not go to sleep while nursing; if, after nursing, theygrow restless and moan a good deal, let the mother or nurse inserher finger into the child's mouth. If the finger is taken hold ofgreedily and sucked at, this is a sure sign that the child is hunand craves more nourishment.In such a case the breasts should be examined at once. If, onmaking pressure around the nipple, the milk does not spirt outreadily ; if the mother is pale and feeble ; if she had lost a godeal of blood during parturition or had been sick for a long timeduring her pregnancy, it becomes at once evident from such circumstances that she cannot possibly afford her infant a sufficient sof nourishment.708 Congenital Anemia.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 595 of 653Bometimes there is an abundance of milk in the breasts, but itis watery, like curd, and, when collected in a tumbler with tepidwater, it soon mixes up with the water without forming undulatingthreads or clouds. If the mother had previously lost a good dealof blood or had been afflicted with some severe disease ; or if ssubject to paroxysms of mental depression from grief, care, jealoanger, etc., the milk loses its nutritive quality, becomes waterydestitute of protein, and consequently does not nourish the childIn all such cases the child should at once be placed in the carea sound and strong wet-nurse.If anaemia sets in notwithstanding the quantity and quality ofthe milk are perfectly satisfactory, the cause of the trouble mussought for somewhere else ; it may be overfeeding, catarrhal irritions of the stomach, bowels, bronchia, etc., for which we referreader to the respective chapters where these diseases are treateFor the anaemia and convulsions arising from teething, and theconsequent sleeplessness and ptyalism (driveling, drooling), we rthe reader to the chapter on Eclampsia infantum.The excessive ptyalism is not unfrequently attended with chronicstomatitis or gingivitis. In either case Merc, sdvb, 3 is an exceremedy ; likewise Cole. carb. 3 to 6, if the gums are pale, and tchildren are very nervous, fretful and wakeful.A too rapid growth sometimes superinduces an anaemic conditionattended with muscular debility and sometimes with a liability ofthe capillary vessels to rupture.If such children, as they approach the period of puberty, exertthemselves beyond their strength, or are exposed to high degreesof temperature, or perform unusual mental efforts, they are oftenattacked with nosebleed or even haemoptysis. These symptoms areof special importance in the case of cldldren born of tuberculousparents.For the treatment of tuberculosis we refer the reader to thechapter on tuberculosis. For the anaemia without great musculardebility or other complications, we generally give two or threedaily doses of Ferr. 1 with much success. More recently we havemade use in many cases of the syrup of Iron^ of which we give twoor three tablespoonfuls a day. This preparation agrees with children who seem to be quite fond of it.If the muscular debility is not very prominent, we find the abovementioned preparations of Iron sufficient. If the muscles are verweak, we resort to Quinine 1, two or three doses a day. If thisConsecutive Anaemia. 709remedy is not sufficient to remove the aneemia, we give Quinineand Ferrum in alternation, giving Quinine one day and Ferr. thenext ; or a dose of Ferrum in the morning after breakfast, shortlbefore dinner a dose of Quinine, another dose of Ferr. in the aftnoon, and a dose of Quinine at night. Either method leads veryspeedily to a successful result.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 596 of 653For the nosebleed of ansemic individuals, two or three doses ofCrocus 8 a day proves very efficient. If debility is a prominentsymptom, China 1 or Phosphor. 3 are important remedies whichwill arrest severe hemorrhages. After the nosebleed ceases^ thegeneral treatment of ansemia has to be continued.For hfiemoptysis from excessive walking, dancing, running,ascending eminences, etc., attended with vascular erethism, Aeon.in solution, a dose every fifteen or thirty minutes, in connectiowith cold applications to the chest, renders most excellent serviIf, under similar circumstances, the lungs have become weariedby much talking or loud reading, blowing on wind-instruments,etc., and an oppression is felt on the chest, and symptoms of pnemonia threaten, we at once resort to Phosph. 8 in solution, a dosevery hour or half hour ; at the same time we employ cold applications to the chest. We likewise refer the reader to the chapter ohfiemoptysis or hemorrhage from the lungs.Nvj: vom. 3 may prove a good remedy for the hsemoptysis ofaneemic persons, when caused by excessive mental labor or by theabuse of spirits.For the best means of invigorating the constitution, diet, exercise, occupation, etc., we refer the reader to the chapter on tubculosis.For the anaemia of chlorotic persons, the reader is referred to tchapter on Chlorosis.it. ConaeeiitlTe Ansemla.Consecutive ansemia is in every particular case attended with adiminution of fat, decrease of strength and loss of bodily weightThese conditions, together with their exciting causes and consequences, are of great importance for the selection of the rightremedy. Among the phenomena which accompany or follow thisform of antemia, we distinguish paroxysms of syncope, spasms, neuralgia, hypersesthesia, ansesthesia, debility, emaciation, hydrseThe treatment of acute anaemia consequent upon severe hemor710 Consecutive Anaemia.rbages from the lungs, stomacli, bowels, womb, etc., has been indcated in the chapters where these accidents are treated of.Chronic anaemia, consequent upon repeated losses of blood, evenwhen complicated with hydrsemic symptoms, requires China 1, fromthree to four doses a day, if debility is the prominent symptom ;and Ferr, met. 1, one to three doses a day, if the anaemic symptoare the most prominent. A strengthening diet, rest and fresh airare likewise indispensable. If both these conditions exist at thesame time, we prescribe China and Ferrum in alternate doses.For the debility superinduced by sexual excesses we give Phosphor, 3 or China 1; for anaemia Phosphori ac, 1, or Calc, carb. 6http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 597 of 653Puis, 3 ; for a disposition to hypochondria or melancholy or habiconstipation or excited sexual passion, Nux vom. 3, or Plat 6 ; fdyspepsia Nuz vom, 3, or Puis, 3, or Sepia 6, two or three dosesday. The cure is hastened by complete abstemiousness and coldbathing.For debility from excessive nursing we give China Ij or Phosphoriac, 1 ; for anaemia, Calc. 6 or Puis. 3 ; for oppression on the cPhos, 3 ; for vaginal blennorrhcea, Sep. 6 ; for a high degree ofanaemia, Ferr. lact, or m^t. 1. Of course the nursing must be atonce discontinued and a strengthening diet be pursued.For anaemia after profuse suppurations, with debility, emaciation or hydraemic symptoms, we give Ars. 3, with fistulous ulcersSilic. 6, with suppurations of glands Hep^ sulph, 3 or Iodine 3 oSilic, 6, with chronic caries Silic. 6 or Asaf. 3, or Lycop. 6; wcutaneous suppurations Hep. 3 or Silic, 6.Anaemia, consequent upon profuse perspiration, yields to China 1,or Phosp, 3, and sometimes to Calc. 6. At the same time we havethe body rubbed twice a day with dilute brandy or a very weaksolution of Phosphorus, one drachm of the first dilution to sixounces of distilled water.For anaemia from excessive diarrhoea, with rapid emaciation,debility, disposition to relapses, we give Ars. 3 ; and if the pusmall, quick, with audible purring through the veins, we resort ttwo or three daily doses of the Acetate or Sulphate of £Anaemia after excessive vomiting is met by Ars. 3.Anaemia after profuse ptyalism generally yields to China 1 orQuinine 1, two or three daily doses.Anaemia after excessive walking, running, dancing, etc., is metby Arnica 1, a few doses a day, together with frictions with a sotion of Arnica. Huta may be employed in a similar manner. IthtisSecondary Anaemia. — Marasmus, Tabes. 711tox. is indicated if the weary limbs feel lamed and they can onlybe moved with difficulty.For ansemia caused by excessive mental exertions we dependupon Cede. 6 or Nux vom. 3 ; in obstinate cases upon Sepia 6.Ancemia from nervous sleeplessness is generally attended withcerebral erethism, for which we give Cocc, 8, Nux vom. 3, andchiefly IffnaL 3, two or three doses a day.!•• Seeondarj Ansemia.Secondary ansemia may occur as an accompaniment of variousconstitutional diseases, such as tuberculosis, chlorosis, syphilicinoma, glandular diseases, diabetes melitus, Bright's disease, rulcer of the stomach, etc. Such forms of ansemia require no specitreatment ; they disappear together with the constitutional maladupon which they depend. H.]http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 598 of 653iS« Marasmiis, Tabes.[This anomaly of the functions of nutrition consists in a perceptible decrease of the normal roundness and fulness of the body.Primarily marasmus arises in consequence of congenital debility,a deficient supply of nourishment, excessive bodily or mental labcontinued mental depression, sexual excesses, self-abuse, continusitting, too frequent confinements. Very often the cause is unknown.Secondarily this disease may be superinduced by excessive secretion, seminal losses, excessive perspiration, ptyalism, excessivenursing, long-lasting diarrhoea, blennorrhoea, diabetes melitus,tinued losses of blood, chronic suppurations or discharges of ichexhausting diseases, pysemia, cancer, syphilis, tuberculosis, lonlasting intermittents, etc.Marasmus likewise arises in consequence of chronic blooding, by Arsen.y Lead, Mercury^ etc., or in consequence of exhauststrength, most frequently in childhood and old age ; it may likewise occur in consequence of continued nervous irritability, sleelessness, chronic febrile conditions, etc.Marasmus is chiefly characterized by a gradual or rapid emaciation, disappearance of the adipose tissue, a wrinkled skin, flabbness of the muscles. The skin is mostly dry, extenuated, wrinkledrough and scaly, without turgor or elasticity ; at times it is yeish, at other times strikingly pale, or cachectic; at times it iscovered with local or colliquative perspiration; the hair on the712 Marasmus, Tabes.head falls out more and more, the nails become curved and brittlethe extremities are mostly cool, the patients frequently complainof a feeling of coldness and cannot get warm.At times the appetite is great, increasing even to canine hunger,but the hunger is soon appeased and digestion takes place veryslowly. At other times the patients experience an irresistible avsion to meat or certain kinds of food. In most cases the thirst iincreased.The breath is often fetid, the gums are atrophied, the teeth aredenuded, and gradually become loose and fall out.The voice is feeble and without resonnance, the respiration isfrequently normal, but often oppressed, and after the least bodilexertion dyspnoea and palpitation of the heart set in. The breastbecome pendulous and flabby, the abdomen is at times sunken, atother times distended ; the bowels are at times loose, at other tconstipated, and again dysenteric ; the urine is mostly secretedsmall quantities and saturated, the genital organs become atrophiand the sexual instinct is either diminished or becomes entirelyextinct. The pulse is small and feeble, sleep fatiguing rather threfreshing, sometimes it is very much disturbed ; the patients areither hypochondriac or irascible; sometimes they show muchhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 599 of 653apathy or obstinacy, their memory is weakened, their behavior isoften childish and vacillating. The muscles are flabby and atrophied, and the strength becomes less and less.The disease may last months or years ; in some cases marasmusprogresses at a rapid rate to a fatal termination.Recovery can only be obtained if the exciting causes can beremoved ; however, it takes place very slowly, sometimes with frequent interruptions and disposition to relapses.Wounds, ulcers, abscesses, etc., heal slowly and with difficulty;accidental diseases run a slow course which inclines to becomechronic. If the patients are compelled to remain in a recumbentposture, hypostatic inflammations are very apt to set in.According to the nature of the cause and of existing complications, death may take place by anaemia, hydrsemia, dropsy, pyaemiembolism, gangrene, etc.The prognosis is favorable only if the disease remains after sevediseases, losses of blood and other animal fluids, excessive exeretc. The marasmus of children is likewise a curable disease, provided the causes can be removed.In marasmus senilis, and in the marasmus consequent upon inMarasmus, Tabes. 718curable diseases, sach as tuberculosis, carcinoma, diabetes, caridiseases of the brain or spinal marrow, etc., the prognosis is unfavorable.TreattnefU* Marasmus scarcely ever sets in without aneemiato which we refer the reader for further details, more particularconsecutive anaemia and the anaemia inherent in the period ofinvolution.The marasmus consequent upon intermittent fevers is alwaysaccompanied with malarial cachexia, the treatment of which hasbeen indicated in the chapter on intermittent fever.Marasmus senilis is almost always complicated with anaemia. Itoccurs either between the years of forty and fifty (marasmus praecox, premature old age), or after the age of sixty or seventy yeaFor the treatment of marasmus praecox we refer the reader to thetreatment of the anaemia of involution; as regards the marasmusof old people, we treat it according to its symptomatic indicatioIf the anaemia is not very considerable ; if the loss of muscularOr adipose tissue is attended with great debility, disposition toin the day-time, feeble impulse and sounds of the heart, withoppression on the chest, dyspnoea after slight exertions, disposito painful diarrhoea, we recommend Phosphor. 3, a dose every twohours.This admirable remedy acts much better upon such symptomsthan Quinine ; it quickens the circulation, invigorates the digeshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 600 of 653functions, regulates the alvine evacuations, and is likewise indiif the patients are attacked with vertigo when walking, stooping,closing their eyes, turning the head, with a sensation as if theyhad to tumble over to one side or the other.If the patients are weak and anaemic, dyspeptic with dispositionto constipation, hypochondriac, irascible; if they are subject tovertigo and nausea; if their gait is unsteady and dragging, we giNiix vom. 3 every two hours, until these symptoms improve, afterwhich we give Quinine with excellent eftect. Ferrum carbon, ormetal, may likewise be given after Nux. In such a case we givethese remedies in daily alternation with excellent effect.For obstinate dyspeptic symptoms without any sj'mptoms of gastric or intestinal catarrh, we have sometimes given Pepsin^ in doof three to five grains.Arsen. 3, a dose every two or three hours, may be employed incases of anaemia if the patients are very feeble, faint frequentldyspeptic and thirsty, restless at night, so that they have to ge714 Obcsitas, Adiposis, Polysarcia, Obesity.and walk about ; this remedy is eminently proper if hectic feverhas set in, with fetor from the mouth and large ecchymoses on thelower extremities. A small and feeble pulse, cold extremities, paless and cadaverously smelling diarrhoeic stools, oedema of the lextremities are further indications for Ars. which may still affohelp in the most desperate cases.If this remedy is not sufficient, we resort to Chininum arsenicosum 1, three to four doses a day, and order small quantities ofpure old wine to be taken during the intervals.In all cases of incipient or far advanced marasmus, a strengthening diet is of the utmost importance. "We recommend broth, extracof beef, old wine, if possible old claret, Malaga, Port or Tokaysmall quantities either pure or diluted with water ; good j)orterlikewise appropriate. The patients must be kept warm, especiallythe feet, lest other diseases should supervene. Country and midmountain air, the use of strengthening springs and, if the lowerextremities are very weak, the use of electricity by induction, apowerful adjuvants during the treatment and promote a cure. H.]14. Obesttas, AdlpoBls, Rolysarcia, Obesity.An excessive accumulation of fat is a morbid condition that maybe attended with a variety of important derangements.A disposition to obesity is at times congenital, at other timeshereditary ; it frequently occurs already in childhood ; it is muless frequent after the period of pubescence is passed and is moafrequently noticed in advanced manhood. As a rule, women aremore frequently subject to fatness than men.An accumulation of fat in the subcutaneous cellular tissue isoften so excessive that the skin is an inch in thickness and thecumference of the body becomes monstrous. The thickest layershttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 601 of 653of fat are found on the breasts, abdomen and thighs. There arefat persons weighing from four to six hundred pounds.Adiposis presupposes a peculiar disposition; many persons caneat and drink as much as they please, they remain thin nevertheless ; many, on the contrary, eat scantily, are a prey to depressemotions, and yet grow or remain fat. .Excessive fatness may be caused by a too copious supply of food,or too much fat or substantial food, and a simultaneous deficiencof exercise in the open air ; drinking beer and spirits to excesssleeping too long; mental indolence; abstemiousness from sexualObesitas, Adiposis, Polysarcia, Obesity. 715intercourse, want of active labor, disposition to idleness, a phlmatic temperament.An excessive deposition of fat may likewise be occasioned bycastration, or at the critical age, after severe diseases, etc.An accumulation of fat in the subcutaneous cellular tissue generally takes place very gradually : single parts of the body growfuller and jounder, the white or yellowish skin becomes smoothand, in consequence of the increased secretion of sebum, glistensfat and has a fatty feel. The more the body increases in volume,more numerous become the semi-circular furrows in various parts othe body, for instance in the umbilical region, in the middle ofthighs, at the nape of the neck, under the chin. If the accumulation of fat becomes excessive, the neck vanishes more and more,the abdomen bulges very strikingly, and the gluteal region expandmore and more in breadth and becomes more and more repulsive.In consequence of the excessive fulness of the abdomen, the diaphragm is pushed up more and more, and the cavity of the thoraxbeing encroached upon, the lungs are compressed. The naturalconsequence of this condition is a striking dyspnoea with whichvery fat persons are more or less afflicted. This dyspnoea embarrasses them in walking, going upstairs, ascending an eminence orperforming the slightest bodily labor. Fat persons generally haveto lie on their backs, in which position they snore, have frightfdreams which often cause them to cry out suddenly as if tormented by anxiety. The compression of the lungs, the encroachment upon the thoracic cavity and the consequent dyspnoea causedisturbances in the circulation characterized by palpitation of theart, syncope, determination of blood to the head or liver, stomach, kidneys, uterus, etc.At the commencement of the disease, the digestion is generallyvery active and frequently degenerates in canine hunger ; after tfatness has acquired a high degree, the patients often become dyspeptic, are tormented by flatulence, acidity of the stomach, eructions. In consequence of the resulting congestion of the stomachand liver, the slightest meal leads to oppression of the stomachnausea which frequently increases to sour or bilious vomiting. Supatients are not troubled with costiveness, and frequently have tor three papescent evacuations in the course of the day. The urinis frequently cloudy, opalescent ; after bodily work, the emissioof urine is attended with a burning sensation in the urethra, andhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 602 of 653quantity of uric acid is deposited.716 Obesitas, Adiposis, Polysarcia, Obesity.The perspiration has a peculiar, sometimes a rancid smell, or likthe odor of a goat. In the above-mentioned semi-circular furrowsor folds the frequent sweating causes an erythema which afterwardchanges to a moist and exce^ingly fetid intertrigo. This may likewise take place under the breasts, between the thighs and pudendum, and even at the anus.The pulse is mostly feeble, small and easily compressible, the sesitiveness to cold is much less, the menses are scanty, the sexuainstinct frigid or even extinct ; women are often sterile.As a rule, fat persons are indolent, apathetic ; they dread bodilexercise, even a little mental labor ; their muscles are deficientone, their senses are dull, their intellect is torpid, and theyinclined to sleep.These phenomena are not, however, without exception ; a greatmany fat persons remain quick, of active mind and body; we haveknown a fat old gentleman who danced more vigorously than hisyoung associates and, not feeling tired, at the same time entertained his company with the most piquant anecdotes.Polysarcia is frequently attended with a disposition to parasiticgrowths, such as lipoma, cancerous depositions, or with a tendencto scurvy or dropsy."While teething, fat children are in danger from congestions of thead. It is very seldom that they live to an old age. Fat personsare often suddenly struck down with apoplexy and paralysis of theheart. Intercurrent diseases often assume a dangerous characteron account of the existing disturbances in the respiration and ciculation. Fat persons are frequently anaemic ; in such a case, escially after severe diseases, hydnemic conditions frequently devethemselves which it is difficult to distinguish from morbid fatneFat persons are frequently attacked with boils and carbuncles ; tlatter frequently run a dangerous course, causing vast destructioin the subcutaneous cellular tissue. Acute diseases are often succeeded by dropsy or marasmus.On this account a good deal of cautious reserve should be usedin establishing a prognosis in high grades of polysarcia, more escially if an atheromatous degeneration of the blood-vessels or afatty degeneration of the heart may be suspected.Treatment, An excessive deposition of fat is an anomaly inthe sphere of nutrition which, in our opinion, depends upon a weaness of the assimilative functions. In the case of children it isquently caused by over-feeding, and in the case of adults an exceObesitas, Adiposis, Polysarcia, Obesity, 71781 ve supply of nourishment is likewise the frequent cause of fathttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 603 of 653In either case the overloading of the digestive organs weakensthem, the food is not adequately transformed into firm constituensuch as muscular fiBre, osseous tissue, but, remaining at a low sof assimilation, is transformed into carbo-hydrates.Starting from this point of view, the treatment of adiposisshould, in our judgment, aim at invigorating the assimilativeenergy of the organism and at the same time preventing an excessive supply of fat-making food.It is a well-known fact that adiposis cannot be arrested by anyknown method of treatment. For, independently of the weaknessof the assimilative functions, we frequently have to contend agaiother congenital, hereditary or individual, known or unknowntendencies which favor the excessive deposition of fat and whichit is either difficult or impossible to control.For this reason, when treating polysarcia, we confine ourselvesto such dietetic and hygienic measures as will quicken the metamorphosis of the tissues and invigorate the assimilative functionat the same time we resort to such internal remedies as will corrconstitutional tendencies and promote nutrition.In order to accomplish this object with as much speed and certainty as possible, we prescribe regular meals and a moderate diebut sufficient to satisly the appetite ; such patients had betterfine themselves to lean and young meat, with fresh vegetables andsalad, and abstain from rich soups, fat gravies, fat farinaceousfat fish, potatoes, beans and peas, quantities of bread, beer, spthey must likewise avoid cofiee, tea and tobacco, for these substances retard digestion and interfere with the metamorphosis ofthe tissues. The best beverage for such patients is fresh water,wine and water, acidulated alkaline beverages with or withoutwine, water mixed with acidulated jellies. For breakfast werecommend weak beef-broth or vegetable soups without fat, orskimmed milk with a little sugar ; eggs and chocolate have to beavoided, they contain too much fatty matter. For dessert we permit fresh or stewed fruit, and for supper a light soup and stewedfruit. Food spiced with a little pepper agrees with such patientsprovided it is not fat. Water-ices are likewise allowable, iceis too rich and must be avoided.Together with these dietetic arrangements which have to bestrictly obeyed if they are to do any good, the following rules aof special importance. In order to stimulate the metamorphosis of718 Obesitas, Adiposis, Polysarcia, Obesity.the tissues and secure the introduction of as much oxygen as possible into the organism, fat persons should walk or ride on horsehack whenever their time and circumstances will permit ; ridingin a carriage is of no use to them ; active exei^ise in the openespecially in the morning and evening, promotes in a high degreethe assimilation of food and the metamorphosis of the tissues. Itis well if, during their walk, they frequently drink cold water,a little when tired and then continue their walk. The more exercise they take in the open air, the more healthy the blood becomeand the more the fat disappears. They had better sleep as littlehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 604 of 653possible, and avoid inaction as much as they can. Active exerciseat home, while attending to their domestic affairs, is advisable;idleness promotes the deposition of fat. Swimming, riding on horsback, hunting, cold ablutions, cold baths, in bad weather walkingup and down in the room at a rapid rate ; gymnastic exercises, ifresorted to in systematic order, impart great activity to the metmorphosis of the tissues.These measures, if carried out strictly, are often alone sufficieto arrest the tendency to fatness and diminish the amount of fat.The so-called panting-cure, which has been frequently resorted toin modern times, rests almost upon the same principles and has prduced good results in some cases. In pursuing a strict diet, themain point is for the patients to persevere until the mass of fathas considerably decreased and they have gained in agility and eaof motion. In pursuing a dietetic treatment, the bodily strengthincreases instead of diminishing, the blood does not grow paler bit attains a higher degree of oxygenation, and the weight and circumference of the body decrease, whereas all the physical andpsychical functions become more animated.In conducting the internal treatment, we pay particular attention to the disturbances in the respiration and circulation, thefunctions of the stomach and intestinal canal, the quality of theblood and the other coexisting abnormal symptoms.Fat persons are often short-breathed, especially when going upstairs or performing the slightest bodily work, or walking a littfaster than usual. In such cases a careful exploration of the thoand abdomen becomes indispensable. If, on percussing the regionof the heart, we discover a dulness over a larger surface, the impulse of the heart remaining vigorous and the sounds of the heartloud and distinct, we infer the existence of a larger abnormaldeposition of fat about the heart or in the mediastinum, in conObesitas, Adiposis, Polysarcia, Obesity. 719sequence of which the thoracic cavity becomes contracted and thenormal expansion of the lungs is interfered with. For these symptoms we give Arnica 2, from six to ten drops in half a pint of waa dessertspoonful every two or three hours. At the same time werecommend the diet that has already been pointed out as mostconducive to persons suffering with adiposis. By continuing thistreatment for weeks, at intervals of two or three days, we haverestored patients to an apparently perfect state of health. Wheththe Arnica acts by diminishing the pressure of the fat upon theheart, or bringing about a reabsorption of the fat-molecules, reman open question.If the dulness in the cardiac region is attended with feeblenessof the impulse, and if the sounds of the heart are likewise lessdistinct, we infer a fatty metamorphosis of the heart, for the trment of which we refer the reader to the article on fatty degenertion of the heart.If the fatty degeneration is accompanied by dilatation of theheart and pulmonary emphysema, we pursue the treatment recommended for emphysema.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 605 of 653If the patient is dyspeptic, the abdomen meteoristically distendethe region of the stomach bulges, the liver, spleen and the heartare pressed upwards ; if the stomach is acid, and nausea and vomiting are complained of, the first thing to be done is that a strdiet should be rigidly enforced. Such derangements generally arisfrom luxurious living or the abuse of spirits. Persons who are inthe habit of using spirits, may gradually be weaned from thisindulgence by diluting their drinks. A sudden and total deprivation often superinduces an injurious weakness. Internally we giveNiLZ vom. 8, or Natr. mxir. 6, or Carbo veg. 6, two or three doseday, until the abdomen becomes softer, the breathing easier, theappetite keener and the diaphragm has resumed its natural positioIf the abdomen is not meteoristically distended, the region ofthe stomach does not bulge, and the other symptoms continue thesame, the abdominal integuments are very thick, the bowels aretorpid and the hemorrhoidal veins somewhat swollen, it is simplythe mass of fat accumulated in the abdominal integuments, in themesentery and in the omentum, which contracts the abdominalcavity and, by pushing up the diaphragm, causes the abovetioned difficulties. These can be remedied by strictly followingdietetic measures suggested in a previous paragraph. Internallywe persevere in the systematic use of Capsicum 2 or 3, and haveobtained handsome results by this means.720 Uraemia.Attention has likewise to be paid to the liver. This viscus islikewise liable to fatty degeneration giving rise to digestive derangements, dyspnoea, pressure in the epigastrium. The treatmentfor fatty liver has been indicated in the chapter on diseases ofliver.Other conditions which sometimes accompany fatty degenerationsof internal viscera, or adiposis generally, such as : hyperaemiathe liver, palpitation of the heart, fainting fits, sudden rush oto the head or chest and other symptoms of plethora ; anaemia,dyspepsia, intertrigo, etc., require the same treatment as is fouindicated in the respective chapters where these conditions arespoken of.Adiposis is sometimes benefitted by the use of mineral springs.Patients of this kind should never visit spas for purposes of heawithout the advice and consent of their family-physician. Chalybeate springs may be advisable in some cases ; in others Sulphursprings, in others effervescent waters, and in others again Iodinsprings. In all cases let the diet and general hygiene of the patbe regulated by his physician. H.]ift. Ursemia.[^Anafotnfcal CharacterisHcH. The cadavers of nreemicpatients do not exhibit any striking alterations by which the grasymptoms during the course of the disease could be satisfactorilyaccounted for. The brain and spinal marrow do not show anypathological alterations of tissue, nor any constantly occurringanomalies in the condition of their blood and vessels. The lungshttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 606 of 653are sometimes infiltrated as in pneumonia, the bowels are injectesometimes covered with follicular ulcerations, the kidneys are frquently hypersemic, or inflamed, or degenerated. The serous effusions which not unfrequently occur in the extremities, as well asthe mucus of the stomach and the secretions in the lungs have beefound to produce an alkaline reaction and to contain ammonia.The blood sometimes has a violet color and, in many cases, showsgreater coagulability and an increase of fibrin.According to Frerichs, the blood contains in all cases where thecharacteristic symptoms of ursemia are present, carbonate of ammonia in varying quantities, sometimes manifesting its presence bits disagreeable odor and at other times effervescing by the addition of muriatic acid.Ur«mia. * 721JEtlolofff/, Urcemia 18 only observed in the course of other diseases. It may be caused by obstructions in the secretion of urineas may occur during an intense hyperemia of the kidneys, nephritis, extensive infiltration of the renal canaliculi iu Bright's din the course of scarlatina, etc.; or in degeneration of the kidnby renal calculi, carcinoma, atrophy, etc., or during the shrinkiof the substance of the kidneys in old people ; or it may be causby obstructions in the excretion of the urine, in consequence ofpressure upon both ureters, or in consequence of obstacles at thesphincter of the bladder or in the urethra, as in the case of stoor gravel, or from hypertrophy of the prostate, strictures of theurethra, etc.Urseniia may likewise occur during the last months of pregnancy,during or after parturition, in the course of scarlatina, choleraor from effusion of the urine between the tissues as during oj)ertions, wounds, injuries, perforations, etc.Symptoms. According to the course and intensity of thesymptoms we distinguish acute and chronic ursemia.Acute uraemia is almost always preceded by a diminished secretion of urine, or the secretion of urine meets with difficultiesobstructed ; at times there is only a reabsorption of the urine iconsequence of effusion of urine into the cellular tissue. The fisigns of ursemic intoxication of the blood often consist in vomitand diarrhoea, or only in vomiting, sometimes in apathy and drowsiness, or in headache with vomiting, weakness of sight and blanddelirium ; or convulsions and amaurosis set in all at once, and acommonly followed by ursemia of the highest degree of intensity.At other times the invasion of uresmia takes place with a violentchill followed by intense fever with typhoid symptoms. If cerebrasymptoms set in, they generally point to the presence of adynamiawe notice a dulness of perception, a difficulty of collecting onemind, stupefaction, somnolence or a deep sopor; the delirium isgenerally of the bland or moaning kind. In rare cases only theregreat restlessness, an excited state of the mind, loud delirium,to escape, etc. The cerebral symptoms are frequently associatedwith amblyopia, vertigo, mistiness of sight, or even real amaurosdeficient irritability of the pupil with hardness of hearing andhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 607 of 653buzzing in the ears, gritting of the teeth or trismus. The buccalcavity and teeth are generally dry, the thirst is very moderate,appetite is entirely gone, the voice is rough or husky, the respition accelerated, dyspnooic or stertorous. The expired air has ofthe smell of urea or contains traces of ammonia.722 • Uramia.The abdomen is distended, at times the distention is bnt triflingat other times meteoristic, the alvine evacuations are frequentlydiarrhoeic, the skin is either dry or covered with a perspirationhas the smell of urea, or with a fine dust consisting of urea ; isome cases petechise or miliary vesicles make their appearance. Tpulse is always very hurried and small, some times irregular andfiliform. Towards the end of the disease, spasmodic tremors, muscular jactitations, subsultus tendinum and an automatic graspingand feeling around, with continued coma, tracheal rattling andfinally paralysis of the sphincters set in.Chronic ursemia develops itself gradually during continued derangements or obstructions in the secretion of urine, or in consequence of a continued decomposition of the urine that had remainebehind in the urinary ducts. Chronic ursemia is characterized bysuch phenomena as the following: Sickly, anaemic appearance; continued loss of appetite, generally with a thickly-coated tongue ;sion to meat, dryness of the mouth ; an increase of thirst, generwith a desire for sour or cooling things ; increasing lassitude,siness ; slowness of speech and thought, apathy and forgetfulnessconstantly increasing dyspnoea, muscular debility and emaciationcostiveness or serous diarrhoea; dryness and sometimes violentitching of the skin which not unfrequently appears studded witheczema, lichen, ecthyma, etc.; asthmatic difficulties, serous catoedema of the lungs, finaHy anasarca and general dropsy in consequence of the constantly increasing marasmus.Course, Terminations, Prognosis. Acute ursemia sometimesruns a very rapid course, striking the patient down with thsuddenness of lightning: if, in the course of Bright's disease, stina, in the last days of pregnancy, previous to or subsequent toconfinement, etc., the urine is suddenly retained or is reabsorbeconsequence of an effusion of urine into the cellular tissue; orthe urine remains stagnant, and an ammoniacal decomposition ofthis fluid takes place: vomiting, eclampsia or amaurosis set in,phenomena which are so speedily followed by a deep sopor, continued convulsions or symptoms of paralysis of the brain, thatdeath may result in a few hours or only at the expiration of oneor two days.In the majority of cases the disease runs a leas rapid course. Thsymptoms manifest themselves gradually, sometimes diminish andthen increase again in intensity, according as the disturbance inthe secretion and excretion of the urine improves or gets worse.Uraemia. 723Fevcre cases are characterized by a constantly increasing stuporhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 608 of 653Bojx)r, or by an increase of the typhoid symptoms. Cases which sein with symptoms of cerebral irritation and bear some resemblanceto meningitis, occur much less frequently. The existing disturbances in the urinary secretions and excretions shed light on thediagnosis. The more violent the symptoms of ursemia, the shorterthe course of the disease; the milder the symptoms, the morechronic its course.The worst cases occur if, in consequence of retention, stagnationor effusion of urine into the cellular tissue, the urine is decomand the blood is poisoned with carbonate of ammonia; this infection is designated by Treitz as ammonicemia.Considerable quantities of urea and carbonate of ammonia arenot only found in the blood, but likewise in the stomach, intesticanal and other secretory organs. The presence of carbonate ofammonia in the stomach is manifested by copious vomiting of substances that have an ammoniacal odor.If the ursemic blood is decomposed in the intestinal canal or isdecomposed already when entering the circulation: watery diarrhoeic stools take place having the odor of ammonia; or else adysenteric process sets in, attended with a diphtheritic or gangrenous destruction of the mucous membrane of the large intestineand of imminent peril to the preservation of vitality. The buccalmucous membrane frequently exhibits scurfy exfoliations spreadingdown into the throat, in consequence of which the voice becomeshusky and sometimes extinct "as in the case of cholera-patients.The saliva, the milk in the breasts, the perspiration contain carate of ammonia and have the odor of ammonia. The expired airlikewise spreads an odor of urine and ammonia. The skin is frequently seen covered with a whitish ammoniacal dust, crystals ofurea and the chloride of sodium.The irritating action of Ammonia upon the various organs frequently causes a momentary hyperseraia of the brain which verysoon results in sopor ; in the lungs an intense catarrh or croupoinflammation develops itself ; effusions rapidly set in in the plpericardium, peritoneum and in the ventricles of the brain : thestagnation and decomposition of the urine in the bladder frequentlead to inflammations and suppurations of the vesical lining membrane, or to depositions of pus between the different layers of tbladder, in consequence of which the symptoms of ammoniaemiaand pyaemia may api>ear together. If renal dropsy is at the same724 Urxmia.time present, the accumulations of serum under tlie skin and thevarious transudations contain urea and carbonate of ammonia.The course of ammonisemia is either acute or chronic ; its symptoms bear the greatest resemblance to urtemia with which it isfrequently confounded. The above-mentioned pathognomonic symptoms give the exact diagnostic distinctions between these two conditions. Uraemic symptoms frequently occur without any symptomsof ammoniffimia ; but the latter never exist without the former.Acute ammonieemia likewise sometimes runs its course with thehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 609 of 653suddenness of lightning, especially in the case of ancemic and exceedingly debilitated patients. Vomiting sets in, or vomiting anddiarrhcea, or diarrhoea without vomiting, or else a sudden dysentery followed by a rapidly increasing sopor and death in twelve,twenty-four or forty-eight hours. In most cases acute ammonisemiaif it runs a moderate course, lasts a few weeks ; but the possibiof sudden efiusions into the pleura, pericardium, cerebral ventrietc.: the possible supervention of croupous pneumonia or acuteoedema of the lungs, etc., impart a high degree of danger to thedisease. Chills frequently occur during the course of acute ammonieemia, frequently with typical regularity and bearing a highldeceptive resemblance to intermittent fever.Chronic uraemia as well as chronic ammonisemia may last monthsand even years ;»they may get better and worse again according asthe determining causes decrease or increase in virulence. The worcases generally occur in consequence of iscburia or anuria. If thdesire to urinate can be restored, the danger is momentarily removed.Dryness of the mucous membrane of the mouth and fauces, ^^ asthough every atom of moisture had been absorbed by blotting paperthe mucous membrane appearing dry and glistening;" hoarsenessor even aphonia ; the plainly ammoniacal odor of the expired aira constant aversion to meat; livid color of the skin, a progressiemaciation and muscular debility constitute, according to ProfessJaksch, reliable diagnostic signs of ammonisemia which are veryseldom observed in cases of ursemia. Convulsions, amaurosis anddropsy have never been seen by Jaksch in the course of ammonisemia. However, since this condition never occurs except in thecourse of uraemia, we hold that the above-described phenomenamay likewise characterize a condition of uraemia.Light and moderate, even severe and very acute cases of uraemiaand ammoniaemia frequently terminate in recovery, provided theUixmia. 725obstacles which impede the excretion of urine, can be removed.These diseaseB, however, are peculiarly liable to relapses in whicase very serious accidents may occur.Cases setting in with a sudden and crushing violence, almostalways terminate fatally.Paralysis of the brain, croupous pneumonia or dysentery withgangrenous destruction of the intestinal mucous membrane, orserous eftusions into the various cavities of the body, or a highdegree of marasmus and general dropsy frequently lead to a fataltermination.In cases of great intensity the prognosis is most commonlyunfavorable.In mild cases of ursemia and ammonieemia the prognosis dependsupon the possibility of removing the disturbance of the urinarysecretion and excretion either totally or partially. This conditilikewise applies to the chronic form of uraemia or ammonisBmia.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 610 of 653The access of convulsions or amaurosis is generally a very badprognosticVomiting and serous diarrhoea sometimes constitute a favorableprognostic symptom in the course of ammonisemia, for the reasonthat quantities of the carbonate of ammonia are often excreted bythis means. If croupous pneumonia, oedema of the lungs, dysenteryand a deep sopor set in, the prognosis is doubtful.Treatment* Whenever the secretion and excretion of urine isinterfered with or entirely obstructed, the cautious physician wiat once be reminded of the possibility of a sudden or gradual development of unemic symptoms. These can only be prevented bythe speediest possible restoration of the excretion of urine eithby the use of internal remedies or by mechanical means or by anoperation.In very acute cases where the disease develops its symptoms withextraordinary rapidity; where the vomiting, or a paroxysm ofeclampsia, or the sudden invasion of amaurosis is speedily followby deep sopor, any kind of treatment is in the majority of casesutterly powerless. If we do not soon succeed in securing an outleto the stagnant urine and, by means of an appropriate medicinewhich has to be repeated again and again at short intervals, removing the sopor and the accompanying paralytic condition of thebrain, the patients are irretrievably doomed.If such symptoms make their appearance during the act of parturition or in the last period of pregnancy, they are caused by t728 Uraemia.obstructed excretion of Urine consequent upon the pressure of thegravid uterus upon the ureters and bladder. In such very acntecases the patient can only be saved by bold measures: artificialdelivery should at once be resorted to, after which the urine isdrawn off with the catheter. A dose of Hyosc. 3, or Opium 3, orHydrocyan. ac. 3, or Ldciuca virosa 8, may be given every five, tor fifteen minutes. In a case of this kind, occurring immediatelyafter confinement, where the symptoms of acute uraemia developedthemselves with fearful rapidity, the patient was at once relieveby the application of cold compresses to the region of the distenbladder. The organ contracted and the urine was expelled withthe fierceness of a torrent. The case occurred in Dr. Hemperspractice.If the jaws are locked, the medicine may be administered subcutaneously. If no improvement sets in in one hour, a second, anda third remedy, etc., may be injected, etc This is the only way opreventing a fatal issue.In the course of scarlatina, ursemic symptoms may set in withsudden violence in consequence of croupous nephritis resulting insudden obstruction of the urinary canals with plastic exudation.Here, help can only be afforded by the speedy removal of the inflammatory process in the kidneys. For this purpose we give everyten minutes a dose of Hepar sulpk. cede. 8 or Kali hydriod. 1. Ifhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 611 of 653exhibition of these remedies for two or three hours results in amore copious diuresis with numerous fibrinous casts, life may besaved.If symptoms of cerebral hypereemia prevail, we give Bellad. orAtropin.^ Apis^ Stramon. or Conium 8.If sopor is most prominent, we resort to Bellad.^ Lact. vir,^ Agaor Anac. 3.For anaemic and paralytic symptoms we give Ar^n. 3, Ghijux 1or Ckinin, arsen. 1, or Phosph. 3, Phosph. 1 or 2, or Camphor. 3.For very acute strangury, with scanty and hot urine, or discharges of the urine drop by drop, and if the urine is mixed withalbumen or blood, Cantharis 3 is appropriate.Chronic ursemia generally occurs with vomiting, constant lossof appetite, coated tongue and aversion to certain kinds of food;is generally mistaken for catarrh of the stomach and treated accoingly. In atony of the urinary bladder, hypertrophy of the wallsof this viscus or of the prostate; in strictures of the urethra,the excretion of urine, according to the statement of the patientUrxmia. 727not unfrequently takes place without much difficulty. The apparently gastric phenomena continue, however, in spite of the mostcareful medicinal treatment, and gradually increase in intensity.In such cases the statements of the patients must not be dependedupon, but the bladder must be carefully explored immediately aftean emission of urine. Almost in every case of this kind a largeror smaller quantity of urine will be found left in the bladder ;long as this urine is pure and undecomposed, it only causes ursemsymptoms ; but as soon as ammonia develops itself in this urine,and the fluid becomes cloudy, acrid and spreads a fetid odor, ammonisemic symptoms make their appearance.In such cases it is absolutely necessary to draw off the urine atleast twice a day with the catheter in order that all stagnationurine may be prevented. At the same time the difficulty causingthe retention of urine, such as the torpor of the detrusor urinesmuscle, the hypertrophy of the prostate, urethral strictures, etchas to be treated with appropriate homoeopathic or surgical meansfor which we refer to the chapter on diseases of the Urinary OrgaWe have already stated that, if the cerebral symptoms are veryprominent, such as headache with vomiting, dryness of the mouth,bland delirium and somnolence, we either administer JBellad. orAtropin. or likewise Hyosc. 8,If the gastric symptoms prevail, with aversion to meat, we giveSulph, is, Sepia 6, Natrum carb, 6, or Puis. 3.If the ansemia and muscular debility are far advanced, with dryness in the mouth, extensive anasarca, incipient effusion into thpleural cavity or pericardium, etc., we use Arsen. 8, or Chinin.1 to 2, or Lachesis 6.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 612 of 653If there is a particular tendency to serous diarrhoea, we resortPhosph. 8, or Arsen. 8, or Argent nitr. 8.Dysenteric symptoms yield very rapidly to Corr. subl. 2 to 8,Hepar 8. 8, or Sulph. 6.If the dysentery is attended with septic symptoms, we administerArsen. 8, or Carbo veg. 6, or China 8, or Mar. ac. 1 to 2.Intercurrent pneumonias are almost always of the croupous kind,and require to be treated with Iodine, Phosph. has never done usany good in such cases.Ammoniaemic phenomena are treated by us in accordance withthe same maxims ; so far, however, we are not acquainted with asingle reliable remedy for this species of blood-poisoning. Phosphas seemed to produce some improvement; Lyeop.^ Phosph. ac.^728 ' Pyaemia.NitH ac, have been tried by us with some good results. Arsen. andHep, sulph. pro ved useless. Asafoet 3 may perhaps do some good.We likewise recommend Kreos. and Petrol. 3 by way of experiment. Such conditions, as a general pruritus, pneumonia, bronchial catarrh, oedema of the lungs, the various exanthemata, etc.have to be treated according to the rules laid down in the chaptewhere these diseases are specially discussed.In acute unemia the diet has to be very much restricted. Patientsafflicted with chronic uraemia might partake of some meat if theyhad not an irresistible aversion to meat-diet of every descriptioIn such cases eggs, milk, vegetables, lish, a light farinaceous dand beer have to be the main articles of food.Patients who are very much debilitated, may likewise partakeof a little old wine.If such patients are tormented by itching of the skin, relief isobtained by washing the body with dilute vinegar and brandy, orby taking a tepid bran-bath two or three times a week. H.]16. Pyflemta.Purulent Decomposition of the Blood.[^Avntomical Chai*acteriHtics. Collections of pus are alwaysfound in the cadavers of pyoemic persons, most frequently in thelungs, less frequently in the liver, spleen, kidneys, in the subcutaneous cellular tissue, in the muscles and sometimes in the brThey form abscesses which are generally located at the peripheryof organs and have a cuneiform shape. Their apex is always turnedinwards, their base outwards. When first forming they representcircumscribed hemorrhagic infarctions of a dark-red or even blackish-red color and a dense consistence. Under the microscope thevessels look turgid and are filled with red corpuscles. These firspots afterwards assume a gray sickly appearance, soften from thecentre outwards and form abscesses which never consist of normalhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 613 of 653pus but always of decayed fibrin, the detritus of tissue and decoposed serous pus.Formerly these abscesses were regarded by Rokitansky as pyjemicmetastases and attributed to an infection of the blood by purulenmatter. Virchow has however shown by numerous experimentsthat these abscesses are the result of embolia ; in other words tthey are caused by the transfer of particles of tissue from one pto another; that pure pus never engenders pysemia, but that itmust be in a state of decomposition and contain decayed fibrin anPyemia. 729that it is the entrance of the latter into thf circulation whichcauses the obstructions in the bloodvessels tjiat are afterward tformed into abscesses.Etiology. Most frequently pysemia arises from suppurationsin the interior of organs, from the downward burrowing of abscesses, purulent inflammations of joints, gangrenous localizatioduring the course of phlebitis, periphlebitis, metrophlebitis, lyangioitis, endocarditis; in the course of puerperal fever, typhusvariola; in consequence of suppurations after surgical operationswounds, etc. Decomposition of the pus is an indispensable condition for the development of pysemia. This decomposition isoccasioned by a want of cleanliness, vitiated air, crowding of sirooms with wounded men, effusion of urine into the cellular tissuaccess of air into open wounds or ulcers.The infection of the blood is supposed to emanate from thedecayed purulent serum.SympUrms* The pysemic process almost always commenceswith a chill followed by intense heat. Sometimes the chills recurin such a manner that the heat is mingled with chilly creepings oeven severe paroxysms of chills. The pulse at once becomes hurrieas soon as the pysemia sets in ; it is seldom below one hundred,small and easily compressible. In most cases delirium sets induring the heat, with restlessness, heat of the head, dulness ofthe sensoriuni and tendency to sopor. The patients feel very muchexhausted, the appetite is entirely gone, thirst intense, the tonbecomes dry, cracks, the teeth are covered with brown sordes, thenostrils look sooty. Sometimes aphthse form on the mucous membrane of the mouth and fauces. Very often bronchial catarrh,pneumonia and pleuritis supervene. The bowels are generallyconstipated, the skin is hot and dry, sometimes icteric or lividelse profuse sweats break out, with sudamiua or numerous pustulesSubcutaneous abscesses are very frequently accompanied by erysipelas of the skin, inflammations of internal organs by violentparoxysms of fever and local pains, purulent effusions into articcavities by painfulness and swelling of the joints.Very frequently the abscesses become flabby and lax, and theircontents change to ichor; the wounds assume a sickly appearanceand become diphtheritic. In such cases profuse diarrhoeic stoolsoften set in, or hemorrhages from internal organs, bedsores orpartial paralysis.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 614 of 653Course, Terminations, Prognosis. The course of the730 Pyaemia.disease is eometimes very rapid, This is most frequently the casein puerperal fever ; the patients are attacked with chills and infever-heat which does not remit; they become delirious, lose theiconsciousness, lapse into a deep sopor and die in fortyhours.In such cases pya^mic localizations are frequently met witin the brain or lungs.A milder course of the disease is marked by distinct remissionslasting from teo to sixteen hours in benignant and only three tofour hours in malignant cases. The shorter the remission the moredangerous the coui'se of the disease. The more violent the fever:the more imminent the danger of internal or external inflammations, the shorter the course of the disease and the more frequena fatal termination.In moderate forms of the disease it may last four, five or sixweeks and terminate in recovery. Convalescence is however in allcases a slow process, slower even than after typhus.In cases running a rapid course the prognosis is generally fatal.In a mild form of the disease a good deal depends upon thecircumstance whether the various manifestations of the pathological process can be improved. If we succeed in moderating theinflammatory symptoms and sustaining the strength of the patient,the prognosis is usually favorable.Sopor, constant diarrhoBa, hemorrhages, decubitus, paralysis ofthe sphincters do not admit of a favorable prognosis. A diphtherichange in existing wounds is likewise a symptom of very bad omen.TreatmenU If we deal with morbid processes in the courseof which pysemia may be apprehended (see etiology), we must takecare to prevent this result. To this end existing abscesses havebe opened in due season, wounds have to be kept clean and theaccess of air into such cavities has to be carefully guarded agaiAt the same time the sick-room has to be frequently ventilated,over-crowding with patients has to be avoided, cleanliness andgood nursing have to be seen to.If, in the course of the above-mentioned diseases repeated shiverings or chills set in, they always denote the beginning of pyiethe symptoms are evidently of a typhoid character, associated witgreat debility and dissolution of the blood.For this reason, with a view of preventing as speedily as possiblthe great loss of strength or correcting the fluids, we resort atto Quinine 1, a dose every two hours, and continue this remedyuntil the chills cease and the violence of the fever abates.Pyaemia. 731http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 615 of 653If a high grade of anaemia and great prostration manifest themAclves during the chills, it is well to substitute Chinin.arsenicIj a dose every two hours.The further course of the pysemic process resembles that oftyphus and the subsequent treatment is likewise like that of typhThe more violent the paroxysms of fever and the longer theexacerbations last, the more imminent becomes the danger ofinflammation. On this account the physician should be unremittingin his attention ; he should frequently examine the surface of thbody, and especially the abdomen ; a physical exploration of thethorax is likewise indispensable. If the sensorium is depressed,is important that, during such explorations, the frequency of therespirations or any impediments to the act of breathing, or adistortion of the features when pressure is made uj-on the abdomeor muscles, should be carefully noted. Inflammations in the subcutaneous cellular tissue, or in the muscles, in internal viscerathe joints, never fail to occur, and they have to be removed asspeedily as possible. For the treatment to be pursued in suchcases we refer the reader to the chapters on meningitis, parotitiarthrocace, pneumonia, puerperal fever, typhus.Of excellent eftect in the course of pysemia are ablutions of thebody with dilute vinegar, two or three times a day. If pustules sthemselves on different parts of the body, they can be destroyedand their increase in number prevented by rubbing the parts withcoarse, wet cloths. Larger pustules have to be opened with alancet.For the aphthsB or diphtheritic exudations in the mouth andfauces we have in vain used Iodine^ Merc.^ Borax and Hepar sulph.The much vaunted Kali cfdoricum and Arg. niir. likewise provedfruitless. Generally these processes only cease with the cessatioof pyaemia. In the case of aphthae the frequent rinsing or washinof the mouth with cold water; and in the case of diphtheriticexudations frictions of the buccal and pharyngeal mucous membrane with dry linen rags, or which have been dipped in coldwater, render excellent service.Abscesses have to be sought for with great care and, even ifdeep-seated, have to be emptied as speedily as possible.The dietetic and general precautionary measures to be adoptedduring convalescence are the same as those that have been recommended for abdominal typhus.After the termination of the disease a high degree of anaemia782 Septicaemia.and muscular debility generally remains. For the former we giveFerr. metalL^ carbon.^ or lacticum 1 ; for the latter China 1 orQuinine 1, two or three doses a day, together with a strengthenindiet.Country-air is well calculated to promote convalescence.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 616 of 653In the British Journal Vol. 26, page 480, Lachesis is recommended for pyaemia. This agent may be adapted to some cases.In our hands a case of pyaemic phlebitis of the left lower extrempromptly yielded to Belladonna preceded by a few doses of Aconiteand a case of pneumonic pyaemia to Tartar emetic, H.]17. Septlciunla.Putrid Decomposition of the Mood.[Anatomical Characteristics* The blood is of dark color,and does not turn red when exposed to the air; it loses its coagulibility either totally or only partially, putrefies more rapidlin many cases, has an acid reaction. The serum has frequently abloody color, the blood-corpuscles are partially dissolved and thblood-vessels are penetrated by their contents. In the interior othe tissues we frequently discover infiltrations with dissolvedhsematin.Utiology. In most cases septicaemia proceeds from gangrenedlocalities or is occasioned by local processes of decomposition otransformation into ichor. Not unfrequently it is the consequenceof contagious or miasmatic influences, as in the plague, dysenteretc. Or it may arise by the decomposition of substances thatought to have been excreted but remain behind in the organism,as in acute gastric and intestinal catarrhs, ichorous exudations,In many cases the etiological origin of the disease remains unknown, in which case the septic infection of the blood has to beexclusively ascribed to the genius epidemicus or to endemicinfluences with which we are unacquainted.Symptoms* The septic condition sets in with or withoutprecursory symptoms. The precursory symptoms consist inweariness and heaviness of the body; in dull headache accompanied by a sense of dreariness, dulness and apathetic indifferenin restless and unrefreshing sleep; in dull, wandering pains in tlimbs; in pressure at the stomach and in the loins; in loss ofappetite with a sensation of repletion, and with an insipid, bittor foul taste ; in frequent chills with fugitive heat and occasiooutbreak of sweat; in the secretion of strong-smelling urine andSepticaemia. 783alvine evacuations having a foul odor. These symptoms havingcontinued for a shorter or longer period, and sometimes withoutany preliminary symptoms, a violent chill sets in followed by amoderate or intense fever-heat. This heat has the peculiarity ofimparting to the hand a stinging or biting sensation (calor mordaThe symptoms of adynamia which now develop themselvesresemble those that characterize the higher and highest grades ofileo-typhus and plague. Most generally the septic symptoms onlymake their appearance after the patients have become debilitatedand apathetic to such an extent that they faint away when theleast attempt is made to raise them or change their position. Thefirst sign of septic decomposition is the fetor of the mouth; thebreath and the bodily exhalations likewise spread a putrid odor,so that, whenever the patient raises the bed-cover by his motion,a sickening stench affects the nostrils. Stool and urine likewisehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 617 of 653have a cadaverous smell. The dissolution of the blood is mademanifest by the following symptoms: readily-bleeding gums inconsequence of which the mouth, tongue, teeth and lips acquire ablack-brown appearance; frequent nose-bleed, vomiting of blood,bloody and foul-smelling diarrhoeic stools, hfematuria, hemorrhagfrom the vagina and uterus. Blood has even been known to exudefrom the canthi and ears. At the same time petechise make theirappearance, either in the shape of ecchymotic spots or of streaksof suffused blood in various parts of the body ; on parts of thebody which are exposed to continued pressure, bedsores break outwhich generally become gangrenous. At the height of the diseaseinflammations of the meningse, pleura or peritoneum frequentlyshow themselves, with sanguineo-serous exudations, occasionalswellings of the parotid glands that soon become ichorous, aphthein the mouth and throat or pains in the joints, with effusion ofbloody serum into the articular cavities.If the disease reaches the highest degree of intensity, a continued sopor sets in, with trembling of extremities, subsultustendinum, grasping at flocks, involuntary evacuations, cold perspiration and fainting fits, and the patients die from exhaustionCourse, Terminations, Prognosis. Cases consequent upongangrene or the reabsorption of ichor, are very seldom precededby preliminary symptoms; most commonly a chill occurs verysuddenly, after which the typhoid symptoms develop themselveswith intensity and more or less rapidity. Such cases generally rua very acute course, the adynamic and septic symptoms set in with734 Septicaemia*overwhelming virulence, so that a fatal termination takes placealready in two or three days. Some cases run a milder course fortwo, three or four weeks and upwards, and sometimes recover.Cases arising in consequence of a contagium or miasm or fromunknown causes, generally set in with precursory symptoms;* theintensity of the pathognomonic phenomena mostly depends uponthe violence of the exciting cause or upon constitutional tendencIf the prevailing type of disease is of a malignant character,and the individual has a feeble, sickly or debilitated constitutithe phenomena of septicaemia are generally very violent and thedisease runs a rapid course. The most dangerous cases are, if thefever remits but little or not at all, the prostration is excessithe septic phenomena make their appearance at an early period.Nevertheless, even the most threatening symptoms should not besufficient to discourage the physician: as in typhus, so in septicaemia, the disease may have reached the acme of its intensity,when all at once the fever abates while copious fetid sweats breaout, or frequent discharges of urine take place, or bloody, alsocolored and fetid stools are passed, after which the disease progresses slowly towards final recovery.In most cases death takes place by exhaustion, or in consequenceof intense and frequent hemorrhages, or by paralysis, gangrenousdecubitus, gangrene in other parts of the body, or by effusions oa bloody serum into the various cavities of the body.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 618 of 653As after diseases we notice a long-lasting weakness of the wholeorganism, obstinate derangements of the digestive functions or inthe composition of the blood, a high degree of anaemia, hectic fea cachectic appearance followed by dropsy or marasmus.As a rule the prognosis is doubtful. Very acute cases withtrifling or no remissions are almost always fatal. Frequent hemorrhages; foul-smelling excretions, a fetid breath and perspirationsoporous conditions, the access of gangrenous decubitus, partialparalysis, rapid prostration with collapse of the features, discotion of the petechise, subsultus tendinum and grasping at flocks,vitiated constitution and depressing social circumstances are unfavorable prognostic signs.Treaffnent, When treating ichorous abscesses, ulcers or ichorous wounds, or any other pathological processes where gangrenehas supervened, we must always be prepared for the superventionof septic phenomena. In many cases septicaemia can be preventedby diligent washing of the abscesses, ulcers, wounds or gangrenouSepticasmia. 733places with chlorine-water or with a solution of Xreosote, by frequently and carefully ventilating and fumigating the sickand by observing the most scrupulous cleanliness and attending tothe most careful nursing of the sick.As soon as chills or shiverings set in, we at once administer Quinine 1, or Chiniru arsenicos. 1 for the reasons that we have statwhen treating of pyaemia.In cases with precursory symptoms we likewise have chills whichare generally succeeded by a more or less intense fever, as in otacute diseases. From the beginning to the end the treatment isthe same as that for typhus.In great prostration with fetor of the mouth, fetid breath andsweat, we give Ars. 8 every hour.This remedy not only moderates the burning fever and prevent*the rapid prostration, but it has likewise a decided effect upondecomposition of organic material, by which means the furtherprogress of the septicaemia is arrested and hemorrhages, petechiedecubitus are prevented.Even if all reasonable ground for hope had disappeared, Arsen,may still prove an efficient remedy if the skin is cool, the featare collapsed, the patient is exceedingly prostrated, in a soporocondition with muttering delirium, grasping at flocks, subsultustendinum, petechise, ecchymoses, involuntary, bloody and cadaverously-smelling stools and even gangrenous decubitus.Carbo veg. 6 in solution, a dose every hour or two hours mayprove serviceable in similar circumstances.If the symptoms of adynamia prevail ; if the patients are sunkin apathy or sopor ; if they faint when trying to raise themselvein bed ; if, on trying to hold a thing, their hands tremble ; if,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 619 of 653trying to put out their tongue, it trembles; if, when lying on thbacks they settle down in the bed, and if they pass bloody, cadaverously-smelling stools, we give China 1, or Chinin. arsenicos. 1Phosph. 8, every hour or two hours (also Muriatic acid).In many cases, especially if the septic condition has to be attributed to a contagium, the adynamia is accompanied by symptomsof extreme nervous irritation ; the patients have a dry or burninheat, are tormented with loquacious or noisy delirium, their cheeshow a circumscribed redness, their thirst is very great, their pis hurried and feeble, with grasping at flocks, subsultus tendinucatching at imaginary objecta, constant desire to get up and dres736 Septicaemia.etc. For such Bymptoms we give Rhus tax. 3 every hour, even ifpetechise, bloody stools, meteorism and clammy sweats are presentIf a high degree of stupor prevails, if the skin is coi)!, the pespiration clammy, the features collapsed, the pulse small and filform, and if the petechise or ecchymoses are at the same time ofbluish-gray color, Camphora 1, in hourly doses, has power to raisthe sunken vitality and bring about a favorable reaction.For violent nosebleed, vomiting of blood, septic haematuria orhemorrhages from the vagina we administer with good successErgotin 1, every two hours.For excessive hemorrhages and their consequences we administerdoses o{ Sulphuric or Nitric ax:. 1, or Ferr. mur. 1, at rapid inFor long-lasting syncope with rapid prostration we alternate thepreviously-mentioned remedies with Moschus 1 ; at the same timewe feed the patient on broth in order to repair the waste by theloss of blood as speedily as possible.Gangrenous decubitus or gangrene of other parts is treated asunder typhus.During the burning fever we have the skin bathed with dilutevinegar or aromatic vinegar, or, if the prostration is very greatwith wine and water.As a beverage during the fever we resort to water with currentjelly or syrups. If the skin is cool and the patient very feeble,dilute wine is preferable. If the patient threatens to faint fromexhaustion, a spoonful of good wine may be given.During convalescence the rules indicated for typhus have to befollowed.1(Addenda from Kafka and from personal experience.)[19. Gastromalacla.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 620 of 653Softening of the Stonuich.Anatomical CharaeterisHcs. In the case of children themucous coat of the stomach, especially in the region of the culsac, is found transformed into a gelatinous, colorless pulp whichm the case of adults, has a dirty-brown color. There are no signsof gastritis or ulceration. During the formative stage of the sofing the mucous coat is interstitially distended, soft and lax ; ieasily destroyed by scraping it with the back of the scalpel andcan no longer, as in its normal condition, be detached in patchesfrom the submucous cellular tissue. In a high degree of softeningall the coats of the stomach decay and the shape of the stomach isustained only by the thin, gauzy peritoneum which tears by theslightest touch; or else the stomach is perforated and its contenare poured into the abdominal cavity or, if the oesophagus is involved in the softening, into the thorax, more especially into itleft half. If the serous coat is intact, the stomach is mostly ditended with gas and chiefly contains a badly-colored, sourfluid. The softened parts are never sharply circumscribed; thesoftening always commences in the mucous coat whence it spreadsoutwardly, frequently drawing the (Bsophagus, the spleen and theleft half of the diaphragm into the morbid process.Etiology. Gastromalacia most commonly attacks children ofa year old, whose constitutions have become deteriorated by improper nourishment, by disease or general neglect. It most frequently occurs after weaning.Secondarily it is apt to set in as a sequel of cholera infantum ;sometimes it develops itself in the course of hydrocephalus andmeningitis.In the case of adults, gastromalacia always constitutes a secondary process developing itself in the course of malignant typhus,pyeemia, puerperal fever, acute tuberculosis, tubercular meningitis, etcThe circumstance that softening of the stomach has been metwith in the case of perfectly healthy individuals who suddenly dishortly after a meal, and that the stomachs of infants at the bre47 (737J738 Gastrotnalacia.are always found in a state of softening if they contain milk shoafter the infants' death, has led modern pathologists to assert tsoftening of the stomach is under all circumstances a simple postmortem appearance. It is possible and probable that many casesof gastromalacia are simple post-mortem appearances in the cadaver ; on the other hand it is likewise certain that many forms ofgastromalacia have been correctly diagnosed as independent diseases which were verified as such by post-mortem examinations.Symptoms. The gastromalacia of children^ as an idiopathichttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 621 of 653disease, at times manifests itself in the form of cholera, at othtimes as a gastritis, again as an acute hydrocephalus and finallywith the symptoms of a typhoid condition.The cholera-form of the disease sets in with frequent vomitingof greenish, mostly sour-smelling slimy fluids; simultaneouslyoccurring alvine discharges having a green color, of watery coiisistence, sour-smelling and corroding the anus; unquenchable thirsudden collapse, fainting turns, convulsions, coldness of the extities, speedy supervention of sopor ; such an attack generally sein without any precursory symptoms and with so much violencethat the little patients are either saved or else succumb to theattack in twenty-four hours.Or the symptoms of tjastritis may set in suddenly without anyprecursory signs : the children are very feverish, cry incessantlwant to drink and to be carried about all the time, belch up windfrequently, vomit frequently without any relief, and have waterydischarges from the bowels, which corrode the anus, are attendedwith severe pain and cause the little patients to draw their limbup to the abdomen. At the same time the region of the stomachis very painful, exceedingly sensitive to contact, the abdomen ishot and distended, the skin much warmer than usual. If we donot succeed in speedily arresting the attack, the patients emaciavery rapidly, the features collapse, the skin gradually cools offcrying of the patients gradually changes to a continual moaning,and they lapse into sopor or convulsions.The hj'^droceijhaloid as well as the typhoid form never set inwithout precursory symptoms. Most commonly they consist incontinual diarrhoea, frequent eructations, occasional sour vomitiwith sleeplessness, peevish or very irritable mood, pallor and expression of suffering of the countenance, loss of appetite. In adays the fever increases, the vomiting and diarrhceic dischargesbecome more frequent, the abdomen becomes bloated;, the head.Softening of the Stomach. 789which had been hot hitherto, and the extremities gradually cooloff, whereas the trunk and especially the abdomen feel hot ; verysoon the little patients become apathetic and, with their eyes haclosed, lie in a soporous condition, from which, however, they areasily roused when spoken to. Thoy hurriedly grasp the tumbler,hold on to it with both hands and are unwilling to relinquish thehold. Very often they start from their slumber with a cry, and,after looking about wildly, they relapse into their sopor. At thesame time the children become rapidly emaciated, especially aboutthe neck ; the pulse becomes smaller and more hurried, the alvinoevacuations acquire a foul odor, become watery, are destitute offsecal matter and distinguished from the urine only by their cadaverous smell ; the respiration becomes short and labored, and isoften accompanied by a tormenting cough. Finally there is complete loss of consciousness and sensibility, the eyeballs are disspasms or convulsions set in, with symptoms of the most profoundexhaustion.This hydrocephaloid condition is distinguished from true hydrocephalus by the absence of the pathognomonic signs of the latter,http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 622 of 653namely : rigidity of the nape of the neck, the piercing cri enc^plique, boring with the head into the pillow backwards, the diminished frequency of the pulse and respiration, the retraction of tabdomen, the dilatation of the pupils and the automatic graspingat the head.If the above-mentioned precursory symptoms usher in a typhoidcondition, the children have frequent attacks of vomiting and diarhcBa while the supervening fever very soon reaches a high degreeof intensity ; they do not sleep, the tongue and lips become dry,the nostrils have a sooty appearance; there is an expression of sfering and anxiety in the countenance ; the little patients becomrapidly emaciated, the skin looks pallid, they are very restless,want to be carried all the time and moan unceasingly. At lastthey quiet down, become cooler, and, owing to the aneemia of thebrain, lapse into a soporous condition which is genefally a precuof approaching death.In some cases the symptoms are less striking and the diseaseruns a chronic course; the diarrhoea and vomiting, the intensethirst, the bloating and painfulness of the abdomen, the rapidemaciation and the gradual prostration most commonly set inwithout fever, and, unless the disease is arrested, the patientsslowly die of exhaustion.740 Gastromalacia*Tbe gastromalacia of adults is not characterized by snch striking pathognomonic symptoms ; in the case of old people who havedied of gastromalacia, derangements of the digestive functions arsaid to have slowly manifested themselves, with oppression andpain in the region of the stomach, dryness of the tongue and rapideveloping marasmus are said to have been noticed without ithaving been possible to localize the disease in any particular spCourse, Termination^ Prognonis. The course of gastromalaciais either acute, as when the disease breaks out suddenlythe form of cholera or gastritis, in which case it often terminatin twenty-four, thirty-six or forty-eight hours ; or most commonlit is less acute, as when the disease assumes an hydrocephaloid otyphoid form, in which case it may run a course of several weeksincluding the precursory spmptoms ; the disease may likewise runa chronic course, during which the morbid phenomena develop *themselves slowly and may continue weeks and even months.The disease either terminates in complete recovery, most generally in its most acute or chronic form, or in death. Death eithertakes place at the height of the acute process, amid convulsions,or, in case the disease runs a slow course, by exhaustion of thevital powers or in consequence of cerebral anaemia.In the case of children, the prognosis is always doubtful ; it ismost favorable in the very acute or in the chronic form. Badlyfed, weakly, neglected and impoverished children are chiefly liabto succumb to the disease.Treatment. The treatment is to be conducted in accordancewith the form under which the disease happens to manifest itself.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 623 of 653If it assumes the symptoms of cholera, we resort to Ars. 3, Veraialb, 8, or Tart emeL 8.If the vomiting is chiefly sour and the stools have a sour smell,are watery and corrosive, attended with violent colicky pains ; ithe thirst is excessive, the extremities are icy-cold, and the chare covered with a cold and clammy perspiration and lying in astate of torpor bordering upon insensibility, Ve give Ars. in soltion, a teaspoonful every fifteen minutes.If the vomiting is greenish and sour, and the act of vomiting ispreceded by paroxysms of nausea and fainting, the watery andinodorous alvine discharges are very copious and attended withsevere colicky pains; and if the extreme collapse is accompaniedby convulsions, we give Veratrum in the same manner.Softening of the Stomach. 741If tliese Rymptoms are accompanied by sopor instead of convulBions, we resort to Tart, emet^ same dose. These three remedies aperfectly reliable and sometimes effect an improvement after thefirst dose.If the disease breaks out in the form of gastritis, Bellad. 8 issovereign remedy which speedily moderates both the pains and thefever and arrests the vomiting and diarrhoea. We give this remedyin solution, a teaspoonful every fifteen minutes, extending theintervals as soon as an improvement becomes apparent. If no improvement sets in in two or three hours, we resort to the Sulphatof Atropine 3 same dose and form, with which we have often succeeded in subduing the most dangerous symptoms. At the sametime we apply cold water compresses to the region of the stomach,and if the abdomen is painful and bloated, likewise to the latterIf the whole body is very hot, we resort to general ablutions witdilute vinegar.If, after the termination of the acute stage, the patients arecollapsed, with cold extremities, frequent diarrhoeic stools, sopconvulsions, Ars. 8 or Laches. 6 may be resorted to, a few dropswine or brandy and water may be administered, the cold extremities may be rubbed with warm wine or brandy and enveloped inwarm cloths, after which a favorable reaction and a generalimprovement will sometimes set in even in cases that had seemedhopeless.If the disease breaks out in the form of an hydrocephaloid, weare guided in the selection of a remedy by the febrile phenomena,the evacuations, the strength of the patient and the cerebralsymptoms.As long as there is fever and the evacuations continue frequent,the children retain their strength, the brain is free, but the heis hot and heavy, we give Bellad. 3 in solution, every hour.If the extremities are cool, the children are pale and languid, ttrunk is hot, the alvine evacuations are copious and symptoms ofsopor set in, we give Verat. alb. 3 in the same dose and form.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 624 of 653If collapse and signs of insensibility show themselves, withsudden cries and starting from the deep sopor, or even convulsionwe depend chiefly upon Arsen. 3 in solution, every half hour orhour. Tart. emet. 3, and Laches. 6, may likewise prove useful insuch cases.For typhoid gastromalacia we recommend Phosphor acid. 3 opShus tox. 3 in solution, every hour.742 Gastromalacia.If cerebral anaemia supervenes, we give Jrs. 8, and Ladies. 6,wine and water, etc., as for the gastric form of gastromalacia.The chronic form of gastromalacia requires Arsen. 8. Kreosot. 8,and Argent nitr. 8.Kreosofe is excellent, if the sour vomiting and rapid emaciationare prominent symptoms, the alvine discharges are not very frequeSecale oomutum 3 is indicated by sub-acute attacks, with sour andfoul smelling vomiting, sensitiveness, heat and bloating of theregion of the stomach, expression of distress in the countenance,sinking pulse, clammy and cold skin, prostration, fetid, serodischarges from the bowels,Arg. nitr. 3 is indicated by a semi-paralytic condition of theintestinal canal, 'the beverage is at once discharged again by threctum with a rumbling noise, the stools are watery and colorlessand are only distinguished from the urine by their cadaverous odoA cure of such a cose of this kind is reported by Kafka in thesecond volume of the Hom. Vierteljahrsschrift, number 4, page 405The convalescence is generally very slow. Convalescent childrenhave to be fed on good beef- or chicken-broth, milk, barleydry rusk, arrow-root, etc.Gastromalacia generally setting in after the children are weaned,we will here subjoin a few remarks about weaning.Children should not be weaned until they are able to partake ofother nourishment beside mother's milk.Weakly or anaemic children who are troubled with acidity ofthe stomach, dyspepsia or diarrhoea, have to remain at the breastuntil these morbid conditions are removed and the little patientslook better and are more vigorous. Experience has shown thatsuch children do not digest the nourishment which is given themafter they are weaned and that symptoms of gastromalacia arevery apt to supervene in consequence of the increasing weaknessof their digestive powers. If such children show symptoms ofdyspepsia or of gastro-intestinal catarrh, they have to be attendto as soon as possible.Children who are brought up on farinaceous diet, or with sugartits habitually in their mouths, are most commonly subject to sucderangements. We have likewise observed the beginning of a longline of gastric and intestinal afiections which afterward lead tohttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 625 of 653gastromalacia, in the case of infants who are fed on cold nourishment in the night, when mothers or nurses are too indolent to firwarm it before giving it to the little ones. For this reason theGoitre, Bronchocele. -'^^ 743choice of food as well as its preparatioiv^nd t^^ime of giving itto the children, are of the utmost importStnce.\ -^ ,For children who have been weaned, t^most suitable kinds ofnourishment are barley-coffee, carefully-strjcTned codo%sheIls boin milk, skimmed milk sweetened with a^Uttfe stjg^r, beefchicken-broth without salt and at first mixedrjwiWi ^ittle milkand sweetened with a small quantity of sugar ; tffter l^j, wi^flesalt may be added and some wheat bread-crust ^nay be -^ated inand boiled with the brofh. All this kind of notfrishmerif^^has tobe given warm and in small quantities.Children should be accustomed at an early age to a certainregularity in their meals; there should be an interval of two orthree hours between one meal and the next in order to preventoverfeeding and give the food a chance to be properly assimilatedFresh well-water, not too cold, is the best drink for children. Iintestinal catarrh supervenes, a slimy decoction, such as ricewater, arrow-root or slippery elm may be substituted in the placeof water.By observing these rules, gastromalacia can be prevented, and avigorous and healthful development of the infantile organism canbe secured.19. €k>ltTe, Broncliocele.Derbyshire Neck,Goitre is a well-known enlargement of the thyroid body in frontof the neck. Sometimes the enlargement involves only one lobe ofthe gland, but most commonly both lobes are hypertrophied.This disease is endemic in many parts of the United States,especially in districts where limewater is habitually used for coing and drinking purposes. It is remarkably prevalent in Derbyshire, England, and in some of the deep, damp valleys of Switzerland. The river Saskatchawan in British North-America isnotorious for its goitre-producing qualities.The structure of goitre varies ; it may consist of a simple engorment of the blood-vessels; or the capsules of the parenchyma ofthe gland may be distended by a gelatinous fluid. We have seenthyroid glands enormously enlarged and of an osseous hardness.Sometimes the enlargement chiefly takes place on the inside, impeing respiration and even threatening suftbcation. If a sore throaoften seems to defy all treatment it is because the soreness depeupon this internal enlargement of the thyroid body, which may bescarcely visible on the outside. "We have known cases of goitrehttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 626 of 653744 Goitre, Bronchocele.terminating 5n tubercular phthisis; in such cases the stmcture ofthe goitre, from the incipiency of the disorganization, was identwith that of the tubercular deposition.TreatmenU For all practical purposes it is suiBcient to distinguish the simple vascular enlargement of goitre, and the hypertrophy of the thyroid parenchyma. The cartilaginous, schirrousand tubercular disorganization may resist all treatment, althoughnot in all cases.In unacclimated individuals first coming under the influence oflime water, we have sometimes succeeded in arresting an incipientgoitre by causing the patient to consume quantities of lemonsour fruit, and to drink water acidulated with lemon-juice orvinegar.A simple vaccular enlargement of the thyroid gland often yieldsto Aconite alone; sometimes Aconite and Iodine have to be used inalternation internally and compresses of a weak solution of Iodinmay have to be applied externally.We sometimes employ with a good deal of success compressesof bay-rum with which the tincture of Iodine is mixed in theproportion of one drachm of Iodine to a quart-bottle of baya weak solution of Iodine being at the same time used internally;even very hard, cartilaginous goitres sometimes yield to thistreatment.The tincture of Iodine rubbed upon the goitre, has been of comparatively little use in our hands. We have derived more benefitfrom the Iodide of Potassium-ointment and a solution of five graiof the salt used internally every day.Another excellent application is an ointment of the Iodide ofMercury, Some persons are very sensitive to the action of thisointment, and it has therefore to be used with great care. Evenone-sixteenth of a grain of the Iodide has been known to blisterthe skin most shockins^ly. We have succeeded in removing verylarge and rather soft goitres with an ointment containing only thone hundredth part of a grain of the Iodide.There are cases of goitre where Spongia, or roast sponge, has tobe given internally and an ointment of Spongia has at the sametime to be applied externally. In other cases CaJcarea and Heparsulphuris may be required to act upon the constitutional disposition. Goitre is very apt to reappear even after it had seemed tohave completely disappeared under the influence of appropriatetreatment. H.]ALPHABETICAL INDEXOF TBBhttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 627 of 653DISEASES TREATED OF IN THESE TWO VOLUMES.(Th« Boman figure II refers to the dlseacee described in the secoPageAbsoess, s= Psoas, see Psoitis.Abscess, retropharyngeal 294Add stomach, see Catarrh of the stomach,acute and chronic... 859 and 879Acne II 478rosacea II 482Adiposis II 714Adipositas cordis II 882Albuminuria, see Bright' s disease.Amenorrhoaa II 65Ammonia)mia, see Uvemia.Amygdalitis 284Amyloid liver 541An»mia II 687of the brain 66, congenital, II 701— , consecutive, II 709^—, secondary, II 711Anasarca, see Dropsy.Aneurysms II 486Angina catarrhalis 281— parotidea 814pectoris IL. 405tonsillaris 284Anthrax II 508http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 628 of 653Aphth» 279Apoplexy, cerebral 70Arteries, inflammation of the, II 486Arthritis II 640-^— deformous II 684Ascarides 493iVscites, see Dropsy.Asiatic cholera II 613Asthma II 811Ataxia, progressive locomotor II 425Atrophy of the liver, acute yellow... 642Aurigo, see Jaundice.Barber's itch II 480Biliari calculi.. 564Bilious fever 422Bladder, inflammation of the 625, paralysis of the 684Blennorrhoea of the coi^junctiva, acute 242chronic 243of the urethra II 1of the vagina, see Gonorrhoea ofthe female and leucorrhssa.Blood, deflcient, II 687> pale, II 687Bloody urine 629Bones, inflammation of, II 410Bottle-nose II 482Bowels, inflammation of the 485, occlusion, obstruction of the... 479y stenosis of the 479http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 629 of 653Brain, anaemia of the 65f concussion of the 92f congestion of the, see Brain,hypersemia of the.; dropsy of the, see Hydrocephalus99, hypersemia of the 57, Inflammation of the 86, yellow softening of the 99Breasts, see Mammse.Bright's disease of the kidneys 696Bronchia, acute inflammation of the,II 1C4, chronic inflammation of the, II. 210; dilatation of the, II 284Bronchitis, acute, IL 164, chronic, II 230Bronchiectasia II 234Bronchocele II 736Calculi, biliari. 564J renal 614Cancer, see also Carcinoma.aquaticus.... 807of the mammsB II 100of the womb II 81(745)746Alphabetical Index.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 630 of 653Capsular hepatitis 581Carbuncle II 603Carcinoma of the liver. 569of the stomach 875— , see also Cancer.Cardialgia 891Carditis II 847Caiies of the yertebr®, see Spondylitis120of vertebra, see also Pott's disease.(Catalepsy 177Catamenia, see Menses.Cataract 256Catarrh 268, acute laryngotracheal, II 107f chronic laryngotracheal, II 129— — , chronic intestinaL 413^ intestinal 404f simple intestinal 406of the stomach, acute 8o9— ^ chronic 879of the nrethra II 1of the vagina II 20Catarrhns intestinalis 404— ventriculi acutns 859— ventriculi clironicus 879Catarrhal fever 422Cellular tissue of the intestinal canal,inflammation of the 451Cellulitis 451http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 631 of 653Cephalalgia 220Cephalffimatoma 218Cerebritis, (see also meningitis) 94Cei*ebro-spinal meningitis 180Chancre II 548Change of life II 87Chest, dropsy of the, II 842Chicken-pox, see Variola.Child-bed fever^ see Puerperal fever.Chlorosis II 624Cholelithiasis 564Cholera, Asiatic, II 618infantum 418sporadica 408Cholerine 408Chorea .* 170Cirrhosis of the liver. 589Clap, see Gk>norrhooa.Climacteric period II 87Climaxis U 87Codcum, inflammation of the. -... 440Cold in the head. 263Colic 468Concussion of the brain :. 93Congestion of the brain, see Brain,hypextemia of the.of the lungs II 150Congestive chill, see IntermittentfevehConjunctiva, acute blenn(M*rh

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 632 of 653the 2431 ehronic blemiorrhooa of the 243i catarrhal inflammation of the 237, scrofulous inflammation of the 249Coi\junctivitis blennorrhoica. 242catarrhalis « 237Bcroftilosa 249Consumption, dorsal 129Convulsions of infants and parturientwomen, see Eclampsia infantumand partarientium.Copper-nose II .• 483Coiiiea, inflammation of the •^ 2~6Comeitis 2r6Coryza 203Coxalgia II 427Coxarthrocace 11 427Critical Age II 87Croup, membranous, II 113Cystitis 625Cystoplegia 634Cystospasmus 633Dandriflf II 470Debility, see Anaemia.Degeneration of the heart, fatty, II. 383Delirium tremens 11 463Dentition, see Eclampsia infantum.Deranged stomach, see Catarrh of thestomach, acute and chronic ...359, 379Derbyshire neck II 743Diabetes melitus „ 617Dlaphragn:!, hernia of the, II 324http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 633 of 653, inflammation of the, II 323Diaphragmitis II 323Diarrhcea, — for the various forms ofdiarrhoda, see Catarrh, intestinal, 404to 413^ chronic, see also Catarrh, intestinal418Dilatation of the heart II 881of the veins 11 438Alphabetical Index.747PanDilatatfon of the bronchia 11 284Diphtheria 296Diphtheritis 296Dorsal consumption 129Dropsy 11 , see also Anasarca, Ascites645— of the brain, see Hydrocephalus 99— ^ of the chest II., see also Hydrothorax842 '— of the lungs II, see also (Edemaof the lungs 807Dysentery, catan-hal 455, epidemic 457Dysmenorrhoea 11 60Dyspepsia, acute, see Catarrh of thestomach, acute 859f chronic, see Catarrh of the stomach,chronic 879Dysphagia inflamroatoria 8*36http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 634 of 653Ear, inJQammation of the inner 258, inflammation of the outer 261Eclampsia 154infantum 154parturientium 168Ecthyma II 499Eczema II 490Emphysema of the lungs 11 286Emprosthotonos, see Tetanus.Encephalitis, (see also Meningitis)... 94Encephalomacia 108Enchondroma II 420Endocarditis II 847Enlargement, see Hypertrophy.Enteralgia 468Enteric fever, see Typhus.Enteritis 485Enui-esis nocturna 681EpUepsy 189Epistaxis 209Erysipelas II 455Erythema II 458Eyes, inflammation of the, see ophthalmia.of newborn infants, inflammationof the 247Face-ache 227Falling, see Prolapsus.Fatness, see Obesitas.Fatty degeneration of the heart II... 882liver 540Favus II ~~... 606http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 635 of 653PageFebris gastrioa catarrhalis, mucosaet biUosa 422icterodes II 603Fever and ague II 568, bilious 422catarrhal 422, enteric, see Typhus., gastric 432, intermittent, II 568mucous 422, puerperal,. II 84> spotted 130typhoid, see Typhus.yellow, II 602Fish-skin II 473Fluor albus II 20Fothergill's prosopalgia 237Furuncle II 508Gangrene of the lungs II 808Gastric fever 422Gastritis 801Gastrodynia, see Cai^dialgia.Gastromalacia, II 787Gland, inflammation of the parotid 814Glossitis 811Glottis, (Bdemaof the, II 187y spasm of the, II 140Glycosuria 617http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 636 of 653Goitre II 736Gonarthrocace II 4^0Gonitis II 430Gonorrhoea of the female II 22^ of the male II 1Gout II 640Gravel 614Green-sickness II 624Grippe II 1 2Gums, scurvy of the 8C2Gutta rosacea II 482Haematemesis 888Hematuria 629Headache 220Heart, dilatation of the, II 881fatty degeneration of the, II... 882, hypertrophy of the, II 872inflammation of the, II 847palpitation of the, II 879, 899Heartburn, see Catarrh of the stomach,acute and chronic... 859 and 879Heloosis II 145748Alphabetical Index.Ilelminthiaslfl 492Hemicrania 221Hemiplegia, see Paralysis.Hemorrhage in the kidneys. 009— from the lungs II 164http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 637 of 653from the nose 269from the stomach 888from the womb II 66Hemorrhoids ^ 485Hepatitis, acute 528> capsular 581^—i chronic 637Hernia of the diaphragm II 824Herpes II - 486— circinnatus II 490, facial, II 487Iris II 490— , preputial, II 487Zoster II 488Hiccup II 828Hip-disease 427Hip-joint, inflammation of; II 427Hives II 466Honey-comb tetter II 606Hydrocephalus, acute 99- — — (stricte sic dictus) 109Hydrothorax IT 842Hypersemia of the brain 67

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 638 of 653Hypopyou 256Hysteria 190Ichthyosis II 478Icterus 654Impetigo II 497Indigestion, acute, see Catarrh of thestomach, acute 859Inflammation of the arteries IL 486of the bladder 625of bones U 410of the bowels 485.— of the brain 86of tlie breasts II 95_ of the bronchia, acute, 11^ 164_ chronic II. ...~ 210Pftg*Inflammation of the cellular tissue •of the intestinal canals 451of the coBcum 440— ^ of the conjunctiva, blennarrhcslo 243catarrhal 237scrofulous . ... 249of the cornea 256of the diaphragm II 323of the inner ear- 258^—- of the outer ear.. ^ 261of the heart II 847of the hip-joint II 427of the iris 256of the joints II 436http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 639 of 653of the kidneys 5C6of the knee-joint II 430of the larynx 107of the liver, acute 629chronic 687of the capsules of the liver.;.... 631of the lungs II 248of lymphatic glands II 445of lymphatic vessels A glands II 443of tiie nose 268of the oesophagus 826of the ovaries II 45of the pancreas 678of the parotid gland 814malignant 817of the periosteum II 410of the peritoneum 508of the pleura IL 825of the psoas-muscle II 421of the rectum, catarrhal 445of the sclerotica ....«.-.* 256of the spinal cord 110of the spleen. 578of the stomach 861of the tarsus II , 488of the testes IL 18of the tongue 811of the tonsUs 284of the trachea 107of the urethra II 1http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 640 of 653of the veins II 486of the vena porta 533of the vertebrse, see Spondylitis 120of the womb II 27»— puerperal, II 84Influenza II 183Insufficiency of aortic valves II 894Alphabetical Index.749Tnsiifficiency of mitral valve IT 888Intercostal neuralgia II 450Intermittent fever II 663Iris, inflammation of tlie 256Iritis 356Irregularities, menstrual 47Irritation, spinal 135Ischias II 447Itch II 607Jacob's ulcer II 483Jaundice 664Joints, inflammation of, II 426Kidneys, diseases of the 680y hemorrhage in the 609, inflammation of the 686Knee-joint, inflammation of, II 430Laryngitis submucosa II 137Laryngotracheitis catarrhalis acutahttp://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 641 of 653II 107*— chronica II 129crouposa II 112Laryngotracheal catarrh, chronic, II 129Larynx, inflammation of the, II 107, ulcers of the, II 145LeucorrluBa II ••••• 20Lichen II 474Liver, acute yellow atrophy of the... 642, carcinoma of the 669, cirrhosis of the 638, fatty 640•^— , hyperemia of the 622— , hypertrophy of the 638, acute inflammation of the 629f nutmeg- - ••• 688, waxy or amyloid 641Lockjaw, see Tetanus 178Lumbago II 422Lumbrici, see Worms.Lungs, congestion of the II • 160, dropsy of the, II 807J emphysema of the, II 236— ^, gangrene of the, II 808J hemorrhage from the, II 164-^— » hyperaamia of the, II 160, inflammation of the, II 243» oddema of the, II 807, plethora of the, II 160Lupus II 488http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 642 of 653Luxation, spontaneous, see Hip-dis-ease.LymphadenitiB acuta II 442Pn

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 643 of 653, scanty, II 60J suppression of the, II 65Menstrual irregularities II 47Mentagra II 480Metritis II 27puei'peralis II 84MetrcHThagia II C6Miliaria II 469Morbilli II 618Mumps 814Myocarditis II 847Myelitis, see Inflammation of thespinal cord 110Nasitis 268NephritU 686Nerve, neuralgia of ischiadic, II 447Nettle-rash II 466Neuralgia" Fothergilli, see Prosopalgia.interoostalis II 4.';0of ischiadic nerve IL 447spinalis 136trigemini 227of the vagina II 92750Alphabetical Index.PageNeuralgia of the womb II 89http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 644 of 653Noma 807Nose, hemorrhage from the 269f Inflammation of the 268bleed 269Nutmeg-liver 688Obesitas II 714Occlusion, obstruction of the bowels 479Odontalgia 828(Esophagitis 826CBsophagus, inflammation of the 826(Edema glottidis II 187of the lungs II 807Oligwmiall 687Oophoritis II 45Ophthalmia, see Conjunctivitis, Corneitis.Iritis, Bcleroiitis.— neonatorum 247Opisthotonos, see Tetanus.Orchitis II - 18Orthotonos, see Tetanus.Ostitis II 410Otitis externa. 261interna 258Ovaries, inflammation of the, II 45Ovaritis II ; 45Oz8Bna 264Psedarthrocace II 420Palpitation of the heart II 879, 899Palsy, see Paralysis.Pancreas, inflammation of the 578http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 645 of 653Pancreatitis 578Paralysis 188, progressive muscular, II. 424Paraplegia, see Paralysis.Paresis, see Paralysis.Parotitis 814— maligna 817Pemphigus II 501Perforating ulcer of the stomach 868Pericarditis II 847Pericardium, inflammation of the, II 847Perihepatitis 531Periosteum, inflammation of, II 410Periostitis II - 410Peritoneum, inflammation of the 508Peritonitis - 503Perityphlitis 440Pertussis II 198Phlebitis II 486Phlebectasia II 488Phthisis, see Tuberculosis.Paes 485Pityriasis 11 470Plethora, constitutional, II 681of the lungs II 150Pleura, inflammation of the, II 325Pleurisy II 825Pleuritis II 825Pleurothotonos, see Tetanus.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 646 of 653Pneumonia II 248Pneqmorrhagia II 154Pneumothorax II 843Poly»mia II 681Polypi in the nose 2C7of the rectum 450Polysarcia II 714Pompholix II. 501Porcupine disease II 473Pott's disease II 410see also Spondylitis ... 120Proctitis 445Progressive muscular paralysis II. ... 424Prolapsus of the rectum 451of the womb II — 88Prosopalgia 227intermittent 238Prurigo II 476Pruritus vulva II 88Psoas-abscess, see Psoitis.Psoas-musde, inflammation of the, II 421Psoitis II 421Psoriasis II 473Ptyalism 819Puerperal inflammation of the wombII 84fever II - 84Pulmonary hemorrhage II 154Py»mia II 728Pylephlebitis - 583Pyrosis, see Heartburn.http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 647 of 653Quinsy 284Ramolissement, see Softening.Ranula 824Rash II 469Rectum, catarrhal inflammation ofthe 4459 polypi in the 450, prolapsus of the 451Renal calculi 614Retina, inflammation of the 256Retinitis 2o7Alphabetical. Index.Paff«RetropliaTyiigeal abBcesa 294RhachitlB U 416Rheumatism 11 680, arthritic H 684J acute articular, II 680^ chronic articular, II 688i acute muscular, IL «• 682Rickets IL 416Ring-worm, see Herpes Iris.Roseola IL 465Round ulcer of the stomach 86SRubeola II 465Running from the nrethr% see Go-norrhcaa, Urethritis.Rupia 11 499http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 648 of 653Salivation 819Scabies 11 607ScaMJiead II 606Scalp, bloody tumor of the 218Scarlatina 11 622Scarlet-fever II 522Sclerotica, inflammation of the 256Sclorotitis 266Sciatica, see Ischias.Scorbutus II 649Scrofulosis II 652Scurvy IL 649of the gums •-.... 822Seborrhcsa II 605Septicemia II 782Shingles 11 488Singultus II 828Smallpox II 682Softening of the brain, yellow 99of the stomach, see Gastromalacia.Sore throat 281Spasm of the bladder 682of the facial nerve 234of the glottis IL 140of the stomach 891Spasmus nervi facialis. 284Spermatorrhooa IL 16Spina ventosa IL 420Spinal cord, inflammation of the 110http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 649 of 653irritation 185Spleen, see Hypochondria 207^ inflammation of the 573Splenitis 678Spondurthrocaoe, see Spondylitis..... 120Spondylitis 120751Pag*Spontaneous limping, see Hip-disease.luxation, see Hip-disease.Spotted fever.. 180Stenocardia 405Stenosis of the bowels. 479of caidiac orifices II 889, 896Stomach, acid, see Catarrh of thestomach, acute and chronic, 859and 879derangement of the, see Catarrhof the stomach, acute andchronic 859 and 879acute catarrh of the 859chronio catarrh of the 879^ carcinoma of the 875■, hemorrhage from the 888•. inflammation of the 861>, chronic or perforating or roundulcer of the 868softening of the, see Gastromalacia., spasm of the 891http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 650 of 653i weak, see Dyspepsia.Stomatitis 278Stone-pock II 478Strophulus n 474Summer-complaint. 418Suppression of the menses II 56Sycosis II 480Syphilis II 542^ secondary, II 648, tertiary, IL 551Tabes II 711dorsalis A 129T»nia solium, see Tape-worm.Tape-worm 494Tarsus, inflammation of the, IL 488Teething, see Dentition.Testicles, inflammation of the, IL... 18Tetanus 178Tetter, scaly, IL 472n 486, see also Herpes.Throaty catarrhal inflammation ofthe 281— , sore 281Thrush, see Aphtha 279Tic convulsif...? 284douloureux, see Neuralgia Fo-thergilli.Tinea capitis IL 606http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 651 of 653752Alphabetical Index.Tongne, inflamTnation of the 811Tonsillitis 284Tonsils, inflammation of the 284Toothache 828Tooth-rash II 474Trismus 178TuberculosU II ^ 658Tumor albus genu II 430of the scalp, bloody 218Tussis oonvulsiya II 198Typhlitis 440Typhoid fever, see Typhus.Typhus II 676Ulcer, Jacob's 488of the stomach, chronic 868Ulcers of the larynx II 145Ulcus perforans ventriculi seu rotundum868Uiwmia II 7J:0Urethra, blennorrhosa of the, II 1, catarrh of the, II 1f inflammation of the, II 1Urethritis II 1Urine, bloody- 629Urticaria II 466Uterine hemorrhage II 66http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 652 of 653Uterus, see Womb.Vagina, catarrh of the, 11 20^— , neuralgia of the, II 92Vaginismus II 94Vaginitis II 20Vaginodynia II 92Valve, insufficiency of mitral, II 888Valves, insufficiency of aortic, II 894Valvular diseases II 888, 899Varices II 4*8Varicose veins II 488Varicella, see Variola.Variola II 63aVarioloid, see Variola.Veins, dilatation of, 11 438inflammation of the, IT 406Vena porta, inflammation of the 5^2Venereal disease II 542Vertebi*», inflammation of the 120Vertigo 69St. Vitus' dance, see Chorea 170Wasting palsy, see Progressive muscularparalysis.Waterbrash, see Catarrh of the stomach,acute and chronic... 859 and 879Waxy liver 541Weak stomach, see Dyspepsia.Wetting the bid 631White swelling II 430Whites, II 2)http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt

Full text of "The Science of Therapeutics: According to the Principles of Homeopath...Page 653 of 653Whooping-cough II 198Wolf II 483Womb, cancer of the, II 81— r-f hemorrhage from the, II 66, inflammation of the 27^, neuralgia of the, II 89, prolapsus of the, II 88, puerperal inflammation of the,II 84Worms 492Yellow atrophy of the liver, acute... 542fever 11 602Zona U 488http://www.archive.org/stream/sciencetherapeu00kafkgoog/sciencetherapeu00kafkgoog_djvu.txt