..v\‘
.~,...\.Lv
.
n‘ -1.
.., 1%. .
xii .;;_aé..m..$m_x..
...
w
at
;.
.‘. - . vL12-.¥
~naMMquv¢)m~w$¢.....t44fi
‘ ..
‘ma’.
.5.‘
$9.
M
, .3
.L..¢_.,.um
L..r.. 1. J U‘
‘ -dauu
sum
. .
4
_, . .‘.r\\; ‘
» n 0' ‘ f
.'‘o' 2» ,_,.-I
‘ W. ‘.2... ~,‘-
1_~
PF-
ium ._


I H. .. .
Q "....I..- /\ 1'
.£§%~q1 :. <\‘
i|.I.=).i\1._ A lv~~NV1I \..(,
:ra-uanr,!Q‘n..“. .au-Ix!"--11‘-\bn“-,

.mE._EE5EW__E§§.uE=E.§_w_““.5 . _._._.._h__._E_.__.m_._.u.§§_mE.a_=.E.F.
L EF.2 . i
W
-, m
M
m.
W
1
W , “H
m
ru-
.... m
“M
m
.u
- W
.~ . m_._q_m_._a_._q..__._q_._=._._a_.__.=_._ . , . _.._.___._~.§___..__.s:_~___.__.=__s_... m.




. Y!-.:v...iI.'.$I1iEI.‘1&!._54._. 2714111 .,
w:| >L~l .Y!\.L..v| I, . ‘.. Ax!’ .. V l .1. _ . _ .\ ‘\ V. .‘ .. .1
c 0 N s U M P TM 0_1:\~I’~;~ ~
;J;:;;
P Q " -‘
s.-1 B -
:4 . 5
9 }_.~5-‘- -'
-_- - _ - W "\ ~ *~r-- ,1-$1.-2-:~,,c“_.r.~<¢,—;~.-v'\~q ,1-_‘—1~w?~-'. 7' "= '
\_
-(PHTHISIS)
ITS NATURE AND TREATMENT.
BY
JOHN ]_E_PPS, M.D. Enm
LONDON:
SANDERSON, 77 FLEET STREET, E.C.

MDCCCLIXa'
-~ PRICE SEVEN SHILLINGS.
INTRODUCTION.
6’
A QUARTER of a century since, the writer of this work
prepared a Treatise on Pulmonary Consumption, but
the result Was so unsatisfactory (he was then an old
systemist) that he put the work aside.
Ill health, in 1857, arising from overwork and the
anxieties connected with the treatment of disease,
necessitated rest. '
The writer Went to Yarmouth, returning to town.
for three days in each week to attend to urgent cases
of disease.
Any one who knows the character of railway
travelling from Yarmouth at times when the EX-T
press train cannot be used, will recognise the almost
insupportable tediousness of the journey. The irri-
tation caused by this tedium determined the writer
to occup.y himself during the journey. To read con~
tinuously while travelling on railways is had both for
the eyes and the head, and to talk was, in the state
the writer then was, too exciting. What then was to
-be done ? To think one is obliged, at least while
awake, and therefore why not think out a book. This
he realized in the journeys to and from Yarmouth.
The pl~anYadopted‘_was, to take the works which .
were needed for reference, selecting large typed edi-
tions, and to mark thereon the points of inte1'est~, - and
then, when the train stopped, as mos_t frequently it
did, to write down any thoughts, and to record the
iv INTRODUCTION.
pages containing references illustrative of these
thoughts. In this way the skeleton of the work
now before the reader was completed. During the
winter and the spring the author added to the work
and wrote it out.
In the autumn of 1858, overwork again necessitated
repose, and the writer went to the seaside. He
adopted the same plan, and revised the whole work
while journeying.
To remove every obscurity from and to abbreviate
as much as possible the work, the writer transcribed
it a third time, employing as far as he could the
phraseology not of technical science but of society.
He has subsequently had it copied by another,
knowing that the most effective mode to discover
mistakes and inefficient and inexact writing is to
read one’s work dressed in an ot-her’s handwriting.
A physician’s holiday may be regarded as not a
very fit time to bring forth a book; but this is cer-
tain, that had not the book been written under the
circumstances stated, it could not have been written
under the interruptions connected with professional
duties, which occupy the writer from eight in the
morning to seven and sometimes later in the evening.
As to the value of the book itself, thus given birth
to, the reader is the party to judge. The Index of
the work and the Preface will give some idea how
far the work has claims on the public attention.
89 GREAT RUSSELL STREET, Nov. 21, 1859.
PREFACE.
a. ONE fundamental idea pervading this work is, _Fundamental
idea in the
that PHTHISIS, more especially that connected with ;v;irs1t{ént(1;:0f
the presence of diseased parts, called tubercles, in the acachexia-
lung tissue, can be developed only when there exists
in the individual a special unhealthy habit, a CACHEXIA
(zwzog, kakos, bad; and 221;, eksis, habit).
And this fundamental idea is in this work developed ilrlggfiénjvliltstl
to the extent of demonstrating, that the phthisical ,‘§I’§,§f,{‘tdeve1-
cachexia is not single, but is multiform, and that each
cachexia has distinctive characters, and that these
distinctive cachexim must be recognised and medi-
cinally met, in order that Phthisis, thereupon resulting
and therewith connected, may be treated scientifically.
b. A second fundamental idea, one indeed which Second
fundamental
grows out of the first, is, that in order to effect a cure idea, that for
cure, the spe-
of the cough, the expectoration, the hectic fever, the fIi,§‘,1s§a,‘,’f,‘eIff,if‘
night-sweats, the emaciation, the rapid pulse, the ,°,§’§,‘_‘ised and
hurried breathing, and other symptoms, so generally
present in Phthisis, the special cachexia in connexion
with which all these symptoms develop themselves,
must be recognised in all their particulars; and, fur-
ther, that any attempt to remove these symptoms,
A
Third
fundamental
idea, that only
by the know-
ledge of the
pure efl'ects
of medicines
cure can be
realized.
Cure how
resulting in
the application
of the law,
1S'imiZia simiZi-
bus curantur.
V1 PREFACE.
except by curing the cachexiae, will be as inefiicient
as is the procedure of the mere surgeon, who presumes
that, in removing the fluid in a dropsy, he cures the
disease on which the dropsical effusion depends.
c. A third fundamental idea is, that it is only by
the knowledge of the ejects of medicines on HEALTHY
individuals,* that the medicine corresponding to each
cachexia, with which the phthisical condition is asso-
ciated, can be discovered, and the cachexia cured;
the cure resulting in the obedience to and in the
effective carrying out of the homoeopathic law,——
LIKES ARE CURED BY LIKES,
/Similia similibus cumntur ; the whole of these cir-
cumstances requiring that, for the cure of each case
of Phthisis, a medicine should be given which has
itself, as its pathogenesis, the power of producing an
aggregate of medicinal effects similar to the symptoms
of and to the states connected with each phthisical
cachexia. Homoeopathyfi therefore, as presenting both

* These effects are designated by Hahnemann as the pure effects, because
obtained by experiments on persons, unmodified by disease; effects designated
also as pathogenetic (a'a9a;, pathos, sufiering, and 9/ave-rmog, genetikos, begotten),
because the knowledge of these was obtained by the sufferings, which were
caused or produced in Hahnemann and his disciples, during a series of years,
in experiments on themselves with medicines, in order to learn their efi"ects.
And yet this noble man and his followers, who pained themselves for the world’s
benefit, are designated by a vulgar herd of medical journalists and medical men
as fraudulent.
1- Persons find fault with the terms used by homoeopathists. With igno-
rance and conceit (the two states attend each other), they sneeringly describe
the term “ homoeopathy” as new fangled, whereas it is so old as to have a place
in the original Bible, where it occurs twice: in Acrs, chapter xiv., verse 15,
dpoloorudng, homoiopathes, translated “we are men of like passions : ” also, in
J muss, chapter v., verse 17, “ a man subject to like passions,” 0'/.mosru4n;, homo-
iopathes. Perhaps, when known as thus occurring, the word will no longer
be sneered at; or at least, if it be, the ignorance and the conceit of the sneerers
will be manifested less obtrusively.
marncn. vii
the necessary knowledge of medicines and the law
regulating the application of that knowledge, affords
the only scientific basis on which the curative, Scientific
i. e. the therapeutic (élegowreloe, therapeia, cure) appli-
cation of medicines for the cure of Phthisis can be
built.
(1. A fourth fundamental idea which obtains a Fourth
manifestation in these pages is, that previous to the iigiaiilgnml
existence of
development of a case of Phthisis, A DEBILITY of the ? Zebililig» of
lung tissue must, in addition to the cachexia, be in- tissue-
duced by some injurious agency. It is true that the
very cachexia, itself a debility, may be a source of
debility ; but there are conditions of debility inde- Conditions
pendent thereof, these being induced by other causes, of debility‘
which ultimately affect both the tubercular formation
itself and the parts in the lung tissue adjacent to the
tubercular formation.
e. N 0 claim to genius is made in putting forth
these views :-
“ Genius, in any inquiry into nature, must act a Duty of
subordinate part; its duty is to arrange, not to fabri- gem“
cate; but the dogma is held and acted upon, that, if
a man is capable of communicating anything in con-
nexion with a subject, the capacity constitutes his right
to communicate.”——(Tyrrell.)
f. It may be, that he may exhibit his capacity in
a way different from that which many will recognise, Mode of
but this will not render less either the capacity or the §€i?iiii§
right to communicate; since, though it is true re-
garding the multitude, “ we think according to nature,
speak according to precept, and act according to cus-
tom ” (Tyrrell) ; yet a mode of thinking different from
basis of cure.
Further
justification
of the views
advanced
in the great
mortality
of Phthisis.
Young physi-
cians think
they can cure
Consumption.
Work of
Dr. Sanders.
viii PREFACE.
the prevalent mode may be true, and, being true,
will be, yea must be, useful.
9. A further justification of this putting forth the
views embodied in this work is found in the fact, that
Phthisis still causes one-fourth of the mortality of
Great Britain; and consequently an attempt, if made
on rational grounds, to cure the disease, and thereby
to diminish this mortality, must be a duty.
h. In the face of this great mortality from Phthisis,
may not the question be put, and put rightly, “Is
not the test of twenty-three centuries of barren inves-
tigation, of mere medical romance, with scarcely a
ray of light to guide our steps, suflicient ground for
further inquiry ?”--(Tyrrell) Or, “Are we to sit down
in despair, bowing to the dogma so frequently pro-
claimed, CONSUMPTION rs INCURABLE ? ”
i. It is allowed that almost all young physicians
think that they can cure consumption. Thirty-one
years since, at a time when the writer commenced his
active professional career, he thought this. Well does
he remember how strongly the conviction gained hold
of his mind, when his friend, Captain Cargill of Edin-
burgh (now Superintendent of the Assembly at Otago,
New Zealand, and who has been for some years a
stanch homoeopathist-what changes a few years can
make !)—brought before his notice “A Treatise on
Pulmonary Consumption, in which a new View of the Prin-
ciples of its Treatment is supported by Original Observa-
tions in every Period of the Disease, by James Sanders,
2%. D., 1808.” How diligently and hopefully, in
obedience to this conviction, did the writer proceed,
employing inhalation, and more especially inhalation
O
PREFACE. IX
of the vapour of an infusion of digitalis, and using
milk simply, and milk in which kidney suet (a dietetic
means recommended by Hippocrates De Internis Afec-
tionibus) had, in conformity with ancient usage (a kind
of imperfect adumbration of the cod liver oil practice),
been boiled, &c.
j. Phthisis, however, was too strong. The writer re-
alized in regard to the effective treatment of Phthisis,
what Melancthon found in regard to the cure of man’s i\g;1:?1:;i1011's
moral diseases, that “Old Adam was too strong for
young Melancthon.”*
lc. Some cases of Phthisis the writer cured by anti- Phzlaisis
. . _ _ cur by
momum tartarzcum ; but these, 1t 1s hkely, were cases anfimonlllm
of Pulmonary catarrh, and not of tubercular Phthisis ; tammum.
the medicine named being, when prepared according
to the homoeopathic formula, and given, when thus
prepared, in infinitesimal quantities, useful in some
forms of this disease.
l. What Bayle states as his experience, very nearly
represents the experience of the writer in relation to The experi-
the treatment of Phthisis during the time he employed ggliiipgieldayle
. . W1 h h of
the old system means. Bayle, 1n ll1S work, “Researches thé a1it1?<ir-
on Pulmonary Phthz'sz's,” translated by Barrow (Liver-
pool, 1815), writes thus :—

* When Melancthon had recognised the Scripture truth, so beautifully em-
bodied by Cowper in the lines,
“ Legible only by the light they give,
Stand the soul-quickening words, BELIEVE AND LIVE,”
he was so filled with gratitude and love to the Great Father of All, as to feel
that all he had to do was to proclaim to his fellow-men these truths, and they
would embrace them. He laboured hard in the diffusion of these truths, but
with little result; he expressed his experience in the acknowledgment to LUTHER,
his co-worker, that “ Old Adam was too strong for young Melancthon.”
Extract from
Bayle.
Important
practical
matter is
presented.
x PREFACE. ‘
“ Whenever I have found the lungs perfectly sound
in those whom I thought phthisical, but who had died
of accidental disease, I found I had erred in the diag-
nosis, and that I had taken for species of Phthisis
peculiar cases of other affections of the chest. I have
the less difficulty in confessing this mistake, from
having often cured phthisical cases in the first years
of my practice, though I now sincerely acknowledge
that I have not cured any since I have more perfectly
discovered the nature of Phthisis. I have, however,
sometimes palliated the symptoms, and even suspended
the progress of the disease; and I have also cured
many with severe cough and puriform expectoration
who were clearly in a state of hectic fever and inci-
pient wasting (marasmus).”
m. Whatever may be the result in regard to the
cure of Phthisis in connexion with the views put
forth in these pages, it is believed that therein much
important practical matter is presented,——matter which
will be of some service both to the profession and to
the public, more especially to those of the public who
are predisposed to phthisical affections : To the former,
in making the way to the cure of Phthisis more clear;
to the latter, in showing how the phthisical tendency
can be, if not removed, kept in abeyance.
n. It may be useful to detail the incidents which
led to the writing of this work.
During the Medical Session of 1856-7, the writer
gave a course of sixty lectures on the Honweopathic
rnnracn. xi
Materia Medica.* One of the students who attended The Writer
states what
these lectures was attacked with inflammation of ’r.he1e‘1h‘1‘n
to write
lungs. When the inflammation was cured by homoeo- the w°“k'

* The subjoined Syllabus is that of the lectures given: as the first course of
lectures on Practical Homoeopathy delivered in Great Britain, the record has
somewhat of a historical character.
Dr. Epps commenced a course of sixty lectures on the Homoeopathic Materia
Medica, on Monday, Nov. 24, 1856. Medical men and students wishing to
attend these lectures can obtain tickets of admission and particulars of S. R.
Bardouleau, Esq., honorary secretary, No. 13, Rochester Road, Camden Road,
London.
SYLLABUS.—-L6C‘l7111'6S 1 and 2 will embrace the pathogenesis of Aconrrn.
The rationale of its curative action in relation to inflammatory fever and in-
jlammations will be unfolded, and the special powers of this medicine explained
and illustrated.
Lectures 3 and 4 will embrace the pathogenesis of BELLADONNA. The ra-
tionale of its curative action in relation to diseases of the cerebrum and of the
skin, in connexion with enlargement of certain portions of the glandular system,
will be considered, and the special powers of this medicine will be explained
and illustrated. The points of analogy and of difference between aconite and
belladonna will be worked out.
Lectures 5 and 6 will embrace the pathogenesis of Bnvoma. The rationale
of its curative action in connexion with diseases of the lungs and the pleura
will be considered, and the special relationships and powers of this medicine
will be explained and illustrated. The points of analogy and of difference be-
tween bryonia, aconite, and belladonna will be worked out.
Lectures 7, 8, and 9, will embrace the pathogenesis of Puns.-rrrnnx. In con-
nexion with these lectures, the rationale of the curative action of pulsatilla in
connexion with gastric and intestinal diseases, and also with the deviations
presented in connexion with the monthly period, will be considered, and the
special powers and relationships of this medicine will be explained and illus-
trated. Points of analogy and of difference between pulsatilla and the medi-
cines previously considered will be brought forward.
Lectures 10 and 11 will embrace the pathogenesis of NUX. In connexion
with this medicine, the rationale of its curative action in connexion with dis-
eases of the gastric, intestinal, and rectal systems will be considered, and the
special relationships and powers of this medicine will be worked out. The
points of analogy and of difference between this medicine and pulsatilla will be
brought forward and illustrated.
Lectures 12 and 13 will embrace the pathogenesis of Lvcoronnm. The ra-
tionale of its curative action in relation to diseases of the urinary organs, in
connexion with the gastric and intestinal system, will be considered, and the
special relationships and powers of this medicine will be fully detailed. The
analogies and points of difference between lycopodium, nux, and pulsatilla will
be illustrated.
X11 PREFACE.
pathic means, the patient’s progress towards health
was delayed. On this account the development of

Lectures 14, 15, and 16, will embrace the pathogenesis of SULPHUR. This
valuable medicine, and the rationale of the extensive range of action of this
medicine in connexion with psora and its effects, will be considered.
Lectures 17, 18, 19, 20, 21, 22, 23, 24, 25, and 26, will embrace a group of
medicines which have a relationship to the urinary and genital organs; this
group consisting of CANTHARIS, CAUsT1cuM, CANNABIS, CLEMATIS, THUYA, and
TR. Acme. The rationale of the general action of these medicines on these
systems will be given, and the special relationships of each will be detailed
and illustrated.
Lectures 27, 28, 29, 30, 31, 32, 33, and 34, will comprise a group of medi-
cines which have a special action on the female genital system; a group con-
sisting of SEcALE, SABINA, Cnocus, and Ans. The special characteristics of
each medicine will appear in the examination of the pathogenesis of each.
Lectures 35 and 36 will embrace the consideration of SEPIA, and the rela-
tionships of this medicine to certain diseased conditions of the uterus and rectum,
together with other relationships which an examination of its pathogenesis
will present, will be considered and illustrated.
Lectures 37 and 38 will embrace the consideration of SPIGELIA and DIGITALIS,
and the relationships which the pathogenesis of these medicines establish as
existing between certain diseases of the heart and these remedies.
Lectures 39, 40, 41, 42, 43, and 44, will embrace a group of medicines,
between which and the bony tissues, and the investments of the bony tissues,
a curative relationship is established by their pathogenesis. This group com-
prises Aunmu, ACIDUM Nrrnrcnn, ASSAFCETIDA, MEZEREQN, and RUTA.
The action of homoeopathic medicines in connexion with the secondary forms
of Syphilis will here be noticed, and the points of analogy and of difference
of each medicine of the group will be worked out.
Lectures 45, 46, 47, 48, 49, and 50, will embrace a group of medicines which
have a relationship to the diseased conditions associated with the development
of abscesses and of ulcers. This group consists of HEPAR SULPHURIS, SILICEA,
and KAL1 CARBONICUM, and the peculiarities of each will be illustrated patho-
genetically and clinically.
Lectures 51 and 52 will embrace the consideration of CALcAREA, and the
rationale of its action in connexion with the peculiar cachectic state of the
body, which causes enlargements and tubercular formations and their develop-
ment, will be explained. The points of analogy and of diiference between it
and kali carbonicum will be worked out.
Lectures 53, 54, 55, 56, 57, and 58, will embrace a group of medicines that
have a curative relationship in connexion with the diseased states developable
in mucous membranes and the glandular tissues, connected more particularly
with the digestive system. This group will comprise LAcHEs1s, Acrnmu
Pnosrnomcun, Acrnun MURIATICUM, ARSENICUM, Mnncumus, MERCURIUS Con-
ROSIVUS.
Lectures 59 and 60 will embrace some general remarks on Coccunns,
COLOCYNTHIS, Dnosnu, and other medicines.
PREFACE xiii
-Phthisis. was inferred by the writer. To satisfy the
minds of some influential members of the patient’s
family, the opinion of Dr. Elliotson was sought by them
in reference to the correctness of the opinion held by
the writer. Dr. Elliotson declared the case to be one (1)3151 Fi1(}1i<>tS<>n’I'
of marked Phthisis, and that nothing could be done, %,I%ftl§§SI<;>5n
except to take con LIVER OIL, to go into the country,
and to let the patient have what he liked, i. e. to go to
. his execution. The patient remained under the writer’s
care, and is now (January 1859) alive and compara-
tively well, although no cod liver oil has been admin-
istered, and none but homoeopathic medicines have
been used, and these only in infinitesimal doses.
0. Disgusted by the indiscriminate, the empirical
administration of cod liver oil (for not a week passes
without the writer seeing some unfortunate, who, by
the waste of time in taking this oil, has lost the best
chances of cure, by passing the period when the
Phthisis was most certainly curable), the writer was Writer’s ob.
determined to try, if, by substituting for this cod liver Zghviiiigl Eli.
oil delusion a scientific treatment, he might be able to
hasten the end of that which keeps itself alive only by
advertisements in every daily, weekly, and monthly
journal, this advertising developing a trade which
causes, in one year, a quantity of oil to be presented
to the public greater than all the cod fish taken from
the ocean can supply. To the supporters of this em-
pirical employment of the oil, the remarks of Dr. Remarks of
Dr. Sanders -
Sanders, in reference to the unscientific character of on the
treatment of
the treatment of Phthisis, practised in his day, apply; Phthisis.
“ Here, in Phthisis,~ every one has some favourite
remedy, which he prescribes without regard to age,“
xiv PREFACE-.
sex, peculiarity of constitution, or period of the dis-
ease.”-(Preface, p. vi., lib. cit.)
p. Having thus determined, the writer looked at
his note books, and turned to the works in his
library.
Tyrre11’s g.' In the latter, he found a work entitled “ CON-~
work on
C°ns“mPti°n' SUMPTION, why so fatal? Wliat are the Means by which
it can he PREVENTED in those predisposed to it, and its
progress ARRESTED in those attacked with it? By
Jorm TYRRELL.” *
This work was now (August 1857) read, and the
writer’s estimation of it will be seen by the numerous
quotations therefrom in the following pages.
vI3g;,§:Z1e’$ r. Another work, to which reference is often made,
f,’,‘§,;",§,1:~“Y is the volume of Dr. Bayle, entitled “ RESEARCHES ON
PULMONARY Prrrnrsrs.”
This work demands attention, originating, as it did,
in an experience gained by the history and the ex-
amination after death of 900 individuals who had died
of Phthisis. ~
s. To Dr. Sanders’s work, after a neglect by the
writer extending to nearly thirty years, attention was
given, and many quotations in this work therefrom
have been, the writer believes, beneficially made.

* On the titlepage of this book was written: “ Paid for the book 4s., July
10, 1835.” What a sadness does this express! This John Tyrrell was, no
doubt, some man of talent, but impoverished, who sought bread by disposing of
his book. The following letter has been received from Mr Renshaw, the pub-
lisher of the work, the writer having applied to him for any information he could
afford of John Tyrrell.—“ 356, Strand, July 14, 1858. Dear Sir,—I regret that
I can recollect nothing about John Tyrrell beyond the fact, that he was intro-
duced to me by Dr. Spillan, who had known him a long time. I am also
pretty sure he told me Mr. Tyrrell was not in the medical profession, but was a
veterinary surgeon. Yours faithfully, HENRY Rmvsnaw.”
PREFACE. XV
t. The labours of Laennec and of Louis, in con-
nexion with this disease, will be found recognised in
the following pages. ~
u. Some reference ‘wilfbe made to the laborious
work of Dr. Walshe, entitled “A Practical Treatise
on the Lungs, Heart, and Aorta, including the Principles
of Physical Diagnosis, 1854.”
This work, full of the most varied and the most"
exact information in reference to the physical signs of
these diseases, is, in regard to the cure of the dis-
eases described, meagre,-—a circumstance which, when
viewed in connexion with the powerful cerebral or-
ganization and the untiring industry of Dr. Walshe,
admits of explanation only by the fact, that, as yet,
Dr. Walshe has not applied his mind to the investi-
gation of the homoeopathic law and of the homoeopa-
thic pathogenesy: a direction of mind. much to be
desired, for Dr. Walshe will, if studying them, be
sure to become a convert: that is, if he has not
foolishly committed himself against homoeopathy by
any unwise expression of opinion; which, if so, to
preserve his consistency, he must uphold.*
w. It will be found that, in remarking on the works

* A work, entitled “ On Consumption : its Nature, Symptoms, and Treatment,
by R. P. Cotton, ]lI.D., 2d Edition, 1858,” came under the writer’s notice after
he had twice written this work. The work is creditable to Dr. Cotton: although
containing little new, it presents many useful facts and some reasoning above
the average. Some extracts have been embodied during the third transcript of
the present volume, chiefly because the views put forth may be regarded as
expressive of the opinions of a considerable number of the old system medical
profession, Dr. Cotton’s work having been originally presented to the world as
an Essay, to which was awarded the Fothergillian Gold Medal by the Medical
Society of London.
Reference will be made to
presents some novel views.
a work on Consumption by Dr. Gardner, which
Works of
Laennec,
of Louis,
and of others.
Dr. Walshe’s
book noticed.
Truth
taught by
Dr. Johnson.
The spirit
which should
influence
criticism.
xvi PREFACE.
of men' of talent and research, referred to in the fol-
lowing pages, the writer exercises his liberty to detect
errors; he recognising the truth taught by Johnson:
.“ If there is any writer, Whose genius can embellish
impropriety, can make error venerable, his works are
the proper subjects of critical inquisition.”
re. The spirit i11 which such inquisition is to be
made is thus detailed by Sanders :
“ I have occasionally used freedom with great and
venerable names, but never with any intention to
diminish their lustre: if; indeed, assisted and guided
by the light they afford, I have sometimes discerned
their imperfections, I would no more presume to
blame them, than to blame the glorious sun, because,
by his rays, I was enabled to discern the spots on his
disk.”-—(Lib. cit.)
To gain for practical use this high state of mind, it
is essential to have realized what is thus described by
one who has afforded to the writer, and to multitudes
beside, some of his and their highest intellectual en-
Dr. Brown’s joyment.- The writer refers to the work of Dr. Thomas
Philosophy
of the Human
Mind.
Brown on the “Philosophy of the Human Mind.”* In
that work he thus writes:
“There is a philosophic spirit which is far more
valuable than any limited acquirements of philosophy;
and the cultivation of which, therefore, is the most
precious advantage that can be derived from the les-
sons and studies of many academic years,—a spirit
which is quick to pursue whatever is within the reach
of human intellect, but which is not less quick to

* To the honour of the phrenologists, it is to be stated, that they were the
first who brought Dr. Thomas Brown’s work into extensive circulation.
PREFACE. xvii
discern the bounds that limit every human inquiry, Quotation
and which therefore, in seeking much, seeks only what therefmm'
man may learn :-—which knows how to distinguish
what is just in itself from what is merely accredited
byillustrious names, adopting a truth which no one
has sanctioned, and rejecting an error of which all
approve, with the same calmness as if no judgment
were opposed to its own; but which, at the same
time, alive, with congenial feeling, to every intellectual
excellence, and candid to the weakness from which no
excellence is wholly privileged, can dissent and con-
fute without triumph, as it admires without envy;
applauding gladly whatever is worthy of applause in
a rival system, and venerating the very genius which
it demonstrates to have erred.” '
3/. In conclusion: The quotations made by a writer ggltfigdine
from other writers generally express the writer’s own
experience. It might be more foodful to one’s van-
ity to put down one’s own experience in one’s own
words; still there is a virtuous because a self-denying
gratification in making use of the observations ofjgflzttiigs for
others. It is a kind of fealty offered to the beneficial
activity of the minds of those who have gone before;
a dutiful testimony to the fact, that one owes some of
his mental wealth to labourers who have ceased to
labour,—a corroborative recognition of the truth, that
all accurate and honest observers agree on points
which are recognisable, and which have been recog-
nised,—a grateful acknowledgment of the value of
recorded experience, and more especially of the arts
of writing and printing, which enable us in this, the
xviii PREFACE.
nineteenth century, to communicate with Hippocrates,
with Galen, and with others:
“ To sit and hold converse with the mighty dead,
Sages of ancient times, as gods revered,
As gods beneficent, that blessed mankind
With arts and arms, and humanized the world.”
Add to these motives, that derived from the fact, that
views put forth, when sanctioned by both ancient and
modern experience, are likely to take a deeper hold
on the public mind; and thus, when the views are
true, the public will, when these views are thus re-
commended, more readily recognise them, and gain
the benefit from their reception.
The plan of this work is the following :—
First, To present a knowledge of the structure
and of the uses of the lungs, the organ affected in
Phthisis.
Second, A history of Phthisis, and of the patholo-
gical phenomena the phthisical state presents.
Third, The history and the explanation of the
symptoms connected with the various stages in the
course of the phthisical disease.
Fourth, On the cachectic state connected with
Phthisis.
Fifth, On the state of weakness connected with the
development of Phthisis, and the conditions tending
to develop this weakness.
Sixth, On the prevalent ideas respecting the incur-
ability of Phthisis.
PREFACE. xix
Seventh, On the means curative of Phthisis af-
forded through the pathogenesis of homoeopathic
medicines.
Eighth, On the correspondence between the several
phthisical cachexiae and the various medicinal cach-
exiae. _
Ninth, On the auxiliary means favouring the pre-
vention and the cure of Phthisis.
Tenth, Cases of cure illustrative of the views pro-
mulgated.
The reader is requested in perusing this work (it
being presumed that his object in reading it is to gain
an understanding of the subjects treated of) to pro-
ceed regularly through the successive chapters: to
make himself master of the views in the one chapter
before proceeding to the next chapter; and in so
doing he will gain a thorough knowledge of the
whole matter.
To aid as much as possible in the understanding of
the views put forth, the whole of the work is para-
graphed, and where in the course of any paragraph
any number or letter is introduced in brackets, such
letter or number refers to the paragraph in which the
matter under consideration was first referred to, and
by turning to such paragraph, if such reference
be deemed necessary, a more clear insight into the
subject may be obtained. VVhere the same number
occurs several times with letters following, such as
72, 72a, 72 b, 7 2 e, such recurrence indicates that the
XX PREFACE.
several paragraphs have a relation to each other. It
would be well also to refer to the index if any ob-
scurity prevails in connexion with any particular
point; and the perusal of the subject in full, as in-
dicated by the index, will, it is likely, cause the
obscurity to disappear.
~ CHAPTER I.
‘ON THE STRUCTURE, THE FUNCTIONS, AND THE USES
OF THE LUNGS.
1. To ascertain phenomena is the first duty of
every inquirer into nature. Cicero, in his work
concerning‘ Duties (De Qfliciis), a work that, by its
wonderful clearness of statement on moral truths,
tends to establish the view, held by the Friends, of
the passage, “ a light that lighteth every man that
cometh into the world,” rightly states :-
Every inquiry concerning any matter, to be ration-
ally undertaken, must be preceded by a definition, so
.that it may be understood what that is concerning
which the investigation is :—-“ Omnis enim, quee a
ratione suscipitur, def aliqua re institutio, debet a
definitione proficisci, ut intelligatur, quid sit id, de
quoy disputetur.”
2. Hence any inquiry into the nature of Phthisis,
the lung being the organ affected in this disease,
requires to be preceded by a narration of the pheno-
mena presented by the lung in its natural or healthy
condition, viewed both as to; its structure, 2'. e., its
B
2 WHAT A LUNG rs.
ANATOMY, and as to its functions and uses, such con-
stituting its PHYSIOLOGY; an acquaintance with these
phenomena preparing the way for the recognition of
the changes which are induced in the diseased, the
phthisical state: a knowledge of a machine in its
sound state being essential to the effective recogni-
tion of the conditions of the machine when in an
unsound state.
3. WHAT IS A LUNG?
4. The lung is the chief organ of those organs,
which constitute the breathing apparatuses; these
being the nose, the windpipe (this consisting of the
larynx and the trachea), the bronchi, the bronchial
tubes, and the air-vesicles.
5. “As there is a high road from the entrance,
formed by the lips, through the fauces -and the gullet
to the organs of the abdomen, so there is a high road
from the two entrances of the nostrils through the
trachea into the lungs, which fill to a great extent
the chamber of the chest.”--(Regnum Animale.)
5 a. “The nostrils open the way and allow the
lungs the possibility of breathing, for they are the
first doors or gates through which the breathings of
this living world are carried to and fro.”—(Regnum
Animale.) .
5 b. “They temper with a gentle warmth the air
which is entering, and impregnate with a dewy
vapour the air which is departing, and cleanse and
purify it from floating particles of dust and noxious
exhalations.”—(Regnum Animate.)
5 c. “ To effect this warming of the air, the interior
of the nostrils is much divided into cavities, through
which the air has to pass; and it is known that, if
the very coldest air be passed through even a short
THE LARYNX AND THE TRACHEA. 3
. tube that has been previously warmed, it instantly
comes out warm at the other end; and the more will
this warming of the air take placein the various pas-
sages of the nostrils, where warmth is imparted by
all the arteries, the membranes, and the constantly
vibrating thin bones, which are spread out through
the interior nostrils.”—(Regnum Animale.)
6. “The LA_RYNX, composed principally of gristles
or cartilages, is the thick upper part of the head of
the trachea, forming the protuberance called Adam’s
Apple, at the upper and front part of the neck. The
larynx contains an opening called the glottis, leading
to the lungs. One of the cartilages of the larynx,
called the epiglottis (em, epi, upon), covers, in the act
of swallowing, the glottis, in the manner of a move-
able bridge, and prevents anything falling into the
glottis.”-—(Heister, I/Vinslow, Zlforgagni.)
7. “ The membrane which lines the larynx is
very sensitive, and is perforated with a great number
of openings or little mouths (oscula), which discharge
a lubricating fluid in minute drops. This membrane
is a mucous membrane.”—-(Heister, Winslow, Mor-
gagni.) '
8. The larynx is the mouth of the lungs.
9. The windpipe or trachea is a continuation of the
cartilaginous tube extending from the fauces to the
lungs, the larynx forming the upper part. It enters
the chest under the breast-bone, and there, before it
joins the lungs, divides into two branches, a right and
a left, termed BRONCHI. ‘ .
9 a. “ The windpipe is formed of sixteen or twenty
cartilaginous rings, the rings not being, as regarding
their cartilaginous structure, perfect, being membra-
nous and muscular at their hind part; this contriv-.
4 THE BRONCHIAL TUBEs.'
ance being to prevent any impediment to swallowing,
the gullet lying behind the windpipe. The windpipe
has numerous openings on its internal coat, which
allow the passage of a mucus formed in the glandular
parts of this tube, this mucus being to defend the
inner surface of the trachea from the acrimony of the
air breathed.”--(Regnum Animale.)
9 b. The cartilaginous rings are connected together
by elastic ligaments, so as to admit of adaptation of
the -windpipe to the various changes in its position.
10. “The windpipe affords a channel for the air
and for the breath of the lungs to pass and to repass,
accommodating itself to all the numerous and diver-
sified modes of action of the lungs, both in inspiration
and in expiration. The windpipe examines and cor-
rects the air about to pass into the lungs, and pre-
vents, unless under special circumstances, anything
hurtful from entering; impregnates with vapour the
air that is passing out, and thus entangles efi"ete ex-
halations, and prevents the contiguous parts being
injured thereby: it clears, by expectoration, the lungs
from viscid phlegm.”—-(Reynum Animale.) '
11. The bronchi, subdivided into fine twigs, called
BRONCHIAL TUBES, are distributed through the lungs
in all directions, ending at last in pulmonary bladders
or VESICLES.
12. The larynx, the windpipe, the bronchi, the
bronchial tubes, are lined on the inside by a very
fine membrane, which continually~ pours out a muci-
laginous fluid; and in the substance of the membrane
are a great number of small blood-vessels. It is the
mucous membrane referred to (7
12 a. This mucous skin or membrane, when un-
folded, is, according to the observations of Hales and
AIR vnsrcrns. 5
Keill, many times more extensive than is the surface
of the body. ~
13. When the bronchi lose their cartilaginous
character, which happens as they subdivide, the
air-tubes become fine, like small hairs, hence called
CAPILLARY (capillus, a hair), and are membranous in
their structure. In the first part of their dividings,
“the bronchial tubes are composed of imperfect rings,
but, in their progress of cartilaginous rings, variously
united, and of contractile membranes.”—(Hez'ster.)
14. Each one of these minute capillary tubes is
widened at the extremity, and is thereby formed into
a small membranous cell, commonly called a vest-
cle. (11.)
15. “ These vesicles or cells, forming the chief part
of the lung substance, leave between them interstices,
which communicate with each other, and, collected
together in bundles, seem to adhere to the little bron-
chial branches, in the manner of clusters of grapes,
each small bronchial branch producing, in connexion
with itself, a bundle. These small vesicular bundles
are called LoBULEs.”—(Hez'ster.)
16. The lobules appear to be parted by another
CELLULAR sunsrancn, surrounding each lobule in the-
whole extent, and filling up all the interstices between
them.
17. All the bronchial cells are surrounded by a fine
NETWORK TISSUE, consisting of the small extremities
of the lung arteries and veins, which communicate in
every way with each other. This network, discovered
first by the anatomist Malpighi, is called the WONDER-
FUL NET (rete ‘mz'rabz'le) of Malpighi.
17 a. This network texture is formed of the capil-
lary extremities of these blood-vessels.
6 PULMONARY AND BRONCHIAL VESSELS.
»_ 18. These blood-vessels are of two kinds; the one,
common to the whole lungs, called the PULMONARY ar-
tery, and the PULMONARY veins: the other, proper to
the bronchial tubes, called the BRONCHIAL arteries and
veins.
" 19. The pulmonary artery goes out from the right
cavity (ventricle) of the heart, and divides into_two
Side-branches: one going to the right, called the
right pulmonary artery; the other to the left, called
the left pulmonary artery: these carrying the blood
from the heart to the lungs. .
19 a. These two vessels are dispersed through the
Whole -substance of the lungs, by branchin gs, very like
to the branchings of the bronchial tubes, and lying in
the same direction.-(l/Vinslow.)
20. The pulmonary veins, spreading by innumer-
able branches through the lungs in the same manner
as the pulmonary artery, terminate, on each side, in
two great branches, which open sideways into the
muscular bag of the left auricle of the heart (the
heart consisting of four cavities or bags, a right auri-
cle and a right ventricle, a left auricle and a left ven-
tricle) : by these veins the blood is carried from the
lungs to the heart. 7
21. The branchings of these two kinds of vessels in
the lungs are surrounded everywhere in their course
by the cellular substance already described. (16) ,
22. The cellular tissue is dispersed through every
part of the lungs, forming cellular or spongy sheaths,
which surround, as already described, the branchings
of the bronchia and of the blood-‘vessels, being} after-
wards spread over the outer surface of each lung,
where it forms a kind of fine covering, which is joined
to the general covering of the lung.
CELLULAR SUBSTANCE or LUNGS. 7
23. This cellular substance, the padding of the
lungs, is designated technically as the parenchyma of
the lungs.
24. The general covering of the lungs consists of a
beautiful transparent tissue, which, besides covering
the lungs, covers also the interior of the ribs, being
called, where covering the ribs and the interstices be-
tween them, the ribor costal PLEURA ; where covering
the lungs, the lung or pulmonal pleura.
25. In addition to these parts helping to form the
lungs, numerous nerves are supplied to the lungs, be-
ing distributed through them by filaments, which
accompany the branchings of the bronchia and the
blood-vessels, and are spread on the cells, the coats,
and all the membranous parts of the lungs.
25 a. These come from a plexus or network of
nerves formed in the chest ; this network being formed
by the parvagum and the intercostal nerves.——(Heister.)
In the fact of these nerves coming from the parva-
gum, is seen the connexion which the lungs have with
the brain, and affords an explanation how, in lung-
diseases, the brain becomes aflbcted.
26'. The lungs are supplied with vessels, that absorb
the old materials of the lungs, and which carry lymph.
These, called the lymphatic vessels, proceed to the
thoracic duct, found in the interior of the body.
27. From the description thus given, it appears,
that, in thelungs, are present the following parts :-—-
27 a. First, the air-tree, consisting of a trunk (the
larynx and the trachea) ; of branchings (the bronchi) ;
of twigs (the bronchial tubes) ; of leaves (the air-cells
and vesicles) ; all these tubes being destined for car-
rying air into the lungs, and being lined for protec-
tion by a mucus secreted by a mucous membrane.
8 PARTS consrrrurrne A LUNG.
27 b. Second, two blood-trees for nourishing the
lungs, consisting of the bronchial blood-vessels, which
attend the bronchia in all their branchings.
27 c.‘ Third, two more blood-trees, the lung arteries
and the lung veins ; the lung arteries carrying the
blood to the air-cells, the lung veins from the air-cells
to the heart : the blood, impure as carried to the lung
by the lung arteries, being purified by the action in
the lungs of the air thereon, through the web of Mal-
pighi, this web admitting the contact of the air with
the blood without admitting i(wondrous is the provi-
sion) into the air-tubes any escape of the blood.
‘ 27 cl. Fourth, the cellular tissue, which binds all
the various parts of the lungs into one whole.
27 e. Fifth, a lymph-tree, consisting of the lym-
phatics to take up the waste parts of the lung tissue.
27 Sixth, a nerve-tree, consisting of nerves, sup-
plying to the lungs sensation and nervous power.
27 g. Added to these parts are muscular fibres,
found on the inner surface of the bronchial tubes.
28. The lungs, as composed of all these parts ag-
gregated together, are massed into two great lobes, a
right and a left lobe: the left lobe, the smaller, is di-
vided into two lobes ; the right lobe, the larger, is di-
vided into three lobes; each again being subdivided
into innumerable little lobes. (15.)
29. The oifice imposed on the lung by its nature,
as connected with - its structure, consists (Reader, ex-
cuse repetition) in admitting the air, contiguous to
the body, through the larynx, the trachea, the bron-
chi, and the bronchial tubes, into the vesicles of the
lung lobules, and driving the air back again through
the same line of passages: this introduction and this
expulsion of the air having reference to the changes
_ mars CONSTITUTING A LUNG. 9
necessary to be effected in the blood in order to pre-
serve the health and the life of the human being.
30. Malpighi thus describes the circulation of the
blood in a frog :--
“The blood, driven by the heart’s impulse, rains
down in the manner of a vapour or effluvium, into
the minutest parts, running through the arteries into
all the cells by one or another of the considerable
branches that pass through them or end therein ; and
thus divided and subdivided, it puts off its red colour,
and, following a sinuous and circuitous route, is scat-
tered on all sides, until it reaches the walls and the
angles of the cells, and the absorbent branches of the
veins.” -
31. The lung may therefore be regarded as a web,
woven out of air-tubes, arterial tubes (pulmonary and
bronchial), of vein-tubes (pulmonary and bronchial),
of lymphatic tubes, of nervous fibres, of cellular tissue,
and of mucous membrane.
31 a. This web unfolded would present a very
large surface. Blumenbach, in his Physiology, states,
that the capacity of the lungs of an adult during a
strong inspiration, is about 120 cubic inches (p. 111,
edition by E lliotson.)
32. The relation of the action of breathing to the
heart’s action is exhibited in the fact, stated by Cole-
man in his work on Natural and Suspended Respira-
tion, p. 10, that in man there is “ one respiration to
four pulsations. Some animals have six; the horse,
in ordinary breathing, has only two.”
83. Science teaches the general truth, that there is
always a balance between the end to be gained and
the instruments appointed by the Creator for gaining
that end. ‘ '
10 coNeEsT1oN or LUNGS.
34. The inference, in connexion with the action of
the lungs, as having relation to the influence of the
air in purifying the blood, is, that there is no surplus
lung-web ; that is, that there is a balance between the
blood to be exposed to the air and the lung-web,
through which, when the lung is expanded in breath-
ing, the air acts on the blood.
35. To realize all the actions in connexion with the
lungs necessary to health, it is essential that all parts
of the lung-web should be in a natural state; that
the bronchial tubes throughout their whole extent
must be free, so as to allow the free passage of the
air; the mucous web, lining the air-tubes, must not
be overloaded with mucus; the cellular tissue must
have no consolid~ation or obliteration of its cells; the
blood must have free passage throughout the blood-
tissue of the lungs, both from the lungs to the heart
and from the heart to the lungs; the fine network,
through which the blood is acted upon by the air,
must be in a state fit to allow of this action.
36. It not unfrequently happens, that a quantity of
blood larger than is natural may occupy the lung at
_a given moment : in such case a temporary congestion
of the lungs is said to be produced. '
,..- 37. Mere congestion of the lung is not necessarily
a disease; indeed, such a state is often an effect, com-
patible with the most perfect health.
38. Simple temporary congestion or over-fulness of
the vessels -of the lungs is readily produced in man,
and other animals, by quick running, particularly if
the individual is not used to such exercise.
39. On the cessation of the action of running, the
power of the vascular tissue quickly restores the equi-
librium.
ANIMAL HEAT. ll
- 40. Though such restoration of the equilibrium
takes place after such congestions have been induced
in the healthy lung, still it is not advisable for any
one to cause these congestions, especially if at all liable
to conditions which may cause a belief that his ten-
dencies are towards lung disease. At the same time,
it. is to be remembered, that by a properly regulated
course of exercises, the capability of bearing this tem-
porary surcharge of blood on the lungs becomes
greatly augmented.
41. The PURIFICATION of the blood may be regarded
as the chief use of the lungs.
42. A use, hardly second to this chief use, result-
ing from the action of the lungs in connexion with
the breathing, is the production of ANIMAL HEAT.
43. Society is indebted to Dr. Crawford for the dis-
covery of this function of the lungs. -
44. Harvey, the discoverer of the circulation, seems
to have almost recognised the truth. He remarks:
“ Hence also appears the chiefhood of the blood, that
the pulse owes its origin to it. Nor is the blood to be
called only the first-begotten and pre-eminent, because
the . pulse and the motion chiefly‘arise from it, but
also, because, inpit, first animal heat is born, the
vital spirit is generated, and life itself consists.*
45. From the experiments of Dr. Crawford it ap-
pears that, when the blood returns from all parts of
the body to the lungs, it has lost a quantity of its
latent heat, and has imbibed some noxious quality:

* Hinc quoque apparet sanguinis principalitas, quod runsus ea: eo ortum
ducat. Ne sanguis solum pars primogenia et principalis dicendus est, quod
ab eo motus pulsusque principium orietur, sed etiam quid in eo primum calor
animalis innascitur, srnurns VITALIS ingeneratur, et anima ipsa consistit.--
Hxxv. Exer. 51.
12 mos IN THE BLOOD.
it appears further, that in the lungs it meets with at-
mospheric air containing oxygen, which oxygen, com-
bining with the carbon (this latter, namely carbon,
constituting in chief the impurity of the blood) pro-
duces carbonic acid,* which is rejected, and the blood
regains its pureness; and it appears further, that the
quantity of heat generated appears to depend on the
quantity of oxygen inspired.
46. It is found that, in every act of breathing, for
every volume of oxygen absorbed from the air, an
equal volume of carbonic acid is given out.
47. Lavoisier recognised the fact, that theoxygen_
consumed in breathing is greater than that required to
produce the carbonic acid formed. Dr. Priestley had
observed the same fact: the rest of the oxygen he
conceived was absorbed by the blood.—(E.rperiments
on Air, vol. iii. p. 379.)
48. It is found that, in the passage of the venous
or dark blood through the lungs, the globules of the
blood change their colour from a dark to a red, and
the redness of these globules is proved to depend on
a compound consisting of iron and oxygen; for
globules of blood, darkened by carbonic acid, become
florid by exposure to oxygen, with disengagement of
carbonic acid.

* Dr. Black made this discovery by breathing either through lime water or
the solution of a caustic alkali, when he found that the lime was precipitated
in the form of chalk, a carbonate'of lime, i. e. a compound of carbonic acid and
of lime; and, in the other case, the acrid alkali was rendered mild, being de-
prived of its causticity by conversion into a carbonate. These effects he attri-
buted to fixed air emitted from the lungs : he consequently conceived that the
change produced by expiration upon wholesome air, consists principally in the
conversion of part of it into fixed air. It appears that he made these discoveries
in the year 1757, and it may be inferred, that they were about the same time
publicly announced in his Lectures.—BLAcx’s Lectures. Published by Robin-
son, vol. p. 87.
CHANGE or COLOUR IN THE GLOBULES. 13
49. It is found, further, that the red globules of
arterial blood retain their colour in the large blood-
vessels, and lose their colour only during their pas-
sage through the smaller vessels, the capillaries.
50. The‘ globules of blood contain a compound of
iron, and it is as such they have connected with them,
and the changes they pass through, the production of
animal heat.
51. This compound of iron is an oxidized com-
pound; the proof of this consisting in the fact that,
by means of diluted mineral acids, pero:/ride of iron
can be extracted from the fresh or even the dried
colouring matter of the blood. .
52. The degree of oxidation is the pero:/ride; that
is, one atom of iron to two atoms of oxygen: the
iron is, so to speak, saturated with the oxygen.
53. It is found that the salts of peroxide of iron
readily give out oxygen, and become reduced to the
protoxide ; i. e., a compound of iron, consisting of one
atom of iron and one of oxygen.
54. The globules of the arterial blood become
changed, in the course of the circulation of the
blood, from a state of peroxide to a state of pro-
toxide; there going on, in the animal economy, an
oxidation both in the lungs and in the capillaries
of the body (13.) In the former, it supplies the loss
of heat from exposure and evaporation. In the
latter, it heats the rest of the body.
55. In this manner the animal heat of the body
is kept up; in other words, in this way does the
circulation of the blood minister to the production
of animal heat, constituting a second important result
from the circulation of the blood; a modification of
which heatis produced in a ‘marked degree in the
14 THE QUANTITY or OXYGEN BREATHED.-
course of the phthisical cachexia; hence the neces-
sity of this statement. '
56. In connexion with this production of animal
heat, the following facts have both interest and prac-
tical bearing :— . ' . i
57. Dr. Blagden’s experiments, recorded in the
Philosophical Transactions, vol. vi., prove, that man
has the power, in connexion with the heat of his
body, of resisting an exposure to an atmosphere
heated fifty to sixty degrees above the boiling point
of water, this exposure producing an increase of only
three to four degrees of the natural temperature of
the human body. This fact is explained thus : Man,
in breathing, exhales much watery fluid, in the form
of vapour, the caloric, taken up in forming the liquid
water into the more expanded form, vapour, neces-
sarily removing much of the heat received externally;
and further, the air that is inbreathed by the person
exposed to this great heat is expanded by the heat
before it is inbreathed, and from this cause, viz., the
\ expanded form of the same, the bulk of hot air cannot
contain a quantity of oxygen equal to that which is
contained in a similar bulk of cold air, and hence the
generation of heat is lessened, the supply of oxygen
being lessened.
58. On the other hand, it is found that the human
body, although surrounded by an atmosphere fifty
degrees lower than the temperature of itself, has the
power of generating heat with cold air, which, from
its being cold, that is, less expanded, contains more
oxygen in a given bulk than that which is contained
in a similar bulk of air which has been expanded
by heat.
59. It is found, further, that those animals whose
Ur
CHANGES or TEMPERATURE. 1
respiratory organs are small in proportion to the
size of their bodies, consume but a small quantity of
oxygen, and the temperature of their blood varies
with that of the medium in which they live; while,
on the contrary, those animals whose lungs, propor-
tioned to the size of their bodies, are largest, and
consume the greatest quantity of oxygen, have gene-
rally, when in health, a uniform temperature.
59 a. An additional fact, bearing on this subject,
is this :--In diseases, especially in fever, the patient
undergoes great and rapid changes of temperature;
these changes being, in a great measure, connected
with the conditions of the blood, as associated with the
condition of the lungs, and also, as connected with
the modifications induced by the disease in connex-
ion with the blood circulating in the capillaries,
and also in connexion with the modifications of the
nervous system, modifications pointed out first with
definitiveness by Dr. Harrison, and illustrated in his
writings by most striking examples.
59 I). These facts have been referred to, as they
have a bearing on some of the phenomena of Phthisis.
CHAPTER II.
A HISTORY OF PHTHISIS, AND OF THE PATHOLOGICAL
PHENOMENA THE PHTHISICAL DISEASE PRESENTS.
60. HIPPOCRATES, called the father of medicine,
observes :-—
“Young people are subject to a spitting of blood,
consumptions, acute fevers, but particularly to lung
afl'ections.”;— (Coac. iii. 260; Aphorism xxiv. sect.
3.) Aphorism ix. sect. 5.
“Those who cough up frothy blood bring it up
from the lungs.”
“ If the matter is not evacuated in fourteen days,
it will end in abscess.”-—(Coac. iii. 216; Aphorism
xiii. sect. 5.) Loo. in Hom. xxv. 10.
“The abscess or imposthume by a pleurisy, if the
matter, after bursting, be evacuated upwards within
forty days, will be cured; if not, it will end in con-
sumption.”-—(M’orb. 10; A phorism xv. sect. 5.)
61. Hippocrates adds :—
“ In hectic fever the heart is pained, the cough is
violent, and there is a discharge of thin mucus; the
disease produces great emaciation; there is an un-
rnrmsrs IN ANCIENT GREECE AND ROME. 17
quenchable thirst throughout; great debility exists
throughout; the patient dies generally within a year
even with every attention.”—(De Internis Afectioni-‘
bus.) '
62. Hippocrates in these testimonies exhibits the
fact, that the lot of the Grecian men and women of
his time was very similar to that which is now the 1
lot of the men and the women of the British isles.
63. Hippocrates adds :—
“I praise that physician who knows how to dis-
tinguish himself above all others by his skill in im-
proving the ordinary modes in curing those acute
diseases which make the greatest havoc among man-
kind.”—(De Ratione Vic. in Acut.)
64. How much, it may be added, will this praise
be due to him who opens the way to the cure of
Phthisis. Well did Cicero remark':—-
“Men in no point approach nearer to the gods
than in giving health to their fellow-men :”—“ Homines
ad deos in nulla re proprius accedunt quam salutenr
hominibus dando.” ‘j
65. CELSUS, born about 400 years after Hippo-
crates, was the 'most celebrated physician of his day.
He practised at Rome.
66. The following remarks, made by him, exhibit
correct ideas regarding Phthisis :—
“There is one species of consumption in which the
body is not nourished, and as something is always,
passing from the body, but nothing entering to supply
the place, extreme emaciation arises, and unless it is
removed, it carries off the sufferer. The Greeks call,
this disease Atrophy (a, a, not; rgepw, trepho, to turn).-
It generally occurs from two causes; for either a per-
son from excessive fear takes less food than he ought,-
c
18 ATROPHY, CACHEXIA, PHTHISIS.
or, from excessive appetite, more than is proper, so
that what is deficient causes weakness, or that which
is redundant is corrupted.
“ There is another kind, called by the Greeks
Cachevia (a), produced by a bad habit of body, which
‘corrupts all sorts of nourishment, the termination of
a long illness which does not admit of a return of
strength.
“There is a third kind ; the Greeks have called it
Phthisis. It arises generally in the head (catarrhal),
thence falls down into the lungs; ulceration follows‘;
from this slight fever takes place, which abatesi and
returns; there is a frequent cough; pus is expecte-
rated, and sometimes something bloody.”--(Celsus de
re Medica, lib. xxii.)
67 . GALEN, who lived 200 years later than Oelsus,
practised as a physician at Rome. He states :-
“ In pulmonary consumption, if a vessel bursts,
unless it unites without inflammation, the disease is
incurable, and the operation for cleansing the lungs
1s 1nJur1ous.”
He adds :—
“Before the appearance of the spitting of blood,
remedies sometimes effect a cure.”-—(Basil, 1562.)
' 68. The elder PLINY mentions cures of cases of con-
sumption in the last stage.
68 a. The eccentric PARACELSUS considered con-
sumption to originate in a want of moisture. 1
69. Almost all writers, both ancient and modern,
agree with GIDEON HARVEY, who, in his "‘ Anatomy
of Consumption,” states that the disease begins between
the ages of eighteen and thirty-five.
70. The fact that the disease so begins, may be of
use in helping to discover its nature, inasmuch as at
ESSENTIAL AND ARTIFICIAL cHARAcTER. 19
these periods of life there must be special states of
the body which favour the development of phthisical
disease; and which states being recognised, may lead
to the discovery of means which may be useful,
because eflective, in warding off the malady.
71. BAYLE maintains, that, in Phthisis, both lungs
' are almost always affected.
71 a. The characters of this disease, thus referred
to by the earlier authors, may be more minutely noted.
72. Phthisis (Pulmonary Phthisis) is one distinct
kind and‘ genus of disease.
73. Its characters, as a disease, are twofold.
73 a. It has an essential character, and an artificial
character. '
73 b. Bayle thus gives its essential character :—
“Every injury of the lungs, which left to itself
produces a progressive disorganisation of the lungs,
and, in the end, ulceration and death.”—-(Bayle, lib.
cit., p. 2.) ‘
73 c. The artificial, the pathognomonic (vraéog, pathos,
a disease, and 9/mun, gnome, proof) character, i. a,
derived from the symptoms presented by the patient,
exhibits itself in cough, difliculty of breathing, mar.as-
mus, hectic fever, and sometimes purulent expecto-
ration.”—(Bayle, lib. cit., p. v.) '
74. These two characters are related; since, as
Bayle states :— _
“ The cough, the wasting, the hectic fever, and the
purulent expectoration, are the effects of the disor-
ganisation of the lungs.”
75. Pinel (N osographie Philosophigue, edit. 3, vol.
iii.~ p. 588) characterizes Phthisis as consisting of
cough, difficulty of breathing, wasting, hectic fever,
and sometimes purulent expectoration.
20 - - ESSENTIAL CHARACTER. ‘
76. Bayle attaches much importance to the recog-
nition of the superiority of the essential character of
Phthisis, i. e., that consisting of the changes of struc-
ture produced by disease (the pathological, vradog, pathos,
sufering, ~and 7\0';/og, logos, a discourse, conditions)
over the artificial or symptomological, i. e., that con-
sisting of the symptoms indicative of these changes
of structure. ' I
77. The grounds on which he builds this superiority
are the following :—
The essential character is, he maintains, always
present,.whereas the artificial, i. e., that composed of
symptoms, is not always, or, at least in regard to the
same, the following facts tend to throw a doubt on
the-symptomological character of Phthisis. ,
77 a. Fact first. Persons have died of Phthisis with-
out having shown any manifest signs of its presence. -
77 b. Fact second. Persons havedied of Phthisis
who have had hectic fever, emaciation, but no cough
or expectoration, and yet numberless tubercles and
large ulcers have been found in the lungs. '
77 c. Fact third. Persons have died of Phthisis,
the lungs presenting tubercles and large ulcers, and
yet the patients appeared to die of exhaustion, pro-
duced alone by excessive diarrhoea. ' ,, ._
77 d.‘ Fact fourth. Persons have died with the
lungs deeply injured, who felt only wandering pains
and nervous affections. ' '
77 e. Fact fifth. Many phthisical personsv have
died and never spat pus in any marked degree. In
the preface to Dr. Bayle’s work, lib. cit., p. x., Dr.
Barrow relates .a case in which the lungs were full of
suppuratingtubercles, and yet the_patient during the
whole of his illness did not expectorate any pus.
BAYLE’s OBSERVATIONS. 21
! 78. These facts are important ;~ but Bayle makes
them to have an importance which is not quite cor-
rect, since it is certain that there cannot be disease
of structure without manifestations thereof by special
phenomena, which are not in accordance with the
phenomena of health, i. e., SYMPTOMS MUST be present
~where DISEASED STATES exist: all that is required is
the minute observation of phenomena by minds well
fitted thereto by a knowledge of the minutenesses of
medicinal pathogeneses; hence the superior practical
skill of homoeopathists, their ‘minds having, by the
study of medicinal pathogeneses, been thus trained;
and no hesitation need be experienced in asserting
that, in all the cases referred to in the facts recorded
by Bayle, the accurate pathogenetically instructed
observer would have detected symptoms indicative
of the lung disease. , -
79. These facts testify to the truth, that Phthisis
presents itself under a variety of aspects, which it is
necessary to notice in connexion with cases of Phthisis.
80. Bayle states, that, of the nine hundredcases of
Phthisis he examined after death, six hundred and
twenty-four presented substances formed of a like
(homogeneous) matter, always opaque, of a white or '
dirty white colour, at one time yellowish, at another
grayish, these substances varying in size from a millet
seed to a walnut.
81. Such substances, tubercles, are, when of the size
of millet seeds, called miliary tubercles. .
82. One hundred and eighty-three of the cases
remaining after the subtraction of the six hundred and
twenty-four, presented little grains like millet seeds, or
like beans, hard, resisting, interiorly semi-transparent,
of a shining white colour, having in the centre a small
22 TURERCULAR PHTHISIS.
opaque point, blackor white, enclosed in a transpa-
rent and firm envelope: these cases Bayle designates
as cases of granular Phthisis.
83. Seventy-two other cases presented ulcers in the
lungs of ‘various sizes, as black as coal and very hard,
sometimes a few lines thick, sometimes many inches.
These cases, from the blackness (,aeAag, melas, black)
of the ulcerous contents, he defines as Phthisis with
melanosis. _
84. The remaining twenty-one of the cases recorded
by Bayle presented other characters not embraced
in these divisions. A few are recorded as cancerous*
Phthisis.
85. TUBERCULAR PHTHISIS, as stated, presented six
hundred and twenty-four cases out of the nine hun-
dred, and thus tubercular Phthisis is that which is to
be examined.
86. T ubercles present themselves in three states.

* The writer was consulted by a lady, whose case had been deemed hope-
less by her medical attendant and by a metropolitan physician accoucheur.
She had scirrhus and cancer of the womb. Her pains these gentlemen had
tried to subdue by opiates, but in vain. The profuse haemorrhagic discharges
they attempted to restrain by injections and outward applications, and by
wine and tonics, but in vain. The patient getting worse and worse, sought
homoeopathic aid. Under homoeopathic treatment she gained sleep, her pains
were subdued, and the haemorrhages and the offensive discharges from the
womb were lessened; moreover, the scirrhous formations were much lessened.
From want of care (she went to the country, and lived in an old dilapidated
house full of draughts and in a bleak situation) pulmonary disease developed
itself, and she died from neglect of this pulmonary malady. On examining the
lungs there appeared hardened cartilaginous portions scattered throughout the
pulmonary tissue. The uterine disease had almost disappeared, and, from
the state the womb presented, it seems logical to infer that, had not the pulmo-
nary disease developed itself, the womb disease would have been cured. A
question suggested itself at the time to the mind of the writer, Did these gran-
ular structures on the lungs indicate any transfer of diseased action from the
Womb to the lungs? Would cancerous Phthisis, adopting Bayle’s nomencla-
ture-, ‘have developed itself had the lady .lived ‘P
cYsTED AND UNENCYSTED TUBERCLES. 23
86 a. At -first, their texture is very firm.
86 1). Subsequently they grow soft in the centre, a
part of their substance being transformed into a clot-
ted purulent matter ; this change being designated
softening of the tubercle.
86 c. The third state is that in which the substance
of the tubercle is destroyed by suppuration : the parts
become ulcers.
87. In addition to these conditions, some tubercles
are contained in bags or cysts : these are called encysted
tubercles.
88. Some tubercles have not this investment : such
are said to be unencysted.
89. When the third stage in the degeneracy of the
tubercle takes place, the cyst enclosing the tubercle
has become the seat of an ulcer; the ulcer itself, oc-
curring whether in an encysted or an unencysted
tubercle, being almost always covered with a distinct
membrane, which secretes pus.
90. The progressive degeneracy of the tubercle may
be illustrated by the conditions occurring in glandular
tissues.
. 90 a. “ Obstruction often takes place in the glands
of scrofulous individuals. Enlargement is then pre-
sented. Those glands which have enlarged slowly,
are transformed either wholly or partially into tuber-
culous matter. Those which have enlarged suddenly,
do not show any in dication of tubercular degene-
racy.”—-(Bayle, lib. cit. 7 O.)
90 b. “ If tubercular glands suppurate, the pro-
cess is very long. ALL THE TUBERCULAR MATTER
MUST BE EXPELLED, in order that that part of the gland
which was swollen may insensibly return to its natu-
ral state.”— (Bayle, lib. cit. 70.) (This fact has an im-
24 CHANGES IN ULCERATION.
portant bearing on the changes which must take place
inthe tubercles of the lungs; showing that expecto-
-ration may be regarded to be essential to cure.)
.90 c. “The cure of the ulceration, subsequent to
the suppuration, is also very slow.—(Bayle, lib. cit.) .
90 d. “When an ulcer forms in glands which do
not contain a tubercular kernel, the exit of the pus is
generally easy, and the cure is not slow.”-—(Bayle,
lib. cit.) .
91. These facts will serve to explain some of the
changes which take place in the degeneration and the
cure of the tubercles in the lungs: will show what is
to be expected in reference to the course which tuber-
cles pass through in their degeneration : will give
ground for the pleasing belief, that, if cures of diseased
tubercular glands take place in some parts of the body,
the peculiar tissue constituting pulmonary tubercles
need not to be excluded from the category of cures.
92. The tubercles are found in the cellular tissue,
the parenchyma (23.) of the lungs. .
93. This parenchyma, when associated with tuber-
cles, passes through the following changes :—
“ The cellular substance round about the ulcer is
more or less altered; erewhile hardened, at another
with but little consistency: when the ulcerations are
very small, the pulmonary tissue is sometimes almost
sound round the membrane which secretes the puru-
-lent matter.—(Bayle, lib. cit. p. 22.)
“ The compression of the pulmonary tissue by the
-progressive development of the tubercles causes the
tissue to be reduced to a very small size : indeed, the
tissue in many cases seems almost to have disap-
peared.”—-(Bayle, lib. cit. p. 23.) .
-93 a. In addition to these changes, there is formed
PROTECTION TO THE LUNG. 25
in this cellular tissue the ALBUMINOUS MEMBRANIFORM
BED or stratum which covers the ulceration.
93 b. “ When there are many ulcerations, they
communicate with one another, and form in the lungs
many rugged cavities, sometimes very extensive.”——-
(Bayle, lib. cit. p. 21.)
94. “ Two kinds of openings are observable in these
cavities: some, which lead to thebranchings of the
bronchia, are round ; others, which preserve the com-
munications of the tubercles with one another, are ir-
regular.”—(Bayle, lib. cit.) . -
95. “ The membrane surrounding the tubercles ap-
pears sometimes continuous with the mucous mem-
brane of the bronchia; it is, however, essentially dif-
ferent and distinct.”-—-(Bayle.)
96. It is a matter of wonder how it happens that
the blood-vessels of the lungs do not become eaten
through by these changes in structure of the lung
tissue. Bayle explains it thus :—
“ Ordinarily the -membrane covering the ulceration
is continued into all the parts, which communicate to-
gether, and furnishes a sheath for the large insulated
vessels of the lungs, which are often observed in the
excavations of the ulcer.”—-(Bayle, lib. cit. p. 22.)
97. Such is the preservative power with which the
Creator has endowed the human system.
98. The production of all these changes must be
attended, as already intimated, with certain deviations
from the regularity of the manifestations of the life-
power in the individual in whom they take place ; in
other words, must be exhibited by symptoms, which
it will be necessary and useful to examine.
CHAPTER III.
HISTORY AND EXPLANATION OF THE SYMPTOMS CONNECTED
WITH THE VARIOUS STAGES IN THE COURSE OF THE
PHTHISICAL DISEASE.
SECTION I.—-Symptoms connected with the Premonitory
Stage.
99. Tubercular* Phthisis, as associated with the
changes in the structure of the tubercles, and with
diseased conditions of the lungs therewith conjoined,
presents three chief stages, together with a premoni-
tory stage. ‘
100. Numerous and varied are the symptoms of the
premonitory stage.
It is a fact well known, that bleeding from the nose is
a common attendant upon 'or precursor of Phthisis.

* Description of a tubercle by Dr. Carswell:—Tuberculous matter is a pale
yellow or yellowish gray, opaque, unorganized substance; the form, the con-
sistence, and the composition of which vary with the nature of the part in
which it is formed, and the period at which it is examined. It may be viewed
as an unorganized secretion, or as a cheesy-looking material, without any trace
of organization.
BLEEDING or THE NosE. 27
Dr. Sanders remarks, “ In certain persons at an early
period of life, but more remarkably about the age of
puberty, occur tension and pain of chest more or
less severe, with titillation of the fauces, and slight,
short, dry cough, readily excited by hot drink, espe-
cially if it contain ardent spirits; to which are fre-
quently added drowsiness and a sense of weight in
the head; occasionally headache is the only symptom
which distresses them. All these symptoms are often
relieved by a spontaneous bleeding of the nose or a
spitting of blood.”-—-(Sanders, lib. cit., p. 2.)
101. Bayle considers both this nose bleeding and
also the spitting of blood (haemoptysis; and a:,aa,
aima, blood, and z-row, ptuo, to spit) to be the effects
of the development of the tubercular affection of the
lungs. Except thus generally, he does not seek to
explain the facts. ‘
102. In connexion with this nose bleeding, the fol-
lowing views seem to have a practical bearing :--
103. The nose is to be regarded as the begin-
ning of the lung apparatus, just as the mouth is the
beginning of the digestive apparatus.
103 a. The nose is one organ of respiration, for
animals breathe not through the mouth, but through
the nostrils; and “ God breathed into his nostrils the
breath of life.”-—-(G-enesis.)
103 b. The nose, too, has its cough; sneezing is the
name the writer affixes to this action.
103 c. The nose thus viewed is a part of the.
breathing apparatus, and hence the reason appears
why, if there is such a state of the lung tissue as is
associated with blood discharge, it is not unlikely
that this tendency existing also in the blood tissue of
the nose, the discharge of the blood from the nose
28 SPITTING or BLOOD.
becomes premonitory, and indicative of the diseased
changes in the lungs.
104. What an admirable contrivance is it that the
discharge of blood- should thus be exhibited in con-
nexion with the nose, since here the blood escapes
exteriorly; whereas, if taking place in the tissue of
the lungs, a suffocation, an asphyxia of the lungs,
would be caused. This nose bleeding gives a notice,
which, if homceopathically attended to, would prevent
in the majority of cases any further development of
the lung disease. It is nature giving warning, and
the wise physician listens to the notice; but only he
who is homceopathically well informed in the patho-
genetic effects of remedies can listen effectually.
The frequency of the occurrence of spitting of blood
(heemoptysis), with the development of Phthisis, is
exhibited in the fact that the acute observer of disease,
Dr. Cullen, in his classification and description of
diseases, places Phthisis as a sequel of haemoptysis, he
not considering Phthisis itself as a primary disease;
a genus. In this arrangement Cullen was inaccurate.
Dr. Young, in his Treatise on Consumption, puts
the relationship between these two diseased states
more accurately.
“Haemoptysis,” remarks this writer, “is usually
enumerated among the exciting and even among the
more remote causes of consumption ; but, in a healthy
constitution, haemoptysis is not materially formidable;
and it is conjectured that, when it appears to produce
consumption, it has itself been occasioned by an in-
cipient obstruction of a different kind.”—-Page 45.
Desault, in his work, Sur les Maladies Vener, la
Rage et la Phthisie, 12mo., Bord, puts the matter
forcibly when he remarks :-
LIABILITY To TAKE COLD. 29
“ We may call it a haemoptysis from consumption,
rather than a consumption from haemoptysis.”
105. The speciality of Phthisis induces peculiarities
in reference to all the systems constituting a lung.
106. Anatomy teaches that every lung artery is
attended by a bronchial tube; the irritation conveyed
to the bronchial tube from the diseased lung cellular
substance connected with the tubercle, is communi-
cated to the lung artery, all these diseased conditions
affecting the lung nervous system; and these influ-
ences acting together will explain how cough, fever,
a rapid pulse, and the peculiar irritableness present
in Phthisis, occur even before any expectoration takes
place. -
107. N 0 one acquainted with Phthisis could fail to.
have observed the fact that there is a special irri-
tability, or rather a susceptibility, connected with this
disease, which manifests itself long before the disease
is fully developed in a liability to take cold.
108. It seems to be a peculiar fever that creates
this susceptibility, not unlike, though arising from a
diiferent cause, to that susceptibility to cold produced
in those who flush after taking any stimulus at meals ;~
a feverishness, causing them to be susceptible to im-
pressions from a draught of air, which, in a state not
~feverish, they would not have experienced.
109. This special irritability affects the nervous
MENTAL system. What is more remarkable, even in
the premonitory stage of Phthisis, than the oscillations
in the mental state between hope and fear; and also
before the disease has actively developed itself, how
constantly do the great extremes in the moral state
of the patients arrest the attention of , those who reside
with them. ' '
3O VARIATIONS IN THE BODILY STATE.
110. This variation is exhibited also in relation to
the bodily state. The patient in whom Phthisis is in
the state of incubation, is at one time very weak, at
other times has an unusual amount of bodily energy;
although, on the whole, there is a regular diminution
of bodily power.
110 a. This applies to the appetite also. One day
the patient has a good appetite, another day no appe-
tite at all; on the whole, the appetite is generally
fanciful.
110 b. The countenance shows great variation.
Sometimes it is dull, and at another period of the
day, particularly towards evening, it is lighted up
with a beauteous vivacity of expression. The features
seem to have a special sharpness.
111. The pulse exhibits considerable changes in this
the premonitory stage.
112. The patient exhibits great variations in regard
to sleep. From being a sound sleeper, almost diflicult
to awake in the morning, when the Phthisis is in the
state of incubation, the patient becomes wakeful ; or
if he sleeps soundly till five in the morning, he cannot
sleep after that time, a condition evidently connected
with a special state of the nervous system, induced
by the diseased action going on in the lungs, this
being developed at that time in the morning by the
physical conditions, associated with the conditions of
the lungs, produced when the individual is asleep.
113. It is well known to those acquainted with
disease, that at different ages different organs of the
body become affected. In children the abdominal
organs are particularly liable to have unusual actions
induced in them, and hence in children the incuba-
tion of Phthisis is oftentimes indicated by the enlarge-
SIGHING IN PHTHISIS. 31
ment of the belly, the thinning of the legs, although
these may arise independent of any affection of the
lungs.
114. Another state often exhibited among the
premonitory symptoms of Phthisis is an occasional
shortness of breath, sometimes associated with sighing,
these being dependent on temporary congestions,
which, affecting the tissue i11 which the diseased action
is going on, cause the difliculty of breathing; and
hence this attempt, by the effort of sighing, to relieve
this condition.
115. Some other premonitory symptoms will be
detailed when noticing the pathogenetic (c) effects of
the medicines to be used for the cure of Phthisis.
116. These premonitory symptoms are considered
to indicate the state of incubation of Phthisis, or as it
is sometimes called, occult Phthisis.

SECTION II.—-The Symptoms connected with the FIRST
Stage, and their Explanation.
117. The stage of Phthisis usually denominated
the first stage, is considered to be identified with the
following diseased conditions of the pulmonary tissue.
Gray granulations, appearing in groups or crude_
tubercles, present themselves in different parts of the
lung tissue at times, but not always, surrounded
with induration of the lung tissue (93.). A certain
number of these tubercles have grown soft in the
centre.
118. The indications of this stage are presented in
the following symptoms :-
I. The emaciation progressive.
32 SYMPTOMS or FIRST STAGE.
II. A dry cough:
II. a. Sometimes attended with pain:
II. b. Followed, after a time, with mucous expecto-
ration, opaque white threads or lumps, like rice much
boiled, being dispersed through the matter expecto-
rated.
III. Sometimes streaks of blood appear in the ex-
pectoration.
IV. In the evening a slight fever, followed by per-
spiration;
And, in the young,
V. The cheeks are frequently red.
VI. The palms of the hands are burning hot.
VII. Oppressed breathing.
VIII. Pains about the chest, not unfrequently be-
tween the shoulders.
IX. Uneasiness, mental and bodily.
X. An increased pulse.
118 a. Other symptoms present themselves, but
these others are associated with conditions which
depend on disease in other organs of the body, and
are called forth by the irritation of the disease in the
lungs; these symptoms will be noted in the course of
the work. Bayle remarks, in regard to this disease
generally :—-
“The only indications ofttimes are simply a me-
chanical oppression, which becomes attended with a
dry cough more or less frequent, and these often
constitute the sum total of phenomena even in an
advanced stage of the degeneracy of the tubercle.”
119. In regard to the emaciation, its production is
easily explained. The life power summons all its
energies to the recovery of the lung—-to the removal
of the diseased conditions. It seems to appropriate
EMAcIATIoN. DRY couen. 33'
from each tissue some of the life-power allotted to
such tissue; the disease in this way consumes every
one of the tissues, or at least the fatty portion of
these tissues, and these being consumed, and not
allowed to be reformed, the life-power being other-
wise active, loss of substance must of necessity result;
hence the progressive emaciation manifest in this
disease, and hence also, as the lung disease progresses
often in a regular ratio, the regular progressiveness
of the emaciation. Has this appropriation of the
adipose tissue anything to do with the beneficial
effect of the cod-liver oil in the few cases where it
is beneficial?
120. The second symptom is the dry cough. The
explanation of this dry cough (and it is quite special,
quite different from the dry cough which so often
attends laryngeal disease) is to be found in the facts
already explained as to the changes in the lung tissue
(86-88. 117.), and, more particularly, in connexion
with the fact that the tubercle dwells in the cellular
tissue of the lungs surrounding the bronchial tubes,
and not in the br.onchial tubes themselves.
120 a. The irritation connected with the tubercular
disease is communicated to the bronchial tubes and
the nervous tissue therewith connected, and of this
irritation the cough is the manifestation; but the
cough is dry. ' -
121. This dryness of the cough, in the early stage
of the degeneration of the tubercle, presents a notice-
able fact which accords with another fact present in
pleurisy. In this latter disease the cough is dry; a
circumstance dependent on the locality affected by
the disease, namely the skin, called the pleura (24.),
covering the lungs and the ribs; a skin having no
1)
34 BLOOD STREAKS.
direct communication with the mucous membrane of
the bronchial tubes of the lungs; but this pleural
skin, when inflamed, communicates its irritation to
the lungs, and indicative of that communicated irri-
tation is the cough; just as the dry cough in Phthisis
is an indication of the irritation produced in the lung
tissue by the changing tubercle being communicated
to the bronchial tubes. .
122. As the irritation arising from tubercular
disease augments, the irritation affecting the bron-
chial tubes is also augmented, the mucous membrane
(9 a. 12 a.) of these tubes~ increases its secretions, and
expectoration manifests itself; a result explanatory of
the symptom No. 2 b. -
123. The third symptom is the appearance of streaks
of blood in the expectoration.
123 a. These streaks of blood may come from a
‘special state developed in the vessels of the mucous
membrane of the bronchial tubes, similar to that state
induced in the vessels of the mucous membrane of
the nose, which produces bleeding from the nose.
123 b. Or these streaks may come from some
Wounded or ulcerated vessel.
123 c. Or these streaks may come from the tubercle
itself having established a communication with the
bronchial tubes; for the tubercles, both encysted and
unencysted (87 .), are permeated by capillary blood-
vessels, and these capillary v~essels may discharge
blood which is mixed with the mucus, and it comes,
as might be expected (the vessels being hair-like in
form), in streaks.
124. When the blood is connected with the con-
dition last noticed, its appearance is unfavourable.
125. A query here is suggested, Why‘ should spit-
EVENING FEVER. RED CHEEKS. 35
ting of blood in large quantities be present in some
cases, while in other cases of Phthisis streaks only are
presented ?
126. Is it that, in the cases where profuse dis-
charge of blood takes place, a special cacl1e.Xia may
exist? This cachexia, so far as the writer’s experi-
ence has ‘extended, seems to be one in which there is
an eruptive condition of the system; the scorbutic
eruptive state seems to be the one most commonly
ass'ociate~'d with this cachectic condition. The writer
has known leprous eruptive crusts bleed at the time
when the monthly discharge ought to have appeared,
but did not appear.
126 a. “ Expectoration of blood in persons labour-
ing under chronic bronchitis, with or without emphy-
sema (puffy swollenness), but without notable disease
of the heart, justifies in itself a suspicion of the exis-
tence of latent tubercle,” is a statement of Dr. Walshe
in his Report on Phthisis as observed at the Brompton
Hospital (British and Foreign M edico- Chirurgical Re-
view, Jan. 4, 1849.) ‘
127. In regard to the fourth symptom, the slight
evening fever, followed by perspiration, an explanation
is obtained in the fact, that all changes of structure,
being results of disease, are attended with fever, and
if the tendency be to the formation of pus, with per-.
spiration.
128. In regard to the fifth and the sixth symptoms_,
the redness of the cheeks and the burning heat ' of the
palms of the hands, they illustrate the fever GOI1I1eCt€d
with diseased formation.
129. The symptoms seventh and eighth, namely,
the oppressed breathing, and the pains about the chest
and the shoulders, may be illustrated more fully.
36 ACTION or INSPIRATION,
129 a. During the act of inspiration the blood
comes readiest into the lungs.
129 b. “ In the act of inspiration, the innermost
spiracles or breathing holes, the lung vesicles, open
first; afterwards the bronchia, beginning at the roots
of these spiracles; then the trachea and the glottis;
lastly, the nostrils all the way to the wings of the
nose, these being dilated by their muscles; thus the
air is admitted, invited, attracted, and flows in as in
a bellows at work according to the given opening, the
height of the incumbent column, and the force of the
gravity dependent thereupon.”—-(Regnum Animale.)
129 c. The act of expiration assists the passage of
the blood from the lungs to the left side of the heart,
and prevents to an important extent the admission of
an additional quantity of blood into the lungs.
129 d. A fact known to most is, that any con-
tinued eifort at expiration, whilst the air is kept con-
fined in the chest, produces a redness, and, if the
attempt at expiration is protracted, a blackness of the
face; results originating in this, that, in the first
place the blood, in the second the dark venous blood,
is prevented entering the lungs, and is consequently
dispersed and retained in other tissues longer and in
a quantity greater than is consistent with the regular
or normal state of these tissues.
129 e. “ Magendie introduced a tube into the neck
vein (jugular) of an animal, and made it penetrate as
far as the heart; the blood was seen to flow by the
tube only in the moment of expiration. In inspira-
tion, on the contrary, the air was drawn forcibly
towards the heart.”--(Barry’s Experiments on Atmos-
pheric Pressure.)
“Also, in the slaughtering of animals, the blood
3 AND or EXPIRATION. ' 37,
gushes out like a fountain at every expiration; the
last effort to assist the hold of life, the last sigh, is an
expiration.”_—-(Tyrrel.) _
129, The effects of certain actions of the body
illustrate the relations established between the circu-
lation and thebreathing. ' . ' ~.
_129 f a. “All are aware that in every attempt to
-run, by a person not used to the action of running,
the extremities do not give way first. The lungs,
from a want ‘of sufficient breathing action, are in-
capable of getting rid of the extra quantity of blood
sent to and kept in them; a temporary congestion of
the blood in the lungs ensues; the natural equili-
brium between the air and the blood in the lungs is
disturbed, and not only the lungs themselves, but the
muscles immediately concerned in the act of breath-
ing, are alike unable, for similar reasons, to send the
blood from- the lun'gs.”—(Tyrrel.)
129 f b. “Further,,no exertion of strength, no vio-
lent effort in the raising, or the throwing, or the
carrying of weights, &c. (seen in the actions of - the
.p_av_ier),' is accomplished without shutting down the
valve (the epiglottis, 6.) at the top ‘of the windpipe,
which closure must be attended with the exertion of
a powerful pressure by the confined air on the blood
in the lungs.”——(Tyrrel.) ~
129 f c. How common is it for people, while run-
ning, to exclaim, “I cannot run further; I must
stop; I shall drop if I go a step further.” The lungs
will not allow any longer the continued congestion;
the vascular tissue will not admit of the distention
produced by the holding of the breath ; indeed, the
action is persisted in, the vascular tissue is ruptured,
and blood is expectorated. -
38 OPPRESSED BREATHING IN THE
129 f d. “ If a fat, unexercised horse is galloped to
what, in sporting phrase, is termed ‘a stand-still,’
five minutes or more of perfect quiet must elapse
before/the oppressive breathing and congestion thus
established are reduced; whereas if the horse’s two
neck veins (jugular) are opened the recovery is in-
stantaneous, the equilibrium being thus at once re-
stored, the quantity of blood going to the lungs being
diminished, and the volume of air being increased.”—--
(Tyrrel) '
130. These congestional conditions are not void of
danger to persons in health unused to the actions
causing them-.
131. Taking into consideration the facts already
recorded in connexion with the lung tissue, and with
the diseased states of the tissue of the lungs connected
with tubercles, the occurrence of pains and difficulty
of breathing in connexion with the first stage of
Phthisis can be easily understood.
131 a. The tubercle is a foreign body, i. e., not
natural to the lungs: it occupies portions of the lung
‘tissue not intended for such occupancy, and thus
causes a congestion; and this, as a congestion associ-
ated with disease, is dangerous.
131 b. The cellular tissue around the tubercle is
thickened and congested, thus causing a pressure on
the lung Vesicles, and thus rendering a portion of the
lung tissue unfit for its uses,-—uses essential to health.
In connexion herewith Dr. Alison mentions an ob-
servation of Magendie, that in those cases where he
detected tubercles of the smallest size in young chil-
dren, and apparently in their earliest stages, the
tubercles were surrounded by a CIRCUMSCRIBED VASCU-
LARITY; a condition impedimental to the free action
PHTHISICAL EXPLAINED. ~ 3-9
of the air on the blood of the lungs, and productive
of pain, by producing a modification of the nerves of
the part.
132. The respiratory power of the phthisical indi-
vidual must by these tubercles and the changes in-
duced in the surrounding cellular tissue of the lung
be diminished; hence in Phthisis the symptom op-
pressed breathing.
133. The injury resulting from the presence of
unusual bodies, causing an occupancy of space in
parts not destined for such occupancy, but destined
to be occupied by organs of a natural size, is evi-
denced in the facts that an enlarged liver, an enlarged
spleen, or an enlarged ovary, will cause not unfre-
quently an effusion of fluid into the cavity of the
belly; will cause ~dropsy.
133 a. A similar law, as to injury to an organ from
occupancy of space by bodies not naturally belonging
to that organ, -must act in regard to the tubercle
and its action in connexion with the lung.
133 b. Still as a liver may be affected morbidly to
a certain extent, so a spleen, so an ovary, without
producing any very definite effects, so a tubercle may
exist in the lung tissue without producing effects
sufliciently marked as to awake attention. Still they
must produce some modifications of the action of the
healthy life-power, and are, as having produced these
modifications, always liable to permit the awakening
of agencies which may render these lung congestions
dangerous to life. Hence the necessity of attention
to any change in the health of persons prone to
Phthisis. ‘
134. Wherever a tubercle is, there is more or less
congestion of lung, and there is more or le~ss diflficulty
TUBERCLE ATTENDED WITH CONGESTION.
of breathing; and if the‘ congested tissue be inflamed
there is more or less pain, the pain presenting itself
where the congestion is, it may be at the chest, it
may be at the shoulders. ‘ -
135. Indeed, every one who understands the rela-
tionship of an instrument to the results to be obtained
from that instrument, in other words, the relationship
between structure and use, will recognise the truth of
the statement of Dr. Walshe :— .
“ The existence of disease involves that of ana-
tomical change, not only in the part originally and
chiefly affected, but also in the structures immediately
adjoining.”-—(Walshe, lib. cit., p. 1.)
136. Congestion occurring in the lungs of indi-
viduals having tubercles, must cause a liability to the
production of diseased manifestations; hence, in per-
sons so affected, any violent exertion, any sudden
and violent effort at coughing, will often cause a tear-
ing of the coat of a blood-vessel, and a consequent
spitting of blood; or it may be that any sudden
change of temperature, such as that which takes place
at day-dawn, may cause, as very frequently happens,
a dangerous spasmodic condition, attended with a wak-
ing up suddenly, with excessive difficulty of breathing
amounting almost to suffocation. (How commonly
do spasmodic croup and Millar’s asthma develop
themselves at day-dawn.)
137. The tenth symptom of the first stage of '
Phthisis is an increased pulse.
138. Remembering the fact, that from whatever
cause the receptacle for air in the lungs is diminished,
the area of each respiratory action is diminished, and
V by consequence the breathing power and the blood-
changing power are lessened, it follows that in order
INCREASE on THE PULSE. 41
-in such a case to establish the equilibrium between
the air surface and the blood-to-air-exposure surface,
there must be an increase of the number of inspi-
rations to effect the required change in the blood.
Thus, supposing the lung web, through the sides of
which the air acts on the blood, effecting its change
from a dark colour to a red colour, from a state im-
pure to a state pure, from a state unfit for life to a
state fit for life, amounts (for the sake of illustration),
say to four yards square, and that the loss of lung
blood-changing surface, a loss caused by the diseased
tubercles and the surrounding diseased tissue, amounts
to one square yard, it is certain, that as the quantity
of blood to be changed does not diminish in a ratio
-with thediminution of lung tissue to whichit has
to be exposed, that the blood, in order to have the
requisite change effected in it, must be brought more
frequently to the web; to effect this the heart is obliged
to work harder,endeavouring to make up, in the
frequent transmission of the blood through the lungs,
the want caused by the diminution of the quantity
of available lung tissue. Herein is one source of the
increased rapidity of the pulse; to which another is
to be added, the fever excitement produced by and
connected with the diseased changes going on in the
l~ung tissue.
139. To conclude this section with a statement of
Bayle :-
, “When tubercles are forming in the lungs, but
have not advanced to suppuration, such formation is
attended with a slight cough, with occasional difilculty of
breathing, with a feeling of slight pain.in some parts of
the chest, and the pulse is somewhat accelerated: these
conditions are sometimes so slightly marked that
42 CHANGE or SYMPTOMS
they are often not noticed by the patients them-
selves.”—(Bayle, lib. cit., p. 70.) ~
-_-_--__|--
SECTICN III.--The Symptoms connected with the Second
Stage of Phthisis, and their Explanation.
140. The stage of Phthisis usually denominated
the second stage, is connected with the changes in the
state of the tubercle, in which the tubercle is com-
pletely softened.
141. The symptoms, as might be inferred, are for
the most part those of the first stage aggravated..
142. Thus the emaciation (symptom No. I.) aug-
ments; the cough (symptom No. II.) is both dry and
attended with expectoration (symptom No. II. b.),
which expectoration is increased. The cough (symp-
tom No. II. a.) increases in severity.
143. The fever (symptom N 0. IV.) assumes a marked
hectic character, and the night sweats are much de-
veloped; the pains about the shoulders (symptom
No. VIII.) increase in severity; the uneasiness (symp-
tom N 0. IX.) augments and manifests itself (symptom
N o. XI.) in sleeplessness.
144. The pulse (symptom No. increases in
frequency and force. '
14-5. Constipation (symptom N o. XII.) now presents
itself, which, as the stage advances, is followed by
(symptom No. XIII.) diarrhoea.
146. The urine shows oftentimes in connexion with
the hectic fever- the brick-dust sediment (symptom
(No. XI V.) .
147. These phenomena show that the general sys- ~
IN THE sEcoND STAGE. 43
tem is beginning to be more and more injuriously
affected; that the life-power summons from all parts-
of the bodily system every aid to the diseased lungs;
concentrates all its energies to the salvation of the
lung tissue, an d thereby deprives, in these blind
efforts, the other organs of the bodily system of that
healthy amount of life-power necessary to carry on
efliciently their functions: thus, in attempting to cure,
ensuring destruction; since, if the other parts of the
system are deprived of their requisite amount of life-
power, the actions of those parts must be different
from what they should be; the products of their
actions, thus modified, must be more or less contrary
to their natural character, and thus these products
not being fitted for life’s actions, fresh sources of
weakness are developed in the system in addition to
those connected with the lung disease itself. In fact,
nature in these actions does destructively in all her
doings.
148. The expectoration and the night sweats exhibit
other blind efforts of nature to relieve the system.
148 a. The expectoration is the effort in relation
to the removal of the irritation produced in the lungs.
Nature recognises the existence of a state contrary to
the natural state; and, like as the mucous membrane
of the bowels pours out mucus and other secretions
to get rid of the irritations induced either by undi-
gested and irritating bodies passing through the in-
testinal tube or by disease, so the mucous membrane-
of the bronchial tubes secretes an increasing quantity
of fluid secretion, in order to relieve the irritation
induced in the pulmonary tissue by the softening
tubercles and the changes in the pulmonary tissue
thereupon attendant.
44 CAUSES or THE NIGHT SWEATS.
_ 148 b. The night sweats, exhibitive of the effects
of the lung disease on the general constitution, are
simply a result of the efforts of nature to relieve the
irritation induced by the disease in the lungs by pro-
ducing an action on the shin. Indeed, the factis well
known that night sweats, associated with or preceded
by chills, are almost always attendant on the forma-
tion of pus or suppuration in any important internal
organ.
148 c. The profuse sweats of the phthisical, be-
sides being connected with the formation of pus, are
dependent upon the excessive production of animal
heat ; nature labouring to remove this excessive heat
by the production of sweat; nature’s effort, though
relieving (for the cough, which is severe at night, is
relieved towards the morning, when the sweats gene-
rally break out), is destructive, like most of her un-
guided efforts. _
149. “ When tubercles inflame and suppurate,
cough and expectoration are almost always present ;”
and Laennec further remarks, “ We rarely ever meet
with a case of Phthisis which arrives at a fatal termi-
nation, without exhibiting, after its nature has become
clear, an abundant catarrhal expectoration.
150. The expectoration becomes a matter of con-
siderable importance in the investigation and in the
treatment, of Phthisis. ~ ,
150 a. In the earlier stages of the disease, as soon
as expectoration shows. itself, the matter expectorated
is generally frothy and white.
150 b. Sometimes the matter expectorated is stringy
and white.
_ 150 c. Sometimes it is more like that expectorated
from taking a cold, a catarrhal expectoration. I
FORMS or EXPECTORATION. ' 45
This is a favourable form of expectoration. The
writer has observed the appearance of such an expec-
toration after the sufferer from Phthisis has, during
the course of his disease, expectorated blood. Whether
this improvement in the expectoration result from ~
the condition, causing the blood expectoration, pro-
ducing a temporary lull of the disorder, and thus
changing the sputa, or whether the blood lost acts in
producing the improvement, it may be difficult to de-
cide, but of the fact of the improvement (temporary
unless homoeopathically treated), there is no doubtfl
As a proof of this, any pain previously present in the
chest is often relieved after the expectoration of blood.
150 d. The difference between catarrhal and puru-
lent discharge is well exhibited in the difference be-
tween catarrhal and purulent inflammation of the
eye.
150 e. Any one who has examined the expectora-
tion of phthisical patients in the advanced stages of
the disease must have noticed that the expectoration
has a twofold character. There is the purulent expec-
toration from the ulcers in the lungs, or from the ulcer-
ated mucous membrane, and there is the mucous ex-
pectoration from the lining membrane of the bronchial
tubes and their ramifications: in other words, the
irritation connected with the tubercular disease causes
an irritation in and an expectoration from the mucous
membrane of the air passages.
151. The purulent ~expectoration is, as might be in-
ferred, that which presents the most serious aspect;
still it does not indicate that extent and that fatal
character of the disease associated with it by many.
152. In the last stages of Phthisis, traces‘of pus are
frequently but not always found in the expectoration.
46 THE CONSTIPATION EXPLAINED.
The matter expectorated in the greater number of
cases of Phthisis is nothing but the secretion of the
mucous membrane of the air passages.
153. The expectoration has a smell oftentimes quite
cadaverous, though this offensiveness of expectoration
attends more frequently the purulent discharge in
cases of pneumonia which have passed into the state
of gangrene; cases which the writer has known to be
cured by homoeopathic treatment.
154. The view may be here again repeated, that
lung catarrh has not unfrequently been confounded
with tubercular Phthisis.
154 a. This lung catarrh seems in some of its worst I
forms to be agdysentery of the lungs. In such cases
there is a violent urging to cough, like as in the dysen-
tery of the bowels there is a violent urging to expel
the contents of the bronchial tubes: the expectoration
the most frequent in these cases is that of transparent
mucus attended with blood streaks or blood clots, con-
ditions very similar to that of the mucus discharged
from the bowels in dysentery. Mercurius corrosivus
is to be looked to in these cases of lung dysentery,
being valuable therein like as it is in dysentery of the
bowels. ' .
155. In reference to symptom (No. XII.) the consti-
pation, the following remarks, extracted from the
writer’s work on Constipation, have an explanatory
character :-—
“ Constipation is the absence of action in a given
way ; and this absence of action is caused by a special
constitutional diseased state, which suspends the har-
monizing actions of the various parts of the human
-frame,‘ of which suspension the constipation is one
THE DIARRHCEA EXPLAINED. ' 47
manifestation.” (P. 151. Constz'patz'on, its Theory and
Care, by JOHN Errs, M.D.)
155 a. In the case of Phthisis, the diseased state
presents the regular action of the bowels: the phthi-
sical diseased state acting in this stage impedimentally
to the daily action of the bowels, the life-power being,
' as it were, drawn from the intestinal system to supply
the morbid increase of action required in the lung
tissue, hurrying on to the speedy separation of the
thread of life.
155 b. It is true that diarrhoea subsequently is
‘developed : a condition resulting in one period of the
disease from a change originating in the mucous mem-
brane of the bowels, which manifests itself by the in-
creased.secretion of mucus, this change in the bowels
being resultative of the mucous membrane being de-
prived of its usual healthy supply of blood, and of
nervous power, in part, by the irritation of the imper-
fectly formed chyle ; or it may arise, as it does in the
more advanced stage, from ulceration of the mucous
membrane itself, this ulceration being induced by the
want of that amount of nutrition necessary to prevent
the development of ulcers in the glandular tissues of
the bowels : it being a fact known to experienced prac-
titioners, that eruptions occurring upon badly fed,-
badly housed children, will, instead of forming crusts,
and therewith ceasing, form ulcers penetrating deeper
and deeper into the subjacent ~tissue. The smell of
the bowel discharges in the last named condition are
cadaverously offensive. '
48 scunvr. SWELLED LEGS.
SECTION IV.—The Symptoms connected with the Third
Stage of Phthisis, and their Eaplanation.
160. The third stage of tubercular Phthisis is indi-
cated by the following phenomena:-—
160 a. -The emaciation (No. I.) frightfully aug-
ments ; the skin seems often to hang loose on the
’ bones; the cough (No. II.) augments, exhausting the
patient; the /expectoration (N 0. II. a.) augments, and
the patient has a greater and greater difliculty to dis-
lodge the matter to be expectorated; the cough often
becoming worse in the evening, and also in the morn-
ing ; traces of pus are now often found in the matter
expectorated ; the hectic fever (N 0. IV.) becomes more
marked, and becomes almost continuous; the hectic
flush on the cheek becomes more marked, being in
painful contrast to the general paleness; the breath-
ing (No. VII.) becomes more and more hurried; the
patient cannot go up stairs or ascend a height but
with the greatest difficulty; diarrhoea (N o. XIII.) be-
comes more marked, and the stoolsare frequently ex-
ceedingly offensive; the pulse (No. increases in
frequency, and beats almost a hundred and twenty
beats in a minute.
160 b. Symptom No. XV. In connexion with this
may be noticed a peculiar appearance in the mouth and
the fauces ; scurvy not unfrequently shows itself.
160 c. Symptom No. XVI. The feet swell, also the
legs, which pit on pressure. ' '
160 cl. Symptom No. XVII. The NAILS assume a
peculiar bent form.
161. All these changes exhibit the constitution gra-
dually sinking under the influence of disease, strug-
DIAREI-IcEA— RAPIDITY or PULSE. 49
gling, it is true, but struggling, if not properly aided,
1n vam.
162. The diarrhoea now developed is that which
results in the want of that amount of life-power neces-
sary to prevent the disintegration of the tissue of the
mucous membrane of the intestines. It does not seem
to relieve the cough and the night sweats, as it some-
times did in the second stage. Indeed this diarrhoeic
state seems to be one in which there is a development
of action, in which, from the state of weakness induced
by the phthisical disease, the mucous membrane
secretes an unnatural fluid, which further irritates the
membrane itself as it passes along through the intes-
tinal tube, the amount of derangement being exhibited
in the fact that the discharge from the bowels is cada-
verously offensive; even the chyle itself, that which
was given for the nourishment of the system, becomes,
from being imperfectly absorbed, a source of irritation
to the mucous membrane ; thus adding to the condi-
tions a fresh irritation aggravating the distinctive
diarrhoea.
163. The rapidity of the pulse acquires a continu-
ous character. This rapidity is present more or less
in all the stages of Phthisis. It is connected, as has
been in part explained, with the altered state of the
lung cellular tissue: a state conjoined with two cir-
cumstances, first, a state of irritation, connected with
or produced by the existence in this tissue of aforeign
body, a tubercle; and, second, a state in which, from
the occupancy of a portion of the cellular tissue space
by the tubercles and their investments, an impedi-
ment is interposed in the way of the free passage of
the air through the lungs ; and, consequently, the
heart having to send the blood more frequently
E
50 MR WARDROP’S vmws.
through the lungs, in order, by its frequent transmis-
sion, to make up the deficiency of the lung surface
through which the blood is exposed to the air, an ex-
posure essential to the effecting the proper changes
in the blood, and by consequence essential to the health
of the individual, beats more frequently.
164. The presence of these physical states in the
lung tissue being connected with the progress of the
tubercle in its various stages, explains the fact of the
rapidity of the pulse during the greater part of the
course of Phthisis, and its increase as the disease pro-
gresses.
165. Mr Wardrop seems to have recognised these
views. He remarks :-—
“The shorter and the more frequent the inspira-
tions, the more rapid become the movements of the
heart: and when, from disease, a portion of the lung
is no longer capable of assisting in the arterialization
of the blood, that which remained sound having an
additional duty to perform, respiration becomes in-
creased in frequency. Respiration quickened, there
must necessarily take place an increase in the heart’s
action, and hence can be explained that quickness of
the pulse which has been considered a pathognomonic
' (73. c.) of tubercular Phthisis.”——(The Nature and
Treatment of the Diseases of the Heart, with some new
Views on the Physiology of the Circulation. Part i. p. 37 .
By JAMES WARDROP.)
~ 166. Both the states referred to conspire to produce
the rapidity of the pulse: since, in inflammation of
the lungs, where the lung does not admit the free
passage of the air, and, in chronic pulmonary catarrh,
where also the free entrance of the air is impeded by
the mucus eifused into the bronchial passages, there
THE PULSE IN ULCERATIVE FEVER. 51
is oftentimes not the rapidity of the pulse as that pre-
sented in Phthisis.
167. Dr Sanders remarks, in -connexion with the
state of the pulse in ulcerative fever (Phthisis), that the
velocity of the pulse in this fever is not diminished by
the surface of the body being cooled, as in other fevers ;
a fact to which, Dr Sanders relates, Galen bears testi-
mony in his work entitled De Dfierentia Febrium,
(SANDERS, lib. cit., p. 159): a fact demonstrative of
the peculiarity of the fever of Phthisis, and affording V
in this peculiarity a guide in connexion with the cura-
tive treatment of the phthisical fever.
168. It will be seen from these statements, that symp-
toms indicative of phthisical disease are present, in a
greater or less degree, with more or fewer complica-
tions, in all the stages of the disease; a fact demon-
strative of this, that the distinction into stages has not
that high value in relation to the CURE of the disease
that has been attached to it: indeed, the only philo-
sophic idea that can be attached to this arrangement
into stages, is that which regards all the symptoms as
phenomena indicative of certain injurious agencies in-
fiuencing the constitution ; and, as thus manifesting
their influence, affording a guide to the selection of
the remedy which, in accordance with the homoeopa-
thic law, will, when applied in obedience to that law,
be curative of the diseased state so phenomenanized.
169. And, further, experience confirms the neces-
sity of this philosophic view of the symptoms by the
establishment of another fact, which is, that all these
symptoms, all these phenomena, are not in every case
invariably present. Here, again, this very want of in-
variability becomes a source of aid in the cure to the
homoeopathic practitioner, since the absence or the
52 PERCUSSION -- sTETHoscoPE.
modification of any of the phenomena of the phthi-
sical disease becomes of great importance, viewed cura-
tively, in helping the skilful homceopathic physician
to select the remedy or the remedies suited, these ab-
sences and the modifications therewith connected being
indicative of the special conditions of the disease to
which the pathogenetic effects of medicines, as recorded
in the Materia Medica, will be found to have special
similitudes; and out of these special similitudes, the-
rapeutically recognised, the cure will come.
170. Indeed, the result of all the inquiry made into
this disease is to demonstrate, that the appearances
produced by the disease, as manifested after death
from this disease, afford little or no benefit to the
practitioner in respect to the means of cure.
SECTION V.—-Other Means of detecting the Eaistence of
‘ Phthisis.
171. All knowledge is useful; hence the occupancy
of another section of this third chapter by the remarks
that follow.
172. The phenomena of Phthisis already described,
present the means by which the existence of the
disease can be detected; but a query occurs,-—
ARE THERE ANY OTHER MEANS or DETECTING THE
ExIsTENcE OETUBERCULAR PHTHISIS ?
173. Percussion and the stethoscope present means,
which, of late years, have been much employed in the
examination of the chest by auscultation, with the
view of detecting both the existence and the course
of Phthisis.
LAENNEC,S AND WALSHE’S TESTIMONY.
174. In reference to these means, the following
remarks embody some important truths :-
“ Auscultation, although it indicates the character,
or, more correctly, the topography of the disease, is
far from perfection even in this point of view. Many
of the most experienced physicians dispense entirely
with its aid, and perhaps wisely consider it better to
have no such criteria to be guided by than to trust
to one which to them is at least of a doubtful charac-
ter. Without questioning its ingenuity and impor-
tance as an auxiliary to observation, it cannot be
denied that as yet, though it has been in use for
nearly twenty (forty) years, it has effected but little
for the cure of Phthisis: with certain exceptions,
it is little “better than a glass by which we may
count the moments of a patient’s life; through
which, although we cannot remove, we seem privi-
leged to foretell the fatal issue of the disease.”—
(Tyrrel, lib. cit.)
175. Laennec remarks :—-
“ When the tubercles are small, however numerous
they may be, auscultation affords no indication of
their presence if the pulmonary tissue in the intervals
between them is otherwise healthy.”—(Gardner, lib.
cit., p. 73.)
176. Dr VValshe, in the preface to the first edition
of his work, makes the following remarks in reference
to the application of these means to the discovery of
diseases of the chest :— ,
“Although in the main confining himself to a
description of physical signs, the author has occasion-
ally stepped aside to consider their mechanism; yet
-not without the full consciousness that in the present
state of thoracic acoustics, and indeed of acoust-ics in
54 WARDROP on THE PHYSICAL SIGNS.
general, all efforts of the kind must be purely tenta-
tive.”—( Walshe, lib. cit., p. viii.)
17 7. These remarks embody ideas similar to those
expressed thus by Wardrop :-
“Until the celebrated Laennec pointed out the
changes to which the sounds of the heart are liable,
we had no other means of ascertaining the alterations
in the functions of this organ than by observations on
the pulse, together with the effects which the changes
in the circulation cause on the other symptoms, more
especially on the respiratory organs, on the brain,
and on the organs of digestion; and imperfect as the
means of diagnosis might have then been, I am per-
suaded that fewer and less serious mistakes were com-
mitted than we now see made by those who look only
to the PHYSICAL signs of the diseases of the thoracic
viscera, and disregard that general assemblage of
symptoms which accompany those affections, and
which arise from the disturbance of the other organs,
or the other symptoms of the economy.”—( Wardrop,
lib. cit., p. 98.)
178. Dr Cotton remarks :-—-
“ I have occasionally noticed severe haemoptysis at
so early a period of Phthisis, that the most careful
examination of the chest has entirely failed in afford-
ing the least evidence of the lungs being otherwise
than healthy, whilst the flow of blood has been so
copious as to forbid any other conclusion than that of
its having proceeded from a ruptured vessel.”—(Cot-
ton, lib. cit., p. 123.)
179. Laennec, to whom Wardrop refers, remarks :-—
“I have often heard the breathing performed on '
both sides with equal force and clearness in indi-
viduals, who, on dissection, presented one lung either
DR JOHN GARDNER’S STATEMENT. 55
healthy or containing merely a few small tubercles,
whilst the other was filled with tumors of the same
nature, varying in size from a millet seed to that of a
filbert, and in such numbers as at least to double the
weight of the lung.”

180. Another means of detecting tubercular Phthisis
is that presented by a careful examination of the
exterior of the chest.
181. Such examination will establish, that in many
cases the ribs seem to sink in at the part where the
disease in the lung is situated; and at that part a
gentle pressure will cause pain, and that where the
patient has not heretofore recognised any pain.

182. This statement respecting the employment of
auscultation in the discovery of Phthisis, appears to
justify the remarks of Dr John Gardner :—
“Percussion, auscultation, and the stethoscope, also
furnish information respecting the physical or me-
chanical state of the lungs; they point out the exist-
ence and the locality of the cavities, and the extent
of consolidated parts; they cannot reveal even the
existence of tubercle; they teach nothing of its
nature.
“Any man, therefore, who pronounces upon the
indications these furnish him that tubercle exists,
merely GUESSES. No inferences can possibly be de-
duced from the state of the respiration alone, touch-
ing the composition or formation of this the radical
essence of consumption.”—-(Lib. cit., p. 7 3.)
CHAPTER IV.
ON THE CACHECTIC STATE CONNECTED WITH PHTHISIS.
183. GALEN seems, in the following remarks, to
have recognised the existence of a special cachectic
state in connexion with Phthisis :—-
“The cases radically incurable are those that de-
pend on a fault of the humours.”
This recognition of a special cachexia, Galen, with
his views respecting the intimate dependence of all
diseased conditions on the humours of the body, could
not express in other terms.
184. CELSUS also seems to have recognised the
existence of a cachexia in Phthisis.
185. The special cachectic condition connected with
Phthisis is thus illustrated by LAENNEC :—
“It is impossible not to admit an aberration of
nutrition, an actual and a peculiar change in the
fluids which give rise to tubercles.”
186. To the existence of this cachexia Dr ALIsoN
testifies, when he remarks, that, “in certain constitu-
tions, chronic inflammation does distinctly lead to the
deposition of tubercles.” In this statement he virtu-
ally maintains the proposition, that, in order that
chronic inflammation should be able to produce
VIEWS or ALIsoN, ANDEAL, AND BAYLE. 57
tubercles, there must be a certain pre-existing con-
stitution, a cachexia.
187. ANDRAL testifies to his belief in the existence
of this cachexia, as necessary to the production of
Phthisis, in the following statement, which, though
deemed by many to be too dogmatic in phraseology,
unfolds an important truth, admitting a wider appli-
cation than as viewed in respect to Phthisis merely :—
“ If the disposition to tubercles be very strong, the
slightest local congestion of blood will produce them;
but if there is no such predisposition, the most in-
tense and longest inflammation will not produce a
tubercle.”
188. Laennec adds another testimony to the neces-
sity of the antecedent existence of this cachexia, before
Phthisis can be produced, in the statement :—-
“ Severe continued or intermittent fever would
seem to be frequently the cause of the production
of tubercles.”
188 a. Such fevers, it is well known, are not
unfrequently dependent upon or connected with a
cachectic condition, of which the peculiar pale yellow-
ness of the complexion is a characteristic sign, and
the very fever itself is often nothing but the sympto-
matic expression of an internal disease become so far
active as to be able to manifest itself.
189. Another fact, illustrative of this special ca-
chectic state, is noticed by BAYLE, th~at,—
“ In the last stage of Phthisis scurvy often develops
itself; ” and scurvy, no one doubts, is a manifestation
of a cachexia.
190. The following well-known facts, recorded by
Bayle, testify to the existence of this cachexia in con-
nexion with Phthisis :—- _
58 ERUPTIONS REPRESSED, AND
“ The repressing of tetters, of the itch, of rheu-
matism, syphilis, hooping-cough, pleurisy, peri-pneu-
monia, of cutaneous inflammation, such as small-
pox, measles, scarlet fever, &c., sometimes occasions
Phthisis: more frequently these diseases only hasten
the course of a Phthisis which has already produced
an alteration of the lungs.”--(Bayle, lib. cit., p. 19.)
Bayle adds :-—
“ In fact, eruptive diseases and cough may accele-
rate a Phthisis already existing, and perhaps deter-
mine its development, in persons whose lungs are as
yet sound.”
191. Bayle adds a very striking evidence of the
existence of this cachexia in the following interesting
fact, in connexion with the appearance of certain
ulcerated spots, aphthoe :-—- '
“ The aphthae affecting the consumptive begin with
an alteration of the mucous membrane of the mouth,
which becomes covered with very numerous small
flakes, white, as if they were silvered over. The flakes
having come off, the mucous membrane is seen uni-
formly exeoriated and very painful. Some facts prove
that these aphthae arise from a general disposition ;”--
i. e. from a cachexia.
192. Dr. YOUNG, in his work entitled, Practical
and Historical Treatise on Consumption, states :—
“ Of the numerous causes of consumption it is im-
possible to speak with any certainty, except to say
what it is not. A great many depend on a peculiarity of
constitution, of which the first effect is the deposition of
a morbid and apparently inorganic substance (tubercle)
in the lungs.”
193. Laennec, in addition to the views already stated,
adds some still more definite. He remarks :-—-
FOLLOWED BY PHTHISIS. 59
“ The progress of pathological anatomy has success-
fully demonstrated, that Phthisis is owing to the de-
, velopment of a species of accidental production, to
which modern anatomists have restricted the name of
tubercle :”
i. e. There exists a peculiar cachexia of the consti-
tution, which causes or admits of the formation of this
tubercular production.
194. The existence of this cachexia is evidenced in
the fact, that Phthisis is hereditary, for no doubt ex-
ists that Phthisis runs in families.
195. In addition to this general fact of the heredi-
taryism of Phthisis, other special facts give their evi-
dence to this cachexia, as united with the hereditary
condition. Thus, in families where the mother was
consumptive, the daughters are more liable to consump-
tion than are the sons. But, if it happens that the
sons have the maternal features, they are more liable
to consumption than are the daughters, these daugh-
ters having, it may be, the paternal features: the writer
has known it attain to this specialty : where one daugh-
ter has been like the father, she has escaped, when
another daughter like the mother has succumbed to
the disease.
196. And here homoeopathy presents another of its
glorious features, as the homoeopathic therapeusy (Pref-
ace, c.) enables the homoeopathic practitioner to pro-
vide curative means, by which these cachexiee can be
removed, andby giving these means to the mother
while in the pregnant state, the condition of the pro-
geny shall be so modified as to prevent therein the
production of the taint. Of this the writer has had
in his practice satisfactory proof.
60 MESENTERIC DISEASE IN MONKEYS.
197. The existence of this cachexia is evidenced by
some facts, recorded in the Dublin Journal of Medical
Science, by Dr. Houston, in connexion with the MON-
KEYS in the collection of the Zoological Society of
Dublin. .
198. Many monkeys died of Phthisis, and tubercles
were found in the lungs, and not only in the lungs,
but also in the glands contained in a tissue of the in-
terior belly, called the mesentery, these glands, the
mesenteric, being for the purpose of completing the
animalization of the nourishment passing from the in-
testines to the blood. In some of the monkeys the
liver was not free of these tubercles.
199. And may not the great similarity existing be-
tween monkeys and man (as Tyrrell appropriately
remarks, lib. cit.), “ Whose very resemblance to man
constitutes, as it were, their deformity”), explain their
obvious liability to Phthisis, inasmuch as, from the
similarity, it is likely the monkeys have the same
cachectic liability? I
200. The fact of the coincidence of the tubercular
state of the mesentery and of the lungs has been no-
ticed by Bayle, he having observed this tubercular state
in both when examining those who had died of
Phthisis.
201. Louis, in his “ Recherches Anatomico-Patholo-
gigues sur la Phthisie, 1825, states that, without one
exception, out of three hundred and fifty dissections,
when he found tubercles in the lungs, he found them
in other organs.”
202. Bayle refers to the fact, that the most common
cause of Phthisis is the tuberculous taint, which is
essentially, says Bayle, a chronic disease, i. e. a diseased
INDIcATIoNs or THE CACHEXIA. 61 I
state, which presents characters belonging to a ca-
chexia.
203. Bayle, besides the three stages of Phthisis
already referred to, notices a stage of Phthisis in
which the Phthisis lies occult or latent, i. e. a state
constituting the cachexia before its active develop-
ment.
204. Bayle thus states his conclusions :--“ All the
observations made by myself prove, that the tubercu-
lar degeneracy is a chronic disease; that it is of a
peculiar nature ; that it ought ‘not to be regarded as
the consequent of any inflammation whatever, either of
the glandular or lymphatic system.” (Lib. cit. p. 74.)
He thus recognises a cachexia.
205. Sanders recognised some facts which, if they
had been logically pursued, must have led him to the
recognition of this cachexia. He remarks :-
“If the constitution is tainted with any other dis-
ease, as scurvy or lues venerea, the remedies of ap-
proved utility in these affections are the fittest to re-
move the concomitant pulmonary disease.”—Lib. cit.
p. 124.
206. The existence of this cachexia being recog-
nised, a query occurs, ARE THERE ANY INDICATIONS BY
WHICH THE EXISTENCE OF THIS CACHEXIA CAN BE PRE-
DICATED? Is it a myth, or is it a reality?
207. The cachexia is exhibited principally in con-
nexion with individuals who have a fair complexion,
light hair, blue eyes, slim and tall frame, and, most
particularly, narrow chest. '
208. To these features may be added, the presence
in early life of inflammation of the eyelids of a ‘seno-
FULOUS character, and this inflammation modified at
each monthly period, showing the connexion of the
62 IODINE PAINTERS.
affection of the eyes with the condition of the
womb.
209. Another feature is, that phthisical persons are
peculiarly liable to disease of the mesenteric glands,
and also of the neck glands : and in them the develop-
ment of the phthisical disease often takes place when
the swollen glands of the neck have been made to
revert to their natural size by the external application
of iodine and other agents, ignorantly used for this
purpose.
209 a. These neck iodine painters are either rashly
daring or grossly ignorant.
210. In connexion with this liability to affections of
the mesenteric glands, as associated with the phthisi-
cal cachexia, the following facts have a value :-A
parent of scrofulous habit of body gives birth to chil-
dren, often beautiful in the extreme. At a time when
‘ the children begin to interest by their delightful prat-
tle, death comes, under the form of mesenteric glan-
dular disease. Perhaps one girl survives. She attains
the age of eighteen to twenty, and then she dies of
consumption. The mesenteric affection was the first
exhibition of the cachectic affection. At puberty the
lungs are called into a peculiar activity; the cachexia
in connexion with the lung state is awakened; the
tubercles become active ; Phthisis proceeds, and death
results.

211. From these facts and these views it will ap-
pear that, in order to render an individual liable to
Phthisis, a special condition of the system must ex-
ist,-—a
PHTHISICAL CACHEXIA.
VACCINATIONAL CACHEXIA. 63
212. Before the discovery of vaccination and the
protection afforded against the attacks of smallpox
by means of vaccination, all persons were not natu-
rally liable to smallpox, a non-liability exhibited in
the fact, that some were attacked, and others simi-
larly exposed were not attacked. The reason of the
non-liability of those not attacked is, that in order to
be liable to the attack of smallpox, there must be ex-
isting in the body a cachectic condition, constituting
the liability, and which not existing, the individual
became thereby safe from smallpox.
212 a. The query occurs, whether this non-liability
is a benefit? or rather, whether this non-liability did
not depend on the existence of some other diseased
habit (cachexia) in the individual? Or is it to be as-
sumed that the possession of sound health, unmodified
by the excitements of dissipation, forms in itself this
non-liability to smallpox? The writer thinks not,
for smallpox often attacks the most healthy indivi-
duals: and those so endowed and so attacked are
oftentimes most severely affected and most deeply
marked. Add to this another fact, well known to all
who have had experience in smallpox, that when
_ smallpox attacks a person who has always been ailing
before the attack, if the person attacked gets through,
he has good health oftentimes to a good old age.
213. The power of vaccination as a protective con-
sists in this, that it communicates to those who are
naturally susceptible to smallpox, an unsusceptibi-
lity, that is, vaccination creates a cachexia which is
antidotal to smallpox.
214. The importance of the entertainment of the
view, that vaccination creates a cachexia, is exhibited
in this, that it teaches the necessity of the greatest
64. COMPULSORY VACCINATION A VIOLATION OF LIBERTY.
care that, in using the vaccine poison, no other ca-
chexia be introduced, as may be done by using con-
taminated matter, or matter not genuine.
215. Another deduction is connected with the fact,
that vaccination is protective against smallpox by its
producing in the person vaccinated a cachexia; it is
this that constitutes the monstrousness of that legis-
lation which makes vaccination compulsory. No power
can by possibility have the right to force a parent to
have his child poisoned with the vaccine poison.
216. So with the liability to the attack of Asiatic
cholera: in the same locality hundreds were attacked
and hundreds escaped.
217. These facts prove, that those attacked had a
_ cachexia which was suited to the reception of the
cholera. Those not attacked had not this cachexia.
218. And, in relation to this, it was proved, that
like as vaccination creates a cachexia which resists
the attack of smallpox, so it is possible, by the exhi-
bition of the homoeopathic medicines Cuprum and
Veratrum, to create thereby MEDICINAL cachexiae which
are protective against the poison of Asiatic cholera.
Of the resistive power of these medicinally produced
cachexiae to resist the cholera disease, thousands of
instances occurred during the prevalence of cholera,
both in Great Britain and in many other European
states.
219. The great question here suggests itself, Is it
not possible that the homoeopathist, aided by his law,
may be enabled, by finding out medicinal cachexiae,
similar to the various phthisical cachexiae, to arrest
the development of Phthisis, just as the vaccine ca-
chexia destroys the liability to smallpox, just as the
Veratrum and the Cuprum cachexiae destroy the
FISTULA AND PHTHISIS. 65
liability to cholera? The answer to this question
will be in part afforded in the contents of a subse-
quent chapter.
219. This subject of the essential necessity of the
existence of a phthisical cachexia in order to allow of
the development of Phthisis, is so important as to jus-
tify an additional illustration in connexion with the
fact, that persons cured of FISTULA IN THE ANUS by
operation are very liable to die of Phthisis.
220. The attention of the author of this work was
drawn to this matter by a patient who had been op-
erated on at the Fistula Infirmary for stricture of the
rectum. After some months the disease again became
excessively distressing, and the person who had been
operated upon applied to the surgical officers of the in-
firmary. They told her that nothing could be done
for her without another operation. The sufferings
she endured at the previous operation produced so
great a horror of a second operation, that she was
brought to the author to see whether homoeopathy
could by its means save her from the necessity of
submitting to a second. After six weeks’ inaction of
the bowels, relief was gained, the bowel content un-
loosing by its gyrelike action the stricture.
221. This patient, referring to the cures performed
at the Fistula Infirmary, added :-
“ The public do not know all: they should follow
the patients who have been operated upon, and are
said to be cured, and they would find that a great
number die of consumption.”
222. The reason of such a termination will appear
on slight reflection. The cachexia which favours the
development of fistula is one which favours the de-
velopment and the degeneracy of tubercle ; and there-
F
66 DR. FELIJS PROCESS.
fore when the FORM, the fistula in the anus, -under which
the cachexia, as it were, manifested its morbid activ-
ity, was removed, the cachexia itself, not being cured
by the operation, manifested itself in a new form : it
acted on the lung tissue, and produced tubercle, or
caused a development of diseased activity in connexion
with the tubercle. A similar transfer is seen in the ex-
traction of cancerous tumors by Dr. Fell‘s process : when
one cancerous tumor has been removed, another forms
in the same breast. The writer was consulted by a lady,
who had had three cancerous tumors form; when Dr.
Fell had removed the first, a second formed; when he
removed that, a third appeared. The cancerous ca-
chexia had not been removed by the operation.
223. The experience of the writer, backed by the
theory just propounded, ustifies the declaration, that
there is great danger in attempting the cure of fistula
by surgical means, unless therewith there is combined
homoeopathic treatment, curative of the cachexia to
which the fistula owes its development.
224. Dr. Gardner relates the following case :-
“ A. B., a delicately formed young man, who had
suffered from fistula, began to exhibit the usual symp-
toms of consumption. The fistula had been operated
on, and the wound slowly healed. But, as soon as it
ceased to discharge, cough, hectic fever, and pains in
the chest followed, and there were found unmistakable
evidence of tubercular choking of the lungs.”
225. Dr. Walshe remarks: “My actual experience
on the question, whether fistula in ano should be cured
in phthisical cases, is small : such as it is, it deposes
emphatically against interference, unless (what is
very rare) there be wasting discharge and serious suf-
fering.”—(Lib. cit.._p. 541.)
SCROFULA OF THE LUNGS. 67

226. The general recognition of the essentiality of
the existence of a cachexia in connexion with Phthisis,
is presented in the fact, that Phthisis has been called,
THE SCROFULA 0E THE LUNGS.
227. Add to this the following fact, recorded by
Laennec, and the existence of the special cachexia, as-
sociated with tubercle, becomes vividly apparent :
Laennec, in examining a body, in which he found
tubercles, wounded his finger. On the day after a
slight redness appeared at the place of the wound, and
gradually a smooth round tumor, the size of a cherry-
stone, formed in the substance of the skin. Subse-
quently the skin cracked, and a firm yellow substance,
resembling exactly a crude tubercle, presented itself.
On the application of caustic it became soft, exactly
like a softened tubercle.—(Gardner, lib. cit.)
228. The idea has been put forth, that “ tubercle
expresses the efect of this cachectic condition; the one
being related to the other in exactly the same way
that sugar is to diabetes, and soda to gout.”—(Cotton,
lib. cit.)
229. The mode of expression is not strictly correct;
still as a recognition that a cachexia must exist pre-
vious to the development of the phthisical disease in
any of its special manifestations, the illustration,‘
though not logical, has its value.
CHAPTER V.
LUNG DEBILITY.
OF THE STATE OF WEAKNESS CONNECTED WITH THE
DEVELOPMENT OF PHTHISIS.
230. Of the fact, that tubercle may remain in a dor-
mant state many years, indeed to the end of a long life,
no doubt can exist in the mind of any one acquainted
with phthisical disease. _
231. This fact establishes, that besides the cachexia
in which the tubercle originates, and the existence of
the tubercle itself, a third condition is necessary, in-
deed essential, to the awakening of the tubercle into
activity, i. e.,‘ to adopt a homely phrase, a light put to
the powder is essential to an explosion.
' 232. For the development of tubercular Phthisis it
is necessary that a weakness of the lung system should
exist; a weakness very likely to be awakened in the
lung tissue of those having tubercles; since it is a ~
truth, that “ newly formed parts, from the imperfect-
ness of their organization, are more liable to inflam-
mation and suppuration; a liability increased by the
LUNG DEBITITY. 69
tubercle being produced and nourished by an organ
which is oftentimes in a state of actual and increasing
debility.”
233. Dr. Sanders recognised this, though not re-
cognising the point in which the debility consists. He
remarks :-—-
“The predisposition to this pulmonary consump-
tion appears to consist in a relative debility of the
lungs with regard to the power of the circulation.”—-
(Sanders, lib. cit. p. 65.)
233 a. The necessity of the existence of a weakness
of the lung tissue as an essential to the production of
tubercular Phthisis, is thus hinted at by Laennec :-
“ Of all the occasional causes which give rise to a
considerable development of tubercles, the most fre-
quent, the most powerful, and the most evident, is the
SOFTENING of a certain number of tubercles already in
existence: since we know it is at this period that the
secondary eruption of numerous tubercles takes place
in the lungs.”
233 b. An action similar to this is presented in dis-
ease of the breast, it happening that, when one gland
is suppurating, the glands in the neighbourhood en-
large.
234. An explanation of the conditions under which
this debility shows itself will present points of inter-
est and of importance, inasmuch as they will unfold
some of the reasons why Phthisis is so common in the
British Isles, in demonstrating that many practices
prevalent among the people are productive of debil-
ity in connexion with the lung tissues; and will af-
ford opportunities of warning against the various
sources of danger in connexion with the development
of this disease.
70 THE REASON . or THE GREATER LIABILITY
SECTION I.—-On the Development of the Weakness neces-
sary to the Awakening into Activity Tubercular Phthisis,
in Connexion with the Conditions of the GENITAL
SYSTEM.
235. Women are, as already noted, more liable to
Phthisis than are men.
236. This liability is in a great measure connected
with the fact, that between the womb and the lungs
there is a most intimate sympathy.
236 a. Illustrative of the action of this sympathy
in producing the weakness necessary to the develop-
ment into activity of the phthisical cachexia, is the
physiological fact, that the development of Phthisis
takes place in the female soon after the monthly dis-
charge has made its appearance, a time when a pecu-
liar irritability of the whole system is present; in many
individuals a kind of excitative fever: further, till the
menstrual habit has become fixed, and is regularly
recurrent, the liability to Phthisis exists ; and that,
by the age of thirty-two, when the monthly discharge
may be considered to be settled as a habit, Phthisis
becomes relatively rare. E
236 b. Another fact illustrative of the sympathy in
this disease producing connexion, is, that Phthisis is
often accompanied with violent hysterical affections,
and has been preceded by suppression or great defi-
ciency of the monthly discharge, or by chlorosis.
236 c. A third fact illustrative of this sympathy is,
that as Phthisis advances in the female the monthly
period becomes suppressed.
236 ol. Illustrative of this sympathy is a fourth fact,
that, in cases where Phthisis has been treated with
0E WOMEN TO PHTHISIS. 71
success, the monthly discharge, if suppressed, gener-
ally re-establishes itself.
236 e. A fifth fact illustrative of this sympathy is,
that very often, when the principal symptoms of
Phthisis are present in a woman not pregnant, and she
becomes pregnant, all the phthisical symptoms cease
till birth is given to the child : i. e., the action of the
womb, necessary to the development of the life and
the life’s actions in the child, suspends the diseased
action in the lungs. The child is born, i. e., the sus-
pending action in the womb is suspended, and in a
few weeks the diseased state in the lungs again appro-
priates to itself the life-power, with which it occupies
itself destructively until death comes. This is a re-
sult very common, though “ it is not uncommon for a
mother to think her health improved by the state of
pregnancy.”—(Sanders, lib. cit. p. 27.)
So usual is this result, that Dr. Hamilton, in his
Lectures on Midwifery, puts forth the axiom,-—“ That
death is the invariable consequence of childbirth to a
woman labouring under an advanced Phthisis Pul-
monalis.”
236 Another fact illustrative of the sympathy refer-
red to is this, that “ abortion often interrupts the preg-
nancy of the consumptive.”-—(Sanders, lib. cit. p. 26.)
This result is dependent on the circumstance, that
l the amount of the disease in the lungs so concentrates
the life-power to the lungs as to deprive the womb of
that amount of life-power necessary to impart that
regular development to the foetus in the womb, as to
cause the foetus to be, by its regular development, a
healthful stimulus. Such healthful stimulus thus
ceasing to be supplied, the womb expels what is no
longer such to it.
72 PREGNANCY AND PHTHISIS.
236 g. In connexion with these views, a fact has
presented itself to the author, which refutes the inva-
riability put forth by Dr. Hamilton ;,namely, he had a
patient who had the symptoms of advanced Phthisis,
(indeed she was given over to die of Phthisis), and
she becoming pregnant the Phthisis was suspend-
ed, and, the child being born, she lived and had two
children successively; each pregnancy arresting the
phthisical disease: in the third pregnancy she had the
foetus die before the proper time of birth. Imme-
diately active symptoms set in, the child was expelled
at the eighth month, and she died the day after the
expulsion ; a fatal result, which, it is believed, would
not have taken place had the child continued its devel-
opment the full time. The regularity of the process be-
ing suspended caused the child to cease to be a proper
stimulus to the womb; and the child being expelled,
the disease in the lungs was allowed to resume its sway.
236 h. And here it may be added, in relation tp the
action of pregnancy in connexion with Phthisis, hom-
oeopathy exhibits a beneficial power. The writer has
known instances where, by giving the pregnant
woman, during her pregnancy, the homceopathic re-
medies suited to cure her phthisical cachexia, the re-
newed development of the lung disease after the birth
of the child has been prevented. _
236 h. An additional fact, illustrative of the sym-
pathy between the womb and its appendages and
Phthisis, is recorded by Bayle :-
“ That the aphthous eruptions which occur in
phthisical patients, appear at the same time on the
interior parts of the folds (labia) of the female genital
organs:
“ That whenever aphthm appear in uterine dis-
LARYNX AEEEGTED IN PHTHISIS. 73
eases, accompanied with hectic fever, the aphthous
eruption resembles that observed in Phthisis, although
the seat of the disease is so far from the womb.”
236 i. Further illustrative of this sympathy between
H the womb and the lungs, is the fact, that diseases of
the womb often produce diseases of the larynx which
end in Phthisis. Bayle relates, that of one hundred
persons who died of Phthisis, eighty-three had the
larynx sound, and seventeen had the larynx diseased,
and all these seventeen were under fifty years of age.
237. Indeed, it is an important fact, which has been
impressed on the mind of the author by repeated ex-
periences, that where throat affections of women are
peculiarly severe, and have been of some duration,
such severity and permanence are, in the majority of
cases, dependent upon disease of the womb; and will,
if unattended to, end in fatal diseases of the womb.
238. This fact ought to serve as a warning to those
patients who run after those physicians whose chief
occupation seems to be the application of caustic to
the neck of the womb ; since it is not unlikely that if
the disease be driven from the womb, it may be thrown
on the larynx (5, 6.), and may thence awaken the
phthisicalfgcachexia in connexion with the lungs, and
cause death by Phthisis. And this is the more likely,
since, if a woman has the cachexia connected with
womb disease, it is not unlikely that the cachexia
connected with Phthisis may exist, and the removal
without cure of the womb disease (one form under
which the cachexia manifested itself) will necessitate
the development of the cachexia in some other form.
239. The development of this special weakness in
connexion with the genital system, as necessary to the
rendering active the phthisical cachexia, is exhibited
74 ' PHTHISIS AND EXCESS.
in the facts, that both~ bleeding from the nose (epis-
taxis) and bleeding from the lungs (haemoptysis) take
place in the young of both sexes at the time of puber-
ty, i. e., at the time when both the pulmonary and the
genital systems become specially active, exhibited in
the breaking of the voice, the development of the
breasts in the female, and in other well known pheno-
mena, both in the male and in the female.
240. Connected with and illustrative of the sym-
pathy existing between the lungs and the genital sys-
tem, is " the fact, that a condition under which the
development of Phthisis in the male occurs, is that in
which excesses connected with the genital system have
been practised. How commonly is Phthisis the result
of these sexual excesses I
241. It is a curious fact, that the phthisical state
seems to be in many individuals associated with a
strong excitement of the sexual desire, which has
prevailed though the sufferer was exhausted with the ‘
most profuse night-sweats.
242. The fact that the form of disease called the
chancrous sore, where removed by external applica-
tions, causes the syphilitic taint to enter the consti-
tution and to affect the throat, inducing syphilitic
sore throat, exhibits the sympathy between the geni-
tal organs and the lung system ; which is still farther
evidenced in the fact, that in such transfer of action
the disease passes from the windpipe to the lungs;
i. e. from the trunk (the windpipe) to the branches,
and Phthisis results, as already recorded (236 Seventeen out of one hundred persons who died of
Phthisis had diseased larynx.
243. Though Phthisis is oftentimes a sequel of
these laryngitic affections, it happens that inflam-
CAUSTICKING THE THROAT. 75
matory affections of the larynx may exist without
Phthisis, though mistaken for Phthisis. Morgagni
relates (Epistola 10. Art. 13.) that the lungs of a
woman who was thought to have died of Phthisis
Pulmonalis were sound, her death having been caused
by a tumor containing puriform matter pressing on
the hind part of the larynx.
244. The fact of the number of persons dying of
Phthisis who have had throat affections, ought to
warn the public against those practitioners who at-
tempt to remove throat diseases by burning with
caustic, and painting (as they call it) the fauces and the
parts adjacent, since such practice not unfrequently
causes a transfer of disease to the lungs.
244 a. It is not denied that in some cases of laryn-
gitic affections causticking the throat has been attended
with success--a result dependent upon this, that the
caustic was homoeopathic to the disease, as every one
acquainted with the pathogenesis of medicines knows;
but the allopathist, not knowing the cases where there
is a homoeopathic relationship between the diseased
state and the caustic employed, renders his employ-
ment of this causticking process purely empirical,
and consequently dangerous.
245. Still further illustrative of the sympathy be-
tween the lungs and the genital organs is the fact,
that the weakness of the lungs necessary to the de-
velopment into activity of the phthisical cachexia
has been often produced by the habit of self-abuse.
245 a. It has been already noticed (197.) that
monkeys are peculiarly liable to consumption. May
not this liability depend in part upon the same habit,
to which they are inordinately given? It is not at
all unlikely that this develops weakness of the lung
76 GALL AND SPURZHEIM’S VIEWS.
system, which favours the activity of the phthisical
cachexia.
246. Another source of the special weakness of the
lung, productive of the development of the phthisical
cachexia, is the existence of the fever of desire.
247. The discoveries of Gall and Spurzheim* have
physically demonstrated that man has an animal, a
moral, and a religious nature; that the animal na-
ture, if not ruled by the moral, and guided by the
intellectual nature, will appropriate to itself almost
the whole life-power, and will, by the insatiableness
of its demands, produce a fever, or to use the pro-
verbial phrase, “ will eat itself up.”
248. This fever is most strongly developed in con-
nexion with the sexual desire. It increases by activ-
ity :
“ Crescit eundo.”
249. It causes at first an animal fever; it causes
at last a bodily fever; and this bodily fever induces
a rapid pulse, heated cheeks, flushed face, hot ears,
and ends in producing a weakness, which admits of,
indeed encourages, the development of the diseased
activity of tubercle.
250. The baneful influence of this passion, so fully
depicted by Gall in his worle on the Functions of the
Cerebellum, translated by Combe, will explain the rea-
son why persons prone to the pleasures connected
with this animal feeling are particularly liable to
consumption, and also why excessive gratification at

“” Gall sur les Fonctions du Cerveazz. Every one who wishes to understand
the height of the philosophy of Phrenology. and to become acquainted with
the immense mass of facts connected with the science, should study the above
scientific and at the same time most interesting work.
F
AUSTERITY OF LIFE AND PHTHISIS. 47
the earlier periods of the married life is often followed
by consumption, unless nature kindly produces, as is
often the case, an abscess or abscesses at the back,
and thus arrests the development of diseased action
in the tubercles of the lungs.
251. In connexion with this sympathy between
the lungs and the genital system may be noticed a
fact recorded by Laennec. He considers great auste-
rity of life produces Phthisis, and instances a religious
community of women who dropped off one after the
other of Phthisis.
252. The austerity of life referred to by Laennec
is connected with an absence on the part of the mem-
bers of this female religious community both of a
special source of nourishment and of an evacuational
relief; the absence of the former tending to develop
a weakness of the constitution, the absence of the
latter throwing on the lungs an action which would
have been produced in connexion with the womb and
its appendages in the necessities of married life. From
these two causes, aided by others, debilitating in con-
nexion with the austerity of life referred to, a weak-
ness was, it is likely, developed in the lung tissue, and
consumption resulted. How physiologically true is
the advice of Paul I “Let the husband render to the
wife due benevolence; and likewise also the wife unto
the husband.”
253. Laennec further declares it to be a fact, that
women are more liable to Phthisis than are men.
253 a. This fact is corroborated by the Report of
the Registrar General. It is true that this fact has
been disputed by some writers. Thus Dr. Cotton
maintains, that “females up to the age of thirty are
shown to be more liable to Phthisis than males of the
78 MORE MEN DIE or PHTHISIS
same age; but after that time, the disease is much
more frequent in the male sex.”—(Lib. cit., p. 56.)
He adds, “ A similar observation is to be found in
the Medical Report of the Hospital for Consumption,
1849.” Out of a thousand cases referred to by Dr.
Cotton, the males affected were 582 ; the females
affected were 418. These cases refer to the metrop-
olis principally.
252 b. It is allowed that in the metropolis the
number of males dying of consumption is greater than
is the number of females so dying. This fact is evi-
denced by the following table given by Dr Walshe :
Metropolis. Males. Females.
Population in 1838, ,. . . . . . . . . 913,077 971,767
Absolute deaths from Phthisis, . . . . . 4,057 3,630
Deaths from Phthisis from 1,000,000 living, . 4,443 3,735
(Walshe, p. 796, lib. cit.)
253 c. But this fact is to be explained thus. The
dissipation of London, into which the male sex enter
with greatest intensity—London gathering together
all those who are likely to be given most to these dis-
sipations, and presenting so many incitements, will
serve to explain how it is that the lung weakness
should be caused in so many males, and thus the
phthisical cachexia be called into activity in males
especially.
253 d. How often it happens that fast-living men,
if having an attack of pneumonia, die of Phthisis at
forty-five. They have lived four years in one, or
rather they have exhausted an amount of life-power
in one year which ought to have spread through four
years; and at this age, forty-five, the constitution
seems to give way (a fact of great importance in judg-
O IN LONDON. 79
ing of the probability of cure); and if they do n~ot
die of water in the chest, or of disease of the heart,
Phthisis becomes the cause of death.
253 (l a. This is a climacteric period in men in
relation to the circulating system and the vascular
tissues; and this will in part explain the fact that,
after thirty, males die in a greater number of Phthisis
than do females. '
253 e. The writer has observed the following fact,
that if these fast-living men have had scrofula in their
youth, the death is from Phthisis; if not affected with
scrofula in youth, they die of water collected round
the heart (hydrocardia).
254. Unequal marriages, i. e. the marriage of the
old with the young, are frequently effective, by the
weakness in connexion with the modifications of the
genital system induced by such unions, in producing
consumption in the progeny, resulting from such
marriages.
254 a. When a student in Edinburgh, the writer
had delightful associations connected with one of the
most intelligent families of that modern Athens. The
father of this family was a fine specimen of the old—
not English, but Scotch gentleman. When about
sixty, he married a young lady, who was regarded as
one of the finest women in Scotland. He had several
children by this lady, and they grew up fine, hand-
some, and ~apparently healthy women; as they at-
tained womanhood they died of consumption. The
writer thinks that those who died numbered seven.
254 b. The inequality of age caused a weakness in
the system, which did not allow the full maturing
80 UNEQUAL MARRIACES.
of the pulmonary tissue, particularly active in its
changes towards puberty. This admitted of the de-
velopment of the phthisical cachexia, and Phthisis
put an end to these intelligent members of an affec-
tionate family.
254 c. The weakness could not have resulted sim-
ply from either parent, for the father died at ninety
years of age, a healthy man up to his death; the
mother lives now, and is a fine matronly lady.
255. Another source of the weakness favourable to
the development of the phthisical cachexia is con-
nected with the conditions arising from the marriage
of NEAR RELATIONS. The writer has known whole
families, derived from the intermarriage of first cousins
(consumption being in the families), removed by
Phthisis. The original cachexia being aggravated in
its injuriousness by the weakness of lung-tissue pro-
duced by the unnaturalness of the union of persons
of such near blood.
. 256. How unerringly does the Creator enforce
obedience to his laws I

SECTION II. —- On the Development of the W’eahness
necessary to the Awahing into Activity Tubercular
Phthisis, in Oonneaion with the Conditions of Want of
Activity of the Lung System.
257. It is a principle, which forms part of the
doctrine of the natural action of the living principle
(physiology), that whatever action Nature intends for a
part of the body, THAT action alone is capable of lceeping
that part in health. Thus, the fact of a joint implies
the motion of that joint: deprived of that motion for
WEAKNESS mom WANT or ACTION. 81
"a time (the time may be longer or shorter), it ceases
to be a joint, it becomes a fixture—it, to use techni-
cal language, is anchylosed.
258. A source of debility affecting the lungs so as
to develop the phthisical cachexia in the production
of Phthisis, is to be found in the want of due action of
the lungs ; which want may be connected with either
* an excess of action or impediments to action.
259. The debility resulting from the want of action
will be rendered more apparent by a short reference
to the beneficial effects resulting from action.
260. Action is essential to the preservation of a
healthy circulation; for action gives to all points in- ,
tended for action the condition necessary to ensure
that state of the blood-vessels essential to the ad-
mission of the free transit of blood through them.
261. The effect of action is evidenced further in
the fact, that parts healthily exercised acquire addi-
tional strength and size. The arms of the blacksmith
indicate the strength derived from action. The legs
of a domestic fowl, being used more than are the
wings, have a colour darker and a texture closer than
are the colour and the texture of the wings ; whereas
the flesh of the wings of birds of flight are as dark and
firm, indeed darker and firmer, than is the flesh of the
legs. The flesh of the deer, an animal of speed, is
redder than that of the sheep.
262. All unexercised muscular fibres lose their tone,
become flabby, the blood does not circulate freely
through them, and the muscular tissue, from this want
of action, becomes weak, perhaps unhealthy.
263. Want of action of a part establishes in that
part what might be termed a relative debility; i. e. '
an amount of strength disproportioned to that which
G
82 CONDITIONS or HEALTH.
the part ought to have in relation to the strength of
the system at large.
264. In connexion with the action of the lungs,
the following conclusions are justified by facts :
264 a. “That the perfect health of the lungs de-
pends upon the full performance of the natural actions,
both as regards the complete expansion of the organ
itself, and the purity of the air inspired.”
264 b. “That every continued deviation from full
natural action of the lungs is a step towards debility.”
264 c. “That this debility is of more importance
in regard to the lungs than to most other parts, this
organ being that by which the blood is purified for
the nourishment of the whole body.” '
264 d. “That the same increased healthful action
of the lungs, like increased action of other parts, adds
to their vigour, and tends to the removal of an ac-
quired or natural liability to debility and disease of
the lungs.”
264 e. “ That on this principle only can it be
accounted for, that horses and other animals, made
gradually to give additional action to the lungs, ac-'
quire additional powers of speed.”
264 “ It is not a little singular, that animals so
trained and exercised are never subject to pulmonary
consumption, unless the rare disease produced by de-
bility, resulting generally from neglect or ill treat-
ment of some acute affection of the lungs, might be
called by that name.”-—(Tyrrell, lib. cit. pp. 56, 57
265. This freedom from disease, as exhibited in the
horse, in connexion with wisely regulated action of
the lungs, is capable of being attained by human
beings, if placed in obedience to the conditions which
develop this state in the lower animal.
TIGHT LACING. 83
266. That such a freedom can be gained will appear
hereafter. Suffice it here to repeat, that want of ac-
tion of any part intended for action, becomes a source
of debility in that part : that debility induced in the
lungs, affected by a tubercular cachexia, will in the
majority of cases end in Phthisis.
267. In regard to the injuries of the lungs, result-
ing from special impediments to their free action, the
first source of injury is that derived from tight lacing.
268. Upwards of two hundred years since, Spigelius
(Spigelii Opera, Arnsterdami, 1654, De Corporis Fa-
brica) attributed the frequency of consumption in
Great Britain to the habit of confining the chests of
young women by tight dresses.
269. The same opinion respecting the injurious ac-
tion of tight dresses was held by Diemerbroek, a phy-
sician of Utrecht, who lived somewhat later than Spi-
gelius,-—an opinion backed by numerous other autho-
rities.
270. How frequently is the skin of the central por-
tion between the breasts of women made quite disco-
loured, hardened, misshaped, and even indented, by
the continued pressure of the hard stay-bone ; and
how often is the fair skin of the waist and of the sides
marked with ridges, the flesh being depressed by the
pressure of the ribs of the stays, making wheals just
as if the individual had been whipped. What a work
of supererogation such a woman practises daily ; what
a laborious attempt she makes to injure her lungs.
271. The following fact shows in an extreme the
84 LACED DEATH.
injurious mechanical effects produced on the lungs by
tight lacing :—- 0
“ Suicide by tight lacing.—A young lady was found
in a brook in Worcestershire last week, and was at
first supposed to have been murdered. This suppo-
sition is now, however, discarded, medical men being
of opinion that she had fallen into the water in a fit
of apoplexy. The degree of tightness of the stays of
the deceased was so great, that on removing the
clothes the surface of the chest and adjacent parts was
perfectly blanched, while the upper parts of the body
still retained their florid appearance. So horrible was
the constriction to which this poor martyr to fashion
had subjected herself, that the skin over the ribs was
compressed into folds, the ribs themselves contracted
and driven inward upon the lungs, the stomach forced
down into the pelvis, and the liver pushed out of its
place toward the left side. It is surprising how any
of the naturalfunctions could have been efficiently
performed under such frightful derangement and dis-
tortiOn.”—A.D. 1841.
272. Granted that the case is an extreme case ; yet
every great is made up of littles; every universal of
particulars; consequently all tight lacing, little in each
individual case though it be, produces an impediment
to the free action of the lungs: and thus, by imped-
ing the free circulation of the blood through the
lungs, tends to the production of debility in the lung
tissue ; and which, by rendering walking difiicult, must
lead to the~neglect of that exercise, this itself adding
a general deb~ility to that which is local. ~
273. The free expansion of the lung being impeded,
the action of the heart is affected, being made to con-
tract more frequently,‘ because it must supply, by the
PIGEON-BREASTEDNESS. 85
more frequent transmission of theblood through the
lung tissue, the want created by tight lacing of lung-
to-air-exposure surface, a want caused by a portion of
the lung being rendered unfree to the transmission of
the blood and of the air. The blood must for health’s
sake be exposed to the air ; the surface through which
the exposure takes place is lessened, and therefore
there must be, as previously illustrated, an increase in
the frequency of exposure to make up the want of sur-
face. --
274. This increased action of the heart, produced
by the impeded action of the lungs, must, if tubercles
exist in the lungs, increase the irritation of the lung
tissue immediately surrounding the tubercle, and of
the tissue of the tubercle itself, both these, from the
peculiarity of their structure, resisting the free course
of the blood through them.
275. These tight lacers create an artificial “ pigeon
breast,” i. e., they flatten the sides of the body, and
push forward the breast-bone.
276. Dupuyt-ren, in his Memoires de C/zirargie, and
Mr Shaw in the Zlfedical Gazette, 1842, have shown,
that “ this alteration of form may be produced, espe-
cially in the flexible chests of children, by protracted
difliculty of breathing, depending on an obstruction of
the upper air passages :” and if such can be produced
by an interior defect, causing impediment, how cer-
tain it appears that tight lacing, an exterior applica-
tion, may produce its injurious effects.
277. Stays will not produce tubercles ; but tend,
by exciting impediments to the natural action of the
lungs, to develop the debility which favou.rs the de-
generation of the tubercle. ~
278. Dr. Copland remarks, “that the use of stiff
86 DR. cornAun’s ATTACK.
stays produces ultimately a morbid state of the blood,
tubercular deposition, especially in the lungs, haemop-
tysis,” &c. '
279. Dr. Copland has made a mistake,* Dr. Walshe
is more correct in his remark :-
“ It may be fearlessly asserted, no single proof ex-
ists that the abuse of the stays produces the specific
disease tubercle.”—-(Lib. cit.)
280. In connexion with this tight lacing by stays,
another form under which an impediment to the free
circulation of air and of blood through the lungs takes
place, is that presented in the practice of wearing tight
nechcloths.
281. Some men seem to practise a perpetual semi-
hanging. Of late years the practice has lessened.
282. The injury resulting from this practice will be
apparent when it is remembered, that “ in no other part
of the human body do so many extraordinary motions
meet together as in the trachea,” (6. 9.) (the part com-
pressed by these tight neckcloths) : there are the res-
piratory motions of the lungs ; all the varieties of
respiration; also all the motions, the modes, and the
articulations of the sounds of singing and of the words
of speech, to the whole of which the trachea has to
adapt itself. Not a syllable issues from the mouth ~

* It is not wonderful that Dr. Copland should be deficient in logical accu-
racy; he, though remarkable for his literary attainments, for his knowledge
of what others have written and said, has not a truly philosophic mind—an es-
sential to accurate reasoning. Had Dr. Copland been so endowed, he would
never have given birth to the definitions put forth by him of homoeopathists,
lay and medical: “ Those who practise homoe-opathy are knaves, and those
who employ them are fools.” What is Dr. Copland ?
SIR BENJAMIN BRODIE. 87
but the trachea must concur with it with a general
assent, by some inflexion, expansion, or contraction
of its own. The trachea has likewise to adapt itself
to every motion of the gullet, the pharynx, the palate,
and the tongue ; again to every bend of the neck: in
a word, to all the actions of the muscles, not only of
this region, but of the thorax, and sometimes of the
abdomen.”-—(Regnum Animale, p. 96, vol. ii.)
283. Any impediment to these actions will tend to
cause a disturbance of the functions of these parts, and
by consequence impeding the free action of the lungs,
will tend to the production of lung weakness, thus
favouring the development of the cachexia condition,
associated with tubercular disease.
284. It is in this way, in fact, that spinal curvature
tends to the promotion of Phthisis; the curvature of
necessity causing an impediment to the free expan-
sion of the lungs, and thus producing Phthisis.
284 a. To Dr Harrison * the world is indebted for
the demonstration of this fact, he having arrested the
progress of several cases of Phthisis by removing, by
his simple but highly scientific means, the curvature.

* Highly illustrative of the persecution of all discoverers in science and of
all improvers in art, is the fact that Sir Benjamin Brodie denounced Dr. Har-
rison as a quack; and yet Sir Benjamin Brodie, after twenty-five years’ mis-
taken and destructive practice by employing setons and burning holes in the
flesh of the back (moxas), was obliged to acknowledge, but not till his oppo-
nent was dead, that his own practice, founded on the idea that curvature of the
spine depended on a caries of the bones of the spine, was built on an error, and
that the idea that curvature depended on a displacement of the bones, a sublux-
ation, arising from an alteration of the tissue of the ligament binding the bones
of the spine together, which Dr. Harrison was the first theoretically to put
forth and practically to establish, is the true one.
88 l A STOOPING GAIT.
285. In connexion with the impediment to breath-
ing produced by lacing too tight, by tying neckcloths
too tight, by deviations of the spinal column, stands
another fact, namely, the injury for a stooping gait.
286. The poet of antiquity, OVID, points out with
great beauty the fact, that God gave to man the-coun-
tenance to be raised to heaven: “ Os homini sublime
dedit;” that is, that man’s thoughts as well as his
countenance, when he attains the true dignity of a
man, should be erect,—that he should look upwards.
287. Great is the benefit to his breathing when he
thus looks upwards. It allows the free expanse of his
chest, and, by consequence, the full dilatation of his
lungs, thus allowing the free circulation of the blood
through the vessels of the lungs, and thus admitting
the proper change in the blood being effected by this
unrestrained circulation. .
288. There is an immensity connected with this
erectness. It realizes in lung health what the writer’s
friend, Mr H. VVainewright, a clergyman though with-
out clericism (may he long preserve his simplicity),
has depicted iii the following statement :*-—

* “ My dear Friend,--The experiments I saw respecting mesmerism illus-
trated this fact, that the mesmeric state is not induced by any influence exer-
cised upon the patient by the practitioner.
“ Mr. Braid conducted the experiments. He disclaims for his theory the
name of mesmerism, and gives to it the name of hypnotism, from borvog, sleep.
He proves that the patient is able to hypnotize himself. He placed a woman
in a chair and told her to look at her finger, at the same time she held her
head back. In about a minute she was completely gone. He remarked that
it was one of the peculiar features of this hypnotic state, that any idea sug-
gested to the mind of the patient became a present reality. In proof he folded
up her apron into the form of a child, and asked her what it was? She replied
a baby, a nice one, but very young. He then told her she was mistaken, it was
a monkey ; she immediately put it from her with symptoms of dread mingled with
disgust. He repeated many experiments in this way, all attended by the same
omen SOURCES or INJURY. 89
289. In conclusion, any mechanical impediments in
connexion with the chest, tending to the production
of hurried or impeded breathing, such as working,
leaning against a desk, &c., must favour the develop-
ment of this lung debility, because they tend to pro-
duce an incompleteness of action between the blood
and the air, i. e. between the air, the noarislzer, and the
blood, the nourished.
289 a. It is well known in regardto the passage of
the food through the intestinal tube, that a certain
time must be allowed for this passage; so that the
nutritive portions of the food may be allowed to come
in contact with the tissue of the intestinal tube, be-
tween which and the nutritive particles there is a
mutual action necessary to perfect the food, just as
there is the action between the air tissue and the

the patient was asked her age, she immediately replied twenty-three, and upon
result. Another remarkable feature in this singular condition is, that every-
thing upward and heavenward is associated in the patient’s mind with the
beautiful, the pleasant, and agreeable; whilst everything downward is gloomy
and sad. The same result is obtained by either opening or contracting the
brow. Thus, when the head was upwards and looking towards the sky, when
the head being bent forwards so that she looked down, she said in a very pitiful
tone, in reply to the same question, eighty. Again, when asked about her own
appearance, with her head held up and an open brow, she thought she was at-
tractive and good looking; but with the head depressed and the contracted
brow, she thought she was uninteresting and plain. Again, he placed her
upon her knees, and in a few minutes she began to pray in a most beautiful
and rapturous manner; she was not told to do so, but the placing her upon her
knees seemed to prompt the idea of devotion.
“ I must here say that she is a very good woman, and therefore accustomed
to such religious exercises. When the prayer was over, during which the
tears trickled down her cheeks, her head was raised so that she looked upward,
she was asked what she saw ? She said, with joy beaming on her countenance,
she saw heaven. The head was then bent forward, and with most distressing
anguish, she replied to the same question, that she saw hell. The same an-
swers were received by the opening or contracting of the brow without the
moving of the head.”
90 ILLUSTRATION FROM THE
blood tissue in the lungs, necessary to effect the proper
change in the blood.
“ The food is taken into the month, there to be cut,
torn, and ground, to be mixed with the salivary fluids,
to be acted upon by the tongue: thence it is passed
under the hanging veil of the palate into the pharynx,
there to be mixed with the mucus of the pharynx, and
to be carried by the muscular actions of the pharynx
and of the oesophagus or gullet into the stomach. In
the stomach it is subjected to the various actions al-
ready so fully described, being mixed with the gastric
juice, and being there aided by the heat and the mo-
tions of the stomach, is converted into chyme: from
the stomach the chyme is passed through the pylorus
into the duodenum, there to be mixed with the bile
and the sweatbread juice, and to be converted into
chyle, portions of which are taken up by the lacteals
of the duodenum. The two portions, the nutritive
and the non-nutritive, of the contents of the duode-
num, are expelled by the motions of the duodenum
into the jejunum. This intestine receives the mate-
rials, rolls them outward, selecting from them the
chyle, the intestine in its motions applying the mate-
rials to the innumerable pores, the openings of the
chyliferous vessels. This intestine seems to carry on
its contents with great rapidity, hence, as already ex-
plained, it is generally found empty (jejune). The
ileum receives the materials passed into it from the
jejunum, and imbibes the chyloid drainings and juices.
The spiral forms, which this intestine makes in its
motions, are more frequent, and the gyrelike move-
ments are shorter : and from this it may be that the
convolutions of this intestine are specially liable to
become knotted together, constituting the disease
PASSAGE 0E THE CHYLE. 91
called ileus, also the iliac passion, in which the vermi-
cular motion of the intestine is arrested.
“The coecum is connected with the ileum above
and with the colon beneath: it is the common hall,
the place of meeting of these two intestines: the goal
of the gyratory course of the small intestines, and the
starting point of the outward career of the large in-
testines.
“ Every time the ileum expands it forces its extre-
mity and its contents into this cup-like intestine ; and
the colon moving up to meet it, receives and swallows
its ejections. The valve of the colon opens and shuts
the door, and also guards against and forcibly prevents
the reflux of materials from the lower into the higher
intestines. The colon, which, as already noticed, has
a greater size and a greater thickness of coats and
strong ligaments, channelling the intestine itself into
great furrows, has these structures to enable it to act
powerfully on the materials that pass into it, so as to
extract everything extractable from these materials,
and to be able to propel the contents to the rectum.
The rectum was noticed as being supplied with pow-
erful muscles, which enable it to expel the hardened
faeces, deprived by this time of all nutritive particles ;
and these being expelled, the sphincter muscle closes
the anal aperture.
“ The history of the process of absorption of the
chyle, the history of the movements of the intestinal
tube, the history of the various valves in the various
parts of the intestinal tube, sufficiently demonstrate
that the contents of the intestinal tube should pass
slowly and regularly through the tube itself. Any
rapidity of transit of these contents must of necessity
prevent the absorption of the chyle, must produce
92 CONTACTOE BLOOD WITH THE AIR.
irregularity in the movements of the tube itself, must
prevent a proper admixture with the various juices
that are poured into the tube, and must, as inducing
all these deviations, cause irritation of the tube itself,
and thus affect the general system, and, by conse-
quence, the health. As purgatives produce this ra-
pidity of transit, their injuriousness is apparent.”—
Constipation, its Theory and Cure, by JOHN EPPS, M.D.
290. May it not be inferred, that if a certain time
is required for the intestinal tube to obtain from the
food taken all the nutritive matter therein, effecting
at the same time the necessary changes in that nutri-
tive matter, and if, further, hurrying the contents of
the bowels through the bowels causes injury and
weakness consequent thereupon, a certain time is also
required to enable the blood, exposed to the air in the
lungs, to undergo the requisite changes.
291. When the breathing is hurried, the requisite
changes in the blood cannot take place, and the blood
not being perfected, must produce a lung weakness.
This want of duration in respect to the contact of the
blood with the air, has, the writer believes, a most im-
portant action in connexion with the production of
that state of the lung tissue necessary to cause the
phthisical cachexia to be awakened into destructive
activity. '
SECTION III.—On the Development of the I/Veahenss neces-
sary to the Awakening into Activity tubercular Phthisis
in Connexion with the Condition of EXCESS of Activity
of the Lung System.
292. A third source whence the debility necessary
to cause the phthisical cachexia to be called into ac-
“ CONGESTIVE” EXPLAINED. 93
tion, is connected with conditions which induce spe-
cial alterations in the pulmonary tissue itself.
293. Conjoined with the existence of tubercle is a
state of the lung blood tissue, in which the vessels of
this tissue become loaded by a peculiar condition of
the tissue itself, independent of any external imped-
ing cause, to be defined as “ congestive,”= for want of
a better term: a state in which the tissue is affected
unnaturally by the quantity of blood existing in the
tissue, that abnormal condition being preceded by an
abnormal modification of the tissue itself.
294. Anything tending to render permanent this
condition of the blood-vessels, or to add to its amount,
must be highly injurious, and will lead to the devel-
opment of debility in the lung tissue, thus awakening
the tubercular cachexia into activity.
295. This agency will be rendered more clear by a

* How apposite are the remarks of Dr. Currie in his work, llledical Reports on
the Effects of Cold Watea', Pref. p. viii. ix. :—“ I have guarded against the
unnecessary use of technical as well as of general expressions. It were better
perhaps that medicine, like other branches of natural knowledge, were brought
from its hiding-place, and exhibited in the simplicity of science and the naked-
ness of truth. If it had been in my choice I would not have adopted the lan-
guage of theory, like Boerhaave or Sydenham, but have exhibited a medical
work in the phraseology that Bacon, had he lived in our days, might have used.
Unfortunately, in the present state of medical knowledge, wholly to avoid the
language of theory is impossible. The corruptions of false doctrines must re-
main more or less in our phraseology, after the doctrines themselves are ex-
ploded ; since custom has rendered the expressions in which they are found
intelligible, and human sagacity has not yet discovered those first principles of
living motion by which the doctrines and the language of physiology might at
once be reformed. Hence the term reaction is applied to certain motions of
life, though in a sense very different from that in which it is used in the science
of inanimate motion, from which it is borrowed; and such words as tone will
still be found in the following pages, though the theory that introduced them
into medicine be universally abandoned. The use of such expressions is how-
ever an evil, justified only by necessity; and I have endeavoured to avoid it as
much as lay in my power.” '
94 ACTION or SUDDEN coma.
short description of the action of cold applied to the
surface of the body.
295 a. When cold is applied to the surface, say it
is cold water, a rush of the blood takes place from the
surface to the interior organs of the body.
295 b. If the whole of the interior organs of the
body are healthy, a reaction takes place from the in-
terior to the exterior, a genial warmth is caused by
the blood returning to the surface, and health is pro-
moted by this double action.
295 c. If, on the other hand, some internal organ
is not in its healthy state, then the rush of blood
affecting this organ acts so as to cause the reaction
not to perfect itself in relation to other organs, and a
chill results, simply because the system has not, in
relation to the unhealthy organ, the power of causing
the genial reaction.
295 d. In this case the organ, i. e. the unhealthy
organ, has a state of its tissue brought about which
favours the development of any disease which hitherto
has been lying dormant in it.
295 e. The following interesting facts recorded by
Dr. Currie gives indirectly a very graphic picture of
the conditions occurring under somewhat similar cir-
cumstances.
“ On the 1st September 1778, two students of medi-
cine at Edinburgh set out on foot on a journey, a
considerable part of which lay along one of the rivers
of Scotland. They started by sunrise, and proceeded
with alacrity in the cool of the morning. At the end
of eight miles they breakfasted, rested for an hour,
and then resumed their ourney. The day grew warm
as it advanced, and after a march of eight miles more,
they arrived heated, but not fatigued, on the banks
BATHING, WHEN INJURIoUs. 95
of the river above mentioned about eleven in the fore-
noon. Urged by the fervour of the day, and tempted
by the beauty of the stream, they stripped instantly,
and threw themselves into the river. The utmost
refreshment followed, and when they retired to the
neighbouring inn, this was succeeded by a disposition
to sleep, which they indulged. In the afternoon they
proceeded, and travelling sixteen miles farther at a
single stretch, arrived at the inn where they were to
sleep a little after sunset. The afternoon had been
warm, and they perspired profusely; but the evening
was temperate and rather cool. They had travelled
for some miles slowly, and arrived at the end of their
journey stiffened and wearied with their exercise.
“The refreshment which they had experienced in
the morning from bathing, induced, however, one of
them to repeat the experiment, and he went perfectly
cool into the same river, expecting to relax his limbs
in the water, and afterwards to enjoy profound sleep.
The consequences were very different. The Tweed,
which was so refreshing in the morning, now felt
extremely cold; and he left the water hastily. No
genial glow succeeded, but a feverish chill remained
for some time, with small frequent pulse, and flying
pains over the body. Warm liquids and friction
brought on at length considerable heat, and towards
morning perspiration and sleep followed. Next day
about noon they proceeded on foot, but the traveller
who had bathed was extremely feeble; and though
they had to perform a journey of a single stage only,
as some part of it was difficult and mountainous, he
was obliged to take the assistance of a carriage which
overtook them on the road. It was several days be-
fore he recovered his usual vigour.”-—-(P. 120, lib. cit.)
96 HEAT, PRODUCING CONGESTION.
296. Suppose this student had had a phthisical
cachexia; the action produced by the second bathing
would have caused the development of Phthisis, i. e.
the conditions induced in the lungs by the want of
reaction would have called into activity the dormant
phthisical cachexia, and Phthisis would then have
been the result.
297. Great cold an.d great heat are both productive
of these lung congestions, and are both productive of
this awakening into activity of a phthisical cachexia.
298. In regard to lung diseases generally, facts
unnumbered prove that every variation in the tem-
perature of the atmosphere, more especially towards
the point of coldness, produces a great number of
fatal lung diseases. The Reports of the Registrar
General prove this. The following facts are selected
from these Reports. '
298 a. In the week ending October 30, 1858, the
deaths were 1133, and the mean temperature of the
week was 47.2°. In this week 132 died of Phthisis.
In the week ending November 6, the deaths were
1217 ; the mean temperature of week was 43.3°, which
is 2.7° below the average of the same week in 43
years. On Monday, the coldest day, the mean tem- '
perature was 8.0° below the average ; the thermometer
ranged from its lowest point, 28.2°, on Monday, to its
highest point, 54°, on Wednesday; 141 persons died
of Phthisis. '
In the week ending November 13, 1858, the weekly
mean temperature was only 39°. The deaths amounted
to 1349. The diseases of the respiratory organs in-
creased, being in the previous weeks 250, in this
week 310. It is curious that Phthisis decreased in
this week from 141 to 131.
INFLUENCE or EXTREMES. 97
In the week ending November 20, 1858, the weather
was still colder, the mean temperature being 35.5°.
The deaths this week were 1487, whereas the deaths
ought to have been, according to the rate of popula-
tion, 1192. The deaths from Phthisis this week rose
from 131 to 166.
In the week ending November 27, 1858, the mean
temperature rose again to 37 .4°. The deaths in this
week were 1803. The number that died of Phthisis
this week were 190°.
This week had a peculiarity. On Wednesday the
lowest point of the thermometer was 20.5°, on Friday
the highest point was 58°;
So that it seems the sudden transition had an effect
on phthisical affections.
298 b. It will be found that great heat has a
powerful effect on the phthisical.
In the week ending June 5, 1858, the mean tem-
perature 66.2°, which exceeds by nearly 10° the
average of the same week in 43 years, the deaths
from Phthisis were 147.
In the week ending May 29, 1858, the mean tem-
perature was 53.9°, which is 0.9° below the average
for the same week in 43 years. The week before, the
mean temperature was above the average. The deaths
from Phthisis on the 29th May 1858 had amounted to
169 ; the week before only 117.
I11 the week ending June 12, the mean temperature
being 63.8°, the deaths frdm Phthisis, though less
than in the previous week, when the mean tempera-
ture was 66.2°, amounted to 151.
298 c. Other illustrations might be given, but these
are quite sufficient to illustrate the view put forth,
that great heat and great cold, and mprze particularly
: : :1 -‘:
98 ACTION or com.
sudden changes, cause those congestions of the lung
tissue which tend to hasten to a fatal termination
phthisical diseases,
299. The cold acts in producing a rush of blood
to the lung tissue, and the lung not being in a healthy
state, it has not power to effect a perfect freedom of
its tissue from the increased flow of blood received
into it, i. e. a full reaction ; and disease develops
itself, and if a phthisical cachexia ' exists, Phthisis
becomes developed. '
299 a. Illustrative of the peculiar condition of the
lung-blood tissue in cases where the phthisical cachexia
exists, the fact is worthy of notice, that in these cases
the early manifestation of its activity very frequently
consists in a discharge of blood from the lungs ; i. e.
-the vessels are in so peculiar a state of delicacy, that,
to relieve themselves from the congestion induced by
the action of the cold, they are obliged to effect this
by a discharge of blood.
299 b. The same happens where great heat has
caused the active congestion, although in this case the
modification of the congestion is induced by the heat,
causing a general increase of circulation, especially
affecting the chest, inducing thereat a fulness. In
this case, how valuable is aconite! more especially
when, in hot weather, people liable to spitting of blood
feel a great fulness in the chest.
299 c. All these conditions when induced embody
a state in which injury is done to the lungs by excess
of action in connexion with this organ-—not, it may
be, an actual excess, but an excess in relation to the
-peculiar state of the lung tissue in connexion with
the cachexia modifying the said tissue.
300. Although in this action the subject of the
-0
Qt . 0
I. .D.
0
WARM CLOTHING. ' 99
means for prevention is not strictly under notice, it
may be well to point to the circumstance, that these
facts and views sufficiently clearly demonstrate that
persons who have the phthisical cachexia should be
warmly and equably clad.
300 a.' Flannel or silk, each being a bad conductor,
should be worn: in the winter to protect the body
from the cold, in the summer from the warmth?“ Its
power in relation to the former is well known; its
power in relation to the latter is exhibited in the fact,
that ice is carried about in blankets!
300 b. It is alleged, says Dr Elliotson, that formerly
in Scotland the people were all dressed in woollen,
and Phthisis was rare amongst them; but since they
have changed woollen clothing for cotton, the disease
has become very prevalent in that country.---(Good’s
Study of Medicine, vol. ii. p. 307
In connexion with the injury to the lungs from
light clothing, Laennec remarks: “ Too light clothing,
or the impression of cold when the body is heated,
seems in our cities to be the occasional cause of
Phthisis in many young persons, whose disease begins
with a pulmonary catarrh or pleurisy (tubercles hav-
ing previously existed/’)
301. How many develop the weakness in the lung
tissue essential to the awakening of the phthisical ca-
chexia by the foolish practice of having an open waist-

* In our school days, how interested we were in the tale of Dionysius, the
tyrant of Syracuse, who being in want of money, and knowing that a statue
of Jupiter in the temple was invested with a robe of gold, took possession of
it, substituting in its place a woollen garment; the royal wag adding for the
comfort of Jupiter, that the flannel would keep him warm in winter and cold
in summer; whereas, added he, the gold must have been very cold in winter
and hot in summer. -
100 OPEN WAISTCOAT.
coat, showing, it is true, a white shirt (a beautiful
thing), and, it may be, attractive shirt-studs. It is
true the parties thus attired sometimes state that they
have flannel underneath; thus acknowledging that
their practice is not quite sound. They should re-
member that they have flannel underneath the parts
that are not exposed, ~and thus the central portion is
of necessity more exposed to the cold than are the
side parts: indeed the lappets of the coat and the
lappets of the waistcoat cover the side parts. Every
consumptive person should have a waistcoat buttoned
to the chin. Indeed this very abundance of wrapping
on the general chest helps to cause a flow of blood in
excess to the pulmonary organs, thereby increasing
the liability to be affected by the cold.
301 a. The very objection which many persons
who have the phthisical cachexia make to this wisdom
in connexion with covering the chest with a waistcoat
buttoning to the chin is, that they feel such an in-
' vestiture too tight. This very objection proves the
necessity of such clothing to prevent the injury from
exposure of the chest to cold, since this very tightness
exhibits the existence of a special congestion——declares
that there is disease in some of the organs contained
in the chest. ‘
302. The production of the debility of the lung
tissue is often the result of the congestion, caused by
the habit of wearing thin shoes, which, by causing a
rush of the blood from the lower extremities°to the in-
terior organs of the body, creates congestions in these
organs, and thus, in those phthisically cachexied, in-
juriously afi'ect the lung tissue, and awaken the dis-
~ eased part into activity.
302 a. How many a beautiful girl has had Phthisis
Q ~. '.Q .0. :
'00
THE BALL--ROOM. 101
developed by walking from the ball-room and delay-
ing in the cold stone hall, and then walking to and
from her carriage; or perhaps, if in the country, run-
ning a few hundred paces home. The system has
been weakened by the fatigues and the excitement of
the dancing and of the warm ball-room: a rush of
blood on the interior organs is caused by the colded
feet: the power of creating a reaction has been di-
minished by that exhaustion, caused as stated: active
disease is developed, and, at the next annual gather-
ing, the star of the party is not met with—she is in
her grave.
302 b. It must not be inferred that these results
are to be gained only in connexion with the ball-
room : they are to be met with as frequently in con-
nexion with the crowded church or chapel. Persons
going out in the cold streets, after being excited and
made hot within the walls of a building deemed by
many to be specially under the Divine protection,
have oftentimes the foundation laid of Phthisis: This
demonstrating that the Divine Parent, while He has
appointed a law for the worshippers “ not forsaking
the assembling of themselves together,” has appointed
" also certain natural laws which regulate the physical
condition, under which alone such assembling can be
physically safe?‘

* The writer was treating with great success a young female for epilepsy.
She had been free of fits for a length of time, when, belonging to the Wesleyan
sect, she followed the practice of the fashionable world of turning night into
day and day into night, going to chapel to sing the old year out and the new
year in. The consequence was that she had a severe fit the mid-day of the
new-year’s day: that is, in obeying what she deemed a religious law, she dis-
obeyed a natural, and received the punishment. -
102 INFLAMMATION or THE LUNGS

303. It has been imagined by many, that inflam-
mation of the lungs is a state which has a tendency to
cause the lung weakness favourable to the develop-
ment of the phthisical cachexia.
304. Fortunately this view does not seem to be
correct. Cur evidence of its incorrectness is exhibited
in the fact, that inflammation of the lungs attacks
frequently the robust and the broad-chested: and
such persons are fabricked quite differently from those
who are predisposed to tubercular formation and de-
generacy, such persons being for the most part deli-
cate and narrow-chested.
305. It is not to be denied, that tubercular Phthisis
does follow inflammation of the lungs in some cases ;
but this, in many such cases, i. e. so originating, is
developed not so much if at all from the inflammation
of the lungs simply as from the extensive depletion of
blood, —a mode of remedial treatment formerly so
much employed in the treatment of lung inflamma-
tion ; for whatever weakens, favours the degeneracy
of tubercles, if tubercles are present.
306. Another evidence, that lung inflammation does
not predispose to tubercle, is found in the fact, that '
in lung inflammation the changes connected with the
disease mostly commence in, and are mostly confined
to, the lower part of the lungs, which is not the case
in tubercular Phthisis; this, though affecting the lungs
generally, affecting more frequently, at least at the
first, the upper part of the lung: phthisical patients
generally complain of pain at the upper part of the
lung.
' 307. The results from lung inflammation not cured,
AND PHTHISIS. 103
though the most prominent symptoms have been re-
moved by bleeding, may favour, as already intimated,
the development of states which tend to the produc-
tion of Phthisis ; so also may the results from the in-
flammation of the rib shin (costal pleura), and of the
lung skin (pulmonary pleura), i. e. pleurisy (pleuritis) :
since it is not at all difiicult to understand that, if
these two tissues, which, in a healthy state, move one
upon the other, lying in close contact, become adhe-
rent, as oftentimes they do after inflammation, the
impediment thus caused to the free action of the lungs
may tend to the production of lung debility, more
especially if bleeding has been employed in the treat-
ment.
308. In relation to the injurious action of bleeding;
the following facts are worthy of being rescued from
oblivion :—-
“ A quantity of tubercles were formed in the lungs
of the pugilist Byrne, who, notwithstanding copious
and repeated bleedings, died a few days after a fight.
Previous to fighting, the pugilist trains so as to bring
himself into a state of health and strength above par,
and thus, it may be inferred, that the lungs were in
good health at the time. How, then, did these tuber-
cles develop themselves? Was it not from the debil-~
ity induced by the repeated bleedings ?”--Tyrrell.
309. No doubt now exists, that the old system an-
tiphlogistic treatment (and the lowest of all vulgar
practice is the mechanical treatment of drawing blood,
since any farrier can order and do this as well as the
best physician) tends to the production of weakness,
and thus, in persons affected with the phthisical ca-
chexia, originates the lung weakness essential to the
production of Phthisis.
104 RAPID GROWTH,
310. How glorious does homoeopathy show itself
in this, that by its therapeutic means it removes the
condition, deemed by the old system practitioners
suited to their so called antiphlogistic measures, with-
out any loss to the constitution. Hence the homoeo-
pathic treatment needs no wine, no beer, no stimu-
lants. The enlightened homoeopathists (there are
many unenlightened ones) know that wherever there
is debility there is disease; and that the true, indeed
the only method of curing the debility, is to cure the
disease.
SECTION IV.-—On some other Sources of the Weakness
necessary to the Awakening into Activity Tabercalar
Phthisis.
311. It may be useful to refer to a few other sources
of the debility which may give rise to those conditions
in the lung tissue tending to develop the tubercular
cachexia into activity.
312. Another source of that lung weakness which
is essential to the awakening the tubercle into activity
is rapidity of growth.
313. It seems to be a law in nature that rapidity of
growth is attended with delicacy. Who has not re-
cognised the difference between the oak and the pop-
lar? A poplar tree is healthy as well as the oak; but
its strength is less.
314. Still, it is not to be supposed that mere rapid-
ity of growth is causative of the weakness of lung con-
nected with the development of the tubercular cachexia,
since such a supposition would imply that the Creator
now ACTING. 105
has put a ban on tall people. The reason why persons
who have rapidly become tall are liable to consumption,
is to be found in this, that the very constitutional con-
dition essential to this sudden development of the body,
is one which is associated with the conditions forming
part of the tubercular cachexia. It is one circum-
stance among many : but if there is no tubercular
cachexia, mere rapidity of growth will never engender
Phthisis; but it engenders a debility which renders
the awakening of disease already existing in a tissue
extremely likely to occur : hence, if the tubercular
cachexia exists, such rapidity of growth will favour
the development of active disease in the tubercle.
314 a. Here again shines forth the glory of homoeo-
pathy. The old system physio can do nothing medi-
cally in these cases but what is in the majority of cases
mischievous. The old system gives its tonics, as the
medicines are ignorantly named: for what medicines
can be tonic? All medicines are poisons: it is true,
when medicines cure disease they improve the strength,
by removing the disease which caused the debility.
But in many cases these tonics very often cause that
degree of excitation of the nervous and the blood-
vessel systems, which favour the development of that
action in the altered tissue of the lungs essential to
the awakening into activity the tubercular degeneracy.
314 b. Homoeopathy, on the other hand, presents
medicines which, having a pathogenesis correspond-
ing to the symptoms which are produced in connexion
with the injurious action of rapid growth, enables the
homoeopathic practitioner, in exhibiting these condi-
tions, to . prevent the development into activity of
the phthisical cachexia, and thus saves the individual.
Among these medicines Calcarea stands pre-eminent.
106 DRUNKENNESS.
315. Another source of the debility necessary to
cause the awakening into activity of the lung tuber-
cle is supposed to be connected. -especially with a dis-
eased state of the stomach. "
316. Drunkards, Dr. Wilson Philip observes, at that
time of life which disposes to Phthisis, frequently fall
a sacrifice to this form of the disease ; and those who
have been long subject to severe attacks of dyspepsia,
and what are called bilious complaints, are liable to
it.-—Transaetions of the Medico Chirurgical Society, vol.
vii. p. 499.
317. This Phthisis Dr. Philip designated as Diges-
tive Phthisis, regarding it as a distinct species ; but
such an estimate is not a correct one, and the action
of the diseased stomach can be regarded only as pro-
ductive of a debility which, either when a tubercular
cachexia exists, or has already commenced its inroads,
will tend to cause that cachexia to assume a morbid
activity, and thus call forth tubercular Phthisis.
318. Indeed, so far from drunkenness being com-
monly a source of Phthisis, it more generally causes
the development of disease in other tissues. The
serous tissues are those on which the injurious action
of intoxicating stimulating drinks is exhibited: a re-
sult easily explained, since these stimuli cause an in-
creased action of the arterial vessels, which at last dis-
turbs the harmony and the balance of action between
these vessels and the venous vessels, and, in like order,
disturbs the harmony between the secreting capillaries
and the absorbing capillaries, and dropsy is the result
of such disturbance: very frequently, in the bag sur-
rounding the heart, the heart having been called into
excessive and irregular activity by the conditions of
life associated with those who profess to live a short
DEPRESSING rAss1oN. 107
life and a merry one : (sad indeed are they when the
merry one indicates by the hurried breathing, the
swollen and earthy yellow countenance, the dropsied
legs, the inability to lie down, that the shortness is
near its realization.) Forty-five is the age at which
such persons generally pass away.
319. In connexion with this injurious action of pas-
sion already detailed in a preceding section, it is to be
remembered that the lung weakness is often developed
under the excitement of the depressing passions, of
strong and of long continuance.
319 a. How commonly is Phthisis associated by the
many with disappointed love. How often does the
victim of affection, victimized by some profligate, pay
the penalty of her trust by a slow pining away—-end-
ing in the development of the dormant tubercle, caus-
ing death. These general beliefs have always some
truth in them. -
319 b. The views and the facts already brought for-~
ward, and those to be brought forward, will demon-
strate the necessity on the part of all those who have,
or think they have, a predisposition to Phthisis, to
regard carefully all their proceedings, to avoid all cir-
cumstances which may tend to develop this lung
weakness; being assured that with care, aided by the
occasional use of remedies suited to remove the special
cachexia, they will be enabled to resist the attack of
Phthisis, and pass from this scene of existence, so far
as Phthisis is concerned, at a good old age.
CHAPTER VI.
ON THE PREVALENT IDEAS RESPECTING THE INCURABILITY
OF PHTHISIS.
320. In the cure of Phthisis two points deserve at-
tention; the first is the special cachexia with which
the disease is in each case conjoined ; the second em-
braces the conditions resulting from the development
of this special cachexia, these conditions manifesting
themselves by positive symptoms ; which, besides pre-
senting the general characters of the Phthisis, exhibit
those special to each cachexia; thus, in relation to
cure, constituting each Phthisis a special Phthisis.
321. It is to the existence of the homceopathic pa-
thogenesis (for which, as already detailed, the world is
indebted to Hahnemann and his followers), that the
great truth, on which alone the scientific treatment
of Phthisis can be founded is deducible. Till the dis-
covery that each medicine has its special pathogenesis,
the other truth, that each phthisical case is the pro-
duct of a special cachexia, could not have been scien-
tifically or curatively recognised. Hence, all old
NUMEROUS CACHEXIE. 109
system writers write respecting a tubercular cachexia :
the enlightened homoeopathist proclaims that there
are numerous tubercular cachexiae, and to the effect-
ing a cure of these, when awakened into activity, the
homceopathist must find the pathogenesis, which in
its details exhibits exact similitudes to the symptoms
present in each individual Phthisis.
322. The correctness of this view will appear with
peculiar force when the features of each cachexia are '
marked out, which marking out will be found in a
subsequent chapter. '
323. This view ought to arrest the attention of
those allopathic and pseudo-homoeopathic practition-
ers who give cod liver oil to every phthisical patient ;
for, even allowing that cachexia may exist associated
with Phthisis, to which cod liver oil is, or rather the
active dynamized principles in cod liver oil are, cor-
respondent, such cachexia is only one among many.
How grossly unscientific, how far from “rational,”
must be the administration of this oil to all phthisical
patients.
324. No well, i. e. scientifically, founded expecta-
tion of the cure of Phthisis can be admitted, unless
resting upon the removal of the special cachexia.
325. An analogy exists between the condition asso-
ciated with the various forms of Phthisis, and the con-
ditions associated with dropsical effusion. Who knows
not that the mere mechanical removal of the fluid in
dropsy does not remove the disease? Who knows
not that the medicine which will effect a removal of
the fluid in one case of dropsy, will have no effect in
removing the fluid in another case of dropsy ‘P this
difference of effect resulting from the circumstance,
that the cachexial condition associated with the drop-
110 nAENNEc’s TESTIMONY.
sical effusion in the one case is quite distinct from the
cachexial condition associated with the effusion in the
other case.
325 a. As Dr. Jeanes judiciously remarks :-—-
“ This connexion of visceral disorder and dropsy
should also induce us not to bestow too much atten-
tion on the latter disease to the neglect of the other
symptoms, which are frequently of primary import-
ance. This is a mistake frequently made, and those
means which promise to remove the symptom which
is the most troublesome and afflicting to the patient,
are sought for with avidity. That remedies thus em-
ployed, incapable of abating or removing the morbid
actions, the primary source of the effusion, should pro-
duce only temporary palliation, and oftentimes not
eflect even this, is only what might be rationally ex-
pected, and what daily experience proves.”—(Homceo-
pathic Medicine, p. 91.)
326. The want of the recognition of these facts, viz.
the existence of special cachexiae, and the existence of
remedies which, on account of their special patho-
genesis, are curative of these special cachexiw, will
explain why those physicians best acquainted with the
pathological conditions of Phthisis, have no faith in the
curability of Phthisis by medicine.
327. Laennec states :—
“ The cure of Phthisis, although possible for nature,
is not for medicine,”--a dogma painfully illustrative of
the recognition by Laennec of the total ineflicacy of
curative means, and yet at the same time putting forth
an absurdity, that nature unaided is more powerful
than nature aided ; since medicine, if worth anything,
is only so as aidful of nature.
327 a. It is medicine that must cure Phthisis. Na-
FABLE or GELLERT. -1 1 1
ture acts, but her action, to be effective, must be regu-
lated by the agency of medicines. The fable of Gel-
lert comes most opportunely : it is thus embodied :-—
“Nature, in reference to the cure of disease, is
blind: man by himself, in reference to the cure of
disease, is lame. A fable of Gellert’s gives the history
of two men who wanted to reach the same place: the
one was blind, the other was lame. They discussed
how they should reach the place. The blind man
lamented that he could not see the way, the lame man
that he could not walls the way. They consulted
together: the lame man suggested to the blind man
to let him mount the blind man’s back, and then he
could guide him to their. mutual destination. The
blind man consented, and they both arrived in safety.”
—(Homoeopathy and its Principles explained, by John
Epps, M. D., p. 142.)
328. The alleged incurability of Phthisis is the de-
claration of an error. It is the creation of an impos-
sibility out of a difliculty. Its promulgation as a
truth, which it is not, realizes practically what Lord
Bacon has so well expressed thus 2--
“ Therefore I will not doubt to note as a deficience,
that they inquire not the perfect cure of many dis-
eases, or extremities of diseases; but pronouncing
them incurable, do enact A LAW or NEGLECT, and ex-
empt ignorance from discredit.”
329. All will allow that Phthisis is very diflicult of
cure; and the fact of the belief in the impossibility
of cure being so generally prevalent, is a demonstra- ,
tive proof that medical men have not realized the
cure : this being realizable only by the more carefully
conducted study of the curative powers of medicines
in accordance with the homoeopathic law.
1 1 2 EXPECTATIONS DEFEATED.
330. One difficulty connected with the cure of
Phthisis is connected with this, that almost all writers
who have studied the change of structure connected
with tubercular Phthisis have noticed, that, when the
tubercles begin to suppurate, fresh tubercles form
rapidly.
331. It is not denied that this disease is still the
opprobrium of the medical art; even now, years after
the discovery of the circulation of the blood, just as
much as it was two thousand years before the dis-
covery. One might suppose that this mighty dis-
covery ought to have led to great results in relation
to the treatment of disease in an organ such as the
lungs, with which the circulation of the blood has
so much to do.
332. It is true,—
That -every great was at first but little, and has
risen to importance and maturity by constant and
almost imperceptible additions; yet the reflection
comes with sadness before the mind, that notwith-
standing the great amount of knowledge, both in re-
gard to the doctrine of the natural action of the living
principle (Physiology), and in regard tothe doctrine
of the morbid action of the living principle (Patho-
logy) gained within the last two centuries, the pro-
gress of the doctrine concerning the treatment and the
cure of disease (Therapeutics) has been so little: in-
deed, with a few exceptions, most of the discoveries in
medicine were, till the time of Hahnemann, the results
of simple accident ; and in regard to the treatment of
Phthisis, all that medical men have contributed, giv-
ing them their favourite cod liver oil, is,-—
“ To promise returning health when it could not be
restored, to flatter misery with expectation of relief,
BACON 0N MEDICAL ART. 113
to sow the seeds of hope when experience promised
nothing but disappointment, to smooth the path which
fate had inevitably marked out for its victim.”--
(T3/rrell.)
333. Indeed, notwithstanding all the aid derived
from the employment of the microscope in studying
the changes in the bodily organs produced by disease,
the remarks of Bacon, made in relation to the system
of medical practice, apply, when the curative action
of old system physio is before the mind, to the treat-
ment of Phthisis :—
“ That though, from daily practice, it might be ex-
pected that physicians had formed correct rules of
treatment, nothing was discovered, on examining their
prescriptions, but temporary expedients and perplexity
of judgment.”--(Bacon, lib. i. De Augment. Scient.)
333 a. Such has been the case, though a priori it
might have been expected, that of all the improved
arts the medical, from its antiquity, its importance,
and, what is more, its necessity, would be
“ The first on the very first line, and that the finite
power of man would, long since, have reached the
goal, at which investigation and inquiry might halt.”
—-(Tyrrell)
334. That such results have not been arrived at is
well known: to the homoeopathist the reason of such
non-arrival is also well known; Such reason exists
not in any want of industry on the part of the indus-
trious men attached to the old system practice; but
is to be found in the circumstance, that that industry
was not well directed: and the cause of its not being
well directed is to be found in the fact, that the old
system practitioner was destitute of the knowledge of
the LAW regulating the action of medicines, the law
1
114 REASON or NON-SUCCESS
propounded by Hahnemann, Similia similibus curantur:
a law implying another knowledge to have been at-
tained to, viz.—that the powers of medicine must be
learned by experiments on the healthy.
335. Medical industry, from this cause, has been
labour misdirected ; knowledge, which has not found
the right way for its application; hnowledge not yet
become wisdom.
336. The query occurs, How does the HOMCEOPATHIC
treatment of Phthisis bear on the point of its CUBA-
BILITY?
337. It gives ground of legitimate hope, because it
enables the practitioner, who has studied the disease-
producing power of medicines upon the healthy, to
apply to the cure of a case of Phthisis, with the cer-
tainty of a law, the medicine which has the power of
producing phenomena similar to the symptoms which
are exhibited in the case under treatment ; and it fur-
ther, by teaching the homoeopathic practitioner that
the various pathogenetic effects of various remedies
correspond to the varying symptoms of the various
cases of Phthisis, extends the power of curative action
to the widest possible extent.
338. Hence it happens that Hahnemann, by his
labours both in ascertaining the pure effects of medi-
cines and in discovering the law regulating their ac-
tions on disease, enables the members of the medical
profession, when bowing, as bow they must (the pub-
lic will compel) to the grandeur of Hahnemann’s
genius, and to the utility of Hahnemann’s discoveries
and observations, to fulfil what Cullen predicted :-—-
“I have often regretted the impotency of physic
in consumption, and I have often wished to improve
this part of our art. I do not despair of a remedy
IN CURE or PHTHISIS. 115
being found hereafter: there is no satisfaction to be
derived from books.”
339. The basis on which the homoeopathic treat-
ment of Phthisis rests its superiority, admits of an
additional illustration :-
339 a. The homoeopathic use of medicines cures the
disease of worms, after the ineffective employment by
the old system of violent purging by scammony, aloes,
calomel, turpentine, &c. &c.,. and this cure is effected
by the medicines, because acting homoeopathically in
removing the intestinal cachexia which favours the
generation of worms. The rudiments of worms exist
in most; but unless the worm-producing cachexia
exists, the worms lie dormant : if the cachexia exists,
all the purging that can be practised will never re-
move the worms; whereas, when the intestinal ca-
chexia is cured, the worms formed are expelled, hav-
ing no appropriate developing conditions, and no
others are called into existence. '
339 b. And, further, as the worm cachexia varies in
relation to each worm, so the medicines having the
power of producing phenomena, homoeopathic to the
symptoms of each, will act curatively in relation to
the removal of each species of worm, and of the symp-
toms thence arising.
339 c. To conclude. Homoeopathy opens up the
legitimately founded hope of the cure of Phthisis ;
legitimately founded, first, because homoeopathy pre-
sents a law, by which the action of medicines on the
diseased body is regulated : a law which makes it cer-
tain that, if a medicine can be found which has the
power of producing symptoms similar to those present
in the disease, it will cure the disease so medicinally
homoeopathized: second, because homoeopathy pre-
116 HIGH GROUND TAKEN.
sents, by the vicarious sufferings of Hahnemann and
his followers, a knowledge of the pure effects of medi-
cines: and, third, because the law being true, and the
knowledge of medicines being sufficiently extended as
to embrace medicines which produce pathogenetic
efiects, which cover, i. e., homoeopathize, the special
phenomena present in every special case of Phthisis,
the use of such medicines must be curative.
339 (I. These views present very high ground: the
justification of them will be found in the facts and
the views promulgated in the next chapter.
CHAPTER VII.
ON THE TREATMENT OF PHTHISIS.
SECTION I.—Some Remarks on the Plan adopted.
340. The consideration of this, the ultimate object
towards which all the preceding investigations-, facts,
and views tend, will be worked out in reference to the
action of ‘medicines in connexion with the various
stages of the phthisical disease.
341. Such consideration, to be complete, will re-
quire a notice of all the symptoms which occur in the
latent and the premonitory stage, the first, the second,
and the third stages of Phthisis, and the affixation to
each symptom, group or groups of symptoms, the in-
dividual remedy or remedies : a labour not slight.
342. Great have been the difliculti-es which the
writer has met with in completing this chapter.
342 oz. Various have been the plans that he attempted
in order to bring the immense mass of material into
an order that would be sufiiciently lucid to enable
others to understand the views and the facts intro-
duced.
118 THE CALCAREA CAOHEXIA.
342 b. After much consideration, the writer has
adopted the plan now presented to the reader. He
has taken one medicine, CALCAREA, the most effective,
as evidenced by its pathogenesis (note to c. page vi.
Preface), in curing the cachexia most commonly asso-
ciated with Phthisis ; and so effective, because the in-
dividualities of its pathogenesis correspond most mi-
nutely to the indications present in the cachexia most
commonly associated with this disease. In other
words, the law, SIMILIA SIMILIBUS CURANTUR, has an
application most general and most special in connexion
with this remedy and the phthisical disease.
343. To go through all the phenomena of the dif-
ferent stages under which Phthisis presents itself, and
to combine therewith the effects of the medicine, and
thus to show the similitudes between the phenomena
of the disease and the pathogenetic effects of the medi-
cine, will be to give to the treatment of Phthisis a ‘
rational, a scientific character.
344. After having established this relationship of
similitude between the pathogenetic effects of Calcarea
and the symptoms of the phthisical disease, the same
process will be pursued in connexion with another
medicine, LYCOPODIUM, and thus will be discovered
the special symptoms of another phthisical cachexia,
and the adaptability of Lycopodium to these symp-
toms, these being placed in the relationship of simili-
tude to the pathogenetic effects of Lycopodium. Thus
the Lycopodium cachexia will be worked out.
345. The same course will be followed with each
succeedingmedicine, until the chief medicines having
the relationship of similitude to the various phthisical
cachexiae will be worked through.
346. The labour required in effecting these exami-
SIMPLICITY or GURE. I19‘
nations and applications has been enormous, and the
writer feels that, with all his labour, the work is still
imperfect. Still he thinks he may claim this : viz. the
having suggested a course which, others pursuing, will
enable them effectively to work out the deliverance of
the medical art from the opprobrium hitherto attached
to it, of not being able to cope with Phthisis. The
writer is quite sure that the course laid down is the
right one, and he will be glad of any facts from others
which may help to complete the application of the
law S. S. C. in the use of the medicines homoeopathic
to the various cases of Phthisis.
347. In carrying out the course stated, it appears
to the writer that it will be beneficial, as opportunities
occur, to notice the character of the old system treat-
ment, i. e., to examine the means which the old sys-
tem practitioner employs in relation to the symptoms,
the homoeopathic treatment of which is under descrip-
tion ; this both giving an opportunity of showing the
superiority of the homoeopathic treatment, and de-
monstrating, with an irresistible clearness, the blind-
ness of the conceit, and in many instances the phari-
saical complacency, of the allopathist, who, calling his
own system the “rational” system of medicine, thanks
the god of his pride that he is not as the poor homoeo-
pathic “ publican.” The comparative view will at the
same time exhibit the scientific simplicity of the treat-
ment adopted by the homoeopathist, contrasting vividly
with the complicated empiricism of the allopathist.
348. Indeed, it is the recognition of the truth, that
the homoeopathic treatment of Phthisis has for its
basis A LAW, which alone could sustain one in going
through the labour required in this investigation : the
labour, being thus regulated, cannot be lost.
120 ACTION or ACONITE
SECTION II. — On the Treatment of the Premonitorg
Stage. '
349. Prominent among the phenomena of the pre-
monitory stage is the bleeding from the nose (epistaxis)
(100).
350. Many medicines produce, as their pathoge-
netic effect, nose-bleeding ; but, of these medicines,
two in particular, namely, Aconite and Calcarea, have
a great correspondence with the symptoms attendant
upon this symptom of the premonitory stage.
351. Aconite has the power of producing that pecu-
liar vascular excitation, designated technically as ERE-
THRISM, which so generally attends the age of puberty,
of which age this nose-bleeding is so common a con-
comitant.
351 a. Aconite, further, is homceopathic to that
peculiar sense of fulness of the chest, so common at
the age of puberty, more especially so where the con-
ditions of the lungs connected with tubercular dis-
ease are present. Thus Aconite produces pathogenetic
effects :—-
(272.) He feels a weight in the chest : he feels as if the whole chest were
being compressed from all sides.
(266) Oppressive anguish in the cavity of the chest, and oppression in the
right side of the chest, afterwards in the whole chest.
351 b. Aconite produces as its p. e. :—- it
(107.) Bleeding from the nose.
351 c. Aconite produces as its pathogenesis all the

* The contraction p. e. is used for pathogenetic efiect.
IN BLEEDING or THE NosE. 121
phenomena of inflammation (phlogosis) ; thus, in the
head it produces p. e. :-
I (62.) Burning headache, as if the brain were moved about by boiling water.
(66.) Very hot in the whole head towards evening, which then becomes very
painful, especially in front, continuing the whole evening (about eleven hours).
In regard to the face, Aconite produces p. e. :—-
(7 0.) Sensation as if the checks were much swelled.
In regard to the eyes, aconite produces :—
(91.) Very painful inflammation of the eyes.
(29.) Sensation of the eyes being much swelled.
In - regard to the body generally, aconite produces
P. 9. I-—-
(375.) Swelling of the part upon which the juice has been laid, and burning
heat, succeeded by excessive suppuration.
(37 6.) Sense as of burning and tingling gradually extends through the
whole body, especially through the arms and the feet.
(465.) Towards evening burning heat in the head and face, with redness in
the cheeks, and headache pressing from within outward: at the same time
chills over the whole body, and thirst.
351 d. Now, from these pathogenetic effects, it ap-
pears that Aconite will be suited to conditions where
the bleeding from the nose, or the bleeding from the
lungs, is present in an individual having symptoms of
inflammation, or of increased vascular action ; and
hence, when so continued, Aconite will be curative of
such bleeding.
351 d. a. Persons so afflicted are particularly liable
to fits of fainting, which Aconite produces in the p. e. :—
(454.) Fits of fainting, with chilliness.
351 e. Another reason why Aconite is so eficacious
in the treatment of this bleeding from the nose, is to
be found in the truth embodied in the following prac-
tical remarks, made by Hahnemann in his introduction
to the pathogenesis of Aconite. Hahnemann states :—-
122 ACTION or CALCAREA
“ Aconite is indispensable for females who suffer
from fear or contrarieties during the catamenia.”
The catamenial discharge has been already shown
to be connected with the age of puberty, at which
time the bleeding from the nose takes place; hence,
from the synchronousness of these two actions, it is cer-
tain that Aconite must have an important relationship
to conditions of the lungs at this period of life devel-
oping themselves.
352. It is, however, in the action of Calcarea that
the cure of the cachexia which causes the bleed-
ing of the nose is to be chiefly sought. An examina-
tion of the pathogenesis of Calcarea exhibits the fol-
lowing effects in connexion with its power of produc-
ing bleeding from the nose :-—
(380.) Flowing from the nose of a blackish blood.
(381.) Considerable bleeding of the nose (during ten days).
(882.) Some bleeding of the nose at nights (during ten days).
(383.) Bleeding of the nose early in the morning.
(384.) Violent bleeding of the nose as from a considerable opening of a vein,
almost to fainting.
353. Old system physic, which its practitioners
have the conceit, as already stated, to designate the
rational, puts forth as one of the arguments in justi-
fication of bleeding in the premonitory stage of Phthi-
sis, the fact of the occurrence of the bleeding of the
nose in this stage of the phthisical disease. It is said
by these logicians, See, Nature tries to relieve the
patient by causing a discharge of blood: and then
they ask, Why should not the medical practitioner
follow her example? The reasoning embodies a beg-
ging of the whole question, namely, that the bleeding
from the arm produced by the lancet is similar to that
which nature causes when establishing a bleeding
from the nose. Had these men been true logicians,
IN BLEEDING or THE NOSE. 123
had they been capable of understanding right reason-
ing, they would have recognised that this should have
been proved at the outset, viz., that the discharge of
blood which they cause from the arm is attended
with the same conditions as those which attend the
bleeding from the nose: they assert but do not prove.
Indeed, the bleeding from the nose, as induced by
nature, is preceded by a special action of the nervous
system in connexion with the vessels of the nose,
causing these vessels to appropriate to themselves a
proportion of the blood greater than is in a healthful
relation to their containing power. A truly rational
system of medicine would at once dictate, that the in-
dividual who could remove the special action by ex-
hibiting a medicine which will alter the state of the
vessels, and of the nerves of the nose, is the only sci-
entific procedure, and that it is pure empiricism, and of
the most vulgar kind, which acts on the belief that the
removing a certain quantity of the circulating fluid
by making an incision in a vein, is an imitation of
the beautiful steps of nature.
353 a. It is true that Tyrrell relates, when a fat
unexercised horse is galloped to what, in sporting
phrase, is termed “ a stand-still,” it will take five min-
utes or more of perfect rest to reduce the oppressive
breathing and congestion thus established; but on
opening “the two jugular veins the recovery is in-
stantaneous : the equilibrium is at once restored, the
quantity of blood in the lungs is diminished, and the
volume of air increased.”-—(Tyrrell, p. 46.)
These facts may be granted, but they present no
analogy to the conditions connected with the state
precursory to Phthisis. The one presents a mechani-
cal obstruction, the other presents a diseased obstruc-
‘124 V CALCAREA, ITS ACTION
tion. Add to this another fact, that the pulmonary
system of a horse is very‘ different from that of a man,
the horse having eight pulmonary veins, man has
four only.

354. Among the phenomena which appear as illus-
trative of the phthisical cachexia, is the symptom of
ulceration of the larynx.
354 a. Among the pathogenetic effects of Calcarea
stand the following :—-
(1015.) T h e th r o a t (kehle) is r a w, especially early in the morning.
(1016.) Rawness of the top of the throat, with pain in swallowing.
(1025.) A piping in the top of the windpipe after lying down.
(1020) Tickling irritation in the windpipe, which provokes cough.
354 b. It will be found, on examining the pathoge-
nesis of nitric acid, that this medicine has a greater
homceopathic relationship to this state of the throat
than is possessed by Calcarea in its pathogenesis.

355. Among those affected with the phthisical ca-
chexia, an eruptive condition, represented by the
freckle, is not at all unfrequent: such freckle is often
in the summer in most young people when exposed
to the country air; but in the phthisical, having the
freckle, it is almost constantly present, i. e., whether
the individual is in or not in the country.
355 a. Calcarea has the power of producing the
following p. e. :—-
(416.) White spots in the face, with itching.
(419.) Many pimples over the whole face, with bad itching.
355 b. It will be found hereafter that the power of
As To TAKING COLD. 125
producing freckles belongs more to Lycopodium than
to Calcarea.
356. One striking characteristic of phthisical ca-
chexia is the liability of the individuals, whose consti-
tutions are modified by this cachexia, to sweat on the
slightest exertion. '
356 a. Calcarea produces this condition :—
(1616.) Sweat in the day on the slightest exertion.
357. Another liability exhibited by persons under
the influence of the phthisical cachexia, is that of easily
taking cold (107).
357 a. Calcarea has the power of producing this in
a marked degree, as is evidenced by the following
Pd en :-
(1446) Great sensitiveness to cold air, the feet feel as if dead.
(1447.) Upon the least cold air being felt, goose skin is produced, both on
the upper and lowerpart of the thigh, so much so as to be painful.
(1451.) Whenever the individual walks in the open air he becomes sad and
weeps.
(1452) Going into the open air produces oppressive headache, at the top part
of the head, which continues until he goes to bed.
(1453.) Upon going into the open air there is a visible swelling.
357 b. An indication of cold taken is sneezing :
Oalcarea has considerable power in producing this
state, as is evidenced by the following p. e. :—
(986.) Frequent sneezing, without running at the nose.
(987 .) Sneezing many times daily.
(996.) Stoppage in the head, with much sneezing.
(997 .) Attack of cold, and stoppage of the head, with sneezing first seven days.
(998.) Cold, with stoppage of the head, with much sneezing. i
(1006.) Flow from the nose, with much sneezing.
358. One of the most characteristic features of
126 MIND-ACTION or CALCAREA.
Phthisis in all the stages which it passes through, is
the variation of the mental state (109.) : hope, in many
cases, preponderating.
358 a. Calcarea has a power similar hereto. It
produces p. e. :-
(61.) The first part of the day he is anxious, the latter part of the day he is
cheerful and satisfied with himself. (L. g. h.)
358 b. In regard to this production of hopefulness,
it is not expected that any remedy will produce hope-
fulness as its primary action, because medicines being
poisons, will not, it is likely, have the power of pro-
ducing hope, which is a condition of health. But as
this feeling of hopefulness must be developed when
the patient is under states in which the symptoms are
alleviated, it is not impossible to find a remedy which,
in its secondary or more strictly its curative action,
may produce the state of hopefulness: that is, a medi-
cine may have the power of producing conditions
which have adjoined to them the state of feeling de-
signable as hopefulness : that is, it may exert so far a
curative action as to awaken a state of brain which
may cause an activity in that part of the cerebral
mass associated with this particular feeling.

359. A symptom not unfrequently present as in-
dicative of the phthisical cachexia, is the occurrence
of “ bad eyes” in the patient, if not at the time of the
development of the cachexia, oftentimes in the child-
hood of the individual.
359 a. Calcarea has the power in a marked degree
of producing “ bad eyes,” as seen in the following
p. e. :— _
(255.) Itching in the borders of the eyelids.
I’
ITCHING or THE EYES. 127
(256.) Itching in the eyes in the evening, and aching early in the morning.
(257.) Bad itching eyes.
(258.) Itching in the corners of the eyes.
(259.) Itching in the right inner corner of the eye.
(260.) Itching of the eyes in both corners.
(261.) Tickling itching in the right outer corner of the eye, and a desire to
rub (twenty-five hours). 7
(269.) Burning and itching in the eyes (eight days).
360. It not unfrequently happens that patients, in
whom Phthisis becomes developed, have either had,
immediately precursory to the development, or at an
early period of life, a discharge from behind the ears.
360 a. Oalcarea hasthe power of producing in a
marked degree this condition, as is exhibited in the
following p. e. :—
.(340.) An eruption behind the right ear.
(341.) A boil before the left ear, which, when touched, pains like an ulcer.
(342) A boil under the ear lappet, which, by chewing, pains like a strain
the jaw joint.
361. Falling of of the hair is another indication of
the phthisical cachexia.
361 a. After severe fevers the hair falls off: a result
indicative of the great change induced in the system
by the fever. The falling off of the hair may take
place quite independent of any phthisical disease : but
it not unfrequently happens, that from the change in-
duced in the constitutional state by the fever, the
phthisical cachexia becomes called into activity, and
Phthisis proceeds.
361 b. It is, however, in cases where, without any
precursory fever, the hair falls off, that this symptom
indicates the existence of the phthisical cachexia.
128 CHEST-ACTION or
361 c. The following p. e. of Calcarea exhibits
the power this medicine has of producing the hair
falling :—
(336.) Her hair combs off.

362. To revert to the bleeding from the nose, as in-
dicative of the phthisical cachexia.
363. It will be found from the pathogenetic effects
already recorded, (paragraph 352), that Calcarea is
more suited, in the majority of cases, to the bleeding
from the nose than is Aconite; so, in other symptoms
conjuncts with this bleeding.
364. Thus, in the premonitory symptoms of Phthi-
sis, a symptom is present of a fulness in and a tight-
ness across the chest. (100). What can be more cha-
racteristic of, and homceopathic to, this state than the
following p. e. :— ‘
(1075.).A narrowing of the chest, as if it were too full
and puffed up with blood.
365. Add to this the p. e. :—-
(1109.) Anxie ty in th e chest (the first day.)
(1110.) A feeling of anxiety in the chest as if it were too narrow, with short
breath, especially in sitting, and aching at the chest especially when breath-
ing: the heart beats uneasily, with trembling.--(W. C.)
366. Another symptom present in the premonitory
stage, as well as in the other stages of Phthisis, is the
spitting of blood (haemoptysis). (101).
366 a. In homceopathic relationship to this is the
p. e. :—-
(1055.) Early in the morning, after swallowing, he must cough violently,
whereby he often spits blood, followed by darting (or pricking?) in the palate.
. 367. In the prevention of the destructive progress
of Phthisis, nothing is more important than the cure
~srrrTINor or BLOOD. 129
of the state of the lungs connected with this spitting
of blood. ‘
368. Dr Walshe (p. 504, lib. cit.) records the fol-
lowing :--
“ Heemoptysis, including under this term even ex-
pectoration simply streaked with blood, is a symptom
of extreme frequency, occurring, as I formerly found,
(British and Foreign Medico- Chiruryical Review, Jan.
1840), in about 81 per 100 of cases.”
369. The writer’s experience coincides with this
statement.
370. It becomes, therefore, of importance to recog-
nise the fact, that Calcarea has the power of producing
expectoration of blood, as is evidenced by the patho-
genetic effects already quoted.
371. From these effects it becomes certain, that
Calcarea will have a curative power in relation to this
state of blood-expectoration; and if its use be com-
bined with certain conditions, which will be detailed
in the Chapter on the Influence of the Air in con-
nexion with the Cure of Phthisis, the progress of the
disease will be, in the majority of cases, arrested.
SECTION III.—-The Treatment of the First /Stages of
Phthisis.
372. The first symptom recorded in connexion with
the first stage of Phthisis, was emaciation. ‘
373. This was regarded as a result of the exhaus-
tive efforts of the system in the attempt made, but
made blindly, to resist the progress of the lung dis-
ease; and, as such, most medicines, from the fact that
K
130 THE CALCAREA COUGH.
they are Ydisturbersl of health in their character as me-
dicines, will have the power, Calcarea among the rest,-
of producing a state corresponding to this. “ _
374. The second symptom was that of the produc-
tion of a dry cough. The query occurs, What isthe
homoeopathic relationship in which Calcarea stands by
its pathogenesis to this symptom ?
37 4 a. Calcarea produces the following p. e. :-—-
(1042 .) Dry cough, especially at night.
(1032.) Evening, especially in bed, a dry cough. (About two days.)
(1037.) At night, after midnight, a dry cough, with a beating of the heart
and the arteries. I
374 b. In relation to the phthisical night cough,-
how common is it for the poor sufferer, and the anxious
family, to dread the coming on of the night, on ac- '
count of the expected but painful repetition of the, at
the time, never-ceasing cough.
374 c. The p. e. already quoted
(1037.) exhibits a very common concomitant in conjunction with the cough
of Phthisis, namely, the beating of the heart and of the arteries, and conse-
quently proves the relationship which Calcarea must have in its curative agency
with this state of the phthisical disease.
375. A feature, connected with the cough of Phthisis
is, that it is often attended with running from nose
(coryza) and eyes. To this Calcarea has a correspond-
ing p. e. :—- -
(1026.) Cough with coryza. , g
(1039.) Cough mostly in sleep; therewith first dry, then moist coryza.
375 a. The almost essential connexion between
Phthisis and-the coryza condition is exhibited in the
fact, that some superior writers on phthisical disease
have maintained that every case of Phthisis is con-‘
nected with coryza.
376. The peculiar irritation excitative of cough in
THE GALGAREA coUGH. 131
Phthisis is characteristic, and is analogized by Oalcarea
in the following p. e. :—
(1027 .) Tickling cough, as from eider-down in the throat.
377. It was noticed (118.), that, as the first stage ad-
vanced, the cough ceases to be dry, and becomes at-
tended with expectoration.
377 a. Oalcarea represents this in the p. e. :—
(1047 .) Mucous cough from time to time.
37 7 b. The peculiar character of the cough in
Phthisis, in connexion with this mucous expectoration,
is strikingly analogized by the p. e. :—
(1048.) Expectoration of mucus early in the morning, with hacking cough.
(1046.) Much cough, with expectoration of mucus, in the evening, after
lying down, and at night; by day, only a little, and a dry cough.
(1045.) Cough, with much tenacious expectoration, which is tasteless and
without smell, early in the morning and evening in bed.
378. A third symptom in the first stage was the
expectoration of streaks of blood ; and to this symptom
Oalcarea analogizes in the following p. e. :—
(1053.) Expectoration of blood through coughing and hawking, with a sense
of rawness and a wounded feeling in the chest. See also 1054, p. 128.
378 a. The first pathogenetic effect represents the
pain present in the chest (Symptom VIII.), in con’-
nexion with the cough; and the pathogenetic effect
(1055.) p. 128, presents a symptom-“ stitches in the
palate ”--which is not unfrequently connected with
the cough of the phthisical character.
379. In the second and third stages, the expectora-
tion oftentimes has a colour, a taste, and a smell. It
is often sweet. Calcarea carbonica produces p. e.
corresponding hereto.
132 EXPECTORATION.
379 a. __In regard to colour :-- ‘
(1051.) Cough early in the morning, with yellow expectoration (about .five
days.)
(1052.) The cough becomes loose, and whole pieces, resembling pure pus,
are expectorated. (G. E.)
379 b. In regard to the taste of the matter ex-
pectorated :—-
(1059) During a violent cough in the evening, there was a sweet substance
expectorated.
(1050.) He expectorates a sweetish--tasting mucus by coughing.

380. As a tubercle is a foreign body, it must cause
by its presence some irritation. (A thorn in the
finger, a foreign body, produces irritation.) The
change in the tissue round the tubercle constitutes
another foreign body, which itself must cause irrita-
tion. Indicative of this irritation induced, as the
disease in the tubercle and the tissue surrounding ad-
vances, is the irritative fever that arises; so that pre-
ceding suppuration there will be inflammatory symp-
toms. . P
380 a. Exhibitive of this irritation is a fifth symp-
tom in the first stage of Phthisis, THE CHEEKS ARE
' FREQUENTLY RED. .
380 b. Calcarea Carbonica corresponds to this in its
Po ea :—-
(396.) Great redness and heat in the face frequently.
(39/4.) Continued and bloated redness and heat in the face.
(1609.) Glowing heat and redness of the face, with a heated forehead and
great thirst, many hours. (Lgh.‘)

381. A sixth symptom in Phthisis is, THE PALMS or
.THE HANDS AND THE SOLES OF THE FEET ARE BURNING
381 a. Galcarea carbonica has a p. e. corresponding
in some respects thereto :—-
HANDS AND FEET BURNING. 133
(1238.) The vessels of the hand enlarge, with a sensation of burning at the
back of the hand.
38 1 b. But the correspondence is more marked in
the following p. e. :-
(1-103.) Burning in the palms of the hands and in the soles of the feet.
(1369.) Burning in the soles of the feet.
(1523.) At night, interior heat, especially in the feet
and in the hands, and early in the mornin g, a dry tongue, without
thirst, with exterior heat of the head (about six days). I
382. A seventh symptom in these stages of Phthisis
is the orrnsssnn BREATHING. _
383. To this Calcarea carbonica has p. e. strikingly
analogical :—- '
(1074.) Tightness of chest. She wants breath.
(1075.) Tightnes s of chest, and as if it were too full,
and filled up with blood. _ _
(1076.) A tight feeling from fulness of the chest, early in the morning when
rising, as if the lungs could not expand enough in breathing. Going away
after some expectoration.
(1064.) Frequent necessity to take a deep breath.
384. An eighth symptom is, the PECULIAR UNEASI-
NESS present in this stage.
(1418.) Restlessness, so that he is obliged to move his hands and feet.
(1419.) Great restlessness in the evening, especially in the limbs; he cannot
keep them still.
385. A ninth symptom present in this first stage,
indeed in most stages of Phthisis, is the QUICK PULSE.
385 a. Calcarea carbonica has a p. e. analogous to
this :-
(1585.) A quick pulse, without a feeling of fever.
385 b. This strikingly represents the state of things i
in Phthisis, for the ‘pulse travels quick, without any
fever proportional.
134 ~ PULSE QUICK.
386. It is allowed that fever is present in Phthisis ;
in fact, there is generally a hectic fever, and during
the heat thereof the pulse’s- frequency is increased ;
but the pulse is rapid whether the patient is cold or hot.
38 7. It is true that many medicines cause a rapidity
-of pulse; yet the selection of Calcarea for the removal
of the rapid pulse of Phthisis rests not simply on the
fact that Calcarea produces a quick pulse, but upon
the additional fact, that its other numerous -patho-
genetic effects are so strictly in accordance with the
symptoms of the ph~thisical disease.
I_—_------
388. A marked feature in the second stage of Phthi-
sis is THE PRODUCTION or swEAT. _
389. In this Calcarea carbonica is analogous to the
phthisical disease to a greater extent than perhaps any
other medicine. “ _l
390. The following is extracted from a lecture on
Calcarea (see PREFACE), delivered to the students in
the year 1856, by the writer :-—-
“ Calcarea produces sweat on all parts of the
body; on some more remarkably than on others. It
will be useful to notice its action in this respect, first
on the bodily surface generally, and then on special
parts of the body. .
“ In relation to the system generally, the follow-
ing p. e. are illustrative :-— " ' '
(1-196.) In the evening, asleep, weariness in all the limbs, with coldness.
- He cannot prevent himself from sleeping; yet he does not sleep soundly, but
wakes repeatedly for a time (sixteen hours long). Early in the morning, much
sweat and dryness inthe throat, without thirst (about four days).
“How strikingly does this correspond with the-
CALCAREA SWEAT. 13.5
phenomena connected with the development of the
sweat which occurs in Phthisis. ’
“ The characteristic of the sweat produced by
Calcarea is, that it is produced early in the morning,
and often in the midst of or as the sequel of great
agi_tation._ _ q _ p ‘ '
“ In regard to the agitation, the disquiet, the fol-
lowing p. e. is striking :—
(1610.) Long continued heat, which makes him weary and anxious, until a
sweat breaks out. .. . - . ' ‘
(1503) He can scarcely sleep at aH the whole night ; he tosses about much-
and sweats over the whole body ‘(about ten hours). (Lgh.) '
I (1628.) Evening fever, exterior cold, with interior heat and violent thirst, in
bed; he is cold also, and he sweats afterwards; is able, however, to get warm;
finally, he sweats abundantly (ten hours). ' '
“ The sweat, as already stated, takes place in the
morning :—
(1624.) Early sweat every morning (about seven days).
(1621.) Profuse early sweat many mornings, one after
the other. - .
(1622.) Early sweat (the following morning).
(1623) Early sweat three mornings in succession.
“ Another characteristic of the sweat of Calcarea
is, that it is excessively exhausting z---
(1612.) Almost constant sweat.
(1613.) Much sweat, as well in the day when walk-
ing, as also in the night in bed.
(1614.) Exhausting sweat, day and night, three whole days long.
(1 615.) Profuse sweat in the day, with cold air.
(1617 .) In the evening he becomes suddenly warm, and sweats the whole
night. -
“ While producing sweats generally, Calcarea pro-
duces also local sweats. . .
“ It causes, in a marked degree, sweats in the head.
“ Oalcarea produces sweats in the back :-
(1619) Night sweat on the back. a ‘
136 CALCAREA SWEAT.
“ Calcarea produces sweats on the legs.
(1620.) Night sweats only on the legs, and sticky to the touch, (for some
days.)
“ This character of stickiness is well worthy of no-
tice; for in many cases of Phthisis sweat is present
only on the legs, and the sweat itself is quite sticky.
“ Calcarea produces sweat on the knees.
_(1325.) Sweat on the knee.
“ It produces sweat on the feet.-
(137 3.) Sweat on the feet towards evening.
“ In regard to this power of producing local sweat,
Calcarea presents the following p. e. :—-
(1630.) Every forenoon, at 11 o’clock, fever heat, without thirst and without
cold before, one hour long. She feels herself hot, and is so to the touch, with a
countenance somewhat red; thereupon anxiety and a gentle sweat, especially
on the hands, the feet, and the face, four successive days (before the catamenia).”
391. Such are the effects of Calcarea in relation to
the production of sweat, and hence its power in curing
-the sweats of the phthisical.
392. In reference to the sweats of Phthisis, how
sadly irrational, how truly empirical, is the treatment,
followed by those who practise the old system medi-
cine, and which they have the conceit to call rational
medicine.
393. In Phthisis, one of the phenomena is the occur-
rence of night sweats. These sweats are found to be
veryexhausting tothe constitution of the patient, and
therefore it is argued, and argued rightly, they must be
~arrested. The old systemists give their sulphuric acid
and other means to arrest these sweats, forgetting alto-
gether that these sweats are merely an effort of nature
OLD SYSTEM TREATMENT. 137
to relieve the lungs. What happens ‘P Directly, or
almost directly, the old systemist has arrested the
sweats, (arrestis not cure), Nature, stopped in her cura-
tive eiforts in that direction, attempts to relieve the dis-
eased state in the lungs by exciting an action in the
bowels; and~ she institutes a diarrhoea. N ow this
diarrhoea the old systemist finds is very weakening;
he therefore supplies the patient with means, called
astringents, to arrest the diarrhoea. He succeeds,
it may be, in arre_sting the diarrhoea, and then the
breathing gets worse, and the cough augments in
severity. He then gives medicines to arrest the cough,
and again do the night sweats appear. Again he tries
to arrest the night sweats, and the diarrhoea appears,
and thus he proceeds till the end of the struggle is in-
dicated by DEATH: and yet the old systemist is the
rational practitioner.
O wad some power the giftie gie us
To see oursels as others see us 1

394. In regard to other symptoms in homoeopathic
relationship with Calcarea, an opportunity will be
afforded to bring them forward more impressively in
connexion with conditions which are to be hereafter
noticed.
~—
395. Sometimes delirium occurs as the disease ap-
proaches its termination, although this is relatively
rare when the patient is under homoeopathic treat-
ment.
396. Under old system treatment, the occurrence
138 DELIRIUM or PHTH_ISIS.' >
of delirium is not unfrequent: a circumstance de-
pendent on the empirical character of this mode of
treatment. This empiricism is exhibited in the at-
tempt to subdue the cough by the employment of
opiates and of narcotics, the necessary consequence of
which is an irritation of the brain by the action of
these medicines.
397. When delirium does occur in a patient treated
homoeopathically, it is pleasing to see, how~completely
he is under. the power of the appropriate homoeopathic
remedy. ~-
398. case which years since attracted strongly
the attention of the writer, was that of a young lady
whose death by Phthisis caused great regret. She
was one of those who help to verify the idea that
Phthisis takes off the most~ lovely, the most intelli-
gent, the most amiable. This young lady was at-
tended by one whose loss is ever to be lamented, the
late Dr Curie. He had saved the life of a sister, who
had every characteristic of phthisical disease. He at-
tended the sister, who became as death approached
very delirious. Dr. Curie was appealed to by the
gentleman who was, had. the lady lived, to have be-
~come her, husband. Dr. Curie with noble honesty
stated that he could do no more for her: it was the
delirium of death. The gentleman came to the
writer, who ordered a sixth part of a drop of the third
dilution of Belladonna, a dose every few hours. I The
delirium was wholly subdued, and the patient died in
peace. ‘
399. This result indicates that the duty of the
medical man exists as long as life lasts, verifying the
sageness of the remark, “ What right have we to say
-Death till God has sent it?”
LYCOPODIUM cAoHEx1A. 139
SECTION I V.—On the Lycopodium Cachexia, as illus-
_trated in the Conditions under which Lycopodium can~ '
be employed in Phthisis.
400. The pathogenesis of Lycopodium is consider-
able, being comprised in sixteen hundred and eight-
effects, recorded. by Hahnemann in his work on Chronic
Diseases. . ~
401. Among these effects those having a homoeo-
pathic relationship to the symptoms present in Phthi-
sis will be noted, and thus will be discovered the
phthisical cachexia, which, from its correspondence
to the Lycopodium cachexia, can be cured by Lyco-
podium. , - H .
402. A phenomenon of the premonitory stage of
Phthisis was a bleeding from the nose (100).
403. The -homoeopathic relationship of Lycopo-
dium hereto is exhibited in the following p. e. :—
(32 6.) A blowing out of bloody mucus (about six days).
i (327) A blowing out of clotted blood (about eleven days).
(328.) A violent bleeding from a little wound in the nose in the evening when
taking a walk (about thirty-two days).
(329.) Bleeding of the nose three days one after the other in the afternoon at
two o’clock.
(330.) Two bleedings from the nose in one day (about twenty-six days).
(331.) Violent nose-bleeding, and thereafter frequent blowing out of blood
(about twenty days).
404. In these effects the pathogenesis of Lycopo-
dium corresponds with that of Oalcarea, and hence
both are homoeopathic to this symptom of the pre-
monitory stage of Phthisis: the speciality, of ~Lycopo-
dium being represented by _the effects 329 and 328,
140 cnnsr TIGHTNESS.
which represent the bleeding as occurring in the after-
noon at two, and in the evening: the special indica-
tion of Calcarea being that exhibited in the p. e. 283,
in which the bleeding takes place early in the morn-
mg.
405. Connected with this premonitory symptom,
bleeding of the nose, was the symptom of a tightness
(a fulness) at the chest (100).
406. To this symptom Lycopodium analogizes in
the following p. e. :-
(990.) Tightness at the chest (some hours).
(991.) Like a sprain at the left breast.
(992.) Tightness in the breast.
(994) Tightness and aching in the chest, which oppresses the breathing,
alternating with distention of the belly, in the evening.
407. Here it will be seen that the pathogenetic
effect is characterized by its production in the even-
Hlg.
408. Another symptom present in the premoni-
tory and also in the first stage of Phthisis was a pain
in the chest. _
409. This Lycopodium represents in the following
p. e. :—
(995.) Pain in the breast (ten days).
(996) Pain in the left breast, G. H.
(997) Pain in a small place, in the true ribs, under the left armpit, G. H.
(998) Pain as from a knob (knopfe) upon the right true ribs.
(999) Pain and aching as of a wound in the breast.

410. Another symptom present in the premonitory
stage of Phthisis is that of easily taking cold (107)
' 410 a. Lycopodium produces this state, as is ex-
hibited in p. e. :—- -
- (1376) Very liable to taking cold.
SNEEZING, ETC. 141
4.10 b. An indication of this liability to take cold is
presented in sneezing, which Lycopodium produces, as
seen in the following p. e. :—
(898.) Sneezing without cold in the head.
(897 .) Sneezing every morning for half an hour. .
(899.) Sneezing fifteen times in the day, without cold in the head.
410 c. Another indication of this liability to take
cold is that of running from the nose, coryza : to this
Lycopodium corresponds. ’
(914.) Cold in the nose, with running therefrom, which renders the upper lip
sore (28 days). ’ ,
(915.) Frequent cold in the nose, with offensive discharges from the left nos-
tril, which becomes sore inside. '
(918.) Great running from the nose, and pain at the chest.
(919.) Renewed violent running from the nose immediately.
411. The pathogenetic effect (915.) evidences the
power that Lycopodium has of producing ulceration, a
symptom present not unfrequently in the premonitory
stage of Phthisis, and exhibited, as already noticed, in
the production of ulceration in the throat: the character
of the sensations arising from the same being repre-
sented by the p. e. :-
(930.) Inclination to hawk, with raw feeling in the throat, as thoughthe
slime hung there, with tickling, which causes cough.
412. Another symptom present in the premonitory
stage of Phthisis was the variation of the mental and
moral states of the patient.
413. To this symptom Lycopodium corresponds in
its p. e. : --- ~ ‘ - -
142 , MENTAL STATE.
(28.) The fear to be alone.
(29.) Interior restlessness (about 24 hours).
(22.) Anxiety in the evening; her sight is half-obscured.
(25.) Great fear from frightful pictures crowding before her fancy in the
evening; in the day, whining. _ _
414. It will be seen that the peculiar mental effects
of Lycopodium take place in the evening. This pecu-
liarity in opposition to the power of Calcarea is illus-
trated by the subjoined remarks, extracted from the
writer’s unpublished lecture on Calcarea :-—-
“Though, in many pathogenetic effects, there is a
striking analogy between the effects of Calcarea and
the effects of Lycopodium, the following effect of Cal-'
carea presents a distinctive feature :—
(61.) The first part of the day he is anxious, the last he is cheerful and sat-
‘ isfied with himself.”—(Lgh.)
“The history of Lycopodium exhibits a mental ex-
acerbation in the evening, illustrated, further by the
following p. e. :-—
(26.) In the evening, in the dark, when trying to open a door which opens
with difficulty, he is seized with fear. 4
(27.) Fear seizes him in the evening, on enteringa room, lest he should see
any one; also, in the daytime, he thinks he hears some one in the house.
415. Another feature of the phthisical cachexia is
the presence in early life of “bad eyes.”
416. The homoeopathic relationship of Lycopodium
to this is thus detailed in an extract from the writer’s
lecture on Lycopodium :—-‘ 7
“Among the aggregates of the pathogenetic effects
of Lycopodium, that aggregate which embraces the
action of this medicine on the. eyes, the eyelids,
and the vision, is very considerable, amounting to
EYES-'-EARS--HAIR. 143
upwards of 70 effects-—an aggregate greater than any
similar aggregate by any other medicine, Pulsatilla
having in the same aggregate only 60; Nux having
about 50.”
416 a. The powerful action of Lycopodium on the
eyes andfthe eyelids is exhibited in the following
p. e. :— '
(231.) Inflammation of the eyelids, with aching pain, and sores in the outer
corners every night.
(236.) Many mattery pimples in the eyelids.
(241.) Sores of the eyes, especially at night, and particularly at the outer
corners.

417. Another feature indicative of the phthisical
cachexia is, that persons so affected not unfrequently
have, in early life, itching in the ears.
' 418. Lycopodium has the power of producing this
state, as is exhibited in the following p. e. :—
(291.) Itching in the ears.

419. Another feature indicative of the phthisical
cachexia is the falling of of the hair. . ~
419 a. Lycopodium analogizes with this in the fol-
lowing p. e. :~-—-
(186.) The hairs of the head fall off extraordinarily.
(187 .) The hairs of the head fall off by combing.
Oalcarea exactly corresponds to this:-—
(188.) The hair of the head falls ofi‘ in quantities, while in other parts of the
body it is produced. _ -

420. Another feature oftentimes associated with the
phthisical cachexia is the freckle.
144 srrrrrue or BLOOD.
420 a. This condition is analogized by Lycopodium
in the following p. e. :—-
(356) Many blotches and summer freckles on the whole of the face.
(357) Many pimples and freckles over the whole face.
421. A symptom present in the premonitory, the
first, and the second stages of this disease, is the spit-
ting of blood.
421 a. This condition is analogized by the follow-
ing p. e. :—-
(490.) Hawking up of bloody mucus when riding on horseback (daily occur-
ring).
(962) Expectoration of blood by coughing.
(963) Heemorrhage in a consumptive person (about ten days). ( Lg. )
422. Present among the symptoms of Phthisis were
a dry cough, a night cough, and the presence of a peculiar
irritation ewcitatioe of cough.
423. In re ard to the ni ht cou h the atho-
g g 7
genesis of Lycopodium 1s marked; the afternoon
and the evening development, so characteristic of Ly-
copodium, manifesting themselves in connexion with
the cough :—
(942) In the evening, from four to eight o’clock, she coughs and drinks
much.
(943) Hawking and short cough in the evening in bed.
(944) Night cough and hoarseness. When the expectoration is free, there
is pain in the breast, as of a wound.
(946) Cough at night, almost without remission, causing pain in the head
and in both sides of the belly.
(948) Dry cough, with yawning, piping and cracking in the throat.
424. The homceopathic relationship of Lycopodium
to the dry cough is exhibited in the p. e. :—
(951) Dry cough, continuous cough, chiefly in the night.
(952) The expectoration from the cough tastes saltish.
LYCOPODIUM conon. 145
425. In regard to the special irritation causing the
cough, the following p. e. are striking :-
(91-30.) An irritation to hawk, with a feeling of roughness in the throat, as if
the Inucus stuck fast in the throat, which excites to cough. (Gfil)
(932.) Cough, from tickling in the throat. '
(933.) With tickling in the throat, some attacks of coughing, which end in
sneezmg. '
(935.) Very fatiguing cough in the evening, before going to sleep, as though
the top of the throat were tickled with a feather; with a little expectoration.
426. In Phthisis, expectoration takes place, and Ly-
copodium shows in its pathogenesis a power of pro-
ducing expectoration, varied in its characters :—
(947 .) Night cough, with some expectoration.
(944.) Night cough and hoarseness; when the expectoration is free, pain in
the chest, as of a wound.
(952.) The expectoration from the cough tastes saltish.
(956.) Green early morning expectoration, with cough, after bad pain in the
chest.
(953,) Saltish, slimy expectoration, early in the morning, evening, and night.
(954.) Gray, salt-tasting expectoration, from cough.
(955.) Blackish, slimy expectoration, with cough day and night.
(957 .) White, slimy expectoration. (G. U.)
(960.) Yellow, mattery expectoration, with raw and sore pain after a tedious,
dry cough.
426 a. In this last pathogenetic effect is a most
7 perfect picture of that which is so frequently presented
in the course of the phthisical disease.
427. Sweat is a symptom present in Phthisis.
427 a. Lycopodium has in its pathogenesis some
marked effects in connexion with the production of
sweat. .
427 b. It produces sweat early in the morning,
which occurs often in Phthisis aftera restless night.
L
146 LYCOPODIUM swEAT.
How strikingly homoeopathic to what occurs in
Phthisis :-—
(1608.) Sweat early in the morning, after a. restless night (about ten days).
(GIL)
(1605.) Sweat early in the morning, only on the joints.
427 c. Lycopodium produces, what appears contra-
dictory to this, the following p. e. :-
(1637.) Sweat early in the morning over the whole body, with a taste of blood.
427 d. This taste of blood is a modification worthy
of remembrance.
428. The following are extracts from the writer’s
lectures on Lycopodium :-—
“The night perspirations of Lycopodium are pecu-
liar. It produces-—
‘ (1602.) Sweat at night only on the rump, and not on the legs.
“ Corresponding with this, but having an important
modification is the p. e. :-—-
(1601.) Profuse sweat, of an acid smell, over the whole body, with the ex-
ception of the legs.
“The development of the sweat at night is exhibited
in the following p. e. :—
(1603.) Every night after midnight, sweat, principally at the chest.
“This development of sweat on the chest is a
marked feature in phthisical and other diseases.”
428 a. The peculiarity of the smell of the sweat is
highly important. This is exhibited in the p. e. :-
(1599.) She experiences round about her a sharp-smelling, sweating smell.
428 b. And this power of producing a peculiar
smell, so often present in cases of Phthisis, is exhibited
still further in the p. e. :-
(1600.) A stinking exhalation, as of sulphur, from the body.
EVENING FEVER. 147
429. Viewing Lycopodium in relation to Oalcarea,
it is certain that Oalcarea has the greater power in
the production of sweat.
430. As one of the symptoms of Phthisis was the
production of evening fever,
431. In relation to this power, the following ex-
tracts from the writer’s lecture on Lycopodium em-
body some practical points :--
“ A power possessed by Lycopodium is that of pro-
ducing its effects at a particular time of the day, and
mostly in the afternoon and the evening, and at night.
It produces 15 p. e. in the afternoon, 80 p. e. in the
evening, and 70 p. e. at night, being a total of 166
p. e. having relation to time of day.
“It will be found that this development of action
in regard to the afternoon, the evening, and the night,
is manifested particularly in regard to the evening
fever :—
(1580.) Fever, one evening after the other; a shudder from seven o’clock
onwards, which, when he lies in bed, caused him to start high up in bed; with-
out heat or sweat thereafter.
(1581.) Shudder in the back, afternoon at three o’clock, but worse towards
evening, after lying down; a quarter of an hour long, with cold feet, without
heat and without sweat following.
(1582.) Fever, every afternoon at three o’clock to late in the evening; shud-
der continually increasing; without heat and without sweat.
(1583.) Fever in the evening, at seven o’clock; shudder strong, and great
cold, even in bed, as though she lay in ice; two hours lasting, with drawing,
in all the limbs, in the back, and in the whole body, and when awaking out of
a sleep, full of dreams.
(1590) Shudder, every evening in bed until twelve o’clock, then again warm
and hot; early in the morning, sour-smellin g sweat.
(1604) At night, profuse sweat, with cold on the forehead and on the neck.
432. “ It appears from this p. e. that Lycopodium
148 LYCOPODIUM URINE.
will be homceopathic to that evening phthisical fever
which has the shudder in the evening.”
433. In many forms of Phthisis, where the fever
assumes a hectic character, as it does when pus is form-
ing, and is formed, the urine presents a brick-dust
sediment.
434. In analogy with this symptom, Lycopodium
stands in a special relationship, Lycopodium being
characterized by the following p. e. :—-
(805) Reddish sand in the urine.
(806) Reddish sand in urine, remaining tolerably clear.
(807) Yellowish red sand in the urine.
(809) Deep red sediment in the urine.
435. This sediment forms one indication for regulat-
ing the choice of this medicine in relation to the
choice of Calcarea in Phthisis, for Calcarea produces
P. 6. I--
(889.) Quite dark coloured urine, without sediment.
436. Another symptom present in the premonitory
and other stages of the phthisical disease, is that of
hot hands.
437. Lycopodium produces a similar state, as is ex-
hibited by the following p. e. :—-
(1163.) Hot hands, constant, which to him is very unusual.
(1164) Swelling and heat of the right hand, evening.
(1165) Feeling of heat in the left hand, with anxiety.
437 a. Somewhat allied to this is the p. e. :—-
(1168.) Great dryness of the skin of the hands.
437 b. In connexion with the condition of the hands
DEADNESS or FINGERS. 149
in Phthisis, a fact may here be recorded, that not un-
frequently the phthisically predisposed are liable to a
deadness of the fingers.
437 c. It is interesting to notice that both Cal-
carea and Lycopodium have the power of producing
this state. Calcarea produces p. e. :-—
(1251.) Deadness of the fingers. I
(1252.) Deadness of the middle fingers; they become white, cold, and with-
out feeling. Beforehand, a fine drawing therein (about three hours). (Gfil)
v 437 d. Lycopodium in its p. e. has a peculiar modi-
fication :-—
(1187.) Numbness, coldness, and deadishness of both the little fingers, early
in the morning when awaking, although they are movable.
(1188.) Deadness of two fingers in the morning, for half an hour, with blue
‘ nails (about thirty-one hours).
437 c. It would seem from these efiects that Lyco-
podium acts more on the little fingers; and the blue-
ness of the nails in the morning is a symptom not un-
frequently present in many cases of Phthisis.

438. Another symptom present in the various
stages of Phthisis is a burning in the soles of the feet,
which Calcarea, it was noticed, produces.
~ 439. Lycopodium produces a similar state of the
feet, as is evidenced by the following p. e. :-—
(1306.) Burning in the soles of the feet at night.
440. The distinction between the Calcarea. action
and the Lycopodium action, is to be found in the fact
that the Lycopodium manifests its action most at
night; and add thereto the effects that Lycopodium
produces on the kidneys and the urine.

150 . coNsT1rAT1oN. .
- 441. A‘ symptom frequently present in the. course.
of Phthisis is constipation. ‘ _
442. The relationship of Lycopodium hereto is ex-
hibited in the following views, extracted from the
writer’s lecture on Lycopodium :—
“Lycopodium has the power of producing con-
stipation: this is its primary action. It produces
p. e. :—
(7 33.) Stool not daily; sluggish, and no desire thereto.
, (7 34.) Stool only every other day. (Gfl)
(7 35.) The stool is suspended for two or three days, but after follows a good
natural stool.
.- “ The stool itself is hard, and even if it is soft, there
are hard, knotty portions :—
1 (756.) With knotty stool, a fine pricking in the rectum.
(744.) Thin stool, with hard pieces.
' ' “ A peculiarity exists in relation to the stool pro-
duced by Lycopodium :-
(742.) The first part of the stool is knotty; the second portion soft, many
days following (sixteen days).
“ Lycopodium produces special sensations in con-
nexion with these hard, knotty stools :— ‘
I (7.59.) With a hard stool, pain in the sacrum, as if it would break, with colic,
as if the intestines would burst out (about forty days).
_ (7 66.) After a scanty, hard stool, a violent contractive pain in the perinaeum,
lasti'ng'several hours.” .
443. Such being the action of Lycopodium, it be-'
comes clear that, in cases of Phthisis attended with
constipation, Lycopodium will call for attention.
444. Lycopodium has great power in producing
pathogenetic effects in connexion _ withthe kidneys
and the bladder, thus recorded in the lecture re-
ferred to—
DEBILITY or LYCOPODIUM. 151
“Perhaps there is no chronic disease in which de-
bility is more marked than in diseases of the kidneys;
and it will be found in the pathogenesis of Lyco-
podium, that it produces disease of the kidneys, and
causes more particularly extreme modifications in the
water. It produces, also, excessive debility.” The
following remarks from the same lecture illustrate
this :—
“ A power possessed in a marked degree by Lyco-
podium is that of producing excessive exhaustion and
prostration of the strength, conditions illustrated by
the following p. e. :—-
(1447 .) One otherwise habituated to toil is obliged by weakness to lie down
several times in the day (about sixteen days).
(1448) After slowly walking, exhaustion of the bodily powers.
(1-445.) Frequent attacks of weakness, which oblige him to let the arms fall.
(1452.) Extreme weakness in ascending the stairs, with pain in the bones of
the lower limbs (about eleven days).
(1444.) Sometimes a sudden weariness of all the limbs, with bad temper.”
444 a. From these views and effects it is certain
that Lycopodium will have a curative relationship to
cases of Phthisis, where with the Phthisis there are
kidney disease and great debility.
445. From these facts and views the character of
the Lycopodium cachexia will be apparent, and some
idea may be gained as to the character of the Phthisis
to which Lycopodium is suited.
SECTION V.-—The lVitric Acid Cachexia, as Illustrative
of the Conditions under which N itric Acid can be
employed in Phthisis. _ p-
446. The pathogenesis of Nitric Acid, as recorded
152 NITRIC ACID.
in Hahnemann’s work on Chronic Diseases, presents
itself in an aggregate of 1424 effects.
447. It will be found in detailing this pathogenesis,
that some of the pathogenetic effects of Nitric Acid
supply the curative means for symptoms of Phthisis,
which have not as yet been fully met by the patho-
genetic effects of Calcarea and of Lycopodium.
448. A phenomenon of the premonitory stage of
Phthisis was a bleeding from the nose. (100)
449. The homceopathic relationship of Nitric Acid
to this symptom is exhibited in the following p. e. :—
(265) Soreness and bleeding of the interior of the nose, with much running.
(270) Bloody running from the nose, early in the morning.
(271) Bleeding of the nose from weeping.
(2 72.) Violent bleeding from the nose (twenty-four hours).
(27 3.) Very great bleeding from the nose, early in the morning.
(274) A discharge of black blood from the nose.
449 a. In this record it will be seen there are two
specialities in connexion with the Nitric Acid—first,
that the bleeding of the nose resulted from weeping
(271), and the blood escaping from the nose is
“ blaclc.” To this may be added a third, namely, that
in two effects it took place early in the morning.
449 b. The bleeding of the nose has a characteristic
detailed in regard to time of occurrence. Allied to
this earliness is, that it occurs at night, as is ex-
hibited in the p. e. :— '
(1287.)At night, bleeding of the nose.

450. Connected with this premonitory symptom of
bleeding from the nose was the symptom of a tightness
(a fulness) at the chest. (l00.)
GAGHEXIA. 153
451. To this symptom Nitric Acid analogizes in the
following p. e. :-—
(885.) Tightness at the chest, so that she cannot fetch a breath (twenty-two
days).
(886.) Tightness and anxiety, if she walks at all quickly, with perspiration
upon the back and chest. -
(887.) Contraction of the chest.
(888.) Tightness at the chest; shorter, more anxious, and more diflicult
breathing.
(889.) Narrowing of the chest in sitting and walking, but especially in bend-
ing back (three days).
451 a. In relation to the 886 pathogenetic effect, it
is worthy of remark that sweat appears on the back
and on the chest, a character often present in cases of
Phthisis.
452. In regard to the pain in the chest, another
symptom in the premonitory stage and other stages of
Phthisis, Nitric Acid has corresponding p. e. :-
‘ (895.) A pressing together at the chest. Pressure at the left breast, as
though the blood would not go through the heart.
452 a. This latter effect is highly characteristic.
453. It was noticed in the history of Phthisis that
ulceration of the throat frequently attends the de-
velopment of the phthisical disease. Nitric Acid pro-
duces p. e. :-
(374.) Ulceration in the mouth and throat.
(375.) An eating ulcer on the side of the salivary gland.
(415.) Sore throat on swallowing; a feeling of swelling therein, and as though
raw and ulcerous.
454. The presence of ulceration, and the conditions
of the u~lceration, being so similar to some of the
mouth and throat phenomena of secondary Syphilis,
will render necessary in the treatment of the phthisi-
154 NITRIC ACID uLcERs.
cal patient a careful investigation as to the circum-
stances of the patient’s previous condition, since the
phthisical state is often associated with the previous
existence of Phthisis; Nitric Acid will be, on this
ground, homoeopathic to the state. _
455. VVhere these ulcers exist, the state of the
breath is foul; a state very frequently existing in the
young, especially about the age of puberty, when the
premonitory symptoms manifest themselves. To this
state Nitric Acid corresponds in the p. e. :—
(402.) Foul smell from the mouth.
(403.) Dirty stinking smell of the mouth.—(BZair.)
(404.) Very clammy slime in the month.
456. In connexion with these conditions of the
mouth and of the throat, it will be well to ascertain
whether the phthisical patient has been or is subject
to a sensation as of a closure of the throat, after having
drunk fasting, for Nitric Acid has the power of pro-
ducing this effect, as is evidenced by the p. e. :--
(408.) Pressure in the throat on swallowing food, as though it could not go
down.
(114.) In eating, small pieces of food press through the posterior nostrils,
and come out at the nose, as though the gullet had not properly secured them,
but had let them escape, so that they had thus become forced through the pos-
terior nostril.
457. A symptom connected with the phthisical
cachexia is that of easily taking cold.
458. To this Nitric Acid corresponds, so far as re-
lates to the following p. e. :-— '
(809.) Much sneezing every day, without cold in the
T1058.
- (810.) Frequent sneezing, with stoppage of the nose.
THE FRECKLE or NITRIC ACID. 155
.5 459. Nitric Acid produces running at the nose :-
(814.) Much sneezing in the daytime, and discharge of much slime from
thenose.
I (836) Violent running from the nose (two days).
460. Still, it would appear that Nitric Acid seems
to be more homoeopathic to those cases where there is
a dry coryza than where there is the opposite. This
may be connected with the fact, that its action on the
bone and bone-covering tissue of the parts about the
mouth, throat, &c., causes its condition to be extended
to the nostrils.
' 461. In connexion with the phthisical cachexia,
cutaneous changes, such as the freckle, the wart, &c.,
have been noticed. Nitric Acid has its special cutane-
ous changes, which will indicate the cases of Phthisis
to which it is suited.
462. One of the characteristic features of the
eruptive-producing power of Nitric Acid is exhibited
in p. e. :—
(1030.) Eruption on the hands and between the fingers; itching burning,
which passes off by rubbing.
_ 462 a. Nitric Acid produces the freckle, but its
freckle is dark.
(1213.) Dark freckles. _
(934.) Itching spots, like freckles, outside the breast.
462 b. It produces warts :--
(1216.) Itching in the warts.
(1214.) Small warts come out on the throat.
(935) Two little warts on the middle of the breast-bone.
156 EARS AND EYES, AND HAIR.
463. Nitric Acid produces brownish and reddish-
brown patches.
463 a. It will be remembered that Lycopodium
produces liver-coloured spots, so that in the conditions
of the eruptions produced by these two remedies will
be found the means of selection.

464. The condition of the eyes afforded character-
istics of the phthisical cachexia. It will be found
that Nitric Acid presents phenomena in regard to the
eyes.
465. Among the effects of Nitric Acid is one of pro-
ducing palsy of the upper eyelid; and with this palsy
is associated a sensation of weight.
466. If, therefore, these conditions manifest them-
selves in a phthisical patient, it will be useful to re-
cognise this power of Nitric Acid.
—_
467. A state often present in persons affected with
the phthisical cachexia is disease of the ears.
468. Nitric Acid produces various diseased states
of the ear, as is evidenced by the following p. e. :—
(234) Itching in the ear.
(241) Red, ulcerous, and violent itching behind the left ear.
(243) Little knots the size of a bean on the back part of the lappet of the
ear, with pain on being touched.
469. Another phenomenon present in persons
affected with the phthisical cachexia, is the falling of
o f the hair.
470. Calcarea and Lycopodium produce this effect,
AFFECTIONS or NITRIC ACID. 157
as does Nitric Acid, but Nitric Acid has a peculiarity,
which is exhibited in p. e. :-— -
(714.) On the private parts, the hair falls ofl‘ much. (Bt-h.)
471. This falling ofi from the special part indi-
cates a symptom which presents itself in syphilitic
disease; and this adds another evidence why Nitric
Acid is peculiarly serviceable in cases of Phthisis
which have supervened after syphilitic disorder.
471 a. Nitric Acid has a peculiarity in relation to
the hair, which is exhibited in the following p. e :-—
(157.) The scabbed eruption on the hair of the head stinks much.
472. Nitric Acid has in its pathogenesis the pro-
duction of spitting of blood, one of the phthisical
symptoms noted as frequently occurring :_—-
(865.) Bloody expectoration from cough with vomiting, early morning, in
bed, after a rattling in the windpipe; afterwards, a feeling of sickness, with
cold shudder, and so forth.
(867 .) Expectoration of black clotted blood, through a cough with vomiting.
(868.) He coughs and vomits black blood, and also blows the same out from
the nose.
473. Nitric Acid has the power of producing
another symptom, almost always present in Phthisis,
namely, that of cough.
474. Among its pathogenetic effects are the follow-
ing, illustrative of the variety of forms under which
cough is presented in phthisical patients :-—
(850.) Much cough (three, four days).
474 a. The irritating tickling, which in Phthisis so
often induces cough, is illustrated by p. e. :—-
(851.) Tickling cough, with soreness in the throat.
158 NITRIC ACID couen.
474 b. In many cases cough occurs in the sleep.
To this Nitric Acid has a corresponding p. e. :-
(852.) Cough from a contracting feeling in the throat, especially at night in
sleep. '
474 c. The action of Nitric Acid is to produce a
night cough. This is exhibited in the following p. e. :-
(855.) Evening in bed, a vomiting cough. _
(856.) In the evening especially, a dry, barking cough.
(857.) In the night, a bad cough, immediately after midnight, for one hour.
(858.) Before midnight, a rough, dry cough.
' (859.) Night especially, cough, which gives not five minutes rest, with shak-
ing of the whole body, whereby frequently the breath catches, as with hooping-
cough; then darting pain in the chest, sore throat, and fever.
474 cl. In regard to the expectoration, a symptom
present in Phthisis, a characteristic of the Nitric Acid
‘expectoration, is exhibited in the following pi e. :-
(863.) Slimy expectoration from coughing.
(864.) A yellow, bitterish-tasting expectoration.
475. In regard to the pain at the chest which attends
the cough of Phthisis, Nitric Acid exhibits its homoeo-
pathicity in the following p. e. :-
(873.) From coughing, pain in the chest.
(874.) In coughing and breathing, many evenings, dartings in the middle of
the left breast, almost every time of drawing a breath, especially on lying i
bed. . .
476. It is interesting to notice that Nitric Acid has
the power of producing with the cough pain in other
parts of the body :-— '
(868.) In coughing and after it, pain under the stomach.
(869.) In‘ coughing, each time, headache.
(870.) In coughing, pain in the hypochondria.
(872.) In coughing, dartings in the throat.
(87 6.) From coughing, pain in the breast.
(877.) In coughing, he feels the knee affected, so that it cracks, and pains
then in the knee-bone in walking.
NITRIC ACID DIARR_H(EA. 159
477. In connexion with this action on the chest,
Nitric Acid has the power of producing heart-beat- -
illg Z—_-
(-87 9.) Loss of breath, heart-beating, and uneasiness in going up steps.
(880.) Sudden failing of breath, and heart-beating in walking gently.
47 8. DIARRHGEJA was noticed as one of the pheno-
mena of the more advanced stage of Phthisis. '
479. This diarrhoea is highly exhausting, and hence
the anxiety of the practitioner to arrest it. The rea-
son of its exhaustive power is connected with the
great extent of the intestinal membrane, and also With
the fact, that when the disease has reached this stage,
the condition of the system has greatly deteriorated.
The arrest of this diarrhoea by the old system means
is almost always injurious, because the arrest is not
the cure of the disease.
480. The homoeopathist, however, is enabled by his
law to find, by conjoining all the concomitants of the
‘diarrhoea, the remedy which will meet the diseased
state, and thus remove the diarrhoea.
481. What conditions attend this diarrhoea state?
With this are an aphthous state of the mouth, and
ulcerations of the genital parts.
482. If, therefore, Nitric Acid has the power in its
pathogenesis of producing these states, a satisfactory
ground exists for the belief that it will cure the
diseased state, more especially if, besides the effect
detailed, it is productive of diarrhoea as well.
483. The power that Nitric Acid has in producing
diarrhoea is evidenced by the following p. e. _:—'
(610.) Diarrhoea, two, three times daily (the first ten days).
(611.) Diarrhoea, with nausea, after eating (twenty days).
160 NITRIC ACID SWEAT.
(612) Diarrhoea every other day.
(613) Frequent stools of mere slime, at times with pain of the belly, and
great urging (the first four days).
484. Nitric Acid has the power of producing aph-
thous eruption and ulcers under the tongue, as is
evidenced by the following p. e. :—
(37 6.) Bladders upon the tongue, and at its edge ; a burning pain to the touch.
(377) Little bladders on the glands found on the under part of the tongue,
which pain.
(378) Little painful pimples upon the side of the tongue.
(381) Sore pain of the red part of the tongue.
(382) Soreness of the tongue.

485. Another symptom present in Phthisis is the
sweat.
486. Nitric Acid produces sweat as one of its p. e. :—-
(1409.) Sweat, with cold hands and blue nails.
(1410) Sweat early in the morning.
(1411) Night damps.
(1412) Night sweat every other night, very great.
(1413) Night sweat, every night.
(1418) Night sweat, merely on the parts on which he lies.
487. The peculiarities as to localities affected are
indicated in p. e. :-—
(1416.) Night sweat, chiefly on the feet.
(1417) Night sweat upon the breast.
(1418) Night sweat, merely on the parts on which he lies.
(1419) Night sweat immediately, if he covers himself with the bed-clothes.
488. In regard to this sweat there are some pecu-
liarities.
489. One peculiarity is, that Nitric Acid produces
a special sweat in relation to the arm-pit :—-
(972.) Astinking, strong-smelling sweat of the arm-pit (about four days).
(1421) Bad smelling sweat, many nights.
(1422) More and bad smelling sweat, on doing bodily work.
(1423) Sour and very bad smelling sweat, like horse’s urine.
(1424) Sourish night sweat, many nights.
NITRIC ACID CACHEXIA. 161
490. Another peculiarity presents itself in con-
nexion with the feet, on which it produces sweat :—-
(1155.) Sweat Of the left foot. .
(1156.) Profuse sweat of the soles, and therewith
soreness of the toes and of the soles, with pricking
as if stitching needles were coming out from them.
491. In conclusion, it will be useful to note that
the relation ship of Nitric Acid to those cases of Phthi-
sis which have originated from syphilitic disease is
evidenced by the power which Nitric Acid possesses
of producing ulcers on the genital organs :-—
(726.) A flat ulcer on the crown of the glans; a clear-looking but badly-
smelling ichor passes from the ulcer. (Bth.)
(7 31.) Itching on the foreskin and moist places on the inner surface (twenty-
eight days).
(732.) Inflammation and swelling of the foreskin, with burning pain ; a
wound-like feeling on the under surface, and very offensive humour secreting
ulcers, which cause spots on the linen, like a bloody pus. (Bth.)
(733.) Great swelling and phymosis of the foreskin, without much redness,
and chancrous-like ulcers, with flat borders, on the inner surface, &c.
492. These conditions will serve to indicate the
phthisical cachexia to which Nitric Acid is suited,
which will become more especially evident after the
other cachexiae have been detailed, since the charac-
ters of each will form a means of drawing out more
clearly, by comparing one with the other, the charac-
ters of each.
SECTION VI .--On the Cache-ria, as illustrated in the
conditions under which Sulphur can be employed in
Phthisis.
493. “ Sulphur, in its pathogenesis, as recorded by
Hahnemann. in his work on chronic diseases, presents
M
162 SULPHUR CACHEXIA..
1965 effects; a fact, testifying to the wideness of
range of its curative action.
493 a. “Another fact, pregnant with interest and
full of importance in regard to the homoeopathic, and,
consequently curative, employment of sulphur is, that
sulphur produces an eruption like the itch.
493 b. “ The production of this effect by sulphur has
been established by the most indubitable evidences
collected by Hahnemann, and form the foundation of
the theory put forth by this illustrious man, that the
great majority of diseases have an itch origin.
493 c. “This itch origin of diseases, Hahnemann has
illustrated by a mass of quotations from authors of
the highest reputation, from the time of Hippocrates
downwards to Hahnemann’s own time; these quota-
tions demonstrating what stupendous literary attain-
ments were possessed by Hahnemann.
493 d. “This psoric (vraoga, psora, itch) theory was
one on which Hahnemann laid great stress.
493 e. “ Many have ridiculed the theory; but such
men do nothing more than illustrate the old dogma
that it is easier to ridicule than to refute.
493 “Indeed, it cannot be deemed at all unrea-
sonable, that the itch, received into the constitution,
should produce a general diseased state, a cachexia,
permeating the whole body: more particularly since,
as is well known, the vaccine ichor taken from the
eruption of a cow’s teat, permeates the constitution,
and generates a diseased state, protective against
another diseased state, the smallpox.
493 9. “And seeing that the vaccine poison produces
a protective influence on the constitution during the
whole of life, which it can do only by the power it
has of creating a life-lasting anti-smallpox cachexia,
THE PSORA THEORY. 163
it appears perfectly rational that the poison of the
itch may exercise similar life-long action, unless the
disease itch is cured by the appropriate homoeopathic
remedy.” - ,
These extracts from the writer’s lecture on Sulphur
will form an introduction to the more special remarks
relating to the employment of Sulphur in Phthisis.
494. In the treatment of Phthisis, if these views are
correct, it is essential for the physician to ascertain
that the patient has or has not ever had the itch.
495. It is true that he will experience much difii-
culty in ascertaining the fact, for persons do not like
to acknowledge that they have had the itch, and per-
sons who have had the itch have had it generally in
early life at a time when they were n-ot likely to be
aware of its nature, and may consequently’ not re-
member its occurrence. ~
496. But here becomes apparent the certainty con-
nected with the existence of the homoeopathic law.
The physician, well instructed in the pathogenesis of
Sulphur, will be able, by the presence of the symp-
toms and their accordance with the effects of Sulphur,
to judge by this strict accordance between the symp-
toms and the pathogenetic efi'ects of Sulphur, of the
probability of the existence of itch.
‘ 497. If the itch has at any period of life been pre-
sent, such presence would of itself be, as just noted,
one circumstance indicating the use of Sulphur in the
treatment of the disease; a use, however, which will
rest solidly on the accordance now to be noted be-
tween the symptoms of some forms of Phthisis and
of the pathogenetic effects of Sulphur.
498. One of the phenomena indicative of the pre-
164 BLEEDING FROM THE Nosn.
cursory state of the phthisical cachexia was the bleed-
ing of the nose.
499. Sulphur produces this, as is exhibited in the
pathogenetic effects. ~
(90) Giddine s s early in the morning, with some
bleeding from the nos’e.
(360) Blowing out of blood from the nose.
(361) Coagulated blood comes from the nose every time of blowing it.
' (362) B l e e din g o f the n o s e, seven whole days (11 days).
(363) Blood from the nose when blowing it (Fr. H)
(364) Violent bleeding at the nose, early in the morning, also on blowing it.
(365.) Bleeding from the nose, from time to time, many days (Fr. H.)
(366) Bleeding from the nose two afternoons (for three hours) in succession,
after which the nose is painful on being touched.
500. It will be perceived from the p. e._ 90 that the
bleeding from the nose is attended with giddiness.
501. A second phenomenon, indicative of the~phthi-
sical cachexia, is tightness at the-chest, as associated with
this ~nose-bleeding. ‘
K 0 Q -. L ' ' ° '
U0./... Sulphur produces the state, as Is exhibited
by the p. e.
(1185) Uneasiness at the chest.
(1186) The whole chest seems as though stretched.
(1240) Great determination of blood to the chest.

503. Another symptom present in the premonitory
stage, and allied with this tightness of the chest, was
the presence of pain in the chest.
504. This (symptom is analogized by numerous
effects of Sulphur. The following may be quoted :—
(1195) A pain at the chest, as of drawing together.
(1190) Aching obliquely over the middle of the chest, as from having swal-
lowed too large a mouthful.
(1191) Early in the morning, when in bed, an aching at the chest, which
increases; he is obliged to get up, whereupon it disappears.
(1199) Very violent pain in the evening, as if some one seized up the back
part of the chest, would turn it round and raise it up, or grind and dash it to
pieces. '
DIsEAsED EYELIDS or SULPHUR. 165
505. Another symptom frequently present as pre-
monitory to the development of the phthisical ca-
chexia is the swelling of the glands of the neck, and of
other parts of the body.
506. This symptom is analogized by the following
p. e. :—- - -
(1330.) A swollen gland near the thyroid gland; pains when touched.
(1331.) Swelling of the glands at the shoulder.
' (1332.) A swollen moist gland, under the right arm. (Ng.)
(1333.) An ulcerous swelling of the arm-pit glands.
507. Another symptom present in -the premonitory
stage of Phthisis is that of easily taking cold.
Sulphur has the power of producing this condition
of the system. It exhibits this in the p. e. :—-
(1080.) Very frequent sneezing, which shakes her almost in a cramp-like
manner. I l ' p
(1084.) Painful dry feeling in the nose, with severe cold in the nose.
(1087.) Very bad cold in the nose.
(1089.) A flowing from the noselike water.
508. Sulphur has the power of producing both a
stoppage of the nose and a feeling of stoppage of the
nose, and in connexion with the stoppage of the nose,
it exhibits the power of producing nose-bleeding :—-
(1096.) Great stoppage vof the nose, many days; by
blowing thenose, blood-clots sometimes come therefrom. -
509. Another condition, already noticed, is often-
times associated with the phthisical cachexia, that of
diseased eyelids. __ ,
Sulphurhas the power of producing such a condi-
tion, as is exhibited in the following p. e. :-—
_ (248.) Feeling of heat in the eyes.
(249.) Feeling of a fulness of blood in theeyes. '
(2 63.) Inflammation of the outer eyelid, without any particular swelling.
166 SPITTING on BLOOD.
. (264.) Swelling in the upper eyelid, and dry ulcer in the lashes.
(265.) Swelling in the upper eyelid, with redness and burning of the eyes.
(268.) Eruption like a barleycorn in the upper eyelid, in the inner corner.
(279.) Early in the morning, the eyes are gummed together, the lids thick
and red; later, a dry slime in the lashes.
510. Disease of and discharge from the ears is a con-
dition associated with the phthisical cachexia. _
Sulphur has in its pathogenesis the following
effects :-
(312.) Great itching, outwardly, in the ears.
(318.) A large ulcer on the ear-lappet.
511. The falling of of the hair is a condition fre-
quently connected with the phthisical cachexia.
Sulphur has the power of producing this in a
marked degree :—
(2()5.) Falling out of the hair.
(206.) Considerable falling out of the hair.
512. It may beiuseful to note that Sulphur pro-
duces a tenderness in the roots of the hair :-—-
(‘204.) Pain at the roots of the hair, especially to touch.
513. As the phthisical disease progresses, other
symptoms present themselves. Spitting of blood is a
most frequent symptom. It is a fact, that as yet I
have been able to find no pathogenetic effect in which
there is, in connexion with Sulphur, an expectoration
of blood from the chest. '
514. In regard to the production of cough, Sulphur
has a wide range of action.
couen or SULPHUR. 167
Sulphur produces a dry cough, as is exhibited in
P. 8. :-—-
(1122.) A dry short cough, merely on walking in the open air.
(1123.) A short cough in the evening, in sleeping and sitting.
(1132.) A dry cough, suddenly, as though the lungs would be torn out, with
increased headache. '
(1133.) Dry cough in the evening, as also at night; and then, towards
morning, some expectoration, and a feeling as though internally some little
bladders were burst. _ y
A 515. Sulphur produces expectoration, which is cha-
racterized by a peculiarity exhibited in p. e. :-—
(11;-38.) An expectoration from the chest, tasting like an old catarrh.
516. The concomitant conditions under which the
cough of Sulphur manifests itself are striking. Thus,
the cough is excited by talking :-— - ‘ -'
(1118.) Tickling in the windpipe; speaking excites coughing.
This is often exhibited in the cough of the con-
sumptive. ' ~ '
Again, the cough is associated with coldness of the
huucls, sweat of the head and of the face :-—
(1125.) Much cough on going to sleep, with heat in the head and the face,
and cold hands.
517. One feature, in connexion with the cough of
Sulphur, is its powerful effect on the head-‘—a fact
well worthy of attention in its selection in the treat-
ment of Phthisis. - .
518. It produces the effect on the head, both dur-
ing coughing, and after coughing :-— I
(1141.) In coughing, headache, as though beaten and torn.
(1142.) In coughing, much pain at the back of the head, as from an ulcer
(immediately).
(1145.) In coughing, dartings in the bones of the side and back of the head.‘
(1146.) In coughing, dartings at the forehead outwards, so that she is obliged
to hold it with the hand.
(1147) In coughing, painful throbbing (stosse) in thehead.
168 THE BURNING or SULPHUR.
519. So that pain is produced by coughing in the
head itself, in the forehead, in the temples, and at the
top of the head, in the back of the head, and at the
back part of the top of the head.
‘ 520. In regard to the cough of Sulphur, there is a
peculiarity indicated by the following p. e. :—-
(1120.) He wishes to cough, and cannot; blackness comes before his eyes.
This peculiarity is illustrated more fully by the 1
P. 6. :'_—'-
(1119.) An irritation inducing cough after eating, so great that he cannot
cough quickly enough: his chest is drawn as by cramp, and he chokes as
though about to vomit.
521. In many forms of Phthisis, the chest affection
is often marked by a sense of burning.
Sulphur produces this state, as will be seen in
the p. e. :—- l
(1220) Burning in the chest, and great warmth in the face, and at the same
time coldness (frost); all the limbs are tired, as though beat to pieces; great
thirst till night, twelve hours, when cold and heat lessen, and sweat appears
all over the body for three hours (nineteen days).
521 a. Hence Sulphur will be indicated where,
with the chest affection, there is conjoined a burning.
V 522. Sulphur represents, in its pathogenesis, a form
of mid-day fever frequently present in Phthisis. This
form is represented in the following p. e. :—
(1944) Fever at mid-day, much internal heat, with redness of the face at the
same time. _ ~-
(1946.) Fever every forenoon, inward cold daily increasing, with giddiness,
as though the head would sink down, without thirst; afterwards weariness so
great that he cannot step up the stairs; sweat night and day merely on the
head, which is swelled up.
1950.) From mid-day to evening, fever heat with thirst.
I 523. The following peculiar pathogenetic effect of
THE swEAT or SULPHUR.‘ 169
Sulphur is worthy of being borne in mind in con-
nexion with the fevers :-—-
(1943.) A feeling as though warm air came now more, now less, on the
thighs. Evening eight o’clock (one day). (Ng.)
524. The sweat of Sulphur occurs chiefly in the
morning :-—
(1956.) Copious sweat, early in the morning, merely on the itching parts.
This pathogenetic effect presents a peculiar feature,
namely, its Occurrence only in the itching parts :—
(1956.) Great sweat merely on the itching parts. (Fr. Watclter.)
(1959) Early in the morning sweat on awaking.
(1960.) Much early morning sweat, which comes first on awaking.
(1957.) Early in the morning, sweat on the hands and feet.
524 a. From the above pathogenetic effects, it ap-
pears that Sulphur has the power of producing a local
sweat; add to this p. e. :—
(1735.) Early in the morning, in bed, sweat in the face and neck, and beating
in the limbs on getting up (rising). ‘
The character of the sweat of Sulphur is that it has
a feverish smell :—-
(1963.) Night-sweats of sourish burnt smell.
(l964.) Considerable night-sweat of a sourish smell commencing in the
evening.
SECTION VII.-—‘On the Sepia Cachexia, as illustrated in
the conditions under which Sepia can be employed in
Phthisis.
525. The medicinal action of Sepia is very exten-
sive. Hahnemann in his Chronic Diseases records
170 THE SEPIA NOSE-BLEEDINGS. ,
1655 pathogenetic effects produced by this medicinal
agent in experiments made with it on the healthy. .
526. The relation which this pathogenesis has in
connexion with the cure of Phthisis will appear in the
following remarks.
527. Bleeding of the nose was one of the phenomena
noticed as indicative of the phthisical cachexia.
528. Sepia has the power of producing bleeding
from the nose, as is evidenced by the following p. e. :-—
(319.) Blowing out blood from the nose, and bleeding of the same (six,
seven, nine days).
(320.) Bleeding from the nose on blowing it; evenings.
(321.) Much bleeding from the nose (twelve days).
(322.) Bleeding from the nose, seven hours continued, yet only from time to
time single drops.
-529. There is one characteristic of Sepia in relation
to the nose which, being peculiar, is well worthy of
notice in itself, and also in connexion with the
phthisical cachexia. It is exhibited in p. e. :-—
(310.) Swollen inflamed nose, the nostrils irritated (bose)
and ulcerous.
(316.) Pimple near the right nostril, which forms itself into a large scab.
530. A tightness of the chest was one of the condi-
tions associated with the premonitory stage of Phthi-
sis. Sepia has the power of producing this, as is
exhibited in the p. e. :—-
(1045.) Tightness at the chest, early in the morning on awaking.
(1()41.) Contraction at the chest, early in the morning and in the evening.
531. This tightness at the chest was attended with
SEPIA AND THE- YELLOW COMPLEXION. 171
heart-beating, and Sepia produces a state correspond-
ing to this :-—
(1044.) A tightening feeling at the chest, with heart-beating, after mental
excitement.
532. The condition of the eyes formed one of the
features of the phthisical cachexia. Sepia has a most
extensive action on the eyes andythe eyelids.
533. It produces 60 p. e. in connexion with these
parts and the vision, and consequently where the
phthisical disease has been preceded by affections of
the eyes, the jaathogenesis of Sepia should be well
studied. D
534. The condition of the ears afforded indications
of the phthisical cachexia.
535. Sepia has a most extensive action in con- \
nexion with the ear. One form of action is exhibited
in the p. e. :—
(2 90.) A thin ichor flows out of the ears, with itching.
(291 .) Much mattery eruption on the outer ears. \
536. In regard to the skin tissue, Sepia has a power
of producing a peculiar YELLOWNESS, which when
present, or if it had been previously present in a case
of Phthisis, would be indicative, in connexion with
other symptoms, of the use of Sepia. This yellowness-
producing power is presented in the following p. e. :-—-
(325.) Yellowness of the face, and of the whites of both eyes, one entire day.
(326) Yellow‘ spots in the face, and a yellow tint of the shape of a saddle,
straight over the upper part of the cheek and nose (twenty days).
(355) Yellowness about the mouth.
172 THE COUGH or SEPIA.
537. One of the phenomena, not unfrequently pre-
cursory of the development of the phthisical cachexia,
was the falling of the hair. ‘
538. Sepia produces this in a marked degree, as is
exhibited in p. e. :—
(694) Great falling out of the hair.
539. One of the symptoms of Phthisis was the dry
cough.
540. Sepia has the power of producing this kind of
cough :—-
(1003) Dry cough, as from the stomach and the abdomen, or from stoppage
of the bowels; or as if something were left in the stomach which would not
pass away.
540 a. This p. e. is well worthy of exact considera-
tion ; as is the following p. e. :—--
(1004) Dry day-cough, which compels lying down, during which it is quiet;
also in the night, lying, there is no cough, but stoppage of the nose.
540 b. The violence of the dry cough is exhibited
in p. e. :—
(1005) Severe dry cough, with dartings in the right breast.
540 c. But the most characteristic feature of the
cough is exhibited in the p. e. :—-
(1010.) Cough often dry, asthmatic, and hacking, with pain in the pit of the
stomach, and scraping, rough wounded feeling on the top of the throat, (kehlkopf)
which is not felt on swallowing the spittle. In sleep, the cough does not
awake the patient; but after waking it is very bad, and continues at times
snufliing in the windpipe, and expectoration of slime.
541. The evening and the night character of the
Sepia pathogenesis is illustrated in the action of the
Sepia in regard to the cough :—-
(994) In the evening, after lying down, the cough is strongest.
(1011) Cough arous e s in the night.
sErIA’s BLOOD SPUTA. 1 7 3
542. In~ this characteristic of the evening aggrava-
tion, Sepia approaches to Lycopodium.
543. Sepia produces expectoration of blood :—-
(1030.) Short, hacking, severe cough, evening after lying down, with much
expectoration of pure running blood once every minute (eight days). '
(1029.) Expectoration of blood in coughing, every morning, without pain in
the chest.
(1028.) Expectoration, with coughing, of streaky blood, after dinner.
543 a. Sepia produces other expectorations :-—
(465.) Bloody slime is hawked out in quantity (fifteen days).
544. The fact that the cough of Sepia produces
pain in the pit of the stomach is worthy of notice :-—-
(1012.) Cough day and night, with pain therefrom at the pit of the stomach.
545. Sepia has the power of producing the p. e. :—-
(555.) Dry cough after a meal.
545 a. In cases of Phthisis, whenever such a.
symptom presents itself, this power of Sepia will have
a practical character.
546-. In studying the pathogenesis of Sepia, two’
conditions attract attention. . The first is the powerful
action of this medicine in connexion with the stomach,
and the second, its still more powerful action in con-
nexion with the womb.
547. The prominence of these two actions would
indicate, that in cases of Phthisis connected markedly
with either or with both these states, the curative
action of Sepia will it is likely be great.
547 a. To guide in the decision as to the employ-
ment of Sepia, it may be useful to notice some of the
efiects connected with the stomach pathogenesis, and
some with the womb pathogenesis, of Sepia.
174 ACTION or snrm
548. In regard to the stomach phenomena, the
following general remarks may be useful ~:—
548 a. Sepia produces greatbitterness of the mouth
after a meal; it produces bitter eructations after break-
fast; itproduces bitter eructations when rising in the
morning, with bitter taste in the mouth; it produces
hiccough after a meal; it produces pain in various
parts of the body after a meal; it produces nausea to
a great degree.
549. The direction in which the action of Sepia has
a special relationship to the phthisical cachexia is,
that in which the phthisical cachexia has developed
itself in connexion with womb disease.
550. The reason of such connexion is to be found
in the fact, that Sepia has so powerful an action on
the womb. Illustrative of this action the following
extracts from the writer’s lecture on Sepia may be
quoted with benefit—-“ Sepia is to be regarded as one
of the most valuable medicines in uterine disease ; the
reason why it is so will be seen from the subjoined
analysis of its pathogenetic effects.
“The -action of Sepia in connexion with the womb
and its appendages is illustrated by many pathogene-
tic effects.
“ It has the power of producing a peculiar stiffness, ‘
as is exhibited in the p. e. :-—
(595.) A painful stiffness in the region of the womb.
“This sensation of stiffness is very frequently ex-
perienced. Many women describe it as a kind of
mixed feeling of numbness and fulness.
“ It produces darting stitches in the womb and parts
adjacent, as is evidenced by the p. e. :-—
(899.)_ Stitches in the pudendum (about three days).
(90().) Violent darting in the pudendum up almost to the navel.
on THE WOMB. 175
(901.) A stitch in the vagina every three or foul-‘seconds, and a similar
paroxysm of stitches in a quarter of an hour.
“The stitch pain augments to a jerking pain.
(898.) A jerking pain in the vagina from below upwards in the morning on
waking from a dream.
“Its special power is the production of the bearing
down of the womb. This is illustrated in the p. e. :-—
(896.) A pressing, affecting the breath, in the womb, from above downwards,
as if all would fall out, together with gripes. In order to prevent a prolapsus,
she was obliged to cross one thigh over the other: although it did not prolapse,
an abundance of j elly-like leucorrhoea (about ten to twenty hours).
“In regard to the monthly discharge, Sepia has a
specific action. It produces the feeling of—
(904.) Pain in the belly as if the menses were coming on (about four days).
“It produces, as its primary effect, the too early
appearance of the menses. In one p. e.—
(906.) Menses two days too early.
“ In another p. e.—
(905.) Menses six days too early (about four days).
“ In another p. e.—-
(907 .) Menses seven days too early (about three days).
“ In another p. e.—-
(910.) Menses eight days too early, and too scanty, appearing only early in
the morning.
“ In another p. e.—-
(908.) Menses fourteen days too early (after some hours).
“ In another p. e.—-
(909.) Menses many days too soon (after forty-eight hours).
(911.) A discharge of a few drops of blood from the vagina, thirteen days
before the time (about eight days).
“ Before the menses it produces—-
(920.) Violent colic, with faintishness before the menses.
(921.) Two days before the menses, shuddering coldness all over the body
the whole day.
176 LEUCCRRH(EA or SEPIA.
(922) Before the menses, burning in the pudendum.
(923) Before the menses, a smarting leucorrhcea, with soreness of the pn-
dendum. _
(924) Before the menses, as if the genital parts were enlarged.
(925) One day before the menses, a pressure in the belly, and when this
passes away, a soreness in the perinaeum, and a swelling of the pudendum
before the blood makes its appearance.”
During the menses Sepia produces the following
p. e. :—-
(926.) During the menses she ‘is very much exhausted early in the morning.
As it produced before the menses faint feelings;
so p. e. :—
-(929.) During the menses, in the evening darkness and cloudiness before
the eyes, with great weakness, which passes off on lying down.
There is a mental weakness as well.
(934) During the menses, very melancholy, especially in the morning early.
(930) During the menses violent aching in the forehead. with a discharge
of hardened offensive scabs and matter from the nose.
Here is presented the fetid scabs-
(935.) During the menses, nose bleeding three evenings in succession.
(937) During the menses pain in the teeth and beating (throbbing) in the
gums.
(931) During the menses, drawing pain in the teeth up into the cheek, which
becomes bloated. '
(935) During the menses she cannot sleep on account of a tearing pain in
the back, chilliness, and heat with thirst, and a painful drawing up together
in the chest.
(936) During the menses she was obliged to remain in bed two whole days
on account of bodily restlessness, drawing pain in the lower limbs and in the
belly, with rumbling; the second day, beating of the heart for several hours,
in the forenoon with dyspnoea about nine days.
(927) During the menses a tearing pain in the shin bone.
In connexion with the action of Sepia on the
womb, the following p. e. has interest :—-
(903) After coitus, a discharge of blood from the vagina.
(912) A discharge of blood from the vagina only in walking..
' , SEPIA CACHEXIA. 177
Numerous forms of Leucorrhoea are caused by
Sepia :-—-
(941.) Leucorrhoea as clear as water (twenty hours).
(942) Leucorrhma as clear as water. ~ ,
(947 .) Leucorrhoea as milk, only in the day-time, with burning pain, making
to feel sore between the legs.
(940.) Yellowish leucorrhoea (about twenty-four hours).
(946.) Leucorrhoea having the appearance of pus.
(944.) A coming away of a green, reddish discharge from the vagina, during
pregnancy.
(949.) Soreness from Leucorrhoea, with pain when walking.
(938.) Leucorrhoea, with itching in the vagina (about three days).
Sepia acts generally, and causes p. e. :—
(902.) Itching in the pudendum (about twenty-one days).
Illustrative of this acridity, it produces :—-
(948.) Profuse Leucorrhoea of numerous lumps, of an offensive smell, with _
drawing pain in the lower part of the belly.
(939.) Escape of bloody mucus from the vagina.
As Sepia produces dartings generally, in regard to
the genital parts it produces p. e. :—-
(937 .) Leucorrhoea, with dartings in the womb (about twenty-five days.)
Knorre cured the following case with Sepia :—-
Abundant flow of thick yellowish mucosity, not
acrid, during the day only, and not lasting in the
night; fulness, extension, heaviness, tension of the
lower part of the belly, painful and continuous pres-
sure, from below upwards, in the sides.

551. From this action of Sepia in connexion with
the womb, and from its power of developing diseased
states of the stomach, more particularly in the state
of pregnancy, it is not unlikely that it will be highly
valuable in cases of Phthisis which occur in pregnant
women, or associated with the state of pregnancy.
N
178 KALI CARBONICUM
SECTION VllI.—Additional remarks on the Kali Car-
bonicam Cachewia, the C’aasticam Cachemia, the
Arsenical Cachewia, and on some other Medicines, as
applicable to the care of Phthisis.
552. The illustrations already given of the action
of Calcarea, Lycopodium, Nitric Acid, Sulphur, and
Sepia on Phthisis, will serve to present a basis on
which the pathogenetic structures of the medicines
having a curative power in regard to this disease can
be reared.
553. The rearing of such structures in relation to
these other medicines with the minuteness, already
presented in connexion with the medicines examined,
would render this work too large.
554. An attempt thus extensive must be given up;
but it is deemed necessary to embrace in this section
a statement, in a more general manner, of some
pathogenetic features of other medicines.

555. The first medicine to be noticed is Kali Car-
bonicam.
556. In regard to the second stage of Phthisis, not
unfrequently the stools become constipated.
557. Calcarea has the power of producing this
state; but it is not its primary power, since the
pathogenesis of Calcarea shows that it has the power
of producing soft stools. -
558. It will be then useful to inquire whether any
medicine, which corresponds to Calcarea in the pro-
duction of those effects that are homoeopathic to the
phenomena of Phthisis, has at the same time the
power of producing constipation.
CACHEXIA. 179
559. Such a medicine is Kali Carbonicum (Gew-
Iatchs Langensalz).
559 a. It has the power in a marked degree of
producing hard stools :-—-
(742.) Hard stools (for three days).
(743.) Hard stools, with painful contraction in the belly.
(744.) Very hard stool, and uneasiness in the belly.
(745.) Hard, difiicult stool; at times with great urging.
(7 47 .) Girdle-kind of stool, passing away only with pain and fatigue.
(448.) Three times less stool, but otherwise natural.
560. _ Kali Carbonicum has, like to Oalcarea, the
power of causing sweats, and these at night.
561. Kali Oarbonicum has, like Oalcarea, the
power of producing general sweats, as also sweats on
special parts of the body.
562. Kali Oarbonicum has the power of producing
in a marked degree ulcerations, and all manner of
conditions in connexion with glandular ulcerations;
and as the phthisical development, asiexhibited in the
phenomena of the second stage, presents itself in
connexion with ulcerative changes in the tubercles,
it becomes clear that Kali Oarbonicum must have a
curative action in some forms of Phthisis.
563. In connexion with this action of the Kali
Carbonicum, it is interesting to notice, that for the
healing of a scrofulous ulcer it is essential that all the
scrofulous substance must be removed before the
healing can take place. The same conditions take
place in connexion with the ulcerated tubercle in the
lung; and perhaps no medicine will carry the process
through more effectually than the Kali Carbonicum.
564. The following remarks are general :-—-
The cachexia of Kali Oarbonicum presents phe-
nomena which represent the conditions exhibited in
the more advanced stage of Phthisis, expressed by
180 KALI CARBCNICUM.
the title of Ulcerous Pulmonary Phthisis. Dr Currie
remarks, “ A patient attacked by Ulcerous Pulmonary
Phthisis will rarely be cured without the use of this
antipsoric remedy.”
565. This medicine has analogies with Calcarea
-Carbonica; thus, the latter produces a tendency to
twist and strain the loins. Kali Carbonicum produces
the samq.if
566. K. C. produces cold feet; so does C. C.
567. K. C. produces profuse sweats when the per-
son is walking; so does C. C.
568. K. C. analogizes with C. C. in producing the
too early appearance of the monthly discharge; also
in producing the whites. .
569. K. C. analogizes with C. C. in producing ob-
struction in the nostril. "
570. K. C. produces, like C. C., sweating of the
feet. The K. C. has the power of producing a fetidity
I of the sweat. (Might it not be useful when expec-
toration is fetid ?)
571. K. C. analogizes with C. C., with Lycopodium,
and with Nitric Acid, in producing a falling off of the
hair. K. C. produces specially a dryness of the hair.
572. ‘K. C. produces constipation, the constipation
being attended with a diflicult passage of the feeces,
and the feeces have mucus passed with them. Pre-
viously to going to stool there is a feeling of anxiety,
and the stools are very large and moulded. C. C.,
on the other hand, produces soft stools.
57 3. K. C. is special in producing eruption and
excoriation between the thighs during the menses.

* K. C. in future passages will represent Kali Carbonicum; C. C., Calcarea
Carbonica.
CAUSTICUM CACHEXIA. 1 8 1
574. K. C. is special in producing the absence of
the sexual appetite, the absence of erections, and
emissions.
575. K. C. produces expectoration of pus with a
cough, more especially spasm of the chest in cough-
ing, and diflicult breathing.
576. K. C. is evidently suited to scrofulous diseases,
and hence where scrofula has preceded in a marked
degree the development of Phthisis, it will be a duty
to regard the pathogenesis of K. C.

577. The Causticum cachexia is indicated by many
marked characters. -
578. The power which it has of producing nu-
merous effects on the eyes and vision will guide to its
choice.
579. It produces fistulae of the gums.
580. ~It produces involuntary emissions of urine day
and night; also involuntary emissions of semen; it
produces insecurity in walking.
581. It produces eruptions on the nose, also
growths on the nose and the eyebrows.
582. It has as its character more particularly the
power of producing paralytic conditions, and conse-
quently where Phthisis develops itself in individuals,
in whom the paralytic state, either generally or of
local organs, exists, or has existed, the pathogenesis
of Causticum in relation to such cases should be
studied.

583. The Arsenical cachexia is represented where ,
the patient has been subject to quotidian or inter-
mittent fever; where the patient has been subject to
whites which have an acrimony; to excessive monthly
182 BELLADONNA IN PHTHISIS.
discharge, where there is an oppression of the breath-
ing on mounting a height, and a weight at the breast-
bone, and bleeding from the gums and the lungs;
where the patient has been subject to swellings with
pain as of scorching in the great toes; to ulcers of
long standing, with burning and lancinatin g pain, and
obstruction of the mesenteric glands; and especially
where there is excessive wasting. Add to these, when
the patient has been subject to common cutaneous
eruption.
584. Add to these conditions the power of arseni-
cum to produce diarrhoea, and in persons phthisical,
who have been subject to the diarrhoeic condition,
the employment of arsenicum will be indicated, at
least so far as to justify a diligent study of the patho-
genesis of the medicine in relation to the phthisical
case.
585. It will be useful also in these cases of Phthisis
where the patient has cold shivers, with difiicult
breathing, and blueness of the fingers and of the nails
in the morning.

586. The following special points in connexion with
the selection of medicines will afford some ideas which
may be useful :—
587. Belladonna, it is well known, has a powerful
pathogenesis, and consequently an equally powerful
curative agency in regard to swellings of the glands
of the throat. From this it will appear that, in a
case of Phthisis supervening on the sudden disap-
pearance of swelling of the glands of the neck, this
medicine will.be useful.
588. The circumstance connected with its powerful
MANGANESIUM IN PHTHISIS. 183
curative action in scarlatina would lead to its use in
cases of Phthisis which may have occurred subsequent
to scarlatina.

589. Manganesium is contained in the human hair.
The query suggests itself, would it not be useful to
give Manganesium in Phthisis where, with the disease,
the hair falls off ?
590. From the pathogenetic effects which it pro-
duces in connexion with the throat, its utility in
Phthisis, preceded by and attended with throat '
disease, will be apparent.

591. Where, in cases of Phthisis, the bleeding of
the nose is associated with ofihnsiveness of breath, as it
often is, especially persons at the age of puberty, at
which age Phthisis so frequently manifests itself,
Baryta Carhonica will be useful, as it produces p. e. :—
(182.) Bleeding of the nose, often during the day (twenty-four hours.)
(183.) Frequent nose bleeding.
(18/4.) Frequent and abundant bleeding of the nose (twenty-four hours).
(185.) Bleeding of the nose, of bright red blood. (N. G.)
(186.) In blowing the nose, each time there comes a streak of blood. (N. G.)
(187.) Nose bleeds easily on blowing and washing.
591 a. In regard to the smell, it produces p. e. :—+
(291.) Insupportable smell from the mouth, which he himself does not feel
(five days). (N. G.) ‘
Add to this that Phthisis is often associated with
glandular swelling, and Baryta Oarbonica produces
glandular swelling, particularly about the neck, and
its adaptability to -some cases of Phthisis seems
evident.

592. In the preliminary stage are present the con-,
--|--4 :. .:
o'.:o
. .
.
.000‘
184 OPIUM IN PHTHISIS.
-\
trary states of excessive vivacity and of depression-4
of brilliancy of the eye, and of the opposite—-of joy
and of its opposite-of fitness to overcome any diffi-
culty, and of inability to cope with the slightest. To
these symptoms Opium has a pathogenesis strikingly
correspondent, and it will be particularly suited, if
with these symptoms constipation, alternating with
diarrhoea, the diarrhoea being less prominent than
the constipation; and the reasons why it is suited
will appear from the study of the pathogenetic effects
of Opium.
593. The examination of these medicinal cachexiae
abundantly proves that these medicines have great
power over the states of the mind. On the other
hand, the examination of the phenomena present in
Phthisis equally proves that the variations of the
mental states form one of the ~most marked features
in the disease.
594. Dr Sanders remarks :-
“ Wlien the mind of the patient is hypochondriacal,
is too easily or unreasonably impressed with either
joy or despair, we must not believe that she is nerv-
ous, or, in other words, that her troubles are ideal,
and require no medical attention. There is as much
reason for assistance when the actions of the mind
are irregular as there is when an arm or a leg is con-
vulsed or paralyzed.”—-(Pp. 143, 144, lib. cit.)
595. Though Dr Sanders recognises the necessity
of such mental treatment, he hadno effective remedy.
It is true he suggests for the relief of these states
lively conversation, horse-riding, boating, generous
diet, wine, and, if food disagrees, brandy and water—-
means, some of them, quite inconsistent with the
diseased state present in Phthisis. The homoeopathist
. ..
0
0'.‘ 0
0
THE MENTAL sTATEs. ~ 185
has remedies which have the power of meeting, by
their direct action, these mental conditions, and thus
curing the disease at the same time that they remove
the mental state connected with the disease ; and the
homoeopathist is thus favoured, because his know-
ledge of remedial means is founded on the patho-
genesis Of medicines derived from experiments on the
healthy. ~
596. It will be seen that though all the medicines
have the power to produce sweat, Calcarea has the
power in the most marked degree ; and that, further,
as Calcarea cures so many diseased states in which
the production of sweat is a prominent symptom, it
is to be inferred that Calcarea will be one of the
chiefest medicines in Phthisis, in which the develop-
ment of sweat is so marked a feature; indeed, Cal-
carea may be regarded as the highest in rank in
reference to the power of cure of Phthisis.
[The writer presents this chapter, lengthened though
it be, as only a brief description of what is necessary
to be known in order to attain to the successful treat-
ment of Phthisis]
CHAPTER VIII.

GENERAL REMARKS ON THE TREATMENT OF PHTHISIS.

597. Having unfolded in the preceding chapter the
pathogenesis of some of the medicines more especially
applicable to the cure of Phthisis, and having re-
ferred as well to some effects of individual medicines,
it will be useful to detail a few general views in con-
nexion with points on the treatment of Phthisis, as
thence general indications will be afforded, enabling
the practitioner more readily to fill up the blanks in
the treatment, and will thus serve to forestall the
necessity of extending the work to a size unsuited to
_ the object of its publication.

SECTION I.—-On the Treatment of the Heat.
598. The first point to be referred to in the gen-
eral treatment is the HEAT which manifests itself in
the course of the disease.
599. In removing the disagreeable and distressing
sensation of heat, which, in the fever of Phthisis, in-
vades the extremities, the sponging of the parts with
a lotion made of the first dilution, diluted with
water, of the remedy in use by the patient, is highly
beneficial.
CENTRAL CURATIVE AGENCY. 187
600. The explanation of this utility is, that the
action on the disease becomes thus (the medicine
being used internally as well) both circumferential
and central: circumferential by the remedy exter-
nally applied—ceritral by the internally administered
remedy.
600 a. It may be stated as a general rule, that the
employment of external remedial applications, uncon-
joined with the internal employment of the remedy,
is not desirable, as such employment is oftentimes not
radically curative, and might, under certain cir-
cumstances, throw the diseased action in the system
on some internal organ more affective of the health
than that in which the diseased action at first in-
trenched itself.
601. The most skilful treatment is that which cures
centrally.
602. A fact illustrative of the power of the com-
bined action was presented in the case of the late
Baron de Bode. He was ordered by the writer, for
some diseased state from which he suffered, to take
Arnica, a globule interiorly, and to use at night, on
going to bed, the Arnica foot-bath.* He did so, and

* See‘ the _sub_joined pamphlet :-—
“ A Treatise on the Virtues of Arnica, Rhus Toxicodendron, and Oalendula,
in reference to Wounds, Bruises, and other diseased States thereupon conse-
quent.” By John Epps, M.D. _
This was published in the “Lancet,” in the year 1840, as an essay on the
virtues of Arnica.
The essay was subsequently enlarged, and was published as a separate work
in 1841, under the title, “On Arnica Montana and its beneficial effects as a
Remedy for Bruises, Falls, Wounds, Sprains, Lacerations, Corns, Swellings,
excessive Fatigue and its consequences.”
In 1850, a second edition was published, entitled, “ A Treatise on the
Virtues of Arnica, Rhus Toxicodendron, and Calendula.”
London: Sold by Piper, Stephenson, & Spence, 23, Paternoster Row. Pp.
112. Price 1s.
188 DR CURRIE’S RULES-
while sitting with his feet in the water he went fast
asleep ; and when he awoke in the morning, he found
his feet and legs, instead of being cold, as he ex-
pected, the water at this ‘time being perfectly cold,
“quite cozy and warm.” The action thus resulting
must have been caused by the two actions of the
Arnica, externally and internally applied.
603. When the febrile heat is general, and when,
as Dr Currie pointed out, the temperature of the body
is steadily above the natural standard, the patient may
use with benefit the cold affusion.
603 a. The following rules, given by Dr Currie in
his work on the use of cold water, embody all that is
required to be attended to :—-
“ It will be proper to premise, that when the term
fever is used in the present work without any adjunc-
tive, it is the low contagious fever that is meant.
This is the typhus of Dr Cullen; the contagious
fever of Dr Lind; the febris irritativa of Dr Dar-
win. In popular -language, it is generally called the
nervous fever, and, where particular symptoms ap-
pear, the putrid fever. It is usually -produced in
situations where there is a want of cleanliness,
and more especially of ventilation; and when pro-
duced, it is propagated by contagion. This is the
common fever of England. Dr Cullen has defined
the disease as follows :—-‘ Morbus contagiosus ; ealor
parum auctus; pulsus parvus, debilis, plerumque
frequens; urina parum mutata; sensorii functiones
plurimurn turbatae ; vires multum imminutae.’ In
sixteen years practice I have found the contagious
fever of Liverpool remarkably uniform, and in gen-
eral to correspond exactly with this concise and per-
spicuous definition. This disease prevails chiefly
As TO COLD AFFUSION. 189
among the poor, who, from the nature of their diet
and habits, are peculiarly exposed to the causes that
produce it. Seldom extending itself in any consider-
able degree among the other classes of the com-
munity, it has been supposed that Liverpool was
little subject to fever; but this will be shown, from
authentic documents, to be a great and a pernicious
error. ‘
“Whoever has watched the progress of fever must
have observed the justness of the observation made.
by Cullen, V ogel, De Haen, and others, that even
those denominated continued, are not strictly such,
but have pretty regular and distinct exacerbations
and remissions in each diurnal period. In this space
of time, Dr Cullen contends, that an attentive ob-
server may commonly distinguish two separate par-
oxysms. My observations do not enable me to
confirm his position in its full extent—but one exa-
cerbation and one remission in the twenty-four
hours seem generally observable. The exacerbation
usually occurs in the afternoon or evening, the re-
,mission towards morning. These exacerbations are
marked by increased flushing, thirst, and restlessness.
If the heat of the patient be at such times taken by
the thermometer, it will be found to have risen one
or two degrees in the central parts of the body above
the average heat of the fever, and still more on the
extremities. The safest and most advantageous time
for using the aspersion or affusion of cold water, is
when the exacerbation is at its height, or immediately
after its declination is begun: and this has led me
almost always to direct it to be employed from six to
nine o’clock in the evening; but it may be safely
used at any time of the~ day, when there is no sense of
190 DR OURRIE’S RULES
chilliness present, when the heat of the surface is steadily
above what is natural, and when there is no general or
profuse perspiration. These particulars are of the
utmost importance.
“ 1. If the aspersion of cold water on the surface
of the body be used during the cold stage of the
paroxysm of fever, the respiration is nearly sus-
pended; the pulse becomes fluttering, feeble, and of
an incalculable frequency; the surface and extremi-
ties become doubly cold and shrivelled, and the pa-
tient seems to struggle with the pangs of instant
dissolution. I have no doubt, from what I have
observed, that in such circumstances the repeated
afiusion of a few buckets of cold water would ex-
tinguish life. This remedy should therefore never be
used when any considerable sense of chilliness is pre-
sent, even though the thermometer, applied to the
trunk of the body, should indicate a degree of heat
greater than usual. .
“ 2. Neither ought it to be used when the heat mea-
sured by the thermometer is less than, or even only
equal to, the natural heat, though the patient should-
feel no degree of chilliness. This is sometimes the
case towards the last stages of fever, when the powers
of life are too weak to sustain so powerful a stimulus.
“ 3. It is also necessary to abstain from the use of
this remedy when the body is under profuse perspira-
tion, and this caution is more important in proportion
to the continuance of this perspiration. In the com-
mencement of perspiration, especially if it has been
brought on by violent exercise, the afi'usion' of cold
water on the naked body, or even immersion in the
cold. bath, may be hazarded with little risk, and some-
times may be resorted to with great benefit. After
AS To COLD AFFUSION. 191
the perspiration has continued some time, and flowed
freely, especially if the body has remained at rest,
either the affusion or immersion is attended with
danger, even though the heat of the body at the
moment of using them be greater than natural.—
Perspiration is always a cooling process in itself, but
in bed it is often prolonged by artificial means, and
the body is prevented from cooling under it to the
natural degree by the load of heated clothes. When
the heat has been thus artificially kept up, a practi-
tioner, judging by the information of his thermome-
ter only, may be led into error. In this situation,
however, I have observed that the heat sinks rapidly on
the exposure of the surface of the body even to the
external air, and that the application of cold water,
either by affusion or immersion, is accompanied by a
loss of heat and a deficiency of reaction, which are
altogether inconsistent with safety. Each of these
points will be illustrated more fully in the sequel.
“ Under these restrictions the cold affusion may be
used at any period of fever; but its effects will be
more salutary in proportion as it is used more early.
When employed in the advanced stages of fever,
where the heat is reduced, and the debility great,
some cordial should be given immediately after it,
and the best is warm wine.”
604. In connexion with the febrile heat present in
Phthisis, Galen notices a curious fact, that the velocity
of the pulse in this fever is not diminished, as hap-
pens in most other fevers, by the surface of the body
being cooled.--(De Diflhrentia Febrium, lib. cit. 12.)
605. This fact will lead the judicious practitioner
not to expect too much from the cold aifusion, even
in the fever: a little may be gained, and that little
192 ON PHTHISICAL EXPECTORATION.
should not be neglected. Besides, the use of all such
means is a doing, and all sick persons, when no ex-
cessive debility interferes, like doing, because it en-
courages hope of cure. '
606.‘ The character of the fever of Phthisis is’
marked. It presents, in common cases, the marked
periodicity.
607. In almost every case are present, more or less
developed, the morning chill, the afternoon flush, the
night sweat, and the cessation of the symptoms after
the sweats, sleep often occurring.
608. From the description already given of the
pathogenesis of Calcarea, it will be seen that Calcarea
corresponds to this fever in numerous cases ; Lyco-
podium in other instances.
609. In the cases where there is great coldness in
the morning, lividity of the countenance, great in-
crease of difficulty of breathing, thirst, and the
patient is particularly affected when sitting writing,
Arsenic-um should be taken in the morning, and
Hepar sulphuris in the evening.
SECTION II.--On the Eapectoration of Phthisis.
610. In relation to the cure of Phthisis, it will be
useful to notice some considerations in connexion with
the expectoration presented in this disease, and more
particularly with the expectoration of pus.
611. In reference to this expectoration, it is to be
noticed, that the formation of pus is not to be con-
sidered as essentially destructive; indeed, often it is
a manifestation of a curative action.
612. When an ulcer has formed on the surface of
THE rus FORMATION. 193
the body, the matter discharged therefrom, if the
previous stages are favourably modified, assumes the
character of healthy pus, although at first the dis
charge might have been composed of blood and un-
healthy pus; a fact proving that the formation at
first of an unhealthy pus does not of necessity imply
destructive action, since the very destruction of parts
necessary in the production of pus in a diseased part,
causes the presence of substances in the internal
cavity, those substances consisting of the ‘original
substance decayed and lodged in the purulent matter.
613. If the suppurative process degenerates, 2'. 6., if
the ulcer becomes less healthy, then the pus becomes
thin., sanious, and viscid, ill-coloured, fetid, and even
putrid.
614. So when pus is formed in the lungs, the first
portion discharged may be of an unhealthy character,
but it does not follow that the ulcer, whether in the
substance of the tubercle itself or in the ulcerated
mucous membrane, should continue to discharge such
matter. It may improve in its character—it may
degenerate. The duty of the physician is to insure
its improvement, and the means for realizing this
consists in the employment of the appropriate homoeo-
pathic remedy.
615. If the pus is healthy, its formation does not
indicate fatal results.
616. Indeed, pus is found Where there is no ulcera~
tion. Dr Haen found pus in the bronchia, where no
signs of ulceration were present; and his inference
was, that pus must have been generated in the blood.
-—-Ratio Medevzdi, cap. vi. p. 214.
617. The difiiculty in the treatment of the condi--
tions connected with purulent expectoration from
o
DIFFICULTIES IN TREATING
the lungs, consists in causing the parts in the lungs,
modified by the phthisical cachexia, and weakened by
that which has caused the debility, to assume and
continuously to heep up a healthy character.
617 a. The continually keeping up the healthy
action is the difficulty, since how painfully does the
practitioner detect that, while the expectoration has
continued to improve for many days, all of a. sudden
it alters, and the expectoration presents characters
quite opposed to the healthiness of condition of the
ulcer ; and how often, further, does he find that this
change depends on the transgression by the patient
of directions in regard to diet.
617 b. The great difiieulty in the treatment con-
sists in the state, so troublesomely present in the
treatment of ulcers in all parts of the body, namely,
the influence, so powerfully active, of any deviation
from the rules of diet necessary to be followed.
Many an ulcer is going on well towards healing up,
when the person affected with the ulcer takes some
beer or other stimulus. The next day his transgres-
sion appears in the fact that the ulcer, in the leg it
may be, presents an unhealthy appeara~nce, and the
discharge has assumed a less healthy character.
617 c. The same changes take place in ulcers
affecting any structure constituting a part of the
lung substance. Changes in diet, sometimes ap-
parently trivial, cause unfavourable modifications;
and these changes are very likely to take place, be-
cause the nature of the disease itself creates much
personal sympathy with the sufferer, and this sym-
pathy is not unfrequently shown by the presentation
of foods deemed “ nice,”—a character necessitating in-
juriousness when taken. After partaking of these
ULCERS IN THE LUNGS. 195
foods (which the patient from their niceness is
tempted to eat, when actual appetite does not re-
quire them), the progress of health in the ulcer is
arrested, and unhealthy action supervenes.
618. The notions frequently put forth that the
access of air to the wounded surfaces, and that the
continual motion of the lungs frustrate all attempts
to induce a cure, are unfounded; for ulcers often
form in the lungs and heal spontaneously; in fine,
the chief causes of anxiety are connected with the
spreading and the degeneracy of the ulcerated surface.
619. The description of the way (paragraphs 93 a,
93 b, 94, 95, 96) by which nature attempts to pre-
vent both the spread of the ulceration and any injury
to the blood-vessels traversing the ulcerated cavities
in the lungs, shows the great aid afforded by the
powers of the system to render the ulceration not
injurious to the system.
620. Many have argued, that as nature produces
expectoration in this disease, it is wise in attempting
to cure Phthisis to follow her steps, and to try to
produce expectoration.
620 a. This assumption is based on the supposition
that expectoration is in itself beneficial; but it is well
to reiterate the view, that it does not follow because
an effect is produced by nature, that the attainment
~of such an effect is to be sought by the physicians.
The secretion which is expectorated is so much taken
-from the blood, and is produced by an increased and
modified action -of the secretory vessels existing in the
lining membrane of the bronchial tubes. This secre-
~tion must tend to augment the debility already exist-
ing in the lungs, and this subtraction of the nutrition
to be derived from the blood must cause an organ
196 EXPECTORATION,
already debilitated to pass. into a state more and
more unfitted to resist the progress of injurious
change in the tubercles.
621. The chief argument in favour of producing
expectoration is founded on the fact, that the severe
symptoms in inflammation of the lungs have their
severity lessened. when the expectoration of the rusty-
coloured sputa takes place.
621 a. But inflammation of the lungs is not Phthi-
sis. The expectoration in Phthisis is’ generally indi-
cative of the injurious advance of the disease ; though
it is a fact that in some cases cure is more easily
eflbcted in this stage than in the preceding stages of
Phthisis.
622. The symptom of expectoration is of use to the
homoeopathist. He studies the expectoration care-
fully, because he knows that if he can find a medicine
which can produce effects similar to those of the
phthisical disease, and a secretion from the mucous
membrane of the air-passages similar to that which is
expectorated, he will be able to arrest and modify
favourably the disease; and thus, though he does not
seek to produce expectoration as a primary object in
curing the disease, he seeks, when expectoration is
one of the symptoms of the phthisical disease, to
realize a medicinal expectoration, because he knows
that the medicine which will cure the disease must
have the power to produce an expectoration similar
to that presented in the disease.
623. The homceopathic practitioner imitates na-
ture; but his imitation is curative, because regulated
by a law, i. e., he imitates in the way which he knows
the Creator has associated with cure.
624. The great object of search is to find out the
rrs INJURIOUSNESS. 197
medicines that have the power of creating an expec-
torated matter similar to that which is presented by
the phthisical patient in the various stages of the
disease.
624 a. The pus expectorated may be and is in many
cases the result of the changes in the state of the
tubercle. It is a product, when so caused, of ulcera-
tion ; and the query occurs, why should not an ulcer
in the lungs be curable as well as ulcers in the other‘
parts of the body?
625. A difficulty exists in the peculiarity of the
tubercular cachexia. In regard, to ulcers in other
parts of the body, there is a great difference in the
rapidity of healing; and the tubercular cachexia is
one that does -not -favour healthy action.
626. But homoeopathy presents medicines that have
the power of causing, among their pathogenetic effects,
ulcers that are diflicult to heal, and therefore such
medicines will cure disease-produced ulcers having the
character of difficulty to heal. Among these Phos-
phorus and Asafoetida hold a high position.
627. The ulceration is in itself a kindly effort of
nature, but requiring on the part of the physician
skilful direction. It has been shown (106 b) that the
expectoration of all ‘the tubercular matter in any
gland is essential to the healing of that gland ; so the
expectoration of pus in Phthisis is not in itself an
injury: but the difficulty is to find a medicine or
medicines which will ensure the expulsion, by expec-
toration, of the whole of the tubercular Inatter, and
the healing of the ulcerated cavity formed by such
expectoration. '
628. To ascertain these medicines, it is necessary
to study diligently the pathogenesis of medicines to
198 VARIETIES or EXPECTORATION.
produce the remedies corresponding to the different
matters expectorated.
629. Expectorat-ion has various forms. It has the
appearance at times of boiled rice, streaked with
white and yellow streaks.
630. Sometimes it has the appearance of flocculent
globular masses. ~
631. Sometimes the expectoration has a sickening
odoun
632. Sometimes it has chalky particles in it.
633. Sometimes, indeed frequently, it is partly
purulent, partly mucous.
634. Sometimes there is no expectoration at all,
though such cases are, relatively to those cases in
which expectoration abounds, rare.
635. These remarks lead to the inquiry, In which
stage of tubercular Phthisis is cure to be expected ?
636. The writer’s experience is, that cure is most
frequently effected in the latter stages. .
636 a. In this opinion he finds himself in harmony
with Laennec, who, while asserting the incurability
of consumption, states that in some cases the disease
is curable in the latter stages, i. e.,after softening of
the tubercles, and the formation of an ulcerous ex-
cavation.-—(Laennec, Diseases of the Chest, 2d Ed.
p. 299.)
636 b. Dr Good testifies to the same. He says :-—-
“ I can distinctly aver, that I have seen Phthisis
terminate favourably in one or two instances, where
the patient has appeared to be in the last stage of the
disease, with a pint and a half of pus and purulent
mucus expectorated daily, with exhausting night
sweats and anasarca.”--(P. 502, vol. ii., Study of
llledicine.
cunns or PHTHIsIs. 199
636 0. Dr Parr affirms (adds Dr Mason Good)
- that he has witnessed six cases of decided Phthisis
recover spontaneously. ,
636 d. The editor of the 2d edition of Dr Mason
Good’s work remarks :— ‘
“Many experienced practitioners still incline to
Bayle’s opinion, that tubercular consumption is in-
curable; the disease, however, may be retarded, and
patients may live with it some thirty or forty years: ”
which is virtual cure.
636 e. Add to these corroborative facts, that eight
to ten cases of cicatrization of the lungs after tuber-
cles are recorded by Andral in his Clinigue Medicale,
tom. iii. p. 382, i. e., cured in the latter stages of the
disease. -

SEcTIoN III.-—ConcZuding Remarks on Treatment.
637. It is true that the whole of the symptoms
corresponding to the whole of the pathogenetic effects
of any of these medicines may not be present in a
given case of Phthisis at a specific time; but if they
have been present at any period of the patient’s life,
and have disappeared without having been cured
with the appropriate medicines (a case under allo-
pathic treatment most frequent; also many symptoms
disappear under improved hygienic conditions, the
diseased states passing into latent states), these
symptoms, once present but now absent, may be re-
garded as constituents of the cachexia affecting the
system, and consequently in their totality will help
to guide to the remedy to be chosen.
638. People have an idea that, because some dis-
eased state, to which as a part of their case they
200 EACH D~IsEAsE UNCURED
referred, occurred years since, it has nothing to do
with their present state. This is a great mistake, as
it is ever to be remembered that the disease, when
existing in part of the body, was existing, and the
system must have been more or less modified by
such disease, which modification formed part of the
aggregate of the various changes through which
the life-power of the individual body has had to
pass, and must be taken into consideration in the
treatment. ~
639. These views are illustrated by the following
fact :—-
The writer was sent for in great haste to see Baron
de Bode. He lived at that time at Norwood. On
reaching him the writer expected, from the descrip-
tion of the symptoms, to find him dead. He was alive,
but in great agony. He could hardly speak, from
an agonizing oppression at the pit of the stomach,
which afflicted his breathing so much, as to make him
and his family believe every moment would be his
last. He had made all his arrangements for death.
His symptoms indicated approaching death from that
condition of the lungs which is produced when a per-
son dies from suffocation, or rather what is called
asphyxia of the lungs. Still, there were some symp-
toms absent which generally attend that state. This
led to the inquiry‘whether the Baron had ever ex-
perienced any injury at the part where the pain and
the ~oppression were felt. At first he could not re-
member, but subsequently stated, that when he
fought with Macdonald’s division of the French
army, a cannon ball passed before him,- passing be-
tween the horse’s head and the chest of the Baron.
It seemed at the time to strike him: it passed him,
IMPRESSES THE SYSTEM. 201
and made, as he expressed it, a “rag fair” of his
aid-de-camp, cutting him in half. The Baron’s
horse shivered and went on his knees from the
shock. Excited by the battle, the Baron took no
further notice at the time, but felt as if he had been
bruised.
These facts led the writer at once to the belief
that the injury then inflicted was now called into
activity, and he prescribed for the Baron Arnica in-
ternally, and an Arnica poultice applied externally.
In the course of an hour the Baron was relieved of
his symptoms. The accident in this case occurred
nearly forty-five years before the time’ at which the
treatment recorded was adopted.
640. Many similar illustrations, in connexion with
the action of Arnica, are detailed in the treatise
already referred to, p. 187.
641. It has been ignorantly asserted that homoeo-
pathists look only to the symptoms, and pay no
regard to the cause, treating with contempt the old
adage which teaches “ to remove the cause,” “ tolle
causam.” The homoeopathist pays the highest atten-
tion to the cause, knowing as he does that a knowl-
edge of the cause will often give him power of de-
ciding what is the remedy for a given set of symp-
toms, which, without any knowledge of the cause of
the diseased affection, he would have had the greatest
difliculty to select.
642. The writer has known (an illustration has
just been given) the most dangerous diseases cured
by the use of Arnica, the selection of which had been
induced by the fact having been ascertained that an
injury had been inflicted, it may have been years
202 IMPORTANCE OF RECOGNITION
before, in the part diseased; indeed, the writer has
known such results from the use of Arnica when the
injury had been inflicted twenty years before.
643. So, in ‘the treatment of Phthisis, it is highly
important to recognise the cause which may have
instituted the phthisical cachexia, as well as the cause
of developing the weakness which induces the activity
of the physical cachexia.
644. The necessity of looking to the cause of the
weakness in the lung-tissue is illustrated by the fol-
lowing case of Dr Gardner :-—
“A gentleman consulted me for symptoms which
had been pronounced consumptive by several medical
men. He had taken cod liver oil, and used blisters
and other irritative applicationsto the chest, but with
no benefit—the fever, night-sweats, debility, and
cough continued unabated. As this patient had
travelled in Holland recently, and could trace the
commencement of his suffering to his first arrival
home, I suspected the case to be one of irregular re-
mittent fever, attributable to marsh miasma, rather
than consumption, although the physical symptoms,
had I trusted to the stethoscope, would have misled
me. It is in such cases as this that a chemical in-
vestigation of the secretions becomes of the utmost
value. Accordingly, on pursuing such an examina-
tion, I found my suspicions justified ; there was no
evidence of .tubercle, and within three weeks the
careful use of antiperiodic remedies completely ban-
ished all the symptoms, and the patient’s recovery
was complete.”
~ 645. ' On looking at the cause, it will be found that
when a phthisical patient has been in early life given
or THE oausn. 203
to drink, he will die more speedily, and from an
amount of disease which in other circumstances
would not -have caused his death. In January
1857, the writer was requested to visit a patient
whom he had treated when he practised the old
system medicine. He found the patient, in the
opinion of his daughter, hopeless. Still, the patient
had a strong desire to see the writer. He was a man
of an iron constitution, but he had drank largely,
which had so reduced him pecuniarily, that he de-
pended almost wholly on his daughter. He had been
four months ill. He had difficult breathing, pain
between the shoulders, and pain at the chest; he
sweated at night, had expectoration; but the pulse had
not that quickness which indicates a certain fatality.
He sank: in his delirium imagining that the people
picked his pocket, though he had no money for them
to pick. ~ .
646. In reference to the recognition of the cause,
it has been noticed that inordinate activity of the
sexual instinct produces debility of the lung tissue
necessary to awaken the tubercular cachexia.
647. The homoeopathist, therefore, in selecting the
remedy in a case of Phthisis, connected with this as
a cause, would seek one which has the power of re-
moving debility caused by this special excess, and
homoeopathy presents remedial agents having this
power. . .
648. The facts embodied in paragraphs 236, 236 a,
show the necessity of taking care of the young female,
especially in connexion with the natural period, since
from the connexion between the womb and the lungs,
it is certain that the non-occurrence, or the cessation,
of the natural discharge at the regular monthly
I
204 THE URINE As INDICATIVE.
period must tend to develop the tubercular cachexia
into maturity. Hence it will be highly useful in
families where‘ the phthisical cachexia seems to exist,
to give during the period, just before the. develop-
ment of the monthly discharge, the medicine suited
to~ the special indication of any cachexial state that
may be present, and thus the development of the
phthisical cachexia may be prevented from manifest-
ing itself at the time specified. This is the cause
must be looked to.
649. Dr lllalshe relates that, in Phthisis, a faint
nauseous odour, peculiar to itself, attends the urine
not unfrequently, and when plainly present, is actu-
ally not without diagnostic signification.
650. There is truth in Dr Vi/'alshe’s statement;
but the urine varies much in the different stages
of Phthisis, and the pathogenesis of different medi-
cines forms one means by which this state of the
urine becomes valuable as a diagnosis; but also as a
means of cure, for when a given medicine produces a
pathogenesis which in its features corresponds with
symptoms of the phthisical affection, and in so cor-
responding corresponds also with the special state of
the urine, the homoeopathist has his confidence well
founded that such medicine will be the medicine for
the cure. ,
651. In the lung weakness connected with rapidity
of growth, there is no medicine which has a more
marked effect than Phosphorus. In pale persons, of
a scrofulous diathesis, it is remarkable how effectu-
ally it serves to check the progress of the disease,
but it must be given in very small doses, about the
fourth of a globuletwice a-day.
652. Where the old system acts beneficially, it does
OLD SYSTEM. 205
so because it acts homoeopathically. Thus in the
diarrhoea the old systemists give Infusion of Roses
and Sulphuric Acid. They give it as an astringent
and tonic; but the action of the sulphuric acid is
decidedly curative of diarrhoea, of which the old
systemist knows little or nothing. -
CHAPTER IX.

THE MEANS AUXILIARY TO THE CURE OF PHTHISIS.
——
653. The means that may be regarded as acting as
auxiliary to the cure of Phthisis have relation to the
air breathed, to the skin and its-conditions, to the
various bodily exercises, and to diet.
654. The investigation of these auxiliaries will de-
monstrate, first, that the agencies derivable from
these sources will not cure the diseased state con-
stituting Phthisis ; second, that they have, when their
employment is carried out with scientific precision,
so decided an effect, that the neglect of these means
would imperil the life of the patient, by diminishing
in a marked degree the chances of cure.
655. This investigation will be of great use in
teaching what can be and what cannot be gained
from auxiliaries, since to seek results where results
cannot be obtained, and to neglect seeking results
where results can be obtained, are equally indicative
of a want of wisdom—betray an absence of the true
philosophic spirit-—“ A spirit which is quick to per-
ceive whatever is within the reach of human intellect,
but which is not less quick to discern the bounds
that limit every human inquiry; and which, therefore,
AIR IN PHTHISIS. 207
in seeking must seek only what man may learn.”-—
(Brown’s Philosophy of the Human Mind.)
656. This investigation will further show the gross-
ness of the ignorance of many writers on consump-
tion in reference to diet,—an ignorance which is a dis-
grace to men pretending to the title of physicians;
and yet some of these writers are considered by the
old systemists as standard authorities.

SECTION I.—-A ir.
657. The chief auxiliary agent in the cure of
Phthisis is the removal of the patient to a DIFFERENT
and a PURER air.
658. The essential action of the air in connexion
with the lungs is acknowledged by all who know the
circulation of the blood. This general recognition is
valuable. To make this recognition practically opera-
tive, it will be useful to notice specially the points in
which the air is placed in relation to phthisical disease.
659. As AIR IS THE FOOD of the lungs, it is certain
that the purer the air is, the better will be the lungs’
food, and the more healthy, as thus fed, will be the
lungs ; and where the lungs are diseased, the greater
chances of their recovery when thus fed.
660. As air is the proper and special stimulus to
the lungs, it follows that when an individual who has
Phthisis does not reap any additional benefit from
one air, it is advisable, indeed it is imperative, to try
a new stimulus—a different air. This necessity has
a parallelism in connexion with the stomach and its
stimuli. It is known that the stomach requires the
stimuli to it to be varied by having presented to it
different kinds of food.
208 CHANGE or AIR.
661. In regard to the influence of change of the
air breathed, it is a fact that-
“Recruits, who have been used previously to a
country life, are almost uniformly attacked with
catarrh on first going into barracks.”-—(Tyrrell.)
That is, they have passed from an open pure air to
an air less pure, and hence the irritation of the air-
passages, resulting in catarrh.
661 a. “ If we take, a healthy colt from the field,
and confine him in an ordinary, deemed a comfortable,
stable, it will be found, in almost every instance, that
within two or three days the colt will be afiected
with cough and a mucous discharge from the lungs,
which will be increased by leaving the colt there, or
by removing him to a warmer stable; and if he be
so transferred, and in flesh, he will probably get
pneumonia.”— (Tyrrell)
661 b. “On the other hand, like results rarely
happen from sending the colt from a warm atmos-
phere to a cold, from the stable to the field.”-—
(Tyrrell) - j
662. Public attention has of late been drawn to
the great mortality from pulmonary disease among
the Foot Guards in the metropolis,——a mortality par-
ticularly great, and dependent in part, no doubt; on
the impure air of the barracks; but this is not the
sole cause. The principal agents are the change from
the pure air of the country, and the entrance into a
course of dissipation, to which London habits pre-
sent so many opportunities and incitements; and it
is not unlikely there are other causes, which the
writer is taking steps to ascertain, and hopes to bring
erelong before the attention of her Majesty’s Govern-
ment.
AIR As AUXILIARY. 209
663. The relation which the air bears to the lungs
must, it may be inferred, have been recognised by
practitioners in all ages, and the utility of pure air in
Phthisis must have been perceived.
664. Galen refers to baths, exercise, and country
air, as the chief remedies in Phthisis.
665. Celsus recommends for Phthisis change of
air.
666. Laennec maintains that change of air is the
chief remedy in Phthisis. He considers sea air the
best; also that a warm climate is better than a cold
one; that country air is preferable to town air. 0
667. One point of view in connexion with the aid-
to-cure-action of country air grows out of the homoeo-
pathic doctrine of the curative action of infinitesimal
quantities of medicine. The view is, that in the air
of the country it is not unlikely the wild medicinal
plants may pour out infinitesimal quantities of them-
selves, which may act curatively on the diseased.
The writer has felt, when walking over the scented
common of Warlingham, decided effects from the
odoriferous particles. And it is interesting to think
that the very plants the foot treads on would, if they
could speak--they can speak when investigated by
Hahnemann’s method—-tell the sick man who passes
by, “ Here is your remedy; ” and glory be to Hahne-
mann: he was the first, as just hinted, who practically
taught the way to find out the virtues of medicines, by
using them in experiments on the healthy. Here is a
fine field for useful investigation--a field in which
every generous spirit can earn honours. Let each
try to fit himself for proving on himself the curative
powers possessed by the various agents surround-
ing him. Here is an immortality connected with the
r
210 VARIATIONS or TEMPERATURE ;
removal of human suffering. Strange to note, vicari-
ous suffering seems the basis of all progress.
668. A condition in relation to the air, auxiliary
to the cure of Phthisis, consists in some cases in re-
moving the individual to an air higher in temperature
than that to which he has been used.
669. Any one who has studied the action of the
skin in conjunction with the action of the lungs,
must have recognised the great sympathy subsisting
between these organs.
669 a. Of this sympathy, the fact that persons who
die from the eflects of burns have their death pre-
ceded by symptoms which unmistakably indicate
pulmonary disease, is a proof.
670. The fact that the difficulty of breathing and
the cough of consumptive patients are relieved when
the perspiration breaks out, as generally happens
once in twenty-four hours, in severe cases of Phthisis,
indicates the same sympathy.
671. It must be (if the views thus put forth are
correct) essential, in aiding the cure of Phthisis, to
realize, if possible, such a state of the surface of the
body as to prevent every rush or impulsion of blood
from the skin to the interior organs of the body, more
especially to the lung organs, since every congestion
produced in the pulmonary tissue must aggravate the
diseased state already existing.
672. All sudden vicissitudes of temperature tend to
produce such congestions.
67 3. In connexion with the necessity for an equable
temperature, both in the prevention and the cure of
Phthisis, the following remarks of Dr Sanders have an
importance :-—-
67 3 a. “ It is worthy of serious attention that there
THEIR INJURY. 21 1
is nothing which so frequently induces phthisical
affections as the fires kept in our apartments during
winter. [Dr Sanders was a native of Scotland] A
person quits an atmosphere which is cooled much
below the freezing point, and places himself near a
fire, where the temperature of the air is raised much
above that of our blood; whence the greater num-
ber of sore throats, catarrhs, and incipient consump-
tions. Nor is the heat the only thing to be dreaded:
the floating dust and various effluvia, which neces-
sarily proceed from fires, are unavoidably injurious,
even to the soundest lungs.”—(Sanders on Consump-
tion, p. 70.)
673 b. “The immediate effect produced by the
sudden change of the atmosphere might be simply
likened to~ the familiar effect produced, only in a
much greater degree, by suddenly holding one’s hands
to the fire after exposure to the action of cold frosty
air. One can readily imagine the effect produced
by the great and sudden increase of the circulation in
vessels previously constringed by the application of
cold.”
674. Excess of food to a hungry man injures the
stomach; excess of heat to a chilled man injures the
lungs.
675. Add to this the fact, that in most phthisical
patients an extreme susceptibility to the impressions
of cold exists, and the conviction becomes strength-
ened, that to aid in the cure of Phthisis it is necessary
that the sufferer from this disease should not be ex-
posed to great vicissitudes of temperature.
> I 676'. A locality where the temperature is mild and
equable should be selected for the phthisical.
212 CHANGES or sEAsoN.
677. What Hippocrates states in reference to dis-
eases generally, applies to Phthisis specially :-
677 a. “Changes of seasons are most effectual
causes of diseases; so are the alternations of cold and
heat in these seasons.”—(Aphorisms, sect. 3, Sprengell’s
Edition, 1708.)
677 b. “When the London Zoological Society was
first established, numerous monkeys died from the
want of a proper ventilation of their houses. By a
proper ventilation, and the establishment of a regu-
lated temperature, a complete stop was put to the oc-
currence of consumption among the monkeys.”—
(Tyrrell)
678. These facts open up a hope that comparative
anatomy and comparative therapeutics may throw
additional light on Phthisis.
678 b. “The cultivation of comparative anatomy
enabled the genius of Hunter to explain systematically
and simply many points connected with the medical
art; and thereby he was enabled to lay the most
stable foundation for a beneficial union both of the
doctrine of the natural action of the living principle
(physiology) and of the doctrine of the morbid action
of the living principle (pathology).”
679. In connexion with the difficulty of realizing
in this insular country an equable and a milder tem-
perature, the question arises-—
How far can such temperature be realized by keep-
ing the patient in a room or rooms, the temperature
of which is preserved at a given medium by artificial
means ?
680. Where a mild temperature in winter can be
obtained, it should be obtained at once ; but where it
PLACES SUITED. 213
cannot be obtained, an artificial climate must be
created, care being taken that in realizing this arti-
ficial climate an abundant supply of pure air should at
the same time be ensured.
681. A temperature from 63 to 80 degrees Dr
Beddoes considers to be the most suited. Another
form of the same opinion is put forth by Mr Read,
who recommends patients that are atrophied to live
in a cow-house where two to six cows are kept, and
to have the temperature continuously at from 63 to
68 degrees. This writer recommends, further, that
the animals should be fed on aromatic herbs, and the
patient’s self on mild vegetable and animal diet. In
these recommendations some truth is fancifully lodged.
682. The query occurs, Are there any places in the
British isles where this equable temperature, or an ap-
proach thereto, can be obtained ? And another
query, perhaps as important as the former, is, Are
there any places in these isles which present special advan-
tages in regard to the cure of phthisical disease ? If the
latter query can be answered in the aflirmative, the
loss of benefit from not being able to realize the
equable temperature referred to in the first query
will be in part compensated.
683. In regard to equable temperature, as obtain-
able in connexion with the atmospheric conditions of
almost every country, great difficulty exists.
684. The data on which any satisfactory deduc-
tions in connexion with this matter can be founded
are so few and so limited, as to exclude any considera-
tion, although, from the facts already accumulated,
A some conclusions can be legitimately arrived at.
685. The examination of~ these matters in regard to
the influence of air establishes the fact, that the influ-
214 UNDUE PRAISE or PLACES.
ence, although in some respects estimated rightly, is
in many cases estimated too highly. The exaltation
of Madeira, of Malta, and of many other places, is a
false exaltation. Any benefits to the phthisical pa-,
tient in connexion with Madeira consists, first and
chiefly, in the effect of hope, as connected with the
expectation of relief. This invigorates the life power,
and helps to lengthen out the struggle. A second
benefit is to be found in the effect of the stimulus of
change.
686. Every place famed in foreign countries as
beneficial for consumptive patients has been con-
demned by those who have had experience of the
place; hence to the climate, therefore, the curative
action cannot be wholly referred, but rather to the
new stimulus given to the lungs and to the brain.
687. The second query, Are there any places in
the British isles which present special advantages in
regard to the cure of phthisical disease ‘P
688. Among the places in the neighbourhood of
London, there is one place particularly adapted to
consumptive patients. It is a place named Warling-
ham, situated about sixteen miles from London, on
the Surrey Hills.
689. The following letters are illustrative of the
eflicacy of the air of this locality :-—-
689 a. Extractsfrom a letter written by the parent
of a student of the University College, whose talent
and industry may be judged of by the fact that he
carried off the gold medal in every class that. he
attended. He had decided marks of Phthisis—not
sufficient to lay him up, but sufficient to make it
necessary that he should avoid all means that would
tend toidevelop debility in his lung-tissue. He was
WARLINGHAM. ' 215
advised by the writer to leave town every -Saturday
during the winter, to sleep at Warlingham on Satur-
day, stay there all Sunday, sleep there on Sunday
night, and return to town on Monday. He did so
for two winters.
LETTER I.
We feel much obliged for the kind interest on our son’s account.
He has been spending the Easter holidays with us, and returns to
town on Monday, and will, I hope, be at Warlingham on Saturday
afternoon. I wish he were as much in earnest about spending his
time there, as his health, I doubt not, renders expedient. He is
much better since being under thy care, and we are very desirous
that he should fully carry out all thy directions.--H. T.—4 mo.
24,1854.
689 b. The gentleman is now (1859) actively en-
gaged dilfusing benefits, which the diligent use of his
opportunities in London has enabled him to dispense,
in one of the most important towns of Yorkshire.
689 c. His sister came under the writer’s care
(1853) for symptoms indicative of latent Phthisis,
was cured, and is now (1858) in the possession of
good health.
689 d. LETTER II.
Highbury, 6th January 1858. '
DEAR DocToR,-—In answer to your note of yesterday, I am able to
give you the following particulars :—-
You began to attend me for a chest affection in February 1851.
The symptoms, amongst others, were pain in the left lung, a cough,
loss of flesh and appetite, wheezing and difficulty of breathing, pro-
fuse sweats and expectoration. You prescribed spongia, arsenicum,
phosphorus, &c. I well remember that I was in a very bad state.
In April you sent me to Warlingham, where I remained till the
middle of May. I should not have retmned home then but for the
death of my sister Caroline, and my mother’s subsequent journey to
France, in which I accompanied her. I was greatly benefited by
my visit to Warlingham. I have a lively recollection of its pure,
bracing, and exhilarating atmosphere, as well as of the delightful
country walks and scenes in its neighbourhood. It must have done
me good, for after that visit I did not require to come under your
care for any affection of the lungs until March 1852, when, I sup-
216 WARLINCHAM.
pose, our horrible English winter had again developed the latent
seeds of disease.
I would gladly give you a further and more minute account of my
Warlingham experiences (for I am convinced of the advantage of
the place as a residence for consumptively inclined patients), but
having no memoranda of what took place so many years back, I am
unable to fix my recollection with more than I have stated above.
I may add that my mother’s notes and experiences of the circum-
stances agree exactly with my own. With best love from all our
family, I remain, dear Doctor, yours very truly,
T. G. B.
This gentleman is now, September 1859, alive and
well.
689 e. LETTER III.
December 23, 1857.
MY DEAR S1R,——It is now about eight years since I was attacked
with severe inflammation on the lungs, spitting of blood, &c., and
having heard of you, I placed myself under your hands, and in
three weeks I was able to resume business. I had been taken by a
friend of mine to see Dr Cobb, in St Helen’s Place, and he pro-
nounced me too far gone, saying that three weeks would determine
the matter. ‘Dr Cronin came to see me, having heard I was
very bad. He declared that with God all things are possible,
but, humanly speaking, it was next to a miracle if I ever became
well.
About six months afterwards I was attacked with cholera, during
the great cholera year, and was under Dr Kelsall, being a very near
neighbour; but for some days I was evidently sinking, when you
came to see me, and I immediately rallied. As soon as you gave
permission, I was sent to Warlingham, where I recovered quickly.
Since that time I have valued highly the air of that place. Not
only have I been there when laid up with illness, but also when my
health has been pretty, good. I have for long periods at a time
gone down on the Saturday afternoon and returned on the Monday
morning, generally walking up and down from and to Croydon. I
believe the air had a peculiar effect on my constitution, as it has
also on my family. For several summers we have been there for
weeks, and derived the greatest benefit.
Some time ago I recommended a young man to go to Warling-
ham, who was evidently sinking in decline. He went for a fort-
night. During that time he rallied amazingly, and he is now quite
well. Many of my friends who have watched me through my
various attacks of illness (most of them opposed to homceopathy),
say they cannot understand it.
I am, dear Sir, yours very respectfully, S
. , R. .
WARLINGHAM. 217
689 fl LETTER Iv.
To Dr Epps. March 18, 1858.
DEAR SIR;--F01‘ a considerable time previous to your treating me,
I had been very unwell. I do not remember any particular pain,
but I was getting thinner and thinner every day, and consequently
weaker. I had lost nearly all the little flesh which I had had.
When in this state I got wet, which brought on a distressing cough,
a great increase of phlegm, with frequent shiverings, &c. I was
afraid to trust myself in every one’s hands; for I knew I was a
delicate subject, and if subjected to harsh means or improper treat-
ment, there could be but one result, death. I had no faith in
homoeopathy, so I tried all I knew to doctor myself; but in vain. I
got no better, and the disease was daily gaining more hold on me.
At last I went to a doctor (an allopathist). The medicine which he
gave me produced a great change in me for the worse. I told him
the effect it had upon me. He said he would change the medicine :
he did so, and two doses of this put me into bed, where I lay till
you saw me. The cough and phlegm increased to an alarming ex-
tent; spitting of blood came on; I could not get breath. The early
part of the night I was in a fever, and afterwards everything was
wet about me with sweating. I got no rest night or day, till I was
completely worn out. For three or four days before you came, I
was quite helpless, and, I think, indifferent whether I recovered
or died—-.-either would have been a relief to me. All who saw me
were of the same opinion, and it was with a sort of forlorn hope
that my wife sent for you, who was the instrument, in God’s
hands, in restoring me to health.
Though my sympathies have always been with the allopathists,
and I confess that I do not yet understand homoeopathy, yet I am
bound to say that the relief I experienced in my breathing, after the
first dose of medicine you gave me, was almost incredible, and com-
pletely staggered all my previous notions of the power of medicines.
You know the rest: the spitting of blood gradually subsided—
the phlegm got less and less—the cough in time ceased, and I was
raised up, through your instrumentality, much quicker, and got my
strength much sooner, than I had ever done before. For several
years previously I was always more or less unwell in the spring and
autumn of each year, sometimes dangerously so. Since you at-
tended me in the illness referred to, although exposed to all kinds of
weather, I am thankful to say that I have been quite well, until
about six weeks since I got cold, and have had a cough, with a
good deal of phlegm. I have taken nothing but a few globules of
homoeopathic medicine of my own prescribing, and am happy to say
that I am now quite well.
As soon as I was sufliciently recovered (about three weeks, I
think, after your first visit to me), I went to VVarlingham, aecord—
ing to your instructions; and there I improved daily and rapidly—
so much so, that at the end of one month, when I was obliged to
218 WARLINGHAM;
get back to business, I was much stouter than I had been for years
before. During the whole of that summer and autumn, till the dark
nights prevented me, I used to go to Warlingham on- the Saturday
afternoon and stay till the Monday; and the effect upon me was
most marked, whether from the salubrity of the air or the nature of
the soil, I knew not, but so it was. For a long time after I got
back to business I had a very bad headache, and a most unpleasant
feeling of heat and irritation a little above the left breast, both of
which were increased and became fixed and constant towards the
latter end of each week, so that by that time I was completely
jaded and knocked up. Well, I set off for Warlingham. It was
surprising the change I felt, many a time, in going up the hill: the
headache and pain in the heart left me, and very often when I
arrived at my lodging I was quite a different man; and invariably
by the Monday morning I was quite free from pain, and fresh to
commence another week’s work.
Believe me, dear Sir, ever gratefully yours,
E. G.
This gentleman is still free of consumptive disease,
September 1859.
689 g. LETTER v.
March 23, 1853.
MY DEAR SIR,—-We received our dear boy yesterday quite safe,
and looking much better than when he went back to school after
Christmas. Our best thanks for your attention to him. I think he
has given ample proof of the excellence of homoeopathic treatment.
0. P.
The child had all the premonitory symptoms of
Phthisis when the parents consulted me. He was in
a collegiate school connected with the King’s College.
He went to Warlingham, and the result drew forth
the above letter.
Numerous other letters, illustrative of the benefits
derivable from the air of Warlingham, might be
given; the fact is, that in the summer the few lodg-
ings there are full of consumptive and other invalids.
690. The query here occurs, What are the condi-
tions which render Warlingham thus favourable to
the consumptive?
691. The study of the Ordnance map will exhibit
the striking peculiarities of the position of this village,
ITS POSITION. 219
both in connexion with the surrounding country and
in relation to its own locality.
692. Besides this peculiarity of position, Warling-
ham is remarkable for the fact that there is no water,
except at a depth of 200 feet and more, and the water
used is rain water. A walk, or a ride or drive, at
Warlingham, exposed to the sun on the south-west,
and protected on the east by a high hedge and
copses, affords the means of exercise to the consump-
tive even in a cold sunless day.
693. The writer, when he visits Warlingham, finds
on the summit of the hill, that forms part of the way
from Oroydon to Warlingham—this bringing the
traveller to Sanderstead, the village on the top ~of
the ascent—a joyous feeling, so great is the exhilarat-
ing effect on his spirits ; he seems to breathe easier.
694. The Warlingham common, too, is covered
with wild flowers, some one or other, at almost every
season of the year. The furze is almost always in
flower; there is the wild thyme sending out its de-
licious scent; there is the harebell, the potentil, the
tormentil, the ononis, the St J ohn’s wort, the heath,
the fern, the little vetchling, the eyebright. It com-
prises several hundred acres, ~and over its surface are
the most delightful smooth roads over the green
sward, where the invalid can ride, inhaling without
fatigue the pure breeze.
' Oonnected with this subject of air is that of ventila-
tion.
695. The bedroom and its adjuncts form a most
important matter in conjunction with ventilation in
connexion with the phthisical patient.
696. The bedroom of the phthisical should, if pos-
sible, look towards the south.
220 REDRCCM FREE or DAMP.
697. The greatest care should be exercised to have
the bedroom free of damp.
697 a. Damp tends to the production of fungi,
which fungi have a noxious influence; indeed, many
fungi have decided medicinal power.
698. The floor of the bedroom should be perfectly
free of dry-rot, as dry-rot emits poisonous effluvia.
699. The bed itself should have no curtains?"=
699 a. The French bedstead, made of oak or of
mahogany, is the best; and the bedstead should rest
on castors, so that it can be moved easily, and have
the dust under it cleared away.
699 b. All dust should be banished from a bed-
room. Dust harbours efliuvia, which effluvia are in-
jurious.
699 c. A four-post bedstead, with curtains drawn
all round, forms a modified black hole of Calcutta,
—a barbarous engine of slow murder, recently re-
instituted by the British authorities at Hong Kong
and in India during the late war.
699 d. The curtains keep in all the impure air ex-
pired by the phthisical patient reposing on the bed.
The curtains become loaded with the moisture which
escapes from the lungs, the oleaginous particles be-
come deposited in the texture of the curtains, and
thus poison is added to poison, and the curtains be-
come quite offensive. This happens especially if the
curtains are of merino and are coloured. If the cur-
tains are dimity, and white, then the liability to
become soiled ensures an occasional washing.

* The writer has not a single bed-curtain in his house. He once had lodg-
ings in one of the mansions at Dover Court, and the brown merino curtains of
the bed were quite offensive from the accumulated perspirable fluid collected
in them.
VENTILATION. 221
700. In connexion with this subject of ventilation,
a question, often put in reference to the consumptive,
is, I s it right that persons should sleep with patients afiected
with Phthisis ?
700 a. The existence of the phthisical cachexia
settles this question, since every cachexia creates, in
connexion with the human body, its own atmosphere
—-the phthisical its own ; and to subject healthy per-
sons to the influence of such an atmosphere must be
injurious.
7 00 b. It is a pleasing fact that, if an absolute
necessity exist that individuals must be thus ex-
posed, homoeopathy enables its practitioner to meet
the difficulty by giving to the healthy persons a
medicine which will act antidotally to the poison of
the cachexia.
7 00 c. These views will serve to explain what
amount of truth exists in the opinion held by Galen,
Riverius, and others, as to the infection from Phthisis.

SECTION II.—-On the Skin in Relation to Phthisis.
701. The intimate sympathy between the skin and
the lungs has been already referred to.
702. Cleanliness will be found to be one of the
most valuable auxiliaries in the treatment of Phthisis.
It keeps up a healthy action of the vessels of the
skin, and thus acts in preventing those lung con-
gestions so favourable to the induction of the de-
bility necessary to render the latent physical cachexia
active.
703. The remarks which Dr Andrew Combe has
made, in connexion with the sympathy existing be-
tween the skin and the bowels, may be transferred
222 SKIN.
to the lungs in connexion with the skin; and the
reader is earnestly entreated to read the work of Dr
Combe.*
704. Another valuable auxiliary in the treatment
of Phthisis has connexion with the skin: it is the
practice of sponging with water the whole body,
about the time night sweats cease.
704 a. Dr Sanders makes the following practical
remarks, p. 148, lib. cit.:—
“The sweat must be wiped off assiduously, by
which the vessels of the skin partly recover their

* This book, one of the most valuable works issued from the press, has ap-
pended to it the following tale of bigotry, a tale which presents a striking ex-
hibition of the same spirit which the vulgar herd of journalists exhibit towards
“ homoeopathy.”
The subjoined letters were forwarded to Dr Epps, in the year 1834, by Dr
Andrew Combe, and afford interesting illustrations :-—
“ Edinburgh, April 25, 1834.
“ MY DEAR SIR,—I have lately published a small volume, entitled ‘Prin-
ciples of Physiology applied to the Preservation of Health and to the Improve-
ment of Physical and Mental Education,’ which, I think, may be useful to
medical students and the public.
“ Longman & Co. are the London publishers, and have instructions to give
you a copy on sending for it; and I have now to request your acceptance of it
as a small mark of respect. It has been out six weeks, and to my surprise
two-thirds of the impression are already disposed of. If you approve of it, and
have the means of noticing it in any of the London journals, I need hardly
say it will be an obligation to do so.
“ Mr Simpson, who carries this, will give you an account of our doings.
He also has been publishing an excellent little work, which you will probably
have seen. With best regards from my brother, I remain, dear Sir, yours
sincerely, .
“. ANDREW COMRE.
“ P.S.—I am desired to say that the book will be sent to you.
“A. C.”
“ Edinburgh, October 23, 1834.
“ MY DEAR SIR,-—Have you heard of, or can you give me any information
regarding, a new bandage or support for curvature or weakness of the spine,
and which is made chiefly of elastic materials, caoutchouc I am told, and
which is said to present the advantage of giving adequate support without
impeding free muscular motion ? I have heard, but very indistinctly, of such
BATHING THE SKIN. 223
tone, and thus we prevent the very injurious efi’ects
of the cooling perspiration, and, in a great degree,
the alarming effects of exhaustion, which are so apt
to appear in the remission.
704 b. Where the temperature of the body is
great, and steadily above the natural temperature in
the febrile stage precursory to the development of
the sweats, the sponging of the whole body with cool
or lukewarm water will often have the most bene-
ficial effect.
704 c. The rule, in order wisely to guide the

a thing, and if it really exists, would be thankful to have access to it, par-
ticularly for a case now under my care. The great objection to ordinary
bandages is their impeding muscular growth and action, and I would rejoice
to see something to which this objection should be inapplicable. Will you
then do me the kindness to make inquiry and communicate the result ?
“I thought I could trace your friendly pen in the handsome notice of my
book in Dr Ryan’s Journal, and was glad to find that I was not mistaken. I
ordered a copy of the second edition to be sent to the journal early in August,
and wish you had seen it, as there is a good deal of additional matter. The
second edition is so nearly out of print that I shall begin the third next week.
The first had been stereotyped at New York, as a volume of the Family Lib-
rary, and the second edition is reprinted at Boston.
“ I had already recommended Dr Ryan’s Journal to some of my professional
friends when in the North some time ago, and shall be glad to do so again
when opportunities occur. I liked your lecture on colchicum very much, as
clear, methodical, and practical. The case of epilepsy I would have noticed
earlier, if I had possessed any fitting medium. The ‘ Phrenological Journal ’
is not the proper place for a medical report, and the editor of the ‘ Edinburgh
Medical and Surgical Journal’ (here) has such a horror of phrenology and
phrenologists, that I believe he would burn his book rather than put anything
of mine into it. Isent him a copy of my work, that he might have no excuse
for not noticing it, and I know that some of his friends were urgent that he
should notice it. So far from complying, he has not even inserted it in the list
of books sent for review! Hoping to hear from you, I remain, with best re-
gards to you from my brother and nephew, yours very truly,
“ ANDREW Comnn.”
So that, in regard to a book which in less than half a year had passed
through two editions, which had been stereotyped in New York as a volume
of the Family Library, and was reprinted at Boston, the editor of the “ Medical
and Surgical Journal” would in no way notice it, because Dr Andrew Qombe
happened to believe in phrenology.
224 I CN BODILY ExERCIsEs.
employment of the sponging, is the presence of a
temperature in the body which is steadily above the
natural standard. This being attended to will cause
the patient to have a delightful refreshment after the
process has been gone through.
705. Where there is considerable debility, the ap- ‘
plication of the wet sheet would, it is likely, be bene-
ficial.
70-6. The writer of this treatise has not unfre-
quently required the patient labouring under Phthi-
sis, and affected with night sweats, to rise and dress
half an hour before the expected night sweats, and to
remain up till the time of the sweats had passed.
Benefit has in many cases resulted.
706 a. The procedure has been recognised by Mor-
ton, in his work, Phthisilogia ; i. e., he advises the
patient to be awakened at night, to prevent sweating.
707. The benefit of keeping up a full action on the
skin by means of the vapour bath is great; and the
vapour bath presents this advantage, that, unlike
the warm water bath, it does not increase any injuri-
ous pressure on the surface of the body. Such pres-
sure often produces an injurious effect on the lung-
tissue in the phthisical. Once a-week it is,_ often of
great service. It should be used before the mid-day
meal.
708. The patient, when unable to bear any one of
these applications of water, should be washed all over
daily, doing the washing with tenderness, and with
such arrangements as not to fatigue.

SECTION III.-—On Bodily Exercises.
709. The exercise of walking is one whence much
WALKING, WHY USEFUL. 225
aid can be obtained in connexion with the cure of
Phthisis. - .
710. The instruments by which motion is realized
by the human machine are the oints and the muscles
which move the joints.
710 a. The muscles may be regarded as composed
of muscular fibres, among which are distributed, in
the form of tissues of almost infinitesimal fineness,
blood-vessels, arterial and venous, and nerves, all
joined together by cellular tissue.
711. These fibres are so arranged, that in walking
the blood is made to circulate freely through all these
tissues, and thus, by this consequently equal distribu-
tion of the blood through the tissues constituting the
muscle, a healthy circulation of the blood is caused.
712. In addition to this, the situation of the
muscles engaged in the act of walking is such as to
cause a pressure on the interior organs in the interior
of the body, and thus the injuries which would result
from an impeded circulation of the blood through the
vessels of those organs is prevented.
713. The tendency to the production of impeded
circulation through the lung-tissue, in connexion with
Phthisis, has been unfolded (paragraph 93.) ; the
effect of want of exercise in tending to induce a
debility of the lung-tissue has been explained (para-
graphs 258. 263.) : andhencewalking, which causes
a free circulation of the blood through the chest,
must be useful in helping to prevent and to remedy, if
present, that state of the vessels of the lungs which
attends the development of the phthisical disease, or»
if the disease is developed, will help to arrest its
progress. ~ q _
. 714. These views in connexion with walking, Show
Q
226 RIDING IN A CARRIAGE.
that the practice is one which must be serviceable in
cases of Phthisis, and will explain the fact, that nearly
twenty centuries since Hippocrates recommended to
the phthisical walking and running.
715. In lung diseases, shortness of breath is present.
If exercise, under certain conditions, produces a short-
ness of breath, may not benefit be derived from ex-
ercise wisely contrived to relieve the diseased state,
by inducing given actions of the lungs ?
716. The exercises introduced by Professor Ling
will be highly valuable in many cases of Phthisis.
Dr Chapman has put forth some valuable facts on
this subject, in a pamphlet entitled Ling’s Educational
and Curative Exercises.

717. Riding in a carriage is serviceable, as it gives
exercise without producing any effect on the pulse.
It does not cause any increase of the circulation-a
matter of considerable importance in some cases of
Phthisis.
718. Riding enables the person using this exercise
to gain two objects—first, the change of air, and
second, the benefit of motion. Many persons fool-
ishly debar themselves from the former benefit by
riding shut up in close carriages. It is easy to
arrange so as to exclude the cold wind by putting up
the carriage window on the side on which the wind
blows; thus the patient has the benefit of the air
without the risk of getting chilled.

719. Riding on horseback is highly serviceable to
persons phthisically inclined.
719 a.‘ It gives exercise, and takes off that part of
HoRsE AND SAILING EXERCISE. 227
the fatigue dependent on the having to carry the
weight of the body, the horse bearing this.
719 b. The action of riding produces beneficial
effects in connexion with the kidneys, and therefore
is likely to have a curative power in those cases of
Phthisis which are preceded by or attended with cal-
culous concretions in the kidneys--a form of Phthisis
which has received the name of Calculous Phthisis.
720. Sydenham highly extols riding on horseback.

721. Sailing in a boat on the water, particularly on
the sea, is highly advantageous.
721 a. The up and the down motion of the sea is
particularly favourable towards the inducing an easy
and a healthful action of the lungs.
721 b. Add to this that the patient has the benefit
originating in the action of the sea air, the uses of
which have been already explained.
722. Oelsus (lib. iv. caput 4) thus refers to this
agency-—“ Utilis etiam in omni tussi peregrinatio,
navigatio ‘longa, loca maritima, natationes,” i. e., in
every cough travelling is useful, long sea voyaging,
sea places, boatings. I
723. Dr Sanders (p. 159, lib. cit.) relates the fol-
lowing :-
“ The first timethat I observed the decided utility
of sailing as a remedy in the purulent stage of Phthi-
sis was about twelve years ago, in the case of a young
gentleman, who, by intemperance and dissipation,
brought pulmonary consumption on himself. He
had had the best medical advice in Britain, particu-
larly that of Dr Monro, senior, and Mr Benjamin
Bell. After purulent expectoration came on, he pro-
228 VOYAGES TO SYDNEY AND EGYPT.
cured a sloop, and having sailed along the coast a few
months, seemed to have entirely recovered.”
724. The writer believes he has preserved the lives
of several by causing the patients phthisically disposed
to voyage all the summer, and then in the winter to .
seek some retreat on the southern coasts of England.
725. A pupil of his, a Mr Tawell, voyaged three
times to Sydney, and saved himself from death by
these’jvoyages: it is true he succumbed at last, but he
added a few years to his life.
726. Laennec states that most naval surgeons with
whom he had conversed informed him, that they had
scarcely ever known a man become phthisical in the
course of a long voyage ; and that they had fre-
quently seen sailors, who had pulmonary complaints
at the time of putting to sea, return benefited or
cured.—(Laennec, lib. cit., p. 352.)
727. Sea voyaging presents the benefit of sea air,
and the sea voyage can be so arranged as to get into
an equable climate at the time of the year when the
season would not be equable in other parts.
728. Add to this the benefit that the voyager
has of being always on a level: a great advantage
in phthisical cases, since in them it not unfrequently
happens that every change in the elevation causes a
difficulty in the breathing, as is seen in the effect on
going, up ' a hill; which disturbance of the lung-
tissue has the effect, to a certain extent, of interfering
with the healing processes which must go on in the
diseased lung-tissue to realize a cure.
729. Old is the observation that there is nothing
new under the sun. Of late years it has become the
fashion for consumptive patients to go to Egypt, and
in many~cases benefit has been derived. It is a
FRICTION. 229
'-curious fact “that Pliny refers to the practice as one
carried out in his day.

730. Another form of exercise is friction.
731. Celsus was a strenuous advocate for rubbing.
He recommends rubbing the eaztremities,—-a recommenda-
tion well worthy of attention, since such rubbing is
attended with the establishment of a healthy circula-
tion through the extremities, which must tend to re-
lieve the condition of the lungs.
732. He recommends rubbing the chest after talcing of
food. .
7 32 a. Much philosophy exists in this, since, after
taking food, there is an increased vascularity in the
mucous coat of the stomach, which, from the close
neighbourhood of the stomach to the lungs, tends to
the increase of the pulmonary congestion. Friction
tends to equalize the circulation.
732 b. By rubbing the chest gently, the action of the
lungs produced by this concentration of action on the
stomach is in part lessened, and thus any sudden re-
action which might take place after the concentration
of action has ceased will be prevented.‘ The diges-
tion of the food may perhaps be a little delayed; but
the injury arising from the sudden transfer of the
action from the stomach to the diseased tissue in the
lungs would be far greater than any injury that ‘might
arise in connexion with delay of the digestion.
733. Another suggestion which , Celsus makes is,
that the phthisical patient should rub himself, holding his
breath at the time of rubbing. - '
- 733 a. Much philosophy lies hidden here also.
The holding the breath keeps the air in the lungs.
239 INHALATION.
Such retention of the air tends to the expansion of
the lung-tissue, and may, by its pressure, produce a
degree of absorption in connexion with the diseased
lung-tissue, the injury from the retention being pre-
vented by the act of rubbing, which keeps up a con-
siderable amount of circulation on the skin surface.
734. As the voluntary power or the will conducts
the inspirations, and the natural or involuntary
power the expirations, it is clear that any curative
action connected with the action of the lungs them-
selves must be in connexion with the inspirations, that
is, it is only in the inspirations that the modifications
on the lung-tissues can be realized.
735. Another mode by which rubbing is made very
aidful to the cure of Phthisis, consists in ‘rubbing
round the part sunken (paragraph 181.) on the chest,
first making the circle of friction round the part, then
a larger circle, then a larger, and so on.
736. Exercise requires to be combined with the
fresh air. Thus two benefits are gained: the bodily
exercise distributes the blood equally through the
vessels of the body, and the fresh air supplies the
real food to the lungs.
737. Indeed, it is a matter worthy of consideration
whether the phthisical patient should not draw in
the outside air, even when confined to the bed-
chamber or to the room, by having a pipe connected
with the outer air, and to inhale the air through the
tube, embracing the tube when inspiring, letting the
tube go in expiring.
737 a. The inhalation of vapours medicinal owes,
in the writer’s opinion, much of any real benefit, not
so much to the vapours inhaled, as to the act of in-
haling.
READING AND SPEAKING ALOUD. 231
737 b. In-this point of view it is not impossible
that Dr Ramadge has effected some benefit by the
instrument that he sells to his patients for the pur-
pose of inhalation.

738. Another form of exercise, of the greatest
power in preventing the development of Phthisis, is
the exercise of the lungs in reading aloud and in
public speaking, practised at first for a short time, and
then gradually extended.
739. Oelsus, in his work “De re Medica,” recom-
mends the patient with a consumptive cough to run
and read aloud, and not to mind the interruption of
the cough, which, he says, will gradually subside.
740. Ouvier, the great naturalist, was consumptive
when a young man. He obtained a professorship at
Paris, the duties of which required that he should
lecture almost daily. Many predicted that he would
soon cease to exist. The lecturing exercised his
lungs, and he soon was free of the phthisical tendency,
and lived to an advanced age.
741. There are exercises of the lungs which are
injurious.
Walking, as has been already explained, is highly
beneficial in producing health, and in thus strength-
ening the lung-tissue, prevents the development of
tubercular phthisis ; yet there are conditions under
which, walking being practised, this, in other circum-
stances health-producing process, becomes productive
of debility in the lung-tissue.
742. The action of walking produces an increased
rapidity of circulation, and an increased rapidity of
breathing.‘
232 MORTALITY on THE FOOT GUARDS.
7 43; It is a fact, established by the experience of
several years, that the mortality among the Foot
Guards is great. The cause of this has been sought
in the fact, that the Guards are chiefly in London.
A second cause has been of late sought" in the miser-
able system of ventilation existing in the barracks of
the Guards. Both these causes may operate, but it
appears to me that the principal cause is to be found
in the following fact :—-
7 43 a. The Guards march across the park daily
when the Queen is in London. They play as they
march. The vocal instrument players have two ac-
tions, both of which operate on the lungs: the first is
the action of walking, to do which the lungs should
have full play ; the other action is holding the breath
in the act of playing on the vocal instrument. These
two actions in persons of weak lungs must be de-
structive; and this is, I believe, the principal cause of
the mortality, for it is in relation to lung diseases that
the mortality manifests itself: in other words, this
playing the vocal instruments in the act of walking
causes a disturbance of the regularity of the inspira-
tions and of the expirations, and consequently a debility
is induced in the pulmonary tissue, and if tubercles
exist they become called into action, and the con-
tinuance of the wind instrumental music exercise
perpetuates the disease, until Phthisis puts an end to
the man.

SECTION IV.--On Diet.
744. The diet required by consumptives is a nutri-
tive but not -a stimulating diet.
745. The idea of nourishing and strengthening
DIET. 233
patients suffering under Phthisis by dietetic means is
ridiculous. It is the disease -that exhausts. Cure
the disease, and the patient, ceasing to be a patient,
will get strength.
746. The digestive powers in persons affected with
this disease are more or less weakened; the patient
requires, on this account, to be fed by food easy of
digestion.
747. There is a fever in the system already, and
therefore all stimulating food which in its digestion
causes fever must be avoided.
748. A small quantity of food should be taken at a
time; because, if the stomach is loaded, the curative
action in the lungs will be interfered with, as the life
power necessary to effect a cure of the diseased lung-
tissue will then, in patients whose stomachs are thus
loaded, be occupied in effecting the requisite actions
in the stomach in connexion with the food taken.
749. In almost every case of Phthisis there is a
marked alteration in the appetite; on the one day
there is a good, almost a ravenous appetite; on the
other day, the appetite languishes. The first condi-
tion oftentimes causes the patient to eat more than is
proper; the second condition causes the patient to
pamper the appetite in order to take a quantity of
food deemed necessary to support the strength.
750. It was noticed that in the progress of Phthisis,
especially in its premonitory stage, there is often
an alternate dayism, i. e., the patient, as just recorded,
has appetite on one day, and no appetite on the next;
cheerful one day, melancholy the next; digestion in-
efl-“ectual one day, effective the next.
750 a. The practitioner will do well to view the
action of Pulsatilla in relation to these conditions, for
234 HUNGER, ITS OHARAOTER.
Pulsatilla has the power of producing this alternation
of symptoms and state.
751. The patient should, however long the absti-
nence from food be carried from an aversion to~ it,
never be allowed to pamper his appetite. Food taken
under such a condition is never properly digested.
752. Mere hunger is no indication that food is to
be taken in disease. The following remarks, and they
deserve the highest attention, illustrate these points:
hence, though the quotation is long, the truths em-
bodied have so extensive a bearing on the treatment
both of Phthisis and of diseases generally, that the
insertion is justified :-—-

Axiom 16. HUNGER BEING DEPENDENT UPON A STATE OF THE BRAIN,
IT MAY BE DEVELOPED IN DIsEAsE, AND, As SUCH, 1s A FALSE
HUNGER.
Brachet has proved by experiments that, when the nervous com-
munication between the stomach and the brain is cut off, the feeling
of hunger instantly ceases, even when a moment before it was
ravenously strong.
The first proposition in this axiom has been demonstrated by the
observations of phrenologists, and has an important practical bearing,
because if hunger so depends, then the desire for food, or more
strictly the appetite of hunger, is, when the brain is in a diseased
state, to be regarded as not at all indicative of a want of food, but as
indicative of a state of disease; and the enlightened physician exer-
cises his judgment, and decides whether the demand of the patient
is or is not to be listened to; and though medically ignorant and
partisan coroners * may try to obtain verdicts of died by starvation
against physicians who do exercise their judgment, such physicians
will still persist in using their judgment on the point in question,
* The following verdict was given in the case of Mr Cordwell, who was a
patient that had been under the care of Dr Curie, but who, by some busy-body,
was transferred to the care of an apothecary, in whose hands he died. A
coroner’s inquest was held, and the verdict given, without hearing what Dr
Curie would have said on the subject, was the following :-—-
“ The jury are of opinion that Henry Cordwell died from exhaustion, caused
by loss of blood from the intestinal canal, produced by natural disease: and in
complying with what the jury believe to be their bounden duty, in returning
their verdict in strict accordance with the sworn evidence of the medical gentle-
FooD IN FEVER. 235
being satisfied that, in so exercising their judgment, they are using
the highest and noblest power of the mind in meeting a question
pregnant with life or death, according as it is wisely or unwisely
answered, to the patient.
The feeling of hunger being developed in disease, is no more in-
dicative of a need of supply than is the hearing of imaginary sounds,
produced in diseased states of the brain, any reason why the sounds
should be obeyed. The physician understands this: his skill con-
sists in the judging whether or not the hunger depends upon the
disease or on the restoration of the healthy condition of the system
calling for a supply. It is most diflicult sometimes to decide.
Granted; but what is skill? what but working the way through
difficulties?
In typhoid cases in particular, hunger is sometimes felt, and in
typhoid cases under the old system, food, and especially wine, is
oftentimes given, and it is said with success. The homoeopathist,
who can use his weapons rightly, never needs to give food or wine
or brandy in typhoid fevers, while the tongue is coated. It is true
he is met with the statements of the benefits which resulted in some
given case from the use of wine and other stimuli. But these cases
are cases in which the life-power has been exhausted under the old
system treatment by the depletory measures, whether by purging,
leeching, bleeding, or other means, and then the stimuli do good,
not because a scientific treatment of the disease needed such aids,
but because the life-power, exhausted by the injurious treatment,
required an auxiliary; so that the deduction of the advocates of
wine in these cases is a testimony, not to the scientific character of
this part of their treatment, but to the miserable and destructive
empiricism of that treatment.
It is true that in certain forms of typhus fever, where semi-starva-7
tion has preceded the attack, some kind of food in very small quanti-
ties, and of a liquid form, may be useful. The utility of food in
these cases does not depend upon the food being necessary for the
cure of typhus fever, but because the constitutional state, in which
the febrile has gained its position, is one which was produced by a
previous deprivation of food.
It may be added, as a fact further confirmatory of the evil of
giving food to patients labouring under fever, that the very worst

men who have been called as witnesses, the jury cannot refrain from express-
ing the strongest feelings of disgust and indignation, at hearing it proved by
the testimony of the nurses, that the afflicted gentleman had been cruelly ex-
posed to a system of starvation while in a state of the-most extreme debility,
during at least ten days previous to his death, he having during that long
time been allowed nothing but cold water, by the advice of his medical at-
tendant.”
Of this verdict Mr Wakley, the coroner for Middlesex, expressed his appro-
bation, he having refused to hear Dr Curie.
236 ~.EOOD IN EEVER.
typhoid fevers are often preceded by and attended with a voracious-
ness of appetite.
Dr Beaumont asserts, “When the stomach is unusually debili-
tated, food is frequently retained twenty-four hours or more, and is
-sometimes the cause of most distressing symptoms, producing, par-
ticularly in children, convulsions and death.”——P. 61, liber cit.
Indeed, experience has given abundant evidence of this. I have
known cases of inflammation of the brain, the treatment of which
was proceeding most favourably, the patients after having been in-
sensible had recovered their senses and their power to notice, and
which have been made to terminate fatally by some unwise mother,
aunt, uncle, or grandmother, giving the patient some (so called but
miscalled) nourishment. '
Axiom 17. IN THE PERRILE STATE LITTLE OR NO GAsTRIC JUICE Is
SECRETED.
The experiment on which this axiom is founded was performed
March 16th. , The villous membrane of Alexis’s stomach was red
and dry. He complained of headache, pain and distress at the pit
of the stomach, lassitude, and loss of appetite. On introducing the
tube into the stomach, no clear gastric juice could be obtained. A
little acrid fluid and frothy mucus only could be extracted.
This axiom and this experiment completely establish. the absurdity,
the unscientificness, of giving food in fever. The agent, the gastric
juice, which is the efficient cause in digestion, is absent; how can
the action of digestion be completed ? The worker is not there, how
then can the work be done? It is hence evident that it is abso-
lutely necessary to withhold food from the stomach in febrile com-
plaints. It can, being undigested, afford no nourishment, but is
actually a source of irritation to the organ, and through it to the
whole system, increasing the fever and perilling the life. “ NO
solvent,” says Dr Beaumont, “can be secreted under these circum-
stances, and food is as insoluble in the stomach as lead would be in
ordinary circumstances.”
It should ever be remembered, that before food can be nutritive
two conditions must exist; first, that the food is by its nature suited
to the stomach; and second, that the stomach is in a state suited to
act on the food. In fever, it is certain, from this experiment of Dr
Beaumont, that the stomach is not in a state suited to act on the
materials taken into that organ, and consequently this condition,
necessary to the realization of nutriment out of the food being
absent, food, instead of being nutritive, is poison to the recipient.
Axiom 18. UNDIGEsTED PORTIONS OF FOOD PRODUCE ALL THE PHE-
NOMENA OF FEVER.
Dr Beaumont observed that there is always disturbance of the
stomach when more ‘food has been received than there is gastric
juice to act upon it: i. e., a condition induced similar to that which is
present in fever, namely, that the gastric juice not being able to act
on the undigested food, the stomach is irritated, just as if food had
ERRORS R~EsPEcTINe DIET. 237
been introduced into the stomach when the system was in the febrile
state.
If to these facts is added the fact, already referred to, that the
gastric juice combines with only a given quantity of aliment, it be-
comes apparent that in weak stomachs, and in persons labouring
under disease, the supply of gastric juice being diminished by the
state of disease, the evils of taking a large quantity of food must be
indeed great.—((/Ionstzpation. By John Epps, M.D.)
753. In Phthisis, too, as already intimated, there
is fever, and this renders the necessity for food to be
slight, because whether there is fever the secretion of
the gastric juice (axiom 17 is more or less affected,
and consequently digestion is more or less interfered
with.
754. The sole method by which the injuries likely
to result from this variability of appetite is to limit,
even to fix, the daily quantity of liquid and of solid
food, thus preventing the patient taking more than is
proper on the day the appetite is strong, and the
pampering on the day the appetite is deficient.
755. Dr Cotton states his opinions :-
Having already stated the general principle which should regu-
late the diet, I need only remark that, in the absence of inflamma-
tory complications, it should be of the most nourishing description.
As a general rule, porter, ale, or wine, should enter into the daily
diet list of the consumptive patient—not as matters of luxury, but
as necessaries. A full amount of animal food in all cases, but
especially in young persons, should be advised; and everything,
when the digestive organs permit of it, should be given calculated
to repair and improve the wasting tissues.—(P. 277
756. Wine is poison in this disease ; so is beer; so
, is ale (pale ale, in reference to the sick, is deep-dyed
delusion). All stimulating liquors are to be avoided.
757. It is true that the advocates for the employ-
ment of wine and beer state that they are to be taken
in moderate quantities. What their notion Of. mode-
rate quantities is may be judged of by the fact, that
the givers of these quantities argue that the “ flush-
238 “GOOD LIVING” IN PHTHISIS.
ings ” caused by wine, beer, and spirits, are not
harmful.
758. Exhibitive of the total want of any scientific
data on which the recommendations of these stimuli
administrators are founded, the same writer who re-
commends a full animal diet observes :-—-
“ Unnitrogenized food, such as arrow-root, sugar,
and the like, given occasionally, are of much service
in allaying the cough, and, as it were, respiting the
stomach from heavier duties.”-—-(Cotton, lib. cit.)
759. Lamentably illustrative of the old system
treatment in this disease is the fact, that old system
practitioners treat their phthisical patients as gover-
nors of jails treat prisoners about to be executed, viz.,
as the condemned soon will not want any diet, the
last two or three days before their execution they
give them a liberal diet. How common is it for the
old system practitioner to direct the parents or the
friends of the consumptive patient, “Let him have
what will be comforting to him.” That is--“ He
must die, let him have what he likes.”
759 a. Indeed, one writer (Cotton) observes, in re-
ference to the treatment of the second stage of
Phthisis-
“Whatever is fancied may be safely indulged in.”
—(P. 22.)
7 59 b. The advocacy of good living, as it is so
destructively called, in Phthisis, is founded upon the
idea that the disease is often developed under causes
which weaken the constitution,‘ and therefore it is
deemed proper to give highly nutritive food. But
this reasoning is altogether fallacious. Though weak-
ening causes may favour the development of a disease,
the weakness induced by the disease is quite different
WEAKNESS or PHTHISIS, HOW MET. 239
from the weakness proceeding from want of food.
The weakness is from the disease itself, and it cannot
be met by nutritive food, it must be met by curative
medicine. How often has the writer seen patients,
prostrate under typhus fever, get strong by taking
only toast and water, a little cocoa when better, and
the appropriate physio.
759 0. Diet, it should ever be remembered, never
cures disease : medicine is required to cure disease.
760. Still, proper diet is an auxiliary to the cure of
disease, and more particularly of Phthisis.
761. Again, how glorious stands forth homoeopathy
in this matter. Where loss of humours has caused
weakness, which has allowed the individual to be
attacked with disease, the homoeopathist has his, not
beefsteaks and soups, &c. &c., but China,*% which will
cure the weakness; not, as the old systemists call it,
a tonic—not, as the great demolisher, Dr Dickson,
calls it, an antiperiodic remedy, but simply because
among its pathogenetic effects it produces phenomena
similar to the indications of the weakness produced
by the loss of humours.

M ilk.
7 62. Hippocrates recommended AssEs’miZk, an article
of diet still employed, and by some highly estimated.
762 a. Celsus recommends asses’ milk.
762 Z). Galen remarks, in connexion with hectic
fever-
“ Asses’ milk and gruel form the proper diet for
hectic patients.”-(Basil)

* The homoeopathist has other agents useful in the weakness from this
cause. Phosphoric acid is one; Baryta is another.
240 ASSES’ MILK.
7 63. Chemists have tried to find out on what
chemical conditions the beneficial and special action
of the asses’ milk depends; but the detection of this
has not been within their skill.
7 64. The physician Rhases, who, on account of his
talent, was considered the Galen of the Arabians, and
who, from his great success, was styled “the ex-
perienced,” advocated strongly the use of milk.
765. Forestus, a physician of high repute, recom-
mended milk from the breast, also the bath.--(Foresti
Observationum et Curationum, 4 vols. Rouen.)
765 a. Napoleon’s son by Maria Theresa was thus
fed, with the view of arresting Phthisis.
766. Mudge, in his work entitled Cure for a
Catarrhous Cough, recommends in consumption, be-
fore the lungs are much injured by the number of
tubercles, vegetable diet and asses’ milk.
7 66 a. Dr Young, in his work, gives the preference
to asses’ milk and eggs, rather than to animal food.
766 b. Laennec considers that, for quieting the
cough, emollient drinks, and alimentary drinks, and
alimentary matter, as milks, &c., are the best.
7 67. Many have expected results almost miraculous
from asses’ milk. Such expectations are, of course, vain.
767 a. Gideon Harvey, in his work entitled Art of
Curing Disease by Expectation, a work in which he
has anticipated some of the views which have been
put forth with such positiveness of late years, re-
marks, in connexion with the employment of asses’
milk-
“ An ulcer in the lungs, with a contemporary hectic
fever and consumption, can no more be cured by
asses’ milk than a capon be roasted at the bottom of
the Thames.”
GOATS’ MILK. 241
768. GOATS’ mil/2 has gained a considerable reputa-
tion in connexion with the cure of Phthisis.
768 a. Near Stirling, in Scotland, is a lovely dis-
trict, called the Bridge of Allan.
768 b. On the hills surrounding this village browse
multitudes of goats. Consumptive patients go and
live in the neighbourhood in the summer, and drink
the goats’ milk. The loveliness of the scenery, the
purity of the air, the rising early (they rise early to
take the milk), may do much to enable the consump-
tive to resist the progress of the disease in the lungs;
but this without medicine will not cure, though this
milk and the attendant conditions, without the de-
structive medicines of the old system practitioner, not
now taken, allows the patient to get well.
769. Many have recommended the use of lime-
water and milk, and favourable results have taken
place under the use of these agents. It is not im-
probable that some benefit is derived from the lime-
water, which contains lime in a condition approach-
ing to the infinitesimal minuteness. -
770. The writer of this work regards a fish diet as
being peculiarly serviceable to persons who have a
phthisical tendency. He thinks he has seen much
benefit from this diet.
770 a. The rationale of its action is not perhaps
as yet recognised. It is not impossible that it may
have connexion with the character of fish as cold-
blooded animals, and as producing a flesh which is
suited to the conditions of the lung present in a phthisi-
cal subject. This is hypothesis: if future experience
R
242 OIL AND OOD LIVER OIL.
establishes the utility, it may be well to examine the
hypothetical point more fully.

Oil and Cod Liver Oil.
771. Riverius, in his Opera Medica, mentions a
medical practitioner who cured patients in the last
stage of consumption by the use of bread and oil,—a
practice anticipatory of the employment of cod liver
oil.
772. In connexion with this cod liver oil, it is in-
teresting to notice how physicians seem to have re-
cognised fat as curative in consumption.
772 a. Hippocrates, as already noticed, recom-
mended kidney fat. Celsus recommends mutton or
goats’ suet. The elder Pliny recommends the fat of
a goat. Paracelsus recommends the fat of field-mice.
773. The employment of cod liver oil presents one
of the vulgarisms of the medical mind, demonstrating
the miserable deficiency of curative means possessed
by the old system practitioners. They give cod liver
oil for almost every disease. What a dearth of effec-
tive curative means does this exhibit I
774. It may be useful to note the conclusions of
those of the old systemists who have tried it most.

7 7 5. Dr Walshe’s Results as obtained from the employ-
ment of Cod Liver Oil, at the Consumption Hospital,
Brompton.
I began to employ oil at the Consumption and University College
Hospitals nine years ago, and the conclusions at which I have ar-
rived concerning its uses in Phthisis are as follows :—
1. That it more rapidly and effectually induces improvement in
the general and local symptoms than any other known agent.
DR WALSHE. 243
This is positive, and would give encouragement as
to the employment of the oil; but mark the conclu-
sion of Dr Walshe :—
2. That its power of curing the disease is undetermined: I mean
here, by “curing” the disease, its power of causing, along with
suspension of progress, such change in the organism generally as
shall render the lungs less prone to subsequent outbreak of tubercles
than after suspension occurring under other agencies.*
So that the chief point is undetermined. Dr
Walshe adds :-—
3. That the mean amount of permanency of the good effects of the
oil is undetermined.
Here again a chief point is undetermined. Dr
Walshe adds :—
4. That it relatively produces more marked effects in the third
than in the previous stages.
This seems something positive; but the following
conclusion, put forth by Dr Walshe, takes away from
the positive results :—

Opinions the most diverse have been held on this point; M.
Taufllied + taught that it had little or no effect on Phthisis, if at all
advanced; M. Péreyra 1 reduced the size of cavities in a few weeks
by its administration.
5. That it increases weight in favourable cases with singular
speed, and out of all proportion with the actual quantity taken ; that
hence it must in some unknown way save waste, and render food
more readily assimilable.
9. That the effects traceable to the oil in the most favourable
cases are—incre_ase of weight, suspension of colliquative sweats, im-
proved appetite, diminished cough and expectoration, cessation of
sickness with cough, and gradual disappearance of active physical
signs.
This shows that cod liver oil is nutrient: it shows
* That such cures really occur in rare instances (and they are as perfect as
in any other organic disease, when they do occur) is indubitable. It has been
the vanity of late years to deny this absolutely, because a scientific (or pseudo—
scientific?) explanation of the fact cannot be found.
1- Gaz. Med. de Paris, Nov. 1839.
1 Du Traitement de la Phthisie. Bordeaux, 1843.
244 DR WALSHE
more, that in cases where it does good it causes in-
crease of weight,—a result dependent in part, it may
be, on the iodine contained. But this increase of
weight is not a certainty, for Dr Walshe’s 6th con-
clusion is——
6. That it sometimes fails to increase weight.
7. That in the great majority of cases, where it fails to increase
weight, it does little good in other ways.
8. That it does not relieve dyspnoea out of proportion with other
symptoms.
10. That in some cases it cannot be taken, either because it dis-
agrees with the stomach, impairing the appetite (without itself ob-
viously nourishing), and causing nausea, or because it produces
diarrhoea.
This constitutes an objection. To meet this diffi-
culty, its employment is conjoined with other agents,
which interfere with any exactness of conclusion as to
the real effects of the oil. Dr Walshe suggests——
11. That in the former case it may be made palatable by associa-
tion with a mineral acid; and in the latter prevented from affecting
the bowels by combination with astringents.
12. That intra-thoracic inflammations and heemoptysis are contra-
indications to its use, but only temporarily so. I have repeatedly
given the oil within a day or two of the cessation of haemoptysis,
without any return taking place.
13. Diarrhoea, if depending on chronic peritonitis, or secretive
change, or small ulcerations in the ileum, is no contra-indication to
the use of oil; even the profuse diarrhoea caused by extensive ulcera-
tion of the large bowel is not made worse by it.
14. That the beneficial operation of the oil diminishes, cceteris
paribus, directly as the age of those using it increases,——-a singular
fact, which probably may one day, when the textural peculiarities of
youth and age are better understood, aid in giving a clue to its mode
of action. 6
15. That the effects of the oil are more strikingly beneficial
when a small extent of lung is implicated to an advanced stage,
than where a relatively large area is diseased in an incipient stage.
16. That when chronic pleurisy or chronic pneumonia exists on a
large scale, the oil often fails to relieve the pectoral symptoms.
17. That it often disagrees when the liver is enlarged and pro-
bably fatty.
18. That weight may be increased by it, and yet the local disease
go on.
ON con LIVER OIL. '. 245
Thus Dr Walshe establishes, that even though one
of the best effects of the oil is to increase the weight
(9.), the weight may be increased by it and yet the
disease go on.
The same is stated more fully in the 19th con-
clusion :—-
19. That weight may increase, the cough and the expectoration
diminish, night sweatings cease, the strength which had been failing
remain stationary, under the use of the oil, and yet the local disease
be all the while advancing. I have known softenings on a small
scale ass in two months into to'lerably extensive excavation under
these circumstances-—-singular proof of the nutritive powers of the
agent.
So that it may produce all these apparent benefits,
and yet not arrest the di.sease.
Dr VValshe thinks that the facts that, under its em-
ployment, tubercular softenings have passed into ex-
tensive excavations, and yet the symptoms of the
disease have lessened, are proofs of the nutritive
powers of the agent. But it would seem more likely
that, if the cod liver oil was really nutritive, it would
have arrested the tubercular softening :~ it then would,
had it been nutritive and curative.
And what; it may be asked, do those conclusions of
Dr Walshe amount to? They demonstrate that the
employment of cod liver oil is purely empirical—that
it wants definitiveness—that it ill becomes those who-
give cod liver oil thus empirically to design-ate
homoeopathists, who give medicines according to a
law, as empirics.

776. Much satisfaction is experienced in quoting
these conclusions of Dr Walshe,* because he is a man
* Dr Walshe does deceive himself; for in a lecture, delivered at
the opening of the Medical Session, 1858, at the University College,
London, he made the following remarks :-—
246 DR wALsHE’s ATTACK
who, if he is capable of acting up to his professions,
_must be a philosopher, since he remarks :-
I am not one of those who refuse to accept the evidence of my
senses because I am unable to comprehend what they teach me, and
in this matter echo the sentiments of the physician in a recent
French tale, speaking of a phthisical recovery :-
“ Ces miracles de guérison, auxquels la science ne croit pas, faute
de les comprendre, et devant lesquels je me prosterne, en priant la
bonne et sage Nature d’en etre moins avare.”—Pierre, par Madame
Reybaud.
“Again, do not people, believing themselves wise beyond common
mortals, profess faith in mesmerism—and believe that, by a facile
process, impressionable females and plastic boys may be made to
read, ad libitum, with their epigastria? Is there not a body of men,
otherwise apparently sane, who, laughing old Euclid to scorn, act
not only as if a part were greater than the whole, but as if the
smaller that part be made the greater its superiority to the whole
that furnished it? A grain is for potency nil, but the decillionth
part of that grain is, in inexperienced hands, dangerously powerful!
“ Note.—Hahnemann endeavoured to escape from the rank absurd-
ity of the doctrine of infinitesimal doses by creating the hypothesis
of dynamising trituration; but as that hypothesis is utterly unsup-
ported by the smallest tittle of evidence, we are justified in ignoring
it,—and the practical fact remains as stated in the text.’-’-—.Medical
Times and Gazette, pp. 390, 391.
The writer of the work now before the reader felt the greatest
regret that Dr Walshe, whose career as a lecturer has as yet been
undegraded by any vulgar attack or mis-statements regarding
homoeopathists, should have thus committed himself; and hoping
that some explanation might be given by Dr Walshe, the following
letter was written to him :-
H
“ 89 Great Russell Street, Nov. 18, 1858.
“DEAR DR WALsHE,-I respect you for your labours in many
fields of research; I respect you for your apparent desire to seek
out realities, and to study all subjects well on which you give an
opinion, so as to avoid all inaccuracy of statement.
“Conceive my regret to find, in the ‘ Medical Gazette,’ the en-
closed report. (See previous paragraph.)
“ This report does not present a correct view of the tenets held by
, those to whom you refer.
“ Your statement does not express what homoeopathists hold; in-
deed, it is a perfect parody ; and the regret is, that one in your im-
portant position should have given utterance to views which many
on HOMCEOPATHY. 247
777. To this statement of the effects of cod liver oil
in this disease may be added the experience of Dr
Cotton :-—-
Cod Liver Oil.—Whether we regard this medicine as a means of
arresting, or simply of palliating consumption, it undoubtedly ranks
higher than any other with which we are acquainted. Some pre-
judice, however, against its employment still exists, based upon a
belief that its good effects are not lasting; and that it fattens, without
permanently improving the health, or adding to the strength. It
certainly does so in a number of cases; but, on the other hand, the

of the students who attend your lectures know to be quite contrary
to the truth. I have heard several express their regret that the
statement was made, that being the first time during their attend-
ance on your lectures, and on your clinical instructions, that they
heard you abuse homoeopathy. They felt that it was beneath the
dignity of your superior mind to create a castle and to attack it as a
reality, whereas it has, as every tyro in the study of Hahnemann’s
writings knows, no existence.
“Indeed, you have committed the very error which you condemn
as committed by the homoeopathists--you make a part of the tenets
of homoeopathists greater than the whole.
“You will find from the enclosed paper, No. 2, * that Charles
Dickens has acted nobly in this matter. Follow his example, and

* Honcnorarnv AND Houcnormrnrsrs, THEIR Docrruxn IN REGARD TO
INFINITESIMAL Dosns.
(Extracted from “ Household Words”)
“ We have never been subjects of the homoiéopathic mode of treatment, nor
have we ever been concerned in making others so. But as we desire to state
the homoeopathic doctrine fairly, like all other doctrines to which we make any
reference, and as it has been suggested to us that we may have scarcely done
so in a passing allusion to it at page 592 of the last volume of this journal, we
will here reprint the following extract from a work in explanation of homoeo-
pathic principles by Dr Epps.
“ ‘ It is not maintained that a millionth part of a grain or of a drop (to take
a given though a large quantity in homoeopathic administration) will produce
any visible action on the manin health; nor is it maintained that a millionth
part of a grain or of a drop will act on the man in disease; but it is maintained
that the millionth part of a grain or of a drop will act on the man in disease,
if between the diseased state of the man and the medicine, infinitesimally ad-
ministered, there is a homoeopathic relationship. In other words, the homoeop-
athists do not vaguely say that medicines in infinitesimal doses cure diseases _;
but they do say that medicines given for the cure of diseases to which they
are homoeopathic, do cure these diseases when administered in infinitesimal
quantities: to repeat, the homoeopathist, in maintaining the efficacy of medi-
cines in infinitesimal quantities, regards three requirements as necessary :-—
First, the development of virtues in medicines by the process of preparation;
second, the increased receptivity to impression produced by disease; and third,
the selection of the right remedy.’ ” T
T Homoeopathy and its Principles Explained, by John Epps, M..D.
248 DR wALsHE’s ATTACK.’
examples of its success are so numerous and unquestionable, that we
are forced to the admission that the use of cod liver oil was the
commencement of a new and most important era in the treatment of
consumption. So highly do I esteem this medicine in phthisical
cases, that I venture to declare my conviction that, where it has not
Eeen administered, all has not been done that might and should have
een.
Cod liver oil is equally applicable to every period of Phthisis—at
its commencement, as in its final stage—and is never contra-indicated,
except perhaps when there is active haemoptysis or diarrhoea, when,
as a matter of precaution, and to afford scope for other remedies, it
is just as well to suspend its use.
777 a. In reply to these bold statements occurs the
question, H are there been fewer deaths from Phthisis
since cod liver oil has been employed (and it has now

give to your class and to the public, as widely as you gave the mis-
statement, the statement of what homoeopathists do hold.
“I judge that the lecture was published with your consent, and
with your revision. If not, perhaps you will kindly inform me.
“ Believe me, dear Dr Walshe, sincerely yours,
“ J onn Errs.
“ Dr Walshe,
“ Professor of Practice of Medicine in the
“ University College.”
To this letter Dr Walshe sent the following reply :—-
“ 4 Queen Ann Street, Nov. 27.
“ DEAR S1R,—I beg leave to acknowledge the receipt of your letter,
enclosing two printed documents (now re-enclosed, under the im-
pression that you might have some other use for them)-—the former
an extract from a lecture published by me in the “ Medical Times,”
the latter an extract from Mr Charles Dickens’ weekly periodical.
“ I am much obliged by the statement you have been so good as to
give me of your views, and am very faithfully yours,
“W. H. WALSHE.”
As the writer of this work referred in the preface (paragraph a)
to Dr Walshe, and has again referred, in connexion with the cod
liver oil, to Dr Walshe, he felt it his duty, as a part of the history
of Homoeopathy, to record the above letters, having previously to
their publication written to Dr Walshe to know whether he has
' made honourable amends for his mis-statement—made in the charac-
ter of a public teacher.
DR OOTTON ON con LIVER OIL. 249
been employed for years) than during the same period
before the employment of cod liver oil?
778. The want of value of all these bold assertions
of Dr Cotton, as to the curative power of ‘cod liver
oil, is, that in numerous cases he acknowledges that
he does not use cod liver oil alone. He adds :—
Many persons cannot take the oil except in a separate form ; but
I am convinced that its value is much augmented when it can be
combined with some preparation of iron, or with one of the vege-
table tonics. For this purpose nothing is better than the syrupus
ferri iodidi, the vinum ferri, and the ferri ammonio-citras; or cin-
chona, quina, cascarilla, or calumba. When the appetite is defec-
tive, or there are dyspeptic symptoms, the latter class of remedies is
the most useful; steel being better adapted to cases of simple de-
bility coupled with anaemia.
779. How does Dr Cotton know, when the cod
liver oil is thus combined with these various remedies,
what of the cure is effected by the oil and what by
the medium he names as given with it ?
780. It is likely that Dr Cotton may sneer at
homoeopathy, but homoeopathy would have taught
Dr Cotton that an exact knowledge of the virtues of
medicine can be obtained only when ONE medicine only
is given at a time.
781. Dr Cotton adds :—
To insure the full effect of cod liver oil, a long trial is essential;
and much of the disappointment it has occasioned is probably owing
to this condition not having been attended to. It should certainly not
be abandoned under at least five or six weeks; and, as a general
rule, the longer it is employed the greater is the chance of its suc-
cess. I have several patients who have been taking it for years,
and who could not be induced to discontinue it.
To this concluding statement no remark can be so
appropriate as the old saying, “There is no account-
ing for tastes.”
7 82. The following views on the action of cod
250 DR GARDNER ON OOD LIVER OIL.
liver oil are put forth by Dr Gardner (pp. 8 and 9,
lib. cit.) :—
Fat Formed with Tubercle.—But besides tubercle, the lungs of
consumptive persons are always loaded with fat—unhealthy fat. This
important fact I also formerly published. In health the structure of
the lungs contains about 5 per cent. of fat. In the lungs of persons
who have died of consumption there is generally from 40 to 50 per
cent. So that, pari passu, with the excavation, ulceration, and in
fact destruction, of the lungs, fatty matter goes on accumulating,
stuffing up the parts surrounding the cavity, and hastening the fatal
termination, by rendering the lungs impenetrable to the air taken in
in breathing. ' '
Consumptive persons generally have also an accumulation of fat in
the liver.
This explains an observation published by the physicians of the
Brompton Hospital, that cod liver oil seems in some cases to do
good, whilst in a large number it hastens the fatal termination of the
disease. Cod liver oil, now or lately the fashionable remedy for
consumption, is useful in certain pseudo-consumptive disorders, but
is mischievous in a true tubercular consumption. Let it be borne
in mind that no diminution of numbers in the Registrar-General’s
lists has been effected by the almost universal employment of cod
liver oil.*

* In the weakly constitutions of persons half fed, ill clad, and inhabiting
unhealthy houses and localities, and in scrofula and the like, cod liver oil is a
useful remedy. But when these conditions do not exist, and when tubercle is
actually formed, I believe it to be uniformly mischievous. That it lays the
foundation for fatty liver I have had abundant experience; and that it actually
hastens the fatal termination of real consumptive cases, by rapidly stufling up
with fat the parts of the lungs upon which life lingers, I can also testify.
Never was a useful remedy so much abused as cod liver oil has been.
CHAPTER X.

CASES ILLUSTRATIVE OF THE TREATMENT OF PHTHISIS
AND SOME OF THE DISEASED CONDITIONS
CONNECTED WITH PHTHISIS.

7 83. It may be useful to notice some conditions
which frequently precede the development of the
phthisical disease.

784. Premonitorg State of Laryngeal Phthisis.
The case of W. Thorp (1852, book), who had been
treated by Mr C., an eminent practitioner, had symp-
toms indicating the development of laryngeal Phthisis.
Aconite, 8/12, and Spongia, 8/11%; of a globule, at
first every six hours ; subsequently, the same quanti-
ties of the medicines administered at twelve hours,
arrested the progress of the disease.--Oct. 14.

7 84 a. Case 0 f Laryngeal Disease, threatening to
end in Phthisis.
The subjoined case illustrates a form of lung
disease which, if not treated wisely, often ends in
Phthisis.
The first form under which the disease presents
itself is that of bronchitis and asthma associated;
252 LARYNGEAL PHTHISIS.
then superadded to these affections is the laryngeal
affection, which frequently resists the treatment,
especially that of the old systemists, and the patient
passes into Phthisis.
In this case the laryngeal development was arrested,
and the patient is now (1859) alive, and in average
health.
May 1.—Mr pE., aged 52. ‘Has had a cough and
expectoration for thirty years. On leaving London
for the country, 1831, his health improved, as often
happens, and the cough became gradually less, until
in 1849 and 1850 it had nearly altogether left. The
cough has returned lately, with more constant wheez-
ing, and irritation in the throat. The phlegm seems
deeper seated, and the effort to move it affects the
head, so that the senses are nearly overcome.
Never had any pain whatever from the cough, or
at the chest.
Sleeps well, but sometimes wakes with headache
and cough.
Have had a pain lately in the humerus bone of
right arm, for which he cannot account.
Am best when the stomach is sparingly fed; but
seem to require more food for strength.
Lately have had occasional hoarseness; not from
cough, but perhaps from debility.
Have lost flesh lately—-limbs more particularly.
The patient was induced to take—
Spongia, one globule. VVait six hours.
Rhus. Wait six hours.
Hepar Sulphuris. Wait six hours.
Rhus. Wait six hours.
Spongia. ~
May 16, 1851.—Finished the course.
PHTHISIS ARRESTED. 253
My cough has ceased, and my breathing is easy,
during the two last days.
My arm is better, but aches if tried.
May 29.—-Have had occasional fits of cough lately,
but neither so violent nor with the former symptoms.
To-day the cough is more frequent, and have had a
return of wheezing in the night.
My arm is quite recovered.
The patient soon became well, and remains to the
present day, Sept. 1859, in the possession of average
health. '

7 85. Premonitory Phthisis Arrested.
These cases are those of a tradesman and his wife.
Both applied to several insurance companies to in-
sure their lives; but so certain were the medical
advisers of the various insurance companies to which
they applied that they would soon die of Phthisis,
that not any one of the companies would take their
lives.
Finally, they applied to the Invalid Insurance
office; but even this insurance company would not
take their lives.
A patient of the writer recommended the lady to
come under homoeopathic treatment, and the writer
restored her, though she had, after having expec-
torated much blood, all the symptoms of Phthisis.
This lady still lives, and enjoys health. Ten years,
at least, have passed since she came under the writer’s
treatment.
In relation to this lady and her husband, the fol-
lowing circumstance occurred :—
The insurance company that last refused their lives
sent down to the city where the parties live, to inquire
254 cAsEs.
whether they were alive, expecting that both would
be dead before the time at which the inquiry was
' made, and, to the astonishment of the insurance com-
pany, they found the parties well, and diligent in the
pursuit of their business-—these parties adding, that
the ground of their not having fulfilled the expecta-
tions, that ere this they would have been defunct,
was, that they had the benefit of homoeopathic treat-
ment, of which, as may be supposed, they became
strenuous supporters.
The husband died in 1858, not under the writer’s
care.
I was consulted by a lady by the recommendation
of these patients, who had been declared, by Mr Rees
and the physician whom he called in, to be suffering
from Phthisis. The physician, a dear friend of the
writer’s, and a most talented man, told her husband
that she could not live many days. The expectora-
tion was profuse, but in a great part watery: she spat
at least a pint a-day. Pulsatilla was the chief medi-
cine. She was cured.
The widow is still alive (1859) ; is in good health;
carries on her late husband’s business—a business
which causes a great amount of fatigue. The patient
derived great benefit from the air of Warlingham.
If it is said that these were not cases of Phthisis,
the answer is to be found in the question, Why did all
the insurance companies refuse to take their lives ?

786. Incipient Phthisis.
Samuel Barfield (whose brother had died of pulmonary
disease), aged 18, exceedingly delicate, consulted me
in April 1849.
He has pain at the left side of the chest over the
CASES. 255
heart: the pain becomes severe whenever he coughs:
the cough is troublesome at night on lying down: he
expectorates yellowish sputa, which taste bitter: he
sweats all over at night.
Ordered Phosphorus.
April 17 .-The symptoms remain the same, except
that the sweat has ceased.
Ordered Aconite 6/12.
April 20.—'His symptoms remain, except that the
taste of the sputa is nauseous, and he has difficult
breathing in going up stairs: he has now some erup-
tion on the back.
Ordered Hepar Sulphuris, vi./12, three-quarters of
a globule every eight hours.
April 24.—The pain at the side has ceased, except
when excited by coughing: he now coughs more by
day, on exertion: he expectorates much less, and the
expectoration has now no taste: the eruption still
continues, and the breath is short.
Ordered Hepar Sulphuris, vi./12, half a globule
every eight hours.
May 1.-—The pain is much better: cough is less-
ened, and is much less on lying down: the expec-
toration still lessens.
Ordered Hepar Sulphuris, vi./30, one-third of a
globule every eight hours. ~
He called in June 1851, and stated that he became
quite well.
-_-_-_-1
7 86 a. Threatening Phthisis Cured.
Charlotte Hatcher (page 954, case book 1851),
was brought for treatment by her mother, July 1,
1851. The mother returned me thanks for curing
256 cases.
her son of consumption: he was in the first stage of
Phthisis.

786 b. Consumption (Incipient) Phthisical Diathesis.
A. B., aged 34, servant, has been ailing for years,
loss of strength, &c.: had spitting of blood twelve
months : was then treated, as also subsequently,
under the allopathic system: has ever since had con-
stant cough on waking of a morning. Present symp-
toms, April 9, emaciation, cough with thick yellow
expectoration, clavicles prominent, with dulness on
percussion, and rough respiratory murmur: has fre-
quent night perspirations, feeling great weakness on
rising, appetite bad, pain at epigastrium after food,
acid bitter taste in mouth, bowels relieved by ha-
bitual use of antibilious pills: catamenia premature,
every two or three weeks; profuse, coagulated: pain,
a forcing weight, duration seven to eight days: has
palpitation, with feeling of faintness on exertion.
Ordered Oalcarea Oarbonica, 18.
April 14.-—Leucorrhoea much better: pain and
palpitation considerably less: cough about same, but
producing pain of a hot character.
Ordered Arsenicum, 6. '
April 21. —Leucorrhoea, with “ ardor urinae,”
bowels regular. I
Ordered Oantharides, 18.
May 1.-—“ Ardor urinae ” less.
Ordered Oantharides, 30.
May 5.—The day after her last visit, she went out
in the rain and got her feet wet: has had most of her
symptoms aggravated (with the exception of “ ardor,”
which is quite gone) : has rigors: severe, dull heavy
pain passing from behind the breastbone to between
cAsEs. 257
the shoulders: cough short and frequent: pulse quick
and sharp : tongue coated with brown fur: dull
headache: bowels confined.
Ordered Dulcamara and Bryonia.
May 10.—Head better, pain at chest better, respira-
tion more easy, bowels confined. 7
Repeat Bryonia.
May 17 .—-Bowels still confined, pain at chest worse
after food.
Ordered Nux.
May 25.--Better in every respect : bowels relieved,
pain less: still has tightness of breathing.
Ordered Phosphorus.
June 5.-Very much better: went into the country
for change of air.
Oct. 5.—This patient applied again for relief, has
nearly all "her former symptoms : cough, palpitations,
pain at chest, feeling of fulness after food. The same‘
course of treatment was pursued, and on 13th she
reported herself as much better, but felt sad and
melancholy—was faint.
Ordered Ignatia.
Nov. 3.—-Last medicine removed her moral symp-
toms; and under the use ‘of Phosphorus, Arsenicum,
Calcarea, &c., she became quite another person: the
catamenia had longer intervals, and were more natu-
ral: night perspirations ceased: her cough was only
occasional: she regained flesh, and was at her own
request discharged: I do not say radically cured, as
time alone can solve that question.

786 c. Phthisis.
Master P., aged 14 (page 30, p. b.), consulted me
about the middle of September 1852.
s .
i 258 CASES.
He has been ill occasionally two years: he was
twice seriously ill in one year: he was taken first
with pain in his belly, towards the left side: leeches
were applied: he became better for a time. He now
complains of pain in his stomach, from near the pit
of the stomach to the bottom of the belly: he has
pain at his left side when he gapes. But his chief
affection is a cough, which hurts him in the belly
and in his head: he has hurried breathing: has great
anxiety of countenance: varying fever: great weak-
ness, rapid pulse, and is emaciated. Indeed, he has
Phthisis in its first stage, developing itself with great
rapidity.
Ordered Bryonia, gtt i. tertiae dilutionis, Phos-
phorus, viii./12, a twelfth part alternately every four
hours. If the fever does not lessen, to take a globule
of Aconite alternately.
Sept. 22.--The pains have ceased: the breath is not
nearly so short : the cough does not hurt him in his
belly: he can gape without pain: his lips are blue:
his bowels, which were confined, are now right: he
is very weak. The change is remarkable: his pa-
rents are filled with joy.
Ordered Baryta Carbonica one day and Pulsatilla
the next day, and so for three weeks. The youth
went to Warlingham, at the top of the Surrey Hills,
and was restored.
Dec. 12.-—The patient called: he is plump and
hearty. He is alive and well, 1859.

786 d. Incipient Phthisis and Deficient Menstruation.
Efiicaey of Pulsatilla.
Emma Brown (page 344, case book 1851), aged 18,
CASES. 259
single, consulted me Dec. 31, 1851. She looks seri-
ously ill.
She has been two months ill: she has a severe
cough, and a pain in her left shoulder: she coughs
most by night: she expectorates a white phlegm:
her monthly period is extremely small in quantity:
she has a pale, earthy-tinted skin : is excessively weak.
Ordered Bryonia.
Jan. 9, 1852.—--Her cough and the pain in her
shoulder still trouble her, and she has pain at left
hip : she has little white bladdery points all over her
tongue: not much thirst.
Ordered Pulsatilla.
Jan. 14.-—»-The cough is very much better: the pain
is better : the little bladders on the tongue are better:
the monthly period still not free.
Ordered Pulsatilla.
Feb. 11.-—-The monthly period came on freely last
week: her cough is well. A

7 86 e. Phthisis cured.
William Crick, aged 55, married (page 363, case
book 1848), has been asthmatic for eight years: he
began to show phthisical symptoms in December
1848, and in July 1849 he was troubled with great
tightness at chest, with difiiculty of breathing, par-
ticularly after breakfast: with pain at chest: with
cough attended with expectoration: he describes his
cough as a thick cough: night sweats: he presents
the phthisical features: his bowels were confined.
Ordered Kali Carbonicum, iv./12.
This was on July 14.
July 18.--—His chest pain and tightness were better:
his breathing was better: his cough is bad, and the
260 cases.
expectoration is white: he sweats less: his bowels
act better. '
Ordered Kali Carbonicum, iv./12.
July 24.—-His chest is better: his breathing is
better: the thick cough is better: his bowels are
better.
Ordered Kali Carbonicum.
Aug. 9.—The pain and the tightness of the chest
are much better: the breathing still improves: the
cough is better: he expectorates sputa of a slate
colour, but it is of a better kind.
Ordered Kali Carbonicum.
Aug. 19.—The chest pain and tightness are almost
well: he has no cough: his expectoration is now
phlegm : his bowels had acted once a-day.
Ordered Kali Carbonicum, half a globule every
third day.
This case shows one form of chest affection to which
Kali Carbonicum is suited, and shows how, at the
same time, it renders the bowels regular.

7 86 Incipient Phthisis cured.
Thomas Riley (page 1318, case book 1851), came
under care, suffering from Phthisis in its first stage:
his brother and his father died of consumption. He
is now cured.

7 86 g. Phthisis threatening.
Catherine Walsh (page 1675, case book 1851),
came under treatment in May with symptoms of
Phthisis, having had a cough for several years: her
father died of consumption the day after she was born.
By the end of July she was cured, and has re-
cAsEs. 26 1
mained free from phthisical symptoms till the pres-
ent time, August 1852.

786 h. Phthisis threatening.
Edmund Tindall (page 1510, case book 1847).
This patient came tome when he was 15 years of
age: he had had scrofulous enlargements under the
chin, which had disappeared,~ and since their disap-
pearance symptoms of Phthisis presented themselves:
his father had died of consumption, which rendered
the case unfavourable: he was cured, and has re-:
mained well till 1852, five years.

7 86 i. Phthisis threatening.
Mr R., who was cured two years ago of Phthisis,
has had during this month, October 1851; a return of
all the premonitory symptoms.—(See letter, p. 215.)
I ordered him to Warlingham, and to take Kali
Carbonicum and Antimonium Tartaricum in alterna-
tion, three-fourths of a globule every four hours. In
ten days he returned with all the symptoms subdued.

786 j. Phthisis in a Child.
- Mary Barnes (page 960, case book 1857), called to
consult me, Nov. 8, 1857. She stated I had cured
her little boy,‘ whom, when she brought him to me,
she thought was following his father; who died of
consumption. - -
It may be said that the mother, was not a judge of
the existence of Phthisis, more especially of the par-
ticular form of Phthisis examined and 7 described in
this work. Still this argument is not final; for the
experience of disease gained by a wife watching her
husband through the course of a phthisical affection,
q
262 GASES.
ending in death, is an experience most productive of
that sort of knowledge which instructs most accu-
rately, fully, and painfully—this symptom, then that
symptom, then another, then a fourth, and so on-
wards, impress themselves on her memory so deeply,
that directly similar symptoms are produced in any
one else, especially those dear to one, the recognition
is immediate, and as painful as immediate. Hence in
this case the mother’s judgment is not to be despised,
in like manner as her joy in having her child restored
to her is not to be lessened.

787. A Case of Mucous Phthisis.
Mr O., aged 43, married, consulted me in the year
1835.
This patient has had a severe cough for three
months: he has had medical treatment, but gets
worse: he is much emaciated, and all his friends
think him to be in a consumption.
He went out in the night air after working hard
during the day.
He has very little pain in the chest, and has only a
slight expectoration.
He coughs most in the morning for two hours: he
never coughs at night.
His tongue is slightly furred, but his appetite is
good: he has a numbness in the legs, and his feet are
always cold: he is very weak, and sweats at night.
Ordered a powder. consisting of Sulphate of Quinine
three grains, Cinnamon powder one grain, Digitalis
powder three-quarters of a grain, and Ipecacuanha
two grains.
Oct. 15.—-The cough is attended with an easier ex-
' pectoration: the sweat comes on at three or four in
cases. ~ 263
the morning: he sleeps till about five: his tongue is
furred: his bowels are quite regular.
Ordered him not to go to bed till three, the object
being to prevent the development of the morning
sweat. The writer did not then know homoeopathy.
Ordered a powder.
Nov. 5.—-His weakness has not increased, though
the cough is still troublesome: he sleeps well: the
perspirations are lessened: he rose at three A.M., took
the powder ordered, and sat up till eight A.M.
Nov. 21.-He is much better: his pulse is well:
he has continued the powders: he sleeps very well:
the perspirations diminish.
The pain in the chest is nearly gone.
The cough is still troublesome.
He feels his legs stronger.
He has continued his powders.
Nov. 28.--His pulse is regular: he sleeps well:
indeed, he is well. He used tartar emetic ointment
to his chest.
Ten to twelve years after,.I attended this patient
for a severe complaint.
No doubt some one or other of the medicines em-
ployed was homoeopathic to the disease, otherwise
the case would not have been cured; but there is no
certainty what was the remedy. It is likely that the
lpecacuanha and the Antimonium Tartaricum had
the greatest effect.

788. Hcemoptgsis, with Mucous Phthisis.
Peter Dow, aged 24, consulted me 1835.
This patient, three weeks before consulting me,
spat red blood after coughing: he has pain in the
right side of the chest, at the upper part of the lung :
264 CASES.
he is sure to cough after any exertion: he almost
always when spitting spits a little blood.
He feels very weak.
He has painat the pit of the stomach; but he has
no wind on the stomach to-cause this pain, and
therefore it cannot be referred to gastric irritation.
He sleeps well till the morning, when a cough
comes on: in the morning he finds himself in a per-
spiration so profuse that his bed-clothes are soaked.
His bowels do not act well.
The chest affection came on three years ago, in 1832.
His father died of cholera : he spat blood, and this
freely, in hurrying to see his father: almost a year
and a half since, he spat red blood.
July 15.--His cough is still troublesome: the ex-
pectoration is yellow and frothy: if sitting, he does
not cough : he now spits no blood : he feels stronger:
he goes to sea, by my advice, next Sunday.
Ordered a mixture of Liquor Arsenic-alis giij, tr.
Lyttae Zi, tr. Digitalis Zij, ten drops three times a-day.
(At this time the writer practised old system medi-
cine, not having had the glorious truth, discovered
by Hahnemann, made known to him.)
This patient had every symptom of Phthisis: he
was cured under the old system treatment. I think
he used the tartar emetic ointment, and it is likely
that the Antimonium Tartaricum was the source of
cure.
In 1841 he was seized with the old symptoms: he
had a dreadful cold and cough. The cough dis-
tresses him much: it causes, by its violence, the
tears to run from the eyes: he has profuse perspira-
tion, which soon becomes cold: he cannot bear the
least wind: the sputa are thick, and have afleshg sort
cAsEs. 265
of taste: he has pain at the lower margin of the ribs:
he has much itching at the chest, obliging him to
scratch.
Aconite and Veratrum restored him, and he is now
(1859) alive. All his friends expected his death.

789. Spitting of Blood attendant upon Phthisis.
A. T. (page 1272, case book 1857), aged 24,
single, consulted me June 8, 1857 . She is consump-
tive: a sister and brother had died of consumption.
She has had a severe cough for a long time : worse
the last two or three months. She had first cold in
her head: her expectoration is now yellow: she spits
blood two or three times in the day: the blood is in
streaks: she has pain in the chest.
She coughs most in the morning and in the even-
ing: she feels hot: her monthly period is too frequent
and profuse.
Ordered Arnica and China in alternation; Arnica
for the expectoration of the blood, and China for the
profuse monthly discharge, this being likely to cause
a weakness, which would allow the development of
tubercle. . '
June 15.—Cough still troublesome: she still spits
bright red blood, and she tastes blood before it comes,
with cough and without cough: her food lies heavy:
the skin is hot. She has a hollow place in her chest,
where she feels uncomfortable.
Ordered Arnica and Pulsatilla.
June 17 .—The expectoration of blood is lessened:
she has great pain between the shoulders when she
breathes.
Ordered Arnica and Pulsatilla. She is going to
the Isle of Wight.
266 CASES.
July 28.—Cough is much better, but not gone:
she coughs most in the morning and in the after-
noon: the expectoration is greenish, tastes a little:
she spat blood a fortnight since : she feels pain at the
chest : she has the sinking in at the part of the chest:
her breath is a little offensive: she can lie on either
side.
Ordered Mercurius and Lachesis.
August l4.—Her cough is better: she has pain at
the top of the right and of the left lung: she spits
very little blood: it comes by coughing, and is bright.
Ordered Arnica and Lachesis.
She was cured.
This case presents in a marked degree the effects of
the medicines used. The Arnica succeeded in arrest-
ing the lung-haemorrhagez the Ohina succeeded in
removing the weakness resulting from the excessive
monthly discharge: and the Pulsatilla removed the
gastric symptoms.
It will be noticed that the patient went to the Isle
of Wight. Some will be ready to refer the restoration
to the air of the island. In going there she gained
that which has been granted as essential in cases of
spitting of blood, associated with the phthisical
diethesis, namely, the use of country air to insure
the necessary power to enable the lung to recover its
healthy state.
The patient, Sept. 1859, is still free from consump-
tive disease.

790. Sjcitting of Blood, Hcemoptysis, with Phtln'.s'2'eaZ
Symptoms. Y
Alfred Dunning (284, 1855), had, in the year
1855, a very severe attack of haemoptysis, with many
CASES 267
phthisical symptoms, for which he consulted the
writer. Arnica at first was administered: 8/12
globules were given, divided into twelve doses at six
hours’ interval; then 8/12, in twelve doses at eight
hours’ interval.
The patient was cured, having taken, in addition
to the Arnica, Cantharides and Ledum in the course
of the cure——the former for a bladder disease, and the‘
latter for an excessive difficulty of breathing that
came on.

790 a. Spitting of Blood and Purulent Eazpectoration
from the Lungs cured.
Robert Conway (page 367, case book 1858), aged
43, a seaman, married. He has a pain at his chest
when he coughs : he coughs much and violently : he
spits yellow matter, intermixed with blood: the
quantity of blood is profuse: he thinks that in the
last six weeks he has brought up three pints: he
sweats at night: his digestive apparatus seems all
right.
Ordered Arnica and Phosphorus in alternation.
June 26.—The chest pain is very much better:
the cough is much lessened: his expectoration is
yellow, but he has expectorated no blood.
Ordered Arnica and Phosphorus in alternation.
July 28.—He is better: he feels drowsy: bowels
confined, and stools large.
Ordered Arnica and Graphites. He was cured.
.N.B.—-T his patient is a seaman on board a British
ship that trades with Holland: the captain is a
homoeopathist, and he states that he has cured a
great many Dutchmen of the peculiar intermittent
268 cases.
which prevails in the ports to which he trades, by
the homceopathic remedies.

790 b. H cemoptgsis and Purnlent Eapectoration cured.
Esther Bates (page 242, case book 1850), aged 46,
married, mother of thirteen children, and has had
several miscarriages: she consulted me August 14,
1850.
She has pain at the chest constantly: she has
cough with yellow expectoration, the expectoration
having a coppery taste: she can lie on either side:
she sweats on her head: her bowels are regular: the
water passes free: her monthly period has stopped
twelve months.
Ordered Phosphorus.
Sept. 14.--She spat blood the day before yesterday:
the pain still continues: she feels every excitement in
her head: she sweats on her head.
Ordered Aconite and Arnica in alternation
Sept. 21.—She spat bright blood yesterday morn-
ing, to which time she had been free from the spitting
of blood: her chest still troubles her, and she has
pain at her left side: her breath is short at times:
she still sweats on her head.
Ordered Calcarea and Arnica in alternation.
June 6, 1851.-—She called and stated that the
medicine last ordered had cured her.

791. Consumption.
John Hughes (page 1829, case book 1851). This
patient, though aged only 45, seems to be a shattered
man, and looks 70: he has been under the care of
an allopathist, and under the care of a homoeopathist;
cAsEs. 269
but getting worse, he sought my aid: hehas been ill
eight weeks: he has a severe cough, with pain in the
chest: he spits sputa yellow but tasteless: his appe-
tite is bad: he can lie on either side: his nails are
bent over, forming the curve so often present in con-
sumptive patients. ~
Ordered Phosphorus.
Jan. 3, 1852.—-His ~cough is still troublesome: the
pain still continues in the chest: the sputa are now
grey: he sweated a little this morning: appetite
none : he has thirst at times: bowels confined.
Ordered Kali Carbonicum.
Jan. 6.__——The pain has ceased: the bowels now act
nicely: he has ‘now no night sweats: the cough and
other symptoms the same: breathing hurried.
Ordered Aconite and Hepar Sulphuris in alterna-
tion.
Jan. 13.—His cough is very much better: he spits
less : the sputa have no taste : he cannot sleep when
he goes to bed.
Ordered Belladonna and Hepar Sulphuris.
Jan. 27 .-The cough has nearly ceased, except in
the morning: he can sleep better: bowels act once
in two days: he sweats across the chest.
Ordered Kali Carbonicum and Hepar Sulphuris.
Feb. 3.—He is better in~ his bowels : sweats still at
chest at night: his cough is a little troublesome.
Ordered Kali Carbonicum and Hepar Sulphuris.
Feb. 17 .—-Cough a little in the morning: bowels
regular. '
Ordered Kali Carbonicum and Hepar Sulphuris.
He is well.
2 70 CASES.
7 92. Phthisis advancing from the First Stage
into the Second.
Maria Calvert (page 403, 1846), aged 49, married,
but not having had any children. She has been ill
three weeks, and she has the countenance and the
characteristic features present in rapidly progressing
Phthisis.
She has a cough, which continues “ all day long: ”
on lying down it is so violent, that she cannot lie:
she expectorates a yellowish matter: she has a tight-
ness across her chest: she has much fever: she has a
soreness across her bowelsi her appetite is good, but
she feels as if her food lies at the top of the throat:
her bowels are confined: her water is rather thick:
her monthly period has stopped the last twelve
months.
Ordered Aconite.
She consulted me again, July 29. She has ex-
perienced no great change in her symptoms; but
now, when sitting up in bed, which she is obliged to
do on account of her breathing, she is obliged to lean
forward: when she lies on the left side, she has a
dragging pain at the right breast.
Ordered Aconite and Hepar Sulphuris in alterna-
tion.
August 1.—Her cough is a little better, and she
now expectorates a frothy phlegm. She can lie down
better, and the pain at the right breast is relieved.
To continue the Aconite and Hepar Sulphuris in
less doses.
August 4.—-From some cause or other, the sputa
have become yellowish. She can still lie down : the
pain has returned, but it is now a shooting pain.
She has a warm sweat at night: her bowels were re-
cnsns. ’ 271
lieved yesterday, and she had a dreadful shooting and
burning pain after stool: excessive anxiety of coun-
tenance : flushed check: her appetite has gone.
Ordered Aconite, 4/12, and Calcarea, 4/12, a globule
alternate four hours. '
August 5.—Better this morning: she can lie down
better : the pain is better : she sweats profusely: still
pain severe after stool : but the countenance has now
lost its anxiety, and is clear.
To continue Aconite and Calcarea at six hours’ in-
terval.
August 10.——Her cough is better : she can lie down
better : her appetite is much better: the sensation at
the top of the throat is better : her bowels are rather
confined: the soreness is better.
Ordered to continue Aconite and Calcarea in doses
at much longer intervals. The change was to herself
wondrous. The health being so improved, she was
enabled to go to Malvern.
The case was as clear a case of the presentation of
the phenomena which indicate the rapid develop-
ment of Phthisis as I remember to have seen, and it
will be found to exhibit strikingly the power of
Aconite and Calcarea.

. 792 a. Phthisis.
Mr Cooper (page 319, 1846). This patient con-
sulted me Feb. 28, 1846. He had been ill since the
previous Good Friday, when he was taken with a
cold and a violent cough, which still continues, though
less violent. His countenance has the anxious, sharp
features, with the clear watery eye, so prevalent in
this disease. He has become very thin. '
27 2 - ’ casrs.
His cough is worse at night, when lying down,
though he can lie on either side.
The expectoration is thin, white, frothy phlegm.
The coughing causes him pain about the chest, i. e.,
it hurts him there.
He sweats mostly about the head.
He was ordered Aconite for the pain, and Calcarea
for the sweats and the cough.
March 7 .—The cough now had become most
troublesome on rising up in the morning: he has
pain, and with it tightness.
He has in addition pain in his back, which makes
it difficult to stand upright: he cannot lie well on his
right side.
He has spat blood every morning but this morning:
he feels worse in the evening.
Ordered Aconite and Pulsatilla, and then Calcarea.
March 27 .—The patient looks much better: the
cough is better : he has expectorated very little
blood, which is of a pinky colour: the pains in his
limbs have ceased: the tightness is less: the chest is
still sore : he is altogether much better.
Ordered Aconite, Pulsatilla, and Calcarea to be
continued.
April 13.——His cough is violent at night, but is not
quite so bad: his chest seems worse.
Ordered Aconite and Phosphorus, then Aconite
and Calcarea.
May 12.—Much better: has slept well: still some
soreness at chest.
Continue medicines.
July 20.—Has been improving steadily, but pain
at chest came on yesterday, and it hurts him to take
a full breath.
cAsEs. 2 73
Ordered Aconite alone. He has been so much
better, that he left off taking medicine.
August 1.--He has still pain at chest, with ofl'en-
~siveness of breath.
Ordered Aconite and Mercurius.
August 7.-—He can lie better on right side: his
cough has been a little more troublesome.
Ordered Aconite and Phosphorus.
He became so much better as to be able to re-enter
business, which he had been obliged to give up.
This patient had passed from the first stage of
Phthisis to the second, and in that second he spat
blood.

7 92 b. Phthisis cured.
Edward Ryman (page 1375, case book 1851),
cured of phthisical disease. Sister died of Phthisis.

792 c. Phthisis. _
Mrs M. This patient came under my treatment
for Phthisis four years since. She had been expec-
torating blood for some months. She has been a
long time under a surgeon of Saint John Street Road;
but getting worse, in fact, being in marked Phthisis,
homoeopathic aid was sought. She was cured in
about four months. The case is the more interesting,
because seven of her brothers and sisters have died of
consumption. '

7 92 d. Phthisis cured.
George Smith, who had been treated successfully
for Phthisis, came back, October 30, 1846, to consult-
me for another disease.
*_--__
2 74 cssns.
7 93. In the Clinique Homceopathique 116 cases are
recorded of Phthisis -cured.
793 a. The detail of these cases would enlarge this
volume too greatly. The cases are well worthy of
the study of the practitioner. They demonstrate that
in all countries the homoeopathic means have been
successful in curing many cases. This destructive
malady, and the accordance between the symptoms of
the disease and the pathogenetic effects of ‘the reme-
dies, will be found very marked, particularly in some
of the cures.

794. Case of Phthisis.
Mrs B. This lady had, previously to coming under
the writerls care, been under the care of a most
eminent physician of the old school. He had, during
the time he treated her, kept her for six months in
her room, which he preserved of a regulated tempera-
ture. She had profuse bleeding from the lungs, with
cough, and the other attendants of Phthisis. When
she was a second time attacked, he considered her
case as hopeless. The writer had attended her hus-
band for a serious kidney disease, of which he was
cured by homoeopathic treatment. On this account,
the writer was consulted when the lady was seized
with the next development of the phthisical condi-
tion. She had profuse haemorrhage from the lungs:
cough most distressing: expectoration of mucus and
of pus: great tenderness at the chest: could not
bear the least pressure at certain parts of the chest.
She had night sweats : pulse rapid: in fact, was as ill
as possible. She was treated by China for the ex-
cessive loss of blood, by Arnica, and by Hepar Sul-
cnsns. 275
phuris. These were the chief remedies, others being
employed as intermediate remedies.
The writer subsequently attended a friend of this
lady, with all the symptoms of Phthisis, having been
preceded by expectoration of blood.
This patient was much benefited, as was also the
lady herself, by the air of Warlingham. '

7 95. Phthisis cured.
— Smart (1564, 1850), was cured of Phthisis. The
case was stated to be Phthisis by one of the physicians
of University Hospital, who treated it before it came
under the writer’s care.

7 96. Phthisis cured.
Mr Wilkin, aged 19. This patient had the night
sweats, the purulent expectoration, the offensive
sputa, the rapid pulse, the bent nails, the emaciation;
indeed, all the phenomena of the second stage of
Phthisis.
He went to Warlingham, underwent homoeopathic
treatment, and is now, ten years after, in the enjoy-
ment of good health, and prosecuting a large business.

797. Phthisis cured.
Mrs Young was in the second stage of Phthisis
when she went to Warlingham. She had the chief
symptoms -of this stage. She was of a decidedly
scrofulous diathesis: her family expected her dissolu-
tion. Phosphorus was the chief remedy, with occa-
sional doses of Lachesis. She recovered.
Years after, she died of caries of the os calcis, show-
ing the scrofulous condition of her constitution.

27 ,6 CASES.
, 798. Discharge from a Vomica, and care. ‘
Master Warren. This boy, aged 14, had cough,
-troublesomehacking: he appeared as if he would be
choked at times: he has much wheezing: his voice
is shrill and hollow: his breathing is very hurried:
his thirst is great: temper irritable: bowels confined.
He has profuse sweats, and his feet are cold.
He has become much better in every respect by
Sept. 30, 1849.
By the 20th October, his cough became moister,
on which day he was sick after coughing, and brought
up a quantity of pus. He was quite exhausted after
this discharge: he lay down as if almost dead, and
after remaining in this posture about an hour, rose
up: all the rattling in the chest had ceased, and he
became as well as ever.—October 2.
This patient is (1859) well; that is, he has re-
mained free from any attack of his old disease for ten
-years; indeed, he has married.

799. A case of Acute Phthisis.
Janet Nelson (page 723, 1859). This patient was
seized, September 1859, with all the symptoms of
what the vulgar call galloping consumption. She
came under the writer’s care, and she was able to
visit the writer on October 5, 1859. '
As the case is so recent, the writer does not present
the particulars; but after the cure has been tested by
waiting till next year, he will publish the full par-
ticulars in the “ Notes of a New Truth.”
This patient had lost two sisters, at nearly the same
age as herself, by consumption. 6

CASES. I
- 800. A case of'Phthisis in Second Stage. ‘
Miss P., aged 21. This patient’s symptoms were—
N o. 1. . Cough violent.
No. 2. She spits blood occasionally.
N o. 3. She has a coppery taste in the mouth before
the blood comes.
No. 4. She has painful breathing.
N o. 5. She has great oppression of the breathing.
N o. 6. She has a tenderness down her back, and at~
her left side. -
N o. 7. Pain in the region of the bladder on awak-
ing in the morning, through to the back.
N o. 8. She has distress when walking.
N o. 9. She faints sometimes, as if she had not
sufficient air.
No. 10. She can lie on right side, but not on the
left.
N o. 11. Her hands burn, and she has much fever.
N O. 12. Has a fainting, and is occasionally sick
with headache.
N o. 13. Her monthly period is generally painful;
when at Warlingham, was not.
N o. 14. Great flushings occasionally.
N o. 15. She has profuse sweats, which she had last
spring also, but they were stopped.
No. 16. Great thirst.
N O. 17 . During the course of the case, she at times-
had great pain at the left side, through to the back,
increased by breathing or speaking.
N o. 18. The sinking for food becomes excessive.
No. 19. The face swollen.
No. 20. She suffers from great prostration.
No. 21. The feet and the ankles swelled towards
night.
2,78 CASES.
N o. 22. She woke up frequently with pain and
distress.
No. 23. She has pain at the upper part of her lungs.
No. 24. Pulse rapid. ~
The chief remedies used during June and July
were Phosphorus for the lung disease, Cannabis and
Spigelia for the heart symptoms and the state of the
water: for the sweats and the pains in the lungs, and
the difficulty of breathing, Lachesis and Kali Car-
bonicum: Sepia for shootings in the belly when
attended with constipation; Clematis for shootings
not so attended: China for the great exhaustion
connected with the expectoration : Calcarea was taken
subsequently.
An attack of bronchitis developed itself in July,
which Aconite and Hepar Sulphuris subdued.
The cough subsequently assumed an incessant,
almost spasmodic character, which Cuprum relieved.
By August 1, the cough was gone.
August 1, 1854.—-The monthly period occurred
more than it had for two years. >
She continued under treatment for a few months: she
subsequently married, and she has had two children :
she is now, August 1859, several years after she first
came under treatment, in the enjoyment of average
health. This lady has a brother who is a surgeon in
extensive practice, and who declared, before she came
under homoeopathic treatment, that she could not
last many months; This lady, moreover, had a sister,
whom the writer happened to see when visiting his
patient, and he told his patient to attend to her
sister, as she was going into a rapid consumption.
The husband, informed of the writer’s opinion, con-
sulted Dr L., who pooh-poohed the opinion of the
casns. 279
writer, stating that the opinion of the writer was not
accurate: however, nature testified to the accuracy,
for she died, within a few weeks after, of consumption-.
This lady regards the‘ air of Warlingham as inti-
mately connected with her cure.

801. A case of Phthisis illustrative of the Curative Power
associated with the Causticum Cachavia.
The following case illustrates the eflicacy of Causti-
cum in pulmonary disease :—
Elizabeth Owens (page 1309, case book 1845),
aged 43, married, the mother of three children. She
has had one miscarriage. The patient’s state is ‘very
unfavourable: her countenance is anxious, her fea-
tures are sunk and lank; indeed, she presents most
of the characteristics of the consumptive diathesis.
May 3.—-She has at present very severe cough, to
which she has been subject each winter for four or
five years. Her cough is particularly distressing at
night: she has pain at the top of the right lung: her
appetite is bad: the tongue is furred, but the food
lies easy: she has low spirits, and night perspirations.
Ordered Aconite.
May 6.-—Her cough is unchanged, and very severe
at night on lying down, and on rising in the morn-
_ ing: the expectoration is greenish, and she has great
difliculty to exp_ectorate: the night perspirations are
lessened, also the pain at the right lung: the appetite
and the tongue are better. 0
As the Aconite did not lessen the cough or the
difiiculty to expectorate, Causticum was prescribed,
4/2.
May 13.—The cough very much better: the night
cough has almost ceased: the expectoration is very
280 ~ cases.
trifling, and the sputa are disengaged with ease: the
sweats at night have ceased: the tongue improves.
Causticum, 4/12, in less doses. The patient was
astonished at the improvement in health.
May 30.—She was much better in every respect.
She became well.
This case would seem to indicate, that in cases
where Phthisis is associated with bladder disease,
Causticum has a marked curative agency.
802. The action of Lycopodium, and the mode
under which Hahnemann used Lycopodium, are pre-
sented in the following facts, published in the Decem-
ber number of the “Notes of a New Truth,” 1859 : --
To the Editor of “ Notes of a New Truth.”
SIR,-—I heard a statement this afternoon, which, as it relates to
the immortal Hahnemann, will, I know, be interesting to you. It
shows how different was his practice to that of most of those who
profess to be his disciples. The gentleman who made the state-
ment lives either in or near Manchester. He had been under the
orthodox medical treatment for consumption till they could do no
more for him, and they therefore ordered him to the south of
France to die. But fortunately, or rather providentially, he heard
of the fame of Hahnemann in Paris, and determined to consult him.
He went to his house accordingly, but found that he could not be
seen for at least three days, in consequence of the doctor’s engage-
ments: he left his card, and called again at the appointed time.
The sage and venerable doctor examined him for an hour and a
half, and then told him he must call again to-morrow, before which
time he would study the case, and select from his materia medica
the most appropriate remedy. On the morrow he came, was sub-
jected to another examination of half an hour’s duration, and then
was told to take one pellet of Lycopodium, of the thirtieth potency,
and to come again in a fortnight; but in the interval he was to take
no medicine. The gentleman, astonished and disappointed, went
his way, but determined to wait the issue. He found himself daily
improving, and, by the end of the fortnight, he was very much
better. He went again to the doctor, and he repeated the dose,
and ordered him to wait another fortnight; by the end of which
time he was so much better that he asked the doctor if he might
not return to his family in ‘England. The permission was granted,
cAsEs. ' 281
on the condition that he would keep up correspondence with Hah-
nemann until cured. He did so: the doctor continued to treat
him with the same minute doses of Lycopodium, and completed the
cure with a dose or two of Sulphur; and the gentleman, whose life
was condemned more than twenty years ago, is now alive and well,
and related this history last week. Vllould that the modern dis-
ciples were worthy of their great master. What would our tincture~
men say to such a case as this? Believe me most truly yours,
C. H. W.
803. Miss W. H., who came under my care in 1858,
for marked Phthisis, derived great benefit from the
alternate use of Nitric Acid and Lycopodium. She
has fair skin, blue eyes.
She took 1/3 of a globule of Nitric Acid, 12th
dilution, in the morning, and 1/10 of a globule of
Lycopodium in the evening, for ten days; then
waited four days; then repeated the medicines, and
waited six days.
804. Accessory Conditions in Connerion with Phthisis.
I ntercurrent Phenomena of Phthisis.
In the intercurrent pneumonia which attends the
progress of Phthisis, the power of Homoeopathy is
strikingly apparent.
In most of these cases Bryonia is specific.
It is often useful, in such suddenly developed affec-
tions, to give i or 16- of a drop of the third dilution
every four or six hours. ‘
805. Pain at Margin of the Ribs, developed in Phthisis.
Aconite, 8/12, taken in twelve doses, at four hours’
interval, cured in Alfred Durrant (page 530, 1859
book) this pain. ' ~
282 CASES.
806. Case of Phthisis cured, attended with Swelling.
Sarah Cook (page 37 9). This patient was treated
for ~ Phthisis. During its course, a general swelling
took place, which was cured by the use in alternation
of Arsenicum, 8/12, and Helleborus niger, 8/12, % of a
globule every four hours.
807. Conditions modifying the Probability of Success in
the Treatment of Phthisical Diseases.
Where skin diseases are connected with Phthisis,
or are developed in the course of treatment, there is
often success. This is illustrated in the following case
of Dr Gardner :-—-
CASE XX. A young lady from Essex, tall, emaciated, with copi-
ous night sweats and considerable expectoration, came under my
care in June 1856. She had been pronounced hopelessly consump-
tive. Both lungs exhibited large patches choked up, and ulceration
was proved, by examination of the sputa, to he proceeding rapidly.
A single grain of arseniated soda, with morphia, divided into forty-
eight pills, was prescribed, and when taken changed the whole
aspect of the symptoms. Followed by hydro-carbons, perfect re-
pose, a liberal, easy-digestive diet, she became towards winter con-
siderably improved. In February she had regained her flesh and
strength, and although a slight cough remained, evidently merely
bronchial, she deemed herself well, and was only anxious about a
slight skin eruption on her feet.
Dr Gardner, from this and other cases which he
records, evidently tends to the administration of in-
finitesimal quantities. ‘
808. A fact, which applies to the treatment of
almost all ‘disease, presents itself in connexion with
Phthisis_: it is that, when diseased states are associated
with gastric affections, cure is most easily obtained.
The irritation connected with gastric disease being
removable, especially by homoeopathic treatment, and
CASES. 283
thus a source of irritation being removed, the cure of
the diseased state is more easily effected.
809. When the development of Phthisis is associated
with kidney disease, more especially when that kidney
disease has been produced by excessive drinking, the
chances of cure are much diminished. One reason of
this want of success is, that kidney disease is so in-
sidious in its approach, that inroads, serious inroads,
are made in the constitution before the patient is led
to notice. He oftentimes feels weak, but no particu-
lar pain : an unwillingness to attend to business, and
yet, if urged, can go away to his duty. He goes
away into the country again, gets better: again re-
turns, and after a time his health fails. All this
while kidney disease is going on; and if he has heart
disease, he dies of dropsy at the heart: if he has the
phthisical diathesis, he dies of Phthisis.
810. These cases might be multiplied to a great
extent; but sufficient have been recorded to show
the agency of homoeopathic medicines in the treat-
ment of this disease; to establish the exact relationship
between the pathogenetic effects of remedies and the
symptoms of each form of Phthisis ; and further, to give
hope that that exactitude will at length be obtained,
which will remove the stigma on the medical art of in-
efiiciency in connexion with the treatment of Phthisis.

N.B.——THE AUTHOR WILL BE GLAD TO RECEIVE ANY CASES ILLUSTRATIVE
OF THE HOM(EOPATHIC TREATMENT OF CASES OF PHTHISIS.
INDEX.
The figures used in this I ndew refer to the numbers of the paragraphs, .
and not to the pages.
ACTION, freedom of, essential to
health, paragraph 260.
Alison, Dr., 131 b, 186.
Anatomy of the lungs, 2.
Aconite, 299 b, 351, 352.
Age of puberty, 100, 101.
Age at which consumption pre-
sents itself, 69, 70.
Adam’s apple, 6.
Air tree, 27 d.
Air cells, 27 d.
Animal heat, 5, 55.
Atrophy, 66.
Auricle, right, 20.
Auricle, left, 20.
Animal heat, production of, 42, 43,
44, 45, 50.
Albuminous membraniform bed, 91,
92, 93, 93 a.
Asthma, spasmodic, at day-dawn,
137.
Auscultation, 173, 174, 175.
Andral, 186, 187.
Aphthae, 236 h.
Air requires to be delayed in the
lungs, 289, 290.
Arnica, examples of beneficial use
of, 602, 639, 642.
Arsenical cachexia, 583 to 585.
BACON, Lord, 328, 333.
Barrow, Dr., 77 e, Z preface.
Bayle, Z and r preface, 71, 74, 76,
80, 90 a, 90 b, 90 c, 93, 95, 96,
139, 189, 190, 201, 202, 203,
236 h.
Black, Dr., 45, 46.
Bladders, pulmonary, 11.
Blood trees, 27 b.

Bronchi, 7, 27 a.
Bronchial tubes, 11, 27 a.
Brown, Dr Thomas,
sophy of the Human Mind]? :2: in
preface.
Blagden, Dr., experiments of, 57.
Bronchial arteries and veins, 18.
Both lungs affected in phthisis, 71.
Bleeding, cause of phthisis, 305.
Bleeding from the nose, 101.
— explanations of this, 104.
Bloodstreaks, 119, 124.
Breathing, oppressed, 119.
— explained, 130, 133.
British and Foreign Medico-Chirur-
gical Review, Jan. 1849, 126 d.
Breaking of the voice, 239.
Brodie, Sir Benjamin, his abuse of
Dr Harrison, and his virtual
adoption, after doing injury for
twenty years, of Dr Harrison’s
views, 284 a.
Byrne the pugilist, 308.
Belladonna, pathogenesis of, 587.
Baryta carbonica, 591, 591 a.
Blumenbach’s physiology (Elliot-
son’s edition) 31 a.
Barry’s experiments on atmospheric
pressure, 129 e.
Bread and oil (Riverius’ “ Opera
Medica,”) 771.
CANCEROUS tumors removed, not
cured, 222.
Causticking the throat productive
of phthisis, 244.
Cachectic state connected with
phthisis, chapter iv.
Cachexia, 66.
“ Philo-
286
Cachexia, its indications, 206, 207.
Capacity of lung, 31 a. I
Capillary air vessels, 13.
Cartilaginous rings of windpipe, 9 a.
-- not perfect, why ? 9 a.
Cicero de Officiis, 1, 64.
Circulation of the blood, 19, 20.
—- in a frog, 30.
Consumption, is it incurable ‘P h in
preface.
-— case of, 791.
Constipation, 155.
— “ Its Theory and Cure,” by
John Epps, M.D., 155.
Cellular substance, 16, 21, 22, 23.
Celsus, 65.
-- de re medica, 66, 184.
Cold, its action on the surface of
the body, 295, 295 a.
-— on the interior, 295 b, 295 c,
295 ol.
Cod liver oil, it in preface, 772, 773,
775, 776, 778, 779, 782.
— injudiciousness of its employ-
ment, a_s postponing until too
late the use of proper r'emedies,
0 in preface.
Costal pleura, 24.
Cotton, Dr, 17 8, 228, 780.
Copland, Dr, 278.
—— the vulgarity of his mind, 27 9.
Coleman on natural and suspended
respiration, 32.
Clothing, 300 to 301 a.
Congestion of the lungs, 36.
Congestion not necessarily a disease,
37.
Crawford, Dr, 43, 45.
Cough, dry, 120.
-— explanation of, 121.
Croup, spasmodic, at day-dawn, 136.
Cuprum antidotal to cholera, 217,
218.
Cysts, 87.
Currie, Dr, interesting facts, 295 e,
399 a, 603, 603 a.
Cure of phthisis, 320.
-— what founded on, 324, 341.
Cullen, 104, 338.

INDEX.
Cholera, liability to, prevented, 216,
217.
Calcarea, pathogenetic effects of,
354 a to 356 a, 357 a, 357b, 358a,
359 a, 360 a, 361 c, 363, 369, 370,
3743, 375, 376, 377 a, 378, 379,
380 b, 381 a, 383, 385 c, 387 b,
387 c, 388, 389 to 391. ‘
Causticum cachexia, indications of,
577 to 582, 801.
Change of air, influence of, 661, 662,
663, 664, 665, 666, 667, 668.
DRYNESS of the cough in phthisis
explained, 122.
Dysentery, 154.
Diemerbroeck of Utrecht, 26.
Dupuytren’s “ Memoires de Chirur-
gie,” 276.
Dionysius, note, 300.
Drunkenness, its relation to phthisis,
316.
Digestive phthisis as designated by
Dr Philip, 317 .
Dropsy, 325.
Diarrhoea explained, 155 to 162.
— in advanced stage of phthisis,
478.
— character of, and treatment by
old system, 479.
— treatment by the homoeopathist,
480.
— conditions attending, 481.
— power of nitric acid in relation
thereto. ‘
Desault’s “ Sur les Maladies Vener.,
, la Rage et la Phthisie,” 104 cl.
Daily washing, 708.
Diet best suited to consumptives,
744, 745, 746, 747, 748, 749, 750,
751, 753, 756, 757, 758, 759, 759 a,
759b, 759 c, 760, 761. See also
“milk.”
EPIGLOTTIS, 6, 129 fd.
Elliotson, Dr, 300 b.
Elastic ligaments of windpipe, 9 b.
Emaciation, 118, 119, 120.
Encysted tubercles, 87 .
INDEX.
Expectoration, 118, 2 b.
—- its character in the first stage,
118, 2 b.’
-- explanation of, 123, 148.
-- frothy, 150 a.
-— stringy, 150 b.
—- of blood sometimes affording
relief, 150 c.
—- purulent, its danger, 151.
Eyelids, connexion of with the
womb, 207, 208.
Excesses, sexual, 240, 241.
FEMALES liable to phthisis, 253,
253 a.
Fast men die at forty-five, 253 d, 318.
Feet swell, 160 c.
Febrium de diiferentia, by Galen,
167.
Fistula in the anus a cause of
phthisis, 219.
— danger of removing them, 220,
221.
-— the reason of this, 222.
—- case by Dr Gardner, 224.
Flannel, remarks by Dr Elliotson,
300 b.
Fundamental ideas, 1st, That phthisis
can be developed only when a
cachexia exists.
-- 2d, To cure phthisis the ca-
chexia must be cured.
— 3d, To cure phthisis, the know-
ledge of the pure effects of medi-
cines (the pathogenetic effects)
essential, as also the application
of medicines to each phthisical
cachexia, in obedience to the
homoeopathic law that “likes are
cured by likes.”
—— 4th, For the development of
phthisis there must be, in addi-
tion to the cachexia, a debility
induced.
Flesh of domestic fowls, 261.
Flesh of game, 261.
Fell, Dr, 222.
Friction, 730, 731, 732, 732 a, 732 b,
733, 733 a, 734, 735, 736.

287
Foot Guards, mortality among, 743,
743 a.
Fish diet, 770, 770 a.
Field mice, fat of (Paracelsus) 772 a.
GALEN, 67, 167, 183, 604.
Gall, discoveries of, 247.
—— Gall, sur les Fonctions du
Cerveau, note, 247 .
— on the functions of the cere-
bellum, by Combe, 250.
Gangrene of lungs cured, 153.
Globules, red, 48.
Gellert’s fables, 327 a.
Glottis, 6.
Granular phthisis, 82.
Gardner, Dr, 182, 224, 644, 645,
807.
Good’s Study of Medicine, 300 b.
—— in harmony with author, 636 b.
General remarks, 597, 637, 638.
Genius, no claim to by author, e in
preface. ‘
—— its ofiice, e in preface.
Goats’ milk, 768, 768 b.
Goats’ fat (Pliny) 7 72 a.
Gastric affections, 808.
HEALTH of the lungs dependent
upon action, 264 to 266.
Heat as arising from fever of phthisis,
599.
— its action in producing devel-
opment of phthisis, 299 b.
—— animal, 42.
Heart, 20.
— increased action of, produced
by tight lacing, 274 to 279.
Heister, 6, 6a, 13, 15, 25 a.
Haemoptysis, 101, 788, 790 b.
— from cold, 299.
Harvey on the function of the
lungs, 44.
Harvey, Gideon, on “Anatomy of
Consumption,” 69.
Hippocrates, i in preface, 60, 61,
62,63,677.
Horse and pneumonia, 264 e, 264 f.
~ Hunter, 678, 678 b.
288
Homoeopathy and its Principles ex-
plained, by John Epps,M.D., 327a.
-—- importance of, as enabling a
mother who is consumptive, and
has borne children who have died
of consumption, to bear children
who shall not be liable to con-
sumption, 195.
as enabling the pregnant
phthisical woman to escape the
development of the phthisis when
the childbirth takes place, 236 g.
—- as enabling the practitioner to
remove the conditions which the
allopathist deemed he could meet
only by bleeding, 309 a.
Harrison, Dr, 59 a, 284 a.
Hahnemann on aconite, 351 e.
-— on chronic diseases, 400, 493,
525.
— discovery of the virtues of
medicines, 667.
Hunger no indication that food is to
be taken in disease, 752 and notes.
-
IRON in blood, 48.
—- peroxide of, 51, 52.
Indications of the phthisical cachex-
ia, 206, 207.
— inflammation, scrofulous, of eye-
lids, 208.
— liability to mesenteric glandular
disease, 209.
Inflammation of the lungs, 303 to
307.
Intermarriage of near relations, 255.
Iodine neck painters, 209 a.
Inhalation, 737, 737 a, 737 b.
Incipient phthisis, cases of, 786,
786 b, 786 c, 786 at.
J EANS, Dr, 325 a.
Johnson, Dr, w in preface.
KALI carbonicum, pathogenetic
effects of, 559 to 563. -
-— general remarks, 564 to 576.
Kidney fat (Hippocrates) 772 a.
Kidney disease, 809, 810.

INDEX.
LAVOISIER on oxygen-, 47.
Lectures (sixty) on the homoeo-
pathic materia medica, n preface.
Laennec, t preface, 149, 175, 179,
185, 188, 193, 227, 233 a, 251,
252, 253. .
—- in harmony with author, 636 a.
Larynx, 6, 6 a, 8, 27 a, 238.
Ligaments, elastic, of windpipe, 9 1).
Lung as a web, 31.
— capacity of, 31 a.
—— what is it? 3, 4.
— web must be free from impedi-
ments, 33.
—- bleeding at the time of puberty,
239.
Lobes of the lungs, 28.
Lobules, 15.
Louis’ “ Recherches
Pathologiques sur la Phthisie,
201.
Lymph, 26.
Lymphatics, 26.
Lymph-tree, 27 e.
Lycopodium, pathogenesis of, 400,
401.
-—- action of, see “ Notes of a New
Truth,” for December, 802.
— examples of homceopathic rela-
tionship, 403, 406, 409, 410 a,
413, 414, 416, 416 a, 418, 419 a,
420 a, 424, 426, 427 a, 427 b, 428,
429, 431, 432, 434, 437, 442, 444.
Louis, 25 in preface.
Ling, Professor, “ Ling’s Educa-
tional and Curative Exercises,”
by Dr Chapman, 716.
Lime water and milk, 769.
Laryngeal phthisis, 784, 784 a.
Anatomic0-
‘H
MAJENDIE, 129 e, 131 b.
Male sex, comparison with female,
253 a.
Malpighi, 17, 30.
Miliary tubercles, 81.
Melanosis, 83.
Mouth of the lungs, the larynx, 8.
Morgagni, 6, 6 a, 243.
Mortality of phthisis, g in preface.
INDEX.
Monkeys, example of death by
phthisis, 197, 198, 199.
Monstrousness of compulsory vacci-
nation, 212, 212 a, 213, 214, 215.
Mucous membrane of the larynx, 6 a.
-—— extent of, 12 a.
Muscular fibres, 27 g.
Marriages unequal, 254 to 254 c.
—- between first cousins, 255.
Medical Gazette of 1842, 276.
Manganesium, 589, 590.
Men dying of consumption in com-
parison with females, 253 b, 253 c.
Marasmus, Z in preface.
Milk, asses’, 762, 762 a, 762 b, 763,
766, 767, 767 a.
— as advocated by Rhases, 764.
-— from the breast, 765, 765 a.
—- as advocated by Laennec, 766 b.
NAILS, a peculiar bent form, 160 03.
Nerves to the lungs, 25, 25 a, 25 b.
Nosographie Philosophique,by Pinel,
7 5
Nostrils, 5, 5a, 5 b. ,
Nose, bleeding from, precursor of
phthisis, 100, 101, 102, 103, 103 a,
103 b, 103 c, 104.
— interior structure peculiar, 5 c.
— bleeding from, at time of puberty,
239.
Neckcloths, practice of wearing them
tight, 280.
Nitric acid, pathogenesis of, 446,
447.
-— homoeopathic relationship of,
449 to 456, 458 to 463 a, 465, 466,
468 to 477, 484, 486, 487, 489 to
492.
— treatment of, 803.
Nerve-tree, 27 b.
Night sweats, 706, 706 a.
OSCULA of mucous membrane of
larynx, 6, 7.
Ovid, 286.
Opium, 592.
PAIN with cough, 118.

289
Pains at chest and shoulders, 118. :
Palms of hands burning hot, 118,
128. *
Pliny the elder, 68. '
Paracelsus, 68 a.
Parenchyma of lungs, 23, 92.
Pathogenesis, 0, u, preface.
study of, productive of practical
skill, 78.
Pathological, 76.
Pathognomonic, 73 0, 165.
Percussion for detection of phthisis,
173.
Physiology of the lungs, 2.
Pleura, 24, 122.
Pulmonal pleura, 24.
Pleuritis, 307.
Pulmonary catarrh, k preface.
—— vesicles, 11, 18.
— veins, 20.
-- arteries, 18.
— artery, right and left, 19,
19 a. ‘
Pulse, increased action of, 119.
— explanation, 138, 165, 166.
Purification of the blood, 41.
Priestley, Dr, on oxygen, 47.
Physical signs of diseases of the
chest, remarks by Laennec and
Dr Walshe, 175, 176.
— imperfection of, by Wardrop,
177.
-—- by Dr Cotton, 178.
— by Laennec, 179.
—— by Dr John Gardner, 182.
Pigeon breast caused by tight lacing,
275.
Physic, old system of, 353, 353 a.
Parr, Dr, in harmony with author,
636 c.
Phthisis, twofold character, 73, 73 a.
—— essential character, 73 b.
artificial character, 73 0.
granular, 82. _
with melanosis, 83.
cancerous, 84.
— superiority of homoeopathic
treatment of, 339 to 339 0.
— first stage of, 117 .
U
290
Phthisis, second stage of, 140, 800.
— third stage of, 160.
—- acute case, 799.
—-— phenomena of premonitory
stage, 349, 350, 364, 366, 402,
405, 408, 410, 412, 436, 448, 507,
521, 530.
-— advancing from first to second
stage, 792.
—- variation of mental state, 358,
358 b.
—-— symptoms of, 1.00 to 116, 118
to 129, 141 to 155, 160 to 164,
360, 373, 373a, 374, 374 b, 377,
378, 379, 380 c, 381, 382, 384,
385,387.
—-— cure of, 320 to 329, 786e, 792a,
792 b, 792 c, 792d, 794 to 797,
806.
— symptoms of, among others,
422, 427, 430, 438, 441, 485, 539.
-— in a child, 786g’.
— sweats of, 392, 393.
.— fever of, 606, 607.
— expectoration of, 610 to 636.
—— means auxiliary to the cure of,
653 656.
—-— accessory conditions, 804.
—-— importance of air in, 657 to
671.
—- mucous, 787.
—- hereditary, 193.
— mortality caused by, g in pre-
face.
Phthisical weakness developed at
the appearance of the monthly
period, 236 a.
—- developed at suppression or
deficiency of the monthly period,
236 b.
—— associated with hysteria, 236 b.
—-— developed by sexual excesses,
240.
— developed by the removal by
external means of the chancrous
sore, 242. ,
,-_ developed by throat-painting,
_, 244.
—-— developed by self-abuse, 245.

INDEX.
Phthisical weakness, monkeys liable
to, 245 a.
— developed by fever of sexual
desire, 246.
— developed by austerity of life,
251,252.
— developed by unequal mar-
riages, 254.
— example of do., 254 a, 254b,
254 c.
—-— developed by marriage with
first cou-sins, 255.
Phthisical cachexia, phenomena of,
354.
— symptoms of, 359, 361, 415,
417, 419, 420, 457, 464, 467, 469,
501, 505, 509, 510, 511, 513, 527,
532, 534, 537.
Plan of this work, p. xviii. in pre-
face.
Phenomena, study of, 1.
Public speaking, 738, 740.
Premonitory phthisis arrested, 785.
Pain at margin of ribs, 805.
RETE mirabile of Malpighi, 17, 27 0,
30.
Regnum animale, 5, 5a, 5b, 5 c, 9a,
10, 129 b, 282.
Respirations in man, 32.
— in a horse, 32.
Relationship between structure and
use, 136.
Rapidity of growth cause of lung
weakness, 312.
Running as inducing temporary con-
gestion, 38.
Riding in a carriage, 717, 718.
— on horseback, 719, 719 a, 719b,
720.
Reading aloud, 738, 739, 740.
SANDERS, Dr, 100, 167, 205, 233,
594, 595, 673, 673 b, 704, i, o, s,
in preface.
Stages of phthisis, 99.
— premonitory indications of, as
bleeding from the nose, 101, 102
to 106. ~
INDEX.
Stages of phthisis, peculiar irritable-
ness, 107.
— susceptibility to cold, 108.
— peculiar fever, 108.
— oscillations in the mental and
moral states, 109.
- variations in the bodily state,
110.
' — variations in the appetite, 110 a.
— variations in the countenance,
110 b.
—- variation in the pulse, 111.
- variation in regard to sleep, 112.
—- variation in breathing, with
sighing, 114.
Stage first, changes in living, 118.
—— second, changes in living, 141.
— third, 160.
Sleeplessness, 143.
Spinal curvature a promoter of
phthisis, 284.
Stethoscope means of detecting
phthisis, 173.
Scrofula of the lungs called phthisis,
226.
Smallpox, 211, 212.
- non-liability to, dependent on
what, a hypothesis, 212 a.
Spigelius’ remarks on consumption
in “ Spigelii Opera, 1654,” 268.
Shaw, Mr, remarks of in Medical
Gazette, 1842, 276.
Semi-hanging by the use of tight
neckcloths, 281, 282, 283.
Silk should be worn, 300 a.
Softening of tubercle, 140.
Spurzheim, discoveries of, 247 .
Stooping gait, causes of, 285.
Shoes, thin, danger of, 302.
Skin, sympathy between it and lungs
and bowels, 701 to 708.
Seasons, changes of, 677.
Sepia, medicinal action of, 525.
— pathogenetic effects of, 528,
529, 530, 531, 535, 536, 538, 540
to 551.
Sulphur, as recorded by Hahnemann,
493 to 493 ‘
-- general features, 494 to 498.

291
Sulphur, pathogenetic effects, 499,
502, 504, 506, 507, 508, 509, 510,
511,512,514,515,516,517,518,
520, 521, 521 a, 522, 523, 524,
524 a. -
Sailing in a boat, and sea voyaging,
721, 721a, 721b, 722, 723, 724,
725, 726, 727, 728, 729.
Stirling (Bridge of Allan) 768 a.
Spitting of blood, 789, 790, 790 a.
THERAPEUTICS, 332, and c in pre-
face. .
Therapeusy, 196. _
Throat-painters, 244.
Tight lacing, 267.
— suicide from, 271.
Tuberculous taint, by “ Bayle,” 201.
Tubercular phthisis, 85, 99, 232.
Tubercles, a in preface.
— three states of, 86, 86 a, 86 b.
—- encysted, 87 .
— unencysted, 88.
— circumscribed vascularity of
tissue around, 131 b.
—- testimony of Louis as to tuber-
cles existing in other organs be-
sides the lungs, 201.
Tyrrell, John, 129 e, 129 fa, 129 f b,
129 j‘ d, 332, 333 a.
Temperature, 679 to 686.
Trachea, 6, 9, 27 a.
Throat affections of women, 237,
238,239,244.
Threatening phthisis cured, 786 a,
786 g, 786 h, 786i.
USE of this work, n in preface.
VENTRICLE right, 20.
— left, 20. _
Vesicles, pulmonary, 11, 14.
Vaccination viewed as a protection
against smallpox, 212, 212a, 213.
— compulsory, its monstrousness,
215- 7 " - ‘Ia.-
Veratrum, antidotal to cholera, 217.
Ventilation, importance in bed-
room, 695 to 700 c.
292

Weakness, development of, in con-
nexion with the genital system,
sect. 2, chap. v.
Wesleyans, note 302 b.
Women more liable to phthisis be-
fore thirty years of age than are
men, 253, 253 a.
Worms, 339, 339 a, 339 b, 339 c.
Wainwright, Mr, 288
Warlingham, adaptation of, as a
place of residence for consumptive
patients, 688 to‘ 694.
Winslow, 6, 6a, 19 a.
Walking exercise, 709, 710, 711,
712, 713, 714, 715, 741 a, 742.
Wet sheet, application of, 7 05.
YOUNG, Dr, “Practical and Histo-
rical Treatise on Consumption,”
104 a, 192.
Vapour bath, 707 .
Vomica, discharge froin, cured, 798.
WAISTGOATS open, foolish practice
of, 301. ~ ,
Walshe, Dr, it in preface, and 126a,
135, 176, 225, 279, 368, 649, 650.
Wardrop,.Mr, on “The Nature and
Treatment of the Diseases of the
Heart,” &c. part i. p. 37, 165,
177.
Warmth of air produced;’by the in-
terior of the nostrils, 5 a.
'Web or lung, 31, 31 a.
Windpipe, 9.
— structure of, 9 a.
— channel for air passing into and
out of lungs, 10.
Weakness, a state of, essential for
the development of the phthisical
cachexia, 232.
INDEX.
THE END.
PRINTED BY OLIVER. AND BOYD, TWEEDDALE COURT, EDINBURGI-L
£1? ®gga’s dfinrlw
MAY BE OBTAINED AT
Messrs Smnnnson, 77 Fleet Street; PIPER, Srnrnnnson,
& SPENCE, 25 Paternoster Row, London; A. W. BENNETT,
5 Bisho sgate Street Without, E. C.; also of Mr JAMES
EPPS, llhmoeopathic Chemist, 112 Great Russell Street,
Bloomsbury, London. '

No.1.
WHAT IS HOMCEOPATHY ?
This work, published first in 1838, is now out of print. It was re-
published in America, and in Melbourne; also in Montreal in Canada.
It was the first pamphlet in English putting forth this inquiry, and
had a large circulation, having passed through three editions. A
pamphlet, having a similar title, has been published since; and as
the People’s Edition of Homoeopathy and its Principles Explained
contains the chief views and illustrations put forward in this pamphlet,
the necessity for its republication has, in a great measure, ceased.

No. 2.
HOM(EOPATHY AND ITS PRINCIPLES
' EXPLAINED.
By JOHN Errs, M.D. Second Edition. The first Edition was
published in 1841.
People’s Edition, 2s. 6d.
No.3.
THE REJECTED CASES.
With a LETTER to THOMAS WAKLEY, Esq., on the Scientific
Character of Homoeopathy. By JOHN Errs, M.D.
People’s Edition, price 1s. 6d.

No. 4.
DOMESTIC HOMCEOPATHY.
Fifth Edition, muck enlarged. Price 2s. 6d.
This work was one of the earliest works published in this country
in relation to the Domestic Treatment of Diseases. The difiiculty in
such domestic treatment is to find the remedy, the non-professional
user of such works being obliged to compare the symptoms of the
disease with the effects produced by the remedies. Remedies, act-
ing in accordance with the homoeopathic law, “likes cured by likes,”
the remedy, fit for the cure of disease, must therefore be one that has
the power of producing effects similar to the symptoms presented by
A . 2 DR EPPs’s wonxs.
the disease. I The selection of such remedy, by one not practised in
such selection, is of necessity attended with difficulty, being a matter
of exact comparison. To aid in meeting this difliculty, so far as is
possible to meet it in a work such as is a Domestic Homoeopathy, Dr
E. adopted the plan of arranging the symptoms in columns, putting
at the head of each group the medicine that has the power of pro-
ducing effects similar to the symptoms presented by the disease, the
user of the book being further aided by the effects, specially belong-
ing to the medicine at the head of each group, being printed in italics.
This arrangement in the columnar form, it is believed, renders the
work especially useful, facilitating, as it does, the comparison between
the remedies and the diseases. '

No. 5. ‘
AFFECTIONS OF WOMEN.
No. 1. The Monthly Period. Price 2s.
This work has arrived at a second edition: it has been of service
in helping to the diminution of many sufferings attendant upon the
period referred to.

No. 6
ASIATIO_ OHOLERA,
Suggestions for the Treatment and the Prevention of. Price 6d.
This tract was written and published at the request of the Eng-
lish Homoeopathic Association,* and was issued to every member of
the Association at the time the Cholera raged.—This work is still
in print.

No. 7
AFFECTIONS OF THE HEAD AND OF THE
NERVOUS SYSTEM.
Being Fzfiy-two Cases treated with success on the Homoeopathic
Principle.
. This work has passed through two editions. The first edition ap-
peared in 1838; the second in 184] . It is now out of print; if rc-
published, it will be as part of a larger work.

No. 8
A CASE OF EPILEPSY OF TWENTY YEARS’
~ STANDING CURED.
This was published upwards of twenty years since. It is now
out of print, but the case is in the pages of the following work.
* This Association was established A.D. 1845, and has been extremely useful
in a variety of ways. It now publishes monthly “ The Notes of a New Truth.”
Persons wishing to subscribe should apply to the Honorary Secretary, Stephen
René Bardouleau, Esq., J efi'rey’s Square, St Mary Axe, E. C.
nn EPPs's wonxs. 3
N o. 9.
EPILEPSY, AND SOME NERVOUS AFFECTIONS,
1Ts mncunsons,
Being Twenty-two Cases successfully treated.

No. 10.
A TREATISE ON THE VIRTUES OF ARNICA, RHUS,
TOXIOODENDRON, AND OALENDULA,
In reference to Wounds, Bruises, and other diseased States
thereupon consequent. Price 3d.
A part of this work was published in the “ Lancet,” in the year
1840, as an Essay on the virtues of Arnica.
The Essay was subsequently enlarged, and was published as a
separate work in 1841, under the title “On Arnica Montana, and
its beneficial effects as a remedy for Bruises, Falls, Wounds, Sprains,
Lacerations, Corns, Swellings, Excessive Fatigue and its conse-
quences.”
In 1850, a second edition was published, entitled “A treatise on
the Virtues of Arnica, Rhus Toxicodendron, and Calendula.”

No. 11.
CONSTIPATION, ITS THEORY AND CURE;
Embracing the Physiology of Digestion, and the Injuries inflicted by
the Employment of Purgatives.
Illustrated by Engravings by LINTON. 440 pp. 8vo, price 12s. 6d.
The subjoined statement of the contents of the work will be
sufficient to demonstrate its practical utility.
Introductory Chapter.-—A general view of the means and of the
processes by which Nourishment is realized to the Human Being.
PART I.—-Chapter 1. On the Digestion of Food and the various
processes constituting it, together with the various parts of the in-
testinal tube associated with these various processes.—Chapter 2.
On Mastication or Chewing: the instruments concerned in the pro-
cess: their physiological action: with practical remarks.——Chapter
3. On Swallowing or Deglutition, with practical remarks and deduc-
tions.—Chapter 4. On the Stomach and Chymification, with practi-
cal deductions in connexion therewith.—Chapter 5. On the Gastric
Juice, with axioms and practical deductions. This chapter em-
bodies the greater part of Dr Beaumont’s valuable work.——Chapter
6. On the remaining agencies in connexion with the Digestion of
the Food in the Stomach.-—Chapter 7. On Chylification and the
organs concerned in the process, with practical deductions.-
Chapter 8. On Defaecation and its course in connexion with the
small and the large intestines.—Chapter 9. On Absorption, the
Lymphatics and the Lacteals, and the process by which the nutri-
ment is prepared for and carried into the blood.——Chapter 10. Con-
cluding general remarks on the similarities of the various parts of
the Intestinal Tube, in reference to structure, fluids, movements,
and the powers affecting the movements.
4 on EPPS’S wonxs.
PART II.——-Chapter 11. Constipation and its varieties. Costive-
ness. Confined bowels. Irregular action of the bowels. Delayed
and imperfect action of the~ bowels. Constipation, as to its cause.
Constitutional diseased state. Evidences of this. Conditions in-
ducing this diseased state.—Chapter 12. On the unscientific character
of the method of attempting to relieve constipation by purgatives.—
Chapter 13. On the injuries resulting from the employment of pur-
gatives. Epilepsy, Blindness, Dyspepsia, Chronic Inflammation of
the Bowels, Hernia, Descent of the Gut, Stricture of the Rectum,
Diseased Bladder, Descent of the Womb, Excessive Monthly Dis-
charge, Excessive White Discharge, Abortion and Death, caused by
purgatives.—Chapter 14. The history of the employment of purga--
tives for the cure of diseases. The views of Dr Hamilton: their
fallaciousness. The explanation of the apparent success of his treat-
ment.—Chapter 15. The arguments used in defence of and justificatory
of the employment of purgatives. _ The non-necessity of -purgatives
in the cure of either chronic or acute diseases. Absurdities connected
with the employment of purgatives.—Chapter 16. On the use of
auxiliary means to promote the removal of constipation. Obeying
the call to relieve the bowels. Soliciting the bowels after breakfast.
Moderation in the use of food. Sponging the body with cold water.
Drinking a tumbler of cold water. Friction to the spine. The
exercise of walking. Reading aloud.—Chapter 17 . Cases of cme.
Group 1st, Cases of Constipation generally. Group 2d, Cases of
descent of gut. Group 3d, Cases of piles. Group 4th, Cases of
stricture, fistula, hernia.
ArPENDIx.—Chapter 18. Cases of cure of almost every form of
disease without any action of the bowels; and cases of cure where
the bowels, having been active, have become confined as the cure
was effected.—Chapter 19. Cases illustrating the serious injuries
produced by purgatives. Cases from allopathic works of obstruction
of the bowels.—Chapter 20. Cases illustrative of the special action
of special medicines in constipation.—Chapter 21. Various matters
connected with the bowels. On the moulding of the faeces: on lia-
bility of the caecum to disease from the action of purgatives.

No. 12.
INTRODUCTION TO BOTANY.
' This was written as a text-book for those medical students who
attended Dr Epps’s lectures when a lecturer on the old school
Materia Medica.

‘I
No. 13.
A MATERIA MEDICA TREE.——Out of print.
No. 14.
JOURNAL OF HEALTH AND DISEASE,
AND Monrnnr JOURNAL or Homeorxrnr.
This work extended to seven volumes. Its place has been taken by
the “NOTES -OF A NEW TRUTH.”

Filmed by Preservation 1990



l\l\ll\i\

Es ii... .. . r.T.....
.. 1.. . L/....“ . , .. .
51.1%. . ...w...... , .
. . ... _
H .\v,,, . .....-
,_ £353-¢_O~:§‘f;7i‘1‘. -... ..- I
N M.“ ‘
~ ~ .
1 . I . ..-..,... ...- . .. . I . Z...
.. . . ., . ,. ., . ...:..Wmms.s.iaunsess.tst
.. . . . . “.1..3x....»ms-a... . . ."s..... ...._.....M..m.Ms..wu..=.H.H.¢....w..pt.w.m..
~ . ~ . ~.
._M....n§€w_W%w. . . . .. F .33.
. - -4 01 Dr
..r.~a¥.. .. .. .. _ . . . - . . ms.....e.t._3...a . . .... .. . . . . . .
n I , . _ . . .. r . -.
V
P
. I
. Fr ... T . . . . . .. .. _ . . . J. .. . . .... . .L£w.lnT-lmM.»_¢ . n. J ..n .. . . .a . . : . . . . .. .. . ..4
. m.._.sa.,._ss.r.,_....u.........t. ..mw....ma . , I .. . in . . .. . . steam. . . .
..v.“a£..u.£.a. ..x...§aa..~.a..a... AWE . . in .w . 1. .. 7.332. . . _ .. . . ..
. .r... ...... . . . Q1w~..m~a...,.... . .. . .. . .. .. ... ... .1. . ms.
. . .....Hi.t..amrm..?.mas#fi$4. .. , .. U . . ...“ ....i..s.........a..m . .... ...aM......W..“......~........"....,.. 4.: . . .. .-.a~a.......a_w1..wss .. . . ...r
. .. . -. .1. . . .. .. .. . . . . .. ....~ . .v1. ... . . . . . ... ...v.|. .<‘...,.fi1x ..n .. .n§.n. .. Q .... ._.n..... ...;
s....r..a..ew. . . . - . ...fi....... .. . ..s.. . . . rs... ..1..,.s....1..... ., .s....a. _ ... :ma%M.eaaas.H...w..
. . L. J . . . . ‘.... _ ..u.. .. .... . . . . . . . ... .
. w -:»am".“. . . . . . .. .. . . . .. . I . . I .. . .. . .. H .. XK..WJm£%. ._~.m=»...aw.. .
a
.. .P.~..a
. st.
iv 1* Q
. .ewa:.n..._
. .. .. . . . . .. . . .. . ..
... ; . . . . . ., . ..2.»£uv§.ma..¢v-... . .. . . 34$» E3 .. . .. . .. . .. . . .3 . .. JT. . .rvnR8.we .
...“.."aw_$£nr..e.»h .. . . _ .. .. ....J.n . . .. ..».s.....w...1».»......“..h.~H.“...n.0~..~in.r.....x. . ..
.. . . . . .. .. _.....Pe.p~H... . .&.tu.,.a.....a.3....-U....,.n....,H.... ...wsa... ... . _ . W . .. , U. ....
I...
...-.. .
a.e"s__amm _ ...1......h , .d.~..,r..a..r.J...H... . .. . .. . . . . . .
.4 .4. ,3... . . .. H. .. , ............e...t..a..,.
. .
......H... in . . I . .. .vTv\..m . :11... “WW. . . .. .. .
.. .. .. . . . .... . .. H 3. . . J . .. . _ . . ... . . mnnflwimfawswgmw . . .. . . . . .... . . ., .. . 1 m..
. . . .. . .. .. 7 .. . . . ... ... . . . ..
A
U
. . .83. .. .
. . . . . . . vfimfiwr wmra
.